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Sultan MI, Ibrahim SA, Youssef RF. Impact of a Mediterranean diet on prevention and management of urologic diseases. BMC Urol 2024; 24:48. [PMID: 38408996 PMCID: PMC10898175 DOI: 10.1186/s12894-024-01432-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
Compared to a Western diet, the Mediterranean diet moves away from red meat and processed foods. Universally regarded as a healthier dietary alternative, the Mediterranean diet has garnered scientific endorsement for its ability to confer an array of compelling benefits. These health benefits encompass not only a lowered incidence of Type 2 diabetes with a reduction in obesity, but also a robust protective effect on cardiovascular health. Extensive literature exists to corroborate these health benefits; however, the impact of a Mediterranean diet on urologic diseases, specifically sexual dysfunction, lower urinary tract symptoms, stone disease, and urologic cancers are not well studied. Understanding how dietary habits may impact these urologic conditions can contribute to improved prevention and treatment strategies.A total of 955 papers from PubMed and Embase were systematically reviewed and screened. After exclusion of disqualified and duplicated studies, 58 studies consisting of randomized controlled trials, cohort studies, cross sectional studies, reviews and other meta-analyses were included in this review. 11 primary studies were related to the impact of a Mediterranean diet on sexual dysfunction, 9 primary studies regarding urinary symptoms, 8 primary studies regarding stone disease, and 9 primary studies regarding urologic cancers. All primary studies included were considered of good quality based on a New-Castle Ottawa scale. The results demonstrate a Mediterranean diet as an effective means to prevent as well as improve erectile dysfunction, nephrolithiasis, lower urinary tract symptoms, and urinary incontinence. The review highlights the need for additional research to study the impact of diet on urologic cancers and other urologic conditions such as premature ejaculation, loss of libido, female sexual dysfunction, and overactive bladder.
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Affiliation(s)
- Mark I Sultan
- Department of Urology, University of California, 3800 Chapman Ave, Suite 7200, Irvine: Orange, CA, 92868, USA
| | - Shady A Ibrahim
- Department of Urology, University of California, 3800 Chapman Ave, Suite 7200, Irvine: Orange, CA, 92868, USA
| | - Ramy F Youssef
- Department of Urology, University of California, 3800 Chapman Ave, Suite 7200, Irvine: Orange, CA, 92868, USA.
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2
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Morańska K, Englert-Golon M, Durda-Masny M, Sajdak S, Grabowska M, Szwed A. Why Does Your Uterus Become Malignant? The Impact of the Microbiome on Endometrial Carcinogenesis. Life (Basel) 2023; 13:2269. [PMID: 38137870 PMCID: PMC10744771 DOI: 10.3390/life13122269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
The aim of this review was to describe the uterine microbiome composition that has been analyzed so far and describe potential pathways in the carcinogenesis of the endometrium. The microbiome in the uterine environment is involved in apoptosis and proliferation during the menstruation cycle, pregnancy maintenance, and immune system support. However, bacteria in the uterus could stimulate inflammation, which when chronic results in malignancy. An altered gut microbiota initiates an inflammatory response through microorganism-associated molecular patterns, which leads to intensified steroidogenesis in the ovaries and cancers. Moreover, intestinal bacteria secreting the enzyme β-glucuronidase may increase the level of circulating estrogen and, as a result, be influential in gynecological cancers. Both the uterine and the gut microbiota play a pivotal role in immune modulation, which is why there is a demand for further investigation from both the diagnostic and the therapeutic perspectives.
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Affiliation(s)
- Katarzyna Morańska
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznanskiego 6, 61-614 Poznan, Poland (A.S.)
| | - Monika Englert-Golon
- Department of Gynaecology Obstetrics and Gynaecological Oncology, Division of Gynecological Surgery, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Magdalena Durda-Masny
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznanskiego 6, 61-614 Poznan, Poland (A.S.)
| | - Stefan Sajdak
- Department of Gynaecology Obstetrics and Gynaecological Oncology, Division of Gynecological Surgery, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Marlena Grabowska
- Department of Gynaecology Obstetrics and Gynaecological Oncology, Division of Gynecological Surgery, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Anita Szwed
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Uniwersytetu Poznanskiego 6, 61-614 Poznan, Poland (A.S.)
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Manilla V, Santopaolo F, Gasbarrini A, Ponziani FR. Type 2 Diabetes Mellitus and Liver Disease: Across the Gut-Liver Axis from Fibrosis to Cancer. Nutrients 2023; 15:nu15112521. [PMID: 37299482 DOI: 10.3390/nu15112521] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Type 2 diabetes mellitus is a widespread disease worldwide, and is one of the cornerstones of metabolic syndrome. The existence of a strong relationship between diabetes and the progression of liver fibrosis has been demonstrated by several studies, using invasive and noninvasive techniques. Patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) show faster progression of fibrosis than patients without diabetes. Many confounding factors make it difficult to determine the exact mechanisms involved. What we know so far is that both liver fibrosis and T2DM are expressions of metabolic dysfunction, and we recognize similar risk factors. Interestingly, both are promoted by metabolic endotoxemia, a low-grade inflammatory condition caused by increased endotoxin levels and linked to intestinal dysbiosis and increased intestinal permeability. There is broad evidence on the role of the gut microbiota in the progression of liver disease, through both metabolic and inflammatory mechanisms. Therefore, dysbiosis that is associated with diabetes can act as a modifier of the natural evolution of NAFLD. In addition to diet, hypoglycemic drugs play an important role in this scenario, and their benefit is also the result of effects exerted in the gut. Here, we provide an overview of the mechanisms that explain why diabetic patients show a more rapid progression of liver disease up to hepatocellular carcinoma (HCC), focusing especially on those involving the gut-liver axis.
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Affiliation(s)
- Vittoria Manilla
- Digestive Disease Center-CEMAD, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Santopaolo
- Digestive Disease Center-CEMAD, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Digestive Disease Center-CEMAD, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Translational Medicine and Surgery Department, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesca Romana Ponziani
- Digestive Disease Center-CEMAD, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Translational Medicine and Surgery Department, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Renal Cell Cancer and Obesity. Int J Mol Sci 2022; 23:ijms23063404. [PMID: 35328822 PMCID: PMC8951303 DOI: 10.3390/ijms23063404] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
Cancers are a frequent cause of morbidity and mortality. There are many risk factors for tumours, including advanced age, personal or family history of cancer, some types of viral infections, exposure to radiation and some chemicals, smoking and alcohol consumption, as well as obesity. Increasing evidence suggest the role of obesity in the initiation and progression of various cancers, including renal cell carcinoma. Since tumours require energy for their uncontrollable growth, it appears plausible that their initiation and development is associated with the dysregulation of cells metabolism. Thus, any state characterised by an intake of excessive energy and nutrients may favour the development of various cancers. There are many factors that promote the development of renal cell carcinoma, including hypoxia, inflammation, insulin resistance, excessive adipose tissue and adipokines and others. There are also many obesity-related alterations in genes expression, including DNA methylation, single nucleotide polymorphisms, histone modification and miRNAs that can promote renal carcinogenesis. This review focuses on the impact of obesity on the risk of renal cancers development, their aggressiveness and patients’ survival.
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Saisana M, Griffin SM, May FEB. Insulin and the insulin receptor collaborate to promote human gastric cancer. Gastric Cancer 2022; 25:107-123. [PMID: 34554347 PMCID: PMC8732810 DOI: 10.1007/s10120-021-01236-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastric adenocarcinoma is common and consequent mortality high. Presentation and mortality are increased in obese individuals, many of whom have elevated circulating insulin concentrations. High plasma insulin concentrations may promote, and increase mortality from, gastric adenocarcinoma. Tumour promotion activities of insulin and its receptor are untested in gastric cancer cells. METHODS Tumour gene amplification and expression were computed from sequencing and microarray data. Associations with patient survival were assessed. Insulin-dependent signal transduction, growth, apoptosis and anoikis were analysed in metastatic cells from gastric adenocarcinoma patients and in cell lines. Receptor involvement was tested by pharmacological inhibition and genetic knockdown. RNA was analysed by RT-PCR and proteins by western transfer and immunofluorescence. RESULTS INSR expression was higher in tumour than in normal gastric tissue. High tumour expression was associated with worse patient survival. Insulin receptor was detected readily in metastatic gastric adenocarcinoma cells and cell lines. Isoforms B and A were expressed. Pharmacological inhibition prevented cell growth and division, and induced caspase-dependent cell death. Rare tumour INS expression indicated tumours would be responsive to pancreatic or therapeutic insulins. Insulin stimulated gastric adenocarcinoma cell PI3-kinase/Akt signal transduction, proliferation, and survival. Insulin receptor knockdown inhibited proliferation and induced programmed cell death. Type I IGF receptor knockdown did not induce cell death. CONCLUSIONS The insulin and IGF signal transduction pathway is dominant in gastric adenocarcinoma. Gastric adenocarcinoma cell survival depends upon insulin receptor. That insulin has direct cancer-promoting effects on tumour cells has implications for clinical management of obese and diabetic cancer patients.
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Affiliation(s)
- Marina Saisana
- grid.1006.70000 0001 0462 7212Newcastle University Centre for Cancer, Translational and Clinical Research Institute, Faculty of Medical Sciences, University of Newcastle-upon-Tyne, Framlington Place, Newcastle-upon-Tyne, NE2 4HH UK
| | - S. Michael Griffin
- grid.1006.70000 0001 0462 7212Newcastle University Centre for Cancer, Translational and Clinical Research Institute, Faculty of Medical Sciences, University of Newcastle-upon-Tyne, Framlington Place, Newcastle-upon-Tyne, NE2 4HH UK ,grid.420004.20000 0004 0444 2244Department of Surgery, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, NE1 4LP UK
| | - Felicity E. B. May
- grid.1006.70000 0001 0462 7212Newcastle University Centre for Cancer, Translational and Clinical Research Institute, Faculty of Medical Sciences, University of Newcastle-upon-Tyne, Framlington Place, Newcastle-upon-Tyne, NE2 4HH UK ,grid.1006.70000 0001 0462 7212Department of Pathology, Faculty of Medical Sciences, University of Newcastle-upon-Tyne, Framlington Place, Newcastle-upon-Tyne, NE2 4HH UK ,grid.420004.20000 0004 0444 2244Department of Oncology, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, NE1 4LP UK
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Li M, Bu R. Biological Support to Obesity Paradox in Renal Cell Carcinoma: A Review. Urol Int 2020; 104:837-848. [PMID: 32841953 DOI: 10.1159/000510245] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/15/2020] [Indexed: 11/19/2022]
Abstract
Obesity is a proven risk factor and a debated prognostic factor in renal cell carcinoma (RCC). Termed as an "obesity paradox," the topic has churned controversies, with a few arguing of no true biological association. Suggesting otherwise, a few studies revealed adiposity-induced altered molecular and transcriptomic signatures, at both the systemic and local (tumor and peritumoral adipose tissue) levels, in RCC patients, favoring the paradox. Summarizing such studies suggests of a considerable biological support to adiposity as a promising prognostic factor in RCC patients, although much needs to be clarified before adopting it as a valuable addition to the existing prognostic model.
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Affiliation(s)
- Ming Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Renge Bu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China,
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Deep frying cooking oils promote the high risk of metastases in the breast-A critical review. Food Chem Toxicol 2020; 144:111648. [PMID: 32745572 DOI: 10.1016/j.fct.2020.111648] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022]
Abstract
Deep-frying is the most common food preparation method, manifestations of color, taste, flavor, and fried consistency. The beneficial role of vegetable oils become deteriorate when repeatedly treated with higher temperature and air. Repeatedly heated cooking oils (RCO) produce various byproducts, containing polycyclic aromatic hydrocarbons (PAHs) and aldehydes, well-known to be a carcinogenic, mutagenic, and tumorigenic properties. RCO is nowadays one of the often consumed media for cooking and frying, which intake can cause various unhealthy adverse effects including various cancer in the multiple organs. Hence, the present comprehensive study targets to provide the intake of RCO elevate the risks of human breast cancer. The data on RCO and its impacts were obtained via various electronic findings and library databases. Notable studies have confirmed that the effects of RCO have been attributed to their unfavorable effects, and underlying molecular mechanisms can also strongly promoting tumorigenic effects in the mammary organ.
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Effects of Environmental pH on the Growth of Gastric Cancer Cells. Gastroenterol Res Pract 2020; 2020:3245359. [PMID: 32211041 PMCID: PMC7085403 DOI: 10.1155/2020/3245359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/04/2019] [Accepted: 02/27/2020] [Indexed: 12/14/2022] Open
Abstract
Background Proton pump inhibitor (PPI) and other acid-suppressing drugs are widely used in the treatment of gastrointestinal ulcer, upper gastrointestinal bleeding, gastritis, and gastric cancer (GC). About 80% of GC patients receive acid suppression treatment. PPI suppresses the production of gastric acid by inhibiting the function of H+/K+-ATPase in gastric parietal cells and raises the pH value to achieve therapeutic purposes. Some studies have found that PPI had a certain antitumor effect in the proliferation and apoptosis of tumor cells. But the effects of environmental pH on the growth of GC cells and its mechanism are unknown. Therefore, we hoped to find the effects of culture medium pH on the biological behavior of GC cells by in vitro experiments and provide guidance for the use of acid-suppressing drugs in GC patients. Aims We aimed to observe the effects of pH changes in GC cell culture medium on the cell biological behavior of cancer cells and to analyze the potential mechanisms. We hoped to find out the effect of acid suppression on the growth of GC cells. Methods The GC cell lines (SGC-7901 and MKN45) were used as the research object. We adjusted the pH value in the cell culture medium to observe the changes in cell viability (MTT), apoptosis (flow cytometry), and invasion (Transwell) at pH 6, pH 7, and pH 8. qRT-PCR and western blot (WB) assays were used to determine the expression changes of genes and proteins (mTOR, AKT, Wnt, Glut, and HIF-1α) at pH 6, pH 7, and pH 8. Results The results of MTT showed that the viability of SGC-7901 and MKN45 in the pH 8.0 group was significantly weaker than that in the pH 6.0 or pH 7.0 group (P < 0.001). Flow cytometry results showed that the apoptosis of SGC-7901 and MKN45 in the pH 8.0 group was more obvious than that in the pH 6.0 or pH 7.0 group (P < 0.001). Flow cytometry results showed that the apoptosis of SGC-7901 and MKN45 in the pH 8.0 group was more obvious than that in the pH 6.0 or pH 7.0 group (P < 0.001). Flow cytometry results showed that the apoptosis of SGC-7901 and MKN45 in the pH 8.0 group was more obvious than that in the pH 6.0 or pH 7.0 group (α) at pH 6, pH 7, and pH 8. P < 0.001). Flow cytometry results showed that the apoptosis of SGC-7901 and MKN45 in the pH 8.0 group was more obvious than that in the pH 6.0 or pH 7.0 group ( Conclusions Compared with the microacid environment, the microalkaline environment inhibited the viability, invasion, and expression of genes and proteins (mTOR, AKT, Wnt, Glut, and HIF-1α) but promoted the apoptosis of GC cells and thus inhibited the growth of GC.α) at pH 6, pH 7, and pH 8.
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Abstract
Introduction: Obesity compromises survival in children with cancer in high-income countries (HICs) and is accompanied often by sarcopenia. In low and middle-income countries (LMICs), where the great majority of children live, the prevalence of under-nutrition is as high as 95% in those with cancer. Nutritional support improves clinical outcomes, including survival.Areas covered: This narrative review describes the evolution of attention to nutrition in children with cancer and the increasing understanding of this relationship. An initial focus on obesity in children with acute leukemias in HICs has been matched more recently by a recognition of the negative effect of under-nutrition on survival in children with cancer in LMICs. These observations have stimulated explorations of underlying mechanisms, including dysbiosis of the gut microbiome, and structured nutritional interventions to redress adverse outcomes.Expert opinion: Studies of the gut microbiome and metabolome have yielded important information on the pathogenesis of malnutrition in children, providing new avenues for interventions. Combinations of plant products that are inexpensive and readily available in LMICs have been shown to 'mature' the microbiome and the corresponding plasma proteome in children with acute malnutrition, offering the prospect of cost-effective remedies that are tested in children with cancer.
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Affiliation(s)
- Ronald D Barr
- Division of Hematology and Oncology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Elena J Ladas
- Division of Hematology-Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University, Irving Medical Centre, New York, USA
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Jones PH, Deng B, Winkler J, Zirnheld AL, Ehringer S, Shetty V, Cox M, Nguyen H, Shen WJ, Huang TT, Wang E. Over-expression of miR-34c leads to early-life visceral fat accumulation and insulin resistance. Sci Rep 2019; 9:13844. [PMID: 31554925 PMCID: PMC6761099 DOI: 10.1038/s41598-019-50191-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 08/15/2019] [Indexed: 12/13/2022] Open
Abstract
Overweight children and adolescents are at high risk for adult and late life obesity. This report investigates some underlying mechanisms contributing to obesity during early life in an animal model. We generated a strain of transgenic mice, cU2, overexpressing human microRNA 34c, a microRNA functionally implicated in adipogenesis. Male and female cU2 mice exhibit significant weight gain, accompanied by marked increase in abdominal fat mass and metabolic abnormalities, including reduction of both glucose clearance rate and insulin sensitivity, as early as two months of age. Adipogenesis derailment at this early age is suggested by decreased expression of adiponectin, the fat mass and obesity-associated gene, and the adiponectin receptor R1, coupled with a reduction of the brown fat biomarker PAT2 and the adipogenesis inhibitor SIRT1. Notably, adiponectin is an important adipokine and an essential regulator of glucose and fatty acid homeostasis. cU2 mice may provide a crucial animal model for investigating the role of miR-34c in early onset insulin resistance and visceral fat mass increase, contributing to accelerated body weight gain and metabolic disorders. Intervention in this dysregulation may open a new preventive strategy to control early-life weight gain and abnormal insulin resistance, and thus prevalent adult and late life obesity.
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Affiliation(s)
| | - Brian Deng
- Palo Alto Veterans Institute for Research, Palo Alto, CA, USA.,Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | - Matthew Cox
- Advanced Genomic Technology, LLC, Louisville, KY, USA
| | - Huy Nguyen
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Wen-Jun Shen
- Department of Endocrinology, Stanford University School of Medicine, Stanford, CA, USA.,Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Ting-Ting Huang
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA. .,Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.
| | - Eugenia Wang
- Advanced Genomic Technology, LLC, Louisville, KY, USA
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Li W, Zhang X, Sang H, Zhou Y, Shang C, Wang Y, Zhu H. Effects of hyperglycemia on the progression of tumor diseases. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:327. [PMID: 31337431 PMCID: PMC6651927 DOI: 10.1186/s13046-019-1309-6] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/02/2019] [Indexed: 12/13/2022]
Abstract
Malignant tumors are often multifactorial. Epidemiological studies have shown that hyperglycemia raises the prevalence and mortality of certain malignancies, like breast, liver, bladder, pancreatic, colorectal, endometrial cancers. Hyperglycemia can promote the proliferation, invasion and migration, induce the apoptotic resistance and enhance the chemoresistance of tumor cells. This review focuses on the new findings in the relationship between hyperglycemia and tumor development.
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Affiliation(s)
- Wenjie Li
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xuehui Zhang
- Department of Pharmacy, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, 215228, China
| | - Hui Sang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Ying Zhou
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Chunyu Shang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yongqing Wang
- Department of Pharmacy, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, 215228, China. .,Research Division of Clinical Pharmacology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Hong Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Favoni V, Giani L, Al-Hassany L, Asioli GM, Butera C, de Boer I, Guglielmetti M, Koniari C, Mavridis T, Vaikjärv M, Verhagen I, Verzina A, Zick B, Martelletti P, Sacco S. CGRP and migraine from a cardiovascular point of view: what do we expect from blocking CGRP? J Headache Pain 2019; 20:27. [PMID: 30866804 PMCID: PMC6734543 DOI: 10.1186/s10194-019-0979-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/26/2019] [Indexed: 12/14/2022] Open
Abstract
Calcitonin gene-related peptide (CGRP) is a neuropeptide with a pivotal role in the pathophysiology of migraine. Blockade of CGRP is a new therapeutic target for patients with migraine. CGRP and its receptors are distributed not only in the central and peripheral nervous system but also in the cardiovascular system, both in blood vessels and in the heart. We reviewed the current evidence on the role of CGRP in the cardiovascular system in order to understand the possible short- and long-term effect of CGRP blockade with monoclonal antibodies in migraineurs.In physiological conditions, CGRP has important vasodilating effects and is thought to protect organs from ischemia. Despite the aforementioned cardiovascular implication, preventive treatment with CGRP antibodies has shown no relevant cardiovascular side effects. Results from long-term trials and from real life are now needed.
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Affiliation(s)
- Valentina Favoni
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3 Pad. G, 40139 Bologna, Italy
| | - Luca Giani
- Ricovero Ferdinando Uboldi, Paderno Dugnano, Italy
| | - Linda Al-Hassany
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Gian Maria Asioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3 Pad. G, 40139 Bologna, Italy
| | - Calogera Butera
- Dipartimento Neurologico e INSPE, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Irene de Boer
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martina Guglielmetti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
- Regional Referral Headache Center, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical Pathology, University of Sassari, Sassari, Italy
| | - Chrysoula Koniari
- 1st Neurology Department, Aeginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Mavridis
- 1st Neurology Department, Aeginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Marge Vaikjärv
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Iris Verhagen
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Angela Verzina
- Neurology Clinic, University of Perugia, Perugia, Italy
- S. Maria della Misericordia Hospital, Perugia, Italy
| | - Bart Zick
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
- Regional Referral Headache Center, Sant’Andrea Hospital, Rome, Italy
| | - Simona Sacco
- UOC Neurologia e Stroke Unit, Ospedale SS Filippo e Nicola, Avezzano, Italy
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - European Headache Federation School of Advanced Studies (EHF-SAS)
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3 Pad. G, 40139 Bologna, Italy
- Ricovero Ferdinando Uboldi, Paderno Dugnano, Italy
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Dipartimento Neurologico e INSPE, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
- Regional Referral Headache Center, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical Pathology, University of Sassari, Sassari, Italy
- 1st Neurology Department, Aeginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Faculty of Medicine, University of Tartu, Tartu, Estonia
- Neurology Clinic, University of Perugia, Perugia, Italy
- S. Maria della Misericordia Hospital, Perugia, Italy
- UOC Neurologia e Stroke Unit, Ospedale SS Filippo e Nicola, Avezzano, Italy
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
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Breast Cancer: Metastasis, Molecular Subtypes, and Overweight and Obesity in Veracruz, Mexico. Clin Breast Cancer 2018; 19:e166-e171. [PMID: 30236925 DOI: 10.1016/j.clbc.2018.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/11/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION We assessed the association between overweight, obesity, and morbid obesity with the incidence of the most aggressive breast cancer subtypes in women. METHODS AND MATERIALS A cross-sectional study was performed. We conducted a record review to identify the following aspects: body mass index, sociodemographic features, tumor characteristics, and reproductive and molecular aspects. Descriptive statistics and univariate analysis were performed to identify the association between the molecular subtypes and the study variables. In addition, we used multivariate analysis to identify the association between obesity and the presence of metastatic lymph nodes. RESULTS We included 1446 women with an average age of 52.5 ± 12.1 years. Of the 1446 patients, 47% were premenopausal and 75% were overweight. Univariate analysis indicated a statistically significant association between obesity and advanced disease stage, as well as nulliparity and multiparity. Similar results were found for women with morbid obesity. Model 1 of the multivariate analysis showed an association between the presence of metastatic lymph nodes and obesity (odds ratio [OR], 1.6; P = .008) and histologic grade 2 or 3 (OR, 2.4; P = .003). Using model 2, an association was identified between an advanced disease stage and 2 factors: morbid obesity (OR, 1.9; P = .02) and positive human epidermal growth factor receptor 2 (OR, 1.8; P = .045). CONCLUSION We found that obesity is associated with the more advanced stages of breast cancer. Further studies are needed to evaluate the role of obesity in breast cancer progression in women.
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Bodai BI, Nakata TE, Wong WT, Clark DR, Lawenda S, Tsou C, Liu R, Shiue L, Cooper N, Rehbein M, Ha BP, Mckeirnan A, Misquitta R, Vij P, Klonecke A, Mejia CS, Dionysian E, Hashmi S, Greger M, Stoll S, Campbell TM. Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. Perm J 2018; 22:17-025. [PMID: 29035175 DOI: 10.7812/tpp/17-025] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
By ignoring the root causes of disease and neglecting to prioritize lifestyle measures for prevention, the medical community is placing people at harm. Advanced nations, influenced by a Western lifestyle, are in the midst of a health crisis, resulting largely from poor lifestyle choices. Epidemiologic, ecologic, and interventional studies have repeatedly indicated that most chronic illnesses, including cardiovascular disease, cancer, and type 2 diabetes, are the result of lifestyles fueled by poor nutrition and physical inactivity.In this article, we describe the practice of lifestyle medicine and its powerful effect on these modern instigators of premature disability and death. We address the economic benefits of prevention-based lifestyle medicine and its effect on our health care system: A system on the verge of bankruptcy. We recommend vital changes to a disastrous course. Many deaths and many causes of pain, suffering, and disability could be circumvented if the medical community could effectively implement and share the power of healthy lifestyle choices. We believe that lifestyle medicine should become the primary approach to the management of chronic conditions and, more importantly, their prevention. For future generations, for our own health, and for the Hippocratic Oath we swore to uphold ("First do no harm"), the medical community must take action. It is our hope that the information presented will inspire our colleagues to pursue lifestyle medicine research and incorporate such practices into their daily care of patients. The time to make this change is now.
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Affiliation(s)
- Balazs I Bodai
- Director of The Breast Cancer Survivorship Institute in Sacramento, CA.
| | - Therese E Nakata
- Program Manager of The Breast Cancer Survivorship Institute in Sacramento, CA.
| | | | - Dawn R Clark
- Chief Facilitator of the Physician Wellness Program and an Obstetrician/Gynecologist at the San Dimas-Baldwin Park Medical Center in San Dimas, CA.
| | - Steven Lawenda
- Internist at the Antelope Valley Medical Center in Lancaster, CA.
| | | | - Raymond Liu
- Chief of Hematology-Oncology at the San Francisco Medical Center in CA.
| | - Linda Shiue
- Internist and the Director of Culinary Medicine at the San Francisco Medical Center in CA.
| | - Neil Cooper
- Radiologist at the Glenlake Medical Center in Atlanta, GA.
| | - Michael Rehbein
- Pediatrician and Assistant Physician-in-Charge for Outpatient Service at the Stockton Medical Office in CA.
| | - Benjamin P Ha
- Associate Area Medical Director for Family Medicine at the Bakersfield Medical Center in CA.
| | - Anne Mckeirnan
- Obstetrician/Gynecologist at the San Diego Medical Center in CA.
| | - Rajiv Misquitta
- Primary Care Physician at the South Sacramento Medical Center in CA. He is also an Elected Representative on The Permanente Medical Group Board of Directors.
| | - Pankaj Vij
- Medical Director of the Kaiser Permanente Weight Management Program in Pleasanton, CA.
| | - Andrew Klonecke
- Nuclear Medicine Specialist at the Sacramento Medical Center and at the Roseville Medical Center in CA.
| | | | - Emil Dionysian
- Orthopedic Surgeon at the Lakeview Medical Offices and at the Orange County Medical Center in Anaheim, CA.
| | - Sean Hashmi
- Internist at the Woodland Hills Medical Center in CA.
| | - Michael Greger
- Physician and Founder of NutritionFacts.org in Kensington, MD.
| | - Scott Stoll
- Co-Founder and Chairman of the Plantrician Project in Rieglesville, PA.
| | - Thomas M Campbell
- Instructor of Clinical Family Medicine at the University of Rochester School of Medicine and Dentistry and the Co-Founder and Clinical Director of the University of Rochester Program for Nutrition in Medicine in NY.
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Yunn NO, Kim J, Kim Y, Leibiger I, Berggren PO, Ryu SH. Mechanistic understanding of insulin receptor modulation: Implications for the development of anti-diabetic drugs. Pharmacol Ther 2018; 185:86-98. [DOI: 10.1016/j.pharmthera.2017.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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16
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Viedma-Rodríguez R, Martínez-Hernández MG, Flores-López LA, Baiza-Gutman LA. Epsilon-aminocaproic acid prevents high glucose and insulin induced-invasiveness in MDA-MB-231 breast cancer cells, modulating the plasminogen activator system. Mol Cell Biochem 2017; 437:65-80. [PMID: 28612231 DOI: 10.1007/s11010-017-3096-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/08/2017] [Indexed: 01/01/2023]
Abstract
Obesity and type II diabetes mellitus have contributed to the increase of breast cancer incidence worldwide. High glucose concentration promotes the proliferation of metastatic cells, favoring the activation of the plasminogen/plasmin system, thus contributing to tumor progression. The efficient formation of plasmin is dependent on the binding of plasminogen to the cell surface. We studied the effect of ε-aminocaproic acid (EACA), an inhibitor of the binding of plasminogen to cell surface, on proliferation, migration, invasion, epithelial-mesenchymal transition (EMT), and plasminogen activation system, in metastatic MDA-MB-231 breast cancer cells grown in a high glucose microenvironment and treated with insulin. MDA-MB-231 cells were treated with EACA 12.5 mmol/L under high glucose 30 mmol/L (HG) and high glucose and insulin 80 nmol/L (HG-I) conditions, evaluating: cell population growth, % of viability, migratory, and invasive abilities, as well as the expression of uPA, its receptor (uPAR), and its inhibitor (PAI-1), by real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blot, MMP-2 and MMP-9 mRNAs were evaluated by RT-PCR. Markers of EMT were evaluated by Western blot. Additionally, the presence of active uPA was studied by gel zymography, using casein-plasminogen as substrates. EACA prevented the increase in cell population, migration and invasion induced by HG and insulin, which was associated with the inhibition of EMT and the attenuation of HG- and insulin-dependent expression of uPA, uPAR, PAI-1, MMP-2, MMP-9, α-enolase (ENO A), and HCAM. The interaction of plasminogen to the cell surface and plasmin formation are mediators of the prometastasic action of hyperglycemia and insulin, potentially, EACA can be employed in the prevention and as adjuvant treatment of breast tumorigenesis promoted by hyperglycemia and insulin.
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Affiliation(s)
- Rubí Viedma-Rodríguez
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Iztacala, 54090, Tlalnepantla, Estado de México, Mexico
| | - María Guadalupe Martínez-Hernández
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Iztacala, 54090, Tlalnepantla, Estado de México, Mexico
| | - Luis Antonio Flores-López
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Iztacala, 54090, Tlalnepantla, Estado de México, Mexico
| | - Luis Arturo Baiza-Gutman
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Iztacala, 54090, Tlalnepantla, Estado de México, Mexico.
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Abstract
Background Women with diabetes have a worse survival after breast cancer diagnosis compared to women without diabetes. This may be due to a different etiological profile, leading to the development of more aggressive breast cancer subtypes. Our aim was to investigate whether insulin and non-insulin treated women with diabetes develop specific clinicopathological breast cancer subtypes compared to women without diabetes. Methods and Findings This cross-sectional study included randomly selected patients with invasive breast cancer diagnosed in 2000–2010. Stratified by age at breast cancer diagnosis (≤50 and >50 years), women with diabetes were 2:1 frequency-matched on year of birth and age at breast cancer diagnosis (both in 10-year categories) to women without diabetes, to select ~300 patients with tumor tissue available. Tumor MicroArrays were stained by immunohistochemistry for estrogen and progesterone receptor (ER, PR), HER2, Ki67, CK5/6, CK14, and p63. A pathologist scored all stains and revised morphology and grade. Associations between diabetes/insulin treatment and clinicopathological subtypes were analyzed using multivariable logistic regression. Morphology and grade were not significantly different between women with diabetes (n = 211) and women without diabetes (n = 101), irrespective of menopausal status. Premenopausal women with diabetes tended to have more often PR-negative (OR = 2.44(95%CI:1.07–5.55)), HER2-negative (OR = 2.84(95%CI:1.11–7.22)), and basal-like (OR = 3.14(95%CI:1.03–9.60) tumors than the women without diabetes, with non-significantly increased frequencies of ER-negative (OR = 2.48(95%CI:0.95–6.45)) and triple negative (OR = 2.60(95%CI:0.88–7.67) tumors. After adjustment for age and BMI, the associations remained similar in size but less significant. We observed no evidence for associations of clinicopathological subtypes with diabetes in postmenopausal women, or with insulin treatment in general. Conclusions We found no compelling evidence that women with diabetes, treated with or without insulin, develop different breast cancer subtypes than women without diabetes. However, premenopausal women with diabetes tended to develop breast tumors that do not express hormonal receptors, which are typically associated with poor prognosis.
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Makhoul I, Yacoub A, Siegel E. Type 2 diabetes mellitus is associated with increased risk of pancreatic cancer: A veteran administration registry study. SAGE Open Med 2016; 4:2050312116682257. [PMID: 28348740 PMCID: PMC5354175 DOI: 10.1177/2050312116682257] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 10/24/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The etiology of pancreatic cancer remains elusive. Several studies have suggested a role for diabetes mellitus, but the magnitude of its contribution remains controversial. OBJECTIVES Utilizing a large administrative database, this retrospective cohort study was designed to investigate the relationship between type 2 diabetes mellitus and pancreatic cancer. PATIENTS AND DESIGN Using the Veterans Integrated Services Network 16 database, 322,614 subjects were enrolled in the study, including 110,919 with type 2 diabetes mellitus and 211,695 diabetes-free controls matched by gender, year of birth and healthcare facility. RESULTS A significantly higher incidence of pancreatic cancer was observed in patients with type 2 diabetes mellitus, with an adjusted hazard ratio (95% confidence interval) of 2.17 (1.70-2.77) for type 2 diabetes mellitus compared to controls (p < 10-9) after controlling for the matching factors. CONCLUSION The association between type 2 diabetes mellitus and pancreatic cancer was statistically significant and may, in part, explain the rising incidence of pancreatic cancer.
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Affiliation(s)
- Issam Makhoul
- Hematology/Oncology Division, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Abdulraheem Yacoub
- Division of Hematology/Oncology, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric Siegel
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Saisana M, Griffin SM, May FE. Importance of the type I insulin-like growth factor receptor in HER2, FGFR2 and MET-unamplified gastric cancer with and without Ras pathway activation. Oncotarget 2016; 7:54445-54462. [PMID: 27437872 PMCID: PMC5342354 DOI: 10.18632/oncotarget.10642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 05/14/2016] [Indexed: 12/28/2022] Open
Abstract
Amplification of seven oncogenes: HER2, EGFR, FGFR1, FGFR2, MET, KRAS and IGF1R has been identified in gastric cancer. The first five are targeted therapeutically in patients with HER2-positivity, FGFR2- or MET-amplification but the majority of patients are triple-negative and require alternative strategies. Our aim was to evaluate the importance of the IGF1R tyrosine kinase in triple-negative gastric cancer with and without oncogenic KRAS, BRAF or PI3K3CA mutations. Cell lines and metastatic tumor cells isolated from patients expressed IGF1R, and insulin-like growth factor-1 (IGF-1) activated the PI3-kinase/Akt and Ras/Raf/MAP-kinase pathways. IGF-1 protected triple-negative cells from caspase-dependent apoptosis and anoikis. Protection was mediated via the PI3-kinase/Akt pathway. Remarkably, IGF-1-dependent cell survival was greater in patient samples. IGF-1 stimulated triple-negative gastric cancer cell growth was prevented by IGF1R knockdown and Ras/Raf/MAP-kinase pathway inhibition. The importance of the receptor in cell line and metastatic tumor cell growth in serum-containing medium was demonstrated by knockdown and pharmacological inhibition with figitumumab. The proportions of cells in S-phase and mitotic-phase, and Ras/Raf/MAP-kinase pathway activity, were reduced concomitantly. KRAS-addicted and BRAF-impaired gastric cancer cells were particularly susceptible. In conclusion, IGF1R and the IGF signal transduction pathway merit consideration as potential therapeutic targets in patients with triple-negative gastric cancer.
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Affiliation(s)
- Marina Saisana
- Northern Institute for Cancer Research, Newcastle upon Tyne Hospitals NHS Foundation Trust, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - S. Michael Griffin
- Northern Institute for Cancer Research, Newcastle upon Tyne Hospitals NHS Foundation Trust, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
- Northern Oesophago-Gastric Cancer Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Felicity E.B. May
- Northern Institute for Cancer Research, Newcastle upon Tyne Hospitals NHS Foundation Trust, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Department of Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
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21
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Flores-López LA, Martínez-Hernández MG, Viedma-Rodríguez R, Díaz-Flores M, Baiza-Gutman LA. High glucose and insulin enhance uPA expression, ROS formation and invasiveness in breast cancer-derived cells. Cell Oncol (Dordr) 2016; 39:365-78. [PMID: 27106722 DOI: 10.1007/s13402-016-0282-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Accumulating evidence indicates that type 2 diabetes is associated with an increased risk to develop breast cancer. This risk has been attributed to hyperglycemia, hyperinsulinemia and chronic inflammation. As yet, however, the mechanisms underlying this association are poorly understood. Here, we studied the effect of high glucose and insulin on breast cancer-derived cell proliferation, migration, epithelial-mesenchymal transition (EMT) and invasiveness, as well as its relationship to reactive oxygen species (ROS) production and the plasminogen activation system. METHODS MDA-MB-231 cell proliferation, migration and invasion were assessed using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT), scratch-wound and matrigel transwell assays, respectively. ROS production was determined using 2' 7'-dichlorodihydrofluorescein diacetate. The expression of E-cadherin, vimentin, fibronectin, urokinase plasminogen activator (uPA), its receptor (uPAR) and its inhibitor (PAI-1) were assessed using qRT-PCR and/or Western blotting assays, respectively. uPA activity was determined using gel zymography. RESULTS We found that high glucose stimulated MDA-MB-231 cell proliferation, migration and invasion, together with an increased expression of mesenchymal markers (i.e., vimentin and fibronectin). These effects were further enhanced by the simultaneous administration of insulin. In both cases, the invasion and growth responses were found to be associated with an increased expression of uPA, uPAR and PAI-1, as well as an increase in active uPA. An osmolality effect of high glucose was excluded by using mannitol at an equimolar concentration. We also found that all changes induced by high glucose and insulin were attenuated by the anti-oxidant N-acetylcysteine (NAC) and, thus, depended on ROS production. CONCLUSIONS From our data we conclude that hyperglycemia and hyperinsulinemia can promote breast cancer cell proliferation, migration and invasion. We found that these features were associated with increased expression of the mesenchymal markers vimentin and fibronectin, as well as increased uPA expression and activation through a mechanism mediated by ROS.
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Affiliation(s)
- Luis Antonio Flores-López
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Ixtacala, Tlalnepantla, Estado de México, CP, 54090, México
| | - María Guadalupe Martínez-Hernández
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Ixtacala, Tlalnepantla, Estado de México, CP, 54090, México
| | - Rubí Viedma-Rodríguez
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Ixtacala, Tlalnepantla, Estado de México, CP, 54090, México
| | - Margarita Díaz-Flores
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Av. Cuauhtémoc 330, Col. Doctores, Del, Cuauhtémoc, DF, 06720, México
| | - Luis Arturo Baiza-Gutman
- Unidad de Morfofisiología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Ixtacala, Tlalnepantla, Estado de México, CP, 54090, México.
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Orgel E, Genkinger JM, Aggarwal D, Sung L, Nieder M, Ladas EJ. Association of body mass index and survival in pediatric leukemia: a meta-analysis. Am J Clin Nutr 2016; 103:808-17. [PMID: 26864366 PMCID: PMC6546230 DOI: 10.3945/ajcn.115.124586] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/28/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity is a worldwide epidemic in children and adolescents. Adult cohort studies have reported an association between higher body mass index (BMI) and increased leukemia-related mortality; whether a similar effect exists in childhood leukemia remains controversial. OBJECTIVE We conducted a meta-analysis to determine whether a higher BMI at diagnosis of pediatric acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) is associated with worse event-free survival (EFS), overall survival (OS), and cumulative incidence of relapse (CIR). DESIGN We searched 4 electronic databases from inception through March 2015 without language restriction and included studies in pediatric ALL or AML (0-21 y of age) reporting BMI as a predictor of survival or relapse. Higher BMI, defined as obese (≥95%) or overweight/obese (≥85%), was compared with lower BMI [nonoverweight/obese (<85%)]. Summary risk estimates for EFS, OS, and CIR (ALL only) were calculated with random- or fixed-effects models according to tests for between-study heterogeneity. RESULTS Of 4690 reports identified, 107 full-text articles were evaluated, with 2 additional articles identified via review of citations; 11 articles were eligible for inclusion in this meta-analysis. In ALL, we observed poorer EFS in children with a higher BMI (RR: 1.35; 95% CI: 1.20, 1.51) than in those at a lower BMI. A higher BMI was associated with significantly increased mortality (RR: 1.31; 95% CI: 1.09, 1.58) and a statistically nonsignificant trend toward greater risk of relapse (RR: 1.17; 95% CI: 0.99, 1.38) compared with a lower BMI. In AML, a higher BMI was significantly associated with poorer EFS and OS (RR: 1.36; 95% CI: 1.16, 1.60 and RR: 1.56; 95% CI: 1.32, 1.86, respectively) than was a lower BMI. CONCLUSION Higher BMI at diagnosis is associated with poorer survival in children with pediatric ALL or AML.
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Affiliation(s)
- Etan Orgel
- Children's Center for Cancer and Blood Disease, Children's Hospital Los Angeles, Los Angeles, CA; Jonathan Jaques Children's Cancer Center, Miller Children's Hospital Long Beach, Long Beach, CA; Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | - Divya Aggarwal
- Institute of Human Nutrition, College of Physicians and Surgeons, and
| | - Lillian Sung
- Division of Haemotology/Oncology, The Hospital for Sick Kids, Toronto, Canada; and
| | - Michael Nieder
- Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL
| | - Elena J Ladas
- Herbert Irving Comprehensive Cancer Center, Institute of Human Nutrition, College of Physicians and Surgeons, and Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY;
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Mackenzie TA, Zaha R, Smith J, Karagas MR, Morden NE. Diabetes Pharmacotherapies and Bladder Cancer: A Medicare Epidemiologic Study. Diabetes Ther 2016; 7:61-73. [PMID: 26894755 PMCID: PMC4801809 DOI: 10.1007/s13300-016-0152-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Patients with type II diabetes have an increased risk of bladder cancer and are commonly treated with thiazolidinediones and angiotensin receptor blockers (ARBs), which have been linked to cancer risk. We explored the relationship between use of one or both of these medication types and incident bladder cancer among diabetic patients (diabetics) enrolled in Medicare. RESEARCH DESIGN AND METHODS We constructed both a prevalent and incident retrospective cohort of pharmacologically treated prevalent diabetics enrolled in a Medicare fee-for-service plan using inpatient, outpatient (2003-2011) and prescription (2006-2011) administrative data. The association of incident bladder cancer with exposure to pioglitazone, rosiglitazone and ARBs was studied using muitivariable Cox's hazard models with time-dependent covariates in each of the two cohorts. RESULTS We identified 1,161,443 prevalent and 320,090 incident pharmacologically treated diabetics, among whom 4433 and 1159, respectively, developed incident bladder cancers. In the prevalent cohort mean age was 75.1 years, mean follow-up time was 38.0 months, 20.2% filled a prescription for pioglitazone during follow-up, 10.4% received rosiglitazone, 31.6% received an ARB and 8.0% received combined therapy with pioglitazone + ARB. We found a positive association between bladder cancer and duration of pioglitazone use in the prevalent cohort (P for trend = 0.008), with ≥24 months of pioglitazone exposure corresponding to a 16% (95% confidence interval 0-35%) increase in the incidence of bladder cancer compared to no use. There was a positive association between bladder cancer and rosiglitazone use for <24 months in the prevalent cohort, but no association with ARB use. There were no significant associations in the incident cohort. CONCLUSIONS We found that the incidence of bladder cancer increased with duration of pioglitazone use in a prevalent cohort of diabetics aged 65+ years residing in the USA, but not an incident cohort.
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Affiliation(s)
- Todd A Mackenzie
- Section of Clinical Research, HB 7505, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Rebecca Zaha
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
| | - Jeremy Smith
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
| | - Margaret R Karagas
- Norris Cotton Cancer Center at Dartmouth, Dartmouth College, Lebanon, NH, USA
- Department of Epidemiology, The Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Nancy E Morden
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
- Norris Cotton Cancer Center at Dartmouth, Dartmouth College, Lebanon, NH, USA
- Department of Epidemiology, The Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
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Luey BC, May FEB. Insulin-like growth factors are essential to prevent anoikis in oestrogen-responsive breast cancer cells: importance of the type I IGF receptor and PI3-kinase/Akt pathway. Mol Cancer 2016; 15:8. [PMID: 26801096 PMCID: PMC4722749 DOI: 10.1186/s12943-015-0482-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 12/10/2015] [Indexed: 01/10/2023] Open
Abstract
Background Detachment of epithelial cells from the extracellular matrix initiates programmed cell death by a process termed anoikis. Malignant cells must acquire anoikis resistance to leave the primary tumour and metastasise. Multiple signal transduction pathways can activate anoikis and confer anoikis resistance, but these are not understood in breast cancer. Methods Models for anoikis of oestrogen-responsive breast cancer cells were established and the protective effects of IGF-1 tested. Cleaved PARP was measured by western transfer and cleaved caspase 3 by flow cytometry. Pathways involved in anoikis and in anoikis resistance were investigated with PI3-kinase, Akt, and MEK1 and MEK2 inhibitors. The importance of the type I IGF receptor was investigated by IGF-concentration dependence, siRNA knockdown and pharmacological inhibition. Association between IGF-1R expression and relapse with distant metastasis was analysed in 1609 patients by log rank test. Results Unattached breast cancer cells required culture in serum-free medium to induce anoikis. Rapid loss of FAK, Akt and Bad phosphorylation was concurrent with anoiks induction, but ERK1 and ERK2 phosphorylation increased which suggested that anoikis resistance is mediated by the PI3-kinase/Akt rather than the Grb2/Ras/MAP-kinase pathway. IGF-1 conferred anoikis resistance in serum-free medium. IGF-1 activated the PI3-kinase/Akt and Grb2/Ras/MAP-kinase pathways but experiments with PI3-kinase, Akt and MEK1 and MEK2 inhibitors showed that IGF protection is via the PI3-kinase/Akt pathway. The concentration dependence of IGF protection, knockdown experiments with siRNA and pharmacological inhibition with figitumumab, showed that IGF-1 signals through the type I IGF receptor. The crucial role of the type I IGF receptor was demonstrated by induction of anoikis in full serum by figitumumab. High IGF-1R expression was associated with reduced time to relapse with distant metastases in oestrogen receptor-positive patients, especially those with aggressive disease which confirms its relevance in vivo. Conclusions Anoikis resistance of oestrogen-responsive breast cancer cells depends upon IGF activation of the type I IGF receptor and PI3-kinase/Akt pathway. Because IGF-dependent evasion of anoikis will facilitate metastasis by malignant breast cancer cells, effective inhibition of IGF signal transduction should be included in combinations of targeted drugs designed to treat metastatic oestrogen receptor-positive breast cancers.
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Affiliation(s)
- Brendan C Luey
- Northern Institute for Cancer Research and Newcastle University Institute for Ageing, Department of Pathology, Faculty of Medical Sciences, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Felicity E B May
- Northern Institute for Cancer Research and Newcastle University Institute for Ageing, Department of Pathology, Faculty of Medical Sciences, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
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Yokoyama NN, Denmon A, Uchio EM, Jordan M, Mercola D, Zi X. When Anti-Aging Studies Meet Cancer Chemoprevention: Can Anti-Aging Agent Kill Two Birds with One Blow? ACTA ACUST UNITED AC 2015; 1:420-433. [PMID: 26756023 DOI: 10.1007/s40495-015-0039-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Recent evidence has strongly supported that the rate of aging is controlled, at least to some extent, by evolutionarily conserved nutrient sensing pathways (e.g. the insulin/IGF-1-signaling, mTOR, AMPK, and sirtuins) from worms to humans. These pathways are also commonly involved in carcinogenesis and cancer metabolism. Agents (e.g. metformin, resveratrol, and Rhodiola) that target these nutrient sensing pathways often have both anti-aging and anti-cancer efficacy. These agents not only reprogram energy metabolism of malignant cells, but also target normal postmitotic cells by suppressing their conversion into senescent cells, which confers systematic metabolism benefits. These agents are fundamentally different from chemotherapy (e.g. paclitaxel and doxorubicin) or radiation therapy that causes molecular damage (e.g. DNA and protein damages) and thereby no selection resistance may be expected. By reviewing molecular mechanisms of action, epidemiological evidence, experimental data in tumor models, and early clinical study results, this review provides information supporting the promising use of agents with both anti-aging and anti-cancer efficacy for cancer chemoprevention.
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Affiliation(s)
- Noriko N Yokoyama
- Department of Urology, University of California, Irvine, Orange, CA 92868, USA
| | - Andria Denmon
- Department of Urology, University of California, Irvine, Orange, CA 92868, USA
| | - Edward M Uchio
- Department of Urology, University of California, Irvine, Orange, CA 92868, USA
| | - Mark Jordan
- Department of Urology, University of California, Irvine, Orange, CA 92868, USA
| | - Dan Mercola
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Orange, CA 92868, USA
| | - Xiaolin Zi
- Department of Urology, University of California, Irvine, Orange, CA 92868, USA; Department of Pharmacology, University of California, Irvine, Orange, CA 92868, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Orange, CA 92868, USA
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26
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Ofotokun I, Na LH, Landovitz RJ, Ribaudo HJ, McComsey GA, Godfrey C, Aweeka F, Cohn SE, Sagar M, Kuritzkes DR, Brown TT, Patterson KB, Para MF, Leavitt RY, Villasis-Keever A, Baugh BP, Lennox JL, Currier JS. Comparison of the metabolic effects of ritonavir-boosted darunavir or atazanavir versus raltegravir, and the impact of ritonavir plasma exposure: ACTG 5257. Clin Infect Dis 2015; 60:1842-51. [PMID: 25767256 DOI: 10.1093/cid/civ193] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/03/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Metabolic effects following combination antiretroviral therapy (cART) vary by regimen type. Changes in metabolic effects were assessed following cART in the AIDS Clinical Trials Group (ACTG) A5257 study, and correlated with plasma ritonavir trough concentrations (C24). METHODS Treatment-naive adult subjects were randomized to ritonavir-boosted atazanavir or darunavir, or raltegravir-based cART. Changes in lipids and other metabolic outcomes over time were estimated. Differences between arms were estimated with 97.5% confidence intervals and compared using pairwise Student t tests. Associations between ritonavir C24 and lipid changes at week 48 were evaluated via linear regression. RESULTS Analyses included 1797 subjects with baseline fasting data. Baseline lipid profiles and metabolic syndrome rates (approximately 21%) were similar across arms. Comparable increases occurred in total cholesterol, triglycerides, and low-density lipoprotein cholesterol with the boosted protease inhibitors (PIs); each PI had greater increases relative to raltegravir (all P ≤ .001 at week 96). Metabolic syndrome incident rates by week 96 (approximately 22%) were not different across arms. Ritonavir C24 was not different by arm (P = .89) (median, 69 ng/mL and 74 ng/mL in the atazanavir and darunavir arms, respectively) and were not associated with changes in lipid measures (all P > .1). CONCLUSIONS Raltegravir produced the most favorable lipid profile. Metabolic syndrome rates were high at baseline and increased to the same degree in all arms. Ritonavir C24 was not different in the PI arms and had no relationship with the modest but comparable increases in lipids observed with either atazanavir or darunavir. The long-term clinical significance of the lipid changes noted with the PIs relative to raltegravir deserves further evaluation. CLINICAL TRIALS REGISTRATION NCT 00811954.
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Affiliation(s)
- Ighovwerha Ofotokun
- Grady Memorial Hospital and Emory University School of Medicine, Atlanta, Georgia
| | - Lumine H Na
- Harvard School of Public Health, Boston, Massachusetts
| | - Raphael J Landovitz
- Division of Infectious Diseases, Center for Clinical AIDS Research and Education, University of California, Los Angeles
| | | | | | - Catherine Godfrey
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | | | - Susan E Cohn
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Daniel R Kuritzkes
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | | - Bryan P Baugh
- Janssen Scientific Affairs, LLC, Titusville, New Jersey
| | - Jeffrey L Lennox
- Grady Memorial Hospital and Emory University School of Medicine, Atlanta, Georgia
| | - Judith S Currier
- Division of Infectious Diseases, Center for Clinical AIDS Research and Education, University of California, Los Angeles
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Andres SF, Santoro MA, Mah AT, Keku JA, Bortvedt AE, Blue RE, Lund PK. Deletion of intestinal epithelial insulin receptor attenuates high-fat diet-induced elevations in cholesterol and stem, enteroendocrine, and Paneth cell mRNAs. Am J Physiol Gastrointest Liver Physiol 2015; 308:G100-11. [PMID: 25394660 PMCID: PMC4297856 DOI: 10.1152/ajpgi.00287.2014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The insulin receptor (IR) regulates nutrient uptake and utilization in multiple organs, but its role in the intestinal epithelium is not defined. This study developed a mouse model with villin-Cre (VC) recombinase-mediated intestinal epithelial cell (IEC)-specific IR deletion (VC-IR(Δ/Δ)) and littermate controls with floxed, but intact, IR (IR(fl/fl)) to define in vivo roles of IEC-IR in mice fed chow or high-fat diet (HFD). We hypothesized that loss of IEC-IR would alter intestinal growth, biomarkers of intestinal epithelial stem cells (IESC) or other lineages, body weight, adiposity, and glucose or lipid handling. In lean, chow-fed mice, IEC-IR deletion did not affect body or fat mass, plasma glucose, or IEC proliferation. In chow-fed VC-IR(Δ/Δ) mice, mRNA levels of the Paneth cell marker lysozyme (Lyz) were decreased, but markers of other differentiated lineages were unchanged. During HFD-induced obesity, IR(fl/fl) and VC-IR(Δ/Δ) mice exhibited similar increases in body and fat mass, plasma insulin, mRNAs encoding several lipid-handling proteins, a decrease in Paneth cell number, and impaired glucose tolerance. In IR(fl/fl) mice, HFD-induced obesity increased circulating cholesterol; numbers of chromogranin A (CHGA)-positive enteroendocrine cells (EEC); and mRNAs encoding Chga, glucose-dependent insulinotrophic peptide (Gip), glucagon (Gcg), Lyz, IESC biomarkers, and the enterocyte cholesterol transporter Scarb1. All these effects were attenuated or lost in VC-IR(Δ/Δ) mice. These results demonstrate that IEC-IR is not required for normal growth of the intestinal epithelium in lean adult mice. However, our findings provide novel evidence that, during HFD-induced obesity, IEC-IR contributes to increases in EEC, plasma cholesterol, and increased expression of Scarb1 or IESC-, EEC-, and Paneth cell-derived mRNAs.
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Affiliation(s)
- Sarah F. Andres
- 1Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - M. Agostina Santoro
- 1Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Amanda T. Mah
- 2Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - J. Adeola Keku
- 1Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Amy E. Bortvedt
- 1Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - R. Eric Blue
- 1Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - P. Kay Lund
- 1Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
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28
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Aleksandrova K, Boeing H, Nöthlings U, Jenab M, Fedirko V, Kaaks R, Lukanova A, Trichopoulou A, Trichopoulos D, Boffetta P, Trepo E, Westhpal S, Duarte-Salles T, Stepien M, Overvad K, Tjønneland A, Halkjær J, Boutron-Ruault MC, Dossus L, Racine A, Lagiou P, Bamia C, Benetou V, Agnoli C, Palli D, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita B, Peeters PH, Gram IT, Lund E, Weiderpass E, Quirós JR, Agudo A, Sánchez MJ, Gavrila D, Barricarte A, Dorronsoro M, Ohlsson B, Lindkvist B, Johansson A, Sund M, Khaw KT, Wareham N, Travis RC, Riboli E, Pischon T. Inflammatory and metabolic biomarkers and risk of liver and biliary tract cancer. Hepatology 2014; 60:858-71. [PMID: 24443059 PMCID: PMC4231978 DOI: 10.1002/hep.27016] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 01/09/2014] [Accepted: 01/15/2014] [Indexed: 12/20/2022]
Abstract
UNLABELLED Obesity and associated metabolic disorders have been implicated in liver carcinogenesis; however, there are little data on the role of obesity-related biomarkers on liver cancer risk. We studied prospectively the association of inflammatory and metabolic biomarkers with risks of hepatocellular carcinoma (HCC), intrahepatic bile duct (IBD), and gallbladder and biliary tract cancers outside of the liver (GBTC) in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition. Over an average of 7.7 years, 296 participants developed HCC (n=125), GBTC (n=137), or IBD (n=34). Using risk-set sampling, controls were selected in a 2:1 ratio and matched for recruitment center, age, sex, fasting status, and time of blood collection. Baseline serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), C-peptide, total high-molecular-weight (HMW) adiponectin, leptin, fetuin-a, and glutamatdehydrogenase (GLDH) were measured, and incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. After adjustment for lifestyle factors, diabetes, hepatitis infection, and adiposity measures, higher concentrations of CRP, IL-6, C-peptide, and non-HMW adiponectin were associated with higher risk of HCC (IRR per doubling of concentrations=1.22; 95% CI=1.02-1.46; P=0.03; 1.90; 95% CI=1.30-2.77; P=0.001; 2.25; 95% CI=1.43-3.54; P=0.0005; and 2.09; 95% CI=1.19-3.67; P=0.01, respectively). CRP was associated also with risk of GBTC (IRR=1.22; 95% CI=1.05-1.42; P=0.01). GLDH was associated with risks of HCC (IRR=1.62; 95% CI=1.25-2.11; P=0.0003) and IBD (IRR=10.5; 95% CI=2.20-50.90; P=0.003). The continuous net reclassification index was 0.63 for CRP, IL-6, C-peptide, and non-HMW adiponectin and 0.46 for GLDH, indicating good predictive ability of these biomarkers. CONCLUSION Elevated levels of biomarkers of inflammation and hyperinsulinemia are associated with a higher risk of HCC, independent of obesity and established liver cancer risk factors.
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Affiliation(s)
- Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-RehbrückeNuthetal, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-RehbrückeNuthetal, Germany
| | - Ute Nöthlings
- Institute of Epidemiology, Christian-Albrechts University of KielKiel, Germany
- Nutritional Epidemiology Unit, Department of Nutritional and Food Science, Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms-Universität BonnBonn, Germany
| | - Mazda Jenab
- International Agency for Research on Cancer (IARC/World Health Organization [WHO])Lyon, France
| | - Veronika Fedirko
- International Agency for Research on Cancer (IARC/World Health Organization [WHO])Lyon, France
- Department of Epidemiology, Rollins School of Public Health, Emory UniversityAtlanta, GA
- Winship Cancer Institute, Emory UniversityAtlanta, GA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research CenterHeidelberg, Germany
| | - Annekatrin Lukanova
- Division of Cancer Epidemiology, German Cancer Research CenterHeidelberg, Germany
- Department of Medical Biosciences/Pathology, University of UmeåUmeå, Sweden
| | - Antonia Trichopoulou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical SchoolAthens, Greece
- Hellenic Health FoundationAthens, Greece
| | - Dimitrios Trichopoulos
- Hellenic Health FoundationAthens, Greece
- Department of Epidemiology, Harvard School of Public HealthBoston, MA
- Bureau of Epidemiologic Research, Academy of AthensAthens, Greece
| | - Paolo Boffetta
- Institute for Translational Epidemiology, Mount Sinai School of MedicineNew York, NY
| | | | - Sabine Westhpal
- Institute of Clinical Chemistry, Otto-von-Guericke-University MagdeburgMagdeburg, Germany
| | - Talita Duarte-Salles
- International Agency for Research on Cancer (IARC/World Health Organization [WHO])Lyon, France
| | - Magdalena Stepien
- International Agency for Research on Cancer (IARC/World Health Organization [WHO])Lyon, France
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus UniversityAarhus, Denmark
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research CenterCopenhagen, Denmark
| | - Jytte Halkjær
- Diet, Genes and Environment, Danish Cancer Society Research CenterCopenhagen, Denmark
| | - Marie-Christine Boutron-Ruault
- Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health TeamVillejuif, France
- Université Paris SudUMRS 1018, Villejuif, France
- Institut Gustave RoussyVillejuif, France
| | - Laure Dossus
- Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health TeamVillejuif, France
- Université Paris SudUMRS 1018, Villejuif, France
- Institut Gustave RoussyVillejuif, France
| | - Antoine Racine
- Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health TeamVillejuif, France
- Université Paris SudUMRS 1018, Villejuif, France
- Institut Gustave RoussyVillejuif, France
| | - Pagona Lagiou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical SchoolAthens, Greece
- Department of Epidemiology, Harvard School of Public HealthBoston, MA
- Bureau of Epidemiologic Research, Academy of AthensAthens, Greece
| | - Christina Bamia
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical SchoolAthens, Greece
- Hellenic Health FoundationAthens, Greece
| | - Vassiliki Benetou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical SchoolAthens, Greece
- Hellenic Health FoundationAthens, Greece
| | - Claudia Agnoli
- Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale TumoriMilano, Italy
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO)Florence, Italy
| | - Salvatore Panico
- Department of Clinical and Experimental Medicine, Federico II UniversityNaples, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, “M.P. Arezzo” HospitalRagusa, Italy
| | - Paolo Vineis
- HuGeF FoundationTurin, Italy
- Division of Epidemiology, Public Health and Primary Care, Imperial CollegeLondon, UK
| | - Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM)Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology, University Medical CenterUtrecht, the Netherlands
| | - Petra H Peeters
- Division of Epidemiology, Public Health and Primary Care, Imperial CollegeLondon, UK
- Julius Center for Health Sciences and Primary Care, University Medical CenterUtrecht, the Netherlands
| | - Inger Torhild Gram
- Department of Community Medicine, Faculty of Health Sciences, University of TromsøTromsø, Norway
| | - Eiliv Lund
- Department of Community Medicine, Faculty of Health Sciences, University of TromsøTromsø, Norway
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of TromsøTromsø, Norway
- Department of Research, Cancer Registry of NorwayOslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetStockholm, Sweden
- Samfundet FolkhälsanHelsinki, Finland
| | | | - Antonio Agudo
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of OncologyBarcelona, Spain
| | - María-José Sánchez
- Andalusian School of Public HealthGranada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)Madrid, Spain
| | - Diana Gavrila
- Servicio de Epidemiología, Department of Epidemiology, Consejería de Sanidad y Politica SocialMurcia, Spain
- Navarre Public Health InstitutePamplona, Spain
| | - Aurelio Barricarte
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)Madrid, Spain
- Navarre Public Health InstitutePamplona, Spain
| | - Miren Dorronsoro
- Public Health Direction, Basque Regional Health Department and BioDonostia Research Institute-CIBERESPSan Sebastian, Spain
| | - Bodil Ohlsson
- Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Lund UniversityMalmö, Sweden
| | - Björn Lindkvist
- Institute of Medicine, Sahlgrenska Academy, University of GothenburgGothenburg, Sweden
| | - Anders Johansson
- Department of Odontology/Public Health and Clinical Medicine, Umeå UniversityUmeå, Sweden
| | - Malin Sund
- Department of Surgical and Perioperative Sciences, Surgery and Public Health, Nutrition Research, Umea UniversityUmea, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of CambridgeCambridge, UK
| | - Nicholas Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's HospitalCambridge, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of OxfordOxford, UK
| | - Elio Riboli
- Division of Epidemiology, Public Health and Primary Care, Imperial CollegeLondon, UK
| | - Tobias Pischon
- Molecular Epidemiology Group, Max Delbrück Center for Molecular Medicine Berlin-BuchBerlin-Buch, Germany
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May FE. Novel drugs that target the estrogen-related receptor alpha: their therapeutic potential in breast cancer. Cancer Manag Res 2014; 6:225-52. [PMID: 24904222 PMCID: PMC4041375 DOI: 10.2147/cmar.s35024] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
THE INCIDENCE OF BREAST CANCER CONTINUES TO RISE 1.7 million women were diagnosed with and 521,000 women died from breast cancer in 2012. This review considers first current treatment options: surgery; radiotherapy; and systemic endocrine, anti-biological, and cytotoxic therapies. Clinical management includes prevention, early detection by screening, treatment with curative intent, management of chronic disease, and palliative control of advanced breast cancer. Next, the potential of novel drugs that target DNA repair, growth factor dependence, intracellular and intercellular signal transduction, and cell cycle are considered. Estrogen-related receptor alpha has attracted attention as a therapeutic target in triple-negative breast cancers with de novo resistance to, and in breast cancers with acquired resistance to, endocrine therapies such as antiestrogens and aromatase inhibitors. Estrogen-related receptor alpha is an orphan receptor and transcription factor. Its activity is regulated by coregulator proteins and posttranslational modification. It is an energy sensor that controls adaptation to energy demand and may facilitate glycolytic metabolism and mitochondrial oxidative respiration in breast cancer cells. Estrogen-related receptor alpha increases breast cancer cell migration, proliferation, and tumor development. It is expressed at high levels in estrogen receptor-negative tumors, and is proposed to activate estrogen-responsive genes in endocrine-resistant tumors. The structures and functions of the ligand-binding domains of estrogen receptor alpha and estrogen-related receptor alpha, their ability to bind estrogens, phytoestrogens, and synthetic ligands, and the effects of ligand agonists, antagonists, and inverse agonists on biological activity, are evaluated. Synthetic ligands of estrogen-related receptor alpha have activity in preclinical models of metabolic disorders, diabetes, osteoporosis, and oncology. The clinical settings in which these novel drugs might have utility in the management of advanced breast cancer, and biomarkers for stratification of patients likely to benefit, are discussed. Finally, the potential side effects of the novel drugs on metabolism, osteoporosis, osteo-metastasis, and cachexia are considered.
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Affiliation(s)
- Felicity Eb May
- Northern Institute for Cancer Research and Department of Pathology, Faculty of Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
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30
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Catsburg C, Gunter MJ, Chen C, Cote ML, Kabat GC, Nassir R, Tinker L, Wactawski-Wende J, Page DL, Rohan TE. Insulin, estrogen, inflammatory markers, and risk of benign proliferative breast disease. Cancer Res 2014; 74:3248-58. [PMID: 24755474 DOI: 10.1158/0008-5472.can-13-3514] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Women with benign proliferative breast disease (BPBD) are at increased risk for developing breast cancer. Evidence suggests that accumulation of adipose tissue can influence breast cancer development via hyperinsulinemia, increased estrogen, and/or inflammation. However, there are limited data investigating these pathways with respect to risk of BPBD. We evaluated serologic markers from these pathways in a case-control study of postmenopausal women nested within the Women's Health Initiative Clinical Trial. Cases were the 667 women who developed BPBD during follow-up, and they were matched to 1,321 controls. Levels of insulin, estradiol, C-reactive protein (CRP), and adiponectin were measured in fasting serum collected at baseline. Conditional logistic regression models were used to estimate ORs for the association of each factor with BPBD risk. Among nonusers of hormone therapy, fasting serum insulin was associated with a statistically significant increase in risk of BPBD (OR for highest vs. lowest quartile = 1.80; 95% confidence interval, CI, 1.16-2.79; Ptrend = 0.003) as were levels of estradiol (OR for highest vs. lowest tertile = 1.89; 95% CI, 1.26-2.83; Ptrend = 0.02) and CRP (OR for highest vs. lowest quartile = 2.46; 95% CI, 1.59-3.80; Ptrend < 0.001). Baseline adiponectin level was inversely associated with BPBD risk (OR for highest vs. lowest quartile = 0.47; 95% CI, 0.31-0.71; Ptrend < 0.001). These associations persisted after mutual adjustment, but were not observed among users of either estrogen alone or of estrogen plus progestin hormone therapy. Our results indicate that serum levels of estrogen, insulin, CRP, and adiponectin are independent risk factors for BPBD and suggest that the estrogen, insulin, and inflammation pathways are associated with the early stages of breast cancer development.
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Affiliation(s)
- Chelsea Catsburg
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Marc J Gunter
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Chu Chen
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Michele L Cote
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Geoffrey C Kabat
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Rami Nassir
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Lesley Tinker
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Jean Wactawski-Wende
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - David L Page
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Thomas E Rohan
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
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Abstract
p21-Activated protein kinases (PAKs) are centrally involved in a plethora of cellular processes and functions. Their function as effectors of small GTPases Rac1 and Cdc42 has been extensively studied during the past two decades, particularly in the realms of cell proliferation, apoptosis, and hence tumorigenesis, as well as cytoskeletal remodeling and related cellular events in health and disease. In recent years, a large number of studies have shed light onto the fundamental role of group I PAKs, most notably PAK1, in metabolic homeostasis. In skeletal muscle, PAK1 was shown to mediate the function of insulin on stimulating GLUT4 translocation and glucose uptake, while in pancreatic β-cells, PAK1 participates in insulin granule localization and vesicle release. Furthermore, we demonstrated that PAK1 mediates the cross talk between insulin and Wnt/β-catenin signaling pathways and hence regulates gut proglucagon gene expression and the production of the incretin hormone glucagon-like peptide-1 (GLP-1). The utilization of chemical inhibitors of PAK and the characterization of Pak1(-/-) mice enabled us to gain mechanistic insights as well as to assess the overall contribution of PAKs in metabolic homeostasis. This review summarizes our current understanding of PAKs, with an emphasis on the emerging roles of PAK1 in glucose homeostasis.
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Abdullah N, Attia J, Oldmeadow C, Scott RJ, Holliday EG. The architecture of risk for type 2 diabetes: understanding Asia in the context of global findings. Int J Endocrinol 2014; 2014:593982. [PMID: 24744783 PMCID: PMC3976842 DOI: 10.1155/2014/593982] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 01/30/2014] [Indexed: 02/07/2023] Open
Abstract
The prevalence of Type 2 diabetes is rising rapidly in both developed and developing countries. Asia is developing as the epicentre of the escalating pandemic, reflecting rapid transitions in demography, migration, diet, and lifestyle patterns. The effective management of Type 2 diabetes in Asia may be complicated by differences in prevalence, risk factor profiles, genetic risk allele frequencies, and gene-environment interactions between different Asian countries, and between Asian and other continental populations. To reduce the worldwide burden of T2D, it will be important to understand the architecture of T2D susceptibility both within and between populations. This review will provide an overview of known genetic and nongenetic risk factors for T2D, placing the results from Asian studies in the context of broader global research. Given recent evidence from large-scale genetic studies of T2D, we place special emphasis on emerging knowledge about the genetic architecture of T2D and the potential contribution of genetic effects to population differences in risk.
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Affiliation(s)
- Noraidatulakma Abdullah
- School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, NSW 2308, Australia
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - John Attia
- Clinical Research Design, IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, NSW 2305, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, NSW 2305, Australia
| | - Rodney J. Scott
- School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, NSW 2308, Australia
- Hunter Area Pathology Service, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Elizabeth G. Holliday
- Clinical Research Design, IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, NSW 2305, Australia
- *Elizabeth G. Holliday:
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Paula AA, Falcão MCN, Pacheco AG. Metabolic syndrome in HIV-infected individuals: underlying mechanisms and epidemiological aspects. AIDS Res Ther 2013; 10:32. [PMID: 24330597 PMCID: PMC3874610 DOI: 10.1186/1742-6405-10-32] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 11/26/2013] [Indexed: 01/09/2023] Open
Abstract
The success of highly active antiretroviral therapy (HAART) has determined a dramatic decline in AIDS- and immunodeficiency-related causes of death in the HIV-infected population. As life-expectancy increases, such individuals have become gradually exposed not only to the effects of aging itself, but also to the influence of environmental risk factors, which are known to act in the general population. These features can lead to obesity, diabetes mellitus and ultimately cardiovascular diseases (CVD). Metabolic complications and abnormal fat distribution were frequently observed after a few years of antiretroviral therapy and, as the array of antiretroviral drugs became broader, long term metabolic alterations are becoming far more common worldwide. Nevertheless, the risk of not being on HAART is overwhelmingly greater than the metabolic adverse events in terms of morbidity and mortality events. HIV/HAART-induced metabolic unbalances overlap in some extent the components of Metabolic Syndrome (MetS) and its high rates in the HIV population place infected individuals in an elevated CVD risk category. MetS can explain at least in part the emergence of CVD as the major morbidity and mortality conditions in the HIV population. In this review we convey information on the underlying aspects of MetS during HIV infection, highlighting some physiopathological and epidemiological features of this comorbidity along with the role played by HIV itself and the synergy action of some antiretroviral drugs. Considerations on MetS management in the HIV population are also depicted.
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