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Gong J, Kim DM, Freeman MR, Kim H, Ellis L, Smith B, Theodorescu D, Posadas E, Figlin R, Bhowmick N, Freedland SJ. Genetic and biological drivers of prostate cancer disparities in Black men. Nat Rev Urol 2024; 21:274-289. [PMID: 37964070 DOI: 10.1038/s41585-023-00828-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/16/2023]
Abstract
Black men with prostate cancer have historically had worse outcomes than white men with prostate cancer. The causes of this disparity in outcomes are multi-factorial, but a potential basis is that prostate cancers in Black men are biologically distinct from prostate cancers in white men. Evidence suggests that genetic and ancestral factors, molecular pathways involving androgen and non-androgen receptor signalling, inflammation, epigenetics, the tumour microenvironment and tumour metabolism are contributing factors to the racial disparities observed. Key genetic and molecular pathways linked to prostate cancer risk and aggressiveness have potential clinical relevance. Describing biological drivers of prostate cancer disparities could inform efforts to improve outcomes for Black men with prostate cancer.
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Affiliation(s)
- Jun Gong
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Daniel M Kim
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Michael R Freeman
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hyung Kim
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Leigh Ellis
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bethany Smith
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dan Theodorescu
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Edwin Posadas
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Robert Figlin
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Neil Bhowmick
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Stephen J Freedland
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Section of Urology, Durham VA Medical Center, Durham, NC, USA
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2
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Garcia J, Krieger KD, Loitz C, Perez LM, Richards ZA, Helou Y, Kregel S, Celada S, Mesaros CA, Bosland M, Gann PH, Willnow TE, Vander Griend D, Kittles R, Prins GS, Penning T, Nonn L. Regulation of Prostate Androgens by Megalin and 25-hydroxyvitamin D Status: Mechanism for High Prostate Androgens in African American Men. CANCER RESEARCH COMMUNICATIONS 2023; 3:371-382. [PMID: 36875158 PMCID: PMC9983358 DOI: 10.1158/2767-9764.crc-22-0362] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/03/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023]
Abstract
Vitamin D deficiency is associated with an increased risk of prostate cancer mortality and is hypothesized to contribute to prostate cancer aggressiveness and disparities in African American populations. The prostate epithelium was recently shown to express megalin, an endocytic receptor that internalizes circulating globulin-bound hormones, which suggests regulation of intracellular prostate hormone levels. This contrasts with passive diffusion of hormones that is posited by the free hormone hypothesis. Here, we demonstrate that megalin imports testosterone bound to sex hormone-binding globulin into prostate cells. Prostatic loss of Lrp2 (megalin) in a mouse model resulted in reduced prostate testosterone and dihydrotestosterone levels. Megalin expression was regulated and suppressed by 25-hydroxyvitamin D (25D) in cell lines, patient-derived prostate epithelial cells, and prostate tissue explants. In patients, the relationships between hormones support this regulatory mechanism, as prostatic DHT levels are higher in African American men and are inversely correlated with serum 25D status. Megalin levels are reduced in localized prostate cancer by Gleason grade. Our findings suggest that the free hormone hypothesis should be revisited for testosterone and highlight the impact of vitamin D deficiency on prostate androgen levels, which is a known driver of prostate cancer. Thus, we revealed a mechanistic link between vitamin D and prostate cancer disparities observed in African Americans. Significance These findings link vitamin D deficiency and the megalin protein to increased levels of prostate androgens, which may underpin the disparity in lethal prostate cancer in African America men.
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Affiliation(s)
- Jason Garcia
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Kirsten D. Krieger
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Candice Loitz
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Lillian M. Perez
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
- University of Illinois Cancer Center, Chicago, Illinois
| | - Zachary A. Richards
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Yves Helou
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Steve Kregel
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Sasha Celada
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Clementina A. Mesaros
- Department of Systems Pharmacology & Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maarten Bosland
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
- University of Illinois Cancer Center, Chicago, Illinois
| | - Peter H. Gann
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
- University of Illinois Cancer Center, Chicago, Illinois
| | | | - Donald Vander Griend
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
- University of Illinois Cancer Center, Chicago, Illinois
| | - Rick Kittles
- Department of Population Sciences, City of Hope, Duarte, California
| | - Gail S. Prins
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
- University of Illinois Cancer Center, Chicago, Illinois
- Departments of Urology, Physiology and Biophysics, University of Illinois at Chicago, Chicago, Illinois
| | - Trevor Penning
- Department of Systems Pharmacology & Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Larisa Nonn
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
- University of Illinois Cancer Center, Chicago, Illinois
- Corresponding Author: Larisa Nonn, University of Illinois at Chicago, 130 CSN, MC 847, 840 S. Wood St, Chicago, IL 60612. Phone: 312-996-0194; E-mail:
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Hussain S, Yates C, Campbell MJ. Vitamin D and Systems Biology. Nutrients 2022; 14:5197. [PMID: 36558356 PMCID: PMC9782494 DOI: 10.3390/nu14245197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The biological actions of the vitamin D receptor (VDR) have been investigated intensively for over 100 years and has led to the identification of significant insights into the repertoire of its biological actions. These were initially established to be centered on the regulation of calcium transport in the colon and deposition in bone. Beyond these well-known calcemic roles, other roles have emerged in the regulation of cell differentiation processes and have an impact on metabolism. The purpose of the current review is to consider where applying systems biology (SB) approaches may begin to generate a more precise understanding of where the VDR is, and is not, biologically impactful. Two SB approaches have been developed and begun to reveal insight into VDR biological functions. In a top-down SB approach genome-wide scale data are statistically analyzed, and from which a role for the VDR emerges in terms of being a hub in a biological network. Such approaches have confirmed significant roles, for example, in myeloid differentiation and the control of inflammation and innate immunity. In a bottom-up SB approach, current biological understanding is built into a kinetic model which is then applied to existing biological data to explain the function and identify unknown behavior. To date, this has not been applied to the VDR, but has to the related ERα and identified previously unknown mechanisms of control. One arena where applying top-down and bottom-up SB approaches may be informative is in the setting of prostate cancer health disparities.
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Affiliation(s)
- Shahid Hussain
- Division of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH 43210, USA
| | - Clayton Yates
- Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, AL 36088, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Oncology Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Moray J. Campbell
- Division of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH 43210, USA
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4
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Non-invasive prostate cancer screening using chemometric processing of macro and trace element concentration profiles in urine. Microchem J 2020. [DOI: 10.1016/j.microc.2020.105464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
The opportunity to prevent, to improve their prognosis, or even to cure uro-oncological diseases by modifying the lifestyle habits is a very modern topical subject and represents a great and fascinating challenge for the future. A PubMed and Web of Science databases search has been performed to review the published knowledge on most important lifestyle habits, such as smoking, physical activity, nutrition, sexual activity, and personal hygiene, highlighting modifiable factors influencing development and progression of urological cancers. Cigarette smoking has been historically established as risk factors for urothelial cancer, and an association with risk of renal cell carcinoma and worse prognosis of prostate cancer has been sufficiently demonstrated. Poor genital hygiene is a recognized risk factor for penile cancer. Furthermore, a convincing evidence has been found on the association between physical activity and both risk and prognosis of bladder and prostate cancer. Obesity is strongly associated with increased risk of developing lethal prostate cancer. An unequivocal evidence of a direct relationship between most of the other lifestyle habits and development of the uro-oncological diseases has not been found.
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Affiliation(s)
- Sacco Emilio
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Vaccarella Luigi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Bientinesi Riccardo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gandi Carlo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
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King Thomas J, Mir H, Kapur N, Singh S. Racial Differences in Immunological Landscape Modifiers Contributing to Disparity in Prostate Cancer. Cancers (Basel) 2019; 11:cancers11121857. [PMID: 31769418 PMCID: PMC6966521 DOI: 10.3390/cancers11121857] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022] Open
Abstract
Prostate cancer affects African Americans disproportionately by exhibiting greater incidence, rapid disease progression, and higher mortality when compared to their Caucasian counterparts. Additionally, standard treatment interventions do not achieve similar outcome in African Americans compared to Caucasian Americans, indicating differences in host factors contributing to racial disparity. African Americans have allelic variants and hyper-expression of genes that often lead to an immunosuppressive tumor microenvironment, possibly contributing to more aggressive tumors and poorer disease and therapeutic outcomes than Caucasians. In this review, we have discussed race-specific differences in external factors impacting internal milieu, which modify immunological topography as well as contribute to disparity in prostate cancer.
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Affiliation(s)
- Jeronay King Thomas
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA; (J.K.T.); (H.M.); (N.K.)
- Cancer Health Equity Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Hina Mir
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA; (J.K.T.); (H.M.); (N.K.)
- Cancer Health Equity Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Neeraj Kapur
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA; (J.K.T.); (H.M.); (N.K.)
- Cancer Health Equity Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Shailesh Singh
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA; (J.K.T.); (H.M.); (N.K.)
- Cancer Health Equity Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA
- Correspondence: ; Tel.: +1-404-756-5718; Fax: +1-404-752-1179
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7
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Ramakrishnan S, Steck SE, Arab L, Zhang H, Bensen JT, Fontham ETH, Johnson CS, Mohler JL, Smith GJ, Su LJ, Woloszynska A. Association among plasma 1,25(OH) 2 D, ratio of 1,25(OH) 2 D to 25(OH)D, and prostate cancer aggressiveness. Prostate 2019; 79:1117-1124. [PMID: 31077420 PMCID: PMC6593756 DOI: 10.1002/pros.23824] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/20/2019] [Accepted: 04/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND African-American (AA) men tend to present with more aggressive prostate cancer (Gleason score >7) than European-American (EA) men. Vitamin D and its metabolites are implicated in prostate cancer biology with vitamin D deficiency, indicated by its metabolite levels in serum or plasma, usually observed in AA men. OBJECTIVE To determine if 1, 25-dihydroxy vitamin D3 [1,25(OH)2 D] plasma levels in AA and EA prostate cancer patients alter the risk of having aggressive prostate cancer. DESIGN Research subjects from the North Carolina-Louisiana Prostate Cancer Project (AA n = 435 and EA n = 532) were included. Plasma metabolites 1,25(OH)2 D and 25-hydroxyvitamin D3 [25(OH)D] were measured using liquid chromatography with tandem mass spectrophotometry. Research subjects were classified into low (Gleason sum < 7, stage T1-T2, and Prostate-specific antigen (PSA) < 9 ng/mL) or high (Gleason sum > 8 or Gleason sum = 7 with 4 + 3, or PSA > 20 ng/mL, or Gleason sum = 7 and stage T3-T4) aggressive disease. RESULTS Research subjects in the second and third tertiles of plasma levels of 1, 25(OH)2 D had lower odds of high aggressive prostate cancer (AA [ORT2vsT1 : 0.66, 95%CI: 0.39-1.12; ORT3vsT1 : 0.83, 95%CI: 0.49-1.41] and EA [ORT2vsT1 : 0.68, 95%CI: 0.41-1.11; ORT3vsT1 : 0.67, 95%CI: 0.40-1.11]) compared with the first tertile, though confidence intervals included the null. Greater 1,25(OH)2 D/25(OH)D molar ratios were associated with lower odds of high aggressive prostate cancer more evidently in AA (ORQ4vsQ1 : 0.45, CI: 0.24-0.82) than in EA (ORQ4vsQ1 : 0.64, CI: 0.35-1.17) research subjects. CONCLUSIONS The 1,25(OH)2 D/25(OH)D molar ratio was associated with decreased risk of high aggressive prostate cancer in AA men, and possibly in EA men. Further studies analyzing vitamin D polymorphisms, vitamin D binding protein levels, and prostatic levels of these metabolites may be useful. These studies may provide a better understanding of the vitamin D pathway and its biological role underlying health disparities in prostate cancer.
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Affiliation(s)
- Swathi Ramakrishnan
- Department of Pharmacology and TherapeuticsRoswell Park Comprehensive Cancer CenterBuffaloNew York
| | - Susan E. Steck
- Department of Epidemiology and BiostatisticsArnold School of Public Health, University of South CarolinaColumbiaSouth Carolina
| | - Lenore Arab
- David Geffen School of MedicineUniversity of CaliforniaLos AngelesCalifornia
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental HealthUniversity of MemphisMemphisTennessee
| | - Jeannette T. Bensen
- Department of EpidemiologyGillings School of Global Public Health, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel HillChapel HillNorth Carolina
| | - Elizabeth T. H. Fontham
- School of Public HealthLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Candace S. Johnson
- Department of Pharmacology and TherapeuticsRoswell Park Comprehensive Cancer CenterBuffaloNew York
| | - James L. Mohler
- Department of UrologyRoswell Park Comprehensive Cancer CenterBuffaloNew York
| | - Gary J. Smith
- Department of UrologyRoswell Park Comprehensive Cancer CenterBuffaloNew York
| | - L. Joseph Su
- Winthrop P. Rockefeller Cancer Institute, Department of Epidemiology, Fay W. Boozman College of Public HealthUniversity of Arkansas for Medical SciencesLittle RockArkansas
| | - Anna Woloszynska
- Department of Pharmacology and TherapeuticsRoswell Park Comprehensive Cancer CenterBuffaloNew York
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8
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Baumann B, Lugli G, Gao S, Zenner M, Nonn L. High levels of PIWI-interacting RNAs are present in the small RNA landscape of prostate epithelium from vitamin D clinical trial specimens. Prostate 2019; 79:840-855. [PMID: 30905091 PMCID: PMC6593815 DOI: 10.1002/pros.23789] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 01/31/2019] [Accepted: 02/19/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Vitamin D, a hormone that acts through the nuclear vitamin D receptor (VDR), upregulates antitumorigenic microRNA in prostate epithelium. This may contribute to the lower levels of aggressive prostate cancer (PCa) observed in patients with high serum vitamin D. The small noncoding RNA (ncRNA) landscape includes many other RNA species that remain uncharacterized in prostate epithelium and their potential regulation by vitamin D is unknown. METHODS Laser capture microdissection (LCM) followed by small-RNA sequencing was used to identify ncRNAs in the prostate epithelium of tissues from a vitamin D-supplementation trial. VDR chromatin immunoprecipitation-sequencing was performed to identify vitamin D genomic targets in primary prostate epithelial cells. RESULTS Isolation of epithelium by LCM increased sample homogeneity and captured more diversity in ncRNA species compared with publicly available small-RNA sequencing data from benign whole prostate. An abundance of PIWI-interacting RNAs (piRNAs) was detected in normal prostate epithelium. The obligate binding partners of piRNAs, PIWI-like (PIWIL) proteins, were also detected in prostate epithelium. High prostatic vitamin D levels were associated with increased expression of piRNAs. VDR binding sites were located near several ncRNA biogenesis genes and genes regulating translation and differentiation. CONCLUSIONS Benign prostate epithelium expresses both piRNA and PIWIL proteins, suggesting that these small ncRNA may serve an unknown function in the prostate. Vitamin D may increase the expression of prostatic piRNAs. VDR binding sites in primary prostate epithelial cells are consistent with its reported antitumorigenic functions and a role in ncRNA biogenesis.
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Affiliation(s)
- Bethany Baumann
- Department of Pathology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinois
| | - Giovanni Lugli
- Department of Pathology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinois
| | - Shang Gao
- Department of BioengineeringUniversity of Illinois at ChicagoChicagoIllinois
| | - Morgan Zenner
- Department of Pathology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinois
| | - Larisa Nonn
- Department of Pathology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinois
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9
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Fleet JC, Kovalenko PL, Li Y, Smolinski J, Spees C, Yu JG, Thomas-Ahner JM, Cui M, Neme A, Carlberg C, Clinton SK. Vitamin D Signaling Suppresses Early Prostate Carcinogenesis in TgAPT 121 Mice. Cancer Prev Res (Phila) 2019; 12:343-356. [PMID: 31028080 DOI: 10.1158/1940-6207.capr-18-0401] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/03/2019] [Accepted: 04/22/2019] [Indexed: 12/14/2022]
Abstract
We tested whether lifelong modification of vitamin D signaling can alter the progression of early prostate carcinogenesis in studies using mice that develop high-grade prostatic intraepithelial neoplasia that is similar to humans. Two tissue-limited models showed that prostate vitamin D receptor (VDR) loss increased prostate carcinogenesis. In another study, we fed diets with three vitamin D3 levels (inadequate = 25 IU/kg diet, adequate for bone health = 150 IU/kg, or high = 1,000 IU/kg) and two calcium levels (adequate for bone health = 0.5% and high = 1.5%). Dietary vitamin D caused a dose-dependent increase in serum 25-hydroxyvitamin D levels and a reduction in the percentage of mice with adenocarcinoma but did not improve bone mass. In contrast, high calcium suppressed serum 1,25-dihydroxyvitamin D levels and improved bone mass but increased the incidence of adenocarcinoma. Analysis of the VDR cistrome in RWPE1 prostate epithelial cells revealed vitamin D-mediated regulation of multiple cancer-relevant pathways. Our data support the hypothesis that the loss of vitamin D signaling accelerates the early stages of prostate carcinogenesis, and our results suggest that different dietary requirements may be needed to support prostate health or maximize bone mass. SIGNIFICANCE: This work shows that disrupting vitamin D signaling through diet or genetic deletion increases early prostate carcinogenesis through multiple pathways. Higher-diet vitamin D levels are needed for cancer than bone.
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Affiliation(s)
- James C Fleet
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana. .,Purdue University Center for Cancer Research, Purdue University, West Lafayette, Indiana
| | - Pavlo L Kovalenko
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Yan Li
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Justin Smolinski
- Division of Medical Oncology, College of Medicine, Columbus, Ohio
| | - Colleen Spees
- Division of Medical Oncology, College of Medicine, Columbus, Ohio
| | - Jun-Ge Yu
- Division of Medical Oncology, College of Medicine, Columbus, Ohio
| | | | - Min Cui
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Antonio Neme
- Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas-Mérida, Universidad Nacional Autónoma de México, Yucatán, México
| | - Carsten Carlberg
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Steven K Clinton
- Division of Medical Oncology, College of Medicine, Columbus, Ohio.,The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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10
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Heath AK, Hodge AM, Ebeling PR, Eyles DW, Kvaskoff D, Buchanan DD, Giles GG, Williamson EJ, English DR. Circulating 25-Hydroxyvitamin D Concentration and Risk of Breast, Prostate, and Colorectal Cancers: The Melbourne Collaborative Cohort Study. Cancer Epidemiol Biomarkers Prev 2019; 28:900-908. [DOI: 10.1158/1055-9965.epi-18-1155] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/19/2018] [Accepted: 02/26/2019] [Indexed: 11/16/2022] Open
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11
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Rubicz R, Zhao S, Geybels M, Wright JL, Kolb S, Klotzle B, Bibikova M, Troyer D, Lance R, Ostrander EA, Feng Z, Fan JB, Stanford JL. DNA methylation profiles in African American prostate cancer patients in relation to disease progression. Genomics 2019; 111:10-16. [PMID: 26902887 PMCID: PMC4992660 DOI: 10.1016/j.ygeno.2016.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 12/02/2015] [Accepted: 02/18/2016] [Indexed: 12/25/2022]
Abstract
This study examined whether differential DNA methylation is associated with clinical features of more aggressive disease at diagnosis and prostate cancer recurrence in African American men, who are more likely to die from prostate cancer than other populations. Tumor tissues from 76 African Americans diagnosed with prostate cancer who had radical prostatectomy as their primary treatment were profiled for epigenome-wide DNA methylation levels. Long-term follow-up identified 19 patients with prostate cancer recurrence. Twenty-three CpGs were differentially methylated (FDR q≤0.25, mean methylation difference≥0.10) in patients with vs. without recurrence, including CpGs in GCK, CDKL2, PRDM13, and ZFR2. Methylation differences were also observed between men with metastatic-lethal prostate cancer vs. no recurrence (five CpGs), regional vs. local pathological stage (two CpGs), and higher vs. lower tumor aggressiveness (one CpG). These results indicate that differentially methylated CpG sites identified in tumor tissues of African American men may contribute to prostate cancer aggressiveness.
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Affiliation(s)
- Rohina Rubicz
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
| | - Shanshan Zhao
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States
| | - Milan Geybels
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Jonathan L Wright
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States; Department of Urology, University of Washington School of Medicine, Seattle, WA, United States
| | - Suzanne Kolb
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | | | | | - Dean Troyer
- Department of Pathology, Eastern Virginia Medical School, Norfolk, VA, United States; Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Raymond Lance
- Department of Urology, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Elaine A Ostrander
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD, United States
| | - Ziding Feng
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
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12
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Steck SE, Omofuma OO, Su LJ, Maise AA, Woloszynska-Read A, Johnson CS, Zhang H, Bensen JT, Fontham ETH, Mohler JL, Arab L. Calcium, magnesium, and whole-milk intakes and high-aggressive prostate cancer in the North Carolina–Louisiana Prostate Cancer Project (PCaP). Am J Clin Nutr 2018; 107:799-807. [DOI: 10.1093/ajcn/nqy037] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/07/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Omonefe O Omofuma
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - L Joseph Su
- Winthrop P Rockefeller Cancer Institute, Department of Epidemiology, Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Amanda A Maise
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
- Community Care Behavioral Health, University of Pittsburgh Medical Center Insurance Services Division, Pittsburgh, PA
| | | | | | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Elizabeth T H Fontham
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Lenore Arab
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
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Mondul AM, Weinstein SJ, Layne TM, Albanes D. Vitamin D and Cancer Risk and Mortality: State of the Science, Gaps, and Challenges. Epidemiol Rev 2018; 39:28-48. [PMID: 28486651 DOI: 10.1093/epirev/mxx005] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/19/2017] [Indexed: 12/31/2022] Open
Abstract
There has been substantial enthusiasm recently regarding the potential role of vitamin D in the primary and secondary prevention of cancer. Laboratory studies demonstrate a range of anticarcinogenic effects for vitamin D compounds, but human studies have yielded little consistent evidence supporting a protective association. Higher circulating levels of vitamin D (i.e., 25-hydroxyvitamin D or 25(OH)D) appear to be associated with reduced risk of colorectal and bladder malignancies, but higher risk of prostate and possibly pancreatic cancers, with no clear association for most other organ sites examined. Despite there being no official institutional recommendations regarding the use of vitamin D supplements for cancer prevention, screenings for vitamin D deficiency and vitamin D supplement use have increased substantially over the past decade. These widespread practices demonstrate that population sociobehavioral changes are often adopted before scientifically well-informed policies and recommendations are available. This review critically examines the currently available epidemiologic literature regarding the associations between circulating 25(OH)D, vitamin D supplementation, and vitamin D-related genetic variation and cancer risk and mortality, with a particular emphasis on prospective studies. We identify several important gaps in our scientific knowledge that should be addressed in order to provide sufficient reproducible data to inform evidence-based recommendations related to optimal 25(OH)D concentrations (and any role for vitamin D supplementation) for the primary and secondary prevention of cancer. With few exceptions, such recommendations cannot be made at this time.
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14
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Gao J, Wei W, Wang G, Zhou H, Fu Y, Liu N. Circulating vitamin D concentration and risk of prostate cancer: a dose-response meta-analysis of prospective studies. Ther Clin Risk Manag 2018; 14:95-104. [PMID: 29386901 PMCID: PMC5767091 DOI: 10.2147/tcrm.s149325] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Though many studies have been performed to elucidate the association between circulating vitamin D and prostate cancer, no conclusive result is available. We carried out a dose-response meta-analysis to quantitatively examine the association of circulating 25-hydroxyvitamin D (25[OH]D) concentration with prostate cancer. Methods Only prospective studies examining the associations of circulating 25[OH]D concentration with prostate cancer were eligible for the meta-analysis. A random-effect meta-analysis was done first, to calculate the summary relative risk (RR) and 95% confidence intervals (CIs) comparing the higher concentration with the lower concentration of 25[OH]D. A dose-response meta-analysis using random-effects model was then carried out to evaluate the nonlinearity and calculate the summary RR caused per 10 ng/mL increment. Results Nineteen prospective cohort or nested case-control studies were included. Higher 25[OH]D concentration was significantly correlated with elevated risk of prostate cancer (RR =1.15, 95% CI 1.06-1.24). No nonlinear relationship was found between 25[OH]D concentration and risk of prostate cancer (P=0.654). Dose-response meta-analysis showed that the summary RR caused per 10 ng/mL increment in circulating 25[OH]D concentration was 1.04 (95% CI 1.02-1.06). Subgroup analysis also found a modest dose-response relationship. Funnel plot and Egger's test did not detect publication bias. Conclusion The findings suggest that highest 25[OH]D concentration is correlated with elevated risk of prostate cancer and a modest dose-response effect exists in this association; however, more studies are needed.
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Affiliation(s)
- Jialin Gao
- Department of Urology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Wei Wei
- Department of Urology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Gang Wang
- Department of Urology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Honglan Zhou
- Department of Urology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Yaowen Fu
- Department of Urology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Nian Liu
- Department of Urology, The First Hospital of Jilin University, Changchun, People's Republic of China
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15
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Lin PH, Aronson W, Freedland SJ. An update of research evidence on nutrition and prostate cancer. Urol Oncol 2017; 37:387-401. [PMID: 29103966 DOI: 10.1016/j.urolonc.2017.10.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 09/15/2017] [Accepted: 10/06/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Prostate cancer (PCa) remains a leading cause of mortality in US and other countries. Preclinical and clinical studies have examined the role of nutrition and dietary intake on the incidence and progression of PCa with mixed results. OBJECTIVE The objective of this chapter is to provide an update of recent published literature and highlight progress in the field. MAIN FINDINGS Low carbohydrate intake, soy protein, ω3 fat, green teas, tomatoes and tomato products and the herbal mixture-zyflamend showed promise in reducing PCa risk or progression. On the contrary, a higher animal fat intake and a higher β-carotene status may increase risk. A "U" shape relationship may exist between folate, vitamin C, vitamin D and calcium with PCa risk. Conclusion Despite the inconclusive findings, the potential for a role of dietary intake for the prevention and treatment of PCa remains promising. Maintaining a healthy body weight and following a healthy dietary pattern including antioxidant rich fruits and vegetables, reduced animal fat and refined carbohydrates, should be encouraged. CONCLUSION Despite the inconclusive findings, the potential for a role of dietary intake for the prevention and treatment of PCa remains promising. Maintaining a healthy body weight and following a healthy dietary pattern including antioxidant rich fruits and vegetables, reduced animal fat and refined carbohydrates, should be encouraged.
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Affiliation(s)
- Pao-Hwa Lin
- Department of Medicine, Duke University Medical Center, Durham, NC.
| | - William Aronson
- Urology Section, Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Urology, UCLA School of Medicine, Los Angeles, CA
| | - Stephen J Freedland
- Department of Surgery, Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA; Section of Urology, Department of Surgery, Durham Veterans Affairs Medical Center, Durham, NC
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16
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Layne TM, Weinstein SJ, Graubard BI, Ma X, Mayne ST, Albanes D. Serum 25-hydroxyvitamin D, vitamin D binding protein, and prostate cancer risk in black men. Cancer 2017; 123:2698-2704. [PMID: 28369777 DOI: 10.1002/cncr.30634] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/22/2017] [Accepted: 01/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Few studies have prospectively examined the relationship between vitamin D status and prostate cancer risk in black men, a group at high risk for both low vitamin D status and prostate cancer. METHODS Among black men in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, we identified 226 prostate cancer cases and 452 controls matched on age at randomization (±5 years), date of blood draw (±30 days), calendar year of cohort entry, and time since baseline prostate cancer screening (±1 year). Conditional logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between serum 25-hydroxyvitamin D [25(OH)D], vitamin D binding protein (DBP), the 25(OH)D:DBP molar ratio, and prostate cancer risk. RESULTS Serum 25(OH)D was not associated with overall prostate cancer (Q4 vs Q1: OR, 0.73; 95% CI, 0.40-1.33; P for trend = .25), although there were apparent inverse associations for nonaggressive disease (global P = .03, clinical stage I/II, and Gleason score <7) and among men ≥62 years old (P for interaction = .04) that were restricted to Q3. Interestingly, serum DBP was significantly inversely associated with prostate cancer risk (Q4 vs Q1: OR, 0.45; 95% CI, 0.20-1.00; P for trend = .03), whereas the 25(OH)D:DBP molar ratio was not. Results were similar when we mutually adjusted for 25(OH)D and DBP, and we found no evidence of interaction between the two. CONCLUSION Our study suggests higher (versus lower) circulating DBP may be independently associated with a decreased prostate cancer risk in black men independent of 25(OH)D status. Cancer 2017;123:2698-704. © 2017 American Cancer Society.
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Affiliation(s)
- Tracy M Layne
- Chronic Disease Epidemiology Department, Yale School of Public Health, New Haven, Connecticut.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Barry I Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Xiaomei Ma
- Chronic Disease Epidemiology Department, Yale School of Public Health, New Haven, Connecticut.,Yale Comprehensive Cancer Center, Yale University, New Haven, Connecticut
| | - Susan T Mayne
- Chronic Disease Epidemiology Department, Yale School of Public Health, New Haven, Connecticut.,Yale Comprehensive Cancer Center, Yale University, New Haven, Connecticut
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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17
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Richards Z, Batai K, Farhat R, Shah E, Makowski A, Gann PH, Kittles R, Nonn L. Prostatic compensation of the vitamin D axis in African American men. JCI Insight 2017; 2:e91054. [PMID: 28138564 DOI: 10.1172/jci.insight.91054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND. African American (AA) men are disproportionately affected by both prostate cancer (PCa) and vitamin D deficiency compared with European American (EA) men. Vitamin D deficiency is linked to increased PCa aggressiveness and mortality. Therefore, it has been hypothesized that vitamin D deficiency may contribute to the PCa disparity between AA and EA men. METHODS. We studied a cross sectional group of 60 PCa patients (AA, n = 31; EA, n = 29) who underwent radical prostatectomy. Vitamin D metabolites 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured in the serum and tissue by uHPLC-MS-MS. Tissue was laser capture microdissected, and gene expression was quantified by microarray. DNA isolated from whole blood was genotyped for West African ancestry markers and vitamin D-related SNPs. RESULTS. Serum concentrations of 25(OH)D were lower in AAs, but concentrations of 1,25(OH)2D in the prostate tissue were higher compared with EAs. Expression of the vitamin D receptor was higher in prostate tissue from AAs. Expression of the extracellular receptor of vitamin D binding protein, LRP2, was positively associated with West African ancestry and inversely associated with tissue 25(OH)D concentrations in AAs. CONCLUSIONS. The relationships between vitamin D binding protein LRP2 and vitamin D metabolites suggest that the prohormone is actively transported into the prostate, followed by intraprostatic conversion to the active hormone, rather than passive diffusion. These findings support the presence of a compensatory response in prostate tissue to vitamin D deficiency in AAs and reveal a previously unknown complexity involving tissue distribution of vitamin D metabolites. FUNDING. Department of Defense Prostate Cancer Research Program Idea Award for Disparities Research PC121923 (LN and RK) and the NIH 1R01MD007105 (RK).
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Affiliation(s)
- Zachary Richards
- Department of Pathology, University of Illinois at Chicago (UIC), Chicago, Illinois, USA
| | - Ken Batai
- Division of Urology, Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Rachael Farhat
- Department of Pathology, University of Illinois at Chicago (UIC), Chicago, Illinois, USA
| | - Ebony Shah
- Division of Urology, Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA
| | | | - Peter H Gann
- Department of Pathology, University of Illinois at Chicago (UIC), Chicago, Illinois, USA
| | - Rick Kittles
- Division of Urology, Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Larisa Nonn
- Department of Pathology, University of Illinois at Chicago (UIC), Chicago, Illinois, USA.,University of Illinois Cancer Center, Chicago, Illinois, USA
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18
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Nelson SM, Batai K, Ahaghotu C, Agurs-Collins T, Kittles RA. Association between Serum 25-Hydroxy-Vitamin D and Aggressive Prostate Cancer in African American Men. Nutrients 2016; 9:nu9010012. [PMID: 28036013 PMCID: PMC5295056 DOI: 10.3390/nu9010012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/05/2016] [Accepted: 12/19/2016] [Indexed: 02/07/2023] Open
Abstract
African American men have higher incidence rates of aggressive prostate cancer, where high levels of calcium and serum vitamin D deficient levels play a role in the racial differences in incidence. In this study, we examined associations of serum vitamin D with aggressive prostate cancer to improve our understanding of higher susceptibility of aggressive disease in this racial cohort. From Howard University Hospital, 155 African American men with clinically-identified prostate cancer were identified; 46 aggressive cases, and 58 non-aggressive cases. Serum vitamin D was assessed from fasting blood samples, and total calcium intake was assessed using the Block Food Frequency Questionnaire. Vitamin D receptor polymorphisms from three different loci were genotyped; rs731236, rs1544410, and rs11568820. Multivariate logistic regression models were used to determine odds ratios (OR) and 95% confidence intervals (CI) comparing aggressive to non-aggressive prostate cancer. Vitamin D deficiency (<20 ng/mL) significantly increased risk of aggressive disease (OR: 3.1, 95% CI: 1.03–9.57, p-value = 0.04). Stratification by total calcium showed high calcium levels (≥800 mg/day) modified this association (OR: 7.3, 95% CI: 2.15–47.68, p-interaction = 0.03). Genetic variant rs11568820 appeared to increase the magnitude of association between deficient serum vitamin D and aggressive prostate cancer (OR: 3.64, 95% CI: 1.12–11.75, p-value = 0.05). These findings suggest that high incidence of aggressive prostate cancer risk in African American men may be due in-part to deficient levels of serum vitamin D. Other factors, including genetics, should be considered for future studies.
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Affiliation(s)
- Shakira M Nelson
- Cancer Prevention Fellow, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Room 6E402, Bethesda, MD 20892, USA.
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 6E402, Bethesda, MD 20892, USA.
| | - Ken Batai
- Division of Urology, Department of Surgery, The University of Arizona, Tucson, AZ 85721, USA.
| | - Chiledum Ahaghotu
- Chief Medical Officer, Carney Hospital-Steward Health Systems, Dorchester, MA 02124, USA.
| | - Tanya Agurs-Collins
- Health Behavior Research Branch, Division of Cancer Control and Population Studies, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA.
| | - Rick A Kittles
- Division of Urology, Department of Surgery, The University of Arizona, Tucson, AZ 85721, USA.
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19
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Anic GM, Albanes D, Rohrmann S, Kanarek N, Nelson WG, Bradwin G, Rifai N, McGlynn KA, Platz EA, Mondul AM. Association between serum 25-hydroxyvitamin D and serum sex steroid hormones among men in NHANES. Clin Endocrinol (Oxf) 2016; 85:258-66. [PMID: 26991691 PMCID: PMC4946966 DOI: 10.1111/cen.13062] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/11/2016] [Accepted: 03/06/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Recent literature suggests that high circulating vitamin D may increase prostate cancer risk. Although the mechanism through which vitamin D may increase risk is unknown, vitamin D concentration could influence circulating sex steroid hormones that may be associated with prostate cancer; an alternate explanation is that it could be associated with prostate-specific antigen (PSA) concentration causing detection bias. OBJECTIVE We examined whether serum vitamin D concentration was associated with sex steroid hormone and PSA concentrations in a cross-sectional analysis of men in the National Health and Nutrition Examination Surveys (NHANES). DESIGN Testosterone, oestradiol, sex hormone-binding globulin (SHBG), androstanediol glucuronide, and 25-hydroxyvitamin D (25(OH)D) were measured in serum from men aged 20 and older participating in NHANES III (n = 1315) and NHANES 2001-2004 (n = 318). Hormone concentrations were compared across 25(OH)D quintiles, adjusting for age, race/ethnicity, body fat percentage, and smoking. PSA concentration was estimated by 25(OH)D quintile in 4013 men from NHANES 2001-2006. RESULTS In NHANES III, higher testosterone (quintile (Q) 1 = 17·2, 95% confidence interval (CI) = 16·1-18·6; Q5 = 19·6, 95% CI = 18·7-20·6 nmol/l, P-trend = 0·0002) and SHBG (Q1 = 33·8, 95% CI = 30·8-37·0; Q5 = 38·4, 95% CI = 35·8-41·2 nmol/l, P-trend = 0·0005) were observed with increasing 25(OH)D. Similar results were observed in NHANES 2001-2004. PSA concentration was not associated with serum 25(OH)D (P-trend = 0·34). CONCLUSION Results from these nationally representative studies support a positive association between serum 25(OH)D and testosterone and SHBG. The findings support an indirect mechanism through which vitamin D may increase prostate cancer risk, and suggest the link to prostate cancer is not due to PSA-detection bias.
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Affiliation(s)
- Gabriella M Anic
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Norma Kanarek
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - William G Nelson
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gary Bradwin
- Department of Laboratory Medicine, Harvard Medical School and Children's Hospital, Boston, MA, USA
| | - Nader Rifai
- Department of Laboratory Medicine, Harvard Medical School and Children's Hospital, Boston, MA, USA
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Elizabeth A Platz
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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20
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Nyame YA, Murphy AB, Bowen DK, Jordan G, Batai K, Dixon M, Hollowell CMP, Kielb S, Meeks JJ, Gann PH, Macias V, Kajdacsy-Balla A, Catalona WJ, Kittles R. Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy. J Clin Oncol 2016; 34:1345-9. [PMID: 26903577 DOI: 10.1200/jco.2015.65.1463] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Lower serum vitamin D levels have been associated with an increased risk of aggressive prostate cancer. Among men with localized prostate cancer, especially with low- or intermediate-risk disease, vitamin D may serve as an important biomarker of disease aggression. The aim of this study was to assess the relationship between adverse pathology at the time of radical prostatectomy and serum 25-hydroxyvitamin D (25-OH D) levels. METHODS This cross-sectional study was carried out from 2009 to 2014, nested within a large epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer screening. In total, 190 men underwent radical prostatectomy in the cohort. Adverse pathology was defined as the presence of primary Gleason 4 or any Gleason 5 disease, or extraprostatic extension. Descriptive and multivariate analyses were performed to assess the relationship between 25-OH D and adverse pathology at the time of prostatectomy. RESULTS Eighty-seven men (45.8%) in this cohort demonstrated adverse pathology at radical prostatectomy. The median age in the cohort was 64.0 years (interquartile range, 59.0 to 67.0). On univariate analysis, men with adverse pathology at radical prostatectomy demonstrated lower median serum 25-OH D (22.7 v 27.0 ng/mL, P = .007) compared with their counterparts. On multivariate analysis, controlling for age, serum prostate specific antigen, and abnormal digital rectal examination, serum 25-OH D less than 30 ng/mL was associated with increased odds of adverse pathology (odds ratio, 2.64; 95% CI, 1.25 to 5.59; P = .01). CONCLUSION Insufficiency/deficiency of serum 25-OH D is associated with increased odds of adverse pathology in men with localized disease undergoing radical prostatectomy. Serum 25-OH D may serve as a useful biomarker in prostate cancer aggressiveness, which deserves continued study.
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Affiliation(s)
- Yaw A Nyame
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Adam B Murphy
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ.
| | - Diana K Bowen
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Gregory Jordan
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Ken Batai
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Michael Dixon
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Courtney M P Hollowell
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Stephanie Kielb
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Joshua J Meeks
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Peter H Gann
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Virgilia Macias
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Andre Kajdacsy-Balla
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - William J Catalona
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
| | - Rick Kittles
- Yaw A. Nyame, Cleveland Clinic, Cleveland, Ohio; Adam B. Murphy, Diana K. Bowen, Gregory Jordan, Michael Dixon, Stephanie Kielb, Joshua J. Meeks, and William J. Catalona, Northwestern University, Chicago; Courtney M.P. Hollowell, Cook County Health and Hospitals System; Peter H. Gann, Virgilia Macias, and Andre Kajdacsy-Balla, University of Illinois at Chicago, Chicago, IL; and Ken Batai and Rick Kittles, University of Arizona, Tucson, AZ
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