Multistage carcinogenesis in mouse skin

Cancer-protective factors are present in several fruits, vegetables and commonly used spices and herbs. They can be divided into several different groups, based on their chemical structure, e.g. polyphenols, thiols, carotenoids and retinoids, carbohydrates, trace metals, terpenes, tocopherols and degradation products of glucosinolates (i.e. isothiocyanates, indoles and dithiothiols) and others. Among each of these groups of compounds are substances, which may exert their cancer-protective action by more than one biochemical mechanism.



The biochemical processes of carcinogenesis are still not known in detail and probably varies with the cancer disease in question. Accordingly, the description of the biochemical backgrounds for the actions of cancer-protective factors must be based on a simplified model of the process of carcinogenesis. The model used in this presentation is a generalised initiation-promotion-conversion model, in which initiators are thought to be directly or indirectly genotoxic, promoters are visualised as substances capable of inferring a growth advantage on initiated cells and converters are believed to be genotoxic, e.g. mutagens, clastogens, recombinogens or the like.



Experimental evidence for the mechanisms of action of cancer-protective agents in fruits and vegetables that protect against initiation include the scavenging effects of polyphenols on activated mutagens and carcinogens, the quenching of singlet oxygen and radicals by carotenoids, the antioxidant effects of many compounds including ascorbic acid and polyphenols, the inhibition of activating enzymes by some flavonols and tannins, the induction of oxidation-and of conjugation (protective) enzymes by indoles, isothiocyanates and dithiothiones, the shielding of sensitive structures by some polyphenols and the stimulation of DNA-repair exerted by sulphur-containing compounds.



Mechanisms at the biochemical level in anti-promotion include the antioxidant effects of carotenoids and the membrane stabilizing effects reported with polyphenols, the inhibition of proteases caused by compounds from soybeans, the stimulation of immune responses seen with carotenoids and ascorbic acid and the inhibition of ornithine decarboxylase by polyphenols and carotenoids.



A few inhibitors of conversion have been identified experimentally, and it can be argued on a theoretical basis, that many inhibitors of initiation should also be efficient against conversion.



The mechanisms of anticarcinogenic substances in fruits and vegetables are discussed in the light of cancer prevention and inhibition.

Cancer‐Protective Factors in Fruits and Vegetables: Biochemical and Biological Background.

Retinoids play an important role in regulating the growth and differentiation of normal, premalignant and malignant cell types, especially epithelial cells, mainly through interaction with two types of nuclear receptors: retinoic acid receptors (RARalpha, beta and gamma) and retinoid X receptors (RXRalpha, beta and gamma). Vitamin A deficiency in experimental animals has been associated with a higher incidence of cancer and with increased susceptibility to chemical carcinogens. This is in agreement with the epidemiological studies indicating that individuals with a lower dietary vitamin A intake are at a higher risk to develop cancer. At the molecular level, aberrant expression and function of nuclear retinoid receptors have been found in various types of cancer including premalignant lesions. Thus, aberrations in retinoid signaling are early events in carcinogenesis. Retinoids at pharmacological doses exhibit a variety of effects associated with cancer prevention. They suppress transformation of cells in vitro, inhibit carcinogenesis in various organs in animal models, reduce premalignant human epithelial lesions and prevent second primary tumors following curative therapy for epithelial malignancies such as head and neck, lung, liver, and breast cancer.

Retinoids and their receptors in cancer development and chemoprevention.

In recent years, there has been an explosion of interest in the involvement of free radicals in carcinogenesis (1 -4) . This seems a natural outgrowth of the long overdue realization that free radicals are formed in biological systems and that they contribute significantly to physiological and pathological processes. Much of the emphasis of research linking free radicals and cancer has focused on intermediates of oxygen reduction such as superoxide anion and hydroxyl radical (2). There is another family of oxygencentered free radicals that have received less attention but may be just as important biologically as reduced oxygen intermediates. This Commentary is intended to familiarize the reader with some of the properties of peroxyl radicals and to explain how these species participate in reactions that are relevant to tumor initiation and promotion. Experimental data are presented that are intended to be provocative rather than definitive because this area of investigation is just beginning to evolve.

Peroxyl free radicals: potential mediators of tumor initiation and promotion

B[a]P (benzo[a]pyrene) has been used as a prototype carcinogenic PAH since its isolation from coal tar in the 1930's. One of its diol epoxides, BPDE-2, is considered its ultimate carcinogen on the basis of its binding to DNA, mutagenicity and extreme pulmonary carcinogenicity in newborn mice. However, BPDE-1 has a similar binding to DNA and mutagenicity but it is not carcinogenic. In addition, BPDE-2 is a weak carcinogen relative to B[a]P when repeatedly applied to mouse skin, the conventional assay site. Its carcinogenicity is increased when applied once as an initiator followed repeatedly by a promoter. This indicates a major role for promotion in carcinogenesis by PAHs. Promotion itself is a 2-stage process, the second of which is selective propagation of the initiated cells. Persistent hyperplasia underlies selection by promoters. The non-carcinogenicity of BPDE-1 has yet to be resolved. PAHs have long been considered the main carcinogens of cigarette smoke but their concentration in the condensate is far too low to account by themselves for the production of skin tumors. The phenolic fraction does however have strong promotional activity when repeatedly applied to initiated mouse skin. Several constituents of cigarette smoke are co-carcinogenic when applied simultaneously with repeated applications of PAHs. Catechol is co-carcinogenic at concentrations found in the condensate. Since cigarette smoking involves protracted exposure to all the smoke constituents, co-carcinogenesis simulates its effects. Both procedures, however, indicate a major role for selection in carcinogenesis by cigarette smoke. That selection may operate on endogenous mutations as well as those induced by PAHs. There are indications that the nicotine-derived NNK which is a specific pulmonary carcinogen in animals contributes to smoking-induced lung cancer in man. Lung adenoma development by inhalation has been induced in mice by the gas phase of cigarette smoke. The role of selection has not been evaluated in either of these cases.

Synergistic mechanisms in carcinogenesis by polycyclic aromatic hydrocarbons and by tobacco smoke: a bio-historical perspective with updates

Malignant progression of mouse skin papillomas treated with ethylnitrosourea, N-methyl-N'-nitro-N-nitrosoguanidine, or 12-O-tetradecanoylphorbol-13-acetate.

Retinoic acid has the ability to act as either a weak first stage promoter or a weak complete promoter in the initiation-promotion protocol for skin carcinogenesis in the SENCAR mouse. The retinoid analog RO-10-9359 lacks this tumor promoting activity. Both retinoids however inhibit 12-O-tetradecanoylphorbol-13-acetate (TPA) promotion. Additional comparisons revealed that retinoic acid alone can induce dark keratinocytes, a characteristic of tumor promoters, while RO-10-9359 cannot. Retinoic acid but not RO-10-9359 can induce an immediate chemiluminescence response in human polymorphonuclear cells. Both retinoids, however, inhibit a TPA-induced response. Since the chemiluminescence response is believed to be due to oxygen free radical generation, the data suggest that the ability of retinoic acid but not RO-10-9359 to promote tumors and induce dark cells may be due to initial oxidative reactions at the cell membrane.

The fust stage and complete promoting activity of retinoic acid but not the analog RO-10-9359

Repopulation of rat tracheas of human tracheobronchial epithelial cells obtained from intermediate autopsies was achieved by introducing into de-epithelialized rat tracheas either pieces of donor tissue containing respiratory mucosa or epithelial cells produced by an in vitro amplification of these cells. After tracheas were sealed, and transplanted into the subcutaneous tissues of nude mice, a newly formed epithelium migrated over the denuded luminal surface. During this process, regenerative epidermoid metaplasias, consisting of the growth of thin stratified epithelium with keratinization but without atypia was observed. Four weeks after xenotransplantation, most of the luminal surface was covered by columnar epithelium with occasional patches of epidermoid metaplasia. When this epithelium was exposed to 7,12-dimethylbenzo[a]anthracene (DMBA) a thick epidermoid metaplasia with mild to moderate atypia was observed. This type of epithelium is seen one to three months after insertion of the DMBA-containing pellets into the tracheal lumen. Immunohistochemical staining with antikeratin monoclonal antibodies AE1 and AE3 revealed increased immunostaining in both regenerative and DMBA-induced metaplasias compared with that of untreated normal mucociliary epithelium. Although no differences between the two types of metaplasias were detected with AE1 and AE3, the use of involucrin immunostain showed important differences. Normal respiratory epithelium did not contain involucrin, but this protein was seen in the surface layer of regenerative epidermoid metaplasias. In DMBA-induced metaplasias, involucrin was found not only in the superficial cells but was also present in numerous suprabasal cells. The hyperplastic nature of these carcinogen-induced lesions, together with the presence of cellular atypia and an altered involucrin distribution pattern, suggest a preneoplastic state.

A.J.P. Klein-Szanto

Papers

Malignant progression of mouse skin papillomas treated with ethylnitrosourea, N-methyl-N'-nitro-N-nitrosoguanidine, or 12-O-tetradecanoylphorbol-13-acetate.

The fust stage and complete promoting activity of retinoic acid but not the analog RO-10-9359

Epidermoid metaplasias of xenotransplanted human tracheobronchial epithelium.

Metastasis from squamous cell carcinomas of SENCAR mouse skin produced by complete carcinogenesis.

Retinoyl-phorbol-acetate is a complete skin tumor promoter in SENCAR mice.