Nitrates in drinking water and cancers of the colon and rectum: a meta-analysis of epidemiological studies

Backgroundsome recent studies have suggested that the risks of colon and rectal cancer increase with exposure to higher concentrations of nitrates in drinking water. This study is a meta-analysis of relevant studies.Methodsliterature published up to June 2021 was accessed and final results abstracted. Two cohort studies and seven case-control studies were analysed, and one case-control study not used because of limited data. Mixed effects meta-regression analysis was used to assess trends in colon cancer, rectal cancer, and colon cancer considered together, with nitrate concentrations in drinking water.ResultsThe usually accepted exposure upper limit for nitrates is 11.3 mg/l NO₃-N. However most studies assess a lower range, with only one study providing data over 8 mg/l. Colorectal cancer risk increased by 2.4% (95% limits 0.4–4.5%) per unit increase in nitrate concentration, over a range from very low values to mid-range values. Extrapolation to higher dosages has insufficient data. The trend for rectal cancer is less than that for colon cancer.ConclusionThe increase in colorectal cancer risk with increasing nitrate concentration is lower than in some recent studies, and applies only over a small range. Extrapolation of these results to higher nitrate levels is not warranted. The studies vary greatly in their design, the nitrate concentrations assessed, and in their results. This association is weak and inconsistent, and may be influenced by bias and confounding factors. Any association of drinking water nitrates with colorectal cancer risk is small, and is uncertain.     

Colorectal cancer and country of birth in New South Wales,Australia: All-of-population data for prioritising health service delivery and research

IntroductionCancer care and outcomes differ across cultural groups in Australia. Quantifying these differences facilitates prioritisation and targeting of services and research. All-of-population data are needed by health agencies to understand and fulfil their cancer-control responsibilities. Compiling these data can be challenging while maintaining privacy. We have used data linkage to gain population-wide colorectal cancer data on stage (degree of spread), treatment, and survival in New South Wales (NSW), Australia, by country of birth (COB), and consider service implications.MethodsWe studied colon and rectal cancers diagnosed in 2003–2016 and recorded on the NSW Cancer Registry (n = 41,575), plus linked hospital data and data from Australian Medical and Pharmaceutical Benefits payments, other treatment data and death records. Outcomes for 12 COB categories were analysed using multiple logistic and proportional hazards regression, with Australia as the reference category.ResultsCompared with Australian born, the adjusted odds ratio for distant spread of colon cancer was higher for people born in Lebanon and the United Kingdom. Treatment was less common for people born in China (surgery), Germany (systemic), Italy (surgery), New Zealand (any treatment) and Vietnam (all treatments), while treatment for rectal cancer was more common for people born in Italy (surgery), United Kingdom (radiotherapy, systemic therapy), and Vietnam (surgery), and less frequent for people born in China (radiotherapy). Adjusted 5-year survival was higher for people born in China, Italy, Vietnam, Greece (colon), Lebanon (colon) and other non-English speaking countries. More advanced stage was negatively related to having surgery and survival.ConclusionsThis study illustrates how linked data can enable comparisons of multiple outcomes for colorectal cancer by country of birth across an entire population. Results disclose “big picture” variations in population characteristics, stage, treatment and survival. This will enable better targeting and prioritisation of services and inform research priorities to address disparities.     

结直肠癌中HSP60和HSP27表达的免疫组织化学研究

目的1观察热休克蛋白60和热休克蛋白27在结直肠癌中的表达及意义。方法：收集结直肠癌80例,其中淋巴结转移40例（转移组）,无淋巴结转移40例（无转移组）;另外,在结直肠癌80例中,有结直肠腺瘤（腺瘤组）以及距肿块15cm以上的正常肠粘膜（对照组）各40例。应用免疫组织化学SP法检测组织中蛋白的表达。结果：HSP60的表达主要定位在癌细胞胞浆,在对照组、腺瘤组、非转移组、转移组中的表达阳性率分别为25％、30％、57．5％、90％,组间比较发现,对照组与转移组、腺瘤组与转移组、转移组与非转移组（x^2=10．912,P〈0．001）的HSP60阳性表达率存在统计学差异;而对照组与腺瘤和非转移组间以及腺瘤与非转移组间无统计学差异。HSP27的表达主要定位在癌细胞的胞浆,在对照组、腺瘤组、非转移组、转移组的表达阳性率分别为5％,35％,50％,90％,组间比较发现,对照组分别与无淋巴结转移组、淋巴结转移组;腺瘤组分别与转移组;非转移组与转移组间存在统计学差异,腺瘤与非转移组间无统计学差异。HSP60和HSP27表达间无统计学相关。结论：HSP27表达可能与结直肠癌发生和转移相关。而HSP60的表达可能在结直肠癌转移中具有重要意义。     

The NOTCH4-GATA4-IRG1 axis as a novel target in early-onset colorectal cancer

The early onset of colorectal cancer (CRC) in individuals younger than 50 years is an emerging phenomenon, and obesity is a strong risk factor. Inflammatory mechanisms are mediated by immune cells, with macrophages and their phenotypical changes playing a significant role in CRC. Obesity-related hormones, such as leptin and adiponectin, affect macrophage polarization and cytokine expression. Macrophage metabolism, and therefore polarization, directly affects tumor progression and survival in patients with CRC. Altered obesity-related hormone levels induce phosphoinositide kinase-3 (PI3K)/serine-threonine-protein kinase (AKT) activation in colon cancer, causing increased cell survival, hyperplasia, and proliferation. Investigating the effects of obesity-related mechanisms on PI3K/Akt signaling can provide new insights for targeting mechanisms in CRC and obesity among the young. Central molecules for the control of cell proliferation, differentiation, and tumorigenesis within the gastrointestinal tract include downstream targets of the PI3K/AKT pathway, such as Neurogenic locus notch homolog 4 (Notch4) and GATA binding proteins (GATA). Leptin and adiponectin both alter gene expression within this pathway, thereby affecting TAM-mediated CRC progression. Our goal is to introduce the NOTCH4-GATA4-IRG1 axis as a link between inflammation and sporadic CRC and to discuss this pathway as a new potential immunotherapeutic target in individuals affected with obesity and early-onset CRC.     

METTL3介导EZH2 m6A修饰在结直肠癌5-氟尿嘧啶耐药中的作用机制研究

摘要 目的：探讨甲基转移酶样蛋白3（METTL3）在5-氟尿嘧啶耐药中的作用机制。方法：大剂量间歇诱导法建立5-FU耐药细胞株。在耐药组细胞中分别敲减METTL3及EZH2抑制GSK343处理。qPCR及Western blot检测METTL3和EZH2表达。CCK-8检测各组细胞增殖情况。m6A甲基化RNA免疫沉淀技术分析EZH2 mRNA m6A修饰修饰情况。结果：各药物浓度处理下的耐药组细胞增殖活性与未处理细胞无显著差异（P>0.05）而原代细胞组肠癌细胞较未处理细胞在0.5-10 μg/mL处理下细胞增殖活性显著减低（P<0.01）。耐药组细胞与原代细胞组相比,METTL3及EZH2表达水平显著升高（P<0.01）。耐药组细胞METTL3敲减后或GSK343处理后,在0.5 μg/mL-10 μg/mL浓度间下的细胞增殖活性与0 μg/mL处理细胞增殖活性相比显著减低（P<0.05）。耐药组细胞METTL3敲减细胞的EZH2表达与对照细胞比,显著下调（P<0.01）。m6A甲基化RNA免疫沉淀实验显示耐药组细胞METTL3敲减细胞的EZH2 mRNA m6A修饰水平（m6A富集度为6361.95±67.47%）,较未敲减细胞修饰水平（396.30±57.74）显著减低（P<0.01）。结论：METTL3在肠癌细胞5-FU耐药抵抗中起到关键作用,靶向抑制METTL3有望成为缓解肠癌耐药的重要分子靶点。     

术前TFF1、HSP70、ASPH与原发性肝癌患者手术切除术后早期复发的关系研究

摘要 目的：研究术前三叶因子1（TFF1）、热休克蛋白70（HSP70）、天冬氨酸-天冬酰胺β羟化酶（ASPH）与原发性肝癌（PHC）患者手术切除术后早期复发的关系。方法：选取2018年1月～2019年12月我院收治的83例PHC患者,均行手术切除治疗,术后均随访2年,根据是否复发分为复发组49例以及未复发组34例。比较两组术前TFF1、HSP70、ASPH水平差异,收集患者基线资料,采用多因素Logistic回归分析PHC患者手术切除术后早期复发的危险因素,采用受试者工作特征（ROC）曲线分析术前TFF1、HSP70、ASPH水平预测PHC患者手术切除术后早期复发的效能。结果：复发组术前TFF1、HSP70、ASPH水平均高于未复发组（P＜0.05）。复发组肿瘤直径≥5 cm、肿瘤数目为多发、有血管侵犯的患者比例高于未复发组（P＜0.05）。多因素Logistic回归分析结果显示：肿瘤直径≥5 cm、多发肿瘤、血管侵犯及术前TFF1、HSP70、ASPH高水平是PHC患者手术切除术后早期复发的危险因素（均OR＞1,P＜0.05）。ROC曲线分析结果显示：术前TFF1、HSP70、ASPH联合检测预测PHC患者手术切除术后早期复发的曲线下面积为0.815,明显高于上述三项指标单独检测的0.704、0.713、0.707。结论：术前TFF1、HSP70、ASPH与PHC患者手术切除术后早期复发密切相关,联合检测三项指标水平可能有助于预测PHC患者手术切除术后早期复发。     

TRPC1 and ORAI1 channels in colon cancer

Colon cancer cells, like other types of cancer cells, undergo the remodeling of the intracellular Ca²⁺ homeostasis that contributes to cancer cell hallmarks including enhanced cell proliferation, migration, and survival. Colon cancer cells display enhanced store-operated Ca²⁺ entry (SOCE) compared with their non-cancer counterparts. Colon cancer cells display an abnormal expression of SOCE molecular players including Orai1 and TRPC1 channels, and the stromal interacting molecule (STIM) 1 and 2. Interestingly, upregulation of Orai1 and TRPC1 channels and their contribution to SOCE are associated with cancer malignancy in colon cancer cells. In a specific cellular model of colon cancer, whereas in non-cancer colon cells SOCE is composed of the Ca²⁺ release activated (CRAC) currents, in colon cancer cells SOCE is composed of CRAC- and cationic, non-selective store operated (SOC) currents. Former SOCs are mediated by TRPC1 channels. Moreover, colon cancer cells also display dysregulation of the expression of 1,4,5-triphosphate receptors (IP₃R) that could contribute to the enhanced SOCE. Another important factor underlying the enhanced SOCE is the differential mitochondrial modulation of the CRAC and SOC currents in non-cancer and colon cancer cells. In colon cancer cells, mitochondria take up more Ca²⁺ that prevent the Ca²⁺-dependent inactivation of the SOCs, leading to sustained Ca²⁺ entry. Notably, the inhibition of SOCE in cancer colon cells abolishes their cancer hallmarks. Robust evidence has shown the efficiency of non-steroidal anti-inflammatory drugs (NSAIDs) and difluoromethylornithine (DFMO) to reverse the enhanced cell proliferation, migration, and apoptosis resistance of cancer cells. In colon cancer cells, both NSAIDs and DFMO decrease SOCE, but they target different molecular components of SOCE. NSAIDs decrease the Ca²⁺ uptake by mitochondria, limiting their ability to prevent the Ca²⁺-dependent inactivation of the SOCs that underlie SOCE. On the other hand, DFMO inhibits the expression of TRPC1 channels in colon cancer cells, eliminating their contribution to SOCE. The identification of players of SOCE in colon cancer cells may help to better understand the remodeling of the Ca²⁺ homeostasis in cancer. Importantly, the use of different pharmacological tools that target different SOCE molecular players in colon cancer cells may play a pivotal role in designing better chemoprevention strategies.     

Immunization with a plant-produced colorectal cancer antigen

Cancer vaccination has become an important focus of oncology in recent years. Active immunization with tumor-associated antigens such as colorectal cancer antigen GA733-2 is thought to potentially overcome the reoccurrence of metastasis. As recombinant protein production in bioreactors is costly and subject to growing safety concerns, we tested plants as an alternative for the expression of a potential colorectal cancer vaccine. Comparing colorectal cancer antigen GA733-2 produced in tobacco plants with the same antigen produced in insect cell culture, we found a similar humoral immune response to injection of either of the two antigen preparations into mice. Some minor differences were observed in the cellular response that might be due to impurities. Our studies compare for the first time, immunization with the same antigen expressed in either plants or insect cell culture. This will provide important data for use of plants as production systems of therapeutics.     

PPARalpha agonists stimulate progastrin production in human colorectal carcinoma cells

The three subtypes of peroxisome proliferator activated-receptors (PPARalpha, delta and gamma) control the storage and metabolism of fatty acids. Treatment of rats with the PPARalpha ligand ciprofibrate increases serum gastrin concentrations, and several lines of evidence suggest that non-amidated gastrins act as growth factors for the colonic mucosa. The aim of the present study was to investigate the expression of PPARs and the effect of PPAR ligands on gastrin production and cell proliferation in human colorectal carcinoma (CRC) cell lines. mRNAs for all three PPAR subtypes were detected by PCR in all CRC cell lines tested. The concentrations of progastrin, but not of glycine-extended or amidated gastrin, measured by radioimmunoassay in LIM 1899 conditioned media and cell extracts were significantly increased by treatment with the PPARalpha ligand clofibrate. Similar increases in progastrin were seen following treatment with the PPARalpha ligands ciprofibrate and fenofibrate, but not with bezafibrate, gemfibrozil or Wy 14643. The PPARgamma agonist rosiglitazone had no significant effect on progastrin production. The PPARalpha ligand clofibrate also stimulated proliferation of the LIM 1899 cell line. We conclude that some PPARalpha ligands increase progastrin production by the human CRC cell line LIM 1899, and that clofibrate increases proliferation of LIM 1899 cells. These studies have revealed a relationship between PPARs and gastrin, two regulatory molecules implicated in the pathogenesis of CRC.