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Department of Molecular Medicine, Northwest Hospital, Bothell, WA 98021
2To whom correspondence should be addressed. E-mail: Belury{at}u.washington.edu.
| ABSTRACT |
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KEY WORDS: conjugated linoleic acid carcinogenesis CLA isomers anticarcinogenic
| INTRODUCTION |
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| Dietary CLA inhibits carcinogenesis in experimental animals |
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45% c9t11-CLA,
42% t10c12-CLA with several other remaining isomers comprising minor amounts) is provided in diets (0.51.5 g/100 g) either during or after initiation, chemically induced skin tumor promotion or mammary and colon tumorigenesis are inhibited (10
In conjunction with identifying the inhibitory properties of CLA in various tumor models, efforts have been made to elucidate the role of CLA in modulating the stages of carcinogenesis known as initiation, promotion and progression. In particular, the anticarcinogenic property of CLA was first identified during the initiation stage of skin carcinogenesis, a stage associated with a genetic alteration in a subset of cells in the target tissue (8
). During initiation, CLA modulates events such as free radicalinduced oxidation, carcinogen metabolism and carcinogen-DNA adduct formation in some tissues (7
). Findings have been ambiguous. In fact, a recent study in male rats demonstrated tissue-specific effects of CLA on 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridineinduced mutation frequencies (18
): Dietary CLA (0.5 g/100 g) reduced mutation frequency in the distal colon, but had no effect or enhanced mutation frequency in the proximal colon and cecum of rats.
In addition to tissue- and/or tumor modelspecific effects of CLA on tumor initiation, several studies demonstrated that CLA inhibits carcinogenesis postinitiation (10
,11
,13
,19
,20
). In chemically induced mammary carcinogenesis, there may be an optimal time for exposure to CLA, i.e., the inhibitory properties of CLA on chemically induced mammary carcinogenesis were most profound when CLA was fed during mammary gland maturation [between 21 and 42 d of age (19
)]. During the promotion stage of skin carcinogenesis, CLA reduces the yield of mouse skin tumors by a mechanism distinct from its anti-initiator activity (10
).
Although a great deal of evidence demonstrates that dietary CLA inhibits the initiation and postinitiation and/or promotion stages of carcinogenesis, its role in the progression stage of carcinogenesis has not been established definitively. Using transplantable tumor models, dietary CLA reduced the growth rates of mammary and prostate cancer cells when implanted in vivo in mice (14
,15
). In addition, at least one study demonstrated that CLA (0.51.0 g/100 g) inhibited the ability of transplanted mammary cancer cells to form secondary tumors in mice (21
). Furthermore, the CLA-responsive chemically induced mammary carcinogenesis model (10
) is a model for human breast cancer ductal carcinomas in situ. Therefore, data showing that CLA inhibits tumorigenesis in this model are consistent with the possibility that CLA will reduce breast cancer metastasis. However, no studies have addressed the role of CLA in the prevention of metastatic cancer. It is critical to understand how CLA modulates malignant tumor formation and metastasis because the growth of secondary tumors is the major cause of morbidity and mortality in people with cancer.
| CLA modulates cell proliferation and apoptosis |
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S phase of the cell cycle (Fig. 2
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| Effects of CLA on phospholipid metabolism and regulation of gene expression |
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Interestingly, when CLA lowers arachidonate-derived eicosanoids such as PGE2 and PGF2
in colon and skin (24
,28
), it also reduces tumorigenesis in these tissues. In contrast, at least one study has shown a relationship between an inability of dietary CLA to alter arachidonate-derived eicosanoids with a lack of its inhibition of intestinal tumorigenesis in Min mice (17
). Together, these studies indirectly suggest that the mechanism by which CLA inhibits carcinogenesis in some tissues may involve the modulation of arachidonate-derived eicosanoids.
CLA may reduce arachidonate-derived eicosanoids such as prostaglandin-E2, PGF2
, leukotriene-B4 and leukotriene-C4 by one of two mechanisms. First, CLA may displace arachidonate incorporation into phospholipids as shown in cultured keratinocytes (34
). In addition, dietary CLA displaces the arachidonate precursor, linoleate, in a dose responsive manner in livers of mice fed various doses of CLA (0.51.5 g/100 g) in one study (31
) but not others (33
,35
Belury, M. A. unpublished data). A recent study demonstrated that dietary CLA reduces phospholipid-associated arachidonate in the colonic mucosa of rats (28
).
A second explanation for the reduction of arachidonate-derived eicosanoids by CLA may be through inhibition of the constitutive enzyme, cyclooxygenase (COX)-1, and/or the inducible form, COX-2, at the level of mRNA, protein, or activity. CLA or elongated and desaturated products from CLA (e.g., conjugated "arachidonate" or conjugated eicosatetraenoate) may act as antagonists for COX thereby reducing available enzyme (at the level of expression or activity) for arachidonate. Using an in vitro activity assay, CLA or individual isomers inhibited the rate of oxygenation of arachidonate in the presence of COX-1 (36
). Furthermore, c9t11-CLA and t10c12-CLA reduced COX-2 at the levels of mRNA and protein in a cultured macrophage cell line (37
).
Although CLA is readily metabolized by
6 desaturase to form numerous downstream products (31
33
,38
,39
), little is known about how CLA modulates metabolism of nonconjugated fatty acids via enzymatic systems such as
6 desaturase-elongase-
5 desaturase. CLA reduces levels of linoleate (18:2) and its desaturated and elongated product, arachidonate (20:4) in mammary tissue (32
). In contrast, one study has shown that CLA may modestly enhance levels of neutral lipidassociated arachidonate in the epidermis of mice (24
). Furthermore, other studies showed no effect of CLA on arachidonate levels in fat pads (40
), liver (33
) or small intestine (17
). The ability of CLA to alter arachidonate levels may depend on the form of CLA (free fatty acid vs. esterified) as well as tissue- and species-specific effects. The relevance of altered arachidonate levels in neutral lipids vs. phospholipid as a modulator of lipid metabolism and eicosanoid formation is not clear at the present time.
CLA may modulate lipid metabolism in part by a mechanism dependent on the activation of the nuclear hormone receptors, peroxisome proliferator-activated receptors (PPAR) [reviewed in (5
)]. In particular, the PPAR
isoform is found in extrahepatic tissues such as adipose, prostate, colon, mammary gland and others. PPAR
2 is a required transcription factor in adipose tissue differentiation [reviewed in (41
)]. In addition, thiazolidinediones, high affinity ligands for PPAR
, modulate carcinogenesis in mammary gland, colon and prostate tissues [reviewed in (42
)]. Isomers of CLA have moderate affinity for binding to and activating PPAR
(43
). Dietary CLA appears to modulate transcription of genes responsive to PPAR
in adipose tissue in vivo [reviewed in (6
)] and in vitro (37
). Our current attempts to study the ability of CLA to activate PPAR
have focused on downstream metabolites of
6 desaturase metabolism of c9t11-CLA or t10c12-CLA. In these studies, we have used approaches to block desaturase activity to determine whether reducing metabolites alters activation of PPAR
(43
). CV-1 cells were transiently transfected with murine PPAR
, luciferase-peroxisome proliferator responsive element reporter and ß-galactosidase, and treated with c9t11-CLA or t10c12-CLA. The activation of PPAR
was determined by measuring luciferase activity. By blocking
6 desaturase using the synthetic inhibitor, SC-26196 (44
), the ability of CLA isomers to activate PPAR
was reduced (P < 0.05). These data indirectly suggest that activation of PPAR
by CLA is increased by the formation of the
6-desaturated products from CLA, c6c9t11-CLA or c6t10c12-CLA. However, the activation of PPAR
by these products is yet to be measured.
In addition to evidence showing that CLA may induce PPAR
-responsive genes in vivo, CLA may induce the level of PPAR
itself (45
). Because PPAR
2 is thought to be one of several transcription factors required for adipose tissue differentiation (41
), and because new evidence suggests that activators of PPAR
are protective against cancers arising in the mammary gland, colon and prostate (42
), it is possible that some of the molecular mechanisms of action of CLA on carcinogenesis are mediated by PPAR
. Perhaps the ability of PPAR
to mediate effects of CLA is through increased levels of PPAR
protein (45
) and/or through activation of PPAR
by downstream metabolites of CLA [e.g., desaturase and elongase products (43
)].
In summary, an inverse relationship has been observed between CLA accumulation and outcomes of breast cancer in postmenopausal women (46
). However, a preventive role for CLA in human cancer (breast and possibly others) is still unproven. To date, all intervention studies have been conducted in experimental animal models of carcinogenesis. It has been estimated that dietary factors contribute to approximately one third of deaths due to cancer in the United States (47
). Because CLA inhibits carcinogenesis in numerous animal models and at multiple stages, this group of fatty acids offers the possibility that several types of cancers in humans may be prevented with a diet rich in a diversity of chemopreventive compounds, including CLA. More work is required to understand fully the implications of dietary CLA and the possibility of lowering the risk for human cancer development.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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3 Abbreviations used: BrdU, bromodeoxyuridine; CLA, conjugated linoleic acid; COX, cyclooxygenase; PG, prostaglandin; PPAR, peroxisome proliferator-activated receptors. ![]()
Manuscript received 16 July 2002. Revision accepted 18 July 2002.
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K. Eder, S. Schleser, K. Becker, and R. Korting Conjugated Linoleic Acids Lower the Release of Eicosanoids and Nitric Oxide from Human Aortic Endothelial Cells J. Nutr., December 1, 2003; 133(12): 4083 - 4089. [Abstract] [Full Text] [PDF] |
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M. Q. Kemp, B. D. Jeffy, and D. F. Romagnolo Conjugated Linoleic Acid Inhibits Cell Proliferation through a p53-Dependent Mechanism: Effects on the Expression of G1-Restriction Points in Breast and Colon Cancer Cells J. Nutr., November 1, 2003; 133(11): 3670 - 3677. [Abstract] [Full Text] [PDF] |
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J. A. Milner Incorporating Basic Nutrition Science into Health Interventions for Cancer Prevention J. Nutr., November 1, 2003; 133(11): 3820S - 3826. [Abstract] [Full Text] [PDF] |
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J. M. Brown and M. K. McIntosh Conjugated Linoleic Acid in Humans: Regulation of Adiposity and Insulin Sensitivity J. Nutr., October 1, 2003; 133(10): 3041 - 3046. [Abstract] [Full Text] [PDF] |
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E. J. Kim, I.-J. Kang, H. J. Cho, W. K. Kim, Y.-L. Ha, and J. H. Y. Park Conjugated Linoleic Acid Downregulates Insulin-Like Growth Factor-I Receptor Levels in HT-29 Human Colon Cancer Cells J. Nutr., August 1, 2003; 133(8): 2675 - 2681. [Abstract] [Full Text] [PDF] |
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