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Division of Endocrinology, Diabetes and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322;
* Vitamin D, Skin and Bone Research Laboratory, Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, MA 02118; and
Section of Gastroenterology, Department of Medicine, Boston University School of Medicine, Boston, MA 02118
3To whom correspondence should be addressed. E-mail: mfholick{at}bu.edu.
| ABSTRACT |
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-hydroxylase (1
-OHase) by quantitative RT-PCR. The expression of the mRNA for the VDR and the 1
-OHase was 37- and 6-fold higher, respectively, in the vitamin Dsufficient mice compared with the vitamin Ddeficient mice. We conclude that vitamin D deficiency enhances the growth of colon cancer in mice. The tumor expression of VDR and 1
-OHase indicates possible autocrine/paracrine cell growth regulation by vitamin D.
KEY WORDS: vitamin D colon cancer 1
-hydroxylase
Epidemiologic studies have suggested that maintaining adequate vitamin D status may prevent colon cancer. Apperly first observed in 1941 (1) that there was an inverse relation between solar irradiation and cancer mortality, thus establishing a possible connection between sunshine, vitamin D, and cancer. Garland and Garland (2) reported that mortality rates due to colorectal cancer in the United States were highest in areas with the least amount of solar radiation. Several cohort studies were conducted and confirmed these initial observations that vitamin D may be protective against colon cancer (36). These studies demonstrated that subjects with low (<12.5 nmol/L) serum 25-hydroxyvitamin D [25(OH)D]4 levels, the major circulating form of vitamin D, were at a 2- to 3-fold increased risk for developing colon cancer.
Cell culture studies further supported that vitamin D was protective against colon cancer. Halline et al. (7) demonstrated that cultured Caco-2 cells, a human colon cancer cell line, expressed the vitamin D receptor (VDR) and was inhibited in a dose-dependent fashion by 1,25-dihydroxycholecalciferol [1,25(OH)2D3] (8). Further, in vitro studies with several human colon cancer cell lines demonstrated that growth was inhibited in the presence of 1,25(OH)2D3 and less calcemic vitamin D analogs (911). Several in vivo rodent models demonstrated that cholecalciferol and its analogs were protective against colon carcinogenesis. These models included carcinogen-induced colon cancer in rats (1214), and human colon cancer xenografts in nude mice (15,16) and APC mutant mice (17).
A few studies evaluated the effect of vitamin D deficiency on the induction and growth of colon cancer in vivo. Sitrin et al. (12) studied rats fed a vitamin Ddeficient diet for 6 wk and found a detrimental effect of vitamin D deficiency in a rat model of carcinogen-induced colon cancer. Mokady et al. (18) evaluated a low vitamin D diet in a carcinogen-induced colon cancer model in rats and found that vitamin D deficiency increased colon cancer proliferation. Studies by Newmark et al. (19) evaluated a Western style diet in rats low in vitamin D and found that the Western diet increased adenoma and carcinoma development.
We sought to evaluate the effect of vitamin D deficiency (undetectable 25-hydroxyvitamin D) on the development and growth of colon cancer. We used the MC-26 mouse colon cancer model, which closely mimics human colon cancer biology (20). This mouse model was used to test new chemotherapeutic agents (2125) against colon cancer and to evaluate gene therapy as a treatment in colon cancer (2631). We also evaluated whether the mouse colon tumors contained the VDR and the 25-hydroxyvitamin D-1
-hydroxylase (CYP27B, 1
-OHase), the enzyme that converts 25(OH)D3 to 1,25(OH)2D3.
| MATERIALS AND METHODS |
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50% confluence. Treatment conditions [25(OH)D3 or 1,25(OH)2D3] were compared with controls in 12 replicates on each dish. The cells were incubated in the presence of either 1,25(OH)2D3 or 25(OH)D3 [108 to 106 mol/L] in the presence of 25 µg/L epidermal growth factor for 18 h. Cellular proliferation was assessed by incubation with [3H]thymidine for 2 h as previously described (32). After the 2-h incubation, the cells were rinsed 3 times with ice-cold PBS and incubated in 5% percholoric acid on ice for 30 min. The percholoric acid was aspirated then replaced again with 500 µL of percholoric acid and incubated at 70°C in a hot water bath to precipitate the DNA. The cellular precipitates were combined with scintillation fluid, placed into plastic vials, and counted with a ß-liquid scintillation counter. Radioactivity data of test wells were expressed relative to those of control wells. In vivo colon cancer assay. The IACUC at Boston University School of Medicine granted approval to conduct this study. Male Balb/c mice (6 wk old) were obtained from Taconic Farms. They were housed at the Boston University Laboratory Animal Sciences Facility and maintained under standard light:dark cycles. At the end of the experiment, animals were killed with 100% CO2.
The rodent diets were obtained from Harlan-Teklad. We used 2 different diets for our studies: a vitamin Dsufficient diet (cholecalciferol 500,000 IU/kg food) with calcium (0.47%) and phosphorus (0.3%) and a vitamin Ddeficient diet (the exact same diet without cholecalciferol) (Table 1). The absence of cholecalciferol was confirmed by HPLC analysis of the diet.
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The MC-26 cells were grown to near confluency in 100-mm Petri dishes. The cells were then trypsinized and gently mixed in a sterile beaker with a stir-bar. With the use of a hemocytometer, the cells were diluted with DMEM to a final concentration of 10,000 cells/0.1 mL. The mice were shaved on the lower posterior trunk and 0.1 mL containing 10,000 MC-26 cells was introduced s.c. through a 27-gauge needle.
The size of the tumors was recorded on a daily basis starting on d 7 after the MC-26 cells were injected. Using a digital caliper, we recorded the length and width of the tumors. The volume of each tumor was calculated using the following formula: volume = length (largest measurement)/2 x width x width. The mice were observed for 20 d before killing. At the time of killing, the mice were bled via the dorsal tail vein for calcium and 25(OH)D determinations (Hitachi 747 Colorimetric Assay). Serum was sent to Antech Diagnostics for calcium determinations. The 25(OH)D concentration was measured by the method of Chen et al. (33). The tumor was dissected from the back for mRNA analysis.
Isolation of total RNA. The tumors were flash frozen in liquid nitrogen and stored at 80°C until use. The tissues were washed once with PBS. Total RNA was harvested using the SV Total RNA Isolation System (Promega). The quality of the RNA was confirmed by a 260abs:280abs ratio > 1.8.
RT-PCR.
1
-OHase and VDR mRNA levels were determined by quantitative RT-PCR assay using the CyberGreen technology and an ABI PrismTM 7700 Sequence Detector (Perkin Elmer). Total RNA (200 ng) was analyzed for each reaction. The primers for the mouse VDR and 1
-OHase are the same as those previously published (34).
Statistical methods. The computer software programs Microsoft ExcelTM with the statistical add-in program Analyze-It and SAS 9.1 were used to analyze the results. Students t test was used to compare the means of the 2 groups. Repeated-measures ANOVA and post-hoc t tests were used to compare tumor sizes in vitamin Dsufficient and deficient groups each day. Differences were considered significant at P < 0.05. Values in the text are means ± SEM.
| RESULTS |
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Growth of colon cancer xenografts in vitamin Ddeficient mice. The tumors in the vitamin Dsufficient mice were significantly smaller than those in the vitamin Ddeficient mice starting at d 9. This difference was maintained until the end of the study (Fig. 2). The final tumor sizes in the vitamin Dsufficient mice were 40% smaller (340 ± 70 mm3) compared with those in the vitamin Ddeficient mice (560 ± 110 mm3) (P < 0.05, t test; Fig. 2 and 3).
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-OHase and VDR in mouse tumors.
Quantitative RT-PCR of the tumors revealed that the colon cancer xenograft tumors contained the mRNA for the 1
-OHase and the VDR. The expression of the VDR and 1
-OHase mRNA was 37- and 6-fold higher in the vitamin Dsufficient mice compared with the vitamin Ddeficient mice, respectively (Fig. 4).
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| DISCUSSION |
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Vitamin D must undergo 2 sequential hydroxylations to form the steroid hormone 1,25(OH)2D (35). The major antiproliferative effects occur when 1,25(OH)2D binds to the VDR to activate nuclear transcription of vitamin Dresponsive genes (36,37). Previously it was thought that the 1
-OHase was expressed mainly in the kidney. However, our laboratory and others demonstrated its presence in normal and malignant colon tissue (9,38). The presence of the 1
-OHase in the mouse colon cancer tumors further supports the role of this enzyme in regulating colon cancer proliferation. The presence of the 1
-OHase in colon cancer tumors suggests that circulating 25(OH)D could be converted to 1,25(OH)2D within the cancer cell. This is supported by the observation that 25(OH)D3 was effective in inhibiting the proliferation of MC-26 cells in vitro (Fig. 1B). This is similar to the observations in prostate cancer cells (38) and in the prostate cancer cell line LNCAP transfected with the 1
-OHase gene (39). The 1,25(OH)2D could then activate vitamin Dresponsive genes that regulate cellular proliferation and differentiation. The expression of the 1
-OHase and VDR was higher in the tumors of the vitamin Dsufficient mice, which was not unexpected because 1,25(OH)2D upregulates the expression of its receptor (40).
Vitamin D deficiency is now recognized as a major health problem. Nearly one third of healthy adults are vitamin D deficient at the end of winter in Boston (41). Nearly half of all patients diagnosed with cancer have vitamin D deficiency in the summer months, a time in which vitamin D deficiency is less common (42). Combined with the epidemiologic data demonstrating a protective effect of vitamin D on colon cancer proliferation, this study supports the notion that vitamin D nutrition could play an important role in either preventing or limiting the progression of colon cancer (43).
In summary, vitamin D deficiency results in the aggressive growth of colon cancer. The presence of the VDR and the 1
-OHase mRNA in these tumors raises the possibility that 25(OH)D may be locally converted to 1,25(OH)2D to bind the VDR to active transcription of vitamin Ddependent genes. Our in vivo mouse model of colon cancer supports the deleterious effect of vitamin D deficiency on colon cancer progression, which further supports the epidemiologic data.
| FOOTNOTES |
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2 Supported by the UV Foundation. ![]()
4 Abbreviations used: 1
-OHase, 25-hydroxyvitamin D-1
-hydroxylase; 25(OH)D, 25-hydroxyvitamin D; 1,25(OH)2D3, 1,25-dihydroxycholecalciferol; VDR, vitamin D receptor. ![]()
Manuscript received 4 March 2005. Initial review completed 12 April 2005. Revision accepted 25 July 2005.
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