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Škara L, Huđek Turković A, Pezelj I, Vrtarić A, Sinčić N, Krušlin B, Ulamec M. Prostate Cancer-Focus on Cholesterol. Cancers (Basel) 2021; 13:4696. [PMID: 34572923 PMCID: PMC8469848 DOI: 10.3390/cancers13184696] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 12/24/2022] Open
Abstract
Prostate cancer (PC) is the most common malignancy in men. Common characteristic involved in PC pathogenesis are disturbed lipid metabolism and abnormal cholesterol accumulation. Cholesterol can be further utilized for membrane or hormone synthesis while cholesterol biosynthesis intermediates are important for oncogene membrane anchoring, nucleotide synthesis and mitochondrial electron transport. Since cholesterol and its biosynthesis intermediates influence numerous cellular processes, in this review we have described cholesterol homeostasis in a normal cell. Additionally, we have illustrated how commonly deregulated signaling pathways in PC (PI3K/AKT/MTOR, MAPK, AR and p53) are linked with cholesterol homeostasis regulation.
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Affiliation(s)
- Lucija Škara
- Department of Medical Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Ana Huđek Turković
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Ivan Pezelj
- Department of Urology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Alen Vrtarić
- Department of Clinical Chemistry, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Nino Sinčić
- Department of Medical Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Božo Krušlin
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Monika Ulamec
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Hirano H, Ide H, Lu Y, Inoue Y, Okada H, Horie S. Impact of Pretreatment Total Cholesterol Level Is Associated With Metastasis of Prostate Cancer. Am J Mens Health 2021; 14:1557988320918788. [PMID: 32349610 PMCID: PMC7233000 DOI: 10.1177/1557988320918788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Metabolic syndrome is reported to play a role in the genesis and development not
only of angina, arteriosclerosis, diabetes, and osteoporosis but also of
prostate cancer. Hypercholesterolemia is a strong risk factor in prostate cancer
development. The current study was conducted to analyze whether pretreatment
serum levels of cholesterol correlate with prostate cancer metastasis. Three
hundred fifty-one subjects who received a histopathological diagnosis of
prostate cancer were evaluated by clinical factors such as age, body mass index
(BMI), disease stage, Gleason score, prostate-specific antigen (PSA), total
cholesterol, Luteinizing hormone (LH), testosterone, and free testosterone. A
multivariate analysis was performed on these factors, and a statistically
significant difference was identified in total cholesterol level
(p =.01) and PSA (p < .001). The total
cholesterol level was higher in cases of metastatic prostate cancer compared to
nonmetastatic prostate cancer in this study and therefore may be a predictive
factor for poor prognosis.
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Affiliation(s)
- Hisashi Hirano
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Hisamitsu Ide
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Japan
| | - Yan Lu
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yasuyuki Inoue
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Japan
| | - Hiroshi Okada
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Japan
| | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
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3
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Garrido MM, Marta JC, Ribeiro RM, Pinheiro LC, Guimarães JT. Serum lipids and prostate cancer. J Clin Lab Anal 2021; 35:e23705. [PMID: 33724557 PMCID: PMC8059719 DOI: 10.1002/jcla.23705] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Conflicting results are found in the literature relating serum lipids levels and prostate cancer. Some results imply a relationship between them; others contradict this association. The purpose of this study was to investigate a possible association between serum lipids levels and prostate cancer, at time of diagnosis. METHODS We measured serum levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides in 237 patients submitted to a prostate biopsy, with PSA between 2 and 10 ng/ml. Patients without cancer at biopsy were used as controls, and the others were considered as cases. No information about lipid-lowering therapy, including statins, was available neither in cases nor in controls. Cases were divided into risk groups, according to the disease severity, based on staging. Lipids levels were compared between groups, using parametric and nonparametric tests. Logistic regression analysis and odds ratios were calculated. RESULTS LDL and total cholesterol levels were lower in patients with cancer, with the difference being statistically significant for LDL cholesterol (p = 0.010) and borderline for total cholesterol (p = 0.050). No significant differences were found between the several risk groups. Odds ratios for low LDL cholesterol (<130 mg/dl) and low total cholesterol (<200 mg/dl), with prostate cancer as the outcome, were 1.983 and 1.703, respectively. There were no significant differences between cases and controls for the other lipids. CONCLUSION Lower LDL cholesterol (<130 mg/dl) and lower total cholesterol (<200 mg/dl) serum levels seem to associate with prostate cancer, at time of diagnosis.
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Affiliation(s)
- Manuel M. Garrido
- Department of Clinical PathologyCentral Lisbon University Hospital Center & Department of Laboratory Medicine, School of Medicine, University of LisbonLisbonPortugal
| | - José C. Marta
- Department of Clinical PathologyCentral Lisbon University Hospital CenterLisbonPortugal
| | - Ruy M. Ribeiro
- Biomathematics LaboratorySchool of Medicine, University of LisbonLisbonPortugal
| | - Luís C. Pinheiro
- Department of UrologyCentral Lisbon University Hospital Center & Department of Urology, Nova Medical SchoolLisbonPortugal
| | - João T. Guimarães
- Department of Clinical PathologySao Joao University Hospital Center & Department of Biomedicine, School of Medicine & Institute of Public Health, University of PortoPortoPortugal
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4
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Mayengbam SS, Singh A, Pillai AD, Bhat MK. Influence of cholesterol on cancer progression and therapy. Transl Oncol 2021; 14:101043. [PMID: 33751965 PMCID: PMC8010885 DOI: 10.1016/j.tranon.2021.101043] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/24/2021] [Accepted: 02/11/2021] [Indexed: 12/24/2022] Open
Abstract
Abnormality in blood cholesterol level is significantly correlated with risk of different cancers. Majority of tumor tissue from cancer patient exhibits overexpression of LDLR and ACAT for supporting rapid cancer cell proliferation. Alteration of the cholesterol metabolism in cancer cells hampers therapeutic response. Targeting cholesterol metabolism for treatment of cancer with other conventional chemotherapeutic drugs appears to be beneficial.
Cholesterol is a fundamental molecule necessary for the maintenance of cell structure and is vital to various normal biological functions. It is a key factor in lifestyle-related diseases including obesity, diabetes, cardiovascular disease, and cancer. Owing to its altered serum chemistry status under pathological states, it is now being investigated to unravel the mechanism by which it triggers various health complications. Numerous clinical studies in cancer patients indicate an alteration in blood cholesterol level (either decreased or increased) in comparison to normal healthy individuals. This article elaborates on our understanding as to how cholesterol is being hijacked in the malignancy for the development, survival, stemness, progression, and metastasis of cancerous cells. Also, it provides a glimpse of how cholesterol derived entities, alters the signaling pathway towards their advantage. Moreover, deregulation of the cholesterol metabolism pathway has been often reported to hamper various treatment strategies in different cancer. In this context, attempts have been made to bring forth its relevance in being targeted, in pre-clinical and clinical studies for various treatment modalities. Thus, understanding the role of cholesterol and deciphering associated molecular mechanisms in cancer progression and therapy are of relevance towards improvement in the management of various cancers.
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Affiliation(s)
| | - Abhijeet Singh
- National Centre for Cell Science, Savitribai Phule Pune University, Ganeshkhind, Pune 411 007, India
| | - Ajay D Pillai
- National Centre for Cell Science, Savitribai Phule Pune University, Ganeshkhind, Pune 411 007, India
| | - Manoj Kumar Bhat
- National Centre for Cell Science, Savitribai Phule Pune University, Ganeshkhind, Pune 411 007, India.
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Zhao Y, Zhang Y, Wang X, Lin D, Chen Z. Relationship between body mass index and concentrations of prostate specific antigen: a cross-sectional study. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 80:162-167. [PMID: 31855065 DOI: 10.1080/00365513.2019.1703217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The possible relationship between body mass index (BMI) and prostate-specific antigen (PSA) concentrations is controversial. The objective of this study was to assess the relationship between BMI and PSA concentrations in Chinese men. A total of 81,122 men who had undergone annual medical examinations at the First Affiliated Hospital of Army Medical University between 1 January 2011 and 31 December 2018 were included. Univariate and multivariate linear regression models were used to assess the relationship between BMI and PSA concentrations. The nonlinear relationship was analyzed using a generalized additive model with a spline smoothing function. Subsequently, a stratified linear regression model was used for subgroup analysis. The mean age and BMI of the participants were 45.91 ± 12.21 years and 24.79 ± 3.11 kg/m2, respectively. After adjustment for age, waist circumference-hip circumference ratio, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase and aspartate aminotransferase, BMI was negatively related to PSA level (p < .001). A nonlinear relationship was detected, and different relationships between BMI and PSA concentrations were observed on each side of the inflection point (BMI = 23.11 kg/m2). Our study revealed an inverse, nonlinear relationship between BMI and PSA concentrations. Thus, this relationship may be a concern when establishing reference intervals or decision limits for PSA concentrations.
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Affiliation(s)
- Ying Zhao
- Health Management Centre, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yuting Zhang
- Health Management Centre, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xin Wang
- Epidemiology Centre, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Dandan Lin
- Health Management Centre, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zongtao Chen
- Health Management Centre, The First Affiliated Hospital of Army Medical University, Chongqing, China
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6
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Ruiz-Plazas X, Rodríguez-Gallego E, Alves M, Altuna-Coy A, Lozano-Bartolomé J, Portero-Otin M, García-Fontgivell JF, Martínez-González S, Segarra J, Chacón MR. Biofluid quantification of TWEAK/Fn14 axis in combination with a selected biomarker panel improves assessment of prostate cancer aggressiveness. J Transl Med 2019; 17:307. [PMID: 31500625 PMCID: PMC6734315 DOI: 10.1186/s12967-019-2053-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/29/2019] [Indexed: 12/22/2022] Open
Abstract
Background Conventional clinical biomarkers cannot accurately differentiate indolent from aggressive prostate cancer (PCa). We investigated the usefulness of a biomarker panel measured exclusively in biofluids for assessment of PCa aggressiveness. Methods We collected biofluid samples (plasma/serum/semen/post-prostatic massage urine) from 98 patients that had undergone radical prostatectomy. Clinical biochemistry was performed and several cytokines/chemokines including soluble(s) TWEAK, sFn14, sCD163, sCXCL5 and sCCL7 were quantified by ELISA in selected biofluids. Also, the expression of KLK2, KLK3, Fn14, CD163, CXCR2 and CCR3 was quantified by real-time PCR in semen cell sediment. Univariate, logistic regression, and receiver operating characteristic (ROC) analyses were used to assess the predictive ability of the selected biomarker panel in conjunction with clinical and metabolic variables for the evaluation of PCa aggressiveness. Results Total serum levels of prostate-specific antigen (PSA), semen levels of sTWEAK, fasting glycemia and mRNA levels of Fn14, KLK2, CXCR2 and CCR3 in semen cell sediment constituted a panel of markers that was significantly different between patients with less aggressive tumors [International Society of Urological Pathology (ISUP) grade I and II] and those with more aggressive tumors (ISUP grade III, IV and V). ROC curve analysis showed that this panel could be used to correctly classify tumor aggressiveness in 90.9% of patients. Area under the curve (AUC) analysis revealed that this combination was more accurate [AUC = 0.913 95% confidence interval (CI) 0.782–1] than a classical non-invasive selected clinical panel comprising age, tumor clinical stage (T-classification) and total serum PSA (AUC = 0.721 95% CI 0.613–0.830). Conclusions TWEAK/Fn14 axis in combination with a selected non-invasive biomarker panel, including conventional clinical biochemistry, can improve the predictive power of serum PSA levels and could be used to classify PCa aggressiveness.
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Affiliation(s)
- Xavier Ruiz-Plazas
- Disease Biomarkers and Molecular Mechanisms Group, IISPV, Joan XXIII University Hospital, Universitat Rovira i Virgili, University Hospital of Tarragona Joan XXIII, C/Dr. Mallafré Guasch, 4, 43007, Tarragona, Spain.,Urology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Esther Rodríguez-Gallego
- Infectious Diseases and HIV/AIDS Unit, Department of Internal Medicine, Joan XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
| | - Marta Alves
- Urology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Antonio Altuna-Coy
- Disease Biomarkers and Molecular Mechanisms Group, IISPV, Joan XXIII University Hospital, Universitat Rovira i Virgili, University Hospital of Tarragona Joan XXIII, C/Dr. Mallafré Guasch, 4, 43007, Tarragona, Spain
| | - Javier Lozano-Bartolomé
- Disease Biomarkers and Molecular Mechanisms Group, IISPV, Joan XXIII University Hospital, Universitat Rovira i Virgili, University Hospital of Tarragona Joan XXIII, C/Dr. Mallafré Guasch, 4, 43007, Tarragona, Spain
| | - Manel Portero-Otin
- Department of Experimental Medicine, Universitat de Lleida-IRBLleida, Lleida, Spain
| | | | | | - José Segarra
- Disease Biomarkers and Molecular Mechanisms Group, IISPV, Joan XXIII University Hospital, Universitat Rovira i Virgili, University Hospital of Tarragona Joan XXIII, C/Dr. Mallafré Guasch, 4, 43007, Tarragona, Spain. .,Urology Unit, Joan XXIII University Hospital, Tarragona, Spain.
| | - Matilde R Chacón
- Disease Biomarkers and Molecular Mechanisms Group, IISPV, Joan XXIII University Hospital, Universitat Rovira i Virgili, University Hospital of Tarragona Joan XXIII, C/Dr. Mallafré Guasch, 4, 43007, Tarragona, Spain.
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7
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Lipid Metabolism and Endocrine Resistance in Prostate Cancer, and New Opportunities for Therapy. Int J Mol Sci 2019; 20:ijms20112626. [PMID: 31142021 PMCID: PMC6600138 DOI: 10.3390/ijms20112626] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 05/24/2019] [Accepted: 05/27/2019] [Indexed: 12/23/2022] Open
Abstract
Prostate cancer (PCa) is the most common cancer in men, and more than 10% of men will be diagnosed with PCa during their lifetime. Patients that are not cured with surgery or radiation are largely treated with endocrine therapies that target androgens or the androgen receptor (AR), a major driver of PCa. In response to androgen deprivation, most PCas progress to castrate resistant PCa, which is treated with anti-androgens like enzalutamide, but tumors still progress and become incurable. Thus, there is a critical need to identify cellular pathways that allow tumors to escape anti-androgen therapies. Epidemiological studies suggest that high-fat diets play important roles in PCa progression. Lipid metabolism rewires the PCa metabolome to support growth and resistance to endocrine therapies, although the exact mechanisms remain obscure. Therapeutic effects have been observed inhibiting several aspects of PCa lipid metabolism: Synthesis, uptake, and oxidation. Since AR remains a driver of PCa in advanced disease, strategies targeting both lipid metabolism and AR are starting to emerge, providing new opportunities to re-sensitize tumors to endocrine therapies with lipid metabolic approaches.
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8
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Allott EH, Masko EM, Freedland AR, Macias E, Pelton K, Solomon KR, Mostaghel EA, Thomas GV, Pizzo SV, Freeman MR, Freedland SJ. Serum cholesterol levels and tumor growth in a PTEN-null transgenic mouse model of prostate cancer. Prostate Cancer Prostatic Dis 2018; 21:196-203. [PMID: 29795142 PMCID: PMC6026483 DOI: 10.1038/s41391-018-0045-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/06/2018] [Accepted: 02/07/2018] [Indexed: 12/28/2022]
Abstract
Background Some, but not all, epidemiologic evidence supports a role for cholesterol, the precursor for steroid hormone synthesis, in prostate cancer. Using a PTEN-null transgenic mouse model of prostate cancer, we tested the effect of modifying serum cholesterol levels on prostate tumor development and growth. We hypothesized that serum cholesterol reduction would lower tumor androgens and slow prostate cancer growth. Methods PTENloxP/loxP-Cre+ mice consuming ad libitum high fat, high cholesterol diets (40% fat, 1.25% cholesterol) were randomized after weaning to receive the cholesterol uptake inhibitor, ezetimibe (30 mg/kg/day), or no intervention, and sacrificed at 2, 3 or 4 months of age. Serum cholesterol and testosterone were measured by ELISA and intraprostatic androgens by mass spectrometry. Prostate histology was graded, and proliferation and apoptosis in tumor epithelium and stroma was assessed by Ki67 and TUNEL, respectively. Results Ezetimibe-treated mice had lower serum cholesterol at 4 months (p=0.031). Serum cholesterol was positively correlated with prostate weight (p=0.033) and tumor epithelial proliferation (p=0.069), and negatively correlated with tumor epithelial apoptosis (p=0.004). Serum cholesterol was unrelated to body weight (p=0.195). Tumor stromal cell proliferation was reduced in the ezetimibe group (p=0.010). Increased serum cholesterol at 4 months was associated with elevated intraprostatic DHEA, testosterone and androstenedione (p=0.043, p=0.074, p=0.031, respectively). However, cholesterol reduction did not significantly affect adenocarcinoma development at 2, 3 or 4 months of age (0%, 78%, 100% in ezetimibe-treated vs. 0%, 80%, 100% in mice not receiving ezetimibe). Conclusions Though serum cholesterol reduction did not significantly affect the rate of adenocarcinoma development in the PTEN-null transgenic mouse model of prostate cancer, it lowered intraprostatic androgens and slowed tumor growth. These findings support a role for serum cholesterol in promoting prostate cancer growth, potentially via enhanced tumor androgen signaling, and may provide new insight into cholesterol-lowering interventions for prostate cancer treatment.
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Affiliation(s)
- Emma H Allott
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth M Masko
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Alexis R Freedland
- Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Everardo Macias
- Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kristine Pelton
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Keith R Solomon
- The Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.,Applied Photophysics, Beverly, MA, USA
| | - Elahe A Mostaghel
- Division of Oncology, Department of Medicine, University of Washington, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - George V Thomas
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.,Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Salvatore V Pizzo
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Michael R Freeman
- Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Stephen J Freedland
- Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. .,Division of Urology, Veterans Affairs Medical Center, Durham, NC, USA.
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9
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Serum cholesterol and risk of high-grade prostate cancer: results from the REDUCE study. Prostate Cancer Prostatic Dis 2017; 21:252-259. [PMID: 29282360 PMCID: PMC6021229 DOI: 10.1038/s41391-017-0030-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 11/13/2017] [Indexed: 12/17/2022]
Abstract
Background Epidemiologic evidence for a serum cholesterol-prostate cancer link is mixed. Prostate-specific antigen (PSA) is positively correlated with cholesterol, potentially increasing PSA-driven biopsy recommendations in men with high cholesterol, though biopsy compliance may be lower in men with comorbid conditions. These potential biases may affect PSA-driven biopsy rates and subsequent prostate cancer detection in men with high serum cholesterol. Our objective was to test the association between serum cholesterol and prostate cancer risk in men receiving PSA-independent, study-mandated prostate biopsies. Methods We conducted a post-hoc analysis of data from 4,974 non-statin users in REDUCE, a randomized trial in men with elevated PSA and a negative baseline biopsy. Men underwent 2- and 4-year trial-mandated prostate biopsies. Associations between baseline serum levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and prostate cancer risk, overall and by Gleason grade (<7 vs. ≥7), were examined using multivariable logistic regression. Results High total serum cholesterol was associated with an increased risk of high-grade prostate cancer diagnosis (ORper10mg/dl 1.05; 95% CI 1.00-1.09; p=0.048), but cholesterol was unrelated to either overall or low-grade prostate cancer risk (p-values>0.185). There was no association between serum LDL and overall, low- or high-grade prostate cancer risk (p-values>0.137). In contrast, elevated serum HDL was associated with increased risk of both overall (ORper10mg/dl 1.08; 95% CI 1.01-1.16; p=0.033) and high-grade prostate cancer (ORper10mg/dl 1.14; 95% CI 1.01-1.28; p=0.034). Conclusions In REDUCE, where all men received PSA-independent, trial-mandated biopsies thus ensuring complete prostate cancer ascertainment, high total serum cholesterol and high HDL were associated with increased risk of high-grade prostate cancer, supporting a cholesterol-prostate cancer link.
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10
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Asare GA, Andam SE, Asare-Anane H, Ammanquah S, Anang-Quartey Y, Afriyie DK, Musah I. Lipid associated antioxidants: arylesterase and paraoxonase-1 in benign prostatic hyperplasia treatment-naïve patients. Prostate Int 2017; 6:36-40. [PMID: 29556488 PMCID: PMC5857163 DOI: 10.1016/j.prnil.2017.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/31/2017] [Accepted: 04/11/2017] [Indexed: 12/27/2022] Open
Abstract
Background Oxidative stress and antioxidants have been implicated in many diseases including prostate cancer and benign prostatic hyperplasia (BPH). Lipid peroxidation contributes to oxidative stress. However, new and emerging antioxidants such as paraoxonase 1 (PON1) and arylesterase (ARE) associated with lipoprotein peroxidation have not been examined in BPH patients. PON1 and ARE, a high-density lipoprotein (HDL) cholesterol-bound enzyme system of antioxidants, protect low-density lipoprotein (LDL) cholesterol and HDL from oxidation by hydrolysis. The study primarily determined paraoxonase (PON1) and ARE activities in BPH treatment-naïve patients. Materials and methods Sixty newly diagnosed patients (treatment-naïve) alongside 30 apparently healthy controls were recruited. Blood examinations included lipid profile (total cholesterol, triglycerides, LDL, HDL), glutathione peroxidase, PON1, ARE, and prostate specific antigen (PSA). Prostate volume and International Prostate Symptoms Score (IPSS) were determined. Results PSA was significantly different between patient and control groups (P < 0.0001). Total cholesterol, triglycerides, and LDL were significantly higher in the patient group (P = 0.002, P < 0.001, P = 0.003, respectively). Glutathione peroxidase was very low in the patient group compared to the control group (5.65 ± 2.30 ng/mL and 17.43 ± 10.98 ng/mL, respectively). Although PON1 was higher in the patient group (50.22 ± 19.68/61.30 ± 29.55 ng/mL; P > 0.05), ARE was significantly lower in the patient group (61.31 ± 21.76/49.30 ± 19.82 ng/mL; P = 0.0098). No correlation was established between antioxidants and the lipid profile except for the LDL and PON1 patient group (r = 0.1486, P = 0.0374). Similarly, a weak correlation was also established between PSA and LDL in the patient group (r = –0.275, P = 0.033). PON1/HDL ratio was not significantly different. However, the ARE/HDL ratio was significantly lower in the patient group (P < 0.0001). Conclusion These results signify the presence of a higher lipoprotein peroxidation activity and lower lipid-associated antioxidant activity in the patient group. The ARE/HDL ratio is a better indicator of the HDL associated antioxidant than the PON1/HDL ratio or the individual antioxidants (PON1 and ARE) as reported by others.
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Affiliation(s)
- George Awuku Asare
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Sabina Ekua Andam
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Henry Asare-Anane
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Seth Ammanquah
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Yvonne Anang-Quartey
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu Campus, Ghana
| | - Daniel K Afriyie
- Department of Pharmacy, Ghana Police Hospital, Cantonments, Ghana
| | - Iddis Musah
- Department of Urology, Ghana Police Hospital, Cantonments, Ghana
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11
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Abstract
While initially effective, androgen deprivation therapy (ADT) is not curative, and nearly all men with advanced prostate cancer will eventually progress to the more resistant, and ultimately lethal form of the disease, so called castration-resistant prostate cancer (CRPC). The maintenance of androgens within the prostate cancer microenvironment likely represents one of the key mechanisms by which this transition from hormone-sensitive to CRPC occurs. This can be accomplished either through intratumoral androgen biosynthesis or the active transport of androgens and androgenic precursors into the tumor microenvironment. More recently, preclinical and clinical data supported therapeutic strategies that seek to target these two mechanisms, either through the use of drugs that impair androgen biosynthesis (e.g. inhibiting the steroidogenic enzymes CYP17 and AKR1C3 with abiraterone and indomethacin, respectively) or drugs that inhibit the SLCO transporters responsible for importing androgens (e.g. statins).
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Affiliation(s)
- Michael T Schweizer
- Division of Oncology, Department of Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Evan Y Yu
- Division of Oncology, Department of Medicine, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Risk factors: Cholesterol level correlates with PSA level in white but not black men. Nat Rev Urol 2015; 12:594. [PMID: 26369727 DOI: 10.1038/nrurol.2015.234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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