Overexpression of HER-2/neu enhances the sensitivity of human bladder cancer cells to urinary isoflavones

Flavonoids and bladder cancer risk

PURPOSE

Flavonoids have drawn attention because of their antioxidant capacity and anti-carcinogenic effect in various types of cancer. A limited number of studies has investigated their potential effect on the risk of bladder cancer, with inconsistent results.

METHODS

We analyzed data from an Italian case-control study including 690 incident bladder cancer cases and 665 controls admitted to the same network of hospitals for acute, non-neoplastic, non tobacco-related diseases. Subjects were interviewed using a reproducible and validated food-frequency questionnaire. We applied data on food and beverage composition to estimate the intake of isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones and flavonols. We estimated odds ratios (ORs) through multiple logistic regression models, including terms for potential confounding factors, including tobacco smoking and total energy intake.

RESULTS

We found an inverse association between isoflavones (OR for the highest compared to the lowest quintile of intake = 0.56, 95% CI 0.37-0.84) and flavones (OR = 0.64, 95% CI 0.44-0.95) and bladder cancer. Non-significant inverse association was found for flavan-3-ols (OR = 0.70), flavonols (OR = 0.85) and total flavonoids (OR = 0.76). The results were consistent for non-muscle-invasive and muscle-invasive bladder cancers.

CONCLUSIONS

Our data indicate an inverse association between isoflavones and flavones with respect to bladder cancer risk.

Potential significance of EMP3 in patients with upper urinary tract urothelial carcinoma: crosstalk with ErbB2-PI3K-Akt pathway

PURPOSE

Upper urinary tract (pyelocalyceal cavities and ureter) urothelial carcinoma is a relatively rare neoplastic disease. Although diagnosis and treatment of this tumor variant have improved significantly, accurate risk stratification remains a challenge. To identify the putative oncogene involved in urothelial carcinoma progression we performed bioinformatics guided experimental investigation targeting chromosome 19q13.

MATERIALS AND METHODS

We investigated the effects of EMP3 on cancer cell growth, migration and adhesion in transfection and siRNA experiments in vitro. Crosstalk of integrins or ErbB2 with EMP3 was examined by reverse transcriptase-polymerase chain reaction and immunoblot. The potential involvement of epigenetic alterations of EMP3 in vitro and in vivo was analyzed by methylation specific polymerase chain reaction. To validate clinical relevance we measured EMP3 expression at the mRNA and protein levels in a cohort of 77 patients with upper urinary tract urothelial carcinoma and compared prognostic significance in relation to that of ErbB2 expression.

RESULTS

We noted functional crosstalk between ErbB2 and EMP3 in vitro. EMP3 over expression promoted cancer cell proliferation and migration but suppressed cell adhesion in vitro. EMP3 activated the ErbB2-PI3K-AKT pathway to increase cell growth in vitro. In the clinical cohort Kaplan-Meier survival estimates showed that ErbB2 and EMP3 co-expression was the most important indicator of progression-free and metastasis-free survival in patients with upper urinary tract urothelial carcinoma (log rank test p = 0.018 and 0.04, respectively).

CONCLUSIONS

EMP3 is an important prognostic indicator for selecting patients with upper urinary tract urothelial carcinoma for more intensive therapy. EMP3 is an innovative co-targeting candidate for designing ErbB2 based cancer therapy.

Biochanin A Modulates Cell Viability, Invasion, and Growth Promoting Signaling Pathways in HER-2-Positive Breast Cancer Cells

Overexpression of HER-2 receptor is associated with poor prognosis and aggressive forms of breast cancer. Scientific literature indicates a preventive role of isoflavones in cancer. Since activation of HER-2 receptor initiates growth-promoting events in cancer cells, we studied the effect of biochanin A (an isoflavone) on associated signaling events like receptor activation, downstream signaling, and invasive pathways. HER-2-positive SK-BR-3 breast cancer cells, MCF-10A normal breast epithelial cells, and NIH-3T3 normal fibroblast cells were treated with biochanin A (2–100 μM) for 72 hours. Subsequently cell viability assay, western blotting and zymography were carried out. The data indicate that biochanin A inhibits cell viability, signaling pathways, and invasive enzyme expression and activity in SK-BR-3 cancer cells. Biochanin A did not inhibit MCF-10A and NIH-3T3 cell viability. Therefore, biochanin A could be a unique natural anticancer agent which can selectively target cancer cells and inhibit multiple signaling pathways in HER-2-positive breast cancer cells.

The novel targets for anti-angiogenesis of genistein on human cancer cells

Genistein has been reported to be a natural chemopreventive in several types of human cancer. In our prior study, soy isoflavones were shown to induce cell cycle arrest and apoptosis of bladder cancer cells in the range of human urine excretion. This study was designed to identify the novel molecular basis underlying anti-angiogenic activities of soy isoflavones. An immortalized E6 and five human bladder cancer cell lines were studied by immunoassay, flow cytometry, functional activity, reverse transcription-polymerase chain reaction, immunoblotting, and transwell co-culture in vitro. The efficacy of soy isoflavones on angiogenesis inhibition in vivo was examined by nude mice xenograft and chick chorioallantoic membrane bioassay. Factors analyzed included angiogenic factors, matrix-degrading enzymes, and angiogenesis inhibitors. Genistein was the most potent inhibitor of angiogenesis in vitro and in vivo among the isoflavone compounds tested. It may also account for most of the reduced microvessel density of xenografts observed and the suppressed endothelial migration by soy isoflavones. Genistein exhibited a dose-dependent inhibition of expression/excretion of vascular endothelial growth factor165, platelet-derived growth factor, tissue factor, urokinase plasminogen activator, and matrix metalloprotease-2 and 9, respectively. On the other hand, there was an up-regulation of angiogenesis inhibitors-plasminogen activator inhibitor-1, endostatin, angiostatin, and thrombospondin-1. In addition, a differential inhibitory effect between immortalized uroepithelial cells and most cancer cell lines was also observed. Altogether, we discovered that tissue factor, endostatin, and angiostatin are novel molecular targets of genistein. The current investigation provides further evidence in support of soy-based foods as natural dietary inhibitors of tumor angiogenesis.

Bladder cancer prevention. Part I: what do I tell my patients about lifestyle changes and dietary supplements?

PURPOSE OF REVIEW

Comprehensive reviews of lifestyle changes and dietary supplements that may prevent bladder cancer are needed in order to facilitate discussions between clinicians and patients.

RECENT FINDINGS

Novel data exist that numerous lifestyle/diet and dietary supplements may lower the risk of this disease. For example, reducing arsenic exposure, incorporating dietary changes, and vitamin E supplements continue to accumulate research that supports their use with some patients at a higher risk for this disease. Regardless, smoking cessation seems to have the largest impact on reducing risk and incorporating these other changes after smoking cessation may reduce an individual's risk to an even greater extent.

SUMMARY

However, a large percentage of cases of individuals diagnosed with this cancer apparently have no known etiology. Diets lower in calories or possibly specific sub-types of fat, and higher in fruits and especially vegetables, seem to provide some protection. Other dietary/supplement options may affect risk, but these benefits could be seriously attenuated by smoking. Dietary selenium, but currently not selenium supplements, may also affect risk, especially in non-smokers. Dietary vitamin E, and vitamin E supplements, may provide some protection. Non-selective (e.g. non-steroidal anti-inflammatory drugs) and selective cyclooxygenase-2 inhibitors are generating interest because bladder tumors seem to contain higher concentrations of this enzyme. Drinking-water quality, especially arsenic concentrations, may seriously affect risk. Providing recommendations for patients with regard to some of these lifestyle modifications is currently recommended because the majority of these alterations are also recommended currently for cardiovascular or general oncology disease reduction.

Effects of soy isoflavones on apoptosis induction and G2-M arrest in human hepatoma cells involvement of caspase-3 activation, Bcl-2 and Bcl-XL downregulation, and Cdc2 kinase activity

Genistein, biochanin-A, and daidzein, the predominant soy isoflavones, have been reported to lower the risk of cancer, but it is not known whether they protect against human hepatoma cancer. This study was designed to investigate their effects on cell growth, the cell cycle, and apoptosis induction in the human hepatoma cell lines, HepG2, Hep3B, Huh7, PLC, and HA22T. Genistein, biochanin-A, and daidzein inhibited growth of all five lines in a dose-dependent manner. DNA fragmentation studies and the TUNEL assay demonstrated that isoflavones caused tumor cell death by induction of apoptosis. Activation of caspase-3 and cleavage of the caspase-3 substrate, poly(ADP-ribose)polymerase, was seen in hepatoma cells after 24 hours' exposure to isoflavones. In addition, isoflavone cytotoxicity correlated with downregulation of Bcl-2 and Bcl-XL expression. Synergistic effects of the three isoflavones were observed on cell growth inhibition, apoptosis induction, and anti-apoptotic protein expression. Flow cytometry showed that genistein, but not biochanin-A or daidzein, induced progressive and sustained accumulation of hepatoma cancer cells in the G2/M phase as a result of inhibition of Cdc2 kinase activity. Coapplication of caffeine prevented this cell cycle arrest, but not apoptosis, showing that cell cycle arrest was not necessary for apoptosis. Furthermore, the isoflavones combination also had a significant tumor-suppressive effect in nude mice. These results suggest that isoflavones might be promising agents for the treatment of human hepatoma.

Potential lifestyle and dietary supplement options for the prevention and postdiagnosis of bladder cancer

Apart from smoking, certain occupational exposures, and schistosomiasis, little is known about other potential lifestyle risk factors for bladder cancer. Other investigations thus far have also been important because of the large number of individuals who are diagnosed with this cancer that apparently have no known risk factors. Preventing the recurrence of bladder cancer has generated some interest because several preliminary trials have found that a combination dietary supplement of vitamins and minerals or a probiotic agent (Lactobacillus casei) may impact this outcome favorably. Advising patients on some of these lifestyle modifications is currently recommended because the majority of them are also currently recommended for cardiovascular disease reduction.