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Research Suggests New Avenue For Stopping, Preventing Colon Cancer

ScienceDaily (Sep. 21, 2004) — NASHVILLE, Tenn. – Researchers at the Vanderbilt-Ingram Cancer Center (VICC) have provided the first evidence that blocking a cellular receptor can inhibit the development of pre-cancerous colon polyps in mice.

The research suggests a new avenue for stopping or preventing colon cancer, which kills more than 50,000 Americans each year, said the paper's senior author, Raymond N. DuBois, M.D., Ph.D., Hortense B. Ingram Professor of Molecular Oncology and the VICC's associate director for Cancer Prevention and Control.

The receptor, called PPARdelta, plays an important role in development, wound healing and fat metabolism. In the current issue of the journal Cancer Cell, the scientists reported that they could inhibit polyp development in mice by "knocking out" the PPARdelta gene. PPAR stands for peroxisome proliferator-activated receptor, a family of three "transcription factors" that serve as on-off switches for a wide variety of genes.

DuBois is internationally known for his pioneering studies linking the development of colorectal cancer to the cyclooxygenase-2 (COX-2) enzyme. COX-2 is a major target for drugs that relieve the pain and inflammation of arthritis, but COX-2 gene expression is also elevated in a variety of malignancies including colorectal tumors.

COX-2 generates several potent, hormone-like substances called prostaglandins that play a role in a wide variety of physiological functions. One of them, prostaglandin E2 (PGE2), has been specifically linked to the development of colon polyps. The current study tested the effect of PGE2 in mice with the mutation that made them susceptible to polyps. Administration of the prostaglandin dramatically increased the number of intestinal polyps.

The animals were then crossed with mice without the PPARdelta gene. This generated animals with the propensity to develop colon polyps but lacking PPARdelta. When PGE2 was given to these mice, "we didn't seen any increase in polyps," DuBois said.

"Our results identify PPARdelta as a critical downstream mediator in PGE2-stimulated promotion of colorectal tumor growth," the researchers concluded.

A drug that blocks PPARdelta has been developed in France, and the Vanderbilt researchers hope to test it in mice to see if it has the same effect as knocking out the gene. "We've been carefully examining drugs which inhibit COX-2," DuBois explained. "Now we can really focus on key components of the downstream pathway."

The research could lead to more specific – and safer -- ways to prevent colorectal cancer. In addition to generating PGE2, the COX-2 enzyme produces another prostaglandin that blocks clot formation and dilates blood vessels. Long-term, high-dose use of the COX-2 inhibitor Vioxx has been linked to high blood pressure and an increased risk of serious heart problems in some patients.

Last month, researchers at the Salk Institute in La Jolla reported that activating PPARdelta in mice stimulated changes in muscle fibers that enabled the animals to run "marathons" and eat a high-fat diet without gaining weight. A drug that turns on PPARdelta is being tested in patients with fat metabolism disorders.

However, when the drug was given to a strain of mice with a genetic mutation that makes them susceptible to developing pre-cancerous intestinal polyps, both the number and size of polyps increased significantly, DuBois and his colleagues reported last February in Nature Medicine. The same mutation is found in 80 percent of patients with colorectal cancer.

The findings suggest that drugs that activate PPARdelta "may encourage abnormal cell growth in certain populations at risk for colorectal cancer," DuBois cautioned.

DuBois credited Sudhansu K. Dey, Ph.D., who directs the division of Reproductive and Developmental Biology at Vanderbilt, with maintaining the PPARdelta "knockout" mouse colony that made the study possible. Dey, DuBois and their colleagues previously have demonstrated the importance of PPARdelta in implantation of the embryo during development.

The study's lead author was Dingzhi Wang, Ph.D., research associate professor of Medicine.

Other members of the research team were Haibin Wang, Qiong Shi, Sharada Katkuri and Sanjoy K. Das, Ph.D., of Vanderbilt; and Walter Walhi, Ph.D., and Beatrice Desvergne, Ph.D., of the University of Lausanne, Switzerland.

### The study was supported by the National Institutes of Health, the National Colorectal Cancer Research Alliance and the T.J. Martell Foundation for Leukemia, Cancer and AIDS Research.

Located in Nashville, Tenn., the Vanderbilt-Ingram Cancer Center is the only Comprehensive Cancer Center designated by the National Cancer Institute in Tennessee, and one of only 38 nationwide. This designation, the highest ranking awarded to cancer centers by the world's foremost authority on cancer, recognizes research excellence in cancer causes, development, treatment and prevention, as well as a demonstrated commitment to community education, information and outreach. For more information, visit http://www.vicc.org.


Adapted from materials provided by Vanderbilt University Medical Center.
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