H. Mostafa

Relationship between schistosomiasis and bladder cancer.

SUMMARY Carcinoma of the urinary bladder is the most common malignancy in the Middle East and parts of Africa where schistosomiasis is a widespread problem. Much evidence supports the association between schistosomiasis and bladder cancer: this includes the geographical correlation between the two conditions, the distinctive patterns of gender and age at diagnosis, the clinicopathological identity of schistosome-associated bladder cancer, and extensive evidence in experimentally infected animals. Multiple factors have been suggested as causative agents in schistosome-associated bladder carcinogenesis. Of these, N-nitroso compounds appear to be of particular importance since they were found at high levels in the urine of patients with schistosomiasis-associated bladder cancer. Various strains of bacteria that can mediate nitrosation reactions leading to the formation of N-nitrosamines have been identified in the urine of subjects with schistosomiasis at higher intensities of infection than in normal subjects. In experimental schistosomiasis, the activities of carcinogen-metabolizing enzymes are increased soon after infection but are reduced again during the later chronic stages of the disease. Not only could this prolong the period of exposure to activated N-nitrosamines, but also inflammatory cells, sitmulated as a result of the infection, may induce the endogenous synthesis of N-nitrosamines as well as generating oxygen radicals. Higher than normal levels of host cell DNA damage are therefore anticipated, and they have indeed been observed in the case of alkylation damage, together with an inefficiency in the capacity of relevant enzymes to repair this damaged DNA. In experimental schistosomiasis, it was also found that endogenous levels of host cell DNA damage were related to the intensity of infection. All of these factors could contribute to an increased risk of bladder cancer in patients with schistosomiasis, and in particular, the gene changes observed may have potential for use as biomarkers in the early detection of bladder cancer that may assist in alleviating the problem.

Salivary Nitrate, Nitrite and Nitrate Reductase Activity in Relation to Risk of Oral Cancer in Egypt

It has been suggested that nitrate and nitrite may play a role in the etiology of human oral cancer. We investigated whether salivary nitrate and nitrite and the activity of nitrate reductase (NRase) may affect the risk of oral cancer in Egypt, an area with high levels of environmental nitrosating agents. Levels of salivary nitrite (8.3 ± 1.0 μg/ml) and nitrate (44 ± 3.7 μg/ml) and activity of NRase (74 ± 10 nmol/ml/min) were significantly (P < 0.05) higher in oral cancer patients (n = 42) compared to control Egyptian healthy individuals (n = 40, nitrite = 5.3 ± 0.3 μg/ml, nitrate = 27 ± 1.2 μg/ml, and NRase activity = 46 ± 4 nmol/ml/min). The adjusted odds ratio (OR) and the 95% confidence intervals (C.I.) for risk of oral cancer, categorized by the levels of salivary nitrate and nitrite and NRase activity, showed a higher cancer risk associated with nitrite > 7.5 μg/ml (OR: 3.0, C.I.: 1.0–9.3), nitrite > 40 μg/ml (OR: 4.3, C.I.: 1.4–13.3) and NRase activity > 50 nmol/ml/min (OR: 2.9, C.I.: 1.1–7.4). Our findings suggest that increased consumption of dietary nitrate and nitrite is associated with elevated levels of salivary nitrite. Together with the increased activity of salivary NRase, these observations may explain, at least in part, the role of nitrate and nitrite in the development of oral cancer in individuals from an area with a high burden of N-nitroso precursors.

Bladder tumor contains higher N7-methylguanine levels in DNA than adjacent normal bladder epithelium.

Schistosoma haematobium–infected patients are more likely to develop bladder cancer and be more exposed to carcinogenic N-nitroso compounds than uninfected patients. As N7-methylguanine is a marker of exposure to methylating agents of this type, we have measured N7-methyldeoxyguanosine 3′-monophosphate (N7-MedGp) by 32P postlabeling. DNA was isolated from 42 paired normal and tumor tissue of Egyptians with bladder cancer. N7-MedGp was detected in DNA from 93% of the tumors and 74% of the normal bladder tissue samples. Adduct levels were highly variable and ranged from 0.04 to 6.4 and from 0.02 to 0.72 μmol/mol deoxyguanosine 3′-monophosphate (dGp) in tumor and normal DNA, respectively. N7-MedGp levels in normal and tumor DNA were highly correlated with one another (P = 0.007). The mean difference (95% confidence interval) in adduct levels between tumor and normal DNA was 0.21 (0.13-0.32) μmol/mol dGp and this was statistically significant (P < 0.001). The adduct ratio (tumor DNA/normal DNA) varied between 0.2 and 136 (median, 4.6). N7-MedGp levels were not associated with gender, age, or the presence of schistosomiasis. However, lower N7-MedGp levels were found in normal DNA from individuals lacking the GSTM1 gene (P = 0.03) but not the GSTT1 gene or in subjects with the Ile105Val GSTP1 polymorphism. These results show that exposure to methylating agents is widespread and suggest that such exposure may play a role both in tumor initiation and progression. (Cancer Epidemiol Biomarkers Prev 2006;15(4):740–3)

Involvement of alkylating agents in schistosome-associated bladder cancer: the possible basic mechanisms of induction

Carcinoma of the urinary bladder is a common malignancy in many tropical and subtropical countries. There is a well documented sequela of chronic urinary schistosomal infection and bladder cancer associated with schistosomiasis is a major cause of morbidity and mortality in the endemic areas. Experimental bladder cancer can be induced in schistosome-infected animals. Multiple factors have been suggested as causative agents in schistosome-associated bladder carcinogenesis and the N-nitroso compounds appear to be of particular importance. These agents have long been suspected to play a major role in the aetiology of a variety of human cancers. A model for the induction of bladder cancer associated with schistosomiasis is proposed which takes into account the interrelationships between different factors resulting from the infection, especially the role of alkylating agents that can contribute to the induction of this neoplasm.

Evidence for the presence of active cytochrome P450 systems in Schistosoma mansoni and Schistosoma haematobium adult worms

Extracts of the adult worms of both Schistosoma mansoni and Schistosoma haematobium can metabolise some typical P450 substrates but to differing degrees. S. mansoni worm extracts displayed a ∼12‐fold higher specific activity for an aminopyrine substrate than rat liver microsomes. At 4 mM substrate concentration the demethylation reaction with N‐nitrosodimethylamine (NDMA) (5 nmol HCHO/mg protein/min) was only half that of rat liver microsomes, whereas in extracts of S. haematobium, no detectable activity was found towards NDMA. Using ethylmorphine as substrate the demethylation activity of S. mansoni extracts (1.82 nmol HCHO/mg protein/min) was 5.5‐fold lower than that of rat liver microsomes. Benzphetamine demethylase activity was also readily detectable in S. mansoni worm extracts at 6.79 nmol HCHO/mg protein/min compared with 10.20 nmol HCHO/mg protein/min in the case of rat liver microsomes. When aniline was used as substrate, surprisingly, no activity was found in worm extracts of either S. mansoni or S. haematobium, whereas rat liver microsomes showed high activity towards this amine. The anti‐P450 2E1 and 2B1/2 cross‐reacted with both worm homogenates and gave a specific band corresponding to a protein of molecular weight of ∼50.0 kDa. A study with anti‐P450 IVA antibody revealed that while this protein was strongly expressed in S. haematobium worm extracts, no immunoreactivity was observed with extracts of S. mansoni. Immunoblotting analyses with anti‐P450 IIIA and P450 1A1 did not detect immunoreactive protein in either S. mansoni or S. haematobium.

Glutathione S-transferase M1, T1 and P1 polymorphisms and bladder cancer risk in Egyptians

Previous studies suggest that bladder cancer risk may vary with GST genotype but these results are inconsistent. The aim of this study was to explore whether GSTM1, GSTT1 and GSTP polymorphisms were associated with increased bladder cancer risk in an Egyptian population. GSTM1, GSTT1 and GSTP1 genotype frequencies were determined in bladder cancer cases (n=72) and healthy controls with no history of malignancies (n=82) using PCR-based techniques. The GSTT1*2 genotype was particularly associated with increased risk (OR 2.71, 95%CI 1.27-5.73) and the GSTM1*2 genotype to a lesser extent (OR 1.63, 95%CI 0.85-3.10). 18.1% of cases but only 7.3% of controls were GSTP1*B*B homozygotes (OR 2.38, 95%CI 0.83-6.87). The presence of two or more a priori at-risk genotypes was associated with increased bladder cancer risk (OR 2.42; 95%CI 1.47-3.97). These results suggest that polymorphisms in the GST genes are associated with increased risk of bladder cancer among Egyptians.

O6-Alkylguanine-DNA alkyltransferase activity in schistosomiasis-associated human bladder cancer

O6-Alkylguanine-DNA-alkyltransferase (ATase) activity was measured in extracts of 55 bladder tissue samples (46 tumour and nine uninvolved mucosal tissue) from Egyptian patients with schistosome-associated bladder carcinoma. Activity varied from 2.0 to 16.2 fmole ATase/microgram DNA (mean +/- S.D.; 5.6 +/- 4.0) or from 28 to 351 fmole ATase/mg (117 +/- 71). ATase levels in schistosome-associated bladder cancer tissues (5.6 +/- 4.0 fmole ATase/microgram DNA) tended to be lower than those observed in normal human bladder mucosal tissue (8.5 +/- 4.4 fmole ATase/microgram DNA). In a previous study (Badawi et al., Carcinogenesis, 1992, 13, 877-881) DNA-alkylation damage (O6-methyldeoxyguanosine) was found in 44/46 of these schistosome-associated bladder cancer samples at levels ranging from 0.012 to 0.485 mumole O6-MedG/mole deoxyguanosine. We now report an inverse correlation between the levels of methylation damage and ATase activity (r = -0.67; P < 0.001). These observations encourage further investigations of the possible role of environmental alkylating agents in the aetiology of early bladder cancer associated with schistosomiasis.

High level of expression and stability of the cloned alkaline protease (aprA) gene in Bacillus subtilis.

Gene expression and plasmid stability of the cloned alkaline protease (aprA) gene in Bacillus subtilis were investigated. B. subtilis cells harboring the multicopy aprA gene were grown on sporulation medium and the activity of the alkaline protease was monitored throughout the cultivation time. Results presented indicate that the expression of the aprA gene occurred late during the stationary phase and the plasmid that carries the aprA gene was segregationally and structurally stable.

N-nitrosamines and their effects on the level of glutathione, glutathione reductase and glutathione S-transferase activities in the liver of male mice

The present study investigates the influence of different chemical structure of N-nitroso compounds on the hepatic level of reduced glutathione (GSH), glutathione reductase (GSH-R) and glutathione S-transferase (GST) activities in the liver of male Balb/C mice after treatment with 20 mg/kg body weight of each compound for 1 h as a single dose. The level of reduced glutathione decreased significantly between 37 and 70% after the treatment of male mice with ethylbutylnitrosamine (-37%), diphenylnitrosamine (-50%), propylbutylnitrosamine (-52%), diethylnitrosamine (-54%), ethylmethylnitrosamine (-55%), and dibutylnitrosamine (-70%), whereas, methylpropylnitrosamine increased the level of GSH by 71%. All the N-nitrosamine compounds tested increased the activity of glutathione reductase except ethylmethylnitrosamine had no effect. The activity of glutathione S-transferase activity was inhibited after treatment of the male mice with diphenylnitrosamine (-60%), dibutylnitrosamine (-60%), and methylpropylnitrosamine (-81%), while, ethylmethylnitrosamine and ethylbutylnitrosamine had no effect on such activity. On the other hand, diethylnitrosamine increased the activity of glutathione S-transferase by 50%. It can be postulated from this study that the chemical structure of N-nitrosamines plays a significant role in the alteration of GSH level and GSH metabolizing enzymes, since the substitution of different groups on the nitroso group was found to be capable of causing an alteration in such activities.

Effect of melatonin on the production of microsomal hydrogen peroxide and cytochrome P-450 content in rat treated with aflatoxin B1

Aflatoxin B(1) (AFB(1)) is a food contaminant fungal toxin that has been implicated as a causative agent in human hepatic and extrahepatic carcinogenesis. In this study we went on to show the effect of melatonin as a free radical scavenger on the production of microsomal hydrogen peroxide (H(2)O(2)) during the metabolic activation AFB(1). The production of microsomal H(2)O(2) in vitro during the metabolic activation of different chemical carcinogens has been reported previously. We also studied the effect of melatonin on the cytochrome P-450 content as a major microsomal monooxygenase isoenzymes system in rat liver responsible for the metabolic activation of AFB(1). The amounts of H(2)O(2) and cytochrome P-450 contents in rat treated with melatonin (0.2 mg/kg BW) and/or AFB(1) (0.2 mg/kg BW) at various time intervals has been measured. Animals treated with melatonin exhibited markedly inhibition in the amounts of H(2)O(2) after 1, 3, and 6 h. The highest level of inhibition (3.0 nmol H(2)O(2)/mg protein) was detected after 6 h. However, cytochrome P-450 contents were also decreased after the same period of time. The highest level of inhibition (2.1 nmol/mg protein) was detected after 3 h of injection. A pronounced augmentation of H(2)O(2) production was observed in rat treated with AFB(1) only. The highest level of H(2)O(2) (100 nmol/mg protein) was measured after 1 h. Cytochrome P-450 contents were also decreased in response to AFB(1) injection over the same time intervals. Contrary data was detected in animals received both AFB(1) and melatonin. The generation of H(2)O(2) was inhibited by melatonin after 1, 3 and 6 h. The highest level of inhibition (44.2 nmol/mg protein) was observed after 6 h. Finally, these data suggested that melatonin as a free radical scavenger inhibited the microsomal production of H(2)O(2) in rat treated with AFB(1).