Padmanabhan P. Nair

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Dietary cholesterol, beta-sitosterol, and stigmasterol.

Cholesterol and fat are implicated as dietary factors enhancing the risk for colon carcinogenesis. Plant sterols such as beta-sitosterol when added to diets of experimental animals treated with colon carcinogens reduce tumor yields and counteract the proliferative changes associated with carcinogenesis. The question of whether the diet of human populations at low risk for colon cancer is mirrored in their sterol composition is addressed in this study. Four study groups consisting of 18 Seventh-day Adventist (SDA) pure vegetarians, 50 SDA lacto-ovo vegetarians, 50 SDA nonvegetarians, and 50 general population nonvegetarians were selected from the greater Los Angeles basin, and 3-day composite diets were analyzed for their sterol composition. The most significant index of dietary sterol status is the ratio, beta-sitosterol + stigmasterol/cholesterol (plant sterol/cholesterol ratio). The values for the four groups ranged from 0.49 to 16.0 (general population nonvegetarians = 0.49; SDA-nonvegetarians = 0.98; SDA lacto-ovo vegetarians = 3.26; SDA pure vegetarians = 16.0). The data also show that the absolute amounts of cholesterol consumed as a factor by itself might not be as significant as its relationship to total plant sterols in the diet.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Metabolism of bile acids.

High levels of fecal bile acids have been associated with populations at high risk for developing colon cancer. In this study, 168 subjects were drawn from populations that show low and high mortality from colon cancer [pure vegetarians, lacto-ovo vegetarians, and nonvegetarians Seventh-day Adventists (SDA) and demographically comparable group from the general population]. Lyophilized aliquots of 3-day stool samples were examined for levels of primary (cholic and chenodeoxycholic acids) and secondary (deoxycholic and lithocholic acids) bile acids. Total bile acids (mg/g lyophilized stools) were statistically different among dietary groups: SDA pure vegetarians 2.16 +/- 0.32, SDA lacto-ovo vegetarians 3.66 +/- 0.41, SDA nonvegetarians 4.39 +/- 0.44, general population nonvegetarians 6.04 +/- 0.75; but were similar when stool weights, body weights, and fat intake were taken into account. The most striking difference was evident in the ratio of secondary to primary bile acids: when compared to SDA pure vegetarians, both SDA lacto-ovo vegetarians and SDA nonvegetarians had twice the ratio while values for general population nonvegetarians were five to six times. The data indicate that these differences in excretion patterns among dietary groups reveal distinctly characteristic metabolic features associated with diet and lifestyle.

Serum HSP70: a novel biomarker for early detection of pancreatic cancer.

Objectives Heat shock protein 70 (HSP70) is overexpressed in human pancreatic cancer cell lines. To determine if serum HSP70 levels are elevated in patients with pancreatic cancer and can function as a biomarker for early detection of pancreatic cancer. Methods Study subjects were divided into 3 groups: histologically proven pancreatic cancer (PC; n = 23), chronic pancreatitis (CP; n = 12), and matched normal control subjects (C; n = 10). Serum HSP70 levels were determined using a novel immunoelectrophoresis method developed and validated by the authors. Significance of difference between the groups was analyzed with analysis of variance (ANOVA). Receiver operating characteristic (ROC) curve analysis was performed to discriminate patients with pancreatic cancer from normal controls. Results The mean ± SE serum HSP70 levels in the PC, CP, and C groups were 1.68 ± 0.083 ng/mL, 0.40 ± 0.057 ng/mL, and 0.04 ng/mL, respectively. Serum HSP70 levels in the PC group were significantly higher compared with either the CP or C groups (P < 0.01). The sensitivity and specificity of elevated serum HSP70 in the PC group was 74% and 90%, respectively. Conclusions Serum HSP70 levels are significantly increased in patients with pancreatic cancer and may be useful as an additional biomarker for the detection of pancreatic cancer.

Effects of omega-3 fatty acid and vitamin E supplementation on erythrocyte membrane fluidity, tocopherols, insulin binding, and lipid composition in adult men

Abstract Dietary supplementation with an omega-3 fatty acid preparation (fish oil) together with pharmacologic doses of vitamin E increased both insulin binding and membrane fluidity in erythrocytes from human adult males. Supplementation with fish oil alone induced significant increases in the α- and γ-tocopherol contents of the red blood cell membranes. Forty healthy men were given controlled diets and supplements, which together provided 40% of energy from fat (polyunsaturated:monosaturated:saturated ratio of 0.8:1:1), 360 mg cholesterol/day, and a minimum of 22 mg α-tocopherol (αT)/day for three successive experimental periods of 10, 10, and 8 weeks, during which they were given capsules containing 15 g of a placebo oil/day, 15 g fish oil concentrate (FOC)/day, and 15 g fish oil + 200 IU αT (FOC + αT)/day, respectively. Erythrocyte ghost insulin binding (IB) and 1,6-diphenyl-1,3,5-hexatriene (DPH) fluorescence-determined fluidity were significantly increased following the FOC + αT period, however FOC alone had no effect. At the end of each experimental period, IB values, as percentage bound/100 μg ghost protein at 4° C, were 0.96, 0.91, and 1.35, and DPH steady state fluorescence anisotropies were 0.311, 0.303, and 0.296, at 4° C, respectively. Small but statistically significant decreases in fluorescence lifetimes further indicated increased fluidity. FOC supplementation resulted in significantly lower membrane cholesterol:phospholipid ratios and increased membrane tocopherols despite daily vitamin E consumption of only 22 mg as in the placebo period. Membrane incorporation of n-3 fatty acids was, however, limited. Thus, dietary polyunsaturated fatty acids exerted substantial effects on erythrocyte membranes by affecting membrane contents of lipid molecules other than the fatty acids.

Studies on the bioavailability of the provitamin A carotenoid, β-carotene, using human exfoliated colonic epithelial cells

The possibility of using exfoliated colonic epithelial cells for assessing the bioavailability of beta-carotene was examined. Analysis of exfoliated colonic epithelial cells showed the presence of beta-carotene and vitamin A. The beta-carotene content was significantly lower in cells from stool samples of subjects on a beta-carotene-poor diet than those receiving a single dose of a beta-carotene supplement. Colonic epithelial cells isolated from stool samples collected daily during a wash-out period while the subjects were on a beta-carotene-poor diet showed a steady decrease in beta-carotene content, reaching the lowest value on day 7. Kinetic analysis showed that a single dose of a beta-carotene supplement in the form of spirulina (Spirulina platensis) or agathi (Sesbania grandiflora) after the wash-out period caused an increase in the beta-carotene content after a lag period of 5-7 d, but the vitamin A levels during these periods were not significantly affected. Analysis of plasma beta-carotene concentration also showed similar changes, which correlated with those of exfoliated colonic cells. A relationship between the beta-carotene content of the diet and that of the colonic epithelial cells suggests that analysis of the beta-carotene content in exfoliated human colonic epithelial cells is a useful non-invasive method to assess the bioavailability of provitamin A beta-carotene.

Coprocytobiology: on the nature of cellular elements from stools in the pathophysiology of colonic disease.

Abstract The gastrointestinal epithelium is known to undergo constant and rapid renewal resulting in millions of cells being shed into the fecal stream every day. The conventional wisdom was that these cells disintegrate upon exfoliation and will not survive the transit through the intestinal tract. In 1990, we (P.N.) made the discovery that a significant number of these cells remain intact and viable and that they can be isolated. The implications of this important discovery became apparent when we demonstrated that these cells are exclusively of colonic origin, are anatomically representative of the entire colon, and can be used for clinical investigations of disease processes. The term coprocytobiology (CCB) was coined to encompass the broad range of applications of this new technology. The somatic cell sampling and recovery (SCSR) process involves the isolation of exfoliated colonocytes from a small sample of stool (≈1 g) collected and transported in a unique medium at ambient temperature, providing cells for the detection of a number of biomarkers of disease propensity. These exfoliated colonocytes express cytokeratins indicating epithelial lineage as well as colon‐specific antigen. Over the years, the study of exfoliated colonocytes has provided striking new insights into the biology of colon cancer and inflammatory bowel disease, including detection of p53 gene mutations, reverse transcriptase polymerase chain reaction amplification, and identification of CD44 splice variants, neoplasia‐associated specific binding of plant lectins, and expression of COX‐2, the inducible form of cyclooxygenase. The functional diversity of cells isolated by SCSR is revealed by the demonstration of cell surface markers such as secretory component, IgA, and IgG on the one hand and the amplification and cloning of the human insulin receptor and the expression of the multidrug resistance gene mdr‐1 on the other hand. This review portrays the immense potential of CCB as a powerful tool for investigating the pathophysiology of disease, identifying genetic variants in pharmacogenetics, assessment of mucosal immunity, and several other applications that use somatic cells.

The influence of cholesterol and fat in maternal diet of rats on the development of hepatic cholesterol metabolism in the offspring

Abstract The influence of a high cholesterol-high fat (HC-HF) diet on the hepatic synthesis and catabolism of cholesterol in the offspring was investigated at various stages of growth and development in the rat. Pregnant rats were fed HC-HF or the control diet throughout the period of pregnancy and newborn pups were suckled by mothers fed either the control or experimental diet throughout the period of lactation. The animals were killed at birth, weaning or at maturity for the determination of serum cholesterol, hepatic HMG-CoA reductase, cholesterol 7α-hydroxylase, and microsomal cholesterol accumulation. Feeding HC-HF diet to pregnant or lactating animals caused a 34% inhibition of HMG-CoA reductase in newborn pups and an inhibition of over 75% in suckling and mature animals. Hepatic 7α-hydroxylase in the newborn from mothers on the experimental diet rose progressively when compared to those from the control group which remained unaffected. Microsomal cholesterol in newborn pups was not influenced by maternal diet. Weanlings nursed by mothers fed the HC-HF diet showed a 66% reduction in HMG-CoA reductase activity and 150% increase in cholesterol 7α-hydroxylase when compared to those nursed by animals on the control diet. The results are compatible with the thesis that exposure to high dietary cholesterol and fat in gestation has a significant influence on the development of enzymes regulating cholesterol metabolism at weaning.

Non-invasive detection of c-myc p64, c-myc p67 and c-erbb-2 in colorectal cancer

Objective. Colorectal cancer is a major cause of cancer mortality in the industrialized nations in the West. Because mortality is closely related to the stage of the disease at the time of diagnosis, detection at an early stage is likely to result in improved recovery rates. Since current diagnostic procedures such as colonoscopy are invasive and the fecal occult blood test (FOBT) lacks sensitivity and specificity for the detection of early lesions, the development of non-invasive methods based on molecular markers of neoplasia can lead to earlier diagnosis and more favorable outcomes for patients with colorectal cancer. Recent advances in the technology for isolating colonocytes from stool (SCSR (somatic cell sampling and recovery)) provide a non-invasive tool for the study of biomarkers expressed in colorectal cancer. The aim of this study was to detect mRNA expression of three biomarkers: (c-erbb-2 and two forms of c-myc: p64 and p67) in fecal colonocytes and to evaluate its use in diagnosing colorectal cancer. Material and methods. Colonocytes (SCSR cells) were isolated from stools from 30 subjects: 15 colorectal cancer patients and 15 normal controls. One cancer patient was excluded from the final data analysis because the tumor was a gastrointestinal lymphoma. Each sample yielded two fractions: a pellet and an interphase. Expression of c-myc p64, c-myc p67 and c-erbb-2 mRNA was evaluated in each of the fractions by reverse transcriptase-polymerase chain reaction (RT-PCR). A marker was considered positive upon detecting an amplicon of the expected size in agarose gel electrophoresis. Results. c-myc p64 mRNA expression was observed in both fractions in 78.5% of colorectal cancer patients, compared with 13.3% in the control group (p=0.009). For c-myc p67, 78.6% of the colorectal cancer patients showed mRNA expression in both fractions in comparison with only 13.3% of the controls (p=0.003). C-erbb-2 showed no significant difference in mRNA expression between colorectal cancer and controls. When the data were analyzed for co-expression of c-myc p64 and c-myc p67, in both pellet and interphase, sensitivity was 64% and specificity was 100%. Conclusions. Fecal colonocytes isolated by somatic cell sampling and recovery (SCSR) technology could be used for the non-invasive assessment of the expression of biomarkers of colon cancer such as c-myc p64, c-myc p67 and c-erbb-2. The expression of c-myc p64 and c-myc p67 in colonocytes showed a significant association with colorectal cancer and may be helpful as a biomarker for the non-invasive detection of colorectal cancer.

The induction of SOS function in Escherichia coli K-12/PQ37 by 4-nitroquinoline oxide (4-NQO) and fecapentaenes-12 and -14 is bile salt sensitive: implications for colon carcinogenesis.

The response of Escherichia coli to genotoxic agents involves the triggering of a complex system of genes known as the SOS response. In E. coli PQ37, a test organism used for the assessment of genotoxicity, lacZ, the beta-galactosidase gene is placed under the control of sfiA, one of the SOS genes through an operon fusion. The induction of beta-galactosidase activity, when the organism is exposed to genotoxic agents, is an indirect measure of the genotoxic activity of the test compound. Incubation of E. coli PQ37 with either 4-nitroquinoline oxide (4-NQO) or one of the fecal mutagens, fecapentaene-12 or -14 (F-12 or F-14) in the presence of sodium taurocholate or sodium deoxycholate resulted in a significant enhancement of induction of beta-galactosidase activity. The molecular mechanisms of 4-NQO-induced mutagenesis in E. coli are similar to those of the effects of UV light in which both replication-dependent and repair-dependent pathways of mutagenesis exist. Since E. coli PQ37 is excision-repair-deficient, alternate pathways are involved in this system. Bile salts by themselves do not trigger the SOS response, and hence their role in enhancing the SOS-inducing potency of mutagens may involve the potentiation of the cleavage-inactivation of lexA (repressor of SOS) by the protein product of the SOS-controlled gene, recA. The potentiating effect of bile salts on the fecal mutagens, F-12 and F-14, has implications in their suspected role in colon carcinogenesis associated with high-fat, low-fiber diets.

Quantitative assessment of the genotoxicity of fecapentaenes.

Fecapentaenes are a group of fecal mutagens of microbial origin isolated from human stools. Fecapentaene-12 (F-12) and fecapentaene-14 (F-14), differing only in two carbon atoms in the side chain, are glyceryl ethers with a highly reactive chromophoric aliphatic side chain incorporating a conjugated pentaene moiety. Although these compounds are known for their genotoxicity, no test systems have been developed to precisely assess their relative genotoxicity. In this study F-12 and F-14 were assayed for their genotoxicity using the SOS Chromotest in which the induction of beta-galactosidase in E. coli PQ37 was used as a quantitative measure of biological activity. The activity obtained with F-12 and F-14 was compared with that of 4-nitroquinoline oxide (4-NQO) as the reference standard of a direct acting mutagen. While F-14 was almost as active as 4-NQO, F-12 was only about 25% as active as F-14, the higher analog.