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ENVR 430 Chemical Carcinogenesis: Initiation, Promotion, Progression Ivan Rusyn Laboratory of Environmental Genomics Department of Environmental Sciences & Engineering [email protected] 843-2596 0031 MHRC CANCER: “A multicausal, multistage group of diseases the mechanisms of which are still only partially known” (IARC Scientific Publications, 1992) “Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells […] that can result in death” (American Cancer Society, 2006) Age adjusted Cancer Death Rates, by Site, US, 1930-2002 • Benign tissue is not cancer. Although the cell growth is moderately increased, the cells do not invade nearby tissue or spread to other parts of the body • Malignant tissue is cancer. The cancer cells divide out of control. They can invade and destroy nearby healthy tissue. Also, cancer cells can break away from the tumor they form and enter the bloodstream and lymphatic system • Metastasis: the spread of cancer beyond the organ of origin WHAT MAY CAUSE CANCER ? Hereditary disorders Chemicals Viruses Chronic inflammation ??? From http://www.cancersupportivecare.com/riskintro.html History of Chemical Carcinogenesis • Chemical carcinogenesis was first suggested by clinicians 200 years ago – Scrotal cancer in chimney sweeps - Potts – Nasal cancer and snuff dipping - Hill – Today, >50 chemicals are recognized as human carcinogens • First experimental studies in animals were done ~80 years ago History of Chemical Carcinogenesis • Large numbers of chemicals were tested for carcinogenic potential in the 1970-1990s – Maximum Tolerated Doses (MTD) were used. – 60% of rodent carcinogens were genotoxic – 40% of rodent carcinogens were nongenotoxic – Some chemicals were single site, single species carcinogens – Others were multisite, multispecies carcinogens – Dose-response varies from <1/2 MTD to <1/1000 MTD • Most regulations use straight mathematical extrapolation of high dose rodent data to predict risks WORLD HEALTH ORGANIZATION INTERNATIONAL AGENCY FOR RESEARCH ON CANCER IARC Monograph Evaluations LYON, FRANCE Slide courtesy of V. Cogliano (IARC) IARC: Slide courtesy of V. Cogliano (IARC) A tour of IARC’s classifications Preamble, Part B, Section 6(d) Slide courtesy of V. Cogliano (IARC) Slide courtesy of V. Cogliano (IARC) IARC (2007) - monographs.iarc.fr •Carcinogenic to humans (group 1) – 100 agents to date •Probably carcinogenic to humans (group 2A) – 68 •Possibly carcinogenic to humans (group 2B) – 246 •Not classifiable as to its carcinogenicity to humans (group 3) – 516 •Probably not carcinogenic to humans (group 4) – 1 U.S. EPA (2003) •Carcinogenic to humans •Likely to be carcinogenic to humans •Suggestive evidence of carcinogenic potential •Inadequate information to assess carcinogenic potential •Not likely to be carcinogenic to humans U.S. NTP (2002) (see NTP levels of evidence.pdf) •Known to be a human carcinogen •Reasonably anticipated to be a human carcinogen Cal/EPA (2004) •Known to the state to cause cancer Cancer Cases Attributable to Environmental Carcinogens (Worldwide, 1990) Infections (viruses, parasites, H. pylori) Tobacco (smoked and smokeless) Occupation Alcohol drinking 16% 14% 4% 3% 37% Diet and dietary components including contaminants Pollution Reproductive factors 25% 2% 2% 29% IARC Group 1 – Carcinogenic to humans Monographs Volumes 1-84 (1972-2002): 89 Agents and Exposures Medical drugs and treatments Industrial processes Infectious agents or processes Physical agents Industrial chemicals Inhaled particulates Metals and inorganic salts Lifestyle factors (incl. herbal remedies) Other 24 13 10 10 7 5 5 7 8 Exposures to Chemicals in the Workplace Agent Industries and Trades with Proved Excess Cancers and Exposure Primary Affected Site p-Aminodiphenyl Chemical manufacturing Urinary bladder Asbestos Construction, asbestos mining and milling, production of friction products and cement Copper mining and smelting Pleura, peritoneum, bronchus Skin, bronchus, liver Chemical manufacturing Bronchus Chemical and rubber manufacturing, petroleum refining Bone marrow Benzidine, -naphthylamine, and derived dyes Dye and textile production Urinary bladder Chromium and chromates Tanning, pigment making Nasal sinus, bronchus Isopropyl alcohol manufacture Chemical manufacturing Nickel Polynuclear aromatic hydrocarbons from coke, coal tar, shale, mineral oils, and creosote Vinyl chloride monomer Nickel refining Steel making, roofing, chimney cleaning Cancer of paranasal sinuses Nasal sinus, bronchus Skin, scrotum, bronchus Chemical manufacturing Liver Wood dust Cabinetmaking, carpentry Nasal sinus Arsenic Alkylating agents (mechloroethamine hydrochloride and bis[chloromethyl]ether) Benzene Modified from Cullen et al. (1990). Carcinogenic Risks of Chemical Agents Associated with Medical Therapy and Diagnosis Chemical or Drug Associated Neoplasms Evidence for Carcinogenicity Alkylating agents (cyclophosphamide, melphalan) Inorganic arsenicals Bladder, leukemia Sufficient Skin, liver Sufficient Azathioprine (an immunosuppressive drug) Lymphoma, reticulum cell sarcoma, skin, Karposi’s sarcoma (?) Bladder Sufficient Leukemia Vagina (clear cell carcinoma) Limited Sufficient Liver cell adenoma Endometrium Skin Sufficient Limited Sufficient Liver Renal pelvis (carcinoma) Limited Sufficient Lymphoma, neuroblastoma Liver (angiosarcoma) Limited Chlornaphazine Chloramphenicol Diethylstibesterol Estrogens Premenopausal Postmenopausal Methoxypsoralen with ultaviolet light Oxymetholone Phenacetin Phenytoin (diphenyhydantoin) Thorotrast Sufficient Sufficient Carcinogenic Factors Associated with Lifestyle Chemical, Physiological Condition or Natural Process Alcoholic beverages Associated Neoplasm Evidence for Carcinogenicity Esophagus, liver, oropharynx, larynx Sufficient Aflatoxins Liver Sufficient Betel chewing Mouth Sufficient Dietary intake (fat, protein, calories) Reproductive history Late age at first pregnancy Zeo or low parity Tobacco smoking Breast, colon, Sufficient endometrium, gallbladder Breast Ovary Mouth, pharynx, laryns, lung, esophagus, bladder Sufficient Sufficent Sufficient Modified from Pitot (1986) and Vainio et al. (1991) Chemical Carcinogenesis in the 21st Century New perceptions of previously known carcinogens: Combined effects of multiple exposures Examples: o Alcohol drinking and aflatoxins o Alcohol drinking and HBV/HBC o Alcohol drinking and tobacco smoking o Alcohol drinking and asbestos/arsenic/radon Stages of Carcinogenesis Initiation Initiating Event Cell Proliferation (clonal expansion) Promotion Cell Proliferation Progression Cell Proliferation Malignancy Cellular and Molecular Mechanisms in Multistage Carcinogenesis: INITIATION “Simple” genetic changes From http://newscenter.cancer.gov/sciencebehind/ Initiating event involves cellular genome – MUTATIONS Target genes: - oncogenes/tumor suppressor genes - signal transduction - cell cycle/apoptosis regulators SOURCES OF MUTATIONS ENDOGENOUS DNA DAMAGE EXOGENOUS DNA DAMAGE Free Polymerase Environmental Life Radicals Errors Depurination Agents Styles DNA REPAIR CELL REPLICATION MUTATION Chemical Exposure (air, water, food, etc.) Internal Exposure Metabolic Activation Macromolecular Binding DNA RNA Detoxication Protein (Biomarker) Biologically Effective Dose X Efficiency of Mispairing X Cell Proliferation Initiation Williams J.A., Carcinogenesis 22:209-14 (2001) Accumulation of mutations during tumor progression Loeb L.A. Cancer Res. 61:3230-9 (2001) EPIGENETICS Epigenetic alterations – changes induced in cells that alter the expression of the information on transcriptional, translational, or posttranslational levels without changes in DNA sequence Methylation of DNA DNMT1 DNMT3a DNMT3b Modifications of histones P Me U SAM SAH A A - acetylation Me- methylation P- phosphorylation U - ubiquitination RNA-mediated modifications • RNA-directed DNA methylation • RNA-mediated chromatin remodeling • RNAi, siRNA, miRNA … ACQUISITION OF ADDITIONAL RANDOM MUTATIONS Clonal selection and expression of initiated cells Mutator phenotype cells Cancer cells Environmental Normal cells ALTERATIONS IN CELLULAR EPIGENOME Epigenetically reprogrammed cells Mutator phenotype cells Cancer cells Endogenous Normal cells Endogenous Environmental GENETIC AND EPIGENETIC MODELS OF THE CANCER INITIATION Cellular and Molecular Mechanisms in Multistage Carcinogenesis: PROMOTION From http://newscenter.cancer.gov/sciencebehind/ Reversible enhancement/repression of gene expression: - increased cell proliferation - inhibition of apoptosis No direct structural alteration in DNA by agent or its metabolites Role of Increased Cell Proliferation in Carcinogenesis • Decreases time available for DNA repair • Converts repairable DNA damage into nonrepairable mutations (not DNA damage anymore!) • Necessary for chromosomal aberrations, insertions, deletions and gene amplification • Clonally expands existing cell populations with mutations 1. X No Tumors 2. X Tumors 3. X Tumors 4. X 5. No Tumors No Tumors Time X = Application of Initiator = Application of Promoter Basophilic Focus N Adenoma M1 Carcinoma MN Promotion Regression Progression No Tumors Tumors = Application of Promoter Adapted from: Marsman and Popp. Carcinogenesis 15:111-117 (1994) Cellular and Molecular Mechanisms in Multistage Carcinogenesis: PROGRESSION • Irreversible enhancement/repression of gene expression • Complex genetic alterations (chromosomal translocations, deletions, gene amplifications, recombinations, etc.) “Complex” genetic changes From http://newscenter.cancer.gov/sciencebehind/ • Selection of neoplastic cells for optimal growth genotype/ phenotype in response to the cellular environment Phenotypic characteristics of cancer cells: • Immortalization • Transformation • Loss of contact growth inhibition • Autonomy of proliferation • Avoidance of apoptosis • Aberrant differentiation • Induction of angiogenesis Human Tumors and Stages of Carcinogenesis Hussain et al., Oncogene, 2007