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 Effect of gamma-linolenic acid on the transcriptional activity of the Her-2/neu (erbB-2) oncogene. Menendez JA, Vellon L, Colomer R, Lupu R. Department of Medicine, Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201, USA. jmenendez@enh.org The omega-6 polyunsaturated fatty acid gamma-linolenic acid (GLA; 18:3n-6), which is found in several plant oils and is used as an herbal medicine, has antitumor activity in vitro. We examined the effect of GLA on the expression of the Her-2/neu (erbB-2) oncogene, which is involved in development of numerous types of human cancer. Flow cytometric and immunoblotting analyses demonstrated that GLA treatment substantially reduced Her-2/neu protein levels in the Her-2/neu-overexpressing cell lines BT-474, SK-Br3, and MDA-MB-453 (breast cancer), SK-OV3 (ovarian cancer), and NCI-N87 (gastrointestinal tumor derived). GLA exposure led to a dramatic decrease in Her-2/neu promoter activity and a concomitant increase in the levels of polyomavirus enhancer activator 3 (PEA3), a transcriptional repressor of Her-2/neu, in these cell lines. In transient transfection experiments, a Her-2/neu promoter bearing a PEA3 site-mutated sequence was not subject to negative regulation by GLA in Her-2/neu-overexpressing cell lines. Concurrent treatments of Her-2/neu-overexpressing cancer cells with GLA and the anti-Her-2/neu antibody trastuzumab led to synergistic increases in apoptosis and reduced growth and colony formation.
 Inhibition of fatty acid synthase-dependent neoplastic lipogenesis as the mechanism of gamma-linolenic acid-induced toxicity to tumor cells: an extension to Nwankwo's hypothesis. Menendez JA, Colomer R, Lupu R. Department of Medicine, Evanston Northwestern Healthcare Research Institute, 1001 Unviersity Place, Evanston, IL 60201, USA. javiermenendez72@yahoo.com gamma-Linolenic acid (GLA), an essential omega-6 polyunsaturated fatty acid (FA) is an attractive concept as anticancer agent because it exerts selective cytotoxic on human breast cancer cells without affecting normal cells. This selective toxicity has been identified to be due, at least in part, to the production of lipid peroxides and free radicals. Interestingly, a novel hypothesis for GLA-induced tumor cell toxicity has recently been proposed. GLA, through a molecular mechanism involving the lipogenic enzyme fatty acid synthase (FAS), coordinately interrupts the pathways that replenish the pools of metabolic intermediates in the citric acid cycle (cellular anaplerosis). First, supraphysiological concentrations of GLA inhibit glycolysis, while a cytochrome P450-dependent epoxidation of GLA generates epoxides metabolites for GLA that would mimic the inhibitory action of standard FAS inhibitors such as cerulenin and C75. Second, GLA-epoxide inhibits FAS activity, thus resulting in the accumulation of cytosolic malonyl-CoA which, in turn, inhibits carnitine palmitoyl transferase I (CPT-I) and prevents FA oxidation. The recent characterization of GLA as a novel regulator of FAS expression in breast cancer cells supports and further expands this hypothesis, and directly involves FAS-dependent de novo fatty acid synthesis as the mechanism of GLA-induced toxicity to tumor cells. We hypothesize that, at low (physiological) concentrations, the inhibitory effect of GLA on FAS-regulated breast cancer cell survival is not specific and is due to cell toxicity caused by lipid peroxidation. Taking into account that the inhibitory effect of FAs on the expression of FAS in cultured hepatocytes has been shown to be related to a non-specific peroxidative mechanism, a similar GLA-dependent FAS regulatory mechanism involving peroxidative products may occur in normal and neoplastic tissues. At high (supraphysiological) concentrations of GLA, the specific downregulation of FAS gene expression leads to accumulation of the substrate for FAS, malonyl-CoA, that, as a result of FAS blockade, continue to be generated by the rate-limiting enzyme of the fatty acid biosynthetic pathway acetyl-CoA carboxilase, which is not inhibited in the absence of FAS-catalyzed long chain endogenous fatty acids. Physiologically, the elevated levels of malonyl-CoA occurring during FA biosynthesis reduce FA oxidation to prevent a futile cycle of simultaneous FA synthesis and degradation. Paradoxically, high-dose GLA treatments of FAS-overexpressing breast cancer cells will promote malonyl-CoA-induced inhibition of CPT-I and FA oxidation, thus precipitating an energy crisis that triggers decreased proliferation or apoptotic cell death. In summary, this working model presents the concept that the breast cancer adaptation in FAS expression can be exploited to develop GLA-based dietary interventions aimed at altering the FA synthesis pathway, which appears to be linked to neoplastic transformation and is associated with tumor virulence and adverse clinical outcome in a subset of human breast carcinomas.
Omega-6 polyunsaturated fatty acid gamma-linolenic acid (18:3n-6) enhances docetaxel (Taxotere) cytotoxicity in human breast carcinoma cells: Relationship to lipid peroxidation and HER-2/neu expression. Menendez JA, Ropero S, Lupu R, Colomer R. Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201, USA. jmenendez@enh.org The omega-6 polyunsaturated fatty acid gamma-linolenic acid (GLA; 18:3n-6) has raised recent interest as novel anti-cancer agent as it possesses effective tumoricidal properties while not inducing damage to normal cells or creating harmful systemic side effects. The taxane docetaxel (Taxotere) is currently one of the most active microtubule-interfering agents for breast cancer. Despite this encouraging therapeutical potential, the clinical use of taxanes involves problems related to the solubility, toxicity and development of drug resistance, which may be partially dependent on the expression of HER-2/neu oncogene. Current trends in the treatment of human tumors are for drug combinations that result in improved responses as well as the ability to use less toxic concentrations of the drugs. Here, we examined the cytotoxic effects of GLA in combination with docetaxel against estrogen-dependent (MCF-7) and estrogen-independent (MDA-MB-231 and SK-Br3) human breast carcinoma cell lines. The cells were exposed simultaneously to GLA and docetaxel or sequentially to GLA followed by docetaxel for 24 h. Cytotoxicity was evaluated by the MTT assay, and the nature of the interactions between GLA and docetaxel (antagonism, additivity, and synergism) was analyzed by median effect and isobologram analyses. Interaction assessment showed that concurrent exposure to GLA plus docetaxel for 24 h resulted in synergism for MCF-7 and MDA-MB-231 cells, whereas an additive effect was observed in SK-Br3 cells. When exposure to GLA (24 and 48 h) was followed sequentially by docetaxel (24 h) a synergistic effect was observed in MDA-MB-231 and SK-Br3 cells, whereas an additive effect was found in MCF-7 cells. GLA-mediated increase in docetaxel cytotoxicity was only marginally abolished by Vitamin E, a lipid peroxidation inhibitor. Moreover, simultaneous exposure to GLA and docetaxel in the presence of the anti-oxidant Vitamin E also resulted in synergism, suggesting a limited influence of the oxidative status of GLA in achieving potentiation of docetaxel-induced cytotoxicity. Further experiments showed that GLA markedly decreased the expression of p185HER-2/neu oncoprotein in MCF-7 breast cancer cells (</=85%), and RT-PCR analysis revealed that HER-2/neu mRNA was selectively decreased in a concentration-dependent manner following GLA treatment. Therefore, our results show that the fatty acid GLA enhances the cytotoxicity of docetaxel in human breast cancer cells by mechanisms other than lipoperoxidation, and that GLA-induced transcriptional repression of HER-2/neu oncogene might be one component of the mechanisms of this interaction.
 Synergistic interaction between vinorelbine and gamma-linolenic acid in breast cancer cells. Menendez JA, Ropero S, del Barbacid MM, Montero S, Solanas M, Escrich E, Cortes-Funes H, Colomer R. Division of Medical Oncology, Hospital Universitario de Octubre, Madrid, Spain. It has been suggested that exogenous unsaturated fatty acids (UFAs) may increase the cytotoxic activity of cancer chemotherapeutic agents. We examined how y-linolenic acid (GLA; 18: 3n-6), the most promising UFA in the treatment of human tumors, affects the effectiveness of the lipophilic drug vinorelbine (VNR) on human breast carcinoma cell lines. Cells were exposed simultaneously to VNR and GLA or sequentially to GLA followed by VNR. Cell viability was determined by MTT assay. The increase in VNR-induced cell growth inhibition was measured by dividing the IC50 and IC70 values (50 and 70% inhibitory concentrations, respectively) that were obtained when the cells were exposed to VNR alone with those with VNR plus GLA. We found that GLA enhanced in a dose-dependent manner the cell growth inhibitory activity of VNR on MCF-7 cells (up to 9-fold). As GLA by itself showed anti-proliferative effects, possible GLA-VNR interactions at the cellular level were assessed employing the isobologram analysis and the combination index (CI) method of Chou-Talalay. Both methods showed an overall synergism between GLA and VNR in MCF-7 cells. At a high level of cell kill, the synergism was greater when a 24 h GLA pre-exposure or co-exposures were tested. Synergy was likewise observed with the GLA-VNR combination in MDA-MB-231, T47D, and SK-Br3 breast cancer cells. In all cell lines, the synergism was independent of the treatment schedule and the exposure time. Under conditions inhibiting lipid peroxidation using Vitamin E (dl-alpha-tocopherol), the enhancing effect of GLA (an easily oxidizable UFA) on VNR activity was partially abolished. However, when Vitamin E was used in combination, a similar synergistic increase in growth inhibition was obtained. These latter observations strongly implies that the synergistic effects of GLA with VNR are not mediated through a mechanism involving a generation of lipoperoxides. For comparison, the effects of other UFAs were examined on VNR chemosensitivity: GLA was the most potent at enhancing VNR activity, followed by docosahexaenoic acid (22: 6n-3), eicosapentaenoic acid (20: 5n-3) and alpha-linolenic acid (18: 3n-3), whereas linoleic acid (18: 2n-6) and arachidonic acid (20: 4n-6) did not increase VNR chemosensitivity. Very high concentrations of oleic acid (OA; 18:1 n-9), an UFA inversely correlated with breast cancer risk, also enhanced VNR effectiveness. Thus, various types of UFAs were not equivalent with respect to their actions on VNR effectiveness. In conclusion, our results give experimental support to the hypothesis that some UFAs can be used as modulators of tumor cell chemosensitivity and provide the rationale for in vivo preclinical investigation.
 Effect of dietary GLA+/-tamoxifen on the growth, ER expression and fatty acid profile of ER positive human breast cancer xenografts. Kenny FS, Gee JM, Nicholson RI, Ellis IO, Morris TM, Watson SA, Bryce RP, Robertson JF. Professorial Unit of Surgery, City Hospital, Nottingham, United Kingdom. Gamma linolenic acid (GLA) possesses a number of selective anti-tumour properties including modulation of steroid receptor structure and function. We have investigated the effect of dietary GLA on the growth, oestrogen receptor (ER) expression and fatty acid profile of ER+ve human breast cancer xenografts. Experimental diets A, B, C, D were commenced after subcutaneous implantation of 40 female nude mice with the MCF-7 B1M cell line (Group A = control diet: B = control diet + GLA supplement: C = control diet + tamoxifen: D = control diet + GLA + tamoxifen; 10 mice/group). The mice were terminated when tumour cross-sectional area reached 250 mm(2). ER H-scores were assessed by immunohistochemical assay and fatty acid profiles by gas-liquid chromatography of termination tumour samples. Groups C and D displayed significantly slower tumour growth (p =.0002, p =.0006) with trend for slower growth in B (p =.065) compared to control Group A. ER was significantly reduced in all groups compared to A (p <.0001) with Group D (combined therapy) displaying markedly lower ER expression than with either therapy alone (p =.0002). There were significantly raised levels of tumour GLA and metabolites in the two groups (B and D) receiving GLA (p <.0001). This xenograft model of ER+ve breast cancer has demonstrated significantly lower tumour ER expression in those groups receiving GLA, an effect which appears to be additive to the reduced ER expression resulting from tamoxifen alone. The effects of GLA on ER function and the possibility of synergistic inhibitory action of GLA with tamoxifen via enhanced down-regulation of the ER pathway require further investigation. Copyright 2001 Wiley-Liss, Inc.
Gamma linolenic acid with tamoxifen as primary therapy in breast cancer. Kenny FS, Pinder SE, Ellis IO, Gee JM, Nicholson RI, Bryce RP, Robertson JF. Professorial Unit of Surgery, City Hospital, Nottingham, UK. Gamma linolenic acid (GLA) has been proposed as a valuable new cancer therapy having selective anti-tumour properties with negligible systemic toxicity. Proposed mechanisms of action include modulation of steroid hormone receptors. We have investigated the effects of GLA with primary hormone therapy in an endocrine-sensitive cancer. Thirty-eight breast cancer patients (20 elderly Stage I-II, 14 locally advanced, 4 metastatic) took 8 capsules of oral GLA/day (total = 2.8 g) in addition to tamoxifen 20 mg od (T+GLA). Quality and duration of response were compared with matched controls receiving tamoxifen 20 mg od alone (n = 47). Serial tumour biopsies were taken to assess changes in oestrogen receptor (ER) and bcl-2 expression during treatment. GLA was well tolerated with no major side effects. T+GLA cases achieved a significantly faster clinical response (objective response vs. static disease) than tamoxifen controls, evident by 6 weeks on treatment (p = 0.010). There was significant reduction in ER expression in both treatment arms with T+GLA objective responders sustaining greater ER fall than tamoxifen counterparts (6-week biopsy p = 0.026; 6-month biopsy p = 0.019). We propose GLA as a useful adjunct to primary tamoxifen in endocrine-sensitive breast cancer. The effects of GLA on ER function and the apparent enhancement of tamoxifen-induced ER down-regulation by GLA require further investigation. Copyright 2000 Wiley-Liss, Inc. |
