title: Modulation of gene expression in subjects at risk for colorectal cancer by the chemopreventive dithiolethione oltipraz.
abstract: Prolonged exposure to mutagenic substances is strongly associated with an individual's risk of developing colorectal cancer. Clinical investigation of oltipraz as a chemopreventive agent is supported by its induction of the expression of detoxication enzymes in various tissues, and its protective activity against the formation of chemically induced colorectal tumors in animals. The goals of the present study were: to determine if oltipraz could induce detoxicating gene expression in human tissues; to identify effective non-toxic doses for more extensive clinical testing; and to establish a relationship between effects in the colon mucosa and those in a more readily available tissue, the peripheral mononuclear cell. 24 evaluable patients at high risk for colorectal cancer were treated in a dose-finding study with oltipraz 125, 250, 500, or 1,000 mg/m2 as a single oral dose. Biochemical analysis of sequential blood samples and colon mucosal biopsies revealed increases in glutathione transferase activity at the lower dose levels. These effects were not observed at the higher doses. More pronounced changes were observed in detoxicating enzyme gene expression in both tissues at all doses. Peripheral mononuclear cell and colon mRNA content for gamma-glutamylcysteine synthetase (gamma-GCS) and DT-diaphorase increased after dosing to reach a peak on day 2-4 after treatment, and declined to baseline in the subsequent 7-10 d. The extent of induction of gene expression in colon mucosa reached a peak of 5.75-fold for gamma-GCS, and a peak of 4.14-fold for DT-diaphorase at 250 mg/m2 ; higher doses were not more effective. Levels of gamma-GCS and DT-diaphorase correlated closely (P < or = 0.001) between peripheral mononuclear cells and colon mucosa both at baseline and at peak. These findings demonstrate that the administration of minimally toxic agents at low doses may modulate the expression of detoxicating genes in the tissues of individuals at high risk for cancer. Furthermore, peripheral mononuclear cells may be used as a noninvasive surrogate endpoint biomarker for the transcriptional response of normal colon mucosa to drug administration.
authors.affiliation: Fox Chase Cancer Center, Philadelpia, Pennsylvania 19111, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: O'Dwyer
authors.forename: C E
authors.initials: CE
authors.lastname: Szarka
authors.forename: K S
authors.initials: KS
authors.lastname: Yao
authors.forename: T C
authors.initials: TC
authors.lastname: Halbherr
authors.forename: G R
authors.initials: GR
authors.lastname: Pfeiffer
authors.forename: F
authors.initials: F
authors.lastname: Green
authors.forename: J M
authors.initials: JM
authors.lastname: Gallo
authors.forename: J
authors.initials: J
authors.lastname: Brennan
authors.forename: H
authors.initials: H
authors.lastname: Frucht
authors.forename: E B
authors.initials: EB
authors.lastname: Goosenberg
authors.forename: T C
authors.initials: TC
authors.lastname: Hamilton
authors.forename: S
authors.initials: S
authors.lastname: Litwin
authors.forename: A M
authors.initials: AM
authors.lastname: Balshem
authors.forename: P F
authors.initials: PF
authors.lastname: Engstrom
authors.forename: M L
authors.initials: ML
authors.lastname: Clapper
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D018890:Chemoprevention; D003106:Colon / Q000187:drug effects / Q000201:enzymology; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D005721:Glutamate-Cysteine Ligase / Q000032:analysis; D006801:Humans; D008658:Inactivation, Metabolic; D007413:Intestinal Mucosa / Q000187:drug effects / Q000201:enzymology; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D016296:Mutagenesis / Q000187:drug effects; D016660:NAD(P)H Dehydrogenase (Quinone) / Q000032:analysis; D011719:Pyrazines / Q000627:therapeutic use*; D012306:Risk; D013871:Thiones; D013876:Thiophenes
chemical_list: D016588:Anticarcinogenic Agents; D011719:Pyrazines; D013871:Thiones; D013876:Thiophenes; C026209:oltipraz; D016660:NAD(P)H Dehydrogenase (Quinone); D005721:Glutamate-Cysteine Ligase