title: Bacterial enterotoxins are associated with resistance to colon cancer.
abstract: One half million patients suffer from colorectal cancer in industrialized nations, yet this disease exhibits a low incidence in under-developed countries. This geographic imbalance suggests an environmental contribution to the resistance of endemic populations to intestinal neoplasia. A common epidemiological characteristic of these colon cancer-spared regions is the prevalence of enterotoxigenic bacteria associated with diarrheal disease. Here, a bacterial heat-stable enterotoxin was demonstrated to suppress colon cancer cell proliferation by a guanylyl cyclase C-mediated signaling cascade. The heat-stable enterotoxin suppressed proliferation by increasing intracellular cGMP, an effect mimicked by the cell-permeant analog 8-br-cGMP. The antiproliferative effects of the enterotoxin and 8-br-cGMP were reversed by L-cis-diltiazem, a cyclic nucleotide-gated channel inhibitor, as well as by removal of extracellular Ca(2+), or chelation of intracellular Ca(2+). In fact, both the enterotoxin and 8-br-cGMP induced an L-cis-diltiazem-sensitive conductance, promoting Ca(2+) influx and inhibition of DNA synthesis in colon cancer cells. Induction of this previously unrecognized antiproliferative signaling pathway by bacterial enterotoxin could contribute to the resistance of endemic populations to intestinal neoplasia, and offers a paradigm for targeted prevention and therapy of primary and metastatic colorectal cancer.
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA. gmpitari@yahoo.com
authors.forename: G M
authors.initials: GM
authors.lastname: Pitari
authors.forename: L V
authors.initials: LV
authors.lastname: Zingman
authors.forename: D M
authors.initials: DM
authors.lastname: Hodgson
authors.forename: A E
authors.initials: AE
authors.lastname: Alekseev
authors.forename: S
authors.initials: S
authors.lastname: Kazerounian
authors.forename: M
authors.initials: M
authors.lastname: Bienengraeber
authors.forename: G
authors.initials: G
authors.lastname: Hajnóczky
authors.forename: A
authors.initials: A
authors.lastname: Terzic
authors.forename: S A
authors.initials: SA
authors.lastname: Waldman
mesh_terms: D001427:Bacterial Toxins / Q000494:pharmacology*; D002118:Calcium / Q000378:metabolism; D002454:Cell Differentiation; D002455:Cell Division / Q000187:drug effects; D003110:Colonic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000517:prevention & control* / Q000628:therapy*; D004247:DNA / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004768:Enterotoxins / Q000494:pharmacology*; D029968:Escherichia coli Proteins; D005768:Gastrointestinal Hormones / Q000378:metabolism; D006162:Guanylate Cyclase; D006801:Humans; D007113:Immunity, Innate; D008024:Ligands; D008564:Membrane Potentials / Q000187:drug effects; D045265:Natriuretic Peptides; D018408:Patch-Clamp Techniques; D010455:Peptides / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000378:metabolism*; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled; D018000:Receptors, Peptide; D015398:Signal Transduction; D014407:Tumor Cells, Cultured
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D029968:Escherichia coli Proteins; D005768:Gastrointestinal Hormones; D008024:Ligands; D045265:Natriuretic Peptides; D010455:Peptides; D011956:Receptors, Cell Surface; D018000:Receptors, Peptide; C034151:heat stable toxin (E coli); C072685:guanylin; C084362:uroguanylin; D004247:DNA; D006162:Guanylate Cyclase; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled; D002118:Calcium