Prostaglandin signaling pathway plays an important role in colon tumorigenesis. Inhibition of COX-2 with resultant decreased levels of prostaglandin E2 (PGE2) is a key mechanism underlying the colon chemo- preventive effects of non-steroidal anti-inflammatory drugs (NSAIDs). 15-hydroxyprostaglandin dehydrogenase (15-PGDH), a downstream metabolic antagonist of COX-2, has recently been established as a novel colon neoplasia suppressor. NSAIDs exert anti-neoplastic effects through a 'sandwiched'manner on the PGE2 pathway by concomitant suppression of COX-2 and up-regulation of 15-PGDH. Emerging evidence suggests that vitamin D also exerts anti-neoplastic effects through its actions on the PGE2 signaling pathway by down- regulating COX-2, up-regulating 15-PGDH, and inhibiting EP1-EP4, the receptors for PGE2. We have shown in a colon adenoma prevention trial that individuals who developed new adenomas while receiving celecoxib also had low colonic 15-PGDH expression levels. Furthermore, we have recently identified a SNP in the promoter region of 15-PGDH gene that is associated with both an increased risk of colon cancer and decreased colonic tissue expression of 15-PGDH in humans. These lead to our central hypothesis that 15-PGDH is a susceptibility gene for human colon neoplasia, and NSAIDs and circulating levels of vitamin D may interact with 15-PGDH to impact colon tumorigenesis. This proposal builds upon the PLCO trial and an established colon screening population in Cleveland, where normal colonic tissues from a subset of cases and controls are readily available. Specifically, Aim 1 uses a 3-stage design (discovery, tissue expression validation, and replication) to interrogate the entire 15-PGDH gene locus (spanning 100kb upstream and downstream) for colorectal neoplasia predisposing genetic variants of 15-PGDH.
Aim 2 examines PE2 signaling pathway key gene expression levels in normal colonic tissues from a set of 309 adenoma cases and 327 controls, and assesses their associations with risk of colorectal adenoma.
Aim 3 synthesizes SNP, gene expression, and exposure data to assess the joint effects of 15-PGDH, NSAIDs, and serum levels of vitamin D on risk of colorectal neoplasia. Our proposed study will provide novel insight into the etiological role of 15-PGDH in colon carcinogenesis, and will inform individualized strategies to maximize the 15-PGDH dependent chemoprevention effects of NSAIDs and vitamin D, and minimize the adverse gastrointestinal and cardiac effects that have thus far hampered population-wide use of NSAIDs for chemoprevention.
This study, building upon the large PLCO screening arm population and a Cleveland colonoscopy screening cohort, addresses the hypothesis that 15-PGDH is a novel susceptibility gene for human colon neoplasia, and genetic variants and tissue expression levels of 15-PGDH may work jointly with non-steroidal anti-inflammatory drug use (NSAIDs) and circulating levels of vitamin D to impact the development of early colorectal neoplasia.
|Cooper, Gregory S; Markowitz, Sanford D; Chen, Zhengyi et al. (2018) Evaluation of Patients with an Apparent False Positive Stool DNA Test: The Role of Repeat Stool DNA Testing. Dig Dis Sci 63:1449-1453|
|Toth, Reka; Scherer, Dominique; Kelemen, Linda E et al. (2017) Genetic Variants in Epigenetic Pathways and Risks of Multiple Cancers in the GAME-ON Consortium. Cancer Epidemiol Biomarkers Prev 26:816-825|
|Li, Wan; Wang, Qi-Long; Liu, Xia et al. (2015) Combined use of vitamin D3 and metformin exhibits synergistic chemopreventive effects on colorectal neoplasia in rats and mice. Cancer Prev Res (Phila) 8:139-48|
|Abola, Matthew V; Thompson, Cheryl L; Chen, Zhengyi et al. (2015) Serum levels of retinol-binding protein 4 and risk of colon adenoma. Endocr Relat Cancer 22:L1-4|
|Noy, Noa; Li, Li; Abola, Matthew V et al. (2015) Is retinol binding protein 4 a link between adiposity and cancer? Horm Mol Biol Clin Investig 23:39-46|