Prediagnostic alterations in circulating bile acid profiles in the development of hepatocellular carcinoma.

Bile acids (BAs) play different roles in cancer development. Some are carcinogenic and BA signaling is also involved in various metabolic, inflammatory and immune-related processes. The liver is the primary site of BA synthesis. Liver dysfunction and microbiome compositional changes, such as during hepatocellular carcinoma (HCC) development, may modulate BA metabolism increasing concentration of carcinogenic BAs. Observations from prospective cohorts are sparse. We conducted a study (233 HCC case-control pairs) nested within a large observational prospective cohort with blood samples taken at recruitment when healthy with follow-up over time for later cancer development. A targeted metabolomics method was used to quantify 17 BAs (primary/secondary/tertiary; conjugated/unconjugated) in prediagnostic plasma. Odd ratios (OR) for HCC risk associations were calculated by multivariable conditional logistic regression models. Positive HCC risk associations were observed for the molar sum of all BAs (ORdoubling  = 2.30, 95% confidence intervals [CI]: 1.76-3.00), and choline- and taurine-conjugated BAs. Relative concentrations of BAs showed positive HCC risk associations for glycoholic acid and most taurine-conjugated BAs. We observe an association between increased HCC risk and higher levels of major circulating BAs, from several years prior to tumor diagnosis and after multivariable adjustment for confounders and liver functionality. Increase in BA concentration is accompanied by a shift in BA profile toward higher proportions of taurine-conjugated BAs, indicating early alterations of BA metabolism with HCC development. Future studies are needed to assess BA profiles for improved stratification of patients at high HCC risk and to determine whether supplementation with certain BAs may ameliorate liver dysfunction.

Circulating bilirubin levels and risk of colorectal cancer: serological and Mendelian randomization analyses.

BACKGROUND: Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of colorectal cancer (CRC). We decided a priori to perform analyses separately in men and women based on suggestive evidence that associations may differ by sex. METHODS: In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC), pre-diagnostic unconjugated bilirubin (UCB, the main component of total bilirubin) concentrations were measured by high-performance liquid chromatography in plasma samples of 1386 CRC cases and their individually matched controls. Additionally, 115 single-nucleotide polymorphisms (SNPs) robustly associated (P < 5 × 10-8) with circulating total bilirubin were instrumented in a 2-sample MR to test for a potential causal effect of bilirubin on CRC risk in 52,775 CRC cases and 45,940 matched controls in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colon Cancer Family Registry (CCFR), and the Colorectal Transdisciplinary (CORECT) study. RESULTS: The associations between circulating UCB levels and CRC risk differed by sex (Pheterogeneity = 0.008). Among men, higher levels of UCB were positively associated with CRC risk (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.04-1.36; per 1-SD increment of log-UCB). In women, an inverse association was observed (OR = 0.86 (0.76-0.97)). In the MR analysis of the main UGT1A1 SNP (rs6431625), genetically predicted higher levels of total bilirubin were associated with a 7% increase in CRC risk in men (OR = 1.07 (1.02-1.12); P = 0.006; per 1-SD increment of total bilirubin), while there was no association in women (OR = 1.01 (0.96-1.06); P = 0.73). Raised bilirubin levels, predicted by instrumental variables excluding rs6431625, were suggestive of an inverse association with CRC in men, but not in women. These differences by sex did not reach formal statistical significance (Pheterogeneity ≥ 0.2). CONCLUSIONS: Additional insight into the relationship between circulating bilirubin and CRC is needed in order to conclude on a potential causal role of bilirubin in CRC development.

Dietary folate intake and pancreatic cancer risk: Results from the European prospective investigation into cancer and nutrition.

Pancreatic cancer (PC) has an exceptionally low survival rate and primary prevention strategies are limited. Folate plays an important role in one-carbon metabolism and has been associated with the risk of several cancers, but not consistently with PC risk. We aimed to investigate the association between dietary folate intake and PC risk, using the standardised folate database across 10 European countries. A total of 477,206 participants were followed up for 11 years, during which 865 incident primary PC cases were recorded. Folate intake was energy-adjusted using the residual method. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. In multivariable analyses stratified by age, sex, study centre and adjusted for energy intake, smoking status, BMI, educational level, diabetes status, supplement use and dietary fibre intake, we found no significant association between folate intake and PC risk: the HR of PC risk for those in the highest quartile of folate intake (≥353 µg/day) compared to the lowest (<241 µg/day) was 0.81 (95% CI: 0.51, 1.31; ptrend = 0.38). In current smokers, a positive trend was observed in PC risk across folate quartiles [HR = 4.42 (95% CI: 1.05, 18.62) for ≥353 µg/day vs. <241 µg/day, ptrend = 0.01]. Nonetheless, there was no significant interaction between smoking and dietary folate intake (pinteraction = 0.99). We found no association between dietary folate intake and PC risk in this large European study.

Effects of the supplementation with alpha-lipoic acid on muscular antioxidant biomarkers of trained mice / Efeitos da suplementação com ácido alfa-lipóico sobre biomarcadores antioxidantes musculares de camundongos treinados

BACKGROUND: Performing high intensity or exhaustive exercise can lead to muscle damage such as injuries, chronic fatigue and overtraining, partly due to the high synthesis of reactive oxygen species. The α-lipoic acid (ALA) and its reduced form, dihydrolipoic acid, act as potent antioxidant and eliminate free radicals. Although this response depends on the type of exercise and supplementation, animal and human studies have shown the benefits of antioxidant supplementation on the recovery of damages caused by exhaustive exercise, either by restoring antioxidant levels or by decreasing the damage. OBJECTIVE: We evaluated the effect of ALA supplementation on muscular biomarkers of oxidative stress following exhaustive exercise of trained mice. METHODS: Sixty mice were trained to swim for 6 weeks. On the last week, half of the animals were supplemented daily with 100 mg/kg of oral gavage of ALA in soy oil as a vehicle. The other half received just the vehicle. On the last day 20 animals from each group were submitted to an exhaustion protocol with 10% overweight attached to tail. Animals were euthanized on 3 moments: basal, just after the exhaustive protocol (0 h) and, 4 h after the exhaustive protocol. The gastrocnemius muscle was promptly excised and homogenized. The homogenates were used to estimate oxidative stress biomarkers. RESULTS: There was a simultaneous decrease of non-protein thiols and vitamin E after 4 h of exhaustive exercise in the ALA group (p<0.05) compared to the control group, suggesting the consumption of these compounds in the process of lipid peroxidation. Interestingly, there was an increase of nitrate and nitrite in ALA group (p<0.05) and a decrease in the control (p<0.05) compared to basal moment, possibly by activation of endothelial nitric oxide synthase. The total antioxidant capacity remained unchanged in the ALA group. CONCLUSION: The supplementation with ALA resulted in a protection against oxidative stress caused by exhaustive exercise.

CONTEXTO: A realização de exercício de alta intensidade ou exaustivo pode levar a danos musculares, como lesões, fadiga crônica e overtraining, em parte devido à alta síntese de espécies reativas de oxigênio. O ácido α-lipóico e sua forma reduzida, o ácido dihidrolipóico, atuam como potentes antioxidantes e eliminam os radicais livres. Apesar de depender do tipo de exercício e suplementação, estudos com animais e humanos mostram benefícios da suplementação com antioxidante na recuperação de danos causados pelo exercício exaustivo, seja restaurando os níveis de antioxidantes ou diminuindo os danos. OBJETIVO: Avaliar o efeito da suplementação com ácido α-lipóico sobre biomarcadores musculares de estresse oxidativo após o exercício exaustivo de camundongos treinados. METODOLOGIA: Os camundongos (n = 60) foram treinados em natação por 6 semanas. Na última semana, metade dos animais foram suplementados diariamente com gavagem oral de 100 mg / kg de ácido α-lipóico em óleo de soja como veículo. A outra metade recebeu apenas o veículo. No último dia 20 animais de cada grupo foram submetidos ao protocolo de exaustão com 10% de sobrepeso atado à cauda. Os animais foram eutanasiados em 3 momentos: basal, logo após o protocolo de exaustão (0 h) e 4 h após o protocolo de exaustão. O músculo gastrocnêmio foi imediatamente coletado e homogeneizado. Os homogeneizados foram usados para acessar os biomarcadores de estresse oxidativo. RESULTADOS: Houve diminuição simultânea de tióis não protéicos e vitamina E após 4 h de exercício exaustivo no grupo ácido α-lipóico (p <0,05) em relação ao grupo controle, sugerindo o consumo destes compostos no processo de peroxidação lipídica. Interessantemente, houve aumento de nitrato e nitrito no grupo ácido α-lipóico (p <0,05) e diminuição no controle (p <0,05) em relação ao momento basal, possivelmente pela ativação da óxido nítrico sintase endotelial. A capacidade antioxidante total permaneceu inalterada no grupo ácido α-lipóico. CONCLUSÃO: A suplementação com ácido α-lipóico resultou em proteção contra o estresse oxidativo causado pelo exercício exaustivo.

Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort.

Flavonoids have been shown to inhibit colon cancer cell proliferation in vitro and protect against colorectal carcinogenesis in animal models. However, epidemiological evidence on the potential role of flavonoid intake in colorectal cancer (CRC) development remains sparse and inconsistent. We evaluated the association between dietary intakes of total flavonoids and their subclasses and risk of development of CRC, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cohort of 477,312 adult men and women were recruited in 10 European countries. At baseline, dietary intakes of total flavonoids and individual subclasses were estimated using centre-specific validated dietary questionnaires and composition data from the Phenol-Explorer database. During an average of 11 years of follow-up, 4,517 new cases of primary CRC were identified, of which 2,869 were colon (proximal = 1,298 and distal = 1,266) and 1,648 rectal tumours. No association was found between total flavonoid intake and the risk of overall CRC (HR for comparison of extreme quintiles 1.05, 95% CI 0.93-1.18; p-trend = 0.58) or any CRC subtype. No association was also observed with any intake of individual flavonoid subclasses. Similar results were observed for flavonoid intake expressed as glycosides or aglycone equivalents. Intake of total flavonoids and flavonoid subclasses, as estimated from dietary questionnaires, did not show any association with risk of CRC development.