RESUMO
BACKGROUND: High oxidative stress as defined by hydroxyl and peroxyl activity is often found in the stroma of human breast cancers. Oxidative stress induces stromal catabolism, which promotes cancer aggressiveness. Stromal cells exposed to oxidative stress release catabolites such as lactate, which are up-taken by cancer cells to support mitochondrial oxidative phosphorylation. The transfer of catabolites between stromal and cancer cells leads to metabolic heterogeneity between these cells and increased cancer cell proliferation and reduced apoptosis in preclinical models. N-Acetylcysteine (NAC) is an antioxidant that reduces oxidative stress and reverses stromal catabolism and stromal-carcinoma cell metabolic heterogeneity, resulting in reduced proliferation and increased apoptosis of cancer cells in experimental models of breast cancer. The purpose of this clinical trial was to determine if NAC could reduce markers of stromal-cancer metabolic heterogeneity and markers of cancer cell aggressiveness in human breast cancer. METHODS: Subjects with newly diagnosed stage 0 and I breast cancer who were not going to receive neoadjuvant therapy prior to surgical resection were treated with NAC before definitive surgery to assess intra-tumoral metabolic markers. NAC was administered once a week intravenously at a dose of 150 mg/kg and 600 mg twice daily orally on the days not receiving intravenous NAC. Histochemistry for the stromal metabolic markers monocarboxylate transporter 4 (MCT4) and caveolin-1 (CAV1) and the Ki67 proliferation assay and TUNEL apoptosis assay in carcinoma cells were performed in pre- and post-NAC specimens. RESULTS: The range of days on NAC was 14-27 and the mean was 19 days. Post-treatment biopsies showed significant decrease in stromal MCT4 and reduced Ki67 in carcinoma cells. NAC did not significantly change stromal CAV1 and carcinoma TUNEL staining. NAC was well tolerated. CONCLUSIONS: NAC as a single agent reduces MCT4 stromal expression, which is a marker of glycolysis in breast cancer with reduced carcinoma cell proliferation. This study suggests that modulating metabolism in the tumor microenvironment has the potential to impact breast cancer proliferation.
Assuntos
Acetilcisteína/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Intraductal não Infiltrante/tratamento farmacológico , Sequestradores de Radicais Livres/uso terapêutico , Mastectomia , Adulto , Apoptose , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/patologia , Carcinoma Intraductal não Infiltrante/metabolismo , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Papilar/tratamento farmacológico , Carcinoma Papilar/metabolismo , Carcinoma Papilar/patologia , Caveolina 1/metabolismo , Proliferação de Células , Feminino , Humanos , Imuno-Histoquímica , Marcação In Situ das Extremidades Cortadas , Antígeno Ki-67/metabolismo , Pessoa de Meia-Idade , Transportadores de Ácidos Monocarboxílicos/metabolismo , Proteínas Musculares/metabolismo , Terapia Neoadjuvante , Estadiamento de Neoplasias , Projetos Piloto , Células Estromais/metabolismo , Resultado do Tratamento , Microambiente TumoralRESUMO
Water and nutrient are the two main factors limiting Hevea brasiliensis growth and its latex yield. With 17 year-old Clone SCATC 7-33-97 H. brasiliensis as test material, the coupling effects of water and chemical N, P and K fertilizers on latex yield were studied by general orthogonal rotation design of quadratic regression with four factors and five levels under field condition, and a regressive mathematical model was set up based on the latex yield by quadratic regression analysis. The results showed that all test coupling levels of water and chemical fertilizers had significant effects on the latex yield. The yield-increasing effect of test factors was in the order of N application rate > irrigation amount > P application rate > K application rate, while the coupling effect of water and chemical fertilizers was in the sequence of water and N > N and P > water and P > water and K. There was a negative coupling effect of K application rate and soil moisture content. For latex yield, the optimum application rates of chemical fertilizers were 476.39 kg x hm(-2) of urea, 187.70 kg x hm(-2) of superphosphate and 225.77 kg x hm(-2) of potassium chloride, and the optimum irrigation amount was to have 82.78% soil relative water content.