Resistance to ursodeoxycholic acid-induced growth arrest can also result in resistance to deoxycholic acid-induced apoptosis and increased tumorgenicity
© Powell et al; licensee BioMed Central Ltd. 2006
Received: 06 May 2006
Accepted: 01 September 2006
Published: 01 September 2006
There is a large body of evidence which suggests that bile acids increase the risk of colon cancer and act as tumor promoters, however, the mechanism(s) of bile acids mediated tumorigenesis is not clear. Previously we showed that deoxycholic acid (DCA), a tumorogenic bile acid, and ursodeoxycholic acid (UDCA), a putative chemopreventive agent, exhibited distinct biological effects, yet appeared to act on some of the same signaling molecules. The present study was carried out to determine whether there is overlap in signaling pathways activated by tumorogenic bile acid DCA and chemopreventive bile acid UDCA.
To determine whether there was an overlap in activation of signaling pathways by DCA and UDCA, we mutagenized HCT116 cells and then isolated cell lines resistant to UDCA induced growth arrest. These lines were then tested for their response to DCA induced apoptosis.
We found that a majority of the cell lines resistant to UDCA-induced growth arrest were also resistant to DCA-induced apoptosis, implying an overlap in DCA and UDCA mediated signaling. Moreover, the cell lines which were the most resistant to DCA-induced apoptosis also exhibited a greater capacity for anchorage independent growth.
We conclude that UDCA and DCA have overlapping signaling activities and that disregulation of these pathways can lead to a more advanced neoplastic phenotype.
Bile acids are polar derivatives of cholesterol which are synthesized in the liver and stored in the gall bladder . During digestion bile is excreted into the intestinal tract where bile acids aid in the absorption of dietary fats. Although the majority of the bile acids is reabsorbed and reused a small fraction (1–4%) is not reabsorbed and passes into the colon . Here the primary bile acids, those bile acids that are produced in the liver, are modified by enteric bacteria dehydroxylating the cholesterol core and removing the conjugated amino acid to produce unconjugated secondary bile acids. These secondary bile acids, principally deoxycholic acid, have been associated with increased risk for colon cancer
Epidemiological and animal model studies support the concept that bile acids may play a role in the development of colon cancer. Studies of populations that eat high fat diets which promote more bile acid production show increased risk for colon cancer [3, 4] and patients diagnosed with colon cancer have elevated levels of serum bile acids, especially deoxycholic acid (DCA) [3, 5]. In studies using animal models DCA was found to act synergistically with carcinogens to increase colon tumorigenesis [6, 7] and could cause transformation of cells in vitro . Collectively these observations suggest that DCA may be a tumor promoter. However it should be noted that not all bile acids act to promote colon tumor development. Ursodeoxycholic acid (UDCA) suppresses the development of colon tumors in AOM-treated rats [9, 10] and two studies in human subjects suggest that UDCA can reduce the risk of developing colorectal cancer [11–13]. Hence, in spite of having very similar chemical structures, these two bile acids have very distinct biological activities both at the organismal level as well as in vitro . To date the mechanism that accounts for this difference in function is not clear.
The mechanism through which bile acids bring about there biological effects is not well understood, however, there is a growing body of evidence indicating that bile acids can regulate gene expression [15–18]. DCA has been shown to activate a number of mitogenic and apoptosis associated signaling pathways which is consonant with its proposed tumor promoting abilities including the epidermal growth factor receptor and the raf/mek/erk pathway [19–21], protein kinase C [22–24], the AP-1 transcription factor [25–27], and Cox2  all of which are known to be dysregulated during colon tumorigenesis. Much less is known about the signaling mechanisms activated by UDCA. However, in general UDCA displays activities that are in opposition to those exhibited by DCA. For instance UDCA can suppress activation of ras, EGFR-raf/mek/erk pathway and AP-1  and is cytoprotective as opposed to cytotoxic DCA [28, 29]. Similarly, while DCA interferes with functioning of the p53 tumor suppressor, UDCA does not . Interestingly, we found that bile acids are not readily taken up by colonic cells , but instead initiate intracellular signaling by their action at cell membrane  in ligand independent manner possibly through specialized domains like caveolae . Given the mode of action of DCA and UDCA on cell membranes, it is likely that these two bile acids can act on some of the same signaling pathways.
Understanding if DCA and UDCA utilize same pathways to bring about diametrically opposed biological outcome is very important in characterizing the role bile acids play in tumorigenesis. In addition, before therapeutically targeting DCA activated signaling to overcome the DCA mediated colon carcinogenesis, it is important to address whether UDCA employs similar signaling pathways as DCA. In order to gain insight into overlap in signaling pathways activated by DCA and UDCA, we isolated cell lines resistant to UDCA induced growth arrest and then tested these for their response to DCA induced apoptosis, since, the most significant biological effects for DCA and UDCA have been shown to be apoptosis and growth arrest, respectively. Characterization of these resistant cells demonstrated that some were also cross resistance to the effects of DCA suggesting that DCA and UDCA signaling activity may overlap. Importantly, we found evidence that resistance to some DCA-activated signaling lead to a more neoplastic phenotype. The relevance of these finding to colon cancer are discussed.
DCA, cholic acid, and hyoDCA were obtained from Sigma Chemical (St. Louis, MO) and UDCA from Calbiochem (La Jolla, CA). All were maintained as 100 mM stock solutions in water. Upon addition of bile acids to media, no change in pH was observed. Etoposide, cisplatin, and adriomyosin were all obtained from Sigma Chemical Co. (St. Louis, MO)
The HCT116 colon cancer cell line was used as the parental cell line in all experiments and was purchased from the American Type Culture Collection (Rockville, Maryland). All cell lines were propagated at 37°C and 5% CO2 in a humidified atmosphere in Dulbecco's modified Eagle's medium (DMEM) (Gibco/BRL, Gaithersburg/MD) supplemented with 10% fetal bovine serum (Gibco/BRL), 100 units of penicillin, 100 mg of streptomycin, 2 mM L-glutamine, 4 mM sodium pyruvate and 100 μM non-essential amino acids.
Derivation of UDCA resistant cell lines
Parental HCT116 cells were plated onto a 162 cm2 flask with 50 milliliters of fresh DMEM and allowed to attach and grow for 24 hours. This produced a cell monolayer that was approximately 40% confluent. These cells were mutagenized by incubation with ethyl methane sulfonate (Sigma) at a final concentration of 500 μg/ml for 12 hours. Cells were then rinsed three times with DMEM, re-fed with fresh DMEM before returning to the incubator for 24 hours. Cells were then split into 20 ten centimeter dishes and allowed to grow for 24 hours prior to the addition of UDCA to a final concentration of 500 μM in each dish. Cells were refed with fresh DMEM supplemented with 500 μM UDCA once a week for four weeks at which time colonies of UDCA resistant cells appeared. From this treatment 47 UDCA resistant colonies emerged, 41 of which were successfully expanded into peremanent cell lines. Once the lines were expanded into 10 cm dishes, cells were maintained in DMEM supplemented with 250 μM UDCA. These lines were designated HOMUR cells for HCT116 Odd Morphology UDCA resistant.
Screening HOMUR lines for cross resistance to DCA and hyoDCA
HOMUR cells were plated at 100,000 cells per 35 mm dish and then incubated for 24 hours prior to the addition of either DCA or hyoDCA to a final concentration of 500 μM. Cells exposed to DCA were incubated for 24 hours and then harvested and the fraction of cells undergoing apoptosis determined as described below. HOMUR cells exposed to hyoDCA were incubated for 48 hours with this bile acid and then the fraction of apoptotic cells determined.
For apoptosis assays 100,000 HCT116 cells were plated onto 60 mm tissue culture plates and allowed to attach for 24 hours. This procedure produced a cell monolayer that was 30–40% confluent at the time bile acids were added. The cells were treated with 500 μM bile acids for the times indicated. The media were removed and saved and the remaining attached cells rinsed in PBS and harvested by trypsinization. The cell pellet was re-suspended in the saved media. The number of apoptotic cells was then quantitated by staining with acridine orange and ethidium bromide as described previously .
Anchorage independent growth
To test for anchorage independent growth cells were grown in 0.6% agarose as follows. A stock of 1.2% LMP agarose (Gibco) was autoclaved and then the solution equilibrated at 37°C for 30 minutes. The LMP agarose was diluted 1:1 with DMEM and one milliliter of the mixture poured into each well of a 6 well plate to form a basal layer. This basal layer was allowed to solidify for 10 minutes at 4°C prior to reequilibrating at room temperature for 30 minutes. The top layer was similar to the basal layer, but contained 5,000 cell per well. The top layer was allowed to solidify at room temperature for approximately 15 minutes and the plates were then transferred to a 37°C incubator with 5% CO2. The following day, one milliliter of medium was added to each well, and the cells refed every 3–4 days for 2.5 weeks. Three sets of experiments were performed in triplicate. The total number of colonies was counted and the percent colony formation determined.
Statistical analysis of data was performed using Sigmastat statistical analysis software. In all cases a p value of <0.05 was considered the threshhold for significance.
Isolation and characterization of cells resistant to UDCA-induced growth arrest
Resistant HOMUR cells also show resistance at the biochemical level
Resistance to bile acids also confers a capacity for anchorage independent growth
We and others have previously postulated that resistance to DCA-induced apoptosis may be important in neoplastic transformation that leads to tumorigenesis in the colon [14, 33]. Because the HOMUR lines exhibit resistance to bile acid-induced apoptosis we reasoned that they might be used to test this hypothesis by examining their tumorigenic properties using anchorage independent growth as a measure of their neoplastic development. Consequently, HCT116 cells and all three HOMUR lines were characterized for growth in soft agar (Figure 5). We found that the HOMUR7 line was significantly more capable of growing in soft agar than were any of the HOMUR lines or parental HCT116 cells (p < 0.05 by t-test). Notably, HOMUR17 cells which are more sensitive to DCA-induced apoptosis, showed significantly reduced soft agar growth capacity (p < 0.05 by t-test). Since anchorage independent growth was exhibited by the DCA-resistant line and not by the sensitive line we concluded that resistance to DCA-induced apoptosis correlated with anchorage independent growth.
In the present study we derived a set of cells that were resistant to UDCA and then tested these cells for cross resistance to the effects of two other bile acids to ascertain whether there was overlap in the signaling pathways that mediate bile acid-induced cell death. We were able to demonstrate that there is an overlap in the signaling mechanisms activated by UDCA which lead to growth arrest and those activated by DCA which bring about apoptosis. Careful examination of the number of UDCA-induced growth arrest resistant cells revealed that the majority of these lines also exhibited resistance to DCA-induced apoptosis a finding that is consistent with the concept that the signaling activities of these two bile acids may overlap. Most of the HOMUR lines exhibited some degree of resistance suggesting that the extent of overlap in signaling activities may be extensive. Hence, it seems likely that the signaling activities induced by bile acids and which are responsible for growth arrest and for apoptosis may have much in common.
The likely extensive overlap in signaling activities between DCA and UDCA raises the question of how these two bile acids can exhibit such distinctly different biological activities. Considering that all bile acids have such similar chemical structures it is not unexpected that they can also activate many of the same intracellular signaling mechanisms. However, there is also slight evidence that some bile acids interact with intracellular signaling in unique ways. For example DCA can stimulate the EGFR/ras/mek/erk signal transduction pathway, yet UDCA has been shown to suppress this same pathway [19, 21]. Hence, although the same pathways may be targeted for modulation by the different bile acids the effect that they have on these pathways, activation or inhibition, may determine the ultimate biological outcome of exposure to these agents. This suggests that the distinction between tumor promotion and prevention may be very subtle
These notions emphasize the importance of elucidating the identity and the nature of the unique signaling mechanisms activated by DCA and UDCA. Insight into the characteristics of these pathways can be gleaned from our characterization of the HOMUR cells. Our observation that only the most profoundly DCA resistant HOMUR 7 line exhibits extensive growth in soft agar supports the notion that resistance to DCA-induced apoptosis favors a more tumorogenic phenotype. Our finding that HOMUR 7 cells are also markedly resistant to three commonly used anti-cancer agents suggests that DCA-induced apoptosis may utilize pathways that are also employed by cancer therapeutics. Hence, profound resistance to DCA correlates with acquired resistance to multiple other drugs each of which is known to cause cell death through very different mechanisms. Collectively these results suggest that resistance to bile acid-induced apoptosis is tumorigeneic and is consistent with findings made using natural human tumors .
Our results strongly suggest that there is overlap in the signaling activated by DCA and UDCA. However, there is also evidence that these two bile acids may activate unique signaling pathways that may account for their diametrically opposed biological effects. Importantly, we show that resistance to DCA induced apoptosis confers a more neoplastic phenotype on tumor cells. Our results also have therapeutic implications as targeting of bile acid pathways may have unexpected consequences unless they are adequately understood.
This work was supported by National Institutes of Health Grant CA72008. AAP was supported in part by National Institutes of Health Grant T32CA09213. SJL was supported by a minority supplement to CA72008.
- Vlahcevic ZR, Heuman DM, Hylemon PB: Regulation of bile acid synthesis. Hepatology. 1991, 13: 590-600. 10.1016/0270-9139(91)90317-O.View ArticlePubMedGoogle Scholar
- Hill MJ: Bile flow and colon cancer. Mutation Research. 1990, 238: 313-320.View ArticlePubMedGoogle Scholar
- Imray CH, Radley S, Davis A, Barker G, Hendrickse CW, Donovan IA, Lawson AM, Baker PR, Neoptolemos JP: Faecal unconjugated bile acids in patients with colorectal cancer or polyps. Gut. 1992, 33: 1239-1245.View ArticlePubMedPubMed CentralGoogle Scholar
- Hill MJ, Drasar BS, Hawksworth G, Aries V, Crowther JS, Williams RE: Bacteria and aetiology of cancer of large bowel. Lancet. 1971, 1: 95-100. 10.1016/S0140-6736(71)90837-3.View ArticlePubMedGoogle Scholar
- Bayerdorffer E, Mannes GA, Richter WO, Ochsenkuhn T, Wiebecke B, Kopcke W, Paumgartner G: Increased serum deoxycholic acid levels in men with colorectal adenomas. Gastroenterology. 1993, 104: 145-151.PubMedGoogle Scholar
- Reddy BS, Watanabe K, Weisburger JH, Wynder EL: Promoting effect of bile acids in colon carcinogenesis in germ-free and conventional F344 rats. Cancer Research. 1977, 37: 3238-3242.PubMedGoogle Scholar
- Sutherland LA, Bird RP: The effect of chenodeoxycholic acid on the development of aberrant crypt foci in the rat colon. Cancer Letters. 1994, 76: 101-107. 10.1016/0304-3835(94)90384-0.View ArticlePubMedGoogle Scholar
- Kaibara N, Yurugi E, Koga S: Promoting effect of bile acids on the chemical transformation of C3H/10T1/2 fibroblasts in vitro. Cancer Research. 1984, 44: 5482-5485.PubMedGoogle Scholar
- Earnest DL, Holubec H, Wali RK, Jolley CS, Bissonette M, Bhattacharyya AK, Roy H, Khare S, Brasitus TA: Chemoprevention of azoxymethane-induced colonic carcinogenesis by supplemental dietary ursodeoxycholic acid. Cancer Research. 1994, 54: 5071-5074.PubMedGoogle Scholar
- Ikegami T, Matsuzaki Y, Shoda J, Kano M, Hirabayashi N, Tanaka N: The chemopreventive role of ursodeoxycholic acid in azoxymethane-treated rats: suppressive effects on enhanced group II phospholipase A2 expression in colonic tissue. Cancer Letters. 1998, 134: 129-139. 10.1016/S0304-3835(98)00248-1.View ArticlePubMedGoogle Scholar
- Pardi DS, Loftus EV, Kremers WK, Keach J, Lindor KD: Ursodeoxycholic acid as a chemopreventive agent in patients with ulcerative colitis and primary sclerosing cholangitis. Gastroenterology. 2003, 124: 889-893. 10.1053/gast.2003.50156.View ArticlePubMedGoogle Scholar
- Serfaty L, De Leusse A, Rosmorduc O, Desaint B, Flejou JF, Chazouilleres O, Poupon RE, Poupon R: Ursodeoxycholic acid therapy and the risk of colorectal adenoma in patients with primary biliary cirrhosis: an observational study. Hepatology. 2003, 38: 203-209. 10.1053/jhep.2003.50311.View ArticlePubMedGoogle Scholar
- Alberts DS, Martinez ME, Hess LM, Einspahr JG, Green SB, Bhattacharyya AK, Guillen J, Krutzsch M, Batta AK, Salen G, et al: Phase III trial of ursodeoxycholic acid to prevent colorectal adenoma recurrence. J Natl Cancer Inst. 2005, 97: 846-853.View ArticlePubMedGoogle Scholar
- Martinez JD, Stratagoules ED, LaRue JM, Powell AA, Gause PR, Craven MT, Payne CM, Powell MB, Gerner EW, Earnest DL: Different bile acids exhibit distinct biological effects: the tumor promoter deoxycholic acid induces apoptosis and the chemopreventive agent ursodeoxycholic acid inhibits cell proliferation. Nutr Cancer. 1998, 31: 111-118.View ArticlePubMedGoogle Scholar
- Ramirez MI, Karaoglu D, Haro D, Barillas C, Bashirzadeh R, Gil G: Cholesterol and bile acids regulate cholesterol 7 alpha-hydroxylase expression at the transcriptional level in culture and in transgenic mice. Molecular and Cellular Biology. 1994, 14: 2809-2821.View ArticlePubMedPubMed CentralGoogle Scholar
- Stravitz RT, Vlahcevic ZR, Gurley EC, Hylemon PB: Repression of cholesterol 7 alpha-hydroxylase transcription by bile acids is mediated through protein kinase C in primary cultures of rat hepatocytes. Journal of Lipid Research. 1995, 36: 1359-1369.PubMedGoogle Scholar
- Zhang F, Subbaramaiah K, Altorki N, Dannenberg AJ: Dihydroxy bile acids activate the transcription of cyclooxygenase-2. Journal of Biological Chemistry. 1998, 273: 2424-2428. 10.1074/jbc.273.4.2424.View ArticlePubMedGoogle Scholar
- Kanda T, Foucand L, Nakamura Y, Niot I, Besnard P, Fujita M, Sakai Y, Hatakeyama K, Ono T, Fujii H: Regulation of expression of human intestinal bile acid-binding protein in Caco-2 cells. Biochemical Journal. 1998, 330: 261-265.View ArticlePubMedPubMed CentralGoogle Scholar
- Im E, Martinez JD: Ursodeoxycholic acid (UDCA) can inhibit deoxycholic acid (DCA)-induced apoptosis via modulation of EGFR/Raf-1/ERK signaling in human colon cancer cells. J Nutr. 2004, 134: 483-486.PubMedGoogle Scholar
- Rao YP, Studer EJ, Stravitz RT, Gupta S, Qiao L, Dent P, Hylemon PB: Activation of the Raf-1/MEK/ERK cascade by bile acids occurs via the epidermal growth factor receptor in primary rat hepatocytes. Hepatology. 2002, 35: 307-314. 10.1053/jhep.2002.31104.View ArticlePubMedGoogle Scholar
- Qiao L, Studer E, Leach K, McKinstry R, Gupta S, Decker R, Kukreja R, Valerie K, Nagarkatti P, Deiry WE, et al: Deoxycholic Acid (DCA) Causes Ligand-independent Activation of Epidermal Growth Factor Receptor (EGFR) and FAS Receptor in Primary Hepatocytes: Inhibition of EGFR/Mitogen-activated Protein Kinase-Signaling Module Enhances DCA-induced Apoptosis. Mol Biol Cell. 2001, 12: 2629-2645.View ArticlePubMedPubMed CentralGoogle Scholar
- Akare S, Martinez JD: Bile acid induces hydrophobicity-dependent membrane alterations. Biochim Biophys Acta. 2005, 1735: 59-67.View ArticlePubMedGoogle Scholar
- Fitzer CJ, O'Brian CA, Guillem JG, Weinstein IB: The regulation of protein kinase C by chenodeoxycholate, deoxycholate and several structurally related bile acids. Carcinogenesis. 1987, 8: 217-220.View ArticlePubMedGoogle Scholar
- Craven PA, Pfanstiel J, DeRubertis FR: Role of activation of protein kinase C in the stimulation of colonic epithelial proliferation and reactive oxygen formation by bile acids. Journal of Clinical Investigation. 1987, 79: 532-541.View ArticlePubMedPubMed CentralGoogle Scholar
- Hirano F, Tanada H, Makino Y, Okamoto K, Hiramoto M, Handa H, Makino I: Induction of the transcription factor AP-1 in cultured human colon adenocarcinoma cells following exposure to bile acids. Carcinogenesis. 1996, 17: 427-433.View ArticlePubMedGoogle Scholar
- Hirano F, Tanaka H, Makino Y, Okamoto K, Hiramoto M, Hanada H, Makino I: Induction of the transcription factor AP-1 in cultured human colon adenocarcinoma cells following exposure to bile acids. Carcinogenesis. 1996, 17: 427-433.View ArticlePubMedGoogle Scholar
- Matheson H, Branting C, Rafter I, Okret S, Rafter J: Increased c-fos mRNA and binding to the AP-1 recognition sequence accompanies the proliferative response to deoxycholate of HT29 cells. Carcinogenesis. 1996, 17: 421-426.View ArticlePubMedGoogle Scholar
- Carubbi F, Guicciardi ME, Concari M, Loria P, Bertolotti M, Carulli N: Comparative cytotoxic and cytoprotective effects of taurohyodeoxycholic acid (THDCA) and tauroursodeoxycholic acid (TUDCA) in HepG2 cell line. Biochim Biophys Acta. 2002, 1580: 31-39.View ArticlePubMedGoogle Scholar
- Im E, Akare S, Powell A, Martinez JD: Ursodeoxycholic acid can suppress deoxycholic acid-induced apoptosis by stimulating Akt/PKB-dependent survival signaling. Nutr Cancer. 2005, 51: 110-116. 10.1207/s15327914nc5101_15.View ArticlePubMedGoogle Scholar
- Powell AA, LaRue JM, Batta AK, Martinez JD: Bile acid hydrophobicity is correlated with induction of apoptosis and/or growth arrest in HCT116 cells. Biochem J. 2001, 356: 481-486. 10.1042/0264-6021:3560481.View ArticlePubMedPubMed CentralGoogle Scholar
- Jean-Louis S, Akare S, Ali MA, Mash EA, Meuillet E, Martinez JD: Deoxycholic acid induces intracellular signaling through membrane perturbations. J Biol Chem. 2006, 281: 14948-14960. 10.1074/jbc.M506710200.View ArticlePubMedGoogle Scholar
- Mullen P: PARP cleavage as a means of assessing apoptosis. Methods Mol Med. 2004, 88: 171-181.PubMedGoogle Scholar
- Garewal H, Bernstein H, Bernstein C, Sampliner R, Payne C: Reduced bile acid-induced apoptosis in "normal" colorectal mucosa: a potential biological marker for cancer risk. Cancer Research. 1996, 56: 1480-1483.PubMedGoogle Scholar
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/6/219/prepub
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