维生素D与前列腺癌
Vitamin D and prostate cancer.
作者信息
Tuohimaa P, Lyakhovich A, Aksenov N, Pennanen P, Syvälä H, Lou Y R, Ahonen M, Hasan T, Pasanen P, Bläuer M, Manninen T, Miettinen S, Vilja P, Ylikomi T
机构信息
Medical School, University of Tampere, 33014, Tampere, Finland.
出版信息
J Steroid Biochem Mol Biol. 2001 Jan-Mar;76(1-5):125-34. doi: 10.1016/s0960-0760(00)00141-2.
Our recent epidemiological study (Ahonen et al., Cancer Causes Control 11(2000) (847-852)) suggests that vitamin D deficiency may increase the risk of initiation and progression of prostate cancer. The nested case-control study was based on a 13-year follow-up of about 19000 middle-aged men free of clinically verified prostate cancer. More than one-half of the serum samples had 25OH-vitamin D (25-VD) levels below 50 nmol/l, suggesting VD deficiency. Prostate cancer risk was highest among the group of younger men (40-51 years) with low serum 25-VD, whereas low serum 25-VD appeared not to increase the risk of prostate cancer in older men (>51 years). This suggests that VD has a protective role against prostate cancer only before the andropause, when serum androgen concentrations are higher. The lowest 25-VD concentrations in the younger men were associated with more aggressive prostate cancer. Furthermore, the high 25-VD levels delayed the appearance of clinically verified prostate cancer by 1.8 years. Since these results suggest that vitamin D has a protective role against prostate cancer, we tried to determine whether full spectrum lighting (FSL) during working hours could increase serum 25-VD concentrations. After 1-month exposure, there was no significant increase in the serum 25-VD level, although there was a bias towards slightly increasing values in the test group as opposed to decreasing values in controls. There was no significant change in the skin urocanic acid production. The possibility to use FSL in cancer prevention is discussed. In order to clarify the mechanism of VD action on cell proliferation and differentiation, we performed studies with the rat and human prostates as well prostate cancer cell lines. It is possible that 25-VD may have a direct role in the host anticancer defence activity, but the metabolism of vitamin D in the prostate may also play an important role in its action. We raised antibodies against human 1alpha-hydroxylase and 24-hydroxylase. Our preliminary results suggest that vitamin D is actively metabolised in the prostate. Vitamin D appears to upregulate androgen receptor expression, whereas androgens seem to upregulate vitamin D receptor (VDR). This may at least partially explain the androgen dependence of VD action. VD alone or administered with androgen causes a suppression of epithelial cell proliferation. VD can activate mitogen-activated kinases, erk-1 and erk-2, within minutes and p38 within hours. Also, auto/paracrine regulation might be involved, since keratinocyte growth factor (mRNA and protein) was clearly induced by VD. Based on these studies, a putative model for VD action on cell proliferation and differentiation is presented.
我们最近的流行病学研究(阿霍宁等人,《癌症病因与控制》11(2000) (847 - 852))表明,维生素D缺乏可能会增加前列腺癌发生和进展的风险。这项巢式病例对照研究基于对约19000名无临床确诊前列腺癌的中年男性进行的13年随访。超过一半的血清样本中25-羟维生素D(25-VD)水平低于50 nmol/l,表明存在维生素D缺乏。血清25-VD水平低的年轻男性(40 - 51岁)患前列腺癌的风险最高,而血清25-VD水平低似乎并未增加老年男性(>51岁)患前列腺癌的风险。这表明维生素D仅在男性更年期前对前列腺癌具有保护作用,此时血清雄激素浓度较高。年轻男性中最低的25-VD浓度与侵袭性更强的前列腺癌相关。此外,较高的25-VD水平使临床确诊前列腺癌的出现延迟了1.8年。由于这些结果表明维生素D对前列腺癌具有保护作用,我们试图确定工作时间内的全光谱照明(FSL)是否能提高血清25-VD浓度。暴露1个月后,血清25-VD水平没有显著升高,尽管试验组的值有轻微上升的趋势,而对照组的值则呈下降趋势。皮肤尿刊酸的产生没有显著变化。讨论了使用FSL预防癌症的可能性。为了阐明维生素D对细胞增殖和分化的作用机制,我们用大鼠和人类前列腺以及前列腺癌细胞系进行了研究。25-VD可能在宿主抗癌防御活动中具有直接作用,但维生素D在前列腺中的代谢在其作用中也可能起重要作用。我们制备了针对人1α-羟化酶和24-羟化酶的抗体。我们的初步结果表明维生素D在前列腺中被积极代谢。维生素D似乎上调雄激素受体表达,而雄激素似乎上调维生素D受体(VDR)。这可能至少部分解释了维生素D作用对雄激素的依赖性。单独使用维生素D或与雄激素一起使用会抑制上皮细胞增殖。维生素D可在数分钟内激活丝裂原活化激酶erk-1和erk-2,数小时内激活p38。此外,可能涉及自分泌/旁分泌调节,因为角质形成细胞生长因子(mRNA和蛋白质)明显被维生素D诱导。基于这些研究,提出了一个维生素D对细胞增殖和分化作用的假定模型。