Abstract

Limited information is available regarding mechanisms that link the known carcinogenic risk factors of gastro-esophageal reflux and cigarette smoking to metabolic alterations in esophageal adenocarcinoma (EAC). In the present study, we utilized a novel in-vitro model to examine whether bile acid and cigarette smoke increase the aggressiveness of EAC and whether these changes are associated with metabolic changes.EAC cells (EACC) were exposed to 10 μg/ml cigarette smoke condensate (CSC) and/or 100 μM of the oncogenic bile acid, deoxycholic acid (DCA), for 5 days. These exposure conditions were chosen given their lack of effect on proliferation or viability. DCA and CSC increased invasion, migration, and clonogenicity in EAC cells. These changes were associated with concomitant increases in ATP, ROS, and lactate production indicative of increased mitochondrial respiration as well as glycolytic activity. DCA and CSC exposure significantly decreased expression of uncoupling protein-2 (UCP2), a mitochondrial inner membrane protein implicated in regulation of the proton gradient. Knockdown of UCP2 in EACC phenocopied DCA and CSC exposure as evidenced by increased cell migration, invasion, and clonogenicity, whereas over-expression of UCP2 had an inverse effect. Furthermore, over-expression of UCP2 abrogated DCA and CSC-mediated increases in lactate and ATP production in EACC.DCA and CSC promote the aggressive phenotype of EACC with concomitant metabolic changes occurring via downregulation of UCP2. These results indicate that UCP2 is integral to the aggressive phenotype of EACC. This mechanism suggests that targeting alterations in cellular energetics may be a novel strategy for EAC therapy.

Highlights

  • Esophageal adenocarcinoma (EAC) is the dominant esophageal cancer histology in the United States with an average annual increase of 6% [1]

  • Similar growth rates suggest that cigarette smoke condensate (CSC) and deoxycholic acid (DCA) induction of EAC malignant progression was dissociated from cell proliferation

  • We established an in-vitro model of the wellknown esophageal adenocarcinoma risk factors, bile acid and cigarette smoke, to query whether they increased the aggressive phenotype of EAC cells (EACC) and, if true, whether this cellular phenotype was associated with metabolic changes

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Summary

Introduction

Esophageal adenocarcinoma (EAC) is the dominant esophageal cancer histology in the United States with an average annual increase of 6% [1]. The 5-year survival rate for all patients diagnosed with esophageal cancer remains less than 20%. There is an urgent need to develop effective and novel approaches for treatment. Environmental risk factors play a significant role in the development and progression of EAC. Gastroesophageal reflux disease and cigarette smoking are major risk factors for esophageal adenocarcinoma [2, 3]. Bile acids enter the esophagus during episodes of reflux [4, 5]. The most common bile acids are cholic acid, deoxycholic acid (DCA), chenodeoxycholic acid (CDCA), glycocholic acid, taurocholic acid, lithocholic acid, and ursodeoxycholic acid.

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