2017-09-13
The Arachidonic Acid Pathway: a potential application in the diagnosis and prognosis of prostate cancer
Publication
Publication
De arachidonzuur metabole route: Een mogelijke toepassing voor diagnose en prognose van prostaatkanker
Prostate cancer (PCa) is the most common cancer in men, and in 2012 more than 400,000
cases were diagnosed in Europe. Although the introduction of the PSA test improved the
management of the disease, its low specificity has led to overdiagnosis and unnecessary
treatments for men considered to be at low risk for progression of the disease. Thus, novel
and reliable molecular markers are needed to improve the diagnosis of PCa and also to better
differentiate indolent cases of PCa from those that will recur after initial treatment.
In this thesis, we aimed to identify and validate novel metabolites and proteins markers in
tissue or bio-fluids, which could improve the diagnosis and/or the prognosis of PCa. We used
analytical approaches to study the role of selected metabolites and proteins, particularly along
the arachidonic acid (AA) pathway.
We used targeted metabolomics approaches in serum to evaluate whether concentrations of
molecules in two pathways could be used as markers for PCa. For tryptophan (Trp) and one
of its metabolites, kynurenine (Kyn), we used an HPLC method with fluorescence detection
on serum samples from older men having low PSA values and no PCa, as well as subjects
diagnosed with PCa.
We could not identify statistical differences between the groups and thus we concluded that
neither the concentrations of these metabolites, nor the ratio Kyn/Trp, could be used as
markers for PCa. Next, we used a UHPLC-MS/MS method to evaluate the concentrations of
AA and some of its metabolites in serum from PCa patients at different stages of the disease.
We developed a method for the simultaneous quantification of six metabolites belonging to
the AA pathway, and we used the results to evaluate PCa diagnosis. Interestingly, we found
that a selected group of patients had higher concentrations of hydroxyeicosatetraenoic acid
(HETE) metabolites, compared to the control group. We then used the same methodology on
an extended and well defined group of patients having different stages of PCa, and we found
that concentrations of HETE metabolites are associated with the most aggressive status of
the disease. Concomitantly, we also found a reduction in the AA concentration in the same
group of patients and these results (which may be related to each other) could be used as an
indicator of PCa relapse after radical
prostatectomy.
In tissue, we used label free quantitative proteomics to identify proteins in PCa that are
associated to diagnosis and prognosis and also to evaluate whether the altered concentrations
of AA and its metabolites in serum could be associated with a deregulation of particular
proteins in the arachidonic acid (AA) pathway.We analysed the protein fraction from RNA
isolation of 67 PCa tissue samples, consisting of 33 normal adjacent tissue (NAP) samples
and 34 PCa samples, using nano-LC high resolution mass spectrometry. In addition, we
validatedthe expression of four proteins by immunohistochemistry and we used tissue
microarrays (TMA) to evaluate the prognostic performance of these markers.
Remarkably, we found that FASN, AGR2, and one protein of the AA pathway: TEBP, were
highly upregulated in PCa. In addition, TMA indicated that both low percentage of positive
AGR2 tumour cells and low percentage of positive LOX5 tumour cells, are predictors of
biochemical recurrence after radical prostatectomy. These results highlight the role of
proteins in the AA pathway inthe diagnosis and prognosis of PCa. We have shown that
proteins and metabolites in the AA pathway play a key role in PCa.
To complement the structural characterisation of AA in mass spectrometry, we studied the
fragmentation of AA in the presence of metal ions such as Ca2+ and Mg2+. We showed that
the addition of these metal ions improved the fragmentation of AA in the gas-phase, and in
particular such fragmentations provide the exact location of the double bonds in the carbon
chain. Thus, this strategy could be further used to analyse extended sets of fatty acids and
lipids using mass spectrometry, and also their role in diseases like cancer.
We conclude that we have shown that the experimental methodologies used in this thesis
help to understand the role of the fatty acid metabolism and arachidonic acid pathway in
PCa. Key metabolites such as HETEs and AA, as well as enzymes along this pathway, could
improve the diagnosis and prognosis of PCa, and they could also become important
therapeutic targets of the disease.
Additional Metadata | |
---|---|
P.A.E. Sillevis Smitt (Peter) , G.W. Jenster (Guido) , T.M. Luider (Theo) | |
Erasmus University Rotterdam | |
The research described in this thesis was funded by the Prostate Research Organizations-Network of Early Stage Training (PRO-NEST) – FP7 Marie Curie initial training network (Grant Agreement No. 238278. | |
hdl.handle.net/1765/100859 | |
Organisation | Department of Neurology |
Rodríguez-Blanco, G. (2017, September 13). The Arachidonic Acid Pathway: a potential application in the diagnosis and prognosis of prostate cancer. Retrieved from http://hdl.handle.net/1765/100859 |