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. 2017 Feb;10(2):142-152.
doi: 10.1158/1940-6207.CAPR-16-0241. Epub 2016 Dec 20.

Unlocking Aspirin's Chemopreventive Activity: Role of Irreversibly Inhibiting Platelet Cyclooxygenase-1

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Free PMC article

Unlocking Aspirin's Chemopreventive Activity: Role of Irreversibly Inhibiting Platelet Cyclooxygenase-1

Lenard M Lichtenberger et al. Cancer Prev Res (Phila). 2017 Feb.
Free PMC article

Abstract

The mechanism by which aspirin consumption is linked to significant reductions in the incidence of multiple forms of cancer and metastatic spread to distant tissues, resulting in increased cancer patient survival is not well understood. In this study, using colon cancer as an example, we provide both in vitro (cell culture) and in vivo (chemically induced mouse model of colon cancer) evidence that this profound antineoplastic action may be associated with aspirin's ability to irreversibly inhibit COX-1-mediated platelet activation, thereby blocking platelet-cancer cell interactions, which promote cancer cell number and invasive potential. This process may be driven by platelet-induced epithelial-mesenchymal transition (EMT), as assessed using confocal microscopy, based upon changes in cell morphology, growth characteristics and fibronectin expression, and biochemical/molecular analysis by measuring changes in the expression of the EMT markers; vimentin, β-catenin, and SNAIL. We also provide evidence that a novel, gastrointestinal-safe phosphatidylcholine (PC)-associated aspirin, PL2200 Aspirin, possesses the same or more pronounced actions versus unmodified aspirin with regard to antiplatelet effects (in vitro: reducing platelet activation as determined by measuring the release of thromboxane and VEGF in culture medium; in vivo: inhibiting platelet number/activation and extravasation into tumor tissue) and chemoprevention (in vitro: inhibiting colonic cell growth and invasive activity; in vivo: inhibiting colonic dysplasia, inflammation, and tumor mass). These results suggest that aspirin's chemopreventive effects may be due, in part, to the drug blocking the proneoplastic action of platelets, and the potential use of Aspirin-PC/PL2200 as an effective and safer chemopreventive agent for colorectal cancer and possibly other cancers. Cancer Prev Res; 10(2); 142-52. ©2016 AACR.

Conflict of interest statement

of Potential Conflicts of Interest: L. Lichtenberger is a co-founder and shareholder in PLx Pharma Inc which is developing PC-NSAIDs for commercial use.

Figures

Figure 1
Figure 1. Platelet-induced proliferation and invasion of colon cancer cells can be attenuated by aspirin test drugs
Mouse or human washed platelets (mWPs or hWPs) promote the growth of (A) mouse MC-26 or (B) human Caco2 and this effect is blocked by aspirin and Aspirin-PC. (C) Evidence that mouse washed platelets (mWPs) promoted the invasion of mouse MC-26 colon cancer cells, and this effect was blocked by both aspirin and Aspirin-PC. (D) Co-culture of platelets with colon cancer cells stimulated medium TXB2 and VEGF levels which were respectively inhibited by aspirin and Aspirin-PC. Values in each group were calculated from triplicates of 3 separate studies (n=9).
Figure 2
Figure 2. Co-culture of MC-26 with mWPs results in Epithelial-Mesenchymal Transition (EMT)
De-convolution confocal microscopy of representative MC-26 cell growth pattern (f-actin in green) and expression of EMT marker (fibronectin in red) in the absence (A) and presence of mouse platelets (B). Fibronectin expression was quantified (C) by assessing fluorescent intensity/cell number which was increased in the presence of platelets and reduced by aspirin and Aspirin-PC (n=4/group).
Figure 3
Figure 3. The effect of aspirin and Aspirin-PC to reverse platelet-induced EMT changes
(A&B) Mouse platelets (P) promote β-catenin translocation into nucleus of MC-26 cells is reduced by aspirin (ASA) and ASA-PC. (A) Western blot: Lanes 1–4 Membrane cytosol fraction; Lanes 5–8 Nucleus fraction; (B) Densitometry ratio of nucleus vs membrane/cytosol fractions. (C&D) Increased expression of Vimentin promoted by co-culture of MC-26 with mouse washed platelets was inhibited by aspirin and Aspirin-PC. (C) Western blot of vimentin of cell culture total lysates; (D) Histogram of densitometric analysis from 3 separate studies.
Figure 4
Figure 4. AOM/DSS mouse cancer model
(A) Timeline (in weeks) of AOM/DSS model. (B) Demonstration that platelet number was dose-dependently increased with DSS concentration. (C) Mouse colon weight and body weight were recorded and the correlation between platelet number and ratio of colon weight to body weight was analyzed, as a reflection of colonic tumor mass. For (B) and (C): control (n=5), AOM (n=6), AOM/2% DSS (n=5), AOM/3% DSS (n=8), AOM/4% DSS (n=5). (D) Evidence that daily aspirin (ASA) treatment reduced platelet number in AOM/DSS challenged mice. (E) Detection of TXB2 in the mouse serum samples from AOM/DSS study, demonstrating the antiplatelet efficacy of both ASA and ASA-PC. For (D) and (E): control (n=6), AOM/DSS+Saline (n=5), AOM/DSS+aspirin (n=14), AOM/DSS+Aspirin-PC (n=11).
Figure 5
Figure 5. The effect of aspirin and Aspirin-PC on mouse colon cancer model
(A) Efficacy of aspirin and Aspirin-PC in significantly reducing the number of colonic aberrant crypts from the elevated values observed in mice treated with AOM/DSS. (B) Colon weight per length of animal in all groups, which is indicative of colonic inflammation induced by AOM/DSS, is reduced by both aspirin test drugs. (C) Ratio of colon weight to body weight, as an index of colonic tumor mass. The AOM/DSS/saline group values are significantly increased over the values of the control group. More importantly, the colon weight/body weight ratio is significantly reduced from elevated AOM/DSS values by treatment with aspirin and Aspirin-PC. Control (n=6), AOM/DSS+Saline (n=5), AOM/DSS+aspirin (n=14), AOM/DSS+Aspirin-PC (n=11).
Figure 6
Figure 6. Localization of platelets in mouse cancer model
FITC-labelling of antibodies directed against mouse CD41 surface antigen in representative colonic tissue of: (A) control mice; and (B) mice challenged with AOM/DSS to induce colonic dysplasia/ adenoma. Arrows indicate localizations of platelet-specific immunoreactivity within blood vessels and surrounding submucosal and mucosal tissue. Both micrographs were taken using a 20X objective. (C) Quantification of platelet immunoreactivity in colonic tissue of AOM/DSS-treated mice, was performed using ImageJ software by measuring pixel units, showing reductions with aspirin and Aspirin-PC treatments. Slides per group: (saline) control=2; AOM/DSS/saline (untreated)=8; AOM/DSS/(aspirin)=7; AOM/DSS/(Aspirin-PC)=4.

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