Long-chain saturated fatty acids are a major component of dietary fat. We and others have reported that long-chain saturated fatty acids and especially stearate inhibit proliferation of breast cancer cells (
1–
3). However, the molecular and cellular mechanism for this inhibition is not clear. Our present studies indicate that stearate arrested cell cycle progression from G
1 to S and to a lesser extent from G
2 to M. These results differ from several studies demonstrating stearate-induced cell death/apoptosis (
24–
26). This may be due to differences in the concentration of stearate used, time of exposure and cell type. Typically, the minimum concentration of stearate used in studies demonstrating decreased cell viability was 100 μM, which is double the concentration used in our experiments and other manuscripts use even higher, non-physiologic, concentrated preparations. In one study, treating human ovarian granulosa cells with 50 μM stearate (or palmitate) for 3 days demonstrated no decrease in cell viability (
24). Recent studies indicate both a time and concentration dependence of stearate to induce apoptosis in human breast cancer cells and that this effect is specific for breast cancer cells compared with non-cancer breast cells (
27). The stearate concentration (50 μM) used in our present study was generally maintained for 6 h and represents a high normal physiological exposure with respect to concentration and time (
28,
29). Thus, the experiments herein indicate an early stage of stearate exposure that precedes apoptosis.
Cell cycle entry and progression rely on the precisely controlled expression and activation of cell cycle-related enzymes, termed Cdks, cyclins and cyclin-dependent kinase inhibitors. The activity of Cdks is controlled by cyclin-binding interactions, regulated phosphorylation and association with cyclin kinase inhibitors (
14). p21
CIP1/WAF1 is a broad spectrum cell cycle inhibitor involved in G
1 to S and G
2 to M phase transitions (
30) and increased p21
CIP1/WAF1 would be expected to inhibit both cdc2 and cyclin E/Cdk2 complexes. p27
KIP1 is also known to inhibit G
1 progression via Cdk2 inhibition (
15,
31,
32). Mitogens stimulate elimination of p27
KIP1 by decreased translation and increased ubiquitin-directed degradation (
33). EGF increased p27
KIP1 degradation in Hs578T human breast cancer cells; however, stearate prevented EGF-induced p27
KIP1 degradation from reaching control cell levels. It has been proposed that inhibition of p27
KIP1 degradation results in elevated levels of p27
KIP1 and inhibition of G
1 progression (
12,
22,
32). Thus, upregulation of both p21
CIP1/WAF1 and p27
KIP1 as observed in our experiments are linked with cell cycle arrest caused by stearate.
Cell transformation by oncogenic Ras has been shown to require the function of Rho. Rho GTPases such as RhoA, Rac1 and Cdc42 have been shown to be required for Ras-induced cell transformation (
34–
36). Subsequent studies indicate that Ras mobilizes not only the Raf–mitogen-activated protein kinase–ERK-mediated kinase signaling cascade but also the PI-3-kinase and RalGDS pathways for complete cell transformation (
37). Exactly how Rho functions in the PI-3-kinase and RalGDS signaling pathways is not clear; however, it has been proposed that Rho signaling involves these two pathways in Ras transformation (
38).
It is known that transformed cells have elevated levels of activated Rho that inhibit the expression of p21
CIP1/WAF1 and induce cyclin D1 thereby promoting cell proliferation (
22,
39). There is evidence indicating that palmitoylation and possibly acylation by stearate can increase Ras activity by promoting Ras association with the plasma membrane (
48,
49). However, the mechanism whereby stearate inhibits Rho activity and expression is not yet known. One possibility of how Rho activity is inhibited by stearate is via inhibition of the translocation of p190 Rho–GAP to detergent insoluble membranes in response to Ras (
40). Our data in and D are consistent with this hypothesis. We used constitutively active Rho's that are not affected by p190 Rho–GAP and showed that constitutively activated Rho B and C were both able to at least partially reverse the effects of stearate on p21
CIP1/WAF1 and p27
KIP1 protein concentration.
In our experiments, although stearate increased Ras activity, it decreased Rho activation and mRNA expression. This may be the key as to how stearate inhibits cancer cell cycle progression. RhoA is known to stimulate p27
KIP1 degradation by inducing cyclin E/Cdk2 activity (
32,
33). Thus, blocking Rho activity and mRNA expression would be expected to lead to a decrease in both cyclin E/Cdk2 activity and p27
KIP1 degradation that is exactly what happened with stearate treatment. Although
in vitro data on Hs578T cells demonstrated that both RhoA and RhoC mRNA expression are inhibited by stearate, only constitutively active RhoC and to a lesser extent B inhibit the effect of stearate on cell cycle proteins p27
KIP1 and p21
CIP1/WAF1. Interestingly, it was reported that upregulation of RhoC plays an important role in inflammatory breast cancer (
41), as well as in other malignant neoplasms including those thought to arise in the urinary bladder, ovary, pancreas and skin (
16,
42–
44). Although we did not see a decrease in RhoC in the NMU model of mammary cancer, it is possible that RhoC does not play a major role in the development of this particular cancer. Consistent with this hypothesis is the fact that RhoC seems to be involved in aggressive forms of breast cancer and the NMU model develops a type of cancer that slowly progresses and did not demonstrate metastasis in our hands. It further indicates that RhoA and B may play important roles both in carcinogen-induced mammary cell transformation and cell proliferation. Although Ras mutations are important in ~30% of cancers (
9), the incidence of Ras point mutations in primary breast cancers is rare (<5%) (
10). Nevertheless in breast cancer there is upregulated Ras signaling through growth factor receptors and other tyrosine kinases or Ras regulators commonly overexpressed, the Ras protein itself or downstream effectors (
10). In the NMU rat model ~80–90% of tumors are Ras dependent making it an ideal model to confirm our
in vitro data that stearate inhibits Rho and thus cell transformation and tumor growth
in vivo (
45,46). Although this study focuses tightly on dietary stearate, the cell cycle, Rho and Ras, a consideration of other mechanistic studies concerning fatty acids and cancer provides better perspective of how the present studies may fit in this field. Dietary fat has been suggested to promote the development of cancer via altering cellular membrane structure (
47). Membrane lipid structure can affect membrane-bound proteins thereby influencing intracellular signaling. Importantly, stearate is preferentially incorporated into phospholipids such as phosphatidylinositol (
48). One of the other signaling systems that may be affected by dietary stearate is the protein kinase C (PKC) pathway. PKC is activated by phospholipases including phosphoinositide phospholipase C which when activated produces diacylglycerol, a co-activator of classical PKCs and 1,4,5-trisphosphate that stimulates the release of intracellular calcium another co-activator of classical PKCs. Others have suggested that palmitate incorporation into diacylglycerol rather than triacylglycerol is associated with apoptosis of MDA-MB-231 breast cancer cells (
49). More recently, we have investigateda possible role of PKC in stearate-induced apoptosis of breast cancer cells
in vitro and found that stearate appears to work specifically via a diacylglycerol/PKC/caspase-3-mediated pathway (
27). Although potentially this is a very important finding, it should be kept in mind that this mechanism has not yet been demonstrated
in vivo with dietary stearate. In addition, although it may be related to the reduction of tumor burden seen in this and one other study (
50), PKC pathways have also been shown to be involved in tumorigenesis. In fact, it has been suggested that Ras and PKC may cooperate during transformation (
51). Investigation of a dietary stearate-induced link between PKC and Ras in the NMU carcinogen model was not explored in the present study but is a logical future study. Interestingly, in a transgenic model of colon cancer, transformation was found to mediated by a PKCβII–Ras–PKCι–RAC1 (a Rho family member)–mitogen-activated protein kinase pathway that was found to be highly sensitive to a mitogen-activated protein kinase inhibitor (
51). Thus, it is possible that a PKC/diacylglycerol/Rho signaling pathway mediates the effects of dietary stearate on carcinogenesis; however, much work remains to prove this.
Nevertheless, results of the
in vivo studies herein support our
in vitro findings via inhibition of mammary tumor burden and carcinogenesis. Although one study has also found that stearate inhibits carcinogenesis using the NMU model (
3), they injected iodostearic acid subcutaneously rather than give highly purified stearate in dietary form. The present study not only provides molecular insights as to how stearate is working but also shows for the first time that dietary stearate inhibits carcinogenesis. Recent studies have also indicated that dietary stearate inhibits breast cancer tumor and metastasis burden in an orthotopic nude mouse model (
50). These studies indicate that dietary stearate may be a preventative agent but is there evidence to support this role? Many case control and cohort studies have been performed in different countries to determine the correlation of dietary fat intake and breast cancer risk. Five meta-studies have summarized these results over the years and their results are conflicting. The link between total dietary fat intake and human breast cancer seems weak and may be related to menopausal hormone use (
52). With respect to saturated fatty acids, three of these meta-studies found no association between saturated fatty acids and breast cancer (
53–
55) whereas two studies did (
56,
57). Data obtained by actually measuring individual fatty acid composition of adipose tissue, erythrocyte membranes, serum and plasma provide quantitative measurement independent of energy intake, and reflects bioavailable and post-absorptive amounts of fat consumed. This eliminates inadequacies of food frequency questionnaires, food composition tables and nutrient databases. A meta-analysis of these data and the risk of breast cancer (3 cohort and 7 case–control studies with 2031 breast cancer cases and 2334 controls) indicate that in cohort studies, stearate was not associated with increased risk of breast cancer whereas palmitate was (
58). They also demonstrate that in a cohort of post-menopausal women both stearate and the stearate/oleate ratio were negatively associated with breast cancer risk. This is consistent with a protective effect of stearate with respect to the risk of breast cancer. In this meta-analysis, no significant associations were derived from the case–control studies. Since the meta-analysis report, a case–control study looking at red blood cell fatty acids and breast cancer found that stearate did not have a positive association with breast cancer whereas palmitate did (
59) similar to the results found from the cohort studies mentioned above. The only other such study since the meta-analysis was done found no relations between breast cancer risk and any fatty acids of erythrocyte membranes (
60). Overall, these studies suggest that stearate is either neutral or may be protective for breast cancer and thus do not contraindicate a possible role for stearate in preventing breast cancer especially in post-menopausal women.
A limitation of these studies is that the
in vitro experiments were only done on one cell line. The choice of Hs578t cells was made because initially we were interested in studying EGFR expressing breast cancer cells since the presence of the EGFR is associated with poorer outcomes. In addition, there remains a great need for therapies/prevention of this type of breast cancer exactly because it is so aggressive. Nevertheless, it is clear that stearate has affects on cancer cells other than basal breast cancer cells. We have published the effects of stearate on HT1080 (human fibrosarcoma) and PC3 and DU145 (human prostate cancer) cells (
61). Interestingly, the basal type non-tumorigenic but EGF-responsive breast cancer cell line MCF10A was not affected by stearate whereas Hs578t, MDA-MB-435 and MDA-MB-231 cells were (
27). Since estrogen suppresses the expression of the EGFR (
62), we have yet to investigate estrogen-responsive (ER+) cell lines. Nevertheless, it is possible that stearate has similar effects on other cancer cell lines and we hope to be able to characterize the effects of stearate on other breast cancer cell lines in future studies.
In summary, our in vitro results demonstrate that stearate inhibits breast cancer cell cycle largely in G1, as well as inhibiting Rho expression and activity in vitro and expression in vivo. In vivo results further showed that dietary stearate inhibited the incidence and tumor burden of NMU-induced mammary cancer. These studies raise the possibility of stearate inhibiting Ras/Rho signaling and demonstrate the effectiveness of dietary stearate as a preventative agent for mammary cancer carcinogenesis.