We report for the first time that multiple PFAAs enhance hepatocarcinogenesis via an estrogen-like mechanism in rainbow trout, an animal model that recapitulates human insensitivity to peroxisome proliferation. Previously, we demonstrated that dietary exposure to the ubiquitous environmental contaminant PFOA enhanced AFB
1-initiated liver tumorigenesis in trout (
Tilton et al., 2008). Subsequent
in vitro and
in vivo experiments showed that several perfluoroalkyl carboxylic acids and sulfonates have weak estrogen activity, likely via direct interaction with the ER (
Benninghoff et al., 2011); moreover, in this animal model, PFAAs did not elicit the typical PP response expected for PPARα ligands. In the present study, we tested the hypothesis that PFAAs structurally related to PFOA would similarly impact liver tumorigenesis. We determined that chronic exposure to three different PFAAs via the diet, including PFOA, PFNA, and PFDA, markedly increased hepatocarcinogenesis in trout in a manner similar to the prototypical estrogen, E2. Also, tumor promotion by PFOA was restricted to the liver but not dependent upon the initiating carcinogen. Dietary exposure to PFOS caused a modest increase in liver tumor incidence, possibly due to the lower diet concentration selected for this compound or the slightly older age of these fish at initiation and start of dietary treatment.
Although the diet concentrations of PFAAs tested in this study (100–2000 ppm, or 2.5–50 mg/kg body weight/day) are typical for PP cancer studies in rodents, these levels were substantially greater than would be expected from a typical human environmental exposure (
Fromme et al., 2009). Extrapolation from a 2-week dietary dose-response study in trout with PFOA and PFDA (
Benninghoff et al., 2011) suggests that the diet concentrations employed in this tumor promotion study result in blood levels in the micromolar range, considerably higher than the nanomolar range reported for these compounds in human blood (
Calafat et al., 2007;
Olsen et al., 2003). Evidence from a previous limited dose-response tumor study with PFOA in trout suggested that a lower dietary exposure to PFAAs might not substantially increase liver cancer risk in animals that are insensitive to peroxisome proliferation (
Tilton et al., 2008). However, the observation from the present study that 200 ppm PFDA increased tumor incidence to an even greater extent than 2000 ppm PFOA (88 and 62% incidence, respectively) points to the need for further studies utilizing a comprehensive dose-response approach with individual PFAAs to appropriately assess cancer risk for these compounds. Moreover, because multiple members of this chemical class are often detected in blood and tissue samples (
Calafat et al., 2007;
Lau et al., 2007), the potential for additive or synergistic effects of PFAA mixtures in promoting liver carcinogenesis should not be ignored.
The liver gene expression profiles obtained by the trout custom DNA microarray were highly similar among E2 and PFAA treatments, suggesting that these compounds likely act via a common mechanism of action to promote hepatocarcinogenesis in trout. Previously, we identified a set of 17 hepatic genes as biomarkers of estrogen exposure (
Benninghoff and Williams, 2008), of which 13 were differentially regulated by PFAAs in trout. Although the specific mechanism for promotion of liver cancer by estrogens in trout is not known, results of this and previous gene expression profiling experiments (
Benninghoff and Williams, 2008;
Tilton et al., 2006,
2008) point to the involvement of genes associated with cell growth, apoptosis, cell signaling, regulation of transcription, protein stability, and transport and immune response. For example, E2- or PFAA-dependent promotion of hepatocarcinogenesis may involve disruption of the nuclear factor kappa B signaling pathway (e.g.,
nfkb1,
ikk1,
ikbe) or suppression of innate immune response (e.g.,
C-3, C-9, mbl) (
Sun and Karin, 2008;
Vainer et al., 2008). Interestingly, the gene expression profiles for PFAAs obtained from the trout microarray are generally similar to profiles reported by
Wei et al. (2007,
2009) following aqueous exposures of PFOA, PFOS, and various mixtures of PFAAs in rare minnow (
Gobiocypris rarus). In rat liver, the transcriptional response to an oral gavage of PFOA or PFOS was dominated by genes associated with lipid metabolism and transport, including genes in the peroxisomal fatty acid oxidation pathway (e.g.,
Acat1) (
Guruge et al., 2006;
Hu et al., 2005). However, few transcripts associated with the metabolism and transport of lipids and cholesterol were significantly altered by PFAA exposure in trout (<3% of all regulated features), and several of these were also regulated by E2. These observations, along with the recent discovery that PFOA, PFNA, PFDA, and PFOS competitively bind to the trout ER (
Benninghoff et al., 2011), provide further evidence that PFAAs promote hepatic cancer in this species via an estrogen-like mechanism involving activation of the ER, rather than via interaction with PPARα and induction of peroxisomal proliferation.
At the time liver tissues were collected for the microarray study, all three perfluoroalkyl carboxylic acids had been administered at the same diet concentration (2000 ppm) for 2 weeks. Thus, apparent distinctions in transcriptional profiles among PFOA, PFNA, and PFDA may reflect chemical-specific responses, differences in the strength of interaction with molecular targets mediating the transcription response or possible differences in uptake, distribution or elimination of these chemicals
in vivo.
Martin et al. (2003a;
2003b) reported that values for bioconcentration and residence time of PFAAs in trout liver generally increased with increasing length of the fluorinated carbon chain (half-life of 5 days for PFOA compared with 14 days for PFDA). However, the high similarity in transcriptional response to PFOA and PFDA observed in this study did not reflect these apparent differences in chemical pharmacokinetics, most likely due to the daily dietary exposure protocol employed. Dietary PFNA altered hepatic expression of 175 transcripts (65 induced, 110 repressed), nearly twice the number for PFOA and PFDA; however, many of these array features were similarly induced or repressed by all three carboxylic acids and E2, though to differing extent. A case in point is dysregulation of the blood coagulation pathway induced by PFNA, a reported side effect of pharmacological estrogen exposure (
Sherif, 1999).
Only a few definitive chemical-specific gene targets were identified in this study, most notably
st2s2 and
cyp3a7 for PFOS and
gstp
1 for 8:2FtOH. Additionally, the modest transcriptional response to PFOS as compared with the carboxylic acids tested should be considered in the context of the lower dietary exposure (200 ppm). Dietary 8:2FtOH (2000 ppm) modified relatively few transcripts, most of which were highly sensitive estrogen biomarker genes (e.g.,
vtg,
zrp,
esr1). Previously, we determined that 8:2FtOH was not overtly estrogenic in trout and does not interact with the ER (
Benninghoff et al., 2011); it is possible that the transcriptional activity of this chemical observed in this study may be due to
in vivo metabolism of 8:2FtOH to PFOA or other estrogenic derivative (
Brandsma et al., 2011). Other laboratories have also reported estrogen-like activity of PFAAs and some fluorotelomers, although inconsistencies among these reports suggest that some species are more responsive to one compound class than the other (
Ishibashi et al., 2008;
Liu et al., 2007;
Maras et al., 2006).
In conclusion, we report the important finding that multiple PFAAs, including PFOA, PFNA, PFDA, and PFOS, enhance liver tumorigenesis in trout, an animal model that is not responsive to peroxisome proliferation. Evidence from gene expression profiling suggests that the mechanism of action for PFAA-dependent promotion of hepatocarcinogenesis likely involves interaction with the hepatic ER. Finally, this study highlights the use of an alternative animal model to reveal novel estrogen-like action of multiple PFAAs in modulating chemical carcinogenesis.