Prostate Cancer: Potential Biological Factor Contributing to Racial Disparities

Dr David P. Turner PhD Assistant Professor Director of shRNA Technology Medical University of South Carolina Dept of Pathology & Lab Medicine Charleston SC Interview with:
Dr David P. Turner PhD
Assistant Professor, Director of shRNA Technology
Medical University of South Carolina
Dept of Pathology & Lab Medicine
Charleston SC 29425 What are the main findings of the study?

Dr. Turner: Our research has identified a potential mechanistic link between sugar derived metabolites and cancer associated pathways which may be a biological consequence of the socioeconomic and biological factors that are known to drive cancer health disparity. African Americans develop and die more frequently of cancer than any other population in the US. We examined the levels of reactive metabolites known as advanced glycation end-products, or AGEs for short, in serum and tumor samples from African American and Non-Hispanic White prostate cancer patients. In both the serum and tumor tissue, the levels of AGE metabolites were consistently higher in the African American prostate cancer patients than their White counterparts. AGE functions as a ligand for the receptor for AGEs, or RAGE for short. We also identified that RAGE protein levels were  higher in African Americans with prostate cancer. Were any of the findings unexpected?

Dr. Turner: AGEs are a consequence of normal metabolism and due to poor clearance accumulate within our tissues and organs as we grow older with pathogenic consequences. Low income, obesity and an inactive/sedentary lifestyle are established factors driving cancer health disparity. Significantly, apart from their production during normal metabolism, AGE’s are also formed through the ingestion of food and by external environmental factors such as lack of exercise. AGE content in the Western Diet has consistently increased over the last 50 years due to increased consumption of sugar laden and cheap processed/manufactured foods which are high in reactive AGE metabolites and can promote obesity. Due to the common links between the factors that drive health disparity and the increased accumulation of AGE metabolites we expected that AGEs may be higher in African Americans, what was unexpected was the particularly high levels of AGE metabolites observed in the prostate cancer tumor tissue. What should clinicians and patients take away from your report?

Dr. Turner: These preliminary studies indicate that increased activation of the AGE-RAGE signaling axis may represent a biological mechanism promoting prostate cancer and cancer health disparity. This has significant connotations for community education and outreach. As AGE accumulation is linked to poor lifestyle choices such as poor diet and a lack of physical activity, small changes to our everyday habits may make a significant contribution to reducing how much AGE metabolite accumulates in our bodies. Avoiding foods high in protein, sugar and fat as well as manufactured foods can reduce our everyday intake of AGEs. Poaching foods rather than frying also reduces the number of AGEs we consume form food. Moderate regular exercise can also maintain and even reduce AGE accumulation levels. Clinicians should be aware of the potential impact of these factors on their patient population and address them as part of their clinic/practice What recommendations do you have for future research as a result of this study?

Dr. Turner: This study needs to be repeated in a larger cohort of samples to confirm our findings. We also need to further examine the mechanistic consequence of AGE accumulation and AGE-RAGE signaling on cancer associated processes and the effects of existing and novel therapeutics on AGE metabolite levels.

Potential Biological Factor Contributing to Racial Disparities in Prostate Cancer

Presented at: Sixth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held Dec. 6-9 2013