The Anti-tumoral Effect of β-D-Mannuronic Acid (M2000) as a Novel NSAID on Treg Cells Frequency and MMP-2, MMP-9, CCL22 and TGFβ1 Gene Expression in Pre-surgical Breast Cancer Patients
Abstract
With respect to the role of chronic inflammation in the induction and progression of breast cancer (BC). The relationship between tumor and tumor microenvironment may be a hopeful strategy for BC therapy. According to the effect of β-D-Mannuronic acid (M2000) as a novel non-steroidal anti-inflammatory drug (NSAID) on BC murine model and 4T1 cell line, we started to study that was a phase II, randomized, controlled clinical trial. 24 women with BC were included in this study and were followed by fixed oral doses of M2000, 500 mg two times a day (6-8 weeks). Blood samples were collected at baseline and weeks 6-8. To compare the patterns of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), C-C motif chemokine ligand 22 (CCL22) and The transforming growth factor-beta 1 (TGFβ1) gene expression and T regulatory cells (Tregs) frequency of healthy women normal controls with BC patients, a set of 10 blood samples of women healthy volunteers was collected. The gene expression was evaluated by quantitative Real-time PCR (qRT-PCR) and the frequency of Tregs was assessed by flow cytometry. Our results showed, reduction in MMP-2 (p=0.08), MMP-9 (p=0.03), CCL22 (p=0.003) and TGFβ1 (p=0.1) gene expression and Tregs frequency (p=0.01) which play a main role in the development of chronic inflammation, angiogenesis, tumorigenesis and metastasis. Our findings demonstrated that M2000 therapy as a novel designed NSAID had valuable therapeutic effects on BC. No adverse effects were observed following the use of M2000 after 6-8 weeks.
2. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136(5):E359-E86.
3. Akbari ME, Sayad S, Sayad S, Khayamzadeh M, Shojaee L, Shormeji Z, et al. Breast Cancer Status in Iran: Statistical Analysis of 3010 Cases between 1998 and 2014. Int J Breast Cancer 2017; 2017:248.
4. Owonikoko TK, Arbiser J, Zelnak A, Shu H-KG, Shim H, Robin AM, et al. Current approaches to the treatment of metastatic brain tumours. Nat Rev Clin Oncol 2014; 11(4):203-22.
5. Kazemi T, Younesi V, Jadidi-Niaragh F, Yousefi M. Immunotherapeutic approaches for cancer therapy: an updated review. Artif Cells Nanomed Biotechnol 2016; 44(3):769-79.
6. Whiteside T. The tumor microenvironment and its role in promoting tumor growth. Oncogene 2008; 27(45):5904- 12.
7. Mylona E, Nomikos A, Magkou C, Kamberou M, Papassideri I, Keramopoulos A, et al. The clinicopathological and prognostic significance of membrane type 1 matrix metalloproteinase (MT1-MMP) and MMP-9 according to their localization in invasive breast carcinoma. Histopathology 2007; 50(3):338-47.
8. Ranogajec I, Jakić-Razumović J, Puzović V, Gabrilovac J. Prognostic value of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and aminopeptidase N/CD13 in breast cancer patients. Med Oncol 2012; 29(2):561-9.
9. Sung H, Choi J-Y, Lee S-A, Lee K-M, Han S, Jeon S, et al. The association between the preoperative serum levels of lipocalin-2 and matrix metalloproteinase-9 (MMP-9) and prognosis of breast cancer. BMC cancer 2012; 12(1):193.
10. Zeng Y, Liu C, Dong B, Li Y, Jiang B, Xu Y, et al. Inverse correlation between Naa10p and MMP-9 expression and the combined prognostic value in breast cancer patients. Med Oncol 2013; 30(2):562.
11. Bierie B, Moses HL. Tumour microenvironment: TGFβ: the molecular Jekyll and Hyde of cancer. Nat Rev Cancer 2006; 6(7):506-20.
12. Neuzillet C, Tijeras-Raballand A, Cohen R, Cros J, Faivre S, Raymond E, et al. Targeting the TGFβ pathway for cancer therapy. Pharmacol Ther 2015; 147:22-31.
13. Zhu Q, Han X, Peng J, Qin H, Wang Y. The role of CXC chemokines and their receptors in the progression and treatment of tumors. J Mol Histol 2012; 43(6):699-713.
14. Jafarzadeh A, Fooladseresht H, Minaee K, Bazrafshani M, Khosravimashizi A, Nemati M, et al. Higher circulating levels of chemokine CCL22 in patients with breast cancer: evaluation of the influences of tumor stage and chemokine gene polymorphism. Tumour Biol 2015; 36(2):1163-71.
15. Franciszkiewicz K, Boissonnas A, Boutet M, Combadière C, Mami-Chouaib F. Role of chemokines and chemokine receptors in shaping the effector phase of the antitumor immune response. Cancer res 2012; 72(24):6325-32.
16. Kim S, Lee A, Lim W, Park S, Cho MS, Koo H, et al. Zonal difference and prognostic significance of foxp3 regulatory T cell infiltration in breast cancer. J breast cancer 2014; 17(1):8-17.
17. Shou J, Zhang Z, Lai Y, Chen Z, Huang J. Worse outcome in breast cancer with higher tumor-infiltrating FOXP3+ Tregs: a systematic review and meta-analysis. BMC cancer 2016; 16(1):687.
18. Mirshafiey A, Rehm B, Abhari RS, Borzooy Z, Sotoude M, Razavi A. Production of M2000 (β-d-mannuronic acid) and its therapeutic effect on experimental nephritis. Environ Toxicol Pharmacol 2007; 24(1):60-6.
19. Mirshafiey A, Cuzzocrea S, Rehm B, Mazzon E, Saadat F, Sotoude M. Treatment of experimental arthritis with M2000, a novel designed non‐steroidal anti‐inflammatory drug. Scand J Immunol 2005; 61(5):435-41.
20. Mirshafiey A, Cuzzocrea S, Rehm B, Matsuo H. M2000: a revolution in pharmacology. Med Sci Monit 2005; 11(8):PI53-PI63.
21. Mirshafiey A, Matsuo H, Nakane S, Rehm BH, Koh C-S, Miyoshi S. Novel immunosuppressive therapy by M2000 in experimental multiple sclerosis. Immunopharmacol Immunotoxicol 2005; 27(2):255-65.
22. Hosseini F, Hassannia H, Mahdian Shakib A, Jadidi Niaragh F, Enderami SE, Fattahi M, et al. Targeting of crosstalk between tumor and tumor microenvironment by β D mannuronic acid (M2000) in murine breast cancer model. Cancer med 2017; 6(3):640-50.
23. Agrawal A, Fentiman I. NSAIDs and breast cancer: a possible prevention and treatment strategy. Int J Clin Pract 2008; 62(3):444-9.
24. Cuzick J, Otto F, Baron JA, Brown PH, Burn J, Greenwald P, et al. Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement. lancet oncolo 2009; 10(5):501-7.
25. Khuder S, Mutgi A. Breast cancer and NSAID use: a meta-analysis. Br j cancer 2001; 84(9):1188.
26. Jafarnezhad-Ansariha F, Yekaninejad MS, Jamshidi A-r, Mansouri R, Vojdanian M, Mahmoudi M, et al. The effects of β-d-mannuronic acid (M2000), as a novel NSAID, on COX1 and COX2 activities and gene expression in ankylosing spondylitis patients and the murine monocyte/macrophage, J774 cell line. Inflammopharmacology 2018; 26(2):375-84.
27. Rastegari Pouyani M, Mostafaie A, Mansouri K, Mortazavi-Jahromi SS, Mohammadi‐Motlagh HR, Mirshafiey A. Anti-angiogenesis effect of β-D-mannuronic acid (M2000) as a novel NSAID with immunosuppressive properties under experimental model. Clin Exp Pharmacol Physiol 2018; 45(4):370-6.
28. Lee AH, Happerfield LC, Bobrow LG, Millis RR. Angiogenesis and inflammation in ductal carcinoma in situ of the breast. J Pathol 1997; 181(2):200-6.
29. Lin EY, Li J-F, Gnatovskiy L, Deng Y, Zhu L, Grzesik DA, et al. Macrophages regulate the angiogenic switch in a mouse model of breast cancer. Cancer res.2006;66(23):11238-46.
30. Klemm F, Joyce JA. Microenvironmental regulation of therapeutic response in cancer. Trends Cell Biol 2015; 25(4):198-213.
31. Farahani MM, Motevaseli E, Maghsood F, Heidari-Kharaji M, Mirshafiey A. Anti-inflammatory property of β-D-mannuronic acid (M2000) on expression and activity of matrix metalloproteinase-2 and-9 through CD147 molecule in phorbol myristate acetate-differentiated THP-1 cells. Iran J Allergy Asthma Immunol 2017; 16(5):443-51.
32. Mirshafiey A, Khorramizadeh MR, Saadat F, Rehm BH. Chemopreventive effect of M2000, a new anti-inflammatory agent. Med Sci Monit 2004; 10(10):PI105-I9.
33. Mirshafiey A, Taeb M, Mortazavi-Jahromi S, Jafarnezhad-Ansariha F, Rehm BH, Esposito E, et al. Introduction of β-d-mannuronic acid (M2000) as a novel NSAID with immunosuppressive property based on COX-1/COX-2 activity and gene expression. Pharmacol rep 2017; 69(5):1067-72.
34. Irjala H, Alanen K, Grénman R, Heikkilä P, Joensuu H, Jalkanen S. Mannose receptor (MR) and common lymphatic endothelial and vascular endothelial receptor (CLEVER)-1 direct the binding of cancer cells to the lymph vessel endothelium. Cancer res 2003; 63(15):4671-6.
Files | ||
Issue | Vol 18, No 1 (2019) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijaai.v18i1.633 | |
Keywords | ||
Breast Cancer β-D-Mannuronic acid Chemopreventive M2000 Non-steroidal anti-inflammatory drug |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |