Abstract
The incidence of urinary bladder cancer in the Ukraine increased from 26.2 to 43.3 per 100 000 population between 1986 and 2001 after the Chernobyl accident. The present study was conducted to evaluate the development of radiation‐dependent lesions in the urinary bladders of people living in cesium 137 (137Cs) radio‐contaminated areas of the Ukraine. Bladder urothelial biopsies from 159 male and 5 female patients were subjected to histological examination and immunohistochemical study of p38 mitogen‐acti‐vated protein kinase (MAPK), as well as the p50 and p65 subunits of nuclear factor kappa B (NF‐kB). A pattern of chronic proliferative atypical cystitis accompanied with large areas of sclerosis of connective tissue in the lamina propria was commonly observed in all cases. Interestingly, these lesions were associated with a dramatic increase in the incidences of dysplasia/carcinoma in situ, and, moreover, small urothelial carcinomas were incidentally detected. We defined the overall condition as “Chernobyl cystitis.'’Greatly elevated levels of p38, p65 and p50 expression in the urothelium were evident and the patients showed increased 137Cs in urine. The data support conclusions from our previous studies of a critical role for increased oxidative stress in generation of urinary bladder urothelial lesions in individuals chronically exposed to low‐dose 137Cs radiation. Alterations in the p38 MARK cascade and accumulation of NF‐kB subunits could be crucial early molecular events in the pathogenesis of Chernobyl cystitis. (Cancer Sci 2003; 94: 328–333)
References
- 1. Pavlova L, Saydacova N, Startzeva L. The state of urologic assistance for the population of Ukraine and the ways to improve it. Ukrainian Ministry of Health. Annual Reports of the Health Care in Ukraine; Kiev; 2001. p. 214–43. [Google Scholar]
- 2. Zhavoronok SV, Kalinin AL, Krylov IuV, Mrochek AG, Okeanov AE, Nikolaev AA, Grimbaum OA, Antipova SI, Poliakov SM, Shebeko NG, Makarov MM. Epidemiology of primary liver cancer in the Belarus Republic. Vopr Onkol 1998; 44: 280–5. [PubMed] [Google Scholar]
- 3. Okeanov AE, Yakimovich AV. Incidence of malignant neoplasms in population of Gomel region following the Chernobyl accident. Int J Rad Med 1999; 1: 49–54. [Google Scholar]
- 4. Raes F, De Cort M, Graziani G. Multifactoral nature of radioactivity deposition on soil after the Chernobyl accident. Health Phys 1991; 61: 271–82. [DOI] [PubMed] [Google Scholar]
- 5. Richmond CR. Accelerating the turnover of internally deposited radiocesium. In: Kornberg HA, Norwood WD, editors. Diagnosis and treatment of deposited radionuclides. Battele‐Northwest Richland, Washington : Excerpta Medical Foundation; 1968. p. 465–78. [Google Scholar]
- 6. Romanenko A, Morimura K, Wanibuchi H, Salim EL, Kinoshita A, Kaneko M, Vozianov A, Fukushima S. Increased oxidative stress with gene alteration in urinary bladder urothelium after the Chernobyl accident. Int J Cancer 2000; 86: 790–8. [DOI] [PubMed] [Google Scholar]
- 7. Romanenko A, Lee CCR, Yamamoto S, Hori T, Wanibuchi H, Zaparin W, Vinnichenko W, Vozianov A, Fukushima S. Urinary bladder lesions after the Chernobyl accident: immunohistochemical assessment of p53, proliferating cell nuclear antigen, cyclin D1 and p21 WAF1/Cipl . Jpn J Cancer Res 1999; 90: 144–53. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. Yamamoto S, Romanenko A, Wei M, Masuda C, Zaparin W, Vinnichenko W, Vozianov A, Lee CC, Morimura K, Wanibuchi H, Tada M, Fukushima S. Specific p53 gene mutations in urinary bladder epithelium after the Chernobyl accident. Cancer Res 1999; 59: 3606–9. [PubMed] [Google Scholar]
- 9. Trosko JE. Radiation‐induced carcinogenesis: paradigm consideration. In: Calabrese EJ, Bosa Raton FL, editors. Biological effects of low level exposures: dose‐response relationships. New York : Lewis Publisher; 1994. p. 205–41. [Google Scholar]
- 10. Tubiana M. The report of the French Academy of Science: problems associated with the effects of low doses of ionizing radiation. J Radiol Prot 1998; 18: 243–8. [DOI] [PubMed] [Google Scholar]
- 11. Cardis E, Gilbert ES, Carpenter L, Kato I, Armstrong BK, Beral V, Cowper G, Douglas A, Fix J, Fry SA, Kaldor J, Lave C, Salmon L, Smith PG, Voelz GL, Wiggs LD. Effects of low doses and low dose rates of external ionizing radiation: cancer mortality among nuclear industry workers in three countries. Radial Res 1995; 142: 117–32. [PubMed] [Google Scholar]
- 12. Trosko JE. Role of low‐level ionizing radiation in multi‐step carcinogenic process. Health Phys 1996; 70: 812–22. [DOI] [PubMed] [Google Scholar]
- 13. Fujimoto H, Sasaki J, Matsumoto M, Suga M, Ando Y, Iggo R, Tada M, Saya H, Ando M. Significant correlation of nitric oxide synthase activity and p53 gene mutation in stage I lung adenocarcinoma. Jpn J Cancer Res 1998; 89: 696–702. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14. Maeda H, Akaike T. Nitric oxide and oxygen radicals in infection, inflammation and cancer. Biochemistry (Moscow) 1998; 63: 854–65. [PubMed] [Google Scholar]
- 15. Irani K. Oxidant signaling in vascular cell growth, death, and survival. A review of the roles of reactive oxygen species in smooth muscle and endothelial cell mitogenic and apoptotic signaling. Circ Res 2000; 87: 179–83. [DOI] [PubMed] [Google Scholar]
- 16. Gupta A, Rosenberger SF, Bowden GT. Increased ROS levels contribute to elevated transcription factor and MAP kinase activities in malignantly progressed mouse keratinocyte cell lines. Carcinogenesis 1999; 20: 2063–73. [DOI] [PubMed] [Google Scholar]
- 17. Wang X, Martindale IL, Liu Y, Holbrook NJ. The cellular response to oxidative stress: influences of mitogen‐activated protein kinase signaling pathways on cell survival. Biochem J 1998; 333: 291–300. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18. Baldwin AS. The NF‐KB and IKB proteins: new discoveries and insights. Annu Rev Immunol 1998; 14: 649–83. [DOI] [PubMed] [Google Scholar]
- 19. Shao J, Fujiwara T, Kadowaki Y, Fukazawa T, Waku T, Itoshima T, Yamatsuji T, Nishizaki M, Roth JA, Tanaka N. Overexpression of the wild‐type p53 gene inhibits NF‐kappa B activity and synergizes with aspirin to induce apoptosis in human colon cancer cells. Oncogene 2000; 19: 726–36. [DOI] [PubMed] [Google Scholar]
- 20. van Hogerlinden M, Rozell BL, Ahrlund‐Richter L, Toftgard R. Squamous cell carcinomas and increased apoptosis in skin with inhibited Rel/nuclear factor‐kB signaling. Cancer Res 1999; 59: 3299–303. [PubMed] [Google Scholar]
- 21. Webster GA, Perkins ND. Transcriptional cross talk between NF‐kappa B and p53. Mol Cell Biol 1999; 19: 3485–95. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22. Huang S, De Guzman A, Bukana CD, Fidler IJ. Nuclear factor‐kB activity correlates with growth, angiogenesis and metastasis of human melanoma cells in nude mice. Clin Cancer Res 2000; 6: 2573–81. [PubMed] [Google Scholar]
- 23. Prasad AV, Mohan N, Chandrasekar B, Meltz ML. Activation of nuclear factor kB in human lymphoblastoid cells by low‐dose ionizing radiation. Radiat Res 1994; 138: 367–72. [PubMed] [Google Scholar]
- 24. Mostofi FK, Davis CJ, Sesterhenn IA. Histological typing of urinary bladder tumors. In: WHO International Histological Classification of Tumors. 2nd ed. Berlin : Springer‐Verlag; 1999. p. 1–99. [Google Scholar]
- 25. Malmstrom PU, Busch C, Norlen BJ, Andersson B. Expression of ABH blood group isoantigen as a prognostic factor in transitional cell bladder carcinoma. Scand J Urol Nephrol 1998; 22: 265–70. [DOI] [PubMed] [Google Scholar]
- 26. Romanenko A, Vozianov A, Mikuz G, Obrist P, Ensinger C, Busch C. Expression of p53 and mdm2 protein in bladder urothelium of patients living in the radiocontaminated areas of Ukraine. J Urol Pathol 1999; 11: 47–58. [Google Scholar]
- 27. Clarke RH. Control of low‐level radiation exposure: what is the problem and how can it be solved? Health Phys 2001; 80: 391–6. [DOI] [PubMed] [Google Scholar]
- 28. Lala PK, Chakraborty C. Role of nitric oxide in carcinogenesis and tumor progression. Lancet Oncol 2001; 2: 149–56. [DOI] [PubMed] [Google Scholar]
- 29. Little JB. Induction of genetic instability by ionizing radiation. C R Acad Sci III 1999; 322: 127–34. [DOI] [PubMed] [Google Scholar]
- 30. Ding M, Shi X, Castranova V, Vallyathan V. Predisposing factors in occupational lung cancer: inorganic minerals and chromium. J Environ Pathol Toxicol Oncol 2000; 19: 129–38. [PubMed] [Google Scholar]
- 31. Kurata S. Selective activation of p38 MAPK cascade and mitotic arrest caused by low level oxidative stress. J Biol Chem 2000; 275: 23413–6. [DOI] [PubMed] [Google Scholar]
- 32. Jang BC, Sanchez T, Schaefers HJ, Trifan OC, Liu CH, Creminon C, Huang CK, Hla T. Serum withdrawal‐induced post‐transcriptional stabilization of COX2 mRNA in MDA‐MB‐231 mammary carcinoma cells requires the activity of the p38 stress‐activated protein (SAP) kinase. J Biol Chem. 2000; 275: 39507–15. [DOI] [PubMed] [Google Scholar]
- 33. Rioux N, Castonguay A. The induction of cyclooxygenase‐1 by tobacco carcinogen in U937 human macrophages is correlated to the activation of NF‐KB. Carcinogenesis 2000; 21: 1745–51. [DOI] [PubMed] [Google Scholar]
- 34. Ibuki Y, Goto R. Enhancement of NO production from resident peritoneal macrophages by in vitro gamma‐irradiation and its relationship to reactive oxygen intermediates. Free Radic Biol Med 1997; 22: 1029–35. [DOI] [PubMed] [Google Scholar]
- 35. Sandhu JK, Birnboim HC. Mutagenicity and cytotoxicity of reactive oxygen and nitrogen species in the MN‐11 murine tumor cell line. Mutat Res 1997; 379: 241–52. [DOI] [PubMed] [Google Scholar]
- 36. Taher MM, Oakley JD, Hershey C, Valerie K. Activation of NF‐KB and p38 MAP kinase is not sufficient for triggering efficient HIV gene expression in response to stress. Biochemistry 2000; 39: 1709–15. [DOI] [PubMed] [Google Scholar]