Carcinogenesis, Vol. 21, No. 10, 1899-1907,
October 2000
© 2000 Oxford University Press
Carcinogenesis |
A simple phenolic antioxidant protocatechuic acid enhances tumor promotion and oxidative stress in female ICR mouse skin: dose- and timing-dependent enhancement and involvement of bioactivation by tyrosinase
Division of Applied Life Sciences, Graduate School of Agriculture, Kyoto University, Kyoto 606-8502,
1 Department of Biotechnological Science, Faculty of Biology-Oriented Science and Technology, Kinki University, Iwade-Uchita, Wakayama 649-6493 and
2 The First Department of Pathology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan
| Abstract |
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The modifying effects of topical application of the phenolic antioxidant protocatechuic acid (PA) on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced mouse skin tumor promotion were investigated. Dimethylbenz[a]anthracene-initiated female ICR mice were treated with TPA (1.6 nmol) twice weekly for 20 weeks to promote papilloma formation. Pre-treatment with 16nmol PA 30 min prior to each TPA treatment significantly inhibited the number of papillomas per mouse by 52% (P < 0.05). On the other hand, PA pre-treatment at a high dose (1600 nmol) significantly enhanced tumor numbers by 38% (P < 0.05). Interestingly, in the group treated with a quite high dose (20000 nmol) of PA 5 min prior to each TPA application, the average number of tumors per mouse was reduced by 38%, whereas the same PA dose 3 h before TPA treatment significantly enhanced tumor numbers by 84% (P < 0.01). These results suggested that topically applied PA was converted to compound(s) lacking antioxidative properties and/or rather possessing the potential to enhance tumor development. A similar tendency was also observed in the short-term experiment of TPA-induced inflammation and oxidative stress; i.e. two groups pre-treated with PA at 20000 nmol, 30min and 3h before TPA treatment, did not show suppression or even significantly enhanced TPA-induced leukocyte infiltration, H2O2 generation, thiobarbituric acid-reacting substances level and proliferating cell nuclear antigen index, while PA treatment together with TPA significantly suppressed these parameters. Treatment with a high dose (20000 nmol) of PA alone for 3h enhanced oxidative stress by reducing glutathione levels in mouse skin, which was counteracted by the tyrosinase inhibitor arbutin. Oxidative stress responses such as leukocyte infiltration and H2O2 generation were also counteracted by arbutin. These results suggested that tyrosinase-dependent oxidative metabolism of PA was at least partially involved in the enhanced effects of PA on TPA-induced inflammatory responses and thus tumor promotion.
Abbreviations: DMBA, dimethylbenz[a]anthracene; GPx, glutathione peroxidase; GSH, glutathione; GST, glutathione S-transferase; HRP, horseradish peroxidase; IE, inhibitory effect; MPO, myeloperoxidase; PA; protocatechuic acid; PCNA, proliferating cell nuclear antigen; ROS, reactive oxygen species; TBARS, thiobarbituric acid-reacting substances; TPA, 12-O-tetradecanoylphorbol-13-acetate.
| Introduction |
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The frequent consumption of fresh fruit and vegetables is associated with a low incidence of cancer (1). This may be partly due to the presence of several vitamins in plant foodstuffs (2). Such foods also contain certain naturally occurring phenolic compounds that have antioxidative properties (3), such as reactive oxygen species (ROS) scavenging, electrophile scavenging, metal cheletion and inhibition of ROS generation systems. Most naturally occurring phenolic compounds in foods are flavonoids, but others include chlorogenic acid, caffeic acid, ferulic acid, catechins and diallylheptanoids such as curcumin. Besides their antioxidative activities, they have been reported to be antimutagenic and/or anticarcinogenic and to possess several other biological activities. Many antioxidants have been investigated for their potential usefulness as cancer chemopreventive agents. Antioxidants have been thought to mainly suppress carcinogenesis during the initiation phase, since most act as radical scavengers, or inducers or inhibitors of xenobiotics metabolizing enzymes including phase I and II enzymes. On the other hand, several antioxidants that can inhibit the initiation events have been found to be second stage tumor promoters (4). Recently, Ogawa et al. (5) clearly demonstrated stage- and organ-dependent promotional effects of antioxidants in a rat multiorgan carcinogenesis model. Thus, chemopreventive agents that act in the initiation stage do not necessarily exert beneficial effects in the post-initiation phase. Moreover, radical scavengers are known to have pro-oxidative potential because of their conversion to more reactive or stable radicals after they react directly with ROS, which may contribute to the induction of secondary oxidative damage on the target organs.
The simple phenolic protocatechuic acid (PA; Figure 1
) is one of the major benzoic acid derivatives from edible plants and fruits and shows a strong antioxidative effect, 10-fold higher than that of
-tocopherol (6). PA even at a 100p.p.m. shows potent chemopreventive effects on colon and oral carcinogenesis in rats (7,8). The present study was initially performed to estimate the effectiveness of PA against 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced tumor promotion in mouse skin. Interestingly, differences in modifying effects were dependent on the dose (~8.120 000 nmol) and timing (~5 min to ~3 h before TPA treatment) of PA. We demonstrated not only the lack of an inhibitory effect but also significant enhancement of mouse skin tumor promotion by pre-treatment with a high dose of PA 3 h before TPA application. The possibility that metabolism by tyrosinase activity of PA to certain compound(s) without antioxidative properties and/or with tumor promotional potency was also suggested.
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| Materials and methods |
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Chemicals and animals
PA was purchased from Nacalai Tesque Inc. (Kyoto, Japan). TPA was obtained from Research Biochemicals International (Natick, MA). RPMI 1640 medium was purchased from Gibco BRL (Rockville, MD). All other chemicals were purchased from Wako Pure Chemical Industries (Osaka, Japan). Female ICR mice (7 weeks old) were obtained from Japan SLC (Shizuoka, Japan). Mice used in each experiment were supplied with fresh tap water ad libitum and rodent pellets (MF; Oriental Yeast Co., Kyoto, Japan) freshly changed twice a week. Animals were treated in accordance with the Guidelines for Animal Experimentation of Kyoto University. Animals were maintained in a room controlled at 24 ± 2°C with a relative humidity of 60 ± 5% and a 12 h light/dark cycle (06:00 to 18:00). The back of each mouse was shaved with surgical clippers 2 days before each experiment.
Tumor promotion experiment
The modifying effect of PA on TPA-induced tumor promotion was examined by a standard initiation-promotion protocol with dimethylbenz[a]anthracene (DMBA) and TPA as reported previously (9). One group was composed of 15 female ICR mice housed five per cage. The back of each mouse was shaved with a surgical clipper 2 days before initiation. The mice at 7 weeks old were initiated with DMBA (190 or 95 nmol/0.1 ml acetone). One week after initiation, the mice were promoted with TPA (1.6 nmol/0.1 ml acetone) and then twice a week for 20 weeks. In four other groups, the mice were treated with PA (16, 160, 1600 or 20 000 nmol/0.1 ml acetone) 0 min, 40 min or 3 h before each TPA treatment. The modifying effect on TPA-induced tumor promotion was evaluated by both the ratio of tumor-bearing mice and the number of tumors, >1 mm in diameter, per mouse. The data were statistically analyzed using the Student's t-test (two-sided), which assumed unequal variance, for the average number of tumors per mouse, and by the
2-test for the incidence of skin tumors.
Inflammatory biomarker determination
The modifying effect on inflammation induced by single TPA application was determined by two biomarkers, edema formation and myeloperoxidase (MPO) activity, as reported previously (10). Mice were killed by cervical dislocation 18 h after a single application of TPA. Mouse skin punches were obtained with an 8 mm diameter cork borer and weighed in an analytical balance. The inhibitory effects (IE) were expressed by the relative increasing ratio of the weight of a treated punch to that of a control punch; IE (%) = {[(TPA alone) (test compound + TPA)]/[(TPA) (vehicle)]}x100. The MPO activity was calculated from the linear portion of the curve and expressed as units of MPO per skin punch. One unit of MPO activity was defined as the activity that degraded 1 µmol of H2O2 per min at 25°C.
Double TPA treatment protocol
One group was composed of five female ICR mice housed at five per cage. PA was topically applied to the shaved area of dorsal skin at various times before application of TPA solution (8.1 nmol/0.1 ml in acetone). This TPA dose (8.1 nmol) was used for the potentiation of oxidative responses compared with the dose for tumor promotion (1.6 nmol). The same doses of PA and TPA or acetone were applied twice at an interval of 24 h for H2O2 determination. Although the timing (24 h apart) of double TPA application was different from tumor promotion protocol, the level of oxidative stress was nearly the same when the time between the two TPA treatments was 2472 h (data not shown).
Determination of oxidative stress parameters
Mice treated by the double-treatment protocol were killed 1 h after the last TPA treatment. The H2O2 content was determined by the phenol redhorseradish peroxidase (HRP) method (911). The final results are expressed as equivalents of nmol of H2O2 per skin punch, on the basis of a standard curve of HRP-mediated oxidation of phenol red by H2O2. Thiobarbituric acid-reacting substances (TBARS) level of mouse epidermis was determined by our previously reported method (10,12). The final results are expressed as equivalents of nmol malondialdehyde per cm2, on the basis of a standard line of TBARS formation using the authentic malondialdehyde.
Histological examination
Mice treated by the double-treatment protocol were killed 1 h after the second TPA treatment. Excised skin was fixed in 10% buffered formalin, and then embedded in paraffin. Skin samples were cut at 3 µm, mounted on silanized slides, dewaxed in xylene, dehydrated through an ethanol series, and stained with hematoxylin and eosin. For each section of skin, the thickness of the epidermis from the basal layer to the stratum corneum was measured at five equidistant interfollicular sites utilizing an image analysis system Leica Q500IW-EX (Leica Co. Ltd, Tokyo, Japan) with a microscope Leica DMRE HC (Leica Co. Ltd). The numbers of infiltrating leukocytes were counted at five different areas of each section using this image analysis system. Proliferating cell nuclear antigen (PCNA) immunohistochemistry was performed as reported previously (10). Skin sections were treated with 1.2% H2O2 in absolute methanol for 30 min and stained by the indirect avidinbiotinHRPO method (ABC standard; Vector Laboratories, Burlingame, CA). Color development with diaminobenzidine (Vector Laboratories) was monitored by the appearance of brown PCNA staining in the normal epidermis. The PCNA labeling index was counted at six different areas of each section using the image analysis system, and expressed as (number of positive squamous cell nuclei/total number of squamous cell nuclei)x100.
Glutathione (GSH) assay
Measurement of GSH was performed spectrophotometrically using a commercial kit (BIOXYTECH® GSH-400TM Assay; OXIS International Inc., Portland, OR). Mice were treated with PA at different time intervals and killed by cervical dislocation. The skin samples were homogenized and extracted with 5% metaphosphoric acid solution containing 5 mM EDTA. Then, after centrifugation (10 000 g, 20 min), 50 µl of 12 mM chromogenic reagent in 0.2 M HCl was added to the resulting supernatant (300 µl) and mixed thoroughly. After 50 µl of 7.5 M NaOH was added and mixed, the mixture was incubated at 25°C for 10 min, and then absorbance was determined spectrophotometrically at 400 nm.
Glutathione peroxidase (GPx) and glutathione S-transferase (GST) assays
Measurement of GPx activity was performed spectrophotometrically using a commercial kit (BIOXYTECH® GPx-340TM Assay; OXIS, International, Inc.). The skin samples were minced in 3 ml of 50 mM TrisHCl buffer (pH 8.0) containing 5 mM sodium azide and 1 mM 2-mercaptoethanol and then homogenized twice at 4°C for 30 s. After centrifugation (10 000 g, 20 min), 700 µl of NADPH reagent containing GSH and GSH reductase were added to the resulting supernatant (70 µl) and mixed thoroughly. After 350 µl of 0.007% (w/w) tert-butyl hydroperoxide solution was added and mixed, increases in absorption at 340 nm were recorded at 0.2 min intervals for 1 min. The GPx activity was calculated from the linear portion of the curve and expressed as units of GPx per skin punch. One unit of GPx activity was defined as the activity that degraded 1 µmol of NADPH per min at 25°C.
GST was measured using 1-chloro-2,4-dinitrobenzene as a substrate according to the method of Habig et al. (14).
| Results |
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Modifying effect of the dose or timing of PA pre-treatment on TPA-induced tumor promotion
The modifying effects of different doses of topically applied PA on TPA-induced tumor promotion were examined in a two-stage mouse skin carcinogenesis model and the results are shown in Table I
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Subsequently, we examined whether the time interval between PA and TPA treatments attenuates its antioxidative properties and thus decreases antitumor promotional activity (Figure 2
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Modifying effect of PA on inflammatory responses and oxidative stress in ICR mouse skin
The possibility that PA could modify TPA-induced inflammation and oxidative stress was assessed by investigating the effects of different doses and different timing of topical application of PA on single TPA application-induced edema formation and MPO activity enhancement as well as double TPA application-induced H2O2 generation in ICR mouse skin. As shown in Table II
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To determine whether the time interval between PA and TPA treatments modifies its antioxidative properties, the effects of pre-treatment with 20 000 nmol PA 0, 0.5, 1, 3 or 6 h before TPA treatment were evaluated (Table II
As topically applied PA significantly modified H2O2 generation induced by double TPA application, we assessed whether such PA treatment influences double TPA application-induced TBARS formation, a well-known biomarker of overall oxidative damage to cellular constituents such as membrane lipids. The quantitative data for the levels of TBARS formation in mouse epidermis homogenate are shown in Figure 3
. The increased level of TBARS caused by the double TPA application was significantly higher than that of the control (0.43 ± 0.09 versus 0.15 ± 0.06 nmol/cm2, P < 0.01). The simultaneous application of PA (20 000 nmol) with TPA treatment significantly inhibited the increase in TBARS level (0.24 ± 0.05 nmol/cm2, P < 0.01 versus double TPA). On the other hand, the application of PA 3 h before TPA treatment significantly enhanced double TPA application-induced TBARS formation (0.63 ± 0.13 nmol/cm2, P < 0.05 versus double TPA).
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Effects of PA on morphological alterations in mouse skin treated with double TPA application
The finding that PA treatment caused the inverse effects on MPO activity, H2O2 generation and TBARS formation led us to select a double TPA application model of mouse inflammation for histological observation to determine whether PA application enhances leukocyte infiltration and hyperplasia in the cutis. Double application of TPA caused morphological alteration of inflammatory response (Table III
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PA causes tyrosinase-dependent reduction of GSH level and antioxidative enzyme activities
We assessed whether redox alteration is involved in the inverse effects of PA on inflammatory responses in mouse skin. Since the treatment of mouse skin with TPA alone showed little influence on total GSH level (15), the modifying effect of PA on GSH level in mouse skin was examined. As shown in Figure 5
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We also examined the inhibitory effects of arbutin on PA-enhanced inflammatory responses and oxidative stress. As shown in Figure 6
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| Discussion |
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The results of the present study demonstrated that topical application of PA exerts contrasting effects on TPA-induced tumor promotion in mouse skin in a manner that is both dose and timing dependent. A low dose of PA (16 nmol; 10-fold dose of TPA) 40 min prior to TPA application significantly decreased both the incidence and the multiplicity of tumors (Table I
There is increasing evidence indicating important roles of oxidative stress in tumor promotion. Tumor promoters such as TPA enhance the generation of ROS and decrease the ROS detoxification enzymes in both epidermal and inflammatory cells. Kensler et al. (21) proposed the requirement of two applications of TPA for massive ROS generation, and the hypothesis that the first treatment of mouse skin with TPA application causes a chemotactic action, i.e. recruitment of neutrophils responsible for ROS generation with the second TPA treatment, i.e. priming and activation, respectively (22). ROS production by double or multiple TPA treatments is closely associated with the metabolic activation of proximate carcinogens (2123) and the increased levels of oxidized DNA bases (2426). We recently demonstrated that a potent inhibitor of leukocyte-derived ROS generation (10) effectively prevented inflammation-related carcinogenesis (2729). The results of the present study clearly demonstrated that application of PA exerted application dose- and timing-dependent inverse effects on TPA-induced inflammatory oxidative stress, trends which were very closely correlated with modifying effects on tumor development. Even a high dose of PA treatment concurrently with TPA significantly inhibited edema formation, MPO activity and H2O2 generation, whereas PA treatment 3 h prior to TPA significantly enhanced these inflammatory parameters. The present result also indicated that although quite high doses of PA showed strong antioxidative effects in lipid peroxidation in vitro (6), PA when applied 3 h prior to TPA treatment significantly enhanced TBARS formation (Figure 3
). TBARS is known as an overall oxidative damage biomarker formed downstream of H2O2 generation in the presence of a metal ion as a catalyst. TBARS formation in vivo is considered not to reflect a single particular phenomenon but to indicate widespread oxidative damage including lipid peroxidation, mitochondrial de-energization and degradation of protein or sugar rather than DNA (30). Thus, the opposite effects of PA on oxidative stress consequent on inflammatory responses are likely to be, at least in part, determinants for TPA-induced tumor promotion. Histological studies also demonstrated that PA treatment 3 h prior to TPA diminished the inhibitory effects, which were observed with simultaneous application of PA, on TPA-induced inflammatory responses such as leukocyte infiltration in the cutis and PCNA-labeling index, also supporting our assumption that topically applied PA was converted to the plausible toxic compound(s).
Compounds with a catechol moiety such as caffeic acid derivatives are known to be strong radical scavengers in vitro and to show more potent antioxidative activity than monophenolic compounds (31,32). On the other hand, endogenous and exogenous catechols are oxidants as well as electrophiles. The catechols are enzymatically or spontaneously oxidized to ortho-quinones that undergo redox cycling mediated by cytochrome P450/P450 oxide-reductase or transition metals. In addition, ortho-quinones are Michael reaction acceptors that can readily react with nucleophiles such as thiol groups. Thus, ortho-quinone or semiquinone formation from catechols has been suggested to explain their cytotoxic and/or genotoxic effects at high doses, since their molecular mechanisms of action are attributed to ROS generation by redox cycling and covalent binding with a variety of cellular macromolecules (33,34). The former events by high doses of PA may occur on the basis of the results that the pre-treatment of a high dose PA 3 h prior to TPA induced TBARS formation in larger quantities than did treatment with TPA alone. It is well-known that the reaction of catechol semiquinone with oxygen leads to generation of superoxide anions with subsequent Fe(II)/Fe(III)-catalyzed production of hydroxyl radicals (34). Cu(II) also strongly mediates the oxidation of hydroquinone producing benzoquinone and H2O2 through a Cu(I)/Cu(II) redox mechanism (35). The in vitro abilities of PA to induce Fe(II)/Fe(III) redox-cycle-dependent lipid peroxidation and Cu(I)/Cu(II) redox-cycle-dependent oxidative DNA damage have recently been observed (unpublished data), suggesting that the effects of PA are mediated by ROS generation. The oxidative phenomenon of nucleophilic addition to sulfur groups was supported by the findings that a high dose of PA significantly reduced the total level of GSH, the most abundant thiol in cells, which can protect against the attack of electrophilic toxicants (Figure 5
). GSH is also known to be an endogenous antioxidant, decomposing H2O2 spontaneously or as a substrate for GPx or GST. The present study clearly demonstrated that the in vitro enzyme activities of GPx and GST were reduced by treatment with PA, although excessive GSH was added in the enzyme activity determination systems. This inhibition may be due to nucleophilic attachment of enzyme proteins, since the metabolism of PA to quinone by tyrosinase was required as discussed below. Thus, the disturbance of ROS detoxification systems such as not only GSH but also GPx and GST by the possible electrophilic metabolite(s) of PA may be partially involved in enhanced oxidative stress induced by PA. On the other hand, it is within the range of possibility that PA-derived electrophilic quinones also play some important roles in anticarcinogenic activity of PA. An appropriate amount of electrophiles such as isothiocyanates are known to stimulate phase II enzyme induction to eliminate chemical carcinogens. Moreover, suppressive effects of PA on tumor development, when its dosage is applied only a short time before the TPA application, could be explained by the cytotoxic properties of ortho-quinones attenuating TPA-induced mitogenic effect, whereas the GSH depletion and consequent oxidative stress potentiate the oxidative and thus tumor-promoting action of TPA when applied 3 h before TPA. Although more extensive studies on action mechanisms should be examined, the present results lead us to hypothesize that PA, in both the protective and enhancing dosage regimes, exerts its action through the electrophiles quinone oxidation products.
Compounds with a carboxylic acid (COOH) moiety including benzoic acid are also known to be immediate- and non-immunological-type irritants in skin (36). In addition, the prior treatment of mouse skin with acetic acid, the pKa (acidity) value of which is quite similar to benzoic acid derivatives, increased the yield of tumors initiated by urethane (37). However, the action mechanism remains unclear. As for disturbance of GSH detoxification systems, the involvement of free COOH group could be ruled out, since some catechol compounds having no COOH group exhibited significant GSH consumption (unpublished data). The permissive role of the COOH moiety of PA should be elucidated.
In the present study, the competitive tyrosinase inhibitor arbutin (38) counteracted not only GSH consumption and enzyme activity inhibition by a high dose of PA, but also PA-induced enhancement of inflammatory oxidative stress (Table IV
; Figures 5 and 6![]()
). Tyrosinase, which catalyzes the hydroxylation of monophenols and the oxidation of catechols to their quinone compartments (3941) as well as the conversions of L-tyrosine to L-dopa, and L-dopa to L-dopaquinone, is regarded as the rate-limiting steps of mammalian melanin synthesis (42). Actually, we have recently detected significant tyrosinase activity in ICR mouse skin (manuscript in preparation). Evidence for the generation of a superoxide anion through enzymatic action of tyrosinase has been reported (43). As mentioned above, PA induced redox-cycle-dependent lipid peroxidation and oxidative DNA damage, suggesting that PA itself chemically generates ROS. In addition, several phenolic toxicants such as urushiols (poison ivy) cause immunomodulation such as type IV hypersensitivity through hapten formation in skin keratinocytes and Langerhans cells (44). In this case, the reactive quinone intermediate is believed to bind protein sulfhydryl or lysyl residue and its conjugates are recognized as haptens by macrophages. We recently observed that treatment with high doses of PA induced hypersensitivity in mouse skin (manuscript in preparation). In addition, tyrosinase was a rate-limiting factor of inhibition of GST and GPx by PA in vitro. PA alone did not inhibit enzyme activities whereas addition of tyrosinase resulted in inhibition (data not shown). These results suggested that the formation of PA-quinone intermediate(s) may occur by means of tyrosinase. Actually, the in vitro data regarding the oxidation of catechols by tyrosinase, the reactivity of the corresponding quinones with thiol groups and the cytotoxicity of tyrosinase-generated ortho-quinones have been described (40,41). The occurrence of hapten formation in mouse skin treated with PA and the relationship to immunomodulatory effects such as leukocytic MPO activity enhancement or up-regulation of H2O2 generation ability remains to be elucidated. In any case oxidative conversion of PA to PA-quinonoid(s) by tyrosinase is likely to be the critical step in enhanced oxidative stress in mouse skin. In addition, we more recently observed PA-induced enhancement of inflammatory responses and disturbance of GSH detoxification systems in the tumor promotion-resistant mouse strain B6C3F1 (unpublished data), which indicates reduced responses to TPA, such as hyperplasia, leukocyte infiltration and H2O2 generation (4550). Thus, the possibility that PA is oxidatively activated to more toxic compounds by TPA-sensitive leukocytic MPO in mouse skin may be excluded, although oxidative conversion of a para-alkyl phenol to toxic quinonoids by MPO was reported (51).
Antioxidants have been considered as a double-edged sword in cancer control. Recently, an interesting study on the evaluation of the sensitivity of transgenic mice with overexpression of GPx or both GPx and superoxide dismutase to skin tumor promotion was reported by Lu et al. (52). Surprisingly, these transgenic mice showed an enhanced tumorigenic response to application of DMBA/TPA. The mechanism responsible for this phenomenon is not yet well understood. They, however, have presumed that the altered ROS-detoxification enzyme levels might influence the process of carcinogenesis by modulating cell growth phenotype, increasing resistance of cells with oxidative damage, or by altering immune function. These results indicated the difficulty in regulation of ROS level and in prevention of cancer by radical-scavenging-type antioxidants.
In conclusion, the dose- and timing-dependent effects of phenolic antioxidant application on skin carcinogenesis and oxidative stress were confirmed. Much attention should be paid to the administration dose of the phenolic antioxidants in chemoprevention studies not only in rodent experiments but also in clinical application in humans.
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3 To whom correspondence should be addressed Email: ohigashi{at}kais.kyoto-u.ac.jp
| Acknowledgments |
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We thank Dr M.A.Huffman for his critical reading and helpful comments on earlier versions of this manuscript. This study was supported by grants-in-aid for Scientific Research on Priority Areas (Cancer) (H.O.) and JSPS Research Fellow (Y.N.) from the Ministry of Education, Science, Sports and Culture of Japan and by a subsidy from the Asahi Beer Foundation for the Promotion of Science.
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