Circulating tryptophan metabolites and risk of colon cancer: Results from case-control and prospective cohort studies

Nikos Papadimitriou, Marc J. Gunter, Neil Murphy, Audrey Gicquiau, David Achaintre, Stefanie Brezina, Tanja Gumpenberger, Andreas Baierl, Jennifer Ose, Anne J. M. R. Geijsen, Eline H. van Roekel, Andrea Gsur, Biljana Gigic, Nina Habermann, Cornelia M. Ulrich, Ellen Kampman, Matty P. Weijenberg, Per Magne Ueland, Rudolf Kaaks, Verena KatzkeVittorio Krogh, Bas Bueno-de-Mesquita, Eva Ardanaz, Ruth C. Travis, Matthias B. Schulze, Maria-José Sánchez, Sandra M. Colorado-Yohar, Elisabete Weiderpass, Augustin Scalbert, Pekka Keski-Rahkonen

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Dysregulation of tryptophan metabolism has been linked to colorectal tumorigenesis; however, epidemiological studies investigating tryptophan metabolites in relation to colorectal cancer risk are limited. We studied associations of plasma tryptophan, serotonin and kynurenine with colon cancer risk in two studies with cancer patients and controls, and in one prospective cohort: ColoCare Study (110 patients/153 controls), the Colorectal Cancer Study of Austria (CORSA; 46 patients/390 controls) and the European Prospective Investigation into Cancer and Nutrition (EPIC; 456 matched case-control pairs). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for colon cancer risk. Tryptophan was inversely associated with colon cancer risk in ColoCare (OR per 1-SD = 0.44; 95% CI, 0.31-0.64) and EPIC (OR per 1-SD = 0.86; 95% CI, 0.74-0.99). Comparing detectable vs nondetectable levels, serotonin was positively associated with colon cancer in CORSA (OR = 6.39; 95% CI, 3.61-11.3) and EPIC (OR = 2.03; 95% CI, 1.20-3.40). Kynurenine was inversely associated with colon cancer in ColoCare (OR per 1-SD = 0.74; 95% CI, 0.55-0.98), positively associated in CORSA (OR per 1-SD = 1.79; 95% CI, 1.27-2.52), while no association was observed in EPIC. The kynurenine-to-tryptophan ratio was positively associated with colon cancer in ColoCare (OR per 1-SD = 1.38; 95% CI, 1.03-1.84) and CORSA (OR per 1-SD = 1.44; 95% CI, 1.06-1.96), but not in EPIC. These results suggest that higher plasma tryptophan may be associated with lower colon cancer risk, while increased serotonin may be associated with a higher risk of colon cancer. The kynurenine-to-tryptophan ratio may also reflect altered tryptophan catabolism during colon cancer development.
Original languageEnglish
Pages (from-to)1659-1669
Number of pages11
JournalInternational Journal of Cancer
Volume149
Issue number9
Early online date1 Jul 2021
DOIs
Publication statusPublished - 1 Nov 2021
Externally publishedYes

Funding

This work was supported by ERA-NET TRANSCAN (JTC2012-MetaboCCC, Project 01KT1503). Sample analyses were supported by the Institut National du Cancer (INCa), Paris, Grant Number 2014-007. The CORSA study was funded by the Austrian Science Fund (FWF) (Grant no.: 1578-B19). The ColoCare Study was supported by National Institutes of Health (U01 CA206110, R01 CA189184, R01 CA207371), the German Consortium of Translational Cancer Research (DKTK), the Federal Ministry of Education and Research (BMBF, Germany; project no. 01KT1512), the German Cancer Research Center (Division of Preventive Oncology, Cornelia M. Ulrich). Eline H. van Roekel is funded by the Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant programme (grant number 2016/1620). The EPIC metabolomics study was supported by WCRF grant 2013-02 (to Marc J. Gunter). The coordination of EPIC is financially supported by International Agency for Research on Cancer and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di San Paolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom). Alcohol & Education Research Council, Grant/Award Number: HFY GR667789; Austrian Science Fund, Grant/Award Number: 1578‐B19; ERA‐NET TRANSCAN, Grant/Award Number: JTC2012‐MetaboCCC; Federal Ministry of Education and Research, Grant/Award Number: 01KT1512; German Cancer Research Center; German Consortium of Translational Cancer Research; National Institutes of Health, Grant/Award Numbers: CA118790, P50 CA098252, R01 CA189184, U01 CA206110; Wereld Kanker Onderzoek Fonds; World Cancer Research Fund International, Grant/Award Numbers: 2013‐02, 2016/1620; International Agency for Research on Cancer; European Commission (DG‐SANCO) Funding information This work was supported by ERA‐NET TRANSCAN (JTC2012‐MetaboCCC, Project 01KT1503). Sample analyses were supported by the Institut National du Cancer (INCa), Paris, Grant Number 2014‐007. The CORSA study was funded by the Austrian Science Fund (FWF) (Grant no.: 1578‐B19). The ColoCare Study was supported by National Institutes of Health (U01 CA206110, R01 CA189184, R01 CA207371), the German Consortium of Translational Cancer Research (DKTK), the Federal Ministry of Education and Research (BMBF, Germany; project no. 01KT1512), the German Cancer Research Center (Division of Preventive Oncology, Cornelia M. Ulrich). Eline H. van Roekel is funded by the Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant programme (grant number 2016/1620). The EPIC metabolomics study was supported by WCRF grant 2013‐02 (to Marc J. Gunter). The coordination of EPIC is financially supported by International Agency for Research on Cancer and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam‐Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro‐AIRC‐Italy, Compagnia di San Paolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) ‐ Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology ‐ ICO (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC‐Norfolk; C8221/A29017 to EPIC‐Oxford), Medical Research Council (1000143 to EPIC‐Norfolk; MR/M012190/1 to EPIC‐Oxford) (United Kingdom).

FundersFunder number
NKR
German Consortium of Translational Cancer Research
DG‐SANCO
Netherlands Cancer Registry
NIHR Imperial Biomedical Research Centre
Dutch Prevention Funds
Ligue Contre le Cancer
Imperial College London
County Councils of Skåne
University of Maryland School of Public Health
Instituto de Salud Carlos III
Associazione Italiana per la Ricerca
German Institute of Human Nutrition Potsdam‐Rehbruecke
Institut national de la santé et de la recherche médicale
German Institute of Human Nutrition Potsdam-Rehbruecke
Kræftens Bekæmpelse
LK Research Funds
Compagnia di San Paolo
FIS
World Cancer Research Fund
Cancerfonden
Catalan Institute of Oncology - ICO
Centre International de Recherche sur le Cancer
Dutch ZON (Zorg Onderzoek Nederland
Deutschen Konsortium für Translationale Krebsforschung
European Commission
Associazione Italiana per la Ricerca sul Cancro
Wereld Kanker Onderzoek Fonds
Ministerie van Volksgezondheid, Welzijn en Sport
Health Research Fund
National Research Council
Institut Gustave-Roussy
Consejería de Salud y Familias, Junta de Andalucía
Deutsche Krebshilfe
Department of Epidemiology and Biostatistics
Deutsches Krebsforschungszentrum
Catalan Institute of Oncology ‐ ICO
Mutuelle Générale de l'Education Nationale
Vetenskapsrådet
National Institutes of HealthR01 CA189184, R01 CA207371, P50 CA098252, CA118790, U01 CA206110
Alcohol & Education Research CouncilHFY GR667789
World Cancer Research Fund International2013‐02, 2016/1620
Cancer Research UK14136, C8221/A29017
Austrian Science Fund1578‐B19
Medical Research Council1000143, MR/M012190/1
ERA‐NET TRANSCAN01KT1503
Bundesministerium für Bildung und Forschung01KT1512
Institut National Du Cancer2014‐007

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