Dicarbonyl Electrophiles Mediate Inflammation-Induced Gastrointestinal Carcinogenesis

Gastroenterology. 2021 Mar;160(4):1256-1268.e9. doi: 10.1053/j.gastro.2020.11.006. Epub 2020 Nov 13.


Background & aims: Inflammation in the gastrointestinal tract may lead to the development of cancer. Dicarbonyl electrophiles, such as isolevuglandins (isoLGs), are generated from lipid peroxidation during the inflammatory response and form covalent adducts with amine-containing macromolecules. Thus, we sought to determine the role of dicarbonyl electrophiles in inflammation-associated carcinogenesis.

Methods: The formation of isoLG adducts was analyzed in the gastric tissues of patients infected with Helicobacter pylori from gastritis to precancerous intestinal metaplasia, in human gastric organoids, and in patients with colitis and colitis-associated carcinoma (CAC). The effect on cancer development of a potent scavenger of dicarbonyl electrophiles, 5-ethyl-2-hydroxybenzylamine (EtHOBA), was determined in transgenic FVB/N insulin-gastrin (INS-GAS) mice and Mongolian gerbils as models of H pylori-induced carcinogenesis and in C57BL/6 mice treated with azoxymethane-dextran sulfate sodium as a model of CAC. The effect of EtHOBA on mutations in gastric epithelial cells of H pylori-infected INS-GAS mice was assessed by whole-exome sequencing.

Results: We show increased isoLG adducts in gastric epithelial cell nuclei in patients with gastritis and intestinal metaplasia and in human gastric organoids infected with H pylori. EtHOBA inhibited gastric carcinoma in infected INS-GAS mice and gerbils and attenuated isoLG adducts, DNA damage, and somatic mutation frequency. Additionally, isoLG adducts were elevated in tissues from patients with colitis, colitis-associated dysplasia, and CAC as well as in dysplastic tumors of C57BL/6 mice treated with azoxymethane-dextran sulfate sodium. In this model, EtHOBA significantly reduced adduct formation, tumorigenesis, and dysplasia severity.

Conclusions: Dicarbonyl electrophiles represent a link between inflammation and somatic genomic alterations and are thus key targets for cancer chemoprevention.

Keywords: Chemoprevention; Colorectal cancer; Electrophiles; Stomach Cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Benzylamines / pharmacology
  • Benzylamines / therapeutic use
  • Cell Nucleus / metabolism
  • Cell Transformation, Neoplastic / drug effects
  • Cell Transformation, Neoplastic / immunology*
  • Colitis-Associated Neoplasms / immunology*
  • Colitis-Associated Neoplasms / microbiology
  • Colitis-Associated Neoplasms / pathology
  • Colitis-Associated Neoplasms / prevention & control
  • Disease Models, Animal
  • Epithelial Cells
  • Gastric Mucosa / cytology
  • Gastric Mucosa / drug effects
  • Gastric Mucosa / immunology
  • Gastric Mucosa / pathology
  • Gastritis / immunology
  • Gastritis / microbiology
  • Gastritis / pathology
  • Gerbillinae
  • Helicobacter Infections / immunology
  • Helicobacter Infections / microbiology
  • Helicobacter Infections / pathology
  • Helicobacter pylori / immunology
  • Helicobacter pylori / isolation & purification
  • Humans
  • Lipids / antagonists & inhibitors
  • Lipids / immunology*
  • Metaplasia / immunology
  • Metaplasia / microbiology
  • Metaplasia / pathology
  • Mice
  • Mice, Transgenic
  • Organoids
  • Precancerous Conditions / drug therapy
  • Precancerous Conditions / immunology*
  • Precancerous Conditions / microbiology
  • Precancerous Conditions / pathology
  • Stomach Neoplasms / immunology*
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / prevention & control


  • Benzylamines
  • Lipids
  • isolevuglandin
  • 2-(aminomethyl)phenol