THE AMERICAN JOURNAL of CANCER a Continuation of the Journal of Cancer Research
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THE AMERICAN JOURNAL OF CANCER A Continuation of The Journal of Cancer Research - - VOLUMEXXX AUGUST,1937 NUMBER4 THE TRANSMISSIBLE AGENT OF THE ROUS CHICKEN SARCOhIA NO. 1 JAMES W. JOBLING, M.D., E. E. SPROUL, M.D., AND SUE STEVENS, M.A. (From the Department of Patlzology, College of Physicians and Surgeons, Columbia University) That animal tumors can be successfully transmitted within the species has been known for many years. The process was easily understood so long as living cells were required for transmission, the growth presumably resulting from continued division of the viable tumor cells. The discovery by Rous in 19 11 ( 1) that a chicken sarcoma could be produced in normal fowl by in- jection of a cell-free extract of the tumor considerably altered the general point of view, but at the same time offered the hope that the nature of the responsible agent would eventually be established. The hypotheses which have stimulated widely varying experimentation may be roughly divided into those regarding the agent as of extrinsic origin and those seeking its source in the metabolic processes of the host itself. Interpretation of the development of the Rous sarcoma as the result of infection with a living parasite, a virus more related to the causative agent of chicken pox, vaccinia, herpes, etc., is supported chiefly by analogy. An- drewes (2) has been most impressed by the properties borne in common by the Rous sarcoma and the more readily accepted virus infections. Nor does he accept the variation in type of response as a serious discrepancy, since he shows that the viruses can stimulate hyperplasia as well as necrosis and that all gradations between the two can be found. This view is also held by Rous (3), who considers that his more recent work with the Shope papilloma has provided him with confirmatory evidence. A somewhat more tangible means of investigation has been supplied by the method of ultra-centrifugation. Ledingham and Gye (4) report the concentration, by this procedure, of "elementary bodies" from the Rous sarcoma filtrate which they believe represent the causative factor of the disease. 1 This investigation has been aided by a grant from the Josiah Macy, Jr. Foundation. 667 668 JAMES W. JOBLING,E. E. SPROUL AND SUE STEVENS Among the extrinsic causes of cancer we must also classify the irritants and perhaps, more specifically, traumatic effects. Wells (5) stated in 1931 that " the trend of these results of recent cancer research is in support of the old view that cancer is usually the result of protracted stimulation of tissue growth by non-specific agents acting on tissues, the susceptibility of which is deter- mined by their hereditary background." Knox (6) and Ewing (7) find no adequate support of a relationship between trauma and tumor growth, but the theory of a causative relation is still considered plausible by many (8). Re- cent stimulus has been offered by Wolbach's histological studies on the tissues acted upon by several synthetic carcinogenic substance^.^ He finds necrosis followed by normal repair which imperceptibly becomes transformed into a new growth. The group believing that the causative agent of cancer, or more specifically of the chicken sarcoma, is endogenous is further divided by diverse views as to its nature. It has been called an enzyme, without further elucidation of its actual nature (9). It has been likened to the hormones (10, 11) in be- havior and chemical composition, and there are those who believe more con- cretely that it may be derived from the sex hormones by some alteration in sterol metabolism (12). Murphy (13) favors the term " transmissible mutagen" for the substance appearing in the cell-free tumor filtrates, indi- cating that the agent is capable of directing the specific development of the cell into abnormal channels and that it is further elaborated by this altered cell. Ludford (14) has also expressed somewhat similar ideas, although not stressing the transmissibility of the mutagen. A decade ago it seemed that Gye (15) might reconcile these opposing forces by his suggestion that an exogenous universal cancer agent, which he termed a virus, received its specificity when combined with an intrinsic factor, presumably elaborated by the various cell types. His experiments, however, were not corroborated by others nor by later developments in his own laboratory. Such unrelated views have provided the means of unearthing a formidable number of facts regarding the character of tumor growth without arriving at a tenable explanation of the course of events. This investigation was begun following the observation that independent studies on distinct phases of the problem indicated the importance of the lipids in abnormal and physiological growth processes. The most outstanding was undoubtedly the synthesis by Cook, Barry and their associates (16, 17) of a series of carcinogenic hydro- carbons in the form of condensed ring compounds, recalling the structure of cholesterol. It would seem unlikely, in view of the prolonged period of ap- plication required for tumor formation, that the known chemicals act directly on the cells, but the remarkable consistency in carcinogenic activity observed in various laboratories leaves no doubt of the specificity of their action (18, 19). The significant changes which each compound suffers in the process of cell metabolism remain for future elucidation. The second most arresting observation was the alliance of the sex hor- mones with cancer and the timely discovery of the molecular structure of 2Reported at the Annual Meeting of the American Society of Pathology and Bacteriology, Chicago, March 1937. several of these complicated substances (19, 20, 21). The recognition by the biologists of the r6le enacted by the ovarian hormone in normal develop- ment and malignant growth of the mammary gland as well as in stiniulation of hyperplastic endometrial change in mice long preceded the isolation by the chemists of these hormones. Lathrop and Loeb (22) in 1916 demonstrated the reduction in the incidence of spontaneous tumors following castration or prevention of breeding and many have subsequently corroborated and ampli- fied this statement. A new type of investigation was offered by the discovery that the follicular and luteal hormones are also phenanthrene derivatives not unlike those stimulating the growth of tumors and structurally related to the sterols (23). It remained then to demonstrate the actual production of tu- mors by injection of pure estrogenic compounds and this was accomplished by Lacassagne (24) working with a strain of mice known to develop spon- taneous mammary cancer. This achievement has been confirmed and the observation made by Loeb (20) that the estrogenic hormones can induce cancer only in those organs normally stimulated by them. Cook and Dodds (25) contributed to the subject by synthesis of a variety of compounds all possessing the tricyclic phenanthrene ring nucleus and biologically estrogenic as well as carcinogenic. The third group of studies, which led to the undertaking of our own experi- ments, had to do with the suggestion that lipids could be classified as growth- stimulating substances. Contradictory evidence has been presented by many authors whose methods of demonstrating the effect of increased lipid intake have differed widely. Robertson and Burnett (26) caused an acceleration of the growth of the Flexner-Jobling rat carcinoma by direct injection of choles- terol into the tumor; lecithin had the opposite effect. Subsequent publications by these authors as well as by Bernstein and Elias (27) and Moravek (28) have been in agreement in regard to the effect on this and other tumors of feeding and injecting these substances. One can also find the view that cholesterol, fed or injected, has no effect upon tumor development (29), and Harnes (30) claimed to have demon- strated a retarding effect when the inoculation of the Brown-Pearce rabbit carcinoma into the testis was preceded by subcutaneous administration of alcoholic brain extract in corn oil. Vassiliadis (31) embraces both assump- tions by the statement that stimulating and inhibiting substances can be found equally in the ether and acetone extracts of normal tissues tested against tar- induced tumors. The most recent observations on this subject are those of MacFadyen and Sturm (32), who demonstrated augmentation of growth of the Bashford mouse carcinoma No. 63 when the graft had been exposed to the ether-soluble fraction of mammary gland. The ether-insoluble material definitely interfered with tumor growth. It is hardly remarkable that there should exist such discrepancies when we consider that inhibiting and stimulating substances ordinarily form a close alliance, and variation in technic may easily favor the one or the other. At least the majority report some influence exerted by fats and related substances on tumor proliferation. The need for investigation of the activity of the lipid fraction of tumor tissue was further emphasized by numerous reports of the high lipid content 670 JAMES W. JOBLING,E. E. SPROUL AND SUE STEVENS of tumors as well as of the blood of tumor-bearing animals and patients. Bul- lock and Cramer (33) concluded from analytical studies on mouse and rat tumors that the phospholipids were associated with rapidity of growth. Sup- port for such a view can be found in the analysis conducted by Bierich and Lang (34), Yasuda and Bloor (35), and more recently by Haven (36). One also finds cholesterol stressed as an important factor in tumor metab- olism, reasoning from content alone. Roffo (37) has written extensively on the correlation of high cholesterol level with the growth of tumors, a view subscribed to by Correa (38) on the basis of analyses of tumors and the blood and non-tumor bearing organs of tumor animals, as well as the personal ob- servation that cholesterol, administered orally or by subcutaneous route, stim- ulated the growth of tumors.