Carcinogenesis is a complex, multistep, multipath process often described as "somatic evolution." Conventional models of cancer progression are typically based on the genetic and epigenetic changes observed in malignant and premalignant tumors. We have explored an alternative approach that emphasizes the selection forces within adaptive landscapes governing growth and evolution in insitu, microinvasive, and metastatic cancers. In each environment, specific barriers to proliferation act as strong selection forces that determine the optimal phenotypic properties that permit tumor growth and invasion. Thus, the phenotypic properties or "hallmarks" of cancer can be viewed as successful adaptations to these microenvironmental selection forces. In turn, these selection pressures are not static but will dynamically change as a result of tumor population growth and evolution.Here, we emphasize the role of hypoxia and acidosis in the progression of tumor from in-situ to invasive cancer. This is a consequence of early tumor cell proliferation on epithelial surfaces, which are separated from the underlying blood supply by the intact basement membrane. As tumor cells proliferate further away from the basement membrane, the diffusion-reaction kinetics of substrate and metabolite flow to and from the blood vessels result in regional hypoxia and acidosis. Cellular adaptation to the former include upregulation of glcyolysis and to the latter include upregulation of Na + /H + exchangers (NHE1) and other acid-regulating proteins such as carbonic anhydrase. We propose this phenotype is critical for subsequent malignant growth of primary and metastatic cancers.

1. We investigated the regulation of intracellular pH (pHi) in rat brain isolated nerve terminals (synaptosomes), using fluorescence pH indicators and time-resolved fluorescence spectroscopy. 2. The resting pHi was not significantly affected by the presence or absence of HCO3-. Removal of external Na+, in the absence or presence of HCO3- caused a rapid acidification of pHi. The recovery from acid loads was primarily due to the activity of the Na+/H+ exchanger, confirming the relevance of this transport system in synaptosomes. 3. Our data revealed that in synaptosomes the activity of the Na+/H+ exchanger was not regulated by either protein kinase C or kinase A. In contrast, Ca2+ played an important role in the regulation of Na+/H+ exchanger. This was supported by the observation that 4Br-A23187 induced a Na(+)-dependent alkalinization of the resting pHi and greatly enhanced the initial rate and the degree of the recovery from acid loads. 4. In most eukaryotic cells, HCO3(-)-based transport mechanisms play an important role in pHi regulation. In synaptosomes, however, HCO3- transport is not significantly involved in pHi regulation, because the presence or absence of HCO3- does not affect resting pHi nor the rate of pHi recovery to acid loads. Further studies to address the role of Cl- and HCO3- in pHi regulation in synaptosomes are discussed in the companion paper. 5. Increasing the concentration of Ko+ also resulted in a rise of steady-state pHi by a processes that is Ca2+ and HCO3- independent. This alkalinization could be due to either K+/H+ exchanger activity, K(+)-induced depolarization, reduction of delta microH+, or a direct reduction of delta microK+. Calculated H+ driving forces suggest that the reduction in the inwardly directed H+ leak is sufficient to explain this K(+)-induced alkalinization because it changes the delta microH+ by virtue of setting the membrane potential difference (Em) to the K+ equilibrium potential (EK+).

HCV was shed into the semen of one-third of HIV-infected MSM with recent or chronic HCV infection. Levels were plausibly sufficient to transmit HCV during unprotected anal intercourse, therefore condoms should be worn to prevent transmission.

1. We have previously shown that rat brain synaptosomes exhibit a very dynamic Na+/H+ exchanger. We have also observed that although synaptosomes lack HCO3(-)-based transport mechanisms, they do respond with changes in pHi upon Clo- removal. 2. Here we show that when synaptosomes are transferred from Ringer solution (RS) to Cl(-)-free RS, there is a cytosolic alkalinization of approximately 0.22 pH units. This phenomenon is DIDS (4,4'-diisothiocyanostilbene-3,3'-disulfonic acid) inhibitable. The alkalinization is completely reversed when Cl- ions are reintroduced. The presence of HCO3- or Ca2+ does not modify the response to Cl(-)-removal or replenishment. 3. In acid-loading experiments, the initial rate of pHi recovery is higher in Cl(-)-free RS than in RS. The final resting pHi after the recovery in Cl(-)-free RS is approximately 0.22 pH units higher than that obtained in media containing Cl-. The magnitude of the NaOAc-induced acidification is 2.5-fold larger in the presence than in the absence of Cl-. Similar results are obtained in the presence of HCO3-. 4. These data suggest that H+ movements may be coupled to Cl- movements. To study this possibility further, we developed a technique to simultaneously measure H+ and Cl- by using the fluorescence of 5' (and 6')-carboxy-10-dimethylamino-3-hydroxy-spyro-[7H benzo[c]xanthene- 7,1'(3'H)-isobenzofuran]3'-one (SNARF-1) and MQAE [N-(6-methoxyquinolyl)acetoxy ester], respectively. 5. Our results indicated that the steady-state [Cl-]i in synaptosomes is approximately 56 mM, thus indicating that Cli- is not passively distributed.(ABSTRACT TRUNCATED AT 250 WORDS)

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