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1.
Carcinogenesis ; 45(5): 288-299, 2024 May 19.
Article in English | MEDLINE | ID: mdl-38466106

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental carcinogens accountable to developing skin cancers. Recently, we reported that exposure to benzo[a]pyrene (B[a]P), a common PAH, causes epigenetic and metabolic alterations in the initiation, promotion and progression of non-melanoma skin cancer (NMSC). As a follow-up investigation, this study examines how dietary triterpenoid ursolic acid (UA) regulates B[a]P-driven epigenetic and metabolic pathways in SKH-1 hairless mice. Our results show UA intercepts against B[a]P-induced tumorigenesis at different stages of NMSC. Epigenomic cytosines followed by guanine residues (CpG) methyl-seq data showed UA diminished B[a]P-mediated differentially methylated regions (DMRs) profiles. Transcriptomic RNA-seq revealed UA revoked B[a]P-induced differentially expressed genes (DEGs) of skin cancer-related genes, such as leucine-rich repeat LGI family member 2 (Lgi2) and kallikrein-related peptidase 13 (Klk13), indicating UA plays a vital role in B[a]P-mediated gene regulation and its potential consequences in NMSC interception. Association analysis of DEGs and DMRs found that the mRNA expression of KLK13 gene was correlated with the promoter CpG methylation status in the early-stage comparison group, indicating UA could regulate the KLK13 by modulating its promoter methylation at an early stage of NMSC. The metabolomic study showed UA alters B[a]P-regulated cancer-associated metabolisms like thiamin metabolism, ascorbate and aldarate metabolism during the initiation phase; pyruvate, citrate and thiamin metabolism during the promotion phase; and beta-alanine and pathothenate coenzyme A (CoA) biosynthesis during the late progression phase. Taken together, UA reverses B[a]P-driven epigenetic, transcriptomic and metabolic reprogramming, potentially contributing to the overall cancer interception against B[a]P-mediated NMSC.


Subject(s)
Benzo(a)pyrene , DNA Methylation , Epigenesis, Genetic , Mice, Hairless , Skin Neoplasms , Triterpenes , Ursolic Acid , Animals , Skin Neoplasms/chemically induced , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Skin Neoplasms/metabolism , Benzo(a)pyrene/toxicity , Triterpenes/pharmacology , Mice , Epigenesis, Genetic/drug effects , DNA Methylation/drug effects , Carcinogens, Environmental/toxicity , Gene Expression Regulation, Neoplastic/drug effects , Carcinogenesis/drug effects , Carcinogenesis/genetics , Carcinogenesis/chemically induced
2.
Pharm Res ; 40(11): 2699-2714, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37726406

ABSTRACT

Since ancient times, dietary phytochemicals are known for their medicinal properties. They are broadly classified into polyphenols, terpenoids, alkaloids, phytosterols, and organosulfur compounds. Currently, there is considerable interest in their potential health effects against various diseases, including lung cancer. Lung cancer is the leading cause of cancer deaths with an average of five-year survival rate of lung cancer patients limited to just 14%. Identifying potential early molecular biomarkers of pre-malignant lung cancer cells may provide a strong basis to develop early cancer detection and interception methods. In this review, we will discuss molecular changes, including genetic alterations, inflammation, signal transduction pathways, redox imbalance, epigenetic and proteomic signatures associated with initiation and progression of lung carcinoma. We will also highlight molecular targets of phytochemicals during lung cancer development. These targets mainly consist of cellular signaling pathways, epigenetic regulators and metabolic reprogramming. With growing interest in natural products research, translation of these compounds into new cancer prevention approaches to medical care will be urgently needed. In this context, we will also discuss the overall pharmacokinetic challenges of phytochemicals in translating to humans. Lastly, we will discuss clinical trials of phytochemicals in lung cancer patients.


Subject(s)
Anticarcinogenic Agents , Lung Neoplasms , Neoplasms , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/prevention & control , Lung Neoplasms/pathology , Anticarcinogenic Agents/therapeutic use , Diet , Proteomics , Neoplasms/drug therapy , Phytochemicals/pharmacology , Phytochemicals/therapeutic use , Biomarkers
3.
Eur J Pharmacol ; 953: 175866, 2023 Aug 15.
Article in English | MEDLINE | ID: mdl-37331680

ABSTRACT

BACKGROUND: Diabetic nephropathy (DN) is the leading cause of end-stage renal disease in the United States. Emerging evidence suggests that mitochondrial metabolism and epigenetics play an important role in the development and progression of DN and its complications. For the first time, we investigated the regulation of cellular metabolism, DNA methylation, and transcriptome status by high glucose (HG) in the kidney of leptin receptor-deficient db/db mice using multi-omics approaches. METHODS: The metabolomics was performed by liquid-chromatography-mass spectrometry (LC-MS), while epigenomic CpG methylation coupled with transcriptomic gene expression was analyzed by next-generation sequencing. RESULTS: LC-MS analysis of glomerular and cortex tissue samples of db/db mice showed that HG regulated several cellular metabolites and metabolism-related signaling pathways, including S-adenosylmethionine, S-adenosylhomocysteine, methionine, glutamine, and glutamate. Gene expression study by RNA-seq analysis suggests transforming growth factor beta 1 (TGFß1) and pro-inflammatory pathways play important roles in early DN. Epigenomic CpG methyl-seq showed HG revoked a list of differentially methylated regions in the promoter region of the genes. Integrated analysis of DNA methylation in the promoter regions of genes and gene expression changes across time points identified several genes persistently altered in DNA methylation and gene expression. Cyp2d22, Slc1a4, and Ddah1 are some identified genes that could reflect dysregulated genes involved in renal function and DN. CONCLUSION: Our results suggest that leptin receptor deficiency leading to HG regulates metabolic rewiring, including SAM potentially driving DNA methylation and transcriptomic signaling that could be involved in the progression of DN.


Subject(s)
Diabetes Mellitus , Diabetic Nephropathies , Animals , Mice , Diabetes Mellitus/metabolism , Diabetic Nephropathies/genetics , Diabetic Nephropathies/metabolism , Epigenesis, Genetic , Epigenomics , Kidney/metabolism , Mice, Inbred Strains , Receptors, Leptin/genetics , Receptors, Leptin/metabolism
4.
Mol Carcinog ; 62(8): 1136-1146, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37144836

ABSTRACT

Kirsten rat sarcoma virus (KRAS) oncogene, found in 20%-25% of lung cancer patients, potentially regulates metabolic reprogramming and redox status during tumorigenesis. Histone deacetylase (HDAC) inhibitors have been investigated for treating KRAS-mutant lung cancer. In the current study, we investigate the effect of HDAC inhibitor (HDACi) belinostat at clinically relevant concentration on nuclear factor erythroid 2-related factor 2 (NRF2) and mitochondrial metabolism for the treatment of KRAS-mutant human lung cancer. LC-MS metabolomic study of belinostat on mitochondrial metabolism was performed in G12C KRAS-mutant H358 non-small cell lung cancer cells. Furthermore, l-methionine (methyl-13 C) isotope tracer was used to explore the effect of belinostat on one-carbon metabolism. Bioinformatic analyses of metabolomic data were performed to identify the pattern of significantly regulated metabolites. To study the effect of belinostat on redox signaling ARE-NRF2 pathway, luciferase reporter activity assay was done in stably transfected HepG2-C8 cells (containing pARE-TI-luciferase construct), followed by qPCR analysis of NRF2 and its target gene in H358 cells, which was further confirmed in G12S KRAS-mutant A549 cells. Metabolomic study reveals significantly altered metabolites related to redox homeostasis, including tricarboxylic acid (TCA) cycle metabolites (citrate, aconitate, fumarate, malate, and α-ketoglutarate); urea cycle metabolites (Arginine, ornithine, argino-succinate, aspartate, and fumarate); and antioxidative glutathione metabolism pathway (GSH/GSSG and NAD/NADH ratio) after belinostat treatment. 13 C stable isotope labeling data indicates potential role of belinostat in creatine biosynthesis via methylation of guanidinoacetate. Moreover, belinostat downregulated the expression of NRF2 and its target gene NAD(P)H:quinone oxidoreductase 1 (NQO1), indicating anticancer effect of belinostat is mediated, potentially via Nrf2-regulated glutathione pathway. Another HDACi panobinostat also showed potential anticancer effect in both H358 and A549 cells via Nrf2 pathway. In summary, belinostat is effective in killing KRAS-mutant human lung cancer cells by regulating mitochondrial metabolism which could be used as biomarkers for preclinical and clinical studies.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Humans , Histone Deacetylase Inhibitors/pharmacology , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Proto-Oncogene Proteins p21(ras)/genetics , Proto-Oncogene Proteins p21(ras)/metabolism , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/genetics , NF-E2-Related Factor 2/metabolism , NAD/metabolism , Glutathione/metabolism
5.
Carcinogenesis ; 44(5): 436-449, 2023 08 10.
Article in English | MEDLINE | ID: mdl-37100755

ABSTRACT

Non-melanoma skin cancer (NMSC) is the most common cancer in the world. Environmental exposure to carcinogens is one of the major causes of NMSC initiation and progression. In the current study, we utilized a two-stage skin carcinogenesis mouse model generated by sequential exposure to cancer-initiating agent benzo[a]pyrene (BaP) and promoting agent 12-O-tetradecanoylphorbol-13-acetate (TPA), to study epigenetic, transcriptomic and metabolic changes at different stages during the development of NMSC. BaP/TPA caused significant alterations in DNA methylation and gene expression profiles in skin carcinogenesis, as evidenced by DNA-seq and RNA-seq analysis. Correlation analysis between differentially expressed genes and differentially methylated regions found that the mRNA expression of oncogenes leucine rich repeat LGI family member 2 (Lgi2), kallikrein-related peptidase 13 (Klk13) and SRY-Box transcription factor (Sox5) are correlated with the promoter CpG methylation status, indicating BaP/TPA regulates these oncogenes through regulating their promoter methylation at different stages of NMSC. Pathway analysis identified that the modulation of macrophage-stimulating protein-recepteur d'origine nantais and high-mobility group box 1 signaling pathways, superpathway of melatonin degradation, melatonin degradation 1, sirtuin signaling and actin cytoskeleton signaling pathways are associated with the development of NMSC. The metabolomic study showed BaP/TPA regulated cancer-associated metabolisms like pyrimidine and amino acid metabolisms/metabolites and epigenetic-associated metabolites, such as S-adenosylmethionine, methionine and 5-methylcytosine, indicating a critical role in carcinogen-mediated metabolic reprogramming and its consequences on cancer development. Altogether, this study provides novel insights integrating methylomic, transcriptomic and metabolic-signaling pathways that could benefit future skin cancer treatment and interception studies.


Subject(s)
Carcinogens, Environmental , Melatonin , Skin Neoplasms , Mice , Animals , Benzo(a)pyrene/toxicity , Benzo(a)pyrene/metabolism , Carcinogenesis/genetics , Skin Neoplasms/chemically induced , Skin Neoplasms/genetics , Tetradecanoylphorbol Acetate , Epigenesis, Genetic
6.
Mol Nutr Food Res ; 66(12): e2200028, 2022 06.
Article in English | MEDLINE | ID: mdl-35429118

ABSTRACT

SCOPE: Butyrate (B) is a short-chain fatty acid produced by dietary fiber, known to inhibit histone deacetylases (HDACs) and possess cancer-preventive/anticancer effects. However, the role of B in metabolic rewiring, epigenomic reprogramming, transcriptomic network, NRF2 signaling, and eliciting cancer-preventive effects in colorectal cancer (CRC) HCT116 cell remains unclear. METHODS AND RESULTS: Sodium butyrate (NaB) dose-dependently inhibits the growth of CRC HCT116 cells. NaB inhibits NRF2/NRF2-target genes and blocks NRF2-ARE signaling. NaB increases NRF2 negative regulator KEAP1 expression through inhibiting its promoter methylation. Associative analysis of DEGs (differentially expressed genes) from RNA-seq and DMRs (differentially methylated regions) from CpG methyl-seq identified the tumor suppressor gene ABCA1 and tumor promote gene EGR3 are correlated with their promoters' CpG methylation indicating NaB regulates cancer markers through modulating their promoter methylation. NaB activated the mitochondrial tricarboxylic acid (TCA) cycle while inhibited the methionine metabolism which are both tightly coupled to the epigenetic machinery. NaB regulates the epigenetic enzymes/genes including DNMT1, HAT1, KDM1A, KDM1B, and TET1. Altogether, B's regulation of metabolites coupled to the epigenetic enzymes illustrates the potential underlying biological connectivity between metabolomics and epigenomics. CONCLUSION: B regulates KEAP1/NRF2 signaling, drives metabolic rewiring, CpG methylomic, and transcriptomic reprogramming contributing to the overall cancer-prevention/anticancer effect in the CRC cell model.


Subject(s)
Colonic Neoplasms , Epigenomics , Butyric Acid/pharmacology , Colonic Neoplasms/drug therapy , Colonic Neoplasms/genetics , DNA Methylation , Epigenesis, Genetic , Histone Demethylases/genetics , Histone Demethylases/metabolism , Humans , Kelch-Like ECH-Associated Protein 1/genetics , Kelch-Like ECH-Associated Protein 1/metabolism , Mixed Function Oxygenases/genetics , Mixed Function Oxygenases/metabolism , NF-E2-Related Factor 2/genetics , NF-E2-Related Factor 2/metabolism , Proto-Oncogene Proteins/metabolism
7.
Free Radic Biol Med ; 179: 328-336, 2022 02 01.
Article in English | MEDLINE | ID: mdl-33359432

ABSTRACT

Biological redox signaling plays an important role in many diseases. Redox signaling involves reductive and oxidative mechanisms. Oxidative stress occurs when reductive mechanism underwhelms oxidative challenges. Cellular oxidative stress occurs when reactive oxygen/nitrogen species (RO/NS) exceed the cellular reductive/antioxidant capacity. Endogenously produced RO/NS from mitochondrial metabolic citric-acid-cycle coupled with electron-transport-chain or exogenous stimuli trigger cellular signaling events leading to homeostatic response or pathological damage. Recent evidence suggests that RO/NS also modulate epigenetic machinery driving gene expression. RO/NS affect DNA methylation/demethylation, histone acetylation/deacetylation or histone methylation/demethylation. Many health beneficial phytochemicals possess redox capability that counteract RO/NS either by directly scavenging the radicals or via inductive mechanism of cellular defense antioxidant/reductive enzymes. Amazingly, these phytochemicals also possess epigenetic modifying ability. This review summarizes the latest advances on the interactions between redox signaling, mitochondrial metabolism, epigenetics and redox active phytochemicals and the future challenges of integrating these events in human health.


Subject(s)
Epigenesis, Genetic , Signal Transduction , Humans , Oxidation-Reduction , Oxidative Stress , Phytochemicals/pharmacology
8.
Mol Carcinog ; 60(6): 391-402, 2021 06.
Article in English | MEDLINE | ID: mdl-33848375

ABSTRACT

Epigenetics/epigenomics has been shown to be involved in carcinogenesis. However, how the epigenome would be altered in the transgenic adenocarcinoma of the mouse prostate (TRAMP) cancer model and the effect of cancer chemopreventive phytochemical phenethyl isothiocyanate (PEITC) on the epigenome in TRAMP mice are not known. PEITC has been reported to reduce the risk of many cancers including prostate cancer (PCa). In this study, male TRAMP mice were fed a control diet or diet containing 0.05% PEITC from 8 weeks to 16 weeks. The tumor incidence was reduced in the PEITC diet (0/6) as compared with the control diet (6/7). RNA-sequencing (RNA-seq) analyses on nontumor and tumor prostatic tissues revealed several pathways like cell cycle/Cdc42 signaling, inflammation, and cancer-related signaling, were activated in prostate tissues of TRAMP mice but were reversed or attenuated in TRAMP mice fed with PEITC diet. DNA CpG methyl-seq analyses showed that global methylation patterns of prostate samples from TRAMP mice were hugely different from those of wild-type mice. Dietary PEITC partially reversed the global methylation changes during prostatic carcinogenesis. Integration of RNA-seq and DNA methyl-seq analyses identified a list of genes, including Adgrb1 and Ebf4, with an inverse regulatory relationship between their RNA expression and CpG methylation. In summary, our current study demonstrates that alteration of the global epigenome in TRAMP prostate tumor and PEITC administration suppresses PCa carcinogenesis, impacts global CpG epigenome and transcriptome, and attenuates carcinogenic pathways like cell cycle arrest and inflammation. These results may provide insights and epigenetic markers/targets for PCa prevention and treatment in human PCa patients.


Subject(s)
Anticarcinogenic Agents/pharmacology , DNA Methylation/drug effects , Isothiocyanates/pharmacology , Prostatic Neoplasms/prevention & control , Animals , Epigenome/drug effects , Female , Gene Expression Regulation, Neoplastic/drug effects , Male , Mice, Inbred C57BL , Mice, Transgenic , Neoplasms, Experimental/genetics , Prostatic Neoplasms/genetics
9.
Cancer Prev Res (Phila) ; 14(2): 151-164, 2021 02.
Article in English | MEDLINE | ID: mdl-33055265

ABSTRACT

Cancer is a complex disease and cancer development takes 10-50 years involving epigenetics. Evidence suggests that approximately 80% of human cancers are linked to environmental factors impinging upon genetics/epigenetics. Because advanced metastasized cancers are resistant to radiotherapy/chemotherapeutic drugs, cancer prevention by relatively nontoxic chemopreventive "epigenetic modifiers" involving epigenetics/epigenomics is logical. Isothiocyanates are relatively nontoxic at low nutritional and even higher pharmacologic doses, with good oral bioavailability, potent antioxidative stress/antiinflammatory activities, possess epigenetic-modifying properties, great anticancer efficacy in many in vitro cell culture and in vivo animal models. This review summarizes the latest advances on the role of epigenetics/epigenomics by isothiocyanates in prevention of skin, colon, lung, breast, and prostate cancers. The exact molecular mechanism how isothiocyanates modify the epigenetic/epigenomic machinery is unclear. We postulate "redox" processes would play important roles. In addition, isothiocyanates sulforaphane and phenethyl isothiocyanate, possess multifaceted molecular mechanisms would be considered as "general" cancer preventive agents not unlike chemotherapeutic agents like platinum-based or taxane-based drugs. Analogous to chemotherapeutic agents, the isothiocyanates would need to be used in combination with other nontoxic chemopreventive phytochemicals or drugs such as NSAIDs, 5-α-reductase/aromatase inhibitors targeting different signaling pathways would be logical for the prevention of progression of tumors to late advanced metastatic states.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Epigenesis, Genetic/drug effects , Gene Expression Regulation, Neoplastic/drug effects , Isothiocyanates/therapeutic use , Neoplasms/prevention & control , Administration, Oral , Animals , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antineoplastic Agents, Phytogenic/pharmacology , Antineoplastic Agents, Phytogenic/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Aromatase Inhibitors/pharmacology , Aromatase Inhibitors/therapeutic use , Biological Availability , Disease Models, Animal , Humans , Isothiocyanates/pharmacology , Neoplasms/genetics , Oxidation-Reduction/drug effects
10.
Curr Pharmacol Rep ; 6(3): 56-70, 2020.
Article in English | MEDLINE | ID: mdl-32395418

ABSTRACT

The current pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has presented unprecedented challenges to the healthcare systems in almost every country around the world. Currently, there are no proven effective vaccines or therapeutic agents against the virus. Current clinical management includes infection prevention and control measures and supportive care including supplemental oxygen and mechanical ventilatory support. Evolving research and clinical data regarding the virologic SARS-CoV-2 suggest a potential list of repurposed drugs with appropriate pharmacological effects and therapeutic efficacies in treating COVID-19 patients. In this review, we will update and summarize the most common and plausible drugs for the treatment of COVID-19 patients. These drugs and therapeutic agents include antiviral agents (remdesivir, hydroxychloroquine, chloroquine, lopinavir, umifenovir, favipiravir, and oseltamivir), and supporting agents (Ascorbic acid, Azithromycin, Corticosteroids, Nitric oxide, IL-6 antagonists), among others. We hope that this review will provide useful and most updated therapeutic drugs to prevent, control, and treat COVID-19 patients until the approval of vaccines and specific drugs targeting SARS-CoV-2.

11.
Biochem Pharmacol ; 175: 113890, 2020 05.
Article in English | MEDLINE | ID: mdl-32119837

ABSTRACT

Triterpenoids are a powerful group of phytochemicals derived from plant foods and herbs. Many reports have shown that they possess chemopreventive and chemotherapeutic effects not only in cell lines and animal models but also in clinical trials. Because epigenetic changes could potentially occur in the early stages of carcinogenesis preceding genetic mutations, epigenetics are considered promising targets in early interventions against cancer using epigenetic bioactive substances. The biological properties of triterpenoids in cancer prevention and in health have multiple mechanisms, including antioxidant and anti-inflammatory activities, cell cycle regulation, as well as epigenetic/epigenomic regulation. In this review, we will discuss and summarize the latest advances in the study of the pharmacological effects of triterpenoids in cancer chemoprevention and in health, including the epigenetic machinery.


Subject(s)
Anticarcinogenic Agents/pharmacology , Epigenesis, Genetic/drug effects , Neoplasms/genetics , Neoplasms/prevention & control , Phytochemicals/pharmacology , Triterpenes/pharmacology , Anticarcinogenic Agents/chemistry , Cell Line, Tumor , Humans , Phytochemicals/chemistry , Triterpenes/chemistry
12.
Mol Carcinog ; 59(2): 227-236, 2020 02.
Article in English | MEDLINE | ID: mdl-31820492

ABSTRACT

Colorectal cancer (CRC) is associated with significant morbidity and mortality in the US and worldwide. CRC is the second most common cancer-related death in both men and women globally. Chronic inflammation has been identified as one of the major risk factors of CRC. It may drive genetic and epigenetic/epigenomic alterations, such as DNA methylation, histone modification, and non-coding RNA regulation. Current prevention modalities for CRC are limited and some treatment regimens such as use the nonsteroidal anti-inflammatory drug aspirin may have severe side effects, namely gastrointestinal ulceration and bleeding. Therefore, there is an urgent need of developing alternative strategies. Recently, increasing evidence suggests that several dietary cancer chemopreventive phytochemicals possess anti-inflammation and antioxidative stress activities, and may prevent cancers including CRC. Curcumin (CUR) is the yellow pigment that is found in the rhizomes of turmeric (Curcuma longa). Many studies have demonstrated that CUR exhibit strong anticancer, antioxidative stress, and anti-inflammatory activities by regulating signaling pathways, such as nuclear factor erythroid-2-related factor 2, nuclear factor-κB, and epigenetics/epigenomics pathways of histones modifications, and DNA methylation. In this review, we will discuss the latest evidence in epigenetics/epigenomics alterations by CUR in CRC and their potential contribution in the prevention of CRC.


Subject(s)
Colonic Neoplasms/prevention & control , Curcumin/pharmacology , Epigenesis, Genetic/drug effects , Epigenomics , Inflammation/prevention & control , Antineoplastic Agents/pharmacology , Colonic Neoplasms/genetics , Colonic Neoplasms/pathology , Curcuma/chemistry , Humans , Inflammation/genetics , Inflammation/pathology , Neoplasm Staging , Phytotherapy/methods
14.
Am J Sports Med ; 40(7): 1488-94, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22582223

ABSTRACT

BACKGROUND: A prior review of catastrophic pole vaulting injuries from 1982 through 1998 revealed an average of 2.0 injuries per year, with 69% (1.38 per year) of the injuries secondary to athletes landing off the sides or back of the landing pad and 25% (0.5 per year) from athletes landing in the vault box. In 2003, several rule changes for the sport of pole vaulting were mandated, including enlarging the minimum dimensions of the landing pad. HYPOTHESIS/PURPOSE: Our goals were to (1) identify the post-2003 rule change incidence and profile of catastrophic pole vaulting injuries through 2011 and compare them, where possible, with the prior incidence and profile and (2) determine, via a questionnaire, the frequency with which pole vaulters land in the vault box. We hypothesized that the new, larger landing pads would reduce the number of catastrophic injuries. STUDY DESIGN: Descriptive epidemiology study. METHODS: We prospectively reviewed all catastrophic pole vaulting injuries (ie, brain hemorrhage; skull, spine, or pelvic fracture; substantial pulmonary or intra-abdominal injury) in the United States from 2003 through 2011, surveyed 3335 pole vaulters to determine the frequency of landing in the vault box, and compared results with those in the literature. RESULTS: From 2003 to 2011, 19 catastrophic injuries occurred (average of 2.1 per year), with the majority (n = 14, 74%, 1.55 per year) landing in or around the vault box. Four (21%, 0.44 per year) injuries occurred when an athlete landed off the sides or back of the landing pad and 1 (5%) when the pole broke. There were 11 (58%) major head injuries (1 fatality), 4 (21%) spine fractures (1 with paraplegia), 2 (11%) pelvic fractures (both with intra-abdominal injuries), 1 (5%) brain stem injury (fatal), and 1 (5%) thoracic injury (rib fractures and pneumothorax). The annual fatality rate fell from 1.0 in the prior study to 0.22 in the current study. According to the pole vaulters survey, during their careers, 77.12% (n = 2572) landed in the vault box 1 to 3 times, 15.92% (n = 531) never landed in the vault box, 6.12% (n = 204) landed in the vault box 4 to 6 times, and 0.84% (n = 28) landed in the vault box 7 or more times. CONCLUSION: The 2003 rule changes have markedly reduced the number of catastrophic injuries, especially fatalities, from pole vaulters missing the back or sides of the landing pads; however, the average annual rate of catastrophic injuries from pole vaulters landing in the vault box has more than tripled over the past decade and remains a major problem.


Subject(s)
Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/prevention & control , Spinal Fractures/epidemiology , Spinal Fractures/prevention & control , Track and Field/injuries , Abdominal Injuries/epidemiology , Abdominal Injuries/prevention & control , Adolescent , Adult , Follow-Up Studies , Fractures, Bone/epidemiology , Fractures, Bone/prevention & control , Humans , Incidence , Male , Pelvic Bones/injuries , Prospective Studies , Surveys and Questionnaires , Thoracic Injuries/epidemiology , Thoracic Injuries/prevention & control , United States/epidemiology , Young Adult
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