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a Divisions of Biometry and Risk Assessment, National Center for Toxicological Research, Jefferson, Arkansas
b Divisions of Genetic and Reproductive Toxicology, National Center for Toxicological Research, Jefferson, Arkansas
c Toxicology and Industrial Health, Little Rock, Arkansas
Angelo Turturro, DABT, HFT-20, NCTR, 3900 NCTR Road, Jefferson, AR 72079 E-mail: Aturturro{at}nctr.fda.gov.
Decision Editor: John A. Faulkner, PhD
| Abstract |
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C57BL/6 mice are often used for research on aging. Modulation of dietary intake can alter aging in these animals, with the best-characterized modulation being dietary restriction (DR). DR, which lowers dietary intake without malnutrition, decreases the aging rate (1) and lowers the age-associated incidences of neoplastic (2)(3) and nonneoplastic diseases (4)(5). Studies of DR in C57BL/6 mice are often done on only one sex (6)(7)(8)(9)(10)(11), with comparisons between studies further confounded by variations in husbandry techniques and feeding paradigms. NIH-31 is an autoclavable form of the cereal-based diets often used in toxicity and drug studies, such as those performed by the National Toxicology Program (12). When aging interventions are tested for drug efficacy and safety, a diet such as this one is likely to be used.
The National Institute on Aging/National Center for Toxicological Research (NIA/NCTR) Collaboration on Biomarkers Program was designed both to provide animals for the development and testing of biomarkers of aging and to elucidate some of the mechanisms of action of DR on toxicity and disease (13)(14). Here we give a summary of life-span studies with a comprehensive characterization of pathologies in large cohorts of C57BL/6 mice of both sexes that were raised under similar conditions on the standard NIH-31 diet and that were either ad libitum fed (AL) or under DR.
| Methods |
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Statistical Methods
Statistical analyses of the mortality curves included calculation of KaplanMeier distributions (20) of survival in the different dietary treatments and comparison by a two-sided log rank test (21). For the PG and SG animals, the survival times of the sacrificed and shipped animals were right censored at the time of disposal. This was done so that the probability of death actually included all animals with a chance of dying during the interval. Upper and lower 95% mortality curve confidence intervals were calculated by an SAS routine, PROC LIFETEST (22).
Age-adjusted statistical analyses of the pathological outcomes were performed by use of the KodellAhn technique (23). Although a test developed by Peto (24) is often used, it requires determination of either an animal's cause of death (COD) or whether a tumor was fatal or not. The characterization of COD has been quite controversial, even in relatively short 2-year rodent chronic toxicity tests (25). In aging studies of almost all mammals, this determination is very problematic because of the multiple chronic diseases that contribute to death. Additionally, characterizations of disease onset and progression, two important disease parameters, are inherently flawed for diseases that are always assessed as fatal because the Peto test assumes that the animal dies immediately when the disease is present. Few diseases kill immediately upon onset although some diseases, such as lymphoma, are almost certainly named as the COD when present. Thus, these diseases would be characterized as instantly fatal. Finally, it should be appreciated that, when culled for humane reasons, a substantial number of animals were removed when moribund and not dead, which is a common practice in long-term studies. In these studies, of the animals examined that were not intentionally sacrificed, approximately 21% of the male AL mice, 34% of the female AL and male DR mice, and 39% of the female DR mice were sacrificed when moribund.
Kodell and Ahn do not make these assumptions; nor do they have these inherent problems. Kodell and Ahn also maximize the use of information both from intentional sacrifices (the SS animals) and from dead and moribund animals, combining the two. Their technique expresses the age-adjusted disease incidence as a function of intervals that are defined by the times of animal sacrifice for neoplastic and nonneoplastic disease. The intervals used in these analyses were the same for AL and DR animals, with the exception that no AL animals survived to the last interval for DR animals (11161284 days). The statistical techniques compared only intervals in which there were animals from both groups (AL and DR); furthermore, the KodellAhn test computed incidence rates only for intervals that included SS animals. In these studies, every interval with surviving animals had at least one sacrificed animal.
For one disease that occurred, a skin condition that resulted in self-mutilation and skin ulcerations leading to death, the assumptions in the Peto test are satisfied. This dermatitis was almost instantaneously "fatal" because the animal was removed and euthanized (for humane reasons) when the disease was identified. Thus, this disease was evaluated by use of the Peto test.
| Results |
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Unlike some of the previous reports containing subsets of these data (16)(26)(27)(28), this report's life-span data include all animals that were culled because of dermatitis. Initially, this condition was thought to be environmentally induced. Thus the deaths were treated as if they were accidental, and they were simply censored (not considered). However, this condition can also be viewed as a commonly occurring inflammatory disease (29). Because sick animals were removed the day the disease was identified as a way to prevent needless suffering, "deaths" actually would have occurred up to 2 weeks later (based on the usual progress of the disease) than they occurred here.
The total group (TG; TG = LG + PG + SG) survival curves have been published elsewhere (15). To illustrate the relationship among the survivals in the various groups, Fig. 4 depicts the survival curves of DR female mice of the LG, PG, and TG types. The PG survival curve is almost coincident with that of the TG, whereas that of the LG appears to indicate better survival for the latter part of the life span (although not at the very end of the life span) than the others do. Fig. 4 also shows the smaller corresponding body weights of the DR animals in the LG versus those in the PG for an appreciable part of the life span. That this decrease in body weight would result in improved survival is consistent with previous demonstrations in long-term studies of the positive effect of lowered body weight at various ages (when nutrition is maintained) on survival (27)(28)(30) and on diseases (27)(30)(31)(32)(33)(34)(35).
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Dermatitis.-- The incidence of ulcerative dermatitis is shown in Table 2 , with the cumulative probability of the disease as a function of age (KaplanMeier distribution) compared with the overall mortality in the combined LG and PG cohorts in Fig. 5.
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Other diseases.-- Although there were effects of DR on almost every organ, the other effects most significant for mortality (outside of those bearing on lymphoma and histiocytic sarcoma) were probably those in the heart, kidney, and central nervous system. The time of onset of disease was delayed, and progression of cardiomyopathy was inhibited in males (p < .001) and thrombosis was eliminated in males (p < .001; Fig. 6) and females (p < .02) by DR. In the kidney, the time to onset of glomerulosclerosis and nephropathy were delayed by DR in both males (p < .001; Fig. 6) and females (p < .001), with less effect on progression. Additionally, amyloid formation, cysts, inflammation (all p < .001), and infarct (p < .009) were all delayed in onset and inhibited in progression by DR in males (cytoplasmic alterations were inhibited in progression; p < .001). In the central nervous system, DR inhibited the onset and progression of spinal degeneration (p < .001) in both sexes (females were delayed in onset compared with males). DR also delayed the onset of the vacuoles in the female brain (p < .001) and spinal cord (p < .002), with the delay being greater in the spinal cord.
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Bone degeneration was ameliorated by DR, with the severity of the disease and the number of animals with observable disease lessened in males (p < .02) and females (p < .001). Eye degeneration in females was delayed in onset (p < .03). Cataracts were almost eliminated by DR (p < .03).
In males, inflammation was delayed in onset and lessened in severity by DR in the gall bladder (p < .002), stomach (p < .001), urinary bladder (p < .02), tongue (p < .001), and tooth (p < .02). In the coagulation gland (p < .004), the epididymus (p < .001), and the prostate (p < .001) (in which the coagulation gland was greater than the epididymus, which was greater than the prostate in total incidence), DR generally inhibited progression, lessened severity, and delayed onset in the epididymus and prostate. In females, DR eliminated inflammation in the eye (p < .03).
In males, atrophy in the pancreas was eliminated (p < .007); in the Harderian (p < .02) and lacrimal (p < .001) glands, it was delayed in onset and lessened in severity by DR. Atrophy was increased in severity in the spleen (p < .001), thymus (p < .02), and testes (p < .05). Cysts in the thyroid (p < .001) and lacrimal glands (p < .02) were delayed in onset and inhibited in progression by DR.
DR almost eliminated the incidence of cytoplasmic alterations in the gall bladder (p < .001) and thymus (p < .03) in males, and it lessened its severity in the olfactory epithelium of the nose of males and females (p < .001).
In males, progression of hyperplasia was inhibited by DR in the pancreatic islets (p < .003) and small intestine (p < .007), and it was eliminated in the prostate (p < .03). The presence of ectopic tissue in the thymus (p < .02) was also inhibited. Delayed in onset and inhibited in progression were granulomas in the testes (p < .04) in males, as well as hyperplasia in the uterus (p < .001) in females.
Organs sensitive to the effects of DR on neoplasia.-- The tumor incidences of the PG and LG animals have been reported elsewhere (2)(3). This report focuses on the cumulative probability of disease in order to place the results in the context of long-term survival; it also focuses on age-related parameters such as tumor onset and progression.
In the adrenal gland, the most significant effects of DR were decreases in the incidence and severity of hypertrophy in males (p < .001) and the progression of cortical hyperplasia (p < .03) in females. Additionally, the age-related cumulative probability of adrenal adenomas was inhibited by DR in males (Fig. 6; p < .002). In the liver, hematopoietic cell proliferation was eliminated by DR in males (p < .001) and inhibited in progression in females (p < .03). DR delayed the onset and inhibited the progression of liver degeneration in females (p < .02). The presence of vacuoles in the liver was quicker in onset and progressed more with DR in both sexes (p < .001). For neoplasms, hemangiomas plus hemangiosarcomas (p < .004), as well as hemangiosarcomas themselves (p < .03), were both inhibited by DR. Hepatocellular adenomas and carcinomas, which are usually combined, were delayed both in onset and progression with DR (p < .001; Fig. 6). Both liver adenomas (p < .002) and carcinomas (p < .001) were inhibited by DR.
DR delayed the onset and inhibited the progression of hematological cell proliferation in male (p < .001) and female (p < .03) liver and spleen (p < .001; Fig. 6). DR (p < .001) significantly lowered the age-related cumulative probabilities of histiocytic sarcoma.
Furthermore, DR generally limited the onset and inhibited the progression of lymphatic cell hyperplasia in male spleen (p < .004) and in male (p < .001) and female (p < .004) lymph nodes, and of hyperplasia in male (p < .001) and female (p < .003) bone marrow. Female mice had a significantly lowered age-related probability of hyperplasia of lymphatic cells in the lymph nodes and incidence of lymphomas with DR (p < .001), which were delayed in onset (Fig. 7). These lymphomas were of all types: undifferentiated, lymphocytic, mixed, and so on. The major effect of DR appeared to be a delay in onset of disease for lymphoma, with any effect on onset for hyperplasia occurring too early to be quantitated by the first sacrifice at 12 months of age.
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Hyperplasia in the follicular cells (p < .001) of the thyroid was significantly inhibited in progression by DR, and tumors were eliminated (Fig. 7). DR also inhibited the onset and inhibited the progression of C-cell hyperplasia (p < .03) in the thyroid.
| Discussion |
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Even with these values lowered by dermatitis, the mean and median survival times seen in AL males in these studies overlap the standard errors (37)(38)(39)(40) or are longer than those reported in six other studies, one done prior to 1971 (see (41)) and the others more recent (42)(43)(44)(45)(46). Our survival values appear to be approximately 5% less than those obtained by Pugh and colleagues (47) and 9% less than those obtained by Hrubant (48). Two experiments that group-housed animalsone by Kunster and Leuenberger (41) (which, additionally, did not sacrifice moribund animals) and one by Harrison and Archer (11)and that reported low mean body weight had an approximately 9% longer survival value.
Because mean and median life span are metrics thought to be very sensitive to environmental factors in maintaining animals, our relatively long survival values could reflect the positive effect of maintaining the animals under barrier conditions. This effect could occur despite the fact that the animals were housed individually, which often results in animals that are larger than those that are housed by group. A heavier body weight is consistent with a shorter survival time (27)(31)(32)(33)(34)(35)(36). The MLS and the maximum life span, which are thought to be better indicators of the genetically defined life span, were also longer in these studies than in a number of others (8)(39)(43)(44)(45)(46). Two exceptions are the studies by Harrison and Archer (11), which reported an approximately 12% longer MLS, and by Pugh and colleagues (47).
For females, the present mean and median life span (for the LG animals, the most appropriate comparison to most other experiments to estimate longevity) exceeded life spans in studies made prior to 1971, such as those reported in Goodrick (38) and in Kunster and Leuenberger (41), as well as other studies (7)(43)(45)(49)(50)(51). These observations again suggest that our protocol results in good AL animal survival because only a few previous studies had better survival values. Kunster and Leuenberger reported an approximately 8% longer survival (41), a difference that disappears if we exclude deaths associated with dermatitis. The 16% increase in mean life span compared with that of our AL females by Cheney and colleagues (9) may be a result of their use of a high protein diet, the absence of dermatitis, or both. In addition, the animals in that study were extraordinarily small, with the AL females weighing approximately 25 g and the DR females weighing only 1618 g, and being between 1 and 2 years of age (estimated from Fig. 3 of that paper). For MLS and maximum life span, only Cheney and colleagues (9) reported survival values that are greater than those reported here. Again, much of this difference disappears if animals with dermatitis are excluded.
Survival curves for AL male and female mice were not clearly different for the LG cohorts, but males clearly appear to have better survival values for the TG AL cohorts. This demonstrates the utility of large studies to remove much of the effect of "noise," as is evident in comparing single LG survival curves of 56 animals per cohort.
The environmental conditions in these studies result in relatively long life-span parameters in this strain, which were only exceeded in experiments in which low body weights occurred. For instance, the low body weight seen by Cheney and colleagues (9) may be related to the supplementation of the diet with salts, a procedure that can lead to lower food intake as a result of unpalatability. The increased life span seen in the study by Pugh and colleagues (47) may be related to a lifetime body weight that is 1015% lower than that seen here in Fig. 2 and Fig. 3.
Diet Effects
Although food consumption values are often used to extrapolate caloric intake, this was not done here. Because of the presence of coprophagy (52) and different energy requirements arising from potential differential activity and response to the fixed environmental temperature (53) between the AL and DR animals, accurate characterization of the energy intake and energy balance resulting from the need to maintain body temperature was considered problematic.
The same 40% restriction in dietary intake resulted in a decrease in mean body weight of 42% in males, but only 26% in females. The increases in mean, median, and maximum longevity, as well as MLS, were also different, from 24% (mean) to 14% (maximum) in males and from 27% (mean) to 20% (maximum) in females. Despite these differences, because the AL females have a shorter life span than AL males, the mortality parameters of the two DR groups are very similar, as reflected in Table 1 . The elimination of much of the malefemale difference by DR suggests that those processes that are differentially sensitive to DR between sexes, such as the presence of dermatitis, are responsible for the sex-specific difference in the AL groups. The similarity of the DR mortality curves can also be considered to represent the similar mean body weight for DR animals in both sexes.
The extension of life span with DR was consistent with every other study done in rodents, with the exception of one by Harrison and Archer (11). As already noted, they multiply housed their animals. As this can distort the measurement of individual food intake and result in behavioral effects such as fighting, especially as food is restricted, it is difficult to compare this result with those from singly housed animals.
Although a formal analysis was not done, it appears evident that the major longevity effect of DR is on the time of the increase in mortality rate, rather than the rate itself, because the curves are fairly parallel (Fig. 2 and Fig. 3).
Disease
The effect of DR on dermatitis appeared to be related to the effects of DR on inflammation (29). This is consistent with the inhibition of inflammation in a number of organs that was observed here, as well as the inhibition of the production of amyloid. This pigment, long associated with aging, is induced by stress (54) and would be sensitive to an anti-inflammatory action of DR. This action may also be important to the increase with DR in atrophy in two glands associated with the hematopoietic system as well as the testes.
To our knowledge, this is the first report of the effects of DR on cardiomyopathy in C57BL/6 mice. The effects on the heart are consistent with work reported in the rat (e.g., (5)) but are rarely reported in the mouse (e.g., (55)). These lesions are accepted as common causes of mortality in rats, but before now they were not considered important for this type of mouse or rarely for mice in general. The accumulation of diseases in the kidney suggests that there is a general problem in this organ in males, similar to what occurs in the rat, and that the problem is significantly affected by DR. Delays in these fatal diseases may be major factors in the delay of mortality seen with DR.
The effects of DR on bone degeneration in the spinal column are consistent with reports of amelioration by DR of degeneration in the vertebrae of mice as a result of osteoarthritis (56). This is despite the smaller and less dense bones that DR animals are known to have.
The effect of DR on cataracts is consistent with what was observed for dark-eyed mice and DR (57).
The effects of DR in the brain and spinal cord vacuoles are consistent with the observation that DR has a role to play in the preservation of brain function (58). It is curious that the effect is only seen in females.
The negative effects of this DR protocol on the lung are seen clearly in both sexes, most prominently at the older ages. It is not clear what the cause is. Generally, there is inhibition of inflammation by DR, so the increased lung inflammation may indicate an irritant or trauma to the lung with DR, which would also be consistent with the observed increase in cysts. It is interesting in this regard that activation of retinoid receptors in bronchial epithelial cells results in G1 arrest through the stimulated degradation of cyclin D1 (59). The DR mice presumably had relatively higher Vitamin A levels per gram of body weight, because their feed was fortified on a per gram feed basis with vitamins to make the total consumption of vitamins per animal in AL and DR animals the same (15). It is possible that the increased lung irritation may be a consequence of chronic relative inhibition of bronchial epithelial growth induced by higher retinoid levels, which would decrease the ability of mouse lung to respond to everyday damage by cell replacement.
The general effect of DR on inhibiting the onset and/or progression of cellular disorders, such as cytoplasmic cell alterations and hyperplasia, is consistent with an overall inhibition of growth (and consequently, risk of disorder) that has been suggested as important to the effect seen with DR (27)(28)(31).
The endocrine system is a prime target for the effects of DR. To our knowledge, this is the first report of the cumulative age-related probability of adrenal adenoma in C57BL/6 male mice. This tumor is uncommon until relatively advanced age, and it is strongly inhibited by DR. The effect of diet on this tumor may be related to the inhibition of luteotropic hormone (LH) (60) as part of a general inhibition of the gonadotropic axis by DR (61). The inhibition of thyroid follicular adenomas in female DR mice is consistent with a direct relationship of early body weight with thyroid adenomas already reported in rats (34) and the effect of DR on these adenomas in B6C3F1 female mice (18). This inhibition may result from an inhibition of thyrotropin by DR ((1); see p. 144). The inhibition of pituitary hyperplasia and tumors by DR is well known (e.g., (62)), and it appears to be related to body weight (34)(63), as is the effect on mammary tumorigenesis. The mechanism of inhibition of prolactin secretion by diet restriction (64) is consistent with the observed inhibition of galactocele. Also consistent with effect of DR on body weight is the inhibition of liver tumors by DR, which is also seen in B6C3F1 mice (3)(30)(31)(32)(33)(34). The mechanism appears to be decreased proliferation and increased apoptosis, which would selectively kill cells that are prone to developing tumors (65).
Liver hemangioma and hemangiosarcoma are rare tumors until late in the life span. The explanation of the inhibition of these tumors by DR may be related to the recent finding that interleukin-6 (IL-6) is an autocrine growth factor for transformed endothelial cells (66). DR inhibits the rise in IL-6 seen with aging (67)(68).
DR appears to delay the onset of histiocytic sarcoma, more in females than males, with an inhibition of progression that is, however, more evident in males. Previously, this disease was often classified as a lymphoma in mice, but such a classification is no longer appropriate (69). Thus comparisons to previous reports of the age-adjusted incidences of "lymphoma" in this mouse are confounded. Pugh and colleagues (47) found a high incidence of plasma cell neoplasms (PCNs) in C57BL/6 mice (47), which was not found in this report. The authors appear to have been referring to (largely) the neoplasms designated here as histiocytic sarcomas. The designation of histiocytic sarcoma is more consistent with modern practice in veterinary pathology, and uses criteria that are relevant to the mouse, unlike the PCN designation, which was derived from humans. If the PCN were actually a histiocytic sarcoma, then the observation that the total incidence of PCN was increased in DR animals would be consistent with the findings here, because the longer life span of the DR animals accounts for the development of more tumors. The precursor cell of histiocytic sarcoma in rodents appears to be a macrophage-like cell, and the effect of DR on inhibiting tumor onset may be related to the DR effect on inflammation (70).
Lymphoma was significantly inhibited in females. There is some evidence that DR inhibited leukemic viral infection in mice (28). Additionally, there have been suggestions that IL-6 is involved in lymphomatogenesis (67), and the influence of DR on IL-6 noted herein may mediate the DR effect on lymphoma.
| Conclusions |
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Except for lymphoma and histiocytic sarcoma, DR had a greater inhibitory effect on endocrine-related tumors, such as pituitary tumors or thyroid tumors, as well as adrenal adenomas, than on other neoplasms. For instance, risk of pituitary tumor is not simply delayed by DR, but appears to be almost eliminated. Similar impacts were seen in nonneoplastic endpoints related to tumorigenesis in these organs, such as hyperplasia.
Although this mouse does not spontaneously develop prostate cancer, the effect on prostate inflammation was especially interesting, because it may suggest a role for DR in the prevention of this disease in other models.
In C57BL/6 mice, similar to other models (63), DR appears to exert its effect on life span through the inhibition, either of time to onset, progression, or both, of numerous diseases through a multitude of hormonal and physiological effects, with many of its effects being mediated by body weight loss and maintenance at low levels. The negative effects on the lung may arise from the increased Vitamin A levels given to the DR mice, suggesting that nutritional factors are especially important to consider in DR animals. Alternatively, negative effects may arise from the pleiotropic nature of DR, in which there is both a torpor to save energy and a stimulation of activity at various times to obtain food (71). The interaction of diet and activity is complex (72), and this composite nature of DR and its interactions with paradigms provides a more comprehensive context to understand both the numerous health effects of DR and how decreased food input affects a multifactorial phenomenon such as aging.
| Acknowledgments |
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We thank Bruce A. Pearce, Division of Biometry and Risk Assessment, NCTR, for his efforts in performing many of the calculations required in this paper. Thanks also to Andy McCracken, of R.O.W. Services, for his help.
Received December 21, 2001
Accepted June 19, 2002
| References |
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-class glutathione-s-transferase positive hepatocytes in aging B6C3F1 mice undergo apoptosis induced by dietary restriction. Am J Pathol. 149:1585-1591. [Abstract]
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