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Tumor Biology |
Departments of Endocrinology [C. S., E. R. B., J. C. M.], Nuclear Medicine [M. K. O.], and Urology [D. J. T., C. Y. F. Y.], Mayo Clinic, Rochester, Minnesota 55905
| ABSTRACT |
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| INTRODUCTION |
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A novel form of gene therapy, using NIS gene transfer to induce iodide accumulation activity in prostate cancer cells by expression of functionally active NIS, would therefore extend the utility of radioiodine therapy to the treatment of prostate cancer. To minimize extratumoral toxicity, a tissue-specific promoter, such as the PSA3 promoter, may be used to provide selective, prostate-specific NIS gene expression (7, 8, 9) . The PSA promoter has been extensively characterized in recent years and has been shown to be responsible for prostate-specific and androgen-regulated expression of PSA, a serine protease of 237 amino acids, that is mainly expressed within the epithelial lining and acini of the prostate gland (10, 11, 12, 13) .
We reported recently the induction of tissue-specific,
androgen-dependent iodide uptake activity in prostate cancer cells
in vitro by PSA promoter-directed NIS gene
delivery (14)
. The androgen-sensitive human prostatic
adenocarcinoma cell line LNCaP was stably transfected with an
expression vector in which full-length NIS cDNA had been
coupled to a 6-kb PSA promoter fragment (14
, 15)
. The
stably transfected LNCaP cell line NP-1 showed perchlorate-sensitive,
androgen-dependent iodide uptake activity, whereas no iodide uptake
activity was detected in LNCaP cells transfected with the control
vectors. The magnitude of iodide uptake in NP-1 cells concentrating
125I
50-fold was highly encouraging and
suggested that a therapeutic effect of accumulated radioiodine
(14)
could be achieved. Although these in vitro
data suggested the feasibility of the concept of NIS gene
transfer as a first step toward radioiodine therapy of prostate cancer,
its utility required direct demonstration. Therefore, the aim of our
current study was to investigate radioiodine accumulation in
NIS-transfected LNCaP cell xenografts in vivo and
to examine the therapeutic effectiveness of 131I
in vitro and in vivo for prostate cancer cells.
| MATERIALS AND METHODS |
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Establishment of Stable Transfected LNCaP Cell Lines.
Stable transfection of LNCaP cells was performed as described
previously (14)
. In brief, the androgen-sensitive human
prostatic adenocarcinoma cell line LNCaP was transfected with
NIS/PSA-pEGFP-1 and the control vectors
NIS-pEGFP-1 and PSA-pEGFP-1, respectively, using
LipofectAMINE Plus Reagent (Life Technologies, Inc., Gaithersburg, MD).
Selection was performed with geneticin, and surviving clones were
isolated and subjected to screening for androgen-dependent iodide
uptake activity. NP-1, the clone with the highest androgen-dependent
iodide uptake activity, was chosen for the following studies, as well
as the stably transfected (PSA-pEGFP-1) control cell line P-1
(14)
.
In Vitro Clonogenic Assay.
LNCaP cells stably transfected with the expression vector (NP-1) or the
control vector (P-1) were incubated for 7 h with 0.8 mCi
Na131I in HBSS supplemented with 10
µM NaI and 10 mM HEPES at pH 7.3. After
incubation with radioiodine, cells were trypsinized and plated in
quadruplicates at cell densities of 1000, 2000, 3000, 5000, and 7000
cells/well in 12-well plates. Four weeks later, after colony
development, cells were fixed with methanol and stained with crystal
violet, and colonies containing >50 cells were counted. Parallel
experiments were performed for each cell line using HBSS without
131I, and all values were adjusted for plating
efficiency. The percentage of survival represents the percentage of
cell colonies after 131I treatment compared with
mock treatment with HBSS. Results are expressed as mean ± SE of quadruplicates. Statistical significance was tested using
Students t test.
Establishment of LNCaP Cell Xenotransplants.
Xenotransplants derived from NP-1 (right flank) and P-1 (left flank)
were established in male BALB/c nu/nu mice (Harlan Sprague
Dawley, Indianapolis, IN) by s.c. injection of 1 x 106 cells suspended in 0.25 ml of RPMI 1640 and
0.25 ml of Matrigel Basement Membrane Matrix (Becton Dickinson,
Bedford, MA). Nude mice were maintained in our facility under specific
pathogen-free conditions with access to mouse chow and water ad
libitum. All experiments were performed in accordance with the
Institutional Animal Care and Use Committee guidelines of the
Mayo Clinic (Rochester, MN).
Western Blot Analysis.
Membrane proteins were prepared from LNCaP cell xenografts as described
previously (14)
and subjected to electrophoresis on a
412% Bis-Tris-HCl buffered polyacrylamide gel. After transfer of
proteins to nitrocellulose membranes by electroblotting, membranes were
preincubated in 5% low fat dried milk in TBS-T (20 mM
Tris, 137 mM NaCl, and 0.1% Tween 20). Western blot
analysis was performed using a mouse monoclonal antibody directed
against amino acid residues 468643 of human NIS (dilution 1:3000;
Ref. 16
) as described previously (14)
.
Immunohistochemistry.
Immunohistochemical staining of frozen tissue sections derived from
LNCaP cell xenografts was performed using the Vectastain Elite ABC kit
(Vector Laboratories, Burlingame, CA). After fixation of tissue
sections in cold acetone, inhibition of endogenous peroxidase activity,
and blocking of nonspecific binding with blocking serum for 30 min,
slides were incubated with the mouse monoclonal hNIS antibody at a
dilution of 1:1600 (16)
for 90 min. Tissue sections were
incubated with biotin-conjugated antimouse-immunoglobulin for 30 min at
room temperature, followed by incubation with preformed avidin and
biotinylated horseradish peroxidase macromolecular complex.
Diaminobenzidine was used as the chromogen (bluish-black precipitate).
Parallel control slides were examined with the primary and secondary
antibodies replaced in turn by PBS and isotype matched nonimmune IgGs.
Iodide Uptake Studies in Vivo.
Eight to 12 weeks after s.c. injection of transfected LNCaP cells, when
tumors had reached
10 mm in diameter, mice were switched to a
low-iodine diet and received T4 supplementation (5 mg/l) in their
drinking water for 2 weeks to maximize radioiodine uptake in the
tumor and reduce uptake by the thyroid gland. After i.p. injection
of 500 µCi 123I, radioiodine imaging was
performed using a gamma camera (Helix system; Elscint, Inc., Haifa,
Israel). Regions of uptake have been quantified and expressed as a
fraction of the total amount of the applied radioiodine. Iodide
retention time within the tumor was determined by serial scanning after
radioiodine injection, and dosimetric calculations were performed.
Radioiodine Therapy Study in Vivo.
Xenografts of NP-1 and P-1 cells were established in four groups
of mice (five mice in each group) as described above. One group of mice
(group 1) was administered 3 mCi 131I by a single
i.p. injection after 810 weeks of tumor growth (late tumors), and
another group of mice (group 2) was administered 3 mCi of
131I after 46 weeks of tumor growth (early
tumors). The other two groups of five mice were administered saline by
i.p. injections and were used as controls. Tumors were measured before
administration of radioiodine and weekly thereafter. Tumor volume was
estimated using the formula: tumor volume = length x width x height x 0.52 (17)
. All mice were followed for a total of 6
weeks. Tumor volumes of NP-1 tumors in the therapy groups were compared
with tumor volumes of P-1 tumors in the therapy groups and tumor
volumes of NP-1 and P-1 tumors in the control groups. Statistical
significance was tested using Students t test (for
unpaired samples: when examining between treated and untreated mice;
and for paired samples: when examining tumors within the same
mouse).
| RESULTS |
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20% of the P-1 cells were
killed by exposure to 131I,
75% of NP-1 cells
were killed (Fig. 1)
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10 mm in diameter, 500 µCi
123I were injected i.p. (n = 6), and radioiodine uptake by the tumors was monitored and
quantified by imaging with a gamma camera. In contrast to the control
P-1 tumors, which showed no in vivo uptake of radioiodine,
NP-1 tumors accumulated 2530% of the total radioiodine dose
administered (Fig. 2)
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350 rads after an i.p. application of a 1 mCi dose
of 131I (37 MBq). In comparison, the average
absorbed dose to stomach was
138 rads/mCi 131I
and approximately 450 rads/mCi 131I to the
thyroid gland.
Western Blot Analysis.
Using a mouse monoclonal hNIS-specific antibody, Western blot analysis
of membrane proteins derived from NP-1 cell xenografts revealed a band
of a molecular weight of Mr
90,000 [consistent with previously reported NIS protein
(16)
], which was not detected in P-1 cell xenografts
(data not shown).
Immunohistochemical Staining.
Immunostaining of frozen tissue sections derived from LNCaP cell
xenografts using a mouse monoclonal hNIS antibody revealed marked cell
membrane-associated hNIS-specific immunoreactivity in LNCaP cells in
NP-1 cell xenografts (Fig. 4A)
. In contrast, LNCaP cells in P-1 cell xenografts did not
show hNIS-specific immunoreactivity (Fig. 4B)
. Control
slides stained with primary and secondary antibodies replaced in turn
by PBS and isotype-matched nonimmune mouse immunoglobulin were
consistently negative (Fig. 4C)
.
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| DISCUSSION |
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Cloning and characterization of the hNIS gene offers the possibility of NIS gene transfer into nonthyroidal tumor cells, thereby inducing radioiodine accumulation and making imaging and treatment of nonthyroidal tumors with radioiodine possible (3 , 4 , 6) . This could offer a highly effective therapy that is remarkably free of adverse affects, except for transient and usually mild sialadenitis and depression of bone marrow activity (2 , 18) . Because thyroidal NIS expression is exquisitely thyroid-stimulating hormone sensitive (19 , 20) , pretreating the patients with thyroid hormone would suppress thyroid-stimulating hormone levels and thyroidal 131I uptake and thereby prevent hypothyroidism. Even if thyroidal radioiodine uptake would cause hypothyroidism, patients could be easily and inexpensively managed by thyroid hormone replacement therapy.
Recently, expression of functionally active NIS was reported in human glioma cells using adenovirus-mediated gene delivery (21) . Shimura et al. (22) reported transfection of malignantly transformed rat thyroid cells (FRTL-5 cells), which normally do not concentrate iodide, with a rat NIS cDNA expression vector. The resulting rat NIS-expressing FRTL-5 cell line accumulated 125I in vitro and in vivo (22) . Furthermore, Mandell et al. (23) demonstrated in vitro and in vivo iodide accumulation in several cancer cell lines, including melanoma, liver, colon carcinoma, and ovarian carcinoma cell lines, after transfection with the rat NIS gene. These data demonstrate the potential of NIS gene transfer to induce iodide accumulation activity in tumor cells, although the therapeutic efficacy of accumulated 131I remains to be investigated.
The purpose of the present study was to evaluate the efficacy of
prostate-specific NIS gene transfer as a novel form of gene
therapy in which tissue-specific radioiodine accumulation is induced in
prostate cancer cells. To maximize intratumoral cytotoxicity and
minimize extratumoral side effects, we used a prostate tissue-specific
promoter to target the NIS gene selectively to prostate
cancer cells. With the PSA gene being strictly regulated in
a tissue-specific and androgen-dependent manner, the PSA promoter,
which has been extensively characterized in recent years
(10, 11, 12, 13)
, provides an efficient means for prostate
cell-specific, androgen-regulated gene delivery (7, 8, 9)
.
Recently, using the PSA promoter, antisense gene delivery targeting DNA
polymerase-
and topoisomerase II
was shown to inhibit cell growth
specifically in human prostate cancer cells. In contrast, no
cytotoxicity was observed in five control nonprostatic cell lines
(24)
.
In our experiments, we stably transfected the human prostatic adenocarcinoma cell line LNCaP with an expression vector containing full-length NIS cDNA coupled to a 6-kb promoter fragment that has been shown recently to mimic, in transgenic mice, the prostate-specific and androgen-regulated expression of the endogenous PSA gene in humans (15) . Prostate cell-specific, androgen-regulated iodide uptake activity was demonstrated in LNCaP cell lines stably expressing NIS under the control of the PSA promoter in vitro (14) . In the current study, the amount of accumulated 131I has been shown to be sufficiently high to selectively kill NIS-transfected LNCaP cells in an in vitro clonogenic assay. These results are highly significant for transfected prostate cancer cells growing in a monolayer, considering that a great proportion of the ß-energy emitted from accumulated 131I is deposited outside from the monolayer. Radioiodine accumulation has further been confirmed in vivo in NIS-transfected LNCaP cell xenografts that accumulated 2530% of the total administered radioiodine with a biological half-life of 45 h. NIS protein expression was confirmed by Western blot analysis and immunohistochemistry. Considering a tumor mass of 1 g, a tumor dose of 350 rad/mCi 131I has been calculated, which is comparable with therapeutic doses achieved in thyroid metastases during radioiodine therapy with a 100150 mCi 131I therapy dose (25) . According to the dosimetry studies, a single therapeutic 131I dose of 3 mCi was administered and shown to elicit a dramatic therapeutic response in NIS-transfected LNCaP cell xenografts with an average volume reduction of >90% and complete tumor regression in up to 60% of the tumors.
In conclusion, a therapeutic effect of 131I has been demonstrated in prostate cancer cells after induction of tissue-specific iodide uptake activity by PSA promoter-directed NIS expression in vitro and in vivo. This study clearly demonstrates the potential of NIS to serve as a novel therapeutic gene in the therapy of nonthyroidal cancers, in particular metastatic prostate cancer.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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1 This study was supported in part by Grant Sp
581/1-1 (to C. S.) from the German Research Council (Deutsche
Forschungsgemeinschaft, Bonn, Germany), by NIH Grants DK 41995 and CA
70892 (to D. J. T. and C. Y. F. Y.), by a CaPCURE research award
(to J. C. M.), and by the Mayo Foundation. ![]()
2 To whom requests for reprints should be
addressed, at Division of Endocrinology, Mayo Clinic, Guggenheim 625,
200 First Street SW, Rochester, MN 55905. Phone: (507) 284-2324; Fax:
(507) 284-4521; E-mail: spitzweg.christine{at}mayo.edu ![]()
3 The abbreviations used are: PSA,
prostate-specific antigen; hNIS, human sodium iodide symporter. ![]()
Received 4/21/00. Accepted 9/20/00.
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