
[Cancer Research 60, 760-765, February 1, 2000]
© 2000 American Association for Cancer Research
Down-Regulation of the Insulin-like Growth Factor I Receptor by Antisense RNA Can Reverse the Transformed Phenotype of Human Cervical Cancer Cell Lines1
Keiichiro Nakamura,
Atsushi Hongo,
Junichi Kodama,
Yasunari Miyagi,
Mitsuo Yoshinouchi2 and
Takafumi Kudo
Department of Obstetrics and Gynecology, Okayama University Medical School, Okayama 700-8558, Japan
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ABSTRACT
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The insulin-like growth factor I receptor (IGF-IR) plays an essential
role in the establishment and maintenance of transformed phenotype, and
interference with the IGF-IR pathway by antisense or dominant-negative
mutants causes reversal of the transformed phenotype in many rodent and
human tumor cell lines. We stably transfected an IGF-IR antisense mRNA
expression plasmid into human papillomavirus (HPV)-negative C33a cell
line, HPV-16-positive SiHa cell line, and HPV-18-positive HeLa S3 cell
line to determine whether the IGF-IR could be a target for cervical
cancer cells, especially in the presence of HPV. Approximately 3080%
down-regulation of IGF-IR expression was observed by Western blot in
antisense transfected clones. There was a little inhibition in
monolayer growth in all cell lines. In C33a cells, wild-type and sense
clones formed 92146 colonies in soft agar after 3 weeks; antisense
clones formed <12 colonies. In SiHa cells, wild-type and sense clones
formed
60 colonies after 5 weeks; antisense clones formed 03
colonies. In HeLa S3 cells, wild-type and sense clones formed 218291
colonies in soft agar after 2 weeks; antisense clones formed 14160
colonies. There was a good correlation between IGF-IR down-regulation
level and inhibition of transformation in soft agar. Tumorigenesis in
nude mice was strongly inhibited in HeLa S3 and SiHa clones transfected
with the antisense. These results indicate that down-regulation of
IGF-IR by antisense RNA can reverse the transformed phenotype of human
cervical cancer cells, even when harboring malignant type HPVs.
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INTRODUCTION
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In recent years, it has become clear that
IGF-IR,3
activated by its ligands, plays different roles in vitro or
in vivo (1)
: (a) the IGF-IR is
mitogenic, although it is required for optimal growth in conjunction
with other growth factors, such as epidermal growth factor and
platelet-derived growth factor (2
, 3)
; (b) it
is quasi-obligatory for the establishment and maintenance of the
transformed phenotypes (4, 5, 6)
; and (c) it
protects cells from apoptosis induced by a large variety of mechanisms
(7, 8, 9, 10, 11)
. Interference with the expression and/or
activation of the IGF-IR by antisense strategies (12, 13, 14, 15, 16, 17)
,
dominant-negative mutants (18, 19, 20, 21)
, or triple-helix
formation (22)
reverse the transformed phenotype or
inhibit tumorigenicity in many rodent and human cancer cells.
Furthermore, antisense strategies (17)
, a myristylated
COOH terminus of the IGF-IR (23)
, and dominant-negative
mutants of the IGF-IR (20)
cause massive apoptosis
in vivo. Because substantial data support that normal cell
growth is much less dependent on the IGF-IR (1)
,
interference with the IGF-IR would be a good candidate for human gene
therapy in many types of tumors.
R- cells, originating from mouse embryo with a
targeted disruption of IGF-I receptor gene (24
, 25)
, are known to be refractory to transformation by several
viral and cellular oncogenes. SV40 T antigen, even with activated ras
(26
, 27)
, bovine papillomavirus E5 protein
(28)
, activated c-src (29)
, and other growth
factor receptors that are overexpressed (30
, 31)
fail to
transform R- cells. However, it was reported
that stable transfection of both E6 and E7 oncoproteins of HPV-16 could
transform R- cells in soft agar
(32)
. By using R- cells and their
wild-type littermate W cells, it has become clear that the IGF-IR is a
necessary requirement for the E7-induced transformation of these
fibroblasts (32)
. In R- cells,
combination of both E6 and E7 transforms R-
cells, indicating that E6 may be acting equally to the IGF-IR
(32)
. In the presence of both E6 and E7 in cervical cancer
cells, it is postulated that these two proteins might use an
alternative pathway for transformation, and that the interference with
the IGF-IR might result in failure to reverse the transformed
phenotypes of cervical cancer cells.
In cervical cancer cells, it is well known that in >85% of the
patients, the cells are positive for HPV (33
, 34)
. In
these cervical cancer cells with malignant-type HPVs, E6 protein may
play an alternative role for IGF-IR and promote E7-induced
transformation, even in the absence of IGF-IR (32)
. The
present study is undertaken to elucidate whether the IGF-IR targeting
can be used for reversal of the transformed phenotypes of cervical
cancer cells in vitro by stable transfection of an antisense
mRNA expression plasmid into HPV-positive and HPV-negative human
cervical cancer-derived cell lines.
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MATERIALS AND METHODS
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Cell Lines.
C33a, SiHa, and HeLa S3 are cell lines originally derived from human
cervical carcinomas. All of these cell lines were obtained from the
Department of Cell Biology, Institute of Cellular and Molecular
Biology, Okayama University Medical School. All of the cell lines were
passed in DMEM supplemented with 10% FBS. Status of HPV and major
tumor suppressor genes p53 and pRB in these cell
lines was characterized previously in detail. SiHa cells contain type
16 HPV, and HeLa S3 cells contain type 18 HPV. C33a cells do not
contain any types of HPV (35
, 36)
. SiHa and HeLa S3 cells
carry wild-type p53 and pRB. Only C33a cells have
p53 mutation at codon 273 and pRB in-frame
deletion in exon 20 (37)
. R+ cells
are R- cells stably transfected with human
IGF-IR and express about 9.0 x 105 receptors/cell (27
, 38) .
Plasmid Transfections.
The expression vectors HSP-IGF-IRS and HSP-IGF-IRAS (39)
produce sense or antisense mRNA to the first 309 bp of cDNA fragment of
IGF-IR including a 30-amino acid signal peptide sequence under the
control of Drosophila HSP70 promoter (40)
. Transfections
of plasmids were performed using Transfectam (Promega) under the strict
selection of G418. To establish stable transformants with higher copy
numbers, selection was performed at a permissive temperature of 34°C
in 2.0, 1.5, and 1.0 mg/ml G418 for HeLa S3, SiHa, and C33a cells,
respectively. Established clones were kept growing at 37°C until use.
Cell Growth in Monolayer.
Cells were plated at a concentration of 5 x 104 per 35-mm plate in DMEM containing 10% FBS.
After 24 h incubation at 37°C, cells were washed three times
with Hanks solution, and medium was replaced with SFM (DMEM
supplemented with 0.1% BSA and 50 µg/ml transferrin), or SFM with 20
ng/ml IGF-I (Life Technologies, Inc.), or DMEM with 10% FBS. Cells
were incubated for an additional 48 and 96 h, and cell numbers
were counted in a hemocytometer. For antisense and sense clones, cells
were passed several times at 39°C in advance, and then cells were
incubated in each condition for 48 h at 39°C and counted. All of
the points were the results of triplicate experiments.
Western Blotting.
Sense and antisense clones maintained at 37°C were shifted to either
34°C or 39°C. After several passages at each temperature, cells
were washed three times with Hanks solution and then incubated for an
additional 72 h in SFM. Fresh SFM was renewed every 24 h.
Subconfluent cells were lysed in a lysis buffer as described
previously. Fifty µg of total cell lysates were separated and
hybridized with anti-ß-subunit of IGF-IR (C-20; Santa Cruz
Biotechnology).
Colony Formation in Soft Agar.
Sense or antisense clones were passed several times in media without
G418 at 39°C prior to seeding in soft agar plates. HeLa S3-derived
clones were seeded at 5 x 103
cells/35 mm plate in DMEM supplemented with 10% FBS and 0.2% agarose
with 0.5% agarose underlay, and colonies >125 µm in diameter were
counted after 2 weeks incubation at 39°C. SiHa- and C33a-derived
clones were seeded at 3 x 104
cells/35-mm plate, and the same sized colonies were counted after 45
weeks incubation at 39°C.
Tumorigenesis in Nude Mice.
Cells were washed three times with Hanks solution and incubated in
SFM for 24 h, trypsinized, and washed twice with PBS. Cells
(5 x 106) were resuspended in 100
µl of sterile PBS and injected s.c. above the hind leg of male BALB/c
nude mice (Charles River Breeders).
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RESULTS
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IGF-IR Expression Levels in Cervical Cancer Cell Lines.
To determine expression levels of the IGF-IR in cervical cancer cell
lines, whole-cell lysates were collected from each cell line incubated
previously at 37°C. Fifty µg of lysates were separated on a 515%
gradient acrylamide gel and stained with anti-ß-subunit of IGF-IR
(Fig. 1)
. Lanes 1 and 5 show negative and positive
controls from lysates of R- cells and
R+ cells. The R+ lane was
intentionally overexposed to show the low expression levels of cervical
cancer cell lines. We used this Western blot for comparison rather than
Scatchard plot analysis since Scatchard plots were often erratic
because of the presence of abundant IGF binding proteins secreted from
cancer cell lines. C33a shows only a slight signal of the IGF-IR at
longer exposure (Fig. 1B)
. IGF-IR numbers were roughly
calculated from comparison by densitometry with several standard cell
lysates, the receptor numbers of which were already determined
(38)
and summarized in Table 1
.

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Fig. 1. Original IGF-IR expression levels in cervical cancer cell
lines. Expression levels of cervical cancer cell lines were evaluated
by Western blot. Fifty µg of each lysates were blotted with an
antibody to the ß-subunit of the IGF-IR. A: Lanes 1,
R- cells; Lane 2, C33a cells; Lane
3, HeLa S3 cells; Lane 4, SiHa cells;
Lane 5, R+ cells. B: Lane 1,
R- cells; Lane 2, C33a cells.
Arrow, the ß-subunit of the IGF-IR is detected as
Mr 97,000 protein above the
nonspecific bands.
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Table 1 IGF-IR expression levels in cervical cancer cell lines
Fifty µg of total lysates from each cell lines were blotted with the
anti-ß-subunit of the IGF-IR, and then the IGF-IR number of each cell
line was roughly calculated by densitometry by comparison with standard
cell lines (described in text).
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IGF-I Dependency of Cervical Cancer Cell Lines in Monolayer Growth.
Each cervical cancer cell line was incubated under various IGF-I
concentrations in monolayer, and their IGF-I ligand dependency was
evaluated (Fig. 2)
. Sole addition of IGF-I stimulated growth of all cell lines tested in
the study, and it depended on IGF-IR expression levels, shown in Table 1
. We repeated this experiment for the C33a cell line, which has the
lowest IGF-IR number, and confirmed that IGF-I stimulation had a slight
but definitely reproducible mitogenic effect.
Down-Regulation of IGF-IR Expression Levels by Antisense RNA.
Established stable clones with sense or antisense were shifted to
34°C or 39°C and passed several times. Because the transfected
IGF-IR antisense is controlled under the thermosensitive HSP70 promoter
(40)
, transcription of the antisense mRNA is on when
clones are kept at 39°C, and it is off at 34°C. After serum
deprivation for 72 h, lysates were collected from subconfluent
cells, and the difference between the two temperatures was compared on
Western blot. Fig. 3
shows the down-regulation of the IGF-IR expression in HeLa S3 antisense
clones. There is a large variety of down-regulation levels among
antisense clones. Because HeLa S3 cells express 744 times more IGF-IR
than the other two cervical cancer cell lines, integration of multiple
copy number seems necessary to get enough down-regulation for this cell
line. In SiHa clones with antisense transfected, IGF-IR signals at
39°C could not be detected. C33a cells express only a little amount
of receptor, and IGF-IR signal of either C33a antisense or C33a sense
clones could not be clearly detected after 60 min exposure (data not
shown).

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Fig. 3. Down-regulation of IGF-IR expression levels in HeLa S3
clones transfected with a plasmid expressing an antisense RNA to the
IGF-IR. Down-regulation of the IGF-IR by antisense is shown in the
Western blot, where cell lysates collected either at 34°C or 39°C
were stained with an antibody to the ß-subunit of the IGF-IR.
wt, wild type.
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Down-Regulation of IGF-IR Slightly Inhibited Mitogenicity in
Monolayer.
Sense and antisense clones, as well as wild-type cells of the three
cervical cancer cell lines, were examined for their mitogenicity in
monolayer. Cells were incubated at 39°C without G418 and used for the
study. Cell growth in SFM, SFM supplemented with 20 ng/ml IGF-I, and
DMEM with 10% FBS was assessed as percentage of increase after 48 h of incubation (Fig. 4)
. Although there are some clonal variations, antisense clones of these
three cell lines showed slightly inhibited monolayer growth than
wild-type and sense transfected clones. Antisense clones showed
20%
inhibition on the average but was not statistically significant.
IGF-IR Antisense RNA Suppressed Colony Formation in Soft Agar.
Sense, antisense, and wild-type cells of these three cervical cancer
cell lines were passed several times at 39°C, seeded into 0.2% soft
agar plates, and incubated at 39°C. HeLa S3 cells were originally
highly transforming, and 5 x 103
wild-type cells seeded in a 35-mm plate formed many colonies after 2
weeks of incubation. SiHa and C33a cells were much less transforming,
so that cells at higher density (3 x 104 per 35-mm plate) and longer incubation time
(4 weeks for C33a and 5 weeks for SiHa) were necessary to obtain enough
colonies, again confirming the much higher expression level of the
IGF-IR in HeLa S3 cells. Colony number in soft agar is summarized in
Table 2
. In SiHa- and C33a-derived clones, the original IGF-IR expression
levels of which were low, there is significant difference in colony
formation in soft agar between antisense transfected clones and sense
clones or wild-type cells. In HeLa S3 cells expressing much higher
IGF-IR, colony numbers of antisense clones vary from 14 to 160.
Suppression of transforming ability in soft agar and levels of the
IGF-IR down-regulation estimated by Western blot are compared in Fig. 5
. There is a good correlation between colony numbers in soft agar and
IGF-IR expression levels, indicating that the integration of large copy
numbers of antisense RNA-expressing plasmid is necessary to achieve
enough down-regulation of the IGF-IR and to reverse transforming
phenotype of these aggressive HeLa S3 cells.
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Table 2 Transformation in soft agar of cervical cancer-derived clones
Cells (5 x 103) for HeLa S3-derived clones and
3 x 104 cells for SiHa- and C33a-derived clones
were plated in 0.2% soft agar plates. Colonies >125 µm in diameter
were counted after 2, 5, and 4 weeks incubation for HeLa S3, SiHa, and
C33a clones, respectively.
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Tumorigenesis in Nude Mice.
The inhibitory effect of the IGF-IR antisense was then tested by
injections of transfected clones into nude mice. Because C33a wild-type
cells are not tumorigenic in nude mice, only HeLa S3- and SiHa-derived
clones were tested. HeLa S3 wild-type and sense clones formed palpable
tumors 23 days after injection, and balky tumors progressed rapidly.
In contrast, representative antisense clones did not form any tumors
until 1 week, and very small palpable tumors (<2 mm in diameter)
remained unchanged for 4 weeks (Fig. 6)
. SiHa wild-type and sense clones formed palpable tumors after 1 week
to 10 days and grew slowly; SiHa antisense clones did not form any
tumors after 4 weeks.

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Fig. 6. Tumorigenicity of HeLa S3-derived clones in nude mice.
Three representative antisense transfected clones as well as sense
clones and wild-type cells were injected s.c. into nude mice, and their
tumorigenicity in vivo was monitored until 4 weeks after
injection. AS, antisense.
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DISCUSSION
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Genomic integration of high-risk types of HPV has been strongly
associated in cervical and other anogenital malignancies
(33)
. It is well known that the oncogenic properties of
malignant HPVs depend on the E6 and E7 proteins, which are capable of
inactivating two major suppressor genes, p53 and
pRB. E6 binds to p53 and promotes its
ubiquitin-dependent proteolysis (41)
. E7 binds
preferentially to hypophosphorylated pRB and inhibits
binding of pRB to transcriptional factor E2F
(42)
. Although E6 and/or E7 are known to transform NIH 3T3
cells and immortalize human primary cultured keratinocytes
(43)
, E6 and E7 are not enough for carcinogenesis. Within
the high-risk HPV-positive lesions, where both tumor suppressor
proteins pRB and p53 are functionally inactivated by the expression of
E6 and E7 proteins, only a small number of the lesions will progress to
carcinomas. As another causative alteration, frequent loss of
heterozygosity in chromosomal arms likely to harbor other tumor
suppressor genes is reported from human cervical intraepithelial
neoplasia patient specimens (44)
.
IGF-I and IGF-IR also play an important role in cell transformation
induced by viral oncogenes (45)
. SV40 T antigen induces
constitutive tyrosyl autophosphorylation of the IGF-IR
(46)
. SV40 T antigen up-regulates IGF-I ligand expression
and binds directly to IRS-1, the major downstream substrate of the
IGF-IR (47)
. v-src also induces marked tyrosyl
autophosphorylation of the IGF-IR (48)
. BPV E5 directly
binds and activates platelet-derived growth factor ß receptor
(49)
and might transactivate IGF-IR through the
platelet-derived growth factor ß receptor (31)
. The fact
that R- cells are refractory to transformation
by these viral oncogenes is striking (26
, 28)
. The only
viral oncogene that is reported to transform R-
cells by itself is the coexpression E6 and E7 of HPV-16 and v-src thus
far (29
, 32) . Interestingly, SV40 T antigen, which does
not transform R- cells, is known to suppress
both pRB and p53, similar to E6 and E7 of HPV. E6 binds to p53 and
induces its degradation, whereas SV40 T antigen just binds stably to
p53 and inactivates its function. The difference between HPV E6/E7 and
SV40 T antigen in transforming ability in the absence of the IGF-IR
still remains unknown. E6 was reported to have a protective effect from
staurosporine-induced apoptosis, even in p53-/- cells, indicating the
probability of a p53-independent pathway of E6 for cell survival
signaling (32)
. In contrast, the IGF-IR is also reported
to have strong protective effects against apoptosis induced by a large
variety of causes (7, 8, 9, 10, 11)
. Steler et al.
(32)
hypothesized that the IGF-IR and E6 were functionally
equivalent in transformation. It is likely that overexpressing E6 and
E7 substitute the transforming ability of the IGF-IR, but a
mechanism(s) of E6 and E7 for transforming R-
cells involves not only the abrogation of two major suppressor gene
functions but also substitution of some other properties of the IGF-IR.
If E6 cooperates with E7 to send transforming and antiapoptotic
signaling that is independent of the IGF-IR pathways, interference with
the IGF-IR cannot be effective for transformed cells harboring
malignant type HPVs, such as cervical cancer cells.
The present study shows that the down-regulation of the IGF-IR by
antisense strategy is effective in the reversal of transformed
phenotypes in vitro and in vivo for human
cervical cancer cell lines in the presence (HPV-16 in SiHa and HPV-18
in HeLa S3) and absence (C33a) of HPV. Antisense oligonucleotide for
HPV-16 E6 and E7 (50)
, antisense RNA against HPV-16 E6/E7
(51)
, and single-chain antibody against HPV-16 E7
(52)
were tried previously in SiHa cells, and they all
inhibited transformation. But all of them were tried in SiHa cells,
which contain only one to two copies of integrated HPV-16 DNA and
express relatively low amounts of IGF-IR (Table 1)
. In contrast, HeLa
S3 cells contain
50 copies of integrated HPV-18 and express huge
numbers of the IGF-IR (Table 1)
. HeLa S3 cells are highly transforming
and make many more colonies in soft agar than SiHa cells. In SiHa and
C33a cells, with lower IGF-IR expression and lower or no HPV
integration, stable expression of the antisense mRNA against the IGF-IR
resulted in marked suppression of colony formation in soft agar. In
HeLa S3 clones with an antisense effect against the IGF-IR, some clones
still formed colonies when the antisense effect was not overwhelming.
But results from antisense clones with sufficient down-regulation of
the IGF-IR were promising, and suppression of colony formation in soft
agar was closely correlated with the down-regulation of the IGF-IR.
Furthermore, it is clear that this biological effect on antisense
clones is not attributable to the toxicity of overexpressing mRNAs,
because no toxicity is observed in sense clones, and its action depends
mainly on the condition of anchor independence. Although there is
variation in the IGF-IR expression levels and integrated HPV copy
numbers among human cervical cancer cells, our data from HeLa S3 clones
clearly show that down-regulation of the IGF-IR, if sufficient, can
reverse transformed phenotypes of cervical cancer cells, even with
malignant-type HPVs.
Targeting the IGF-IR for cervical cancer cells seems ideal, now that it
is confirmed that it can reverse transformed phenotypes, even in the
presence of high copy number of malignant-type HPV, because:
(a) it can be widely applied for all types of cervical
cancer cells, regardless of specific HPV subtypes; (b) it
can be also used in the absence of HPV; (c) normal cells are
less dependent on the IGF-IR for growth; and (d)
antimitogenic, antitransforming, and proapoptotic effects arising from
interference with the IGF-IR pathways are usually more dramatically
emphasized in vivo than in vitro.
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ACKNOWLEDGMENTS
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We thank Dr. R. Baserga, Kimmel Cancer Center, for kindly
providing HSP-IGF-IRS and AS (or HSP-EGF-ERAS) expression vectors,
R- and R+ cells.
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FOOTNOTES
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
1 Supported in part by Grant-in-Aid for Scientific
Research 10671544 (to A. H.) and Grant 09671684 (to M. Y.) from the
Ministry of Education, Science, Sports and Culture of Japan. 
2 To whom requests for reprints should be
addressed, at Department of Obstetrics and Gynecology, Okayama
University Medical School, 2-5-1 Shikata, Okayama 700-8558, Japan.
Phone: 81-86-235-7890; Fax: 81-86-225-9570. 
3 The abbreviations used are: IGF-IR, insulin-like
growth factor I receptor; FBS, fetal bovine serum; HSP, heat shock
protein; SFM, serum-free medium; HPV, human papillomavirus. 
Received 8/16/99.
Accepted 12/ 2/99.
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