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Advances in Brief |
Howard Hughes Medical Institute [P. B., C. R., B. V.] and Johns Hopkins Oncology Center [B. S. C., K. E. R., S. S., L. Z., B. V., K. W. K.], Johns Hopkins Medical Institutions, Baltimore, Maryland 21231
| ABSTRACT |
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20-fold in adenomas, 40 transcripts were elevated
20-fold in cancers, and 9 transcripts were elevated
20-fold in both. Products of six of these nine transcripts (TGFBI, LYS, RDP, MIC-1, REGA, and DEHL) were predicted to be secreted or to reside on the cell surface, and these were analyzed in more detail. The abnormal expression levels predicted by serial analysis of gene expression were confirmed by quantitative PCR analyses of each of these six genes. Moreover, the cell types responsible for the elevated expression were identified by in situ hybridization and by PCR analyses of epithelial cells immunoaffinity purified from primary tumors. This study extends knowledge of the differences in gene expression that underlie various stages of neoplasia and suggests specific diagnostic approaches that may be useful for the early detection of colorectal neoplasia. | Introduction |
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135,000 patients diagnosed each year and
55,000 ultimately succumbing to the disease (1)
. Most colorectal cancers develop slowly, beginning as small benign colorectal adenomas that progress over several decades to larger and more dysplastic lesions that eventually become malignant. This gradual progression provides multiple opportunities for prevention and intervention. Indeed, benign adenomas can be detected and removed by simple colonoscopy and polypectomy, precluding the need for radical surgical and adjuvant treatments. It is therefore believed that early detection and removal of these benign neoplasms provide the best hope for minimizing morbidity and mortality from colorectal cancer. Various screening methods for detecting early colorectal tumors are available, such as fecal occult blood testing, sigmoidoscopy, and colonoscopy (reviewed in Ref. 2
). However, none of these methods are optimal, and new approaches are needed. In an effort to identify potential molecular markers of early colorectal tumors, we have here analyzed gene expression in benign and malignant colorectal tumors in an unbiased and comprehensive fashion. Our results, which are reported below, demonstrate that several genes are expressed at markedly higher levels in both benign and malignant tumors compared with normal colonic epithelium. Furthermore, several of the most differentially expressed genes are extracellular, thereby providing opportunities for clinical application. | Materials and Methods |
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Quantitative PCR.
Tumors were collected, snap frozen, and stored at -80°C. They were verified to be composed predominantly of neoplastic cells by histopathological analysis. mRNA was isolated from tumors and patient-matched normal colonic mucosa using QuickPrep reagents (Amersham Pharmacia Biotech UK, Buckinghamshire, United Kingdom), and single-stranded cDNA was synthesized using Superscript II (Life Technologies, Inc.). Quantitative PCR was performed using an iCycler (Bio-Rad, Hercules, CA), and threshold cycle numbers were determined using iCycler software, version 2.1. Reactions were performed in triplicate, and threshold cycle numbers were averaged. All genes examined were normalized to a control gene (ß-amyloid precursor protein, shown by SAGE to be expressed at equivalent levels in all colorectal samples), and fold induction was calculated according to the formula 2(Rt-Et)/2(Rn-En) where Rt is the threshold cycle number for the reference gene observed in the tumor, Et is the threshold cycle number for the experimental gene observed in the tumor, Rn is the threshold cycle number for the reference gene observed in the normal tissue, and En is the threshold cycle number for the experimental gene observed in the normal tissue. The primers used for quantitative PCR were obtained from GeneLink (Hawthorne, NY), and their sequences are available on request.
Epithelial Cell Immunoaffinity Purification.
Tumor epithelial cells were purified using a modification of the procedure developed previously for the isolation of tumor endothelial cells (6)
. In brief, fresh surgical specimens of tumor and matched normal tissue were obtained and digested with collagenase, and the resulting material was filtered through a nylon mesh to obtain single cell suspensions. The cells were then bound to a mixture of anti-CD14 and anti-CD45 immunomagnetic beads (Dynal, Oslo, Norway) to deplete the population of hematopoietic cells (negative selection). The remaining cell suspension was then incubated with anti-Ber-EP4 immunomagnetic beads to isolate epithelial cells (positive selection). Purified cells were lysed directly on the beads, and mRNA was purified using QuickPrep reagents (Amersham Pharmacia Biotech UK).
In Situ Hybridization.
Nonradioactive in situ hybridization was performed as described previously (6)
. For each gene analyzed, a mixture of antisense probes made through in vitro transcription was used to increase sensitivity. The primers used to generate templates for the synthesis of the in situ riboprobes were obtained from GeneLink, and their sequences are available on request.
| Results and Discussion |
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20-fold in the adenomas, and 40 were elevated by
20-fold in the cancers (Table 2)
20-fold in adenomas, and 52 transcripts were decreased by
20-fold in the cancers (Table 2)
There were 9 transcripts that were elevated by
20-fold in both adenomas and cancers (Fig. 1B
and Table 3
) and 23 that were repressed by
20-fold (Table 4)
. We were especially interested in genes whose products were predicted to be secreted or displayed on the cell surface because these would be particularly suitable for the development of serologic or imaging tests for presymptomatic neoplasia, respectively. We were able to identify six such genes (TGFBI, LYS, RDP, MIC-1, REGA, and DEHL) from among those whose transcript tags were elevated in both adenoma and carcinoma SAGE libraries. These genes were analyzed further, as described below.
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20-fold higher levels of the studied transcripts compared with their patient-matched normal colonic mucosa, as predicted by SAGE. Another control was provided by the quantitative PCR analysis of four genes whose expression was observed to be reduced in the SAGE libraries prepared from adenomas and cancers compared with those from normal colonic mucosa. As shown in Fig. 3
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Regenerating islet-derived pancreatic stone protein, encoded by the REGA gene, is a secreted polypeptide first found in pancreatic precipitates and stones from patients suffering from chronic pancreatitis (7)
. The cDNA encoding this protein was isolated from a random screen of genes highly expressed in a regenerating islet-derived cDNA library (8)
and subsequently shown to be elevated in colorectal cancers (9)
. More recently, REGA was isolated in a hybridization-based screen for genes elevated in colorectal cancers and shown to be elevated in many colorectal adenocarcinomas (10)
. Consistent with these published observations, we observed a strong elevation in expression of REGA in unpurified tumors and a similar elevation in one purified tumor. In situ hybridization experiments demonstrated REGA to be strongly expressed in the epithelial cells of the tumors, with no expression evident in the stroma (Fig. 5A)
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Lysozyme (LYS, 1,4-ß-N-acetylmuramidase; EC 3.2.1.17) is an enzyme with bacteriolytic activity (14)
capable of cleaving ß1,4 glycosidic bonds found in the cell walls of Gram-positive bacteria. The enzyme is expressed in the secretory granules of monocytes, macrophages, and leukocytes, as well as in the Paneth cells of the gastrointestinal tract. Fecal lysozyme levels are dramatically elevated in patients with inflammatory bowel disease (15
, 16)
, and serum lysozyme activity is significantly elevated in patients with sarcoidosis (17)
, both of which are diseases characterized by aberrant chronic inflammation. Furthermore, lysozyme immunoreactivity has been observed in the epithelial cells of both adenomas and carcinomas of the large intestine (18)
. In our study, the degree of elevation of expression of LYS varied from 4-fold to 55-fold in the unpurified samples. In contrast, the degree of elevation of expression of LYS observed in purified epithelial cells was only 25 fold. This suggested that a substantial portion of the expression for this gene in the tumors could have been derived from nonepithelial cells. Consistent with this hypothesis, in situ hybridization experiments revealed that the majority of LYS mRNA was present in a stromal component that appeared to be macrophages (Fig. 5C)
. The expression of LYS in the macrophage compartment of colorectal tumors was also supported by its high representation in a SAGE library constructed from hematopoietic cells (CD45+, CD64+, and CD14+) purified from colorectal tumors (602 LYS tags/56,643 total tags; Ref. 6
).
One interesting gene identified in the current study is renal dipeptidase (RDP). RDP is a glycosylphosphatidyl inositol-anchored enzyme whose major site of expression is the epithelial cells of the proximal tubules of the kidney (reviewed in Ref. 19
). The enzyme has been extensively analyzed with respect to its catalytic mechanism and inhibition kinetics by a variety of synthetic inhibitors. RDP is unique among the dipeptidases in that it can cleave amide bonds in which the COOH-terminal partner is a D-amino acid, providing an excellent opportunity for the development of specific probes for its detection in vivo. Quantitative PCR revealed RDP to be markedly elevated in both unpurified and purified tumor epithelial cells, and in situ hybridization experiments showed that RDP was localized exclusively to epithelial cells of colorectal tumors (Fig. 5D)
.
Macrophage inhibitory cytokine (MIC-1) is a small polypeptide of Mr 16,000 first isolated from a differential screen for genes that were induced on macrophage activation (20)
. Concurrently, it was identified by a search for molecules homologous to the bone morphogenic protein/TGF-ß family of growth and differentiation factors (21)
. In addition to being highly expressed in activated macrophages, MIC-1 has been noted to be highly expressed in placenta and the epithelial cells of normal prostate. In the current study, we found MIC-1 expression to be elevated between 7- and 133-fold in the unpurified tumors. As observed for LYS, the purified tumor cells demonstrated significant but less elevation of expression of MIC-1 (57-fold), indirectly implicating stromal expression to be partly responsible for the dramatic elevation seen in some tumors. Consistent with this hypothesis, in situ hybridization experiments revealed expression in both the epithelium of the tumor and a cell type resembling infiltrating macrophages (Fig. 5E)
.
The results summarized above show that although a large number of tags are observed in the colorectal tissues analyzed, only a small fraction (957 of 21,343; <5%) were expressed differentially in benign or malignant neoplastic tissues. A similarly small fraction of genes [66 of 4000 (1.7%)] were found to be aberrantly expressed in colorectal neoplasms using oligonucleotide arrays (22) . Analysis of these differentially expressed genes not only has the potential to provide insights into the biology of human neoplasia but may also have clinically useful applications. One of the most exciting potential applications concerns the identification of genes whose products provide cellular and serum markers for colorectal neoplasia. The ideal tumor marker would be expected to have several characteristics. First, it should be expressed at high levels in tumors and at greatly reduced levels in normal tissues. Second, the elevated expression should occur early and remain elevated during the neoplastic process. Third, such a marker should be elevated in the majority of clinical samples. Fourth, the marker should be expressed on the cell surface or secreted to facilitate its detection. Previous application of a subset of these criteria led to the identification of a marker that was elevated in the serum of patients with pancreatic cancer (23) . In the current study, we identified several genes that appeared to meet all of these criteria and may therefore be especially useful for the development of diagnostic tools for the early detection of presymptomatic colorectal neoplasia. Indeed, the product of one of these genes (MIC-1) has recently been found to be elevated in the serum of patients with colorectal and other cancers, providing further validation of this approach.6
| FOOTNOTES |
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1 Supported by NIH Grants CA43460, CA57345, and CA62924. K. W. K. received research funding from Genzyme Molecular Oncology (Genzyme), and K. W. K. and B. V. are consultants to Genzyme. Under a licensing agreement between the Johns Hopkins University and Genzyme, the SAGE technology was licensed to Genzyme, and K. W. K. and B. V. are entitled to a share of royalty received by the Johns Hopkins University from sales of the licensed technology. The SAGE technology is freely available to academia for research purposes. The Johns Hopkins University, K. W. K., and B. V. own Genzyme stock, which is subject to certain restrictions under university policy. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies. ![]()
2 To whom correspondence should be addressed, at The Johns Hopkins Oncology Center, Cancer Research Building Room 588, 1650 Orleans Street, Baltimore, MD 21231. Phone: (410) 955-2928; Fax: (410) 955-0548; E-mail: kinzlke{at}jhmi.edu ![]()
3 The abbreviations used are: SAGE, serial analysis of gene expression; TGF, transforming growth factor. ![]()
5 www.sagenet.org/sage_protocol.htm. ![]()
6 D. A. Brown, T. Liu, R. L. Ward, N. J. Hawkins, W. D. Fairlie, A. R. Bauskin, P. J. Russell, D. I. Quinn, J. J. Grygiel, A. G. Moore, R. L. Sutherland, J. Turner, E. A. Kingsley, and S. N. Breit. Macrophage inhibitory cytokine-1 (MIC-1) in epithelial neoplasia, submitted for publication. ![]()
Received 6/22/01. Accepted 8/ 2/01.
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