
[Cancer Research 61, 823-826, February 1, 2001]
© 2001 American Association for Cancer Research
PAX3 Is Expressed in Human Melanomas and Contributes to Tumor Cell Survival1
Florence A. Scholl,
Jivko Kamarashev,
Omar V. Murmann,
Ralf Geertsen,
Reinhard Dummer and
Beat W. Schäfer2
Division of Clinical Chemistry and Biochemistry, Department of Pediatrics, University of Zurich [F. A. S., O. V. M., B. W. S.], Department of Dermatology, University Hospital [J. K., R. G., R. D.], and Medica, Department of Molecular Diagnostics [R. G.], CH-8032 Zurich, Switzerland
 |
ABSTRACT
|
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Deregulated expression of the transcription factor PAX3 was
observed previously in several tumors like rhabdomyosarcoma and
Ewings sarcoma. Because PAX3 expression is also found in pluripotent
neural crest cells, we investigated whether melanomas, tumors derived
mostly from cutaneous intraepidermal melanocytes, might show
deregulated PAX3 expression. Using a specific and sensitive reverse
transcription-PCR, we detected PAX3 mRNA in 77% (27 of 35) of primary
cultured melanomas. These results could be confirmed by direct
in situ hybridization on the corresponding tissue
sections where PAX3 expression was unambiguously confined to tumor
cells and not detected in surrounding normal tissue, normal skin
sections, or sections of benign lesions. Furthermore, down-regulation
of PAX3 expression achieved through a specific antisense
oligonucleotide-based treatment resulted in >70% of dead cells
specifically in PAX3-positive melanomas. Annexin V staining confirmed
that primary melanoma cells underwent apoptosis after treatment. These
experiments suggest that in situ hybridization of PAX3
on paraffin-embedded tissue may represent a novel means to identify
melanoma cell lesions, which appear to become dependent on expression
of this deregulated transcription factor.
 |
Introduction
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Melanoma is a tumor with increasing incidence whereby advanced
disease is associated with a poor prognosis and responds very poorly to
treatment modalities including chemotherapy and immunotherapy
(1)
. Despite the availability of a fair number of marker
genes/proteins (e.g., melanA/MART-1, MAGE-3, and
tyrosinase), there is a need to identify proteins involved in the
conversion from benign to malignant disease and in tumor cell survival.
These factors should have diagnostic or prognostic implications and
might also be functionally important for tumor development.
PAX proteins are developmentally expressed transcription factors that
play a fundamental role in the establishment of cell lineages. Their
importance has been underscored by several loss-of-function mutations
that usually lead to a lack of the specific structures or organs where
a PAX protein is normally expressed (2)
. For example, PAX3
is expressed during normal development in specific areas of the neural
tube, sensory organs, and the dermomyotome. A naturally occurring PAX3
loss-of-function mutation in mice (Splotch Sp) exhibits
severe pigmentation defects and fails to establish hypaxial skeletal
muscle cells (3)
. Homozygous affected mice die shortly
after birth. Mutations in the human PAX3 gene cause
Waardenburg syndrome, which is characterized by pigmentation
abnormalities and hearing impairment attributable to the absence of
melanocytes (4)
.
Apart from the normal physiological role during development, several
PAX genes are reexpressed in malignant neoplasms
(5)
, e.g., PAX3 in rhabdomyosarcoma
and in Ewings sarcoma (6)
, PAX5 in
medulloblastoma and lymphomas, and PAX2 and PAX8
in renal cell carcinoma and Wilms tumor. Because PAX3 is expressed
during development in proliferating melanocyte precursor cells, it
might be reexpressed in melanomas, analogous to the situation in
rhabdomyosarcoma. In this report, we demonstrate that PAX3 is indeed
deregulated in the majority of melanomas analyzed by
RT-PCR3
as well as in situ hybridization on paraffin-embedded tissue
sections and contributes to tumor cell survival.
 |
Materials and Methods
|
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Cell Culture.
A total of 35 primary cultures established from melanoma lesions of
patients in different stages and five melanoma cell lines were cultured
as monolayers at 37°C and 5% CO2 in RPMI 1640
(Life Technologies, Inc.) supplemented with 10% fetal bovine serum and
100 units/ml penicillin/100 µg/ml streptomycin as described
previously (7)
.
Analysis of RNA Transcripts.
Total RNA extraction and RT-PCR reactions were performed as described
previously (8)
. RNA integrity was checked by amplification
of the ubiquitous FKHR cDNA. RT-PCR was also performed to monitor the
presence of the melanoma-associated antigens MAGE-3, melanA, and
tyrosinase mRNA, as described previously (7
, 9)
.
In Situ Hybridization.
The phPAX3-sp6 plasmid containing 152 bp of human PAX3
(10)
was linearized with EcoRI to synthesize
biotin-14-CTP-labeled antisense RNA (MAXIscript; Ambion, Inc.).
In situ hybridization of paraffin sections was performed as
detailed in the instruction manuals of the mRNAlocator-Hyb and
mRNAlocator-biotin kit (Ambion, Inc.). Briefly, sections were
hybridized overnight at 55°C, and the detection reaction was
performed for 6 h at 37°C.
ODN Incubation.
ODN treatment was performed as reported earlier (11)
. The
ODNs were synthesized as phosphothioate molecules by Microsynth
(Balgach, Switzerland), purified over a reversed phase column and
resuspended in TE (10 µM Tris-HCl, 1 mM EDTA,
pH 7.5).
Apoptosis Assay.
An Annexin V-FITC kit (BenderMedSystems, Vienna, Austria) was used to
assess apoptotic cells. Sixty-five h after ODN treatment, cells were
washed with DMEM and stained for 10 min at room temperature with
Annexin V-FITC according to the manufacturers instructions.
 |
Results
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PAX3 Expression in Melanoma Cell Lines.
To test initially whether PAX3 mRNA is expressed in melanomas,
several cell lines were screened by RT-PCR. Indeed, three of the five
investigated cell lines were found to be positive for PAX3 expression,
i.e., MEL15, G-361, and UKRV-Mel2 (Fig. 1A)
. No PAX3 expression was detected in the other two
melanoma-derived cell lines (A365 and Küng-A375). Hence, 60% of
the investigated melanoma cell lines expressed PAX3 mRNA.

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Fig. 1. A, expression of PAX3 in human melanoma
cell lines. Total RNA (100 ng) for each RT-PCR reaction was used,
whereas FKHR was amplified as an internal control for RNA quality.
RT-PCR products were loaded on 2% agarose gels and stained with
ethidium bromide. As a marker, a 100-bp ladder was used.
B, viability of melanoma cell cultures treated with
lipofectin ( ), MS-ODN ( ), and AS-ODN ( ). Cells were treated
with 1 µM ODN and 10 µg of lipofectin or with
lipofectin alone and counted after 72 h. At least three
independent experiments were carried out for each treatment, and each
experiment was performed in triplicate; bars, SD.
C, morphology of melanoma cells 72 h after start of
the ODN treatment. Küng A375 and 980928 melanoma cells were
treated with either lipofectin alone or in combination with 1
µM MS-ODNs or AS-ODNs. D, detection of
apoptosis after AS-ODN treatment. Annexin V-FITC labeling of 980928
(AD) and A365 (EH) cells 65 h
after incubation with 1 µM of either AS-ODN
(C, D, G, and
H) or MS-ODN (A, B,
E, and F). A,
C, E, and G are phase
contrast pictures.
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PAX3 Expression in Cultured Melanomas.
Because expression of PAX3 was found only in some of the melanoma cell
lines analyzed, we next asked whether PAX3 expression might depend on a
given tumor stage or is a property of established cell lines only. To
this end, cultured primary melanomas established from different stages
and locations from a cohort of patients were analyzed (7)
.
From 35 melanoma cultures analyzed totally, 27 were found to express
PAX3 representing 77% of all investigated tumors (Table 1)
. The highest prevalence of PAX3 expression was found in stage III
tumors, where 11 of 12 (92%) of all cultures analyzed were PAX3
positive. In stage I, 9 of 11 (82%), and in stage II, 7 of 12 (58%),
melanoma cultures expressed detectable levels of PAX3.
To investigate whether PAX3 expression changes with time of tumor
progression and to test whether a correlation exists with other
melanoma markers, cultured melanomas established from the same patients
at different disease stages were analyzed (Table 2)
. In four of eight patients analyzed, an increase in PAX3 expression
was found in more advanced tumors (patients II, III, V, and
VII), whereas three patients had no alterations in the
levels of PAX3 expression (patients IV, VI, and VIII). Finally, one
patient lost PAX3 expression in a more advanced stage (patient I).
However, there was no correlation either with expression of the
melanoma-specific antigens melanA, MAGE-3, nor with tyrosinase. Hence,
PAX3 expression identifies a distinct subset of melanomas.
PAX3 Expression in Tumor Sections.
To ensure that expression of PAX3 in short-time melanoma cultures
does accurately reflect expression in the tumor tissue, in
situ hybridization of paraffin tissue sections with a
PAX3-specific antisense probe was performed. Sections from the original
tumors of the same biopsy that were used to establish melanoma cultures
from a total of 10 different lesions were hybridized. Six of these were
found to be positive for PAX3 (950728, 961127, 960306, 960819, 961209,
and 980513), whereas four tumors showed no PAX3 expression (950504,
961205, 970917, and 980229). Hence, the in situ
hybridization data correlate perfectly with the RT-PCR results of the
cultured melanomas (Table 1)
. As an example, a PAX3-positive (980513)
tumor is shown hybridized with antisense or sense probe (Fig. 2A and B
, respectively). A PAX3-negative (970917)
metastasis is shown in Fig. 2C
. Intriguingly, PAX3
expression was confined to malignant metastases and not observed in the
surrounding normal tissue (Fig. 2E)
. Also, in PAX3-negative
tumors, only melanin deposits can be seen, and tumor cells are clearly
negative (Fig. 2F)
. When tumor and normal skin are present
in the same sections and tumor cells are clearly positive (Fig. 2D)
, epidermis including melanocytes is negative (Fig. 2G)
. To further confirm that PAX3 expression is confined to
malignant cells, several benign nevi have been analyzed including
dysplastic, compound, dermal, and junctional nevi (Fig. 2, H and I)
. No PAX3 expression was detected in these lesions.
Hence, the expression of PAX3 is restricted to malignant melanomas
already at early stage I as well as their distant metastases and not
detected in normal skin melanocytes or benign lesions.

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Fig. 2. Detection of PAX3 expression in melanomas by in
situ hybridization. Tissue sections from malignant metastasis
(A, positive sample 980513; B, control
staining with sense probe of the same tumor; C, negative
sample 970917; D, positive sample 960819; and
E, positive sample 950728) and primary tumor
(F, negative sample 961205) were hybridized with a
biotinylated PAX3-specific antisense riboprobe. G, a
different portion from the same section as shown in D.
H and I, benign lesions, dysplastic, and
compound nevi, respectively. Positive reaction is indicated by the
blue stain; the brown stain is caused by
melanin deposits. AC and
E, x200; D, F, and
GI, x100.
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Survival of Melanoma Cells Depends on PAX3 Expression.
We described previously that PAX3 expression in rhabdomyosarcoma, a
childhood tumor associated with myogenic precursor cells (10
, 12) , provides a critical survival function (11)
.
Therefore, we hypothesized that expression of PAX3 in melanomas might
also affect cell survival. To test this, different melanoma cell lines
were treated with oligonucleotides designed to down-regulate PAX3
expression, and cell survival was monitored by counting after trypan
blue exclusion. To determine liposome and ODN toxicity, cells were
incubated with lipofectin alone and with MS-ODN (Fig. 1B)
.
Incubating PAX3-positive cells with specific AS-ODNs resulted in
dramatically reduced cell viability (down to 2832%; Fig. 1B
). In contrast, AS-ODN treatment of PAX3-negative cells
had no effect on cell viability compared with lipofectin-treated cells.
The cellular morphology observed during ODN treatment of the
PAX3-positive melanoma culture 980928 and the PAX3-negative cell line
Küng-A375 is illustrated in Fig. 1C
. AS-ODN-treated
980928 cells show nuclear condensation, rounding up, and finally
detachment from the culture dish, indicating an apoptotic process. To
assess this observation on the molecular level, the same cells were
stained for Annexin V after incubation with either MS-ODN or AS-ODN
(Fig. 1D)
. Sixty-five h after ODN incubation, the few 980928
cells still remaining after AS-ODN treatment stained to 30% (29 of 96)
positive for Annexin V, whereas incubation with MS-ODN did not yield in
any Annexin V-positive cells. In contrast, in the PAX3-negative cell
line A365, neither incubation with AS-ODN nor MS-ODN resulted in any
Annexin V-stained cells (Fig. 1D)
. These results demonstrate
that treatment of PAX3-expressing melanomas with AS-ODN targeting PAX3
results in substantial reduction of viability via an apoptotic pathway.
 |
Discussion
|
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PAX3 appears to play an essential role in the establishment
of melanogenic and myogenic cell lineages, as suggested by the severe
phenotypes in mice and in humans with reduced functional PAX3 protein.
Because PAX3 is implicated in the pediatric tumor rhabdomyosarcoma,
both because of the occurrence of a specific translocation involving
PAX as well as its overexpression (5)
, we speculated that
reexpression of PAX3 might also occur in melanoma. Indeed, in this
study, we demonstrate by sensitive and specific RT-PCR analysis in
cultured melanomas, as well as by in situ hybridization on
tissue sections, that PAX3 is expressed in a substantial fraction of
melanomas. Importantly, PAX3-positive and -negative cultured melanomas
could be unambiguously distinguished by RT-PCR and confirmed by
in situ hybridization on the corresponding tissue sections.
These cultured primary melanomas were additionally analyzed for known
melanoma markers (Melan A, MAGE-3, and tyrosinase) to ensure the
presence of melanoma cells. Nevertheless, any contaminating fibroblasts
in these cultures would not have been detected in our RT-PCR analysis,
because fibroblasts are negative for PAX3 expression (data not shown).
However, whereas PAX3 expression was confined to malignant melanomas
and not detected in benign lesions or normal skin by in situ
hybridization, sensitive RT-PCR methods were also able to generate a
signal in foreskin (data not shown). Hence, nonquantitative RT-PCR
should be used cautiously when directly analyzing biopsy specimens. For
paraffin-embedded tissue sections, in situ hybridization
will therefore be the method of choice for the detection of
tumor-specific PAX3 expression, because available antibodies against
PAX3 are not sufficiently sensitive to detect the endogenous protein.
One evident interpretation of these results might be that PAX3
expression simply indicates progressive dedifferentiation of
melanocytes. However, some interesting parallels exist between
myogenesis and melanogenesis. PAX3 seems to be necessary for the
development of both lineages and in each case activates tissue-specific
transcription factors of the basic helix-loop-helix class, which are
important in cell determination and differentiation (myoD family
members in muscle and MITF in melanoblasts; Refs. 13
and
14
). How the activity of PAX3 is regulated toward either
one or the other lineage is unknown at present.
In tumor cells, expression of developmentally regulated genes occurs
fairly often. However, it is unclear if the reexpressed genes play any
role in the development or maintenance of the tumorigenic phenotype.
Therefore, an antisense strategy to investigate the functional role of
PAX3 expression in melanomas was applied. Indeed, PAX3-expressing
melanoma cell lines and cultures were susceptible to AS-ODN treatment
and showed reduced viability compared with control cells. Because dying
cells could readily be stained with Annexin V and show clear nuclear
condensation, we conclude that these cells die by apoptosis. The effect
is specific because PAX3-negative cells did not respond to AS-ODN
treatment, nor did cells treated with control MS-ODN. These experiments
suggest that PAX3 has a conserved antiapoptotic function in both
melanoma and rhabdomyosarcoma.
The PAX3-dependent survival pathway is not yet fully understood.
Because PAX3 is a transcription factor, either activation or repression
of target genes might be involved. Recently, several direct targets for
PAX3 have been identified. The best-studied PAX3 target gene is the
proto-oncogene c-met, which encodes the tyrosine kinase
receptor for HGF/SF (15)
. The importance of the c-met/HGF
signaling pathway for tumor development and cell survival is well
documented, and indeed strong c-met expression is found in both
melanomas (16)
and rhabdomyosarcomas (17)
. Of
specific interest might also be that transgenic mice ectopically
expressing HGF/SF develop malignant melanomas, which were shown to
overexpress both HGF/SF and c-met (18)
. Hence, stimulation
of c-met expression by PAX3 might be an important pathway in melanoma
development. Additional PAX3 target genes that might play a role in
cell survival include another member of the tyrosine kinase receptor
family, the
IGF-1R,4
as well as the antiapoptotic survival guide gene
bcl-XL (19)
. The IGF-1R
has been implicated to play a crucial role in melanoma development,
because growth of melanomas in xenotransplanted nude mice could be
inhibited by blocking the IGF-1R signalling pathway with neutralizing
antibodies (20)
. Less is known about the role of the
antiapoptotic protein bcl-XL in melanoma development.
Future work will have to address the relationship between PAX3 and
these putative target genes and its potential significance for melanoma
progression and diagnosis.
Expression of PAX3 in the majority of melanomas might participate in
their development and/or maintenance because cell survival appears to
be dependent on PAX3 expression. PAX3 might therefore represent a
possible novel target for therapeutic molecular interventions in
melanomas.
 |
ACKNOWLEDGMENTS
|
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We are thankful for the continuous support of C. W. Heizmann.
 |
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 by Grants 31-46886.96 and 31-56869.99
from the Swiss National Science Foundation, the Krebsliga of the Kanton
Zurich, and the Hartmann Muller Foundation. 
2 To whom requests for reprints should be
addressed, at Division of Clinical Chemistry and Biochemistry,
Department of Pediatrics, University of Zurich, Steinwiesstrasse 75,
8032 Zurich, Switzerland. Phone: 41-1-266 75 53; Fax:
41-1-266 71 69; E-mail: schafer{at}kispi.unizh.ch 
3 The abbreviations used are: RT-PCR, reverse
transcription-PCR; ODN, oligonucleotide; MS-ODN, missense ODN;
AS-ODN, antisense ODN; HGF/SF, hepatocyte growth factor/scatter factor;
IGF-1R, insulin-like growth factor receptor 1. 
4 O. V. Murmann, C. M. Masque, D. Le Roith, F. G.
Barr, F. Niggli, B. W. Schäfer. Paired-box transcription factors
PAX3 and PAX3/FKHR modulate expression of the type 1 insulin-like
growth factor receptor, submitted for publication. 
Received 5/22/00.
Accepted 12/ 6/00.
 |
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