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1 Gastroenterology Division, Department of Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania; 2 Department of Gastroenterological Surgery, Transplant, and Surgical Oncology, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan; 3 Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Departments of 4 Medicine, 5 Genetics, and 6 Pharmacology, University of Pennsylvania, Philadelphia, Pennsylvania; and 7 Pediatric Endocrinology, Childrens Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| ABSTRACT |
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| INTRODUCTION |
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EGFR is a receptor tyrosine kinase whose biochemical and structural properties have been extensively studied (2) . EGFR critically regulates a number of cellular functions, including cell proliferation, survival, differentiation, migration, cellcell adhesion, and cellextracellular matrix interactions. EGFR is a classical proto-oncogene that can transform NIH3T3 fibroblasts in a ligand-dependent fashion (3) . EGFR overexpression, partially accounted for by gene amplification, is found in up to 80% of esophageal squamous cell carcinomas (ESCCs) and esophageal adenocarcinomas (EACs), as well as their precursor lesions, such as squamous dysplasia and Barretts esophagus, respectively (4 , 5) . However, most studies on EGFR biological functions have been carried out in rodent fibroblasts or human cancer cell lines, thus hindering insights into the molecular and physiologic mechanisms through which EGFR overexpression contributes to immortalization and malignant transformation.
We have recently isolated and characterized primary human esophageal cells (6) . Moreover, using retrovirus-mediated transduction, we established stable cell lines expressing EGFR and/or the catalytic subunit of human telomerase (hTERT; refs. 6 , 7 ). Primary esophageal cells overexpressing EGFR demonstrated unique cell biological properties, including increased migration associated with induction of matrix metalloproteinase-1, pronounced cell aggregation through enhanced functions of E-cadherin, and basal cell hyperplasia in organotypic culture (6) . However, EGFR alone failed to immortalize primary esophageal cells. By contrast, hTERT-mediated telomerase activation resulted in immortalization of primary human esophageal cells without affecting the p53 and pRb pathways (7) .
Insulin-like growth factor-binding protein (IGFBP)-3, one of six IGFBPs, is the major carrier protein for insulin-like growth factor (IGF)-I or IGF-II in circulation. IGFBP-3 protein has molecular masses of 43 to 45 kDa, depending on posttranslational modifications such as glycosylation and phosphorylation. It exists as a component of a 150-kDa ternary complex comprising an 85-kDa acid labile glycoprotein subunit and IGF-I or IGF-II (8 , 9) . Various cell types including fibroblasts, endothelial cells, and epithelial cells secrete IGFBP-3 (10, 11, 12) . Although many endogenous and pharmacological agents, including peptide growth factors, cytokines, and hormones, have been shown to induce IGFBP-3, how IGFBP-3 expression is regulated remains largely undetermined.
IGFBP-3 has been demonstrated to regulate cell proliferation through both IGF-dependent and independent mechanisms (9 , 13) . IGFBP-3 is known to be up-regulated in senescent cells or mitotically quiescent cells (11 , 12 , 14) . However, little knowledge is available regarding IGFBP-3 expression and function in cancer. Depending on the experimental context, IGFBP-3 has been shown to possess growth-stimulatory, antiproliferative, or proapoptotic activities in vitro. In transgenic mice, ubiquitous expression of IGFBP-3 resulted in growth retardation, suggesting that IGFBP-3 may impair the growth-promoting functions of IGFs in vivo (15) . However, tissue-specific targeted expression of the IGFBP-3 transgene by metallothionein-I induced selective organomegaly of the spleen, liver, and heart (16) . In other IGFBP-3 transgenic mice, the mammary gland underwent delayed involution after lactation, suggesting that IGFBP-3 overexpression potentiated the antiapoptotic activities mediated by IGFs (17) .
To gain further insights into how EGFR overexpression affects cellular functions of primary human esophageal cells, we carried out gene expression profiling and identified IGFBP-3 as a critically up-regulated gene. We find that IGFBP-3 is frequently overexpressed in esophageal cancer cell lines and primary esophageal tumors. We also demonstrate a basis for IGFBP-3 regulation by EGFR. Moreover, IGFBP-3 appears to negatively regulate cell proliferation in esophageal cancer cells. Indeed, the novel findings described herein may help to explain how EGFR through IGFBP-3 may modulate cell growth but not induce immortalization and malignant transformation.
| MATERIALS AND METHODS |
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EGFR Transgenic Mice.
Generation of EGFR transgenic mice was described previously (6)
. The EGFR transgene was targeted in the oral-esophageal epithelium in a tissue-specific fashion with the Epstein-Barr virus ED-L2 promoter (18)
. The EGFR transgenic mice and age-matched wild-type mice were sacrificed at age 6 months for immunohistochemistry. All transgenic mouse experiments were carried out in accordance with the standards and guidelines of the Institutional Animal Care and Use Committee at the University of Pennsylvania.
Cell Lines.
Fifteen human esophageal carcinoma cell lines (TE series, T.T., HCE4, and HCE7) and six nonesophageal cell lines (HepG2, PANC-1, MCF7, HeLa, A431, and HaCaT) were cultured under standard conditions as described previously (19)
. TE7 cells were derived from adenocarcinoma, whereas the other esophageal carcinoma cell lines were established from ESCCs. EPC1 and EPC2 are primary human esophageal keratinocytes that have been described previously (6
, 7)
. EPC1 and EPC2 cells were grown at 37°C under 5% CO2 in serum-free medium (Keratinocyte-SFM) supplemented with 40 µg/mL bovine pituitary extract and 1 ng/mL epidermal growth factor (EGF; Invitrogen, Carlsbad, CA). Esophageal epithelial cells (designated mouse esophageal keratinocytes) were isolated from the EGFR transgenic mouse and the control mouse and grown in culture as described previously (20)
. Cells were counted using Coulter Z1 counter (Beckman Coulter Inc., Fullerton, CA). Cell viability was determined by trypan blue exclusion. Conditioned medium (CM) was harvested by incubating subconfluent cells for an indicated time period with full Keratinocyte-SFM or Dulbeccos modified Eagles medium (DMEM) containing either 10% fetal calf serum (FCS) or 0.5% FCS. To concentrate CM, Centricon YM-10 centrifugal filter units (10,000 nominal molecular weight limit; Millipore, Billerica, MA) were used according to the manufacturers instructions.
Organotypic cell culture was performed as described previously (6) . In brief, 5 x 105 esophageal cells were seeded onto collagen matrix containing 7.5 x 104 human skin fibroblast cells. After cell culture under submerged conditions for 4 days, cells were exposed to the airliquid interface and cultured for an additional 6 days. The reconstituted epithelial sheets and the collagen matrix were fixed with 10% formaldehyde, embedded in paraffin, and subjected to histology and immunohistochemistry.
AG1478 (Calbiochem, San Diego, CA) was dissolved in 0.1% dimethyl sulfoxide (Sigma, St. Louis, MO) and added into culture medium at the indicated concentrations to inhibit EGFR-tyrosine kinase activity.
Small Interfering RNA Preparation.
To stably express short hairpin small interfering RNA (siRNA) under the control of the H1-RNA polymerase III promoter, complementary oligonucleotides consisting of 5'-gatccccATGCTAGTGAGTCGGAGGAttcaagagaTCCTCCGACTCACTAGCATtttttggaaa-3' and 5'-agcttttccaaaaaATGCTAGTGAGTCGGAGGAtctcttgaaTCCTCCGACTCACTAGCATggg-3', including sense and antisense 19-nucleotide sequences specific for human IGFBP-3 mRNA (Genebank sequence X64875; nucleotides 539557), separated by a 9-nucleotide spacer, were annealed, and subcloned into the BglII and HindIII sites of the pSuper-retro-neo vector (Oligoengine, Seattle, WA), resulting in the creation of pSRN-IGFBP-3-3, according to the manufacturers instruction.
Retrovirus-Mediated Transduction.
Stable transduction of primary esophageal cells with retroviral vectors was described previously (6
, 7)
. The pFB-neo retroviral vector (Stratagene, La Jolla, CA) containing the entire coding sequence for the human EGFR (pFB-neo-WT-hEGFR) or green fluorescent protein [GFP (pFB-neo-GFP)], pSuper-retro-neo, and pSRN-IGFBP-3-3 were transfected into a Phoenix-Ampho packaging cell line (gift of Dr. Garry Nolan, Stanford University, Palo Alto, CA) with LipofectAMINE 2000 reagent (Invitrogen), according to the manufacturers instructions. Culture supernatants from individual Phoenix-Ampho cells were used to infect EPC1, EPC2, and EPC2-hTERT as well as TE11 cells. Cells were passaged 48 hours after infection and selected with 300 µg/mL Geneticin (Invitrogen) for 7 days, resulting in generation of EPC2-EGFR, EPC2-GFP, EPC2-Neo, EPC2-hTERT-EGFR, and EPC2-hTERT-Neo. TE11 cells transduced with the siRNA vectors were also similarly selected with 300 µg/mL Geneticin.
RNA Isolation and cDNA Synthesis.
TRIzol reagent (Invitrogen) and the RNeasy Fibrous Tissue Midi Kit (Qiagen, Valencia, CA) were used to isolate total RNA from cultured cells and snap-frozen tissues, respectively. RNA was treated with DNase I (Invitrogen). The integrity of total RNA was determined by 1% formaldehyde-agarose gel electrophoresis. cDNA synthesis was carried out with the Superscript First Strand Synthesis System (Invitrogen) using 3.3 (cell RNA) or 5 µg (tissue RNA) of total RNA as a template. The cDNA synthesis reactions without reverse transcriptase yielded no amplicons in the polymerase chain reaction (PCR) reactions described below.
Gene Expression Profiling.
Gene expression profiling of EPC2-EGFR and EPC2-GFP cells was carried out using the Affymetrix HG-U95A Human GeneChip array (Affymetrix, Santa Clara, CA). Preparation of cRNA, hybridization, and scanning of the arrays were performed according to manufacturers protocols. Briefly, 5 µg of total RNA were primed by an oligo(dT)24 primer containing a T7 RNA polymerase promoter 3' to the poly(T) (Geneset, La Jolla, CA) and converted to first-strand cDNA using Superscript II reverse transcriptase (Invitrogen). Second-strand cDNA synthesis was followed by in vitro transcription for linear amplification of each transcript incorporating biotin-11-CTP and biotin-16-UTP (Enzo, Farmington, NY) to generate labeled cRNA. The labeled cRNA was purified over RNeasy columns. Fifteen micrograms of cRNA were fragmented to
200 nucleotides at 94°C for 35 minutes in 40 mmol/L Tris-acetate (pH 8.1), 100 mmol/L potassium acetate, and 30 mmol/L magnesium acetate; heat-denatured at 99°C for 5 minutes; and hybridized for 16 hours at 45°C to the HG-U95A microarray in 200 µL of hybridization mixture consisting of 100 mmol/L 4-morpholineethanesulfonic acid, 1 mol/L NaCl, 20 mmol/L EDTA, 0.01% Tween 20, 0.1 mg/mL herring sperm DNA (Promega, Madison, WI), and 500 µg/mL acetylated bovine serum albumin (Invitrogen). The microarray was then washed at low (0.9 mol/L NaCl, 60 mmol/L NaH2PO4, 6 mmol/L EDTA, and 0.01% Tween 20) and high (100 mmol/L 4-morpholineethanesulfonic acid, 0.1 mol/L NaCl, and 0.01% Tween 20) stringency and stained with streptavidin-phycoerythrin (Molecular Probes, Eugene, OR). Fluorescence was amplified by adding biotinylated antistreptavidin and an additional aliquot of streptavidin-phycoerythrin stain. The GeneArray scanner (Affymetrix) was used to collect fluorescence signal at 3 µm resolution after excitation at 570 nm. The average signal from two sequential scans was calculated for each microarray feature. The Affymetrix array data were analyzed using Affymetrix Microarray Suite 5.0 (Affymetrix) and Genespring 5.0 (Silicon Genetics, Redwood City, CA), programs designed for the analysis of high-throughput microarray expression data. Genes that are absent in all samples were removed from consideration. The list of genes was condensed to genes that changed
3-fold (whether up or down) between EPC2-GFP and EPC2-EGFR cells.
Real-Time Reverse Transcription-Polymerase Chain Reaction.
Real-time PCR was performed using SYBR green reagent (PE Applied Biosystems, Foster City, CA) and the ABI PRISM 7000 Sequence Detection System (PE Applied Biosystems) according to the manufacturers instructions. The following oligonucleotides were used as primers: (a) human IGFBP-3, 5'-CCATGACTGAGGAAAGGAGCTC-3' (BP32218-F; exon 4; nucleotides 1048710508; forward primer) and 5'-TGCAGCAGGGCAGAGTCTC-3' (BP32325-R; exon 4, nucleotides 1057610594; GenBank accession no. M35878; reverse primer); (b) mouse IGFBP-3, 5'-GAGTGTGGAAAGCCAGGTTGTC-3' (mBP3525-F; forward primer) and 5'-GCATGGAGTGGATGGAACTTG-3' (mBP3593-R; GenBank accession no. NM_008343; reverse primer); (c) human ß-actin, 5'-CCTGGCACCCAGCACAAT-3' (exon 5; hBAC-F; forward primer) and 5'-GCCGATCCACACGGAGTACT-3' (exon 6; hBAC-R; reverse primer); (d) human glyceraldehyde-3-phosphate dehydrogenase (GAPDH), 5'-GGTGGTCTCCTCTGACTTCAACA-3' (exon 7; hGAPDH-F; forward primer) and 5'-GTTGCTGTAGCCAAATTCGTTGT-3' (exon 8; hGAPDH-R; reverse primer); and (e) mouse GAPDH, 5'-GGTTGTCTCCTGCGACTTCAAC-3' (mGAPDH-F; forward primer) and 5'-CCAGGAAATGAGCTTGACAAAGTT-3' (mGAPDH-R; reverse primer). ß-Actin was used as an internal control for human tissues. GAPDH was used as an internal control for cultured cells as well as mouse tissues. PCR conditions were optimized by performing primer matrix reactions and generating standard curves for IGFBP-3, ß-actin, and GAPDH. All PCR reactions were performed in triplicate in a 25-µL total volume using 500 nmol/L each of forward and reverse primers. One microliter of cDNA was used as template per reaction to detect human and mouse IGFBP-3 mRNA, whereas 0.125 µL of cDNA was used for ß-actin and GAPDH. The relative expression level of IGFBP-3 mRNA between normal and tumor was calculated by normalizing to ß-actin mRNA expression level using the comparative CT (
CT) method, where CT represents the cycle number at which the amplification reaches a threshold level chosen to lie in the exponential phase of all PCR reactions. Relative expression levels were calculated using the formula 2
CT, where
CT represents the difference between the average IGFBP-3 CT value and the average ß-actin CT value within a given tissue. 
CT represents the difference between the
CT values for normal and tumor. The normalized IGFBP-3 expression level for normal tissues was set to 1. Likewise, the relative expression level of IGFBP-3 mRNA among cell lines was determined by normalizing to the GAPDH mRNA level. EPC2 [3 population doublings (PDs)] was used as a normal control. Thus, the normalized IGFBP-3 mRNA expression level in EPC2 (3 PDs) was set to 1. Data were analyzed using ABI PRISM 7000 sequence detection system software (PE Applied Biosystems).
Antibodies.
Affinity-purified goat antihuman IGFBP-3 (DSL-R00536; Diagnostic Systems Laboratories, Inc., Webster, TX), affinity-purified rat antimouse IGFBP-3 (138202; R&D Systems Inc., Minneapolis, MN), affinity-purified goat antihuman IGFBP-4 (DSL-R00637; Diagnostic Systems Laboratories, Inc.), anti-EGFR Ab-12 mouse monoclonal antibody (Cocktail R19/48; NeoMarkers, Union City, CA), antiß-actin (Sigma), anti-tubulin (DMA1A+DM1B; Neo Markers), and secondary horseradish peroxidase-conjugated donkey antigoat IgG (sc-2020; Santa Cruz Biotechnology, Santa Cruz, CA) and sheep antimouse IgG (Amersham Pharmacia Biotech, Piscataway, NJ) were purchased.
Western Blotting.
Western blotting was carried out as described previously (6)
. In brief, cells and tissues were homogenized with a radioimmunoprecipitation assay buffer consisting of 10 mmol/L Tris-HCl (pH 7.4), 150 mmol/L NaCl, 1% Nonidet P-40, 0.1% SDS, 0.1% sodium deoxycholate, 1 mmol/L EDTA, 2 mmol/L Na3VO4, 1 mmol/L phenylmethylsulfonyl fluoride, and a protease inhibitor mixture tablet (Complete; Roche Applied Science, Indianapolis, IN) and cleared by centrifugation at 14,000 rpm at 4°C for 15 minutes. The total protein sample (20 µg) was denatured and fractionated on a NuPAGE Bis-Tris 4% to 12% gel with NuPAGE MOPS running buffer using the NuPAGE system (Invitrogen) and electrotransferred to polyvinylidene difluoride membrane (Immobilon-P; Millipore Corp., Bedford, MA) according to the manufacturers instructions. After blocking with 5% nonfat milk (Bio-Rad) in Tris-buffered saline [TBS (10 mmol/L Tris, 150 mmol/L NaCl, pH 8.0)] for 1 hour at room temperature, the membranes were probed with primary antibody diluted 1:1,000 in TBS with 0.1% Tween 20 (TBST) containing 2% milk overnight at 4°C, washed three times in TBST, incubated with secondary antigoat (1:10,000) or antimouse (1:10,000) antibody diluted in TBST for 1 hour at room temperature, and then washed three times in TBST. The signal was visualized by an enhanced chemiluminescence solution (ECL Plus; Amersham Pharmacia Biotech) and exposed to Eastman Kodak Co. (Rochester, NY) X-OMAT LS film. Western blots were quantified by densitometry with Scion Image ß 4.02 program (Scion Corp., Frederick, MD).
Western Ligand Blotting.
Western ligand blotting was done as described previously (21)
, with modifications. Briefly, protein samples were electrophoresed on a NuPAGE Bis-Tris 4% to 12% gel under a nonreduced condition and transferred to a polyvinylidene difluoride membrane (Immobilon-P). The membrane was rinsed once with TBS containing 3% Nonidet P-40 for 30 minutes at 4°C and then rinsed once with TBST containing 1% bovine serum albumin for 2 hours at 4°C. The membrane was incubated with 1 µCi of 3-[125I]iodotyrosyl recombinant human IGF-I (Amersham Pharmacia Biotech) in 10 mL of TBST containing 1% bovine serum albumin for 16 hours at 4°C. After a brief wash with TBST, the membrane was subjected to autoradiography using Kodak X-OMAT AR film with an intensifying screen at 80°C.
Enzyme-Linked Immunosorbent Assay.
Enzyme-linked immunosorbent assay (ELISA) was performed using human IGFBP-3 DuoSet ELISA development systems (R&D Systems Inc., Minneapolis, MN), according to the manufacturers instructions. Briefly, a BD Falcon 96-well microplate (BD Biosciences, San Jose, CA) was coated with mouse antihuman IGFBP-3 capture antibody and blocked with 5% Tween 20 and 5% sucrose in PBS containing 0.05% NaN3 at room temperature for 16 hours. After washing with wash buffer consisting of 0.05% Tween 20 and 5% sucrose in PBS [137 mmol/L NaCl, 2.7 mmol/L KCl, 8.1 mmol/L Na2HPO4, and 1.5 mmol/L KH2PO4 (pH 7.4)] containing 0.05% NaN3, 100 µL of CM samples or serially diluted recombinant human IGFBP-3 were added into each well and incubated for 2 hours at room temperature and washed three times with the wash buffer. Signal was visualized by incubation with 100 µL/well of 36 µg/mL biotinylated goat antihuman IGFBP-3 antibody, 100 µL/well streptavidin-horseradish peroxidase, and 100 µL/well of a 1:1 mixture of H2O2 and tetramethylbenzidine. The reaction was terminated by 50 µL/well of 2N H2SO4, and the absorbance of each well was immediately determined using the Vmax kinetic microplate reader (Molecular Devices Corp., Sunnyvale, CA) at 450 nm with correction at 546 nm.
Immunohistochemistry.
Immunohistochemistry for IGFBP-3 was performed with the Vectastain Elite kit (Vector Laboratories, Burlingame, CA) following the manufacturers protocol. In brief, paraffin sections were deparaffinized with xylene, hydrated in descending ethanol solutions, and then placed in a microwave in 10 mmol/L citric acid buffer. Endogenous peroxidase was quenched using hydrogen peroxide before sections were blocked in avidin D blocking reagent and biotin blocking reagent. Sections were incubated with primary antihuman IGFBP-3 mouse monoclonal antibody (clone 84728.111; R&D Systems Inc.) at a 1:250 dilution and with biotinylated antimouse IgG at a 1:200 dilution, and then signal was developed using the 3,3'-diaminobenzidine substrate kit for peroxidase. The immunohistochemical staining was assessed independently (A. J. K-S.), and the intensity was expressed as negative (), weakly positive (+), moderately positive (++), or strongly positive (+++).
Immunocytochemistry.
Immunocytochemistry was performed as described previously (6)
. Briefly, cells grown in chamber slides (Nalge Nunc, Inc., Naperville, IL) were fixed in 1:1 methanol/acetone for 10 minutes at 20°C. After blocking with 1% bovine serum albumin (Sigma) for 10 minutes, slides were incubated with antihuman IGFBP-3 mouse monoclonal antibody (clone 84728.111; R&D Systems Inc.) at a 1:250 dilution overnight at 4°C and then incubated with Cy3-conjugated secondary donkey antimouse IgG antibody (Jackson ImmunoResearch Laboratories, Inc., West Grove, PA) at a 1:400 dilution for 30 minutes at 37°C. Stained slides were examined with a Nikon Microphot microscope and imaged with a digital camera at specific magnifications.
[3H]Thymidine Incorporation Assay.
To assess cell proliferation, DNA synthesis was measured by incubating cells with 1 µCi of [methyl-3H]thymidine (1 µCi/mL/well; Perkin-Elmer Life Sciences Inc., Boston, MA) for 4 hours in 12-well tissue culture dishes. Cells were washed three times with cold PBS, washed once with cold 10% trichloroacetic acid, and washed three times with 5% trichloroacetic acid. Cells were lysed with 0.5N NaOH on ice for 10 minutes and neutralized with 0.5N HCl. The cell lysate was supplemented with 10% trichloroacetic acid, incubated on ice for 20 minutes, and filtrated with glass microfiber filters (Whatman, Kent, United Kingdom) using a sampling vacuum manifold (Millipore, Billerica, MA). The filters were rinsed three times with ethanol, dried at 80°C for 45 minutes, and suspended in 10 mL of Ready Value Liquid Scintillation Cocktail (Beckman Coulter Inc.) to measure radioactivity with a LS 6500 Multi-Purpose Scintillation Counter (Beckman Coulter Inc.).
Statistical Analyses.
Simple linear regression analysis was performed to compare EGFR level and IGFBP-3 level between tumors and adjacent normal tissues. Students t test was used to compare data between two groups. Data represent the mean ± SE. Ps of <0.05 were considered statistically significant.
| RESULTS |
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12,500 probe sets. Two independent data analysis programs, Affymetrix Microarray Suite 5.0 and Genespring 5.0, extracted 23 and 35 genes, respectively, as
3-fold up-regulated in EPC2-EGFR cells. IGFBP-3 was the most highly up-regulated gene in EPC2-EGFR cells.
To verify the gene array result for IGFBP-3 in EPC2-EGFR cells, real-time reverse transcription (RT)-PCR and Western blotting were carried out. EPC2-EGFR cells expressed 4.4-fold more IGFBP-3 mRNA than control cells (Fig. 1A)
. This was corroborated by Northern blotting (data not shown). Western blotting also revealed a 3.5-fold induction of IGFBP-3 protein in EPC2-EGFR cells compared with control cells (Fig. 1B)
. To further confirm IGFBP-3 up-regulation in EGFR-overexpressing cells, retrovirus transduction was carried out in an independent fashion. In EPC2, EPC2-hTERT, and another primary human esophageal line, EPC1, EGFR transduction resulted in IGFBP-3 mRNA and protein induction (Fig. 1A and B)
. We also confirmed by Western blotting that the IGFBP-3 full-length form is secreted in CM from EPC2, EPC2-hTERT, and EPC1 cells transduced with EGFR (Fig. 1C)
. An ELISA confirmed that the CM from these EGFR-overexpressing cells contained 2.5- to 5-fold higher levels of IGFBP-3 than media from control cells (Fig. 1D)
. Furthermore, immunocytochemistry revealed that both EGFR and IGFBP-3 are more intensely expressed in the EGFR-transduced cells than control cells (Fig. 1E and F
; data not shown). It should be noted that there was no significant variation in IGFBP-3 expression between cells, even though the primary cell derivatives were pooled after retrovirus infection.
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We also observed that IGFBP-3 mRNA was initially down-regulated when presenescent EPC2 cells (42 PDs) were transduced with hTERT. However, IGFBP-3 expression was increased in immortalized EPC2-hTERT cells at a later PD (>200 PDs; data not shown). This prompted us to investigate whether or not IGFBP-3 is up-regulated in esophageal cancer cells that are typically associated with EGFR overexpression and telomerase activation.
IGFBP-3 Is Highly Expressed in Primary Esophageal Cancer Tissues.
To determine IGFBP-3 expression in primary esophageal cancer tissues, real-time RT-PCR, Western blotting, and immunohistochemistry were performed. IGFBP-3 mRNA was overexpressed in 15 of 19 (78.9%) primary ESCC tissues, including 8 samples (36.8%) that showed a
10-fold increase compared with adjacent normal mucosa (Fig. 3A)
. IGFBP-3 overexpression was also observed in four of seven EAC tissues (57.1%; Fig. 3B
). Western blotting confirmed IGFBP-3 overexpression in ESCC; 8 of 11 ESCC samples showed a
3-fold increase in IGFBP-3 expression compared with adjacent normal mucosa (Fig. 3C)
. The IGFBP-3 mRNA and protein levels tended to correlate with the EGFR protein level in the tumor tissues (R2 = 0.365; P = 0.003). Concomitant up-regulation of EGFR and IGFBP-3 was observed in 7 of 11 (60%) samples of primary ESCCs. Finally, immunohistochemistry revealed that IGFBP-3 was intensely expressed in tumor tissues of 16 of 17 (94.1%) invasive ESCCs as well as 5 of 6 (83.3%) EACs (Fig. 4
; data not shown). Whereas IGFBP-3 expression was increased in almost all layers of dysplastic squamous epithelia (Fig. 4B)
, it was confined to the basal and suprabasal cell layers of the normal esophageal squamous epithelium (Fig. 4A)
. IGFBP-3 was diffusely distributed in the cytoplasm of both ESCC and EAC (Fig. 4CH)
. Interestingly, some foci of cancer cells had a very intense cytoplasmic staining for IGFBP-3 (Fig. 4H)
, which may represent localization of IGFBP-3 before secretion.
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To determine whether IGFBP-3 produced by cell lines is functional, we performed Western ligand blotting. It is known that only full-length IGFBP-3, but not proteolytically cleaved versions, is capable of high-affinity binding to IGF-I (22
, 23)
. Fig. 6A
demonstrates that CM from A431 and TE2 cells contains proteins whose molecular masses are consistent with IGFBP-3 (4044 kDa) and IGFBP-4 (24 kDa; ref. 21
), which were documented by reprobing the ligand blot with specific antibodies (Fig. 6B and C)
, thus indicating that IGFBP-3 secreted by these cancer cell lines can bind to IGF-I.
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Inhibition of IGFBP-3 by Small Interfering RNA in TE11 Cells Augments Cell Proliferation.
To gain insight into the biological role of IGFBP-3 in esophageal cancer cell lines, we stably transduced TE11 cells with siRNA directed against IGFBP-3, resulting in creation of IGFBP-3 siRNA-expressing TE11-S cells and empty vector-transduced TE11-N control cells. We confirmed by Western blotting that IGFBP-3 protein expression was suppressed by 70% in TE11-S cells compared with TE11-N cells (Fig. 8A)
. ELISA also revealed a 78% reduction in IGFBP-3 secretion in CM of TE11-S cells (Fig. 8B)
. When cell growth was assessed, TE11-S cells appeared to grow faster than control cells (Fig. 8C)
. This notion was documented by a [3H]thymidine incorporation assay showing 14-fold more active DNA synthesis in TE11-S cells than in TE11-N cells (Fig. 8D)
. Moreover, DNA content analysis by flow cytometry revealed a decrease in G1 phase (10%) and an increase in S phase (10%) in TE11-S cells compared with TE11-N cells (data not shown). No sub-G1 fraction was observed in both cell lines when they were grown under standard tissue culture conditions or in a serum-starved condition for 48 hours (data not shown). The trypan blue dye exclusion test also detected no significant difference in cell viability rate between TE11-S and TE11-N cells. These observations indicate that IGFBP-3 may restrain TE11 cell proliferation without inducing apoptosis. However, we would emphasize that further investigation is needed.
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| DISCUSSION |
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What is the basis for EGFR-mediated regulation of IGFBP-3? One possibility is that IGFBP-3 expression is subject to regulation by EGFR signaling. Additionally, EGFR overexpression in EPC2 cells induces a phenotypic change associated with growth inhibition, earlier senescence, or differentiation, culminating in up-regulation of IGFBP-3. Akerman et al. (24)
observed that excessive EGFR signaling shortened the replicative life span of normal human skin keratinocytes. IGFBP-3 has been found to be up-regulated in senescent or quiescent human diploid fibroblasts (11)
, vascular endothelial cells (12)
, and prostate epithelial cells (14)
. Thus, IGFBP-3 induction in EPC2-EGFR and EPC2-hTERT-EGFR cells may be associated with growth inhibition in monolayer culture. By contrast, it is unlikely that IGFBP-3 up-regulation is a consequence of EPC2-EGFR cell differentiation because our gene array data did not show any changes for early and terminal keratinocyte differentiation markers, including cytokeratins K1/K10, K4/K13, involucrin, and profilaggrin (data not shown). In addition, EPC2-EGFR cells are capable of undergoing differentiation in organotypic culture (6)
. By contrast, IGFBP-3 up-regulation is associated with esophageal epithelial cell hyperproliferation induced by EGFR overexpression in both organotypic cell culture and transgenic mice (Fig. 2)
. Thus, regulation of IGFBP-3 by EGFR in a physiologic context may be different from that observed in monolayer cell culture.
IGFBP-3 is transcriptionally activated by p53 (25 , 26) through several p53-binding cis-regulatory elements (25 , 27) . Given the role of p53 in cellular senescence (28) , it is intriguing to speculate that p53 transcriptional activity is involved in IGFBP-3 induction in EPC2-EGFR cells. In fact, we have recently observed that p53R175H inhibited IGFBP-3 mRNA up-regulation and prolonged the replicative life span of EPC2-EGFR cells (data not shown).
Mechanisms for IGFBP-3 Overexpression in Esophageal Cancer.
Our finding of IGFBP-3 overexpression in esophageal cancer is the first such demonstration in this cancer type. Our data showed a significant correlation between mRNA levels and protein levels in cancer cell lines as well. It is noteworthy that EGFR and IGFBP-3 are localized in close proximity on human chromosome 7p12.3-p12.1 and 7p13-p12, respectively. Because EGFR gene amplification is noted in several esophageal cancer cell lines including TE3, TE5, and TE8 (29)
and A431 cells, it is interesting to consider the possibility of coamplification of the IGFBP-3 and EGFR loci. However, gene amplification seems to be the least likely mechanism for IGFBP-3 overexpression in the majority of cases because EGFR gene amplification is found in only 10% to 20% of primary esophageal cancer tissues that overexpress EGFR (5
, 30)
. Hintz et al. (31)
also found no chromosomal alterations such as recombination and gene amplification in renal tumors that overexpress IGFBP-3.
ELISA and Western blotting showed remarkable down-regulation of IGFBP-3 in most of the cell lines examined on serum deprivation (Fig. 5D)
, thus suggesting that serum factors play a role in regulation of IGFBP-3 expression in these cells. Serum deprivation could affect cell growth and thus production of IGFBP-3. An equivalent number of cells were seeded per plate to collect conditioned media for ELISA. However, differences in cell number on harvesting of conditioned media could affect the IGFBP-3 concentrations. Thus, we calibrated the ELISA data on conditioned media using total protein yield from simultaneously harvested cell lysates.
In this study, EGFR tyrosine kinase activity was involved in the regulation of IGFBP-3 expression in several esophageal cancer cell lines and A431 cells. A431 and TE11 cells exhibited partial dependency of IGFBP-3 expression on EGFR tyrosine kinase activity when they were grown in the presence of 10% FCS (Fig. 7A
; data not shown). By contrast, suppression of EGFR kinase activity did not influence the IGFBP-3 level in TE2 and TE7 cells (Fig. 7A)
, suggesting that EGFR ligands in serum may not be the only factors contributing to IGFBP-3 induction. In addition, the IGFBP-3 level maximally induced in CM by EGF in TE11 and A431 cells appeared to be lower than that induced by 10% FCS (Figs. 5D
and 7C
; data not shown). In primary esophageal tumor tissues, IGFBP-3 expression level tended to correlate with EGFR level (Fig. 3C)
. However, three samples (ESCC9, ESCC13, and ESCC20) appeared to express an increased level of IGFBP-3 without EGFR overexpression (Fig. 3C)
, suggesting a separate mechanism accounting for the IGFBP-3 induction in these samples.
Numerous agents other than EGF have been shown to induce IGFBP-3 in vitro (9
, 13)
. They include growth hormone, IGF-I, transforming growth factor ß, tumor necrosis factor
, retinoic acid, and vitamin D. Thus, such peptide growth factors and hormones may contribute to IGFBP-3 induction in cell lines and primary tumor tissues. They may also affect cellular responses to EGFR ligands in modulating IGFBP-3 expression. For example, all-trans-retinoic acid induces IGFBP-3 in the presence of EGF at concentrations that suppress IGFBP-3 in cervical epithelial cell lines (32)
. Further complexity underlying EGFR-mediated regulation of IGFBP-3 was observed in that the effect of EGF stimulation on IGFBP-3 expression is different among the cell lines examined. EGF has been shown to inhibit IGFBP-3 mRNA and protein expression in primary and spontaneously immortalized human skin keratinocytes (33
, 34)
. These observations are consistent with our observations in TE2 and TE7 cells when they were stimulated at nanogram levels of EGF (Fig. 7DG)
. By contrast, picogram levels of EGF induced IGFBP-3 in these cell lines, albeit modestly (Fig. 7E and G)
. Furthermore, EGF potently induced IGFBP-3 expression and secretion in TE11 and A431 cells (Fig. 7B and C
; data not shown). EGF-mediated induction of IGFBP-3 secretion has been demonstrated in fetal rat lung fibroblasts (35)
and newborn rat astroblasts (36)
. Such a discrepancy in EGF response among cell lines may be accounted for by differences in EGFR level or activation. Additionally, we also found that higher cell density enhances EGF-mediated induction of IGFBP-3 expression in these esophageal cancer cell lines (data not shown).
Feldser et al. (37)
recently showed that IGFBP-3 expression is prominently impaired in hypoxia-inducible factor (HIF)-1
/ embryonic stem cells and that hypoxia induces IGFBP-3 mRNA in HIF-1
+/+ embryonic stem cells. They also showed that hypoxia, as well as fibroblast growth factor and EGF, induces HIF-1
in 293 cells. Functional inactivation of the von Hippel-Lindau (VHL) gene, an essential component of E3 ubiquitin-ligase complex, is common in renal cancer and known to result in HIF-1
stabilization. However, VHL deficiency is not common in esophageal cancer (38, 39, 40)
. Treins et al. (41)
showed that insulin activates HIF-1
through the phosphatidylinositol 3'-kinase/AKT pathway in retinal epithelial cells. Because EGFR activates AKT in esophageal cancer cell lines (19)
and EPC2-EGFR cells (6)
, it is tempting to speculate that HIF-1
may play a role in IGFBP-3 induction in esophageal cancer cells as well as in primary and immortalized human esophageal cells transduced with EGFR.
Growth hormone, a potent inducer of IGFBP-3, activates Jak2 to induce tyrosine phosphorylation of EGFR, independent of its own ligands and intrinsic kinase activity, resulting in recruitment of Grb2 and activation of mitogen-activated protein kinases (42) . Thus, it is also possible that growth hormone utilizes EGFR to induce IGFBP-3 in the absence of EGFR ligands. Interestingly, a prospective study on a cohort of 1,041 men with acromegaly revealed an increased incidence rate for esophageal cancer (43) .
Our data also clearly suggest that p53 is unlikely to contribute to IGFBP-3 induction in cancer cell lines, contrary to primary human esophageal cells, because p53 mutation and/or loss of p53 functions have been documented in almost all esophageal cancer cell lines (44 , 45) .
The Role of IGFBP-3 in Regulation of Esophageal Cell Proliferation and Apoptosis.
IGFBP-3 has been shown to both stimulate and inhibit cell proliferation under various experimental conditions through IGF-dependent and independent mechanisms (9
, 13)
. However, IGFBP-3 plays a critical role in the induction of apoptosis of several cancer cells in a p53-dependent (46)
and -independent (47
, 48)
fashion. In addition, many agents have been shown to inhibit breast cancer cell proliferation in vitro through induction and secretion of IGFBP-3 (48)
. They include tumor necrosis factor
, transforming growth factor ß, retinoic acid, vitamin D, and antiestrogen compounds such as tamoxifen and ICI182,780. Recently, silibinin, a flavonoid antioxidant derived from milk thistle, has been shown to up-regulate IGFBP-3 to inhibit proliferation of prostate cancer cells (49)
. Interestingly, EGFR appeared to mediate the cytotoxic effect of silibinin on rat glioma cells (50)
.
Thus, the antiproliferative or proapoptotic activities of IGFBP-3 may provide a safeguard mechanism against carcinogenesis in certain tumor types. In fact, down-regulation of IGFBP-3 has been documented in several cancers, including prostate cancer (51) and hepatocellular carcinoma (52 , 53) . Consistent with these observations, IGFBP-3 was down-regulated in prostate epithelial cells immortalized by human papilloma virus E7 oncoprotein through a mechanism involving physical interaction between E7 and IGFBP-3, leading to polyubiquitination and proteolytic degradation of IGFBP-3 (14 , 54) , although another study (55) showed up-regulation of IGFBP-3 in cervical keratinocytes immortalized with human papillomavirus E6 and E7. Hanafusa et al. (56) showed epigenetic silencing of IGFBP-3 transcription through hypermethylation of the IGFBP-3 promoter as a mechanism for IGFBP-3 down-regulation in hepatocellular carcinoma.
Our findings of IGFBP-3 overexpression in esophageal cancer represent a sharp contrast to these previous observations. One interpretation is that IGFBP-3 may stimulate cell proliferation by enriching IGF on the cell surface and thereby allowing it to activate the IGF receptor, following the proteolytic cleavage of IGFBP-3 mediated by enzymes such as matrix metalloproteases (9 , 57) . Another possibility is that IGFBP-3 was induced in esophageal cancer cells as a result of exposure to various growth factors, hormones, and cellular stress such as hypoxia and therapeutic agents in tumor tissues. However, a subset of these cancer cells acquires genetic alterations to negate the growth-inhibitory effect of IGFBP-3. Consistent with such a notion is the finding that growth inhibition on excessive EGFR activation observed in A431 cells is not found in the majority of esophageal cancer cell lines (58) . Another possibility is that IGFBP-3 inhibits tumor cell proliferation as a negative feedback mechanism. EGF treatment of human papilloma virus type 16-immortalized ectocervical epithelial cell lines results in decreased IGFBP-3 expression and concomitant enhancement of cell proliferation (32 , 59) . Thus, it is possible that EGF-induced down-regulation of IGFBP-3 in TE2 and TE7 cells may facilitate the mitogenic effect of EGF in these cell lines.
It is noteworthy that IGFBP-3 up-regulation was observed in esophageal squamous dysplasia by immunohistochemistry. It should be emphasized that IGFBP-3 has been demonstrated to enhance EGFR phosphorylation, activation of p44/42 and p38 mitogen-activated protein kinases, and cell proliferation in MCF10A breast epithelial cells stimulated with 0.1 to 1 ng/mL EGF (60) . Because EGFR overexpression is one of the earliest genetic changes found in esophageal carcinogenesis, it is intriguing to speculate that the interplay of EGFR and IGFBP-3 contributes to aberrant cell growth of the esophageal epithelium.
In aggregate, we have identified IGFBP-3 as an aberrantly regulated gene through the EGFR signaling pathway. IGFBP-3 overexpression in esophageal cancer implies a role in esophageal carcinogenesis through IGF-dependent or independent actions. Additional studies are required to elucidate how IGFBP-3 affects cellular functions, such as proliferation, differentiation, and migration, and the interplay between EGFR and IGFBP-3.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
|---|
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.
Requests for reprints: Hiroshi Nakagawa, Gastroenterology Division, University of Pennsylvania, 415 Curie Boulevard, 638 CRB, Philadelphia, PA 19104-2144. Phone: 215-573-1867; Fax: 215-573-2024; E-mail: nakagawh{at}mail.med.upenn.edu
Received 2/26/04. Revised 7/26/04. Accepted 8/25/04.
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