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Cell, Tumor, and Stem Cell Biology |
1 Institute for Molecular Virology, 2 Howard Hughes Medical Institute, 3 McArdle Laboratory for Cancer Research, 4 Department of Statistics, and 5 Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin; 6 Department of Statistics, Texas A&M University, College Station, Texas; 7 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; 8 Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland; and 9 MacKay Memorial Hospital and 10 National Taiwan University, Taipei, Taiwan
Requests for reprints: Paul Ahlquist, Institute for Molecular Virology, University of Wisconsin-Madison, 1525 Linden Drive, Madison, WI 53706. Phone: 608-263-5916; Fax: 608-262-9214; E-mail: ahlquist{at}wisc.edu.
| Abstract |
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| Introduction |
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75% are differentiated or undifferentiated nonkeratinizing carcinomas (2), invariably positive for EBV. The role of EBV in NPC and in other epithelial tumors remains poorly understood. EBV has been studied extensively in B cells, which are readily infected and usually retain EBV DNA on passaging. In contrast, EBV is strongly associated with NPC cells in tumors but easily lost from NPC cells in culture, suggesting that selective advantages that EBV provides to the tumor are not needed on explantation. NPC incidence among Cantonese people from Guangdong is >25-fold higher than average, indicating genetic or environmental predispositions. Specific HLA types (reviewed in ref. 3 and references therein) or chromosomal regions closely linked to the HLA locus (4) are associated with increased NPC risk. High-resolution genotyping implicated the HLA-A2 subtype, prevalent among Chinese (5), but the mechanism of increased susceptibility is unknown.
Other NPC risk factors include consumption of volatile nitrosamines introduced during traditional food preparation (6) as well as polymorphisms in CYP2E1, which activates nitrosamines into reactive, DNA-damaging intermediates (7, 8), and in hOGG1 and XRCC1, involved in DNA repair (9).
To uncover mechanisms linking these complex risk factors to NPC, it is essential to study the interrelations of host and viral gene expression. Earlier studies measured human gene expression using low-density cDNA arrays and used NPC cell lines rather than tumors (10) or used bulk NPC specimens containing significant amounts of nonepithelial cells (11). A recent study addressed some of these limitations by using higher density cDNA arrays (
9,000 cDNA clones) and laser-microdissected tissue but had a limited sample size (n = 8) and used reference RNA from pooled cell lines, including many nonepithelial types (12). None of these studies analyzed EBV gene expression.
We describe the first comprehensive NPC gene expression study using laser capture microdissected tissue from 31 tumors and 10 normal healthy nasopharyngeal epithelium specimens, analyzed for essentially all human mRNAs and all EBV latent genes. Our results identify a panel of human genes differentially expressed in NPC versus normal healthy nasopharyngeal epithelium and reveal that EBV gene expression levels closely correlate with inhibited expression of a subset of human genes, notably genes involved in MHC class Imediated antigen presentation.
| Materials and Methods |
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Tissue processing. Frozen biopsies were embedded in Tissue-Tek OCT (Sakura Finetek, Torrance, CA) for serial 6-µm cryosectioning. Step sections were stained with H&E, and intervening unstained sections were evaluated for cytokeratins using monoclonal mouse anti-human cytokeratin antibody (AE1/AE3, 1:20 dilution) and EnVision+ System Peroxidase (3,3'-diaminobenzidine, DAKO Corp., Carpinteria, CA). EBV-harboring cells were identified by detecting EBV-encoded small RNAs (EBER) using the EBV Probe In situ Hybridization kit (NCL-EBV-K, Novocastra Laboratories, Newcastle upon Tyne, United Kingdom). Supplementary Table S1 lists histology results and tumor stage. Laser capture microdissection (LCM) was done on tumor samples containing <70% tumor cells and to dissect epithelial cells from normal healthy nasopharyngeal specimens using an Arcturus PixCell II LCM microscope and CapSure Macro LCM caps (Arcturus Bioscience, Mountain View, CA). For orientation, unstained sections were briefly dipped in hematoxylin, step dehydrated through increasing ethanol concentrations, and air dried. Typically, from one to a few thousand cells per sample were captured. RNA was extracted using Trizol (Invitrogen, Carlsbad, CA), DNase I treated, and amplified twice using Affymetrix Small Sample Labeling Protocol VII (Affymetrix, Santa Clara, CA) that preserves original sample mRNA representation (13). One twentieth of second-round cDNA was used to assay amplification by measuring ß-actin using the QuantiTect SYBR Green Real-time PCR kit (Qiagen, Valencia, CA).
Microarray analysis. Using the BioArray High Yield RNA Labeling kit (Enzo Life Sciences, Farmingdale, NY), half of the second-round cDNA was used to synthesize biotinylated antisense RNA, which was hybridized to Affymetrix HG U133 Plus 2.0 microarrays containing 54,675 probesets for >47,000 transcripts and variants, including 38,500 human genes.11 A typical probeset contains eleven 25-mer oligonucleotide pairs (a perfect match and a mismatch control). Some genes are measured by multiple probesets.
Quantitative real-time PCR. Using AmpliTaq Gold (Applied Biosystems, Foster City, CA) on an ABI Prism 7700, quantitative real-time PCRs contained one thirtieth of the second-round cDNA, 0.5 µmol/L of each primer, 0.2 µmol/L FAM/TAMRA-labeled probe (MWG Biotech, High Point, NC), and 1x ROX reference dye (Invitrogen). See Supplementary Table S2 for primers and probes.
Microarray data analysis. Probeset summary measures were computed by robust multiarray averaging (14) of all 41 arrays. Global gene expression was analyzed by unsupervised hierarchical clustering and multidimensional scaling. A series of statistical filters, including fold changes, t tests, and mixture model scores (15), identified altered gene expression. Spearman rank correlation calculations evaluated viral-host gene expression associations. Detailed description of statistical methods is in Supplementary Data.
Gene ontology and Ingenuity pathway analysis. Gene ontology analysis categorizes genes into biologically meaningful groups (16). Gene ontology annotations enriched for genes whose expression was altered between tumor and normal samples or correlated with EBV gene expression were identified using Pearson
2 tests detailed in Supplementary Data. Lists of genes with altered expression were independently analyzed with Ingenuity Pathways software12 using a database of genetic and molecular interactions to identify networks of functionally related genes. Probability scores reflect the probability that genes are present in such networks by chance: a 1 in 100 chance is scored 2, 1 in 1,000 is scored 3, etc. The software assigns more weight to genes with higher fold expression changes. Genes whose expression showed the strongest association with EBV expression (correlation
0.60) were used without such weighting.
| Results |
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Comparison of genome-wide human gene expression profiles by unsupervised hierarchical clustering clearly distinguished normal epithelial samples from tumors (Fig. 1A ), which was confirmed by multidimensional scaling, displaying the difference in summarized gene expression profiles between any two samples as their distance in a two-dimensional plane (Fig. 1B; ref. 17). Other class discovery techniques based on identifying signature gene sets also did not provide strong statistical support for NPC subclassification. Therefore, by global gene expression, NPCs are a relatively homogenous group sharing many features distinct from site- and patient-matched normals.
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Analysis of donor-matched reference tissue minimizes the chance of inappropriately scoring genetic variability between patients as a difference between tumor and normal tissue. For the four matched sample pairs, 466 probesets measured consistent down-regulation and 581 probesets measured consistent up-regulation in the tumors (at least 1.5-fold). Of these, 429 and 402 probesets were on the shared list, respectively. Thus, two independent, stringent analyses identified 831 probesets that most consistently measured altered expression across the tumor collection and within the four matched tumor/normal pairs (gene IDs and information in Supplementary Table S3).
Many differentially expressed genes in NPC are involved in cell division and DNA replication. Gene ontology annotations describe gene products in terms of associated biological processes, cellular components, and molecular functions (16). More than 2,000 gene ontology categories of at least 10 probesets were examined for enrichment in genes represented by the 831 probesets. Thirty-six of 57 gene ontology classes enriched for up-regulated genes in the tumors described aspects of cell division and DNA replication, and of 23 gene ontology classes enriched for down-regulated genes, 10 described cytoskeleton-associated processes, including 4, relating to microtubule-based movement (Supplementary Table S4).
The 831 probesets measuring differential expression in NPC were also analyzed using the Ingenuity Systems database,12 which integrates published findings on biologically meaningful genetic or molecular gene/gene product interactions and identifies functionally related gene networks that overlap statistically significantly with a user-supplied gene list. Fourteen groups of genes were identified with a random chance probability of
106 (Supplementary Table S5). As in the gene ontology analysis, cell cycle and DNA replication/repair functions were prominent. Group 1, for example, contained 35 genes linked to cell cycle regulation, DNA replication and repair, or cell death. Of these, 23 were from the list of 831 probesets, a degree of overlap with a 1025 chance probability (Supplementary Table S5).
Viral gene expression in NPC. NPC biology is the result of cellular and EBV gene expression. Therefore, in parallel with the microarray-based human gene expression analysis, we used quantitative real-time PCR to measure expression of all EBV latent genes (EBNA1, EBNA2, EBNA3A, EBNA3B, EBNA3C, LMP1, and LMP2A), two early lytic genes (BZLF1 and BHRF1), and the EBV BART family of differentially spliced transcripts (20). All measurements were normalized to human ß-actin mRNA levels.
No significant EBV gene expression was detected in healthy tissue (Fig. 2
). In the tumors, EBNA1 and LMP2A RNAs and, particularly, BART RNAs were consistently detected, whereas LMP1 RNA was detectable in
60% of cases (Fig. 2; Supplementary Table S6). Detection of EBNA1, LMP2A and LMP1, BARTs, and EBERs, as verified histochemically, is consistent with a type II EBV latency program in NPC (21). The levels of other viral latent transcripts (EBNA2 and EBNA3s) were 200- to 2,000-fold lower than those of EBNA1 and LMP2A (Supplementary Table S6), likely representing infiltrating lymphocytes commonly present in NPCs but representing <5% of cells in our microdissected samples. EBNA2 and EBNA3 signals did not arise from PCR contamination, as measurements between samples did not show coordinated variation in levels of the different EBV genes, and EBNA2 and EBNA3 signals were absent from normal tissue samples and negative controls included in the experimental setup. Detectable levels of BZLF1 and BHRF1 RNA were observed in a few tumors, possibly reflecting a subpopulation of cells undergoing lytic EBV replication (Fig. 2; Supplementary Table S6).
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Increased EBV gene expression is highly correlated with down-regulated expression of MHC class I antigen presentation genes. Of 2,354 gene ontology classes containing
10 probesets, only 3 were significantly enriched for genes whose reduced expression was correlated with increased EBV expression. All three of these classes, "antigen presentation and endogenous antigen," "MHC class I receptor activity," and "antigen processing and endogenous antigen via MHC class I," are functionally related. The average inverse correlation between gene expression in these three gene ontology classes and EBNA1 expression was unusually high (chance probability <109). Figure 4
and Supplementary Table S7 illustrate the association between signals of EBNA1 and all 42 probesets representing 11 genes in one of these gene ontology classes, "antigen presentation and endogenous antigen." Most notable in Fig. 4 is the inverse correlation between expression of EBNA1 and all MHC class I HLA genes as indicated by the decrease in HLA expression (shift from red to blue) from top to bottom as EBNA1 RNA levels increase. Similar inverse correlation, albeit more moderate, was observed for most other genes in this class, including CD1D, HFE, HCG9, and TAP2 (Supplementary Table S7). HFE, expressed via
11 alternatively spliced transcripts, and CD1D encode MHC-like B2M-binding membrane proteins involved in iron absorption regulation and lipid antigen presentation, respectively (22, 23). TAP2 is a membrane-associated ATP-binding transporter protein with key roles in MHC class Imediated antigen presentation (24). HCG9 lies within the MHC class I region but has no assigned function. Because all of these genes, except CD1D, are closely chromosomally linked, their EBV-associated inhibition might involve coordinated regulation at the DNA level.
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0.6; Supplementary Table S8), identified three gene networks with a <1011 chance probability (Table 1
). The first group, with 12 focus genes among 35 functionally associated genes and an extremely low random chance probability of <1016, again contained several genes involved in MHC class I antigen presentation. The other two additional high-scoring groups of genes listed in Table 1 were involved in cancer-related functions, such as cell proliferation and DNA metabolism.
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LMP1-expressing tumors have increased antiapoptotic gene expression and decreased keratin gene expression. EBV latent protein LMP1 is an oncoprotein with antiapoptotic functions and associated with increased invasiveness and metastasis of EBV-associated tumors (29). Of the 31 tumor samples, 19 had detectable LMP1 mRNA levels. Using the EBarrays mixture approach (15) at 0.1% FDR, a set of 779 probesets measured up-regulated or down-regulated expression between LMP1-positive and LMP1-negative tumors (Supplementary Table S9). Among the 100 most highly up-regulated genes in LMP1-positive tumors were antiapoptotic BCL2-related protein A1 (BCL2A1) and Fas apoptotic inhibitory molecule (FAIM). Other genes highly up-regulated in LMP1-positive tumors included matrix metalloproteinase-1 (MMP-1), Spi-B transcription factor (SPIB), and v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homologue (KIT). Among highly down-regulated genes were multiple keratins (KRT4, KRT6B, KRT14, KRT23, and KRT24).
| Discussion |
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Most aberrantly expressed genes reflect tumor proliferative state. Functional categorization of genes overexpressed and underexpressed in NPC was independently achieved by querying the gene ontology (16)13 and Ingenuity Systems12 databases, each including thousands of functional categories. Not unexpectedly, the majority of up-regulated genes related to the proliferative state of the tumors, including cell division and DNA replication, recombination, and repair. Overexpressed genes included BUB1B and MAD2L1, mitotic spindle assembly checkpoint components responsible for proper chromosome segregation (30, 31). Their aberrant expression could be associated with chromosomal alterations frequently observed in NPC (32). Cyclin E2, whose expression peaks at the G1-S phase, is overexpressed in NPC as in many tumor-derived cell lines (33). Also up-regulated was NBS1, involved in DNA double-strand break repair and DNA damage-induced checkpoint activation (34).
Recently, a smaller study profiling expression of
9,000 genes in eight laser-microdissected NPC tissue samples reported 154 differentially expressed genes (12). Of those, only 7 up-regulated and 19 down-regulated genes were in our core set of 831 highly validated, differentially expressed genes (Supplementary Table S3). This limited overlap likely reflects a different choice of reference samples, as the previous study compared NPC RNA with pooled RNA from cell lines of various origins (including nonepithelial origins) rather than with normal healthy nasopharyngeal epithelium. Among genes that both studies measured as overexpressed in tumors were mitosin and Topoisomerase II
, which are essential for proper chromosome segregation (35, 36), MUC1, which is overexpressed in many carcinomas and related to invasiveness and poor prognosis (37, 38), and G2-M checkpoint gene CHEK1, up-regulated in response to DNA damage (39). CHEK1 inhibitors abrogating the G2 block enhance radiation toxicity in human lymphoma and colon cancer cell lines (40). Because radiotherapy is the recommended treatment for NPC, sensitizing tumor cells to radiation with CHEK1 inhibitors might improve outcome.
EBV is highly associated with modulation of antigen presentation in NPC. The quantitative real-time PCR data agree with previous assessment of NPC as displaying a type II EBV latency program. As in other EBV-associated epithelial malignancies, EBNA1 is the single viral gene product that is invariably detected, whereas a subset of tumors is positive for LMP1, LMP2A, or other viral oncogenes (41). In addition, a family of differentially spliced viral transcripts, the BART RNAs, is highly expressed in NPC (42, 43). Most EBV transcripts were undetectable in microarray-based assays using 24-mer or 70-mer oligonucleotide platforms (data not shown), which underscores the importance of low-abundance transcripts that remain undetected by microarrays.
With the noted exception of BART transcripts, expression levels of EBV genes in NPC were similarly and inversely correlated with the expression of a large subset of human genes (Fig. 3A; Supplementary Table S8). Therefore, the changes in host gene expression were not necessarily attributable to any particular single viral gene product. For further comparisons with human gene expression, we chose EBNA1 to represent EBV gene expression because, among viral genes sharing correlated expression with host gene expression, EBNA1 was consistently detected in all tumor samples, in line with its essential role in faithful segregation of EBV DNA with host chromosomes during mitosis (44). We did not use BART transcripts to represent overall viral gene expression because differences in BART transcript levels surprisingly did not correlate with any expression changes in either EBV or host genes. The high levels of BART expression, approaching ß-actin mRNA levels, may be saturating so that dose responsiveness of host genes to the actions of BART is no longer evident. In addition, our quantitative real-time PCR analysis did not distinguish between differentially spliced BART transcripts encoding BARF0, A73, RPMS1, and RPMS1A (42). RPMS1 binds CBF1, a mediator of Notch signaling, possibly negatively regulating Notch signal transduction (42). A73 has been suggested to contribute to tumor cell development via its association with RACK1 (42). The high abundance of BART RNAs suggests important function(s) in NPC that needs further study.
Gene ontology analysis showed that, for host genes with highly EBV-associated decreases in expression, significantly enriched annotations were antigen processing, presentation, and receptor activity. Most strongly inverse correlated with EBNA1 expression were the expression levels of all MHC class I HLA genes (Fig. 4), which play central roles in immunity by presenting foreign peptides to cytotoxic T cells. Ingenuity Pathway analysis independently identified HLA-A and HLA-F in the highest scoring functional gene network. The strong correlation between EBV gene expression and down-regulation of HLA expression is particularly intriguing in light of other links between MHC class I HLAs, NPC, and EBV. Recent high-resolution HLA typing confirmed a particular HLA allele common in individuals of Chinese, but not Caucasian, descent as a NPC risk factor (5). This HLA allele might be associated with greater susceptibility to suppression by EBV, reduced efficiency for presenting EBV or host antigens, or both.
Because histopathology and quantitative real-time PCR showed that EBV is present in all NPC tumor cells but at varying genome copy numbers and/or expression levels, the strong inverse correlation in NPC between HLA and EBV gene expression (Fig. 4) implies dose responsiveness similar to down-regulation of MHC class I surface expression by other herpesviruses (2528). Overall, our results are consistent with reports that NPC cells and cultured NPC cell lines display class I cell surface HLA (45, 46) but indicate that they do so at reduced levels. These findings imply that, in NPCs, EBV inhibits MHC class I presentation of its own antigens, including TAP-independent presentation of LMP2A (47), and presentation of other antigens, facilitating tumor cell evasion of immunosurveillance. This would increase tumor cell survival while allowing elevated viral gene expression and consequently enhanced tumorigenic potential through viral functions, such as from LMP1. The observation that tissue-cultured NPC cells rapidly lose EBV is also consistent with an immunosurveillance-based selection mechanism.
Other genes whose expression is inversely correlated with EBNA1 expression. Expression of PSMD5, part of the 19S regulator of the 26S proteasome, showed the strongest inhibition with increasing levels of EBNA1, suggesting a function for EBV in down-regulating protein turnover. This would be separate from generating antigenic peptides presented by MHC class I, which is the responsibility of a modified proteasome with the 11S regulator instead of 19S (48). EBNA1 RNA levels were used only to represent overall viral gene expression, and PSMD5 regulation does not necessarily relate to previous suggestions that Gly-Ala repeat sequences in EBNA1 prevent its proteosomal degradation (49, 50).
In B cells, EBNA1 inhibits apoptosis, a potential advantage for EBV-positive tumor cells (51). Latent EBV infection protects Burkitt lymphomaderived cells from cell cycle arrest and apoptosis by interfering with a G2 phase or mitotic checkpoint, possibly through EBNA1, the EBNA3 family of proteins (EBNA3A, EBNA3B, and EBNA3C), the EBERs, or the BARTs (52). Not inconsistently, our findings in epithelial cells show that EBNA1 expression correlates with down-regulated expression of AKIP, SCYL1, and NIN (Supplementary Table S8), all associated with cell cycle checkpoints. AKIP down-regulates and interacts specifically with Aurora-A kinase, whose overexpression transforms cultured cells and causes aneuploidy via aberrant chromosomal segregation (53). SCYL1 is a centrosome-associated, cell cyclerelated protein whose dysfunction likely plays a role in cancer (54). NIN encodes a centrosomal protein important for positioning and anchoring microtubule minus ends in epithelial cells and correct chromosomal segregation (55). By suppressing accumulation of these mRNAs, EBNA1 might contribute toward bypassing the mitotic spindle checkpoint and eventual chromosomal disarray in tumor cells.
Antiapoptotic and metastasis-associated genes are highly overexpressed in LMP1-positive tumors. EBV LMP1 is a well-studied oncogene (41). Accordingly, we identified human genes differentially expressed between tumors with or without detectable LMP1 expression (Supplementary Table S9). Many keratin genes were down-regulated in LMP1-expressing tumors, including Keratin 4, which is expressed in differentiated epithelia (56), perhaps reflecting the contribution of LMP1 to the undifferentiated state of NPCs. Independently validating our results is the overexpression of tyrosine kinase KIT in LMP1-expressing tumors (Supplementary Table S9) as previously observed in EBV-positive, undifferentiated nonkeratinizing NPCs (57). Recently, KIT was shown to be a major component in KSHV-induced cell transformation (58).
Also up-regulated in LMP1-positive tumors are antiapoptotic genes, such as FAIM (59) and BCL2A1, which blocks caspase activation by reducing mitochondrial cytochrome c release (60). LMP1 inhibits apoptosis in Burkitt's lymphoma by up-regulating BCL2A1 transcription through interactions with tumor necrosis factor receptor/CD40 signaling (61, 62).
LMP1-positive tumors had 2.5-fold increased levels of MMP-1 expression (Supplementary Table S9), in keeping with a recent targeted study of MMP-1 in NPCs (63). MMP-1 and other MMPs facilitate extracellular matrix breakdown and are associated with metastasis and poor prognosis. High MMP-1 expression might contribute to the highly malignant nature of NPC. LMP1-positive tumors also overexpressed SPIB, consistent with epithelial cell studies showing that LMP1 induces MMP-1 transcription via ETS transcription factors, such as SPIB (64). In addition, another recent report described a possible link between EBV LMP2A and NPC metastasis (65).
| Acknowledgments |
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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.
We thank the NPC patients enrolled in these studies and the study nurses, technicians, and coordinators in Taiwan; Beth Mittl, Jeanne Rosenthal, and Erika Wilson (Westat, Inc., Rockville, MD) and Jackie King (BioReliance Corp., Rockville, MD) for specimen and data management support and storage; and Andreas Friedl (University of Wisconsin-Madison) for interpreting histopathology, Lona Barsness (University of Wisconsin-Madison) for histopathology assistance, Dan Lautenschleger (University of Wisconsin-Madison) for computer support, Jim Bruce (University of Wisconsin-Madison) for helpful discussions, and the University of Wisconsin Gene Expression Center for microarray analysis facilities.
| Footnotes |
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S. Sengupta is currently at the WiCell Research Institute, Madison, Wisconsin. I.-H. Chen is currently at the Department Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.
13 http://www.geneontology.org/. ![]()
Received 12/12/05. Revised 5/26/06. Accepted 6/15/06.
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