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Molecular Oncology |
College of Pharmacy [Y. G., Y. M., J. E. K., J. L., M. G. W., J. L-S. A.] and James Cancer Hospital and Solove Research Institute [M. G. W., J. L-S. A.], The Ohio State University, Columbus, Ohio 43210, and University of Southern California, Los Angeles, California 90033 [K. D., P. D.]
| ABSTRACT |
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| INTRODUCTION |
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MMC is activated by one-electron reduction to a semiquinone radical and/or two-electron reduction to a hydroquinone. The one-electron reduction is mainly catalyzed by P450R (8)
, and the two-electron reductase is mainly mediated by DTD, also known as NAD(P)H:quinone oxidoreductase (9)
. Multiple studies have indicated a correlation between DTD and tumor sensitivity to MMC: (a) the expression of DTD gene and its enzyme activity correlate with MMC sensitivity in multiple cancer cell lines and lung tumor xenografts (10, 11, 12, 13, 14, 15)
; (b) transfection of the DTD gene into the DTD-deficient and MMC-resistant gastric cancer cell line St-4 enhances the MMC activity by 5- to 10-fold (10)
; and (c) induction of MMC-resistance in non-small cell lung cancer cells (PC-9 and LU99) and bladder cancer cells (J82) by continuous exposure to MMC or its analogues is accompanied by decreased DTD activities (12, 13, 14)
. The relationship between DTD and MMC activation is complex. The expression of DTD is induced by multiple drugs including MMC, possibly involving the AP-1 promoter (16)
and the nuclear factor
B response element (17)
. On the other hand, high levels of DTD protect cells from MMC toxicity (reviewed in Ref. 18
). Single nucleotide polymorphism in the DTD gene results in altered enzyme function. For example, a C to T change at the position 609 of DTD cDNA results in a greatly diminished DTD protein level and a >95% reduction of DTD activity (19
, 20)
.
The role of P450R in the activation of MMC is less clear. Some studies indicate a relationship between P450R and MMC activity, including the findings that (a) transient transfection of monkey kidney COS1 cells with the P450R gene resulted in activation of MMC and detection of specific MMC-DNA adducts and interstrand DNA cross-linking (21) ; (b) resistance of Chinese hamster cells to MMC is related to decreased P450R activity (22) ; and (c) addition of exogenous P450R in the culture medium enhances the MMC activity in cultured cells (23) . However, other studies have shown a lack of correlation between P450R activity and tumor sensitivity to MMC and MMC analogues (10 , 13 , 24) .
Despite the rather extensive knowledge on the relationship between quinone reductases and MMC sensitivity in human cancer cells, it is not known whether the expression of these enzymes correlates with the MMC sensitivity in human solid tumors. The goal of the present study was to establish the extent of intertumor variability in the expression of DTD and P450R and whether the variability in the enzyme expression contributes to the variability of MMC sensitivity in human bladder tumors. We used three-dimensional histocultures of human bladder tumors to study the MMC effect. DTD and P450R expression in tumors was determined by competitive RT-PCR, and their activities were measured by bioreductive assays. The major advantages of the histoculture system are the maintenance of tissue architecture, cell-cell interaction, and inter- and intratumoral heterogeneity (25) . The clinical relevance of the human tumor histoculture system has been demonstrated by Hoffman and colleagues (Robbins et al., Kubota et al., and Furukawa et al.; 26, 27, 28) . These investigators have shown in retrospective and semiprospective preclinical and clinical studies that drug response in human solid tumor histocultures correlates with the sensitivity, resistance and survival of cancer patients to chemotherapy (26, 27, 28) .
| MATERIALS AND METHODS |
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Tumor Specimens and Histocultures.
Specimens of human bladder tumors were placed in MEM within 1030 min after surgery. Tumors from our institute was obtained from the Tumor Procurement Service at The Ohio State University Comprehensive Cancer Center and tumors from off-campus sources were shipped by overnight delivery services. Tumor grade and stage were determined by pathologists at individual institutions. All of the tumor specimens used in this study were from chemotherapy naive patients.
Histoculture of tumors was performed as described previously (29 , 30) . In brief, tumor specimens were cut to about 1 mm3. Four to six tumor pieces were placed on a 1-cm2 presoaked collagen gel and were cultured in a humidified atmosphere of 95% air and 5% CO2 at 37°C. The medium was MEM supplemented with 9% heat-inactivated fetal bovine serum, 0.1 mM nonessential amino acids, 100 mg/ml gentamicin, and 95 mg/ml cefotaxime, and had a pH of 7.4.
Pharmacodynamic Studies.
The antiproliferative effect of MMC was measured by the inhibition of DNA precursor incorporation in tumor cells. Initial experiments used [3H]thymidine as the DNA precursor. On the basis of the finding that the two DNA precursors, BrdUrd and [3H] thymidine, labeled the same cells, which resulted in identical labeling indices in human bladder tumors (31)
, the nonradioactive BrdUrd was used in subsequent experiments.
Tumor histocultures were exposed to various concentrations of MMC ranging from 0.01 to 100 µg/ml for 2 h. The exposure time is equivalent to the duration of drug instillation for intravesical therapy in patients. After drug treatment, the medium was exchanged, and the tumors were washed three times with 5 ml of drug-free medium. Tumors were labeled with [3H] thymidine (1 µCi/ml) or BrdUrd (40 µM) for 96 h, then fixed in 10% neutralized formalin and embedded in paraffin. The embedded tissues were cut into 5-µm sections using a microtome and deparaffinized, and then were processed for autoradiography for 4 days or were stained for BrdUrd incorporation by immunohistochemistry (29 , 30) . Controls were processed similarly, with the exception of drug treatment. Tissue sections were examined microscopically, the [3H]thymidine- or BrdUrd-labeled tumor cells were scored, and LI was determined.
The relationship of MMC-induced inhibition of proliferation and drug concentration was analyzed by computer-fitting the following equation to the experimental data.
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Preparation of Internal Standard.
In competitive RT-PCR, internal standards are used to correct for the differences in the amplification efficiency. An ideal internal standard should have the same primer sites and consist of nearly identical DNA sequence as the target gene, with the exception of a small size difference to enable separation from the target gene product. Several methods have been used to develop internal standards, including site-directed mutation to create a restriction enzyme recognition site, introducing a spacer gene into the target sequence, and artificially synthesizing a short internal standard (reviewed in Ref. 32
). In the present study, we developed a simple method to construct internal standards that have the ideal properties. We first obtained the sequences of DTD, P450R, and ß-actin genes from a BLAST search and then selected the PCR primers to amplify target gene fragments that contain two recognition sites of restriction enzymes. The amplified sequences were cut with appropriate restriction enzymes, and the two ends were then ligated with ligase to yield the internal standards, which shared the same sequences as the target genes with the exception of the deleted sequences. The detailed procedures were as follows. For DTD, the two primers were DTDA, 5'-AGGCTGGTTTGAGCGAGTGTTC-3'; and DTDB, 5'-ATTTGAATTCGGGCGTCTGCTG-3'; these two primers amplified a 270-bp cDNA fragment that contains RSAI and HaeIII recognition sites separated by 44 bp. For P450R, the two primers were P450RA, 5'- GAAGAGCTACGAGAACCAG-3'; and P450RB, 5'-ATCCAGGTTGTTCAGGGA-3'; these primers amplified a 259-bp cDNA fragment that contains two MaeII recognition sites that were separated by 72 bp. For ß-actin, the two primers were actinA, 5'- GCGGGAAATCGTGCGTGACATT-3'; and actinB, 5'-GATGGAGTTGAAGGTAGTTTCGT-3', which amplified the 232-bp cDNA fragment that contains two HaeIII sites, separated by 52 bp. The amplified PCR products using the above-described primers were cut by the corresponding restriction enzymes. The fragment were separated by 1.8% agarose gel electrophoresis and eluted by gel extraction kit. The fragments at 5' and 3' ends were ligated by T4 DNA ligase and cloned into the pGEMT-easy vector according to the manufacturers instruction. The recombinant plasmids that contained short DTD (226 bp), P450R (187 bp), and ß-actin(180 bp) were confirmed by sequencing and were used as template for preparation of internal standards by PCR.
Competitive RT-PCR.
Tumor tissues (24 mm3 in size) were minced into smaller fragments (less than 0.5 mm3) and transferred to 1.5-ml Eppendorf tubes. The tissues were homogenized with a Kontes pellet pestle (Fisher, Pittsburgh, PA) in Tris-HCl buffer [40 mM (pH 7.4); 100 µl per
1 mm3 tumor tissue]. The mixture was centrifuged at 18,000 x g for 15 min at 4°C. Two hundred µl of supernatant were used for extracting total RNA. The remaining supernatant (from larger tumor samples) was used to measure DTD and P450R activity. Total RNA was extracted using the High Pure RNA Isolation kit. The first strand cDNAs were synthesized according to the description in the First Strand cDNA Synthesis kit for RT-PCR. To establish the standard curve for competitive RT-PCR, we first determined the amount of internal standard template that yielded a band intensity that was similar to the intensity of the target gene band. The amount of the internal standard was 7.5 x 10-14 g for DTD, 3 x 10-14 g for P450R, and 3 x 10-13 g for ß-actin. We then mixed a fixed amount of internal standard with different amounts of target gene template to identify the linear range of the standard curve. Two µl of sample cDNA was used in PCR amplification (25-µl total volume). PCR was performed on the GeneAmp PCR system 2400 (Perkin-Elmer) and was initiated by 1 cycle at 94°C for 3 min, at 55°C for 2 min, and at 68°C for 2 min; then 30 rounds at 94°C for 30 s, at 55°C for 30 s, and at 68°C for 30 s; followed by 68°C for 10 min. The PCR products (10 µl) were electrophoresed on 1.8% agarose and visualized by ethidium bromide staining. The image was captured by a gel documentation system (Gel Print 2000 i, Biophotonics) and analyzed using the GPTools software package. The ratios of the intensities of the bands corresponding to DTD, P450R, ß-actin and their internal standards were determined and used, together with the standard curves, to calculate the amount of DTD, P450R, and ß-actin cDNAs. The expression of DTD and P450R was normalized to the ß-actin expression.
Measurement of Enzyme Activity.
Protein concentrations were determined using the Bicinchoninic Acid Kit. The activity of DTD and P450R was measured according to the methods of Benson et al. (33)
and Smitskamp-Wilms et al. (13)
, respectively, with the following modifications. Briefly, aliquots of the supernatant fractions of tumor homogenates containing 050 µg of protein (for P450R) or 020 µg of protein (for DTD) in a volume of 100 µl were added in duplicate to the wells of a 96-well plate kept on ice. Blank samples without tumor extracts were used to correct for nonenzymatic reduction of substrates. The enzyme reaction was followed by monitoring changes in absorbance using a microplate reader. Enzyme activity was expressed as the rate of reduction of substrate per mg of protein for both DTD and P450R.
For DTD determination, the standard curve was constructed using different concentrations of DCPIP (0, 2.5, 5, 10, 20, 40, 80, and 160 µM) dissolved in a Tris/NADPH solution [final concentration of 25 mM Tris-HCl (pH 7.4) and 0.2 mM NADH], with and without 75 µM dicumarol, a DTD inhibitor. DCPIP is an electron acceptor for DTD, and its absorbance at 600 nM decreases on reduction by DTD and by nonenzymatic processes. To the tumor protein extract, 200 µl of the Tris/NADPH solution containing 60 µM DCPIP with or without 75 µM dicumarol was added. The enzymatic reaction was initiated by incubating the plate on a water bath at room temperature and followed by measuring the absorbance at 600 nM at 2.5 min. The amount of DCPIP remaining in the samples with and without dicumarol was determined using the corresponding standard curves. DTD activity was calculated as the dicumarol-inhibited fraction of the DCPIP reduction.
The standard curve for P450R was constructed using different ratios of reduced:oxidized cytochrome C in a total amount of 50 µM (0:50, 1:49, 2.5:47.5, 5:45, 10:40, 20:30, 40:10, and 50:0) dissolved in the Tris/NADPH solution. To the tumor protein extracts, a mixture of 200 µl of Tris/NADPH solution containing 50 µM cytochrome C was added, and the reaction was started at room temperature. The appearance of reduced cytochrome C was determined from the increase in absorbance at 550 nm, at 2.5 min. Samples containing only oxidized cytochrome C were used as blanks.
Statistical Analysis.
Differences in mean values between two or more groups were analyzed using Students t test and the one-way ANOVA, respectively. Predictive relationships between tumor pathobiological parameters and tumor chemosensitivity were evaluated by linear regression analysis using the maximal r2 selection method and the REG software routine of SAS (Cary, NC). This analysis identifies the model with the highest coefficient of determination for combinations of predictors. An accepted principle of development of a predictive model is to select the simplest model that gives a good description of the data (34)
. Generally, an increase in model complexity or number of predictors increases the goodness of fit or r2. We used the Akaike Information Criterion (AIC) to balance model simplicity and goodness of fit (34)
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| RESULTS |
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Relationship between DTD/P450R Expression and Tumor Sensitivity to MMC.
In the 21 patient bladder tumors, the expression of DTD and P450R was correlated with tumor sensitivity to MMC; the IC50 and IC90 of MMC were inversely correlated with DTD expression (r2, 0.28, and P = 0.01 for IC50; r2, 0.25, and P < 0.05 for IC90) and with P450R expression (r2, 0.26 for IC50; r2, 0.19 for IC90; for both, P < 0.05). Multivariate analysis identified DTD expression and P450 expression as the first and second most important single-parameter determinants of MMC activity, and the combination of expression of DTD and P450R as the most important two-parameter determinant (Table 2)
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| DISCUSSION |
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In cultured cells, DTD is considered the more important enzyme in the activation of MMC, as compared with P450R. For example, DTD is the only enzyme the activity of which correlates with the sensitivity of 69 cell lines to MMC (35) , whereas the activity of P450R is not correlated with MMC sensitivity in multiple cancer cell lines (10 , 13 , 24 , 35) . On the other hand, it is well established that the relative contribution of DTD and P450R to the activation of MMC depends on the microenvironment; P450R is the key enzyme under hypoxic conditions, whereas DTD activates MMC under both aerobic and hypoxic conditions (reviewed in Refs. 18 , 36 ). The bioactivation of MMC by DTD is also pH dependent. For example, DTD is active and capable of reducing MMC at or below pH 7.4 but not above pH 7.8 (36) . The present study was performed using histocultures of patient tumors. Histocultures are three-dimensional systems that retain some of the features of solid tumors including cell-to-cell interaction and intratumoral microenvironmental heterogeneity. Hence, our finding suggests that both DTD and P450R are important in the activation of MMC in solid tumors. Our laboratory is currently investigating the relationship between the expression of these enzymes and the response to intravesical MMC treatment in individual patients, as a part of a Phase III clinical study.
| FOOTNOTES |
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1 Supported in part by NIH R37CA49816 and R01CA58988 from the National Cancer Institute, Department of Health and Human Services. ![]()
2 To whom requests for reprints should be addressed, at College of Pharmacy, The Ohio State University, 500 West 12th Avenue, Columbus, OH 43210. Phone: (614) 292-4244; FAX: (614) 688-3223. ![]()
3 American Cancer Society. Estimated new cancer cases and deaths by sex for all sites, United States. Internet address: http://www.cancer.org. ![]()
4 The abbreviations used are: MMC, mitomycin C; DTD, DT-diaphorase; DCPIP, 2,6-dichlorophenolindophenol; IC50 and IC90, drug concentration needed to produce a 50% and 90% inhibition of DNA precursor incorporation; P450R, cytochrome P450 reductase; RT-PCR, reverse transcription-PCR; BrdUrd, bromodeoxyuridine; LI, labeling index. ![]()
Received 8/10/00; revised 2/ 5/01; accepted 2/14/01.
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B in the induction of NAD(P)H:quinone oxidoreductase (DT-diaphorase) by hypoxia, altipraz and mitomycin C. Biochem. Pharmacol., 49: 275-282, 1995.[CrossRef][Medline]
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