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Experimental Therapeutics, Preclinical Pharmacology |
Department of Cancer Biology and the Cancer Center, University of Massachusetts Medical School, Worcester, Massachusetts 01605
| ABSTRACT |
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Experimental Design: Human umbilical vein and dermal microvascular endothelial cells were infected with replication-deficient adenoviruses encoding survivin (pAd-Survivin), green fluorescent protein (pAd-GFP), or a phosphorylation-defective survivin Thr34
Ala (pAd-T34A) dominant negative mutant. The effect of wild-type or mutant survivin was investigated on capillary network stability, endothelial cell viability, and caspase activation in vitro and on kinetics of tumor growth and development of angiogenesis in a breast cancer xenograft model in vivo. The cell death pathway initiated by survivin targeting was mapped with respect to cytochrome c release, changes in mitochondrial transmembrane potential, and apoptosome requirements using mouse embryonic fibroblasts deficient in Apaf-1 or caspase-9.
Results: Adenoviral transduction of endothelial cells with pAd-Survivin inhibited growth factor deprivation- or ceramide-induced apoptosis, reduced caspase-3 and -7 generation, and stabilized three-dimensional capillary networks in vitro. Conversely, expression of pAd-T34A caused apoptosis in umbilical vein and dermal microvascular endothelial cells and resulted in caspase-3 activity. Cell death induced by survivin targeting exhibited the hallmarks of mitochondrial-dependent apoptosis with release of cytochrome c and loss of mitochondrial transmembrane potential and was suppressed in Apaf-1 or caspase-9 knockout mouse embryonic fibroblasts. When injected in human breast cancer xenografts, pAd-T34A inhibited growth of established tumors and triggered tumor cell apoptosis in vivo. This was associated with a
60% reduction in tumor-derived blood vessels by quantitative morphometry of CD31-stained tumor areas, and appearance of endothelial cell apoptosis by internucleosomal DNA fragmentation in vivo.
Conclusions: Survivin functions as a novel upstream regulator of mitochondrial-dependent apoptosis, and molecular targeting of this pathway results in anticancer activity via a dual mechanism of induction of tumor cell apoptosis and suppression of angiogenesis.
| INTRODUCTION |
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Among the regulators of apoptosis that may participate in cancer (4) , interest has been recently focused on survivin (8) . A member of the IAP5 gene family (9) , survivin is expressed in most human tumors but is largely undetectable in normal differentiated tissues and correlates with reduced tumor cell apoptosis in vivo, abbreviated patient survival, accelerated rates of recurrences, and increased resistance to therapy (10) . Molecular antagonists of the survivin pathway, including antisense, ribozymes, or dominant negative mutants, have shown efficacy in causing spontaneous apoptosis in tumor cells, enhancement of cell death stimuli, including chemotherapy and irradiation, and catastrophic mitotic defects (10) . Consistent with the idea that manipulation of apoptotic pathways could provide novel cancer therapeutics (11) , molecular targeting of survivin showed promising results in preclinical models in vivo, suppressing de novo tumor formation and inhibiting growth of established tumors, alone or in combination with other anticancer approaches (reviewed in Refs. 10 and 12 ). However, critical gaps in our understanding of the survivin pathway still exist that have hampered its full exploitation for cancer therapeutics. Specifically, how survivin couples to the cell death machinery (13) has not been fully elucidated, and the potential cellular targets of survivin antagonists have not been clearly defined (10) . The complexity of the survivin pathway may extend beyond the tumor cell population, and increased survivin expression has been demonstrated in endothelial cells during the proliferative (14 , 15) and remodeling (16 , 17) phases of angiogenesis, potentially acting as a cytoprotective mechanism for these cells (18) .
To conclusively credential the survivin pathway for cancer therapeutics, we used a phosphorylation-defective survivin Thr34
Ala dominant negative mutant (19)
and mapped the link between survivin and the cell death machinery and its implications for tumor growth in vivo. We found that survivin functions as a novel upstream regulator of mitochondrial-dependent apoptosis and that this pathway is required for preservation of tumor cell viability as well as maintenance of tumor-associated angiogenesis in vivo.
| MATERIALS AND METHODS |
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Ala mutant [survivin(T34A)] upon Tet removal (Tet-off system) was characterized previously (20)
. MEFs originated from wild-type, Apaf-1-/- (21)
, or caspase 9-/- (22)
embryos have been described previously. MEFs were cultured in DMEM supplemented with 10% fetal bovine serum, 100 units/ml penicillin, 100 µg/ml streptomycin, and 0.05% ß-mercaptoethanol. Breast carcinoma MCF-7 and kidney epithelial HEK293 cells were obtained from the American Type Culture Collection (Manassas, VA) and maintained in culture according to the suppliers specifications. An affinity-purified rabbit antibody to full-length recombinant survivin (1:1,000; NOVUS Biologicals, Littleton, CO) was characterized previously (23)
. Rabbit polyclonal antibodies to caspase-3 (1:5,000) or caspase-7 (1:750) were from Transduction Laboratories or NOVUS Biologicals, respectively. Antibodies to GFP (1:1,000; Clontech, Palo Alto, CA), ß-actin (1:10,000; Sigma, St. Louis, MO), cytochrome c (1:1,000; PharMingen, San Diego, CA), PARP (1:1,000; PharMingen), or Cox-4 (1:5,000; Clontech) were also used.
Adenoviral Transduction.
Replication-deficient adenoviruses encoding wild-type survivin (pAd-Survivin), GFP (pAd-GFP), or survivin Thr34
Ala mutant (pAd-T34A) were generated using the pAd-Easy system, as described previously (24)
. Viruses were propagated in HEK293 cells and purified by CsCl banding. With this protocol, no replication-competent adenovirus particles are generated (24)
. For adenoviral transduction, monolayers of proliferating endothelial cells or genetically modified MEFs were incubated with pAd-GFP, pAd-Survivin, or pAd-T34A at a multiplicity of infection of 50 in M199 medium plus 20% FCS for 10 h, washed with PBS (pH 7.4), and placed in fresh medium plus 20% FCS for 16 h at 37°C. Transduction efficiency (>95% of the cell population) was estimated by GFP fluorescence.
Three-dimensional Capillary Formation.
HUVEC monolayers (80% confluence) in 6-well clusters were incubated with pAd-GFP or pAd-Survivin at a multiplicity of infection of 50 for 8 h at 37°C followed by an additional 24-h incubation in complete medium at 37°C. Rat tail type I collagen (3 mg/ml; Becton Dickinson, Bedford, MA) in 0.1 volume of 10x DMEM was neutralized with sterile 1 M NaOH and kept on ice. HUVECs were added to the collagen suspension to a final concentration of 1 x 106 cells/ml collagen. Ten drops (0.1 ml each) of the HUVEC-collagen mixture were added to a 35-mm plate. Plates were placed in a humidified incubator at 37°C, and the HUVEC-collagen mixtures were allowed to gel for 10 min, after which 3 ml of M199 medium containing 20% FCS, 50 µg/ml endothelial cell growth supplement, 100 µg/ml heparin, 100 µg/ml penicillin, and 100 µg/ml streptomycin were added to each plate. Cells were allowed to form capillary-like vascular tubes over a 7-day culture in the presence of 16 nM PMA (Sigma). Addition of PMA results in a potent morphogenic effect promoting the formation of three-dimensional vascular tube-like structures, which closely mimic capillary formation in vivo via a protein kinase C-, mitogen-activated protein kinase-, and phosphatidylinositol 3'-kinase-dependent pathway (25)
. As determined in previous studies, PMA withdrawal under these conditions results in rapid regression of capillary structures and HUVEC apoptosis in vitro. In other experiments, capillary tube formation was assessed in HUVEC or DMVEC cultures in Matrigel (200 µl) in the presence of VEGF (50 ng/ml) and assessed by phase-contrast microscopy during a 4872-h culture at 37°C. To quantify tube formation, cells were washed three times in PBS (pH 7.4) and snap frozen in OCT embedding compound. Cryostat sections of the gels (6 µm) were placed on poly-L-lysine-coated glass slides, fixed with acetone for 10 min at -20°C, air-dried, and stained with H&E. Sections were examined by phase-contrast microscopy, and the total vessel area (in 3 fields/slide in each experiment) was quantified using the NIH (Bethesda, MD) Image program.
Cell Viability and Apoptosis.
HUVECs transduced with pAd-GFP, pAd-Survivin, or pAd-T34A were incubated in 0% FCS for up to 72 h or, alternatively, treated with 25 µM C6 ceramide or the combination of TNF-
(10 ng/ml; Endogen, Woburn, MA) plus CHX (10 µg/ml; Sigma), for 612 h at 37°C (14)
. Cultures under the various conditions were analyzed for nuclear morphology of apoptosis after fixation in 4% paraformaldehyde containing 0.25% Triton X-100 for 10 min at 22°C, and staining of cell nuclei was performed with 6.5 µg/ml DAPI (Sigma) in 16% polyvinyl alcohol (Air Products and Chemicals, Allentown, PA) and 40% glycerol. The percentage of apoptotic cells was calculated by direct counting of nuclei with apoptotic morphology (condensed chromatin, fragmented DNA) in five independent high-power fields (x400; each field contained about 150 cells) in three independent experiments, using a Zeiss fluorescence microscope (26)
. For survivin targeting, exponentially growing HUVECs or DMVECs were transduced with pAd-GFP, pAd-survivin, or pAd-T34A; harvested after a 96-h culture at 37°C; and analyzed for DNA content by propidium iodide staining and flow cytometry. The hypodiploid (i.e., apoptotic) cell fraction was quantified using CELL Quest software (Becton Dickinson), as described previously (27)
. Apoptosis in transduced wild-type or Apaf-1 or caspase-9 knockout MEFs was also assessed by DNA content analysis and flow cytometry (27)
. For quantification of caspase activity, virally transduced HUVECs were lysed in 0.5% Triton X-100, 10 mM KCl, 1.5 mM MgCl2, 1 mM EDTA, 1 mM DTT, 20 mM HEPES, and protease inhibitors. Protein-normalized aliquots of the various cell extracts were separated by SDS-gel electrophoresis, transferred to nylon membranes (Millipore Corp.), and immunoblotted with antibodies to caspase-3, caspase-7, survivin, GFP, or ß-actin, followed by chemiluminescence and autoradiography. In parallel experiments, detergent-solubilized HUVEC extracts were assayed for caspase-3-dependent hydrolysis of the fluorogenic substrate N-acetyl-Asp-Glu-Val-Asp-aldehyde (Ac-DEVD-AMC; PharMingen, San Diego, CA), with determination of fluorescence emissions on a spectrofluorometer with excitation wavelength of 360 nm and emission of 460 nm.
Characterization of Mitochondrial-dependent Apoptosis.
Tet-regulated YUSAC-2 cells (5 x 107 cells; Ref. 20
) were washed in TD buffer containing 135 mM NaCl, 5 mM KCl, and 25 mM Tris-HCl (pH 7.6) and allowed to swell for 10 min in ice-cold hypotonic CaRSB buffer [10 mM NaCl, 1.5 mM CaCl2, 10 mM Tris-HCl (pH 7.5) and protease inhibitors]. Cells were Dounce-homogenized with 60 strokes, with addition of MS buffer [210 mM mannitol, 70 mM sucrose, 5 mM EDTA, and 5 mM Tris (pH 7.6)] to stabilize mitochondria (2 ml of 2.5x per 3 ml of homogenate). After removing nuclear contaminants by centrifugation at 3,000 rpm for 15 min on ice, the supernatants were layered over a 12 M sucrose step gradient [in 10 mM Tris (pH 7.6), 5 mM EDTA, 2 mM DTT, and protease inhibitors] and centrifuged at 110,000 x g for 30 min at 4°C. Mitochondria were collected at the 11.5 M interphase by lateral suction through the tube, washed in 4 volumes of MS buffer at 15,000 rpm, and suspended in a final volume of 200 µl of MS buffer. The top layer containing a cytosolic and free protein fraction was collected and used in parallel experiments. Samples from cytosolic or mitochondrial fractions harvested at various time intervals in the presence or absence of Tet were analyzed sequentially by Western blotting with antibodies to cytochrome c, PARP, Cox-4, or ß-actin followed by chemiluminescence. To monitor changes in mitochondrial transmembrane potential, Tet- YUSAC-2 cells expressing wild-type survivin or survivin(T34A) were harvested at increasing time intervals (672 h) at 37°C, suspended in 600 µl of distilled deionized water, and homogenized. Cell homogenates were incubated with the green fluorescence dye JC-1 (10 µg/ml; Molecular Probes Inc., Eugene, OR) for 10 min in the dark, washed in ice-cold PBS, and analyzed by flow cytometry.
Breast Cancer Xenograft Model.
Female 68-week-old C.B.-17 SCID/beige mice (Taconic Farms, Germantown, NY) received s.c. injection (one injection in each flank) with 2.5 x 106 exponentially growing MCF-7 cells in 250 µl of sterile PBS (pH 7.4). Tumor growth was confined to local masses and did not affect animal survival over a 4-month observation period, as described previously (24)
. About 5 days after injection, tumors became palpable, and groups of three animals were randomized and distributed between treatment groups (6 tumors/group). Animals were treated with pAd-GFP or pAd-T34A by intratumoral injections (109 green fluorescence units in 50 µl distributed between 3 sites/tumor mass) on 2 consecutive days followed by 5 days of interval (24)
. Tumor volume was monitored by measuring tumors in the three dimensions with a caliper every other day for up to 14 days after tumors became palpable (total of two pAd injections). Adenoviral gene transfer in situ was assessed for GFP expression by fluorescence microscopy, as described previously (24)
. All experiments involving animals were approved by the institutional animal care and use committee.
Histological Assessment of Tumor-associated Angiogenesis.
Breast cancer tumors prepared as described above were harvested after 7 days of treatment, formalin-fixed, and paraffin-embedded. Five-µm tissue sections were cut, air-dried on glass slides, deparaffinized, rehydrated, and quenched with 1% hydrogen peroxide for 45 min at room temperature. For endothelial cell detection by CD31 (platelet-endothelial cell adhesion molecule-1) staining, a two-step antigen retrieval method was used with pressure cooking for 5 min in 10 mM sodium citrate buffer (pH 6.0) and tissue digestion with 0.05% trypsin at 37°C for 10 min. Tissue sections were blocked with 10% goat serum for 30 min at room temperature. A previously described rabbit polyclonal antibody to mouse CD31 [Sleet4; a kind gift of Dr. J. A. Madri, Yale School of Medicine, New Haven, CT (28
, 29)
] was applied for 14 h at 4°C at a 1:500 dilution in 0.5% goat serum. Naïve normal rabbit antiserum was used at an equivalent dilution and produced no staining (data not shown). Binding of the primary antibodies was detected using a biotinylated goat antirabbit secondary antibody, followed by the avidin-biotin-peroxidase system (NovaRed Peroxidase Substrate Kit; Vector Laboratories, Burlingame, CA) with 3-amino-9-ethyl carbazole (Vector Laboratories) as the chromophore. Total CD31 positivity was determined by measuring the percentage of positively stained areas within each field using a color-sensitive software imaging program based on MATLAB script (The MathWorks Inc., Natick, MA) and developed by B. Bourke in the laboratory of Prof. A. Sinusas (Yale School of Medicine, New Haven, CT). Quantitative image analysis was performed on 7 randomly selected fields/section (magnification, x200), for each of 2 sections/tumor, for each of 4 tumors/treatment group (n = 56). In vivo apoptosis was determined by TUNEL (Zymed, San Francisco, CA) as described previously (24)
, except that antigen retrieval was carried out by tissue digestion in 0.05% trypsin at 37°C for 30 min.
Statistical Analysis.
The kinetics of tumor growth under the various conditions tested was analyzed by the unpaired two-tailed t test on a GraphPad Prism software package for Windows. A P of 0.05 was considered statistically significant.
| RESULTS |
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60% of the HUVEC population expressing pAd-GFP showed morphological signs of apoptosis (Fig. 1A)
plus CHX was only minimally reduced (Fig. 1D)
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3-fold and stabilized tube formation by phase-contrast microscopy and H&E staining (Fig. 2, D and E)
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115,000 proform PARP to an apoptotic Mr
85,000 fragment, whereas no PARP cleavage was observed in the presence of Tet (Fig. 4C)
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3-fold suppression of blood vessel density in MCF-7 xenografts, as compared with pAd-GFP (Fig. 7B)
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| DISCUSSION |
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Despite the considerable interest in survivin for its bifunctional role in cell viability and regulation of mitosis (10) and the dramatic exploitation of this pathway in human tumors (12) , critical aspects of the survivin pathway have remained elusive. In particular, how survivin couples to the cell death machinery has not been conclusively elucidated. Earlier claims that this may involve suppression of caspase catalytic activity (30) , similar to other antiapoptotic IAP proteins (9) , were disputed on both functional (31) and structural grounds (32) . More recent arguments favored an indirect model of survivin-mediated cell viability, in which interference with survivin expression/function resulted in cell death merely as a consequence of catastrophic cell division defects (33 , 34) , potentially involving mistargeting of Aurora B kinase (35) .
Here, we obtained clear evidence to unambiguously rule out these speculations (34)
and, for the first time, to firmly position the survivin pathway as a novel upstream regulator of mitochondrial-dependent apoptosis (13)
. Interference with survivin function using a phosphorylation-defective survivin Thr34
Ala mutant (20)
caused all of the earliest cellular and biochemical events of mitochondrial-dependent apoptosis (13)
, including release of cytochrome c, loss of mitochondrial transmembrane potential, and cleavage of caspase substrates. This cell death response was abolished in MEFs deficient in the upstream apoptosome components, Apaf-1 and caspase-9 (13)
. This model for survivin function is consistent with the ability of survivin to reduce the generation of active caspase-3 and -7 (Fig. 1)
, rather than suppressing the activity of the mature enzymes, and with the previously reported physical interaction between survivin and the upstream mitochondrial initiator, caspase-9 (19)
. Several possibilities for how survivin could influence the upstream initiation of mitochondrial-dependent apoptosis could be envisioned, including its recently reported association with Smac/DIABLO (36)
, a mitochondrially released protein, which relieves the inhibitory function of IAP on caspase-9 activation (32)
. Clearly, the present data do not support the preliminary claims of Chen et al. (35)
suggesting that survivin function could be recapitulated by its potential interaction with Aurora B kinase. Although critical for cell division, Aurora B is not believed to couple to the mitochondrial cell death machinery, and the phenotype of reduced spindle microtubule density and apoptosis induced by microinjection of antibodies to survivin (37)
is quite distinct from the defect of microtubule bundling and astral microtubule extension observed after interference with Aurora B function (38
, 39)
.
The Thr34
Ala mutation used here to map the survivin pathway abolishes a phosphorylation site for the main mitotic kinase p34cdc2-cyclin B1 (19)
and has been used previously to interfere with the function of endogenous survivin, resulting in apoptosis (19)
and anticancer activity in vitro and in vivo (24)
. Recently, Temme et al. (40)
used an overexpression approach with a large, tetrameric DsRed-survivin fusion protein to investigate the subcellular distribution and function of wild-type survivin and survivin(T34A). In that study, expression of DsRed-survivin(T34A) caused mitotic defects, inhibited cell proliferation, and induced apoptosis (40)
, similar to the findings presented here. Surprisingly, however, Temme et al. (40)
also reported that survivin(T34A) inhibited apoptosis in HeLa cells. The contradictory results of Temme et al. (40)
may reflect their highly artificial overexpression system, which is unlikely to recapitulate the dynamic intracellular trafficking and association with multiple protein partners of endogenous survivin (23)
. Also contrary to the claims of Temme et al. (40)
that mislocalization of survivin(T34A) may cause the observed cellular phenotype, published data have demonstrated that this survivin mutant exhibits accelerated degradation in vivo (41)
, suggesting that its dominant negative mode of action may involve dimerization with endogenous survivin and premature destruction of the heterocomplex.
Consistent with previous observations (14 , 15 , 17) , expression of survivin in endothelial cells representative of different vascular beds resulted in a broad cytoprotective mechanism counteracting apoptosis, reducing the generation of active caspases, and preserving cellular survival. This translated in a productive proangiogenic response with stabilization of three-dimensional capillary networks in vitro. It was recently proposed that expression of survivin in the endothelium could have profound repercussions for tumor growth, reducing the effectiveness of metronomic, antiangiogenesis chemotherapy (18) . The data presented here fit well with that model and demonstrate that survivin expression during angiogenesis may provide a pivotal advantage factor to maintain a florid blood supply during tumor growth. Previous studies have demonstrated that this may involve up-regulated survivin expression during the proliferative phase of angiogenesis as a transcriptional target of VEGF (14) as well as during the nonproliferative, remodeling of blood vessels contributed, among others, by angiopoietin-1 (16 , 17) . Although increased survivin expression in the transformed tumor cell population or angiogenic endothelium may involve distinct signaling pathways that may include loss of p53, activation of phosphatidylinositol 3'-kinase, or phosphorylation of signal transducers and activators of transcription 3 (14, 15, 16, 17 , 42) , the data presented here demonstrate that survivin provides a broad cytoprotective mechanism for the tumor microenvironment as a whole. This may explain, in part, the unfavorable outcome associated with survivin expression in embryologically disparate tumors and their propensity to progress to an invasive phenotype (10) , as characterized recently in a transgenic mouse model of stepwise skin cancer (43) . On the other hand, these data provide a rational basis for targeting survivin as a novel cancer therapeutic strategy aimed at lowering a general antiapoptotic threshold in tumor cells and favoring the collapse of tumor-associated angiogenesis.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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1 Supported by NIH Grants HL54131, CA78810, and CA90917. ![]()
2 Present address: INSERM Unit 541, Hôpital Lariboisière, 41 Boulevard de la Chapelle, 75010 Paris, France. ![]()
3 Present address: Curagen Corp., 322 East Main Street, Branford, CT 06405. ![]()
4 To whom requests for reprints should be addressed, at Department of Cancer Biology, LRB-428, University of Massachusetts Medical School, 364 Plantation Street, Worcester, MA 01605. Phone: (508) 856-5775; Fax: (508) 856-5792; E-mail: dario.altieri{at}umassmed.edu ![]()
5 The abbreviations used are: IAP, inhibitor of apoptosis; GFP, green fluorescent protein; MEF, mouse embryonic fibroblast; HUVEC, human umbilical vein endothelial cell; DMVEC, dermal microvascular endothelial cell; PMA, phorbol 12-myristate 13-acetate; TUNEL, terminal deoxynucleotidyl transferase-mediated nick end labeling; Tet, tetracycline; VEGF, vascular endothelial growth factor; TNF-
, tumor necrosis factor
; CHX, cycloheximide; DAPI, 4',6-diamidino-2-phenylindole; PARP, poly(ADP-ribose) polymerase; DEVD-AMC, Asp-Glu-Val-Asp-aldehyde. ![]()
Received 11/27/02; revised 3/26/03; accepted 4/16/03.
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