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From the Departments of Pathology*
and
Surgery,
University of Graz School of
Medicine, Graz, Austria, and the Division of Cell
Biology,
German Cancer Research Center,
Heidelberg, Germany
| Abstract |
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| Introduction |
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1-antitrypsin (AAT)-containing
globules, and Mallory bodies (MBs), have been found in hepatocellular
carcinoma (HCC) cells.1-11
MBs are complex filamentous
protein aggregates that are associated with a variety of chronic liver
disorders, particularly alcoholic and non-alcoholic steatohepatitis,
but also benign and malignant hepatocellular neoplasms in man and
experimental animals (for review see Ref. 12
).
They consist of cytokeratins (CKs) but
also contain non-CK components12-16
that are
post-translationally modified, eg, by phosphorylation, partial
proteolysis, and cross-linking.17
AAT globules are present
in some HCCs, not necessarily associated with AAT deficiency, and
resemble abnormal cytoplasmic accumulations of this
anti-protease.11
Pale bodies usually contain
fibrinogen.6,11
In contrast, the nature of intracytoplasmic
hyaline bodies (IHBs), which are not restricted to HCC
cells,2
is still controversial. IHBs are round or ovoid,
ranging from barely visible globules to large inclusions. They are
eosinophilic in hematoxylin and eosin (H&E) and red or blue in
chromotrope aniline blue (CAB)-stained sections and remain unstained
with the periodic acid-Schiff (PAS) reagent.4,11
In
electron microscopy, they present as a mixture of filamentous and
granular material.4
They do not react with antibodies to
AAT,
1-fetoprotein, or CKs.4
On the basis of their light
and electron microscopic appearance, IHBs were thought to be related
to, but not identical with, MBs.1,4 In the present communication we report immunohistochemical, ultrastructural, and biochemical analyses of IHBs and demonstrate p62, a recently described cytosolic protein playing a role in cellular signal transduction,18,19 as a major constituent.
| Case Report |
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| Material and Methods |
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Immunohistochemistry and Electron Microscopy
For indirect immunofluorescence microscopy, the following
antibodies were applied to cryostat sections (3 µm thick, fixed in
acetone at -20°C). Primary antibodies were MM120-1
(specific for MBs13), SMI 31 (detecting an abnormally
phosphorylated epitope on tau protein in paired helical filaments in
Alzheimer's disease and hyperphosphorylated neurofilaments;
Sternberger Monoclonals, Baltimore, MD), RT 97 (detecting paired
helical filament-associated tau; Boehringer Mannheim, Mannheim,
Germany20), SMI 34 (detecting phosphorylated
neurofilaments; Sternberger Monoclonals), MPM-2 (detecting mitotic
phosphoproteins; Upstate Biochemicals, Lake Placid, NY), R 27
(anti-lamin A+C21), X 223 (anti-lamin B221),
C219 (detecting MDR 1+3; Signet, Dedham, MA), tau-1 (Boehringer
Mannheim), antibodies to phosphoserine (Sigma Chemical Co., St. Louis,
MO), phosphothreonine (Sigma), phosphotyrosine (Sigma), tau (Sigma),
neurofilament (Dako, Glostrup, Denmark), HBs antigen (Dako), CK 7 (OVTL
12/30; Monosan, Am Uden, The Netherlands), CK 8 (Ks 8.7; Progen,
Heidelberg, Germany), CK 18 (Ks 18.04; Progen), CK 19 (Amersham, Little
Chalfont, UK), CKs 8 and 18 (CK8/18; 50K160; produced in our
laboratory14), HSP 60 (Stress Gene Biotechnologies Corp.,
Victoria, BC, Canada), HSP 70 (Santa Cruz Biotechnology, Santa Cruz,
CA), HSP 90 (Transduction Laboratories, Lexington, KY),
1-fetoprotein (Dako),
1-antitrypsin (Dako),
1-antichymotrypsin
(Dako), albumin (Dako), ubiquitin (Cambridge Research
Biochemicals, Cambridge, UK; Chemicon International, Temecula,
CA; Dako),
B-crystallin (Novocastra, Newcastle upon Tyne, UK),
ß-amyloid (Chemicon), fibrinogen (Dako), and 14-3-3 protein (Upstate
Biochemicals). Secondary antibodies were tetramethylrhodamine
(TRITC)-conjugated goat anti-mouse (Dianova, Hamburg, Germany)
or fluorescein (DTAF)-conjugated swine anti-rabbit immunoglobulins
(Dako). Controls with corresponding isotype immunoglobulins (Dako) were
invariably negative. Double-immunofluorescence staining was performed
as described previously.13
Immunofluorescent specimens were
analyzed with a MRC600 (BioRad, Richmond, CA) laser-scanning confocal
device attached to a Zeiss Axiophot microscope. Different excitation
wavelengths (488 nm for DTAF, 568 nm for TRITC, and a krypton/argon ion
laser) were used.
Immunohistochemistry on paraffin-embedded tissue was performed with SMI 31 (dilution, 1:2000), MPM-2 (1:1000), and ubiquitin antibody (1:1000), respectively. The 4-µm-thick paraffin sections of formaldehyde-fixed material were deparaffinized, rehydrated, and either digested with 0.1% protease (type XXIV; Sigma) in PBS for 10 minutes (for SMI 31 and MPM-2) or microwaved in 0.1 mol/L citrate buffer, pH 6.0, at 750 W for 10 minutes (for demonstration of ubiquitin). Endogenous peroxidase was blocked by incubation in 1% H2O2 in methanol for 10 minutes. Incubation with primary antibodies for 1 hour at room temperature was followed by washing and incubation with biotinylated multi-link swine anti-goat, -mouse, and -rabbit Ig (Dako; dilution, 1:100) as secondary antibody and finally with the ABC complex using diaminobenzidine as chromogen (Dako).
For electron microscopy, 4-µm-thick frozen sections were fixed for 30 minutes in 4% paraformaldehyde (in PBS), dehydrated and resin (AGAR-100, Agar Scientific, Essex, UK) embedded. The 50-nm-thick sections were contrasted with uranyl acetate/lead citrate and studied with a Philips CM 100 electron microscope.
Gel Electrophoresis and Immunoblotting
Proteins were extracted from tumor and peritumor non-neoplastic liver tissue by sequential homogenization (followed by centrifugation) in low- and high-salt buffers containing 50 µg/ml leupeptin, 0.3 µmol/L aprotinin, 200 µmol/L Pefabloc SC, 1.0 µmol/L pepstatin, 2 mg/ml sodium fluoride, 0.1 mmol/L sodium pyrophosphate, and 0.2 mmol/L sodium vanadate to inhibit proteolysis. Briefly, frozen liver tissue (1.5 g) was homogenized (5% w/v) in low-salt buffer (LS; 90 mmol/L NaCl, 8 mmol/L KH2PO4, 5.6 mmol/L Na2HPO4, 0.5 mmol/L KCl, 10 mmol/L sodium EDTA, pH 7.4) using an Ultraturrax and centrifuged for 20 minutes at 10,000 x g at 4°C. The resulting pellet was rehomogenized in 30 ml of high-salt buffer (HS; 2 mmol/L KCl, 200 mmol/L NaCl, 10 mmol/L TrisHCl, pH 7.4) by 30 strokes in a Potter homogenizer, incubated on ice for 30 minutes, and centrifuged for 20 minutes at 10,000 x g at 4°C. The pellet was then resuspended in 30 ml of high-salt buffer containing 1% Triton X-100 (HSTX) and incubated on ice for 30 minutes followed by centrifugation at 10,000 x g for 20 minutes. The supernatants, ie, low-salt supernatant (LS-S), high-salt supernatant (HS-S), and high-salt/Triton X-100 supernatant (HSTX-S), were subjected to protein precipitation (1:1) with methanol/chloroform (4:1). The high-salt-Triton X-100 protein pellet (HSTX-P) and the methanol/chloroform precipitated proteins were taken up in sample buffer and electrophoresed on 10% SDS-polyacrylamide gel.14 For two-dimensional analysis, frozen tumor material was homogenized in sample buffer (9 mol/L urea, 35 mmol/L Trizma base, 65 mmol/L dithiothreitol (DTT), 4% CHAPS) using Eppendorf micropestles and incubated for 20 minutes at 37°C. Protein content was measured by the method of Bradford.22 Isoelectric focusing was performed with nonlinear immobilized pH gradient strips ranging from pH 3.5 to 10 (Pharmacia, Uppsala, Sweden). The strips were rehydrated for at least 8 hours in rehydration solution (8 mol/L urea, 2% CHAPS, 10 mmol/L DTT, 2% v/v carrier ampholytes Resolyte, pH 3.5 to 10 (BDH, Poole, UK) and a trace of bromophenol blue) using a reswelling chamber (Pharmacia). For analytical separation (immunoblotting and silver staining), 100 µg of protein (in a volume of 70 to 100 µl) was applied on the top of the strips in sample cups. Running conditions at 15°C were as follows: voltage was increased stepwise from 300 to 500, 1000, and 1500 V during the first 80 minutes and subsequently to 3000 V to give a total of 100 kVolt-hours. After isoelectric focusing, the strips were equilibrated for 10 minutes in a solution of 0.05 mol/L TrisHCl, pH 6.8, containing 6 mol/L urea, 30% glycerol, 2% SDS, and 2% DTT, followed by a second equilibration step for 10 minutes in a solution without DTT but with 2.5% iodoacetamide and a trace of bromophenol blue. Separation in the second dimension was performed in 1.5-mm-thick SDS-polyacrylamide gradient gels (4% to 16%) in a Bio-Rad Protean II xi multi-cell (equilibrated strips were mounted on the gels with 0.5% agarose in running buffer containing 50 mmol/L Tris, 384 mmol/L glycine, 1% SDS23).
Proteins on analytical gels and gels after transfer were visualized by silver staining. Gels were rinsed with deionized water for 5 minutes, and proteins were fixed in ethanol/acetic acid/water (40:10:50) overnight. After washing the gels five times for 5 minutes each in deionized water they were soaked in 1% glutaraldehyde/0.5 mol/L sodium acetate for 30 minutes. This was followed by three washing steps, each for 3 minutes in deionized water, and soaking the gels twice in 0.05% 2,7-naphthalene disulfonic acid solution for 30 minutes. The gels were then washed four times for 15 minutes in deionized water and placed into the silver nitrate solution (0.8% silver nitrate, 0.3% ammoniac, 0.02 mol/L NaOH). After washing the gels in deionized water four times for 4 minutes each, they were developed in 0.005% citric acid/0.1% formaldehyde. The reaction was stopped by placing the gels into 5% Tris/2% acetic acid.
For immunoblotting, proteins were transferred electrophoretically onto nitrocellulose membranes (0.2-µm pore size; 20 mmol/L Tris, 200 mmol/L glycine, and 20% methanol as transfer buffer) in a wet blot apparatus (Bio-Rad). Thereafter, transfer membranes were blocked with 5% nonfat milk in PBS with 0.1% Tween-20 (PBS-T), followed by incubation with SMI 31 and MPM-2 or, as negative controls, with isotype-matched immunoglobulins (diluted in PBS containing 1% normal rabbit serum) overnight. After a 1-hour washing step in PBS-T, membranes were incubated with horseradish-peroxidase-conjugated rabbit anti-mouse immunoglobulins (Dako) and washed again for at least 1 hour in PBS-T. The enhanced chemiluminescence system (ECL, Amersham) was used for detection with exposure times between 5 and 60 seconds.
Sequence Analysis of the SMI 31 and MPM-2 Reactive Material
The Coomassie-blue-stained major spot of a two-dimensional gel
(arrow in Fig. 5
) was excised and digested in the gel with trypsin
using an automated protein digestion apparatus (DigestPro, Abimed,
Langenfeld, Germany). The reduction of disulfide bonds and the
alkylation of cysteine residues before digestion followed the protocol
recommended by Abimed. The peptides obtained were separated by
high-pressure liquid chromatography (HPLC) using a Hypersil C18 BDS
3-µm LC-Packings column (150 x 1.0 mm; BIA, Bensheim, Germany)
and a 130A HPLC separation system (Applied Biosystems, Weiterstadt,
Germany) with 0.1% trifluoric acid (TFA) as solvent A and 80%
acetonitrile in 0.085% TFA as solvent B. The HPLC-separated fragments
were sequenced on Polybrene-treated filters using a Procise 494A
protein sequencer (Applied Biosystems).
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| Results |
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The majority of the tumor cells were large (larger than
non-neoplastic hepatocytes) with oxyphilic cytoplasm and moderate
anisokaryosis. The nuclei were enlarged and vesicular with accentuated
nuclear membrane and prominent, mostly eosinophilic nucleoli. The tumor
cells were arranged in trabecular and tubular (pseudoglandular)
structures. Multinuclear giant cells and tumor cells with single but
large and bizarre, irregular nuclei were interspersed. Most tumor cells
contained oxyphilic dense hyaline inclusions varying in size from small
globules, approximately half the size of the nucleus, to two to three
times nuclear size, and sometimes even filling most of the cytoplasmic
space (Figure 1, a and b)
. In the latter
situation, the nucleus still occupied a central position and was
almost completely surrounded by hyaline material. At their periphery,
the hyaline inclusions were demarcated by a narrow clear halo. The
hyaline inclusions were negative with PAS (Figure 1c)
and iron (Perls)
stains. With CAB they were mostly stained red and only occasionally
blue (Figure 1d)
. The inclusions thus resembled classical
IHBs.2,4,11
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Immunofluorescence Microscopy and Immunohistochemistry
IHBs strongly and homogeneously reacted with SMI 31 and MPM-2
(Figure 2, a, b, d, and e
, and Figure 3, a and c
) as well as with RT 97 and
phosphoserine antibodies. Occasional IHBs displayed faint ubiquitin
staining, but the majority of IHBs were ubiquitin negative (Figure 2, g and h)
. A large number of antibodies tested, including those against
CKs, did not react with IHBs (Figure 3, b and c)
. The results are
summarized in Table 1
. No SMI 31, MPM-2,
and RT 97 staining was revealed in non-neoplastic liver (Figure 2, a, c, d, and f)
.
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Western Blotting
Homogenization of tumor and non-neoplastic peritumor liver tissue
in low-salt buffer followed by centrifugation released proteins mostly
ranging in molecular weights between 40 and 80 kd into the supernatant
as revealed by Coomassie blue staining (Figure 4
, lanes LS-S). On the basis of Coomassie
blue staining, the patterns of proteins released were similar in
neoplastic and non-neoplastic tissue. Treatment of the pellets with
high-salt buffer extracted proteins with molecular weights between 60
and 70 kd and ~50 kd, respectively, the higher molecular weight
proteins being slightly more pronounced in the tumor (Figure 4
, lanes
HS-S). Extraction of the resulting pellet with high-salt buffer
containing Triton X-100 released a major protein with a molecular
weight between 62 and 65 kd from the tumor but not from the control
sample, in addition to proteins with molecular weights ~50 kd and
with high molecular weight, which were retained at the interphase
between stacking and resolving gels (Figure 4
, lanes HSTX-S). Only
minor protein bands could be electrophoretically detected in the final
pellet (Figure 4
, lane HSTX-P) mostly in the high molecular weight
range. The differences between neoplastic and non-neoplastic tissue
extracts suggest altered solubility of proteins in the neoplastic
situation.
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Electron Microscopy
IHBs displayed a heterogeneous ultrastructure. They consisted of
beaded filaments with diameters of ~10 nm in irregular as well as
parallel arrangement (Figure 6)
. Beads or
granules measuring 10 nm in diameters seemed to constitute the
subunits. Although a similar ultrastructure has been described for MB
filaments,12,24,25
IHB filaments are less distinct and more
granular (Figure 6, a and b)
than MB filaments.
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By microsequencing of HPLC peaks obtained after digestion of the
major protein spot (arrow in Figure 5
) three distinct amino acid
sequences were obtained: 1) VAALFPALRP, 2) LAFPSPFGHL, and 3)
EAALYPHLPP. Each of these peptides could be aligned to the p62 protein
sequence reported by Joung et al.18
In fact, they were
completely identical with positions 51 to 60, 166 to 175, and 379 to
388 of p62 (Figure 7
; Gen Bank accession
U46751). Thus, the analyzed fragments corresponded to different domains
located in the amino-terminal, middle, and carboxy-terminal regions of
p62, indicating that the sequence identity of the IHB component is not
restricted to only one part of the protein.
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| Discussion |
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To the best of our knowledge, IHBs observed in the HCC presented are the first examples of a pathological accumulation of p62. Their further analysis could be useful in elucidating the function of this protein under physiological and pathological conditions. Aggregation of p62 in HCC cells could be due to alteration of p62 structure, profound disturbance of its metabolism (ie, synthesis or degradation), or modification of associated proteins. Although the exact chemical composition of IHBs is still unknown, the analysis of soluble material by one- and two-dimensional gel electrophoresis and by immunoblotting using phospho-epitope antibodies suggests that p62 is a major (although probably not the only) component of IHBs and that it is phosphorylated (phosphorylation may account for the slightly higher molecular weight of IHB-associated p62 as compared with normal p6218,19). Although phosphorylation seems to be involved in the regulation of its function, hyperphosphorylation, on the other hand, may have adverse effects in this respect and may contribute to its accumulation. At least in vitro, the interaction of p62 with the p56lck SH2 domain is impaired in the presence of phosphatase inhibitors.19 The serines and threonines as components of the PEST motif present in p62 are expected to be targets for several kinases, including Ser/Thr kinase but also proline-directed kinase.19 It is noteworthy in this context that p62-containing IHBs are not ubiquitinated, in contrast to many other abnormal intracytoplasmic protein aggregates, including MBs in alcoholic hepatitis and related disorders, Lewy bodies associated with Parkinson's, and neurofibrillary tangles with Alzheimer's disease.26,27 This was unexpected in view of the ubiquitin-binding capacity of normal p62.28 Lack of ubiquitination could be due to abnormal composition or configuration of the ubiquitin binding (carboxy-terminal) domain of p62 in IHBs.
The reactivity of IHBs with antibodies to different phospho-epitopes not only demonstrates phosphorylation but also throws some light on the kinases involved. SMI 31 as well as MPM-2 recognize phospho-epitopes that are present on paired helical filament-associated tau in Alzheimer's disease but also on other proteins.29-32 Despite sharing phospho-epitopes with abnormal paired helical filament-associated tau proteins, at least in its pathological state, as revealed by SMI 31 immunostaining, p62 does not seem to have a more intimate relationship to tau proteins as proved by the sequence data. MPM-2 was raised against mitotic HeLa cell extracts and has been shown to react with ~40 proteins that are synthesized during interphase and become MPM-2 reactive after entering M-phase, apparently due to the action of M-phase-specific kinases.33,34 Particularly, in vitro studies suggest that p34cdc2 but also mitogen-activated protein (MAP) kinase may be involved in the production of the MPM-2 reactive epitope. The distribution of MPM-2 antigens in a wide variety of species, including plants, indicates pronounced evolutionary conservation of mitosis-specific phosphorylation.35 MPM-2 also recognizes one of the two regulatory phosphorylation sites on MAP kinase, a member of a family of kinases that are regulated by extracellular signals and involved in the activation of G0 and G2 arrested cells. Phosphorylation of the MPM-2 epitope leads to a decrease in MAP kinase activity in vitro. As MPM-2 can inhibit ubiquitin-mediated destruction of cyclin B (determined with Xenopus egg extracts35), a relationship between p62 MPM-2 immunoreactivity and function can be anticipated. In fact, the reaction of MPM-2 antibodies with p62 further supports the assumption of an important role of p62 in signal transduction, mitosis, and cell cycle regulation and the role of mitosis-related kinases in p62 phosphorylation, at least in the pathological situation of IHB formation in HCC cells.
Some authors emphasized a relationship between IHBs and MBs on the basis of light and electron microscopic similarities and their occasional simultaneous presence in HCC cells.1,2,4 Particularly, the filamentous ultrastructure of IHBs resembles MB filaments types I and II as first described by Yokoo et al.24 However, there are still significant differences to reject a close relation between IHBs and MBs. The major distinguishing feature is the absence of CKs, which are major constituents of MBs, in IHBs.12,15 Moreover, the almost complete lack of ubiquitination of IHBs in contrast to MBs and other types of cytoskeleton-related inclusion bodies, such as neurofibrillary tangles in Alzheimer's disease, Lewy bodies in Parkinson's disease, neuronal inclusions in motor neuron disease (amyotrophic lateral sclerosis), and astrocytic Rosenthal fibers,26,27 is another significant distinguishing feature. On the other hand, IHBs share SMI 31 and MPM-2 immunoreactivity with MBs36 (C. Stumptner, A. Fuchsbichler, M. Lehner, K. Zatloukal, H. Denk, in preparation) and neurofibrillary tangles.29-32 This suggests similarities in pathogenesis that deserve further attention. The elucidation of the mechanisms involved in IHB formation may, therefore, shed light not only on common pathogenetic mechanisms associated with cellular inclusion body formation but also on regulatory principles in neoplastic and non-neoplastic hepatocytes.
| Acknowledgements |
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| Footnotes |
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Supported in part by Fonds zur Förderung der wissenschaftlichen Forschung (grant 7628-MED to H. Denk; grant S7401-MOB to K. Zatloukal).
Accepted for publication March 6, 1999.
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