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From the Departments of Urology* and Pathology,
University of Innsbruck, Innsbruck, Austria; the Department of Urology,
General Hospital Feldkirch, Feldkirch, Austria; and the Department of Urology,
University of Zagreb, Zagreb, Croatia
| Abstract |
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met. In two sublines of LNCaP cells that contain the mutated AR 877 thr
ala and overexpressed CBP, increase in AR activity was observed after treatment with hydroxyflutamide but not with bicalutamide. Anti-androgens did not influence AR expression in cells transfected with CBP cDNA, as judged by Western blot analysis. Endogenous CBP protein was detected by Western blot in nuclear extracts from the three prostate cancer cell lines, LNCaP, PC-3, and DU-145, all derived from therapy-resistant prostate cancer. In addition, CBP was expressed in both basal and secretory cells of benign prostate epithelium, high-grade prostate intraepithelial neoplasia, and prostate cancer clinical specimens, as evidenced by immunohistochemical staining. Taken together, our findings demonstrate the selective enhancement of agonistic action of the anti-androgen hydroxyflutamide by the transcriptional co-activator CBP, which is a new, potentially relevant mechanism contributing to the acquisition of therapy resistance in prostate cancer.
Failure of hormonal therapy in prostate cancer is associated with alterations in the expression and function of hormone and growth factor receptors as well as growth factors and cytokines themselves. AR protein is expressed in nearly all prostate cancer tissues from patients who failed endocrine therapy and is in some cases mutated or up-regulated because of amplification of the AR gene.5,6 It was shown that increased expression of the AR may occur because of the up-regulation of mRNA or increased stability of the protein.7,8
Several mutant ARs detected in prostate cancer were functionally characterized and those studies revealed that hydroxyflutamide rather than bicalutamide acts as an agonist in the presence of structurally altered ARs.9 In one study, AR mutations were found in 5 of 16 prostate cancer specimens from patients who received flutamide.10 Those patients responded to the second-line treatment with bicalutamide. We have reasoned that differences in the regulation of AR activity by the two nonsteroidal anti-androgens should be further explored. One possibility that should be tested is that alterations in the expression and function of AR-associated co-regulatory proteins occur.
Functional activity of the AR is enhanced by co-activators, which have histone acetylase activity and act as bridging factors between steroid receptors and components of the transcription initiation complex. Although it was demonstrated that a number of proteins interact with the AR and enhance its functional activity, significance of these interactions for prostate cancer remains primarily unknown. AR activity was stimulated by both nonsteroidal and steroidal anti-androgens in the presence of the AR-associated protein ARA70.11 The up-regulation of the co-activators SRC-1, TIF-2, and RAC3 in advanced prostate cancer suggests that these proteins play a role in the development of resistance to endocrine therapy.12,13 One of the proteins that augments AR activity in a ligand-dependent manner is CREB (cAMP response element-binding protein)-binding protein (CBP).14,15 Moreover, Fu and associates16 demonstrated that the AR is acetylated by the CBP-related protein p300 and that a p300 mutation results in a reduced ligand-dependent activation of the AR. The CBP-associated factor P/CAF rescued cyclin D1-mediated trans-repression of the AR.17 CBP is implicated in the cross-talk between the AR and the activator protein-1 pathway, which consists of Jun and Fos oncoproteins and can block AR activity.14 CBP acts not only as a steroid receptor co-activator but it has a key role in the control of activity of various genes involved in the regulation of proliferation, differentiation, and apoptosis, such as the cell-cycle inhibitor p21WAF1.18,19 CBP and p300 have a tumor suppressor-like activity, which is altered in a variety of human cancers. CBP mutations that result in the generation of truncated proteins were detected in malignant neoplasms.20 p300/CBP proteins might nucleate the assembly of various co-factor proteins into a large co-activator complex,21 which explains their involvement in the regulation of multiple signaling pathways. Association of p300/CBP with p42 mitogen-activated protein kinase (MAPK) could be of importance for the modulation of AR activity.22 The MAPK pathway is implicated in ligand-independent activation of the AR.23,24 In the present study, we have addressed the question whether CBP is involved in the acquisition of agonistic properties of nonsteroidal anti-androgens and investigated its expression in prostate cancer cell lines and patient specimens by Western blot and immunohistochemistry.
| Materials and Methods |
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LNCaP, PC-3, and DU-145 cells were obtained from the American Type Culture Collection (Rockville, MD). LNCaP-abl cells were generated after long-term androgen ablation in vitro and previously characterized.25 PC-3 and DU-145 cells were grown in RPMI 1640 (HyClone, Logan, UT) and LNCaP and LNCaP-abl cells in MCDB 131 medium (Invitrogen, Leek, The Netherlands). Media were supplemented with 10% fetal calf serum and penicillin/streptomycin (PAA Laboratories, Linz, Austria). MCDB 131 medium was supplemented with sodium pyruvate, glucose, and HEPES buffer, pH 7.2. LNCaP-abl growth medium contained charcoal-stripped fetal calf serum.
Chemicals
The synthetic androgen methyltrienolone (R1881) and 3H-labeled acetyl-CoA were purchased from New England Nuclear (Dreieichenhain, Germany). Chloramphenicol and unlabeled acetyl-CoA were from Sigma (Deisenhofen, Germany). Hydroxyflutamide was kindly provided by Essex Pharma (Munich, Germany) and bicalutamide was synthesized at Schering AG (Berlin, Germany). Dual luciferase reporter assay was from Promega (Madison, WI). The polyclonal anti-CBP antibody A-22 was from Santa Cruz Biotechnology (Santa Cruz, CA) and the monoclonal anti-AR antibody F 39.4.1 from BioGenex (San Ramon, CA). An anti-mouse secondary antibody was a product of Amersham (Amersham Place, UK). Nuclear and cytoplasmatic extraction reagents were purchased from Pierce (Rockford, IL) and The PicTure kit for immunohistochemical detection from Zymed Laboratories (San Francisco, CA).
Co-Transfection-Transactivation Assays
DU-145 cells were seeded onto 24-well plates at a cell density of 45,000 cells/well. Liposome-mediated transfection was performed with 0.4 µg/well of the androgen-inducible reporter plasmid ARE2TATA-CAT, 0.08 µg/well of either wild-type or mutated AR 730 val
met cDNA, and 0.015 µg/well of the CBP expression vector pCMV CBP (kindly provided by Dr. R. Eckner, Institute for Molecular Biology, University of Zurich, Switzerland). A portion of cells was transfected with the same reporter and AR cDNA as described above but instead of CBP cDNA the empty vector driven by the same CMV promoter (5 x 10-3 µg/well, plasmid was gift from Dr. F. Saatcioglu, Biotechnology Centre, University of Oslo, Oslo, Norway) was included. For transfection, lipofectamine reagent (Invitrogen) was used. The synthetic androgen methyltrienolone and/or AR antagonists were added 24 hours after transfection and the cells were incubated for 24 hours. Reporter gene activity was measured by CAT assay. LNCaP and LNCaP-abl cells were grown on six-well plates and 300,000 cells/well were transfected with 0.7 µg of the androgen-inducible reporter pGL3E-probasin along with 0.05 µg of CBP cDNA. For transfection of LNCaP cells, the probasin construct was used because liposome-mediated transfection with the ARE2TATA-CAT reporter resulted in a very low reporter gene activity. To measure the efficiency of the transfection, the renilla luciferase plasmid pRLTK was co-transfected. The dual luciferase assay for measurement of reporter gene activity after incubation with androgen and/or AR blockers was used. Because of different transfection efficacies in individual experiments, relative values from the co-transfection-transactivation assays have been calculated.
AR Western Blot Analysis
For AR Western blot, DU-145 cells were seeded onto 12-well plates (85,000 cells/well) and transfected as described for the transactivation experiments. After treatment with either androgen or anti-androgen, the cells were collected in NuPAGE sample buffer (Invitrogen), sonicated, and boiled for 10 minutes at 70°C. The lysates were loaded on a 3 to 8% Tris-acetate gel and run with 1x NuPAGE sodium dodecyl sulfate running buffer for 1 hour. After sodium dodecyl sulfate-polyacrylamide gel electrophoresis, proteins were transferred to the Immobilon-P polyvinylidene difluoride membranes (Millipore, Bedford, MA) with the Xcell blot module for 1 hour at 30 V using NuPAGE transfer buffer. After the transfer procedure, the membranes were washed in Tris-buffered saline (TBS) once for 5 minutes and in TBS with 0.05% Tween-20 (TBST) three times for 5 minutes. The membranes were preincubated with 5% skim milk in TBST (TBSTM) for 1 hour and then incubated with the anti-AR antibody (dilution, 1:1000) overnight at 4°C. After two washes in TBS and five in TBST, the membranes were incubated with the anti-mouse secondary antibody. Then they were washed twice with TBS, five times with TBST, and the final wash step was with TBS. Western blots were developed by means of the ECL Plus substrate (Amersham). As a control for equal protein loading, Western blot for ß-actin was performed.
Assessment of CBP Expression in Prostate Cancer Cell Lines
To detect CBP expression in prostate cancer cells, Western blot analysis was performed in the cell lines LNCaP, PC-3, and DU-145. Nuclear extracts were prepared from 2 x 106 cells using nuclear and cytoplasmatic extraction reagents. The anti-CBP antibody was applied at a dilution 1:100 in Western blot. The Western blot procedure was basically the same as that described above.
Tissue Specimens
Formalin-fixed, paraffin-embedded tissues from 49 patients with prostatic adenocarcinoma were selected for this study. The tumor cases were separated into three groups. In the first group, there were tissue samples from 23 patients who underwent radical prostatectomy. They did not receive endocrine treatment before surgery. In the second group, there were eight patients who received neoadjuvant treatment for 3 to 4 months with AR blockers before radical prostatectomy. From those patients, five prostate tissue samples and three lymph nodes were obtained. The third group consisted of 23 lymph node metastases from 18 patients who underwent diagnostic pelvic lymphadenectomy. Those patients did not receive any endocrine therapy. The slides were reviewed and Gleason pattern was determined on prostate tumor tissue.26 For each case, one representative tissue block was used for immunohistochemistry. The expression of CBP was analyzed in nine samples in tumor-adjacent benign tissue and in four cases in high-grade prostate intraepithelial neoplasia.
Immunohistochemistry
Five-µm-thick sections were cut and subsequently rehydrated through a series of graded alcohols followed by blocking of endogenous peroxidase activity. Pretreatment by wet autoclaving was used for antigen retrieval.27 The sections were incubated overnight with the polyclonal antibody against CBP. The dilution of the primary antibody was 1:100 in TBS/1% human serum. The PicTure kit based on a one step immunohistochemical detection method with the horseradish peroxidase/Fab polymer conjugate and development with diaminobenzidine was used for visualization. All cases had a negative control that was run simultaneously with the test slide in which the primary antibody was omitted. The cytokeratin AE1/AE3 served as a fixation control and was diffusely strong reactive in all adenocarcinoma samples.
Evaluation of staining in benign (secretory and basal cells), premalignant, and malignant prostatic epithelium was performed on the basis of a five-point scale (0, <5% of cells positive; 1, 5 to 20% of cells positive; 2, 20 to 50% of cells positive; 3, >50% of cells positive, low intensity (appearance on high-power magnification); 4, >50% of cells positive, high intensity (appearance on low-power magnification).
| Results |
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Consistent with previous reports, the synthetic androgen R1881 enhanced AR activity in DU-145 cells that overexpressed wild-type AR and CBP cDNA by fivefold in comparison with androgen-treated cells that expressed the empty plasmid (Figure 1A)
.14,15
There were differences in the magnitude of AR activity induced by hydroxyflutamide or bicalutamide in the presence of the overexpressed co-activator. Hydroxyflutamide, at a concentration of 5 µmol/L, induced 50% of the maximal CAT activity caused by the synthetic androgen R1881, whereas bicalutamide-induced reporter gene activity was 24%. When either anti-androgen was added in combination with R1881, somewhat higher reporter gene activities were observed in cells treated with androgen and bicalutamide. Lower antagonistic activity of bicalutamide than that of hydroxyflutamide was reported previously under different experimental conditions.28,29
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met, which was discovered in a specimen of clinically localized prostate cancer.30
Functional characterization of that mutated AR revealed increased activation by metabolic products of dihydrotestosterone and hydroxyflutamide.31
The aim of those experiments was to assess a contribution of CBP to the enhanced activation. CAT activities induced by hydroxyflutamide in the presence of transfected CBP were higher with the mutated than with the wild-type AR (Figure 1B)
Then we have investigated how overexpression of CBP influences antagonist/agonist balance of nonsteroidal anti-androgens in LNCaP cells that express endogenous AR. In that cell line, the differences in activation of the AR between hydroxyflutamide and bicalutamide were more pronounced than in DU-145 cells. In experiments in which AR blockers were applied alone, luciferase activity was induced in the presence of CBP with hydroxyflutamide (1 and 5 µmol/L) but not with bicalutamide (Figure 2A)
. Androgen-induced reporter gene activity was down-regulated to a greater extent by 5 µmol/L of bicalutamide than by an equimolar concentration of hydroxyflutamide both in CBP-transfected and -nontransfected cells. These results could be explained with the mutation of the AR in LNCaP cells, which renders the receptor more sensitive to stimulation by hydroxyflutamide. In addition, we have explored the action of anti-androgens in LNCaP-abl cells derived after long-term steroid ablation in vitro.25
In long-term steroid-deprived cells, AR activities induced by hydroxyflutamide were higher both in the absence or presence of overexpressed CBP than those assessed in parental LNCaP cells (Figure 2B)
. Interestingly, bicalutamide did not exhibit agonistic activities with the probasin reporter in androgen-ablated cells regardless whether they expressed CBP cDNA or not. Collectively, our findings indicate that in the presence of CBP, hydroxyflutamide induces higher reporter gene activity than bicalutamide with the wild-type and the mutated AR 730 val
met and AR 877 thr
ala. The presence of CBP differentially influenced action of bicalutamide with the two mutant receptors; antagonism was abolished with the AR 730 val
met but not with the LNCaP AR 877 thr
ala.
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Next we examined whether the effects of anti-androgens on AR activity in cells that contain CBP occur because of the up-regulation of AR expression. For this purpose, DU-145 cells were transfected with AR and CBP plasmids and AR expression was assessed by Western blot analysis after treatment with R1881 or anti-androgens. As shown in Figure 3, A and B
, neither R1881 nor AR blockers caused appreciable changes in AR expression when CBP was overexpressed.
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To assess the relevance of our findings with cells transfected with CBP cDNA to human carcinoma of the prostate, we have investigated endogenous CBP expression in the three prostate cancer cell lines, LNCaP, PC-3, and DU-145. All of the cell lines were derived from metastatic lesions from prostate cancer patients.32-34
CBP was detected by immunoblotting in nuclei of all cell lines (Figure 4)
and the expression in nuclear extracts was higher in either LNCaP or PC-3 than in DU-145 cells. Interestingly, there was also expression of CBP in cytoplasmatic preparations of LNCaP and PC-3 cells.
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The studies on the expression of CBP in prostate cancer cells were extended on tissue specimens from patients who underwent radical prostatectomy, received neoadjuvant endocrine therapy before prostate surgery, or underwent diagnostic pelvic lymphadenectomy, respectively. Staining was evaluated on the basis of a semiquantitative scale, which considered both percentage of positive cells and staining intensity (Table 1)
. Although immunohistochemical reaction was confined mainly to the cell nuclei, there was also some positive staining in the cytoplasm (Fig. 5)
. In benign prostate epithelium, both basal and secretory cells were CBP-positive in all nine cases investigated (Fig. 5a)
. CBP was also detectable in four high-grade prostate intraepithelial neoplasia lesions (Fig. 5b)
. In malignant prostatic tissue, the expression of CBP was investigated in the Gleason patterns 2 to 5 (n = 38) (Table 1)
. CBP expression was lost in only three primary tumors and in 2 of 26 lymph node metastases.
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| Discussion |
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In this study, we show that antagonist/agonist balance of nonsteroidal anti-androgens is influenced by the transcriptional co-activator CBP. Enhancement of agonistic activities of AR antagonists was also reported for the AR-associated protein ARA70.11 The major difference between the actions of ARA70 and CBP in the presence of anti-androgens is that the stimulation of agonistic properties by ARA70 is not selective. The levels of reporter gene activity measured in cells transfected with ARA70 cDNA and treated with either anti-androgenic compound hydroxyflutamide, bicalutamide, cyproterone acetate, or RU 58841 were similar.11 In this context, it is important to note that the increase in AR activity by ARA70 or CBP is achieved by two different mechanisms: whereas androgens and anti-androgens promote physical interaction between the AR and ARA70, the association between the AR and CBP is not influenced by the ligand.11,14,15 Our findings showing that AR expression is not altered by anti-androgens in DU-145 cells are consistent with previous data that the levels of immunoreactive ARs are not changed by androgen in cells transfected with AR and CBP cDNA.15 In LNCaP cells, however, androgenic hormones enhance AR expression by protein stabilization even when neither co-activator is overexpressed.42,43 This would compromise interpretation of results of any immunoblot experiments similar to those performed in DU-145 cells.
The up-regulation of the AR co-activators SRC-1 and TIF-2 was documented in a collective of patients with recurrent carcinoma of the prostate.8
Gregory and associates8
reported that those co-activators potentiate AR activation by adrenal androgens, which were shown to increasingly stimulate function of mutated AR.5,8,36
Expression of the co-activator RAC3, which belongs to the same p160 family of co-activators as SRC-1, correlated with prostate tumor grade and stage.13
Taken together, those findings indicate that prostate cancer progression is associated with overexpression of some AR co-activators. Because of ethical concerns, it was not possible for us to analyze CBP expression in clinical specimens from patients with therapy-resistant carcinoma of the prostate. However, all cell lines used were obtained from patients who had advanced prostate cancer and they express the CBP protein. In future studies, it will be necessary to address the issue of regulation of CBP expression by steroids and peptide hormones in prostate cancer cells. That information, in connection with data on CBP expression in clinical specimens from patients with therapy-resistant disease, could improve understanding of the role of CBP in prostate cancer progression. The ability of CBP to stimulate agonistic action of hydroxyflutamide to a higher level than that of bicalutamide was not limited to the wild-type AR and was also seen with two mutated AR and in the subline of LNCaP cells, which was established after long-term androgen ablation. In our previous study, we noted that bicalutamide caused a twofold stimulation of AR activity in LNCaP-abl cells.25
However, in that study a different reporter gene and transfection method were used, which could at least partly explain the different results obtained after bicalutamide treatment. Reduced antagonism of bicalutamide was observed in the presence of the HER-2/neu tyrosine kinase and ß-catenin.44,45
Bicalutamide also enhanced the proliferation of a LNCaP subline generated after long-term treatment with tumor necrosis factor-
and, possibly, that effect was associated with the stimulation of AR activity.46
The results of the present study do not rule out an involvement of CBP in those activation processes. Alternatively, one or more other AR co-activators might account for diminished antagonism of bicalutamide with HER-2/neu or ß-catenin. In clinical studies, the anti-androgen withdrawal syndrome, characterized by a temporary improvement in symptoms and prostate-specific antigen serum levels decline after cessation of anti-androgen therapy was first described for hydroxyflutamide.47
In subsequent studies, however, similar findings with bicalutamide were reported.48-50
Recently, mutated ARs were detected in samples from patients whose tumors relapsed after a combined androgen blockade by orchiectomy and bicalutamide.51
It is, however, not known whether those mutants are increasingly activated by bicalutamide.
The detection of the CBP protein in all prostate cancer cell lines studied is consistent with the results of our previous study, in which CBP mRNA was detected in prostate epithelial cells by reverse transcriptase-polymerase chain reaction.52 On immunohistochemistry, CBP was present in the vast majority of prostate cancer specimens. Thus, in future experimental studies its interaction with key regulators of tumor growth should be addressed. In two of three cell lines and in clinical specimens, we found that CBP is expressed in both nucleus and cytoplasm. Functional significance of cytoplasmic expression is not clear but, in this context, it should be noted that similar observations were made for the co-activators FHL2 and RAC3.13,53
Because of its association with a number of molecules that control proliferation and apoptosis, CBP is a good candidate to be involved in ligand-independent activation of the AR, as recently demonstrated in the case of interleukin-6.54 Taken together, findings of our study and those reported by others indicate that the transcriptional co-activator CBP might be considered a potential therapy target in prostate cancer.
| Acknowledgements |
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| Footnotes |
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Supported by CaP CURE and the Austrian Research Fund (grants P14709 and SFB 002 F203).
B. C. and L. L. contributed equally to this work.
A. H. and Z. C. are joint senior authors.
Present address of L. L.: Glaxo Smith Kline Greece Medical Department, L. Kifisias 266, GR 15232 Athens, Greece.
Accepted for publication October 3, 2002.
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