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From the Digestive Health Center of Excellence* and the Department of Pathology,
University of Virginia Health System, Charlottesville, Virginia
| Abstract |
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10% of newly diagnosed cancers.1,2
Gastric cancer is the fourth most common new cancer diagnosis in the world, accounting for an estimated 876,341 new cancer cases and 646,567 deaths worldwide in 2000.2
In human, it is rather rare to detect dysplastic lesions because these patients tend to be asymptomatic, and are only diagnosed when tumors already are present at an advanced stage.3
In the United States this is reflected in an overall 5-year survival rate of less than 20%.1
Thus, identification of early genetic changes in gastric tumorigenesis is a challenging task. Mouse models of human disease are useful to explore the molecular basis of a disease that is difficult to perform in humans. The trefoil factor-1 (Tff1) is strongly and specifically expressed in the epithelial cells within the upper part of the gastric pits, an area where cells undergo commitment to differentiation, to limit gland proliferation, and give rise to a functional secreting mucosa.4-6
We and others have reported that Tff1 expression is remarkably down-regulated in nearly all human gastric cancers.7,8
Recent reports support the notion that Tff1 may be a candidate tumor suppressor gene that may be involved in development and/or progression of human gastric cancers.6,7,9
The Tff1 knockout (/) mouse model was first reported in 1996 as a model for spontaneous development of intestinal-type gastric dysplasia and cancer, similar to human disease.10
Thus, the Tff1/ mouse model provides a window to look into molecular alterations that are associated with precancerous lesions and understand the development of gastric cancers. Herein, we report gene expression profiling in dysplastic lesions of Tff1/ mice as contrasted to normal mucosa and compare the results with our transcriptome database of human gastric cancer. This approach allowed us to discover and validate molecular changes that are associated with early gastric tumorigenesis. | Materials and Methods |
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For global analysis, we have performed microarray analysis on four samples obtained from different mice, two tissue samples from dysplastic gastric lesions of two Tff1/ mice and two normal gastric mucosal samples from Tff1 wild-type (WT) (+/+) mice. The Tff1/ mice were first developed and described by Lefebvre and colleagues.10
All tissues were microdissected using laser capture microdissection (Pixcell laser capture microdissection apparatus; Arcturus Engineering, Mountain View, CA). All animal experiments were performed in accordance with University of Virginia institutional approval for animal care. Total cellular RNA from microdissected samples was prepared using the RNeasy kit (Qiagen GmbH, Hilden, Germany); labeled cRNA was prepared and hybridized to oligonucleotide microarrays (GeneChip, Mouse Genome 430A 2.0 Array; Affymetrix Inc., Santa Clara, CA) that contains
14,000 well-characterized mouse genes. Scanned image files were analyzed with GENECHIP 3.1 (Affymetrix Inc.). To identify genes with elevated expression in tumors, the intensity values of each probe set were compared in all of the tumor and corresponding normal tissue samples and were then sorted by the magnitude of the fold change between the average intensity values of all dysplasia and normal tissue samples.
Serial Analyses of Gene Expression (SAGE)
High-quality total RNA (500 µg) was extracted using the RNeasy kit (Qiagen) from four dissected gastric adenocarcinoma and two normal gastric mucosa pools, each pool consists of four normal gastric mucosal biopsy samples from normal individuals. The tumors selected for SAGE analysis were estimated to consist of more than 80% tumor cells. All normal samples had histologically normal mucosa confirmed on review of hematoxylin and eosin-stained sections. Importantly, histopathological examination confirmed that none of the normal samples had any areas of inflammation or necrosis. All samples were collected after consent in accordance with the Human Investigation Committee regulations at the University of Virginia. SAGE libraries were constructed using NlaIII as the anchoring enzyme and BsmFI as the tagging enzyme as described in SAGE protocol version 1.0e, June 23, 2000, which includes few modifications of standard protocol.11 A detailed protocol and schematic of the method is available (http://www.sagenet.org/protocol/index.htm). Two thousand clones were sequenced for each case by the Cancer Genome Anatomy Project. We used eSAGE 1.2a software to extract SAGE tags, remove duplicate ditags, tabulate tag contents, and link SAGE tags in the database to UniGene clusters using the recently reported ehm-Tag-mapping method.12,13 The resulting libraries tags were compared to UniGene cluster and to the SAGE tag reliable mapping database (http://www.sagenet.org/resources/genemaps.htm) and the statistical analyses were performed using the eSAGE software. We have earlier reported the results of two SAGE libraries (GSM757 and GSM784).14
Quantitative Real-Time Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR)
Gastric mucosa samples were dissected from gastric tissue of 13 mice at 5 months of age (seven Tff1/ gastric dysplasia and six Tff1+/+ normal gastric mucosa tissue samples). In addition, 20 human gastric adenocarcinoma samples and 13 normal human gastric mucosa samples were dissected to obtain more than 70% sample purity. All tumors and normal gastric mucosal epithelial tissues were verified by us (H.F.F. and C.A.M.). The primary gastric adenocarcinoma used in this study consisted of a diverse panel of tissues representing all stages of development [tumor-node-metastasis (TNM) stages I to IV], and histopathology (well differentiated to poorly differentiated; intestinal and diffuse type). RNA was purified from all samples using an RNeasy kit (Qiagen). Single-stranded cDNA was generated using an Advantage RT-for-PCR kit (Clontech, Palo Alto, CA). qRT-PCR was performed using an iCycler (Bio-Rad, Hercules, CA) with SYBR Green technology, and the threshold cycle numbers were calculated using iCycler software v3.0.15 Reactions were performed in triplicates and threshold cycle numbers were averaged. For validation of our microarray results, we selected CLDN7, EGR1, and EMP1. We designed gene-specific primers for mouse CLDN7, EGR1, EMP1, and ß-actin and human CLDN7, EGR1, EMP1, and HPRT1. The primers used for qRT-PCR were obtained from GeneLink (Hawthorne, NY), and their sequences are available on request. The mouse results were normalized to ß-actin and the human results were normalized to HPRT1, which had minimal variation in all normal and neoplastic samples that we tested. Fold-overexpression was calculated according to the formula 2(Rt Et)/2(Rn En) as described earlier15,16 where Rt is the threshold cycle number for the reference gene observed in the tumor, Et is the threshold cycle number for the experimental gene observed in the tumor, Rn is the threshold cycle number for the reference gene observed in the normal sample, and Rt is the threshold cycle number for the reference gene observed in the tumor sample. Rn and En values were an average for the corresponding normal samples that were analyzed. A single melt curve peak was observed for each sample used in the data analysis, thus confirming purity of all amplified products.
Western Blot Analysis
Primary dysplastic and normal mouse tissues were collected from Tff1/ and Tff1+/+ mice, respectively. All tissues were collected in compliance with the University of Virginia institutional animal care and use committee protocol. Stomach tissues were immediately snap-frozen in liquid nitrogen and stored at 80°C. All tissues were dissected to obtain a minimum of 75% purity of the desired cell population (dysplastic or normal). Frozen tissues were suspended in 0.4 ml of TENN buffer (50 mmol/L Tris, pH 8.0, 5 mmol/L ethylenediamine tetraacetic acid, 150 mmol/L NaCl, 0.2% Nonidet P-40, pH 8.0) containing a protease inhibitor mixture (Roche, Indianapolis, IN) and disintegrated by homogenizer and sonication. Lysates were centrifuged twice at 14,000 rpm for 15 minutes, and supernatants were loaded onto 12% sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels. Membranes were immunoblotted with the claudin-7 antibody C-15 (Santa Cruz Biotechnology, Santa Cruz, CA) at 1:100 dilutions. ß-Actin antibody AC-74 (Sigma-Aldrich, St. Louis, MO) was used at 1:1000 dilutions for normalization of protein loading.
Immunohistochemistry (IHC)
Immunohistochemical staining was performed using a Cldn7 (C-15) goat polyclonal antibody (Santa Cruz Biotechnology). Cldn7 protein expression was evaluated by IHC on histological sections of stomachs of 11 Tff1/ that developed dysplastic epithelial lesions. Additionally, 10 WT Tff1+/+ with normal gastric mucosa were included for comparison. All animal tissue samples were collected according to the University of Virginia institutional approval for animal care. In addition, Cldn7 was tested on human samples that comprised 11 normal gastric mucosa samples, 3 intestinal metaplasia samples, 10 gastric dysplasia samples, and a tissue microarray of 93 gastric adenocarcinoma. All human samples were collected from tissue archives of the Department of Pathology at University of Virginia and in accordance with our institutional human investigation committee-approved protocols. After the sections were deparaffinized and rehydrated, they were incubated with the antibody at a 1:200 dilution (0.05 µg/ml final concentration) for 1 hour at room temperature. Antibody binding was visualized using the avidin-biotin immunoperoxidase technique (Vectastain Elite ABC kit; Vector Laboratories, Burlingame, CA), with diaminobenzidine staining and hematoxylin counterstaining. The intensity of the immunoreactivity of the samples tested was scored as either 0 (no staining), 1 (weak), 2 (moderate), or 3 (strong) as demonstrated in Figure 5
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| Results |
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| Discussion |
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Our studies demonstrate that CLDN7 up-regulation in gastric neoplasia is conserved between the mouse model and human disease. Using clinical samples, Cldn7 IHC staining was not detected in any normal tissues, whereas specific cytoplasmic staining with apical patterns was seen in intestinal metaplasia, dysplasia, and adenocarcinomas. Interestingly, Cldn7 was weak in metaplasia, and became moderate to strong in dysplasia, whereas most of the intestinal-type adenocarcinoma showed strong expression. We have found that Cldn7 expression correlates with intestinal-type (P < 0.01), but not with tumor site, stage, or grade. This finding is most likely attributed to the differences in biological properties of intestinal versus diffuse histological subtypes. The fact that Cldn7 is expressed in early stages of gastric tumorigenesis and remains expressed in advanced intestinal-type gastric adenocarcinomas raises a potential biological role of Cldn7 in the tumorigenesis cascade.
Adhesion between neighboring epithelial cells is a crucial and tightly controlled process. In epithelial cells, specialized structures such as tight junctions and adherens junctions (also called the zonula adherens) are responsible for the establishment of contacts between neighboring cells.19,20
Tight junctions contain the transmembrane proteins occludin and the claudins, which are connected to the cytoskeleton via a network of proteins such as zonula occludens-1 (ZO-1).20
Claudins comprise a multigene family, and each member of
23 kd bears four transmembrane domains. To date, more than 20 members of this gene family have been identified.21,22
Claudins are exclusively responsible for the formation of tight junction strands and are connected with the actin cytoskeleton mediated by ZO-1.21-23
Tight junctions in epithelial cells act as cell-cell adhesion structures and govern paracellular permeability. They have two functions, the barrier (or gate) function and the fence function. The barrier function of tight junctions regulates the passage of ions, water, and various macromolecules, even of cancer cells, through paracellular spaces. Epithelial cells, and the tight junctions between them, form a polarized barrier between luminal and serosal fluid compartments and segregate luminal growth factors from their basal-lateral receptors. This property may promote cancer formation in premalignant epithelial tissues in which the tight junctions have become chronically leaky to growth factors.24
On the other hand, the fence function maintains cell polarity. This function is deeply involved in cancer cell biology. The establishment and stability of both adherens junctions and tight junctions are tightly regulated by several factors such as growth factors, cytokines, and hormones25
and can also have a significant impact on tumor development and metastasis.19,22,23
Although the present literature about claudins in cancer remains scarce; recent studies have suggested a potential role for claudins in cancer development and progression. In ovarian cancer, studies have shown claudins as potential molecular targets where claudin-3 and claudin-4 are frequently overexpressed.26,27 Cldn4 protein overexpression was observed in primary and metastatic pancreatic cancer. The Cldn4 overexpression within pancreatic intraepithelial neoplasia, the precursor lesion of pancreatic cancer, suggests a potential benefit of imaging claudin-4 before the development of an invasive carcinoma.28,29 Moreover, claudin-4 was observed in 73% of 22 invasive intraductal papillary mucinous neoplasms but in none of 16 noninvasive intraductal papillary mucinous neoplasms (P < 0.0001).30 This notion is in agreement with our findings that Cldn7 is overexpressed in gastric dysplasia and adenocarcinomas but not in surrounding nonneoplastic tissues. Interestingly, a member of the claudin protein family, claudin-1, is involved in the ß-catenin-TCF/LEF signaling pathway, and that increased expression of claudin-1 may have some role in colorectal tumorigenesis.31 Cldn7 is responsive to androgen stimulation in the LNCaP prostate cancer cell line and can regulate the expression of prostate-specific antigen.32 Recently, it was reported that Cldn7 is unlike other claudins, has both structural and regulatory functions and may be related to cell differentiation.32 Thus, our results together with the growing data about claudins strongly suggest that some members of this large protein family are involved in epithelial tumorigenesis and may have an early diagnostic and or prognostic clinical value.
In this study, we have used the Tff1/ mouse model to explore genetic changes related in premalignant lesions and have discovered molecular alterations of early gastric tumorigenesis. We have confirmed overexpression of Cldn7 at both the transcript and protein levels and showed specific overexpression of Cldn7 in the murine dysplastic gastric epithelial cells, but not in the surrounding normal epithelial cells. Moreover, we have shown that Cldn7, a member of tight junction proteins, is indeed overexpressed in human gastric dysplasia and adenocarcinoma but not in the surrounding nonneoplastic epithelial cells. The precise mechanism behind overex-pression of Cldn7 and their biological role in gastric tumorigenesis will be the subject of future studies.
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| Acknowledgements |
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| Footnotes |
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Supported by the National Cancer Institute (CA93999 to W.E.-R.) and the Cancer Center at University of Virginia.
Accepted for publication April 29, 2005.
| References |
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