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Laboratory of Molecular Endocrinology, Division of Cellular and Molecular Research, National Cancer Center of Singapore, Singapore 169610
Address all correspondence and requests for reprints to: Dr. Hung Huynh, Laboratory of Molecular Endocrinology, Division of Cellular and Molecular Research, National Cancer Center of Singapore, Singapore 169610. E-mail: cmrhth{at}nccs.com.sg.
| Abstract |
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| Introduction |
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Tamoxifen (TAM) has been reported to improve the survival of women with breast cancer and has proved to be clinically useful for the treatment of metastatic estrogen receptor-positive breast tumors (4, 5). However, long-term administration of TAM has been reported to be associated with endometrial thickening in some postmenopausal women (6) and increased risk of endometrial cancer in postmenopausal women (7). Over 40% of women receiving TAM had an endometrium more than 8 mm thick compared with only 5% of control women receiving placebo (6). It has been suggested that the estrogenic effect of TAM on the atrophic postmenopausal endometrium causes hyperplasia that may progress to atypia and cancer in a manner similar to that seen with estrogen replacement therapy (6). The molecular mechanisms responsible for TAM-induced endometrial hyperplasia are not well understood. We previously reported that TAM significantly increased uterine weight, whereas ICI 182,780 administration suppressed it (8). We also proposed that TAM might alter, in addition to enhancing IGF-I (8) and UO-44 (9) and inhibiting IGFBP-3 (10) gene expression in the uterus, the expression of other genes involved in the regulation of proliferation. To identify additional TAM- and estradiol-regulated genes in the uterus, differential display was used to examine the transcript expression profile of the ovariectomized (OVX) uterus under conditions of TAM supplementation. We isolated a TAM-regulated cDNA. This cDNA is identical to the cDNA encoded for a growth inhibitor isolated from urogenital sinus mesenchymal cells, ps20 (11). By virtue of its activation by antiestrogen and inhibition by estradiol and TAM, ps20 protein may play an important role in the growth regulation of normal and neoplastic uterine tissues.
| Materials and Methods |
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mRNA differential display
OVX rats were either untreated or treated with 2 mg TAM/kg·d (OVX-TAM) for 14 d. Total RNA was isolated from uteri using TRIzol reagent (Invitrogen Life Technologies, Inc., Carlsbad, CA) as described previously (9). Differential display was performed using RNA derived from uteri of OVX-vehicle- and OVX-TAM-treated rats according to the protocol supplied with the RNAmap kit (GeneHunter Corp., Nashville, TN) and as previously described (9).
Isolation of ps20 cDNA
The 270-bp probe of rat ps20 cDNA was used to screen rat uterine cDNA library as previously described (9). Clones identified by this probe were isolated and sequenced by the Sanger dideoxy chain termination method as previously described (9).
Animals and drug administration
Animal experiments were approved by the local animal care committee. Fifty-day-old, ovary-intact female Sprague Dawley rats were obtained from National University of Singapore, Singapore. OVX rats used in the experiments were 2 wk after ovariectomy.
To determine whether ps20 gene expression changes during the estrous cycle, uteri were collected from rats at estrous, proestrous, metestrous, and diestrous stages of cycle and frozen in liquid nitrogen for Northern blot analysis. Different stages of estrous cycle were ascertained by examining vaginal smears as described previously (9).
To study the in vivo effects of the antiestrogen ICI 182,780, TAM, and estrogens on ps20 gene expression in the rat uterine tissue, groups of ovary-intact rats were implanted with 0.5-, 1.0-, or 1.5-cm SILASTIC brand silicon tubes (inside diameter, 0.078 in.; Dow Corning, Midland, MI) containing 17ß-estradiol (Sigma-Aldrich, Singapore) on the back of the neck. Control rats experienced the same surgical implantation with empty SILASTIC brand silicon tubes. Based on previous work (12), the release rate of 17ß-estradiol from the implants was documented to be 2.4 µg/cm·d. TAM (Sigma-Aldrich) was dissolved in castor oil at a concentration of 10 mg/ml. Female rats daily received either 2 or 5 mg TAM/kg BW via sc injections. Preformulated ICI 182,780 (AstraZeneca Pharmaceuticals, Macclesfield, UK) was supplied at a concentration of 50 mg/ml in castor oil solution. Female rats were received weekly sc injections of either castor oil alone or three different doses (1, 1.5, or 2 mg) of ICI 182,780/kg BW for 3 wk. At the end of the experiments, animals were killed by carbon dioxide exposure. The uteri were excised, trimmed, weighed, and snap-frozen in liquid nitrogen and stored at 70 C for RNA extraction. Part of the uterine tissue was fixed in neutral buffer containing 10% formalin and embedded in paraffin for immunohistochemistry. To study the effects of ovarian hormones on ps20 gene expression, female rats were OVX, and the uteri were collected at various times after ovariectomy for ps20 mRNA determination. To study the effects of estradiol and progesterone on ps20 gene expression, OVX rats were implanted with 1.5-cm SILASTIC brand silicon tubes containing either 17ß-estradiol or progesterone, and the uterine tissue was harvested at the indicated times after hormonal supplementation.
ps20 Antibody
Rabbit antirat ps20 antibodies were raised against amino acid peptides in the N terminal of rat ps20. The amino acid sequences of rat ps20-specific peptide were as follows: TWEAMLPVRLAEKSQAEEVA. Affinity-purified ps20 antibody was diluted in Tris-buffered saline (20 mM Tris and 200 mM NaCl, pH 7.6) containing 0.1% Tween 20 at a final concentration of 1 µg/ml. The specificity of ps20 antiserum was verified by Western blot analysis of conditioned medium (CM)-derived MCF-7 cells that were transfected with full-length rat ps20 cDNA.
Immunohistochemical analysis and assessment
For immunohistochemistry, sections (5 µm thick) were cut, dewaxed in xylene, and then rehydrated as previously described (13). Antigen retrieval was performed by boiling the slides in 10 mM citrate buffer, pH 6.0, for 20 min. After blocking unspecific binding with 5% skim milk, sections were incubated with rabbit antirat ps20 (1:1000 dilution) overnight at 4 C as previously described (14). Immunohistochemistry was performed using the streptavidin-biotin peroxidase complex method according to the manufacturers instructions (Lab Vision, Fremont, CA) using 3,3'-diaminobenzidine as the chromogen. Sections known to stain positively were incubated in each batch, and negative controls were also prepared by replacing primary antibody with preimmune serum.
Primary uterine cell isolation and treatment
Uterine tissue derived from 10-wk-old rats was finely minced and washed three times with serum-free MEM (SRF). The minced tissue was incubated with MEM containing 5% FBS and 5 mg/ml collagenase A (Roche, Indianapolis, IN) at 37 C for 12 h as described previously (10). Cells were harvested by centrifuging at 800 x g for 10 min. The cell pellets were washed three times with SRF medium and allowed to grow in MEM containing 10% FBS. To study the effects of ps20 on the proliferation of PC-3 human prostate cancer cells and primary rat uterine cells, cells were plated at a density of 1 x 104 cells/well in 96-well plates and allowed to grow in growth medium for 24 h. Cells were washed once with SRF medium, then incubated in SRF medium for another 18 h. To determine the effects of bacterial recombinant ps20, cells were then treated with indicated concentrations of bacterial recombinant ps20. To study the effects of ps20 produced by MCF-7 cells on cellular proliferation, PC-3 cells were treated with SRF medium containing either 30% CM of ps20-transfected or 30% CM of pcDNA-3-transfected MCF-7 cells for 48 h. [3H]Thymidine incorporation was determined 48 h after treatment as previously described (15). Experiments were repeated three times, and the data were expressed as the mean ± SD.
Western blot analysis
To determine whether the different forms of secreted ps20 were due to differential glycosylation, concentrated CM derived from pcDNA-3-transfected MCF-7 cells was incubated with 10 U recombinant N-glycanase enzyme (Genzyme, Cambridge, MA) as described by the manufacturer. N-Glycanase-digested proteins were subjected to Western blot analysis as previously described (13). To examine the effects of estrogens, TAM, and ICI 182,780 on ps20 secretion, primary rat uterine cells were plated at a density of 5 x 106 cells/100-mm dish in the growth medium. After 24 h, the cell monolayer was washed, then treated with SRF medium containing 0.05% ethanol, 109 M ICI 182,780, 108 M TAM, and 1010 M 17ß-estradiol for 48 h. After treatment, CM was harvested. To determine changes in the levels of ps20 in CM, 1 ml CM was concentrated to 0.1 ml and subjected to Western blot analysis as previously described (13). Blots were incubated with rabbit antirat antibodies (1:4000) and horseradish peroxidase-conjugated donkey antimouse or antirabbit secondary antibodies (1:7500). Blots were then visualized with a chemiluminescent detection system (Amersham Biosciences) as described by the manufacturer.
Northern blotting
Total RNA was isolated from indicated tissues of female rats as previously described (16). Northern blots were performed on total RNA, and blots were hybridized with rat ps20 or human GAPDH (American Type Culture Collection, Manassas, VA) cDNAs as previously described (9). mRNA levels were determined by densitometric scanning of autoradiographs.
Stable ps20-transfected MCF-7 cells
The entire coding region of rat ps20 cDNA was cloned into the mammalian expression vector pcDNA3.1 (Invitrogen Life Technologies, Inc.) to create the ps20-pcDNA3.1 expression vector. The ps20-pcDNA3.1 sequence was confirmed by sequencing. MCF-7 cells were seeded at a density of 2 x 105 in 100-mm culture dishes in 90%
-MEM (Sigma-Aldrich) containing 10% FBS with 1% penicillin -streptomycin for 24 h before transfection. Cells were transfected with either 5 µg ps20-pDNA3.1 or pDNA3.1 and 28 µl Lipofectamine reagent (Invitrogen Life Technologies, Inc.) as previously described (14). Forty-eight hours after transfection, cells were subcultured at 1:10 and replaced with
-MEM containing 10% FBS and 800 µg/ml G418 (Calbiochem, La Jolla, CA). After 4 wk of selection, individual clones were isolated, expanded, and assayed for ps20 expression by Western blot analysis.
Expression and purification of ps20-His
The coding region of rat ps20 cDNA without signal peptide was cloned into pQE-30 bacterial expression vector (Qiagen, Mississauga, Canada), a vector that allows incorporation of a His-Tag at the carboxyl terminus. The ps20-QE-containing clone was confirmed by sequencing and transformed into the M15 bacterial expression cell line (Qiagen). Five hundred milliliters of bacterial cultures were grown and induced with 1 mM isopropyl-1-thio-ß-D-galactopyranoside for 2 h. Soluble extract was generated by suspending bacteria in buffer containing 8 M urea, 0.1 M NaH2PO4, and 0.01 M Tris-HCl, pH 8.0, and kept at room temperature for 30 min. The soluble extract was centrifuged at 13,000 rpm for 30 min. Recombinant ps20-His protein was purified on a nickel-charged resin (Qiagen) as described by the manufacturer. Fractions containing proteins were pooled and dialyzed against 1 M acetic acid (pH 2.5) overnight at 4 C. The dialyzed samples were quickly frozen, lyophilized, and stored at 80 C.
Statistical analysis
For quantitation analysis, the sum of the density of bands corresponding to mRNA hybridized to ps20 probe or protein blotting with the antibody under studied was calculated and normalized to the amount of GAPDH mRNA or
-tubulin, respectively. Differences in ps20 mRNA levels, [3H]thymidine incorporation, and the levels of ps20 were analyzed by ANOVA.
| Results |
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To study the effects of estrogens and TAM on the uterine growth and expression of ps20 in the uterus, ovary-intact rats were treated with various doses of TAM, estradiol, and the antiestrogen ICI 182,780. Figure 2A
shows that after estradiol implantation for 3 wk, a dose-dependent decrease in ps20 expression was observed (P < 0.01). Similarly, at doses of 2 and 5 mg/kg body weight, TAM significantly reduced ps20 mRNA by 45% and 50%, respectively (Fig. 2B
; P < 0.01). ICI 182,780, in contrast, significantly increased ps20 mRNA levels in uterine tissue compared with the controls (Fig. 2C
; P < 0.01). Maximal induction was observed at a dose of 1 mg ICI 182,780/kg body weight/wk (Fig. 2C
). The results indicate that TAM acts as an estrogen agonist to inhibit ps20 expression. In all cases, an inverse relationship between ps20 gene expression and uterine weight existed.
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To determine the cell type-specific expression of ps20 in uterine tissue, immunohistochemistry was performed on sections of uteri derived from vehicle-, ICI 182,780-, estradiol-, and TAM-treated rats using antirat ps20 antibody. High ps20 expression was detected in smooth muscle cells. Faint signal was also detected in luminal epithelial cells and the glandular population of the uteri (Fig. 6A
). Treatment of rats with 17ß-estradiol (Fig. 6B
) and TAM (Fig. 6C
) resulted in a significant reduction in ps20 protein in smooth muscle and luminal epithelial cells. ps20 expression in the smooth muscle cells and particularly in luminal epithelial cells was greatly increased by ICI 182,780 treatment (Fig. 6D
). In ICI 182,780-treated uterine tissue, a strong immunostaining was also detected on the apical surface of glandular and luminal epithelial cells (Fig. 6D
). Similar staining patterns were seen when the sections derived from uterine tissue of OVX rats were stained with ps20 antibody (data not shown). No staining was observed in smooth muscle cells when the antibody was preadsorbed with ps20 peptide (data not shown).
To determine whether estrogens also regulated ps20 secretion, primary rat uterine cells were isolated, grown, and treated with SRF medium containing vehicle, 109 M ICI 182,780, 108 M TAM, and 1010 M 17ß-estradiol for 48 h. Figure 7
shows that although ICI 182,780 caused a 2-fold increase in ps20 accumulation in CM, exposure of cells to TAM and estradiol resulted in 50% and 90% reductions in basal ps20 secretion, respectively.
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| Discussion |
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, TGF-ß, IGF-I receptor, epidermal growth factor receptor, and pS2 (reviewed in Ref. 4), IGF-I (8), UO-44 (9), and IGFBP-3 (10) in uterine tissue. In the present study we demonstrate for the first time that estrogens and TAM inhibit ps20 expression in this tissue. Levels of ps20 transcripts are high in heart, lung, and tissues containing a high proportion of smooth muscle cells, but are low in tissues with more epithelial cells. The localization of ps20 in smooth muscle as well as luminal epithelial cells in uterine tissue suggests that ps20 may play an autocrine and/or paracrine role in the regulation of cellular proliferation and the maintenance of homeostasis in this tissue. The high expression of ps20 found in uterine smooth muscle is consistent a previous study (11) showing that in the prostate, smooth muscle cells express high levels of ps20. Low expression of ps20 occurred at the estrous and proestrous stages of the ovarian cycle coincident with estrogen-induced uterine cell proliferation, in contrast to high levels during metestrus and diestrus. In rodents, circulating levels of estrogens are high in proestrus and low in diestrus. Concomitant with this rise and fall in circulating estrogen levels, there is a decline and rise in ps20 mRNA levels in uterine tissue. This pattern of expression during the reproductive cycle suggests that ps20 plays a role in growth regulation. A rapid increase in ps20 gene expression after ovariectomy and antiestrogen ICI 182,780 treatment also supports the inhibitory effects of estrogens on ps20 expression.
The precise mechanism(s) by which TAM inhibits ps20 gene expression is not known at present. TAM is a classical partial agonist and exhibits tissues specificity for inducing either an agonist or antagonist response. In rats and humans, TAM exhibits partial agonist (reviewed in Ref. 4). It produces antagonist effects in breast, but agonist effects in vagina and endometrium (reviewed in Ref. 4). Long-term TAM use is generally associated with a reduced incidence of contralateral breast cancer (antagonist), a reduced incidence of primary breast cancer in high risk women (antagonist), maintenance of bone density (agonist), and an increased risk of endometrial carcinomas (agonist) (17). ICI 182,780 seems to be an antagonist; it is devoid of agonist activity in the uterus or vagina of rats (18). Although TAM and estradiol suppress ps20 expression in uterine tissue, TAM is approximately 800- to 1500-fold less potent than estradiol. The decrease in ps20 expression after TAM treatment suggests that TAM acts as an estrogen agonist in the uterus. The results reported here are clinically relevant, because women treated with TAM frequently exhibit endometrial hyperplasia (19) and rarely show neoplasia (7, 20, 21). TAM has been proposed as a treatment for neoplastic conditions of the uterus (22), but the results of clinical trials have not been impressive, and there are clinical and laboratory data suggesting that stimulation of endometrial neoplastic growth and leiomyoma growth by TAM are possible (23, 24). It is possible that the estrogen-like effect of TAM on ps20 expression in uterine tissue, as described here, is related to its adverse effects.
An immunohistochemical study reveals that ps20 protein expression is not only confined to smooth muscle cells, but is also present in luminal and glandular epithelial cells of the uterus. This observation is consistent with the recent report (25) that ps20 is localized in stromal cells as well as in a more aggressive epithelial phenotype. High levels of ps20 gene expression are found in smooth muscle cells and the apical surface of luminal epithelial cells of ICI 182,780-treated uterine tissue. Although ps20 expression is inversely correlated with uterine growth, the biological function of ps20 in the uterus is as yet unclear. ps20 Belongs to the whey acidic protein-type, four-disulfide core domain protein family (11). They are serine protease inhibitors that exhibit a variety of growth and differentiation functions. Recently, McAlhany et al. (26) proposed that ps20 is a TGF-ß1-induced regulator of angiogenesis. They suggest that ps20 functions by either promoting endothelial cell migration or contributing to pericyte stabilization of newly formed vascular structure (26). In the present study we observed that estrogens, which are known to induce angiogenesis, potently inhibit ps20 expression. Ovariectomy and ICI 182,780, in contrast, are potent stimulators of ps20 expression and inhibitors of angiogenesis. Thus, in the uterus, ps20 may function as a local growth regulator, rather than a regulator of angiogenesis.
Previous studies have shown that recombinant ps20 inhibited the proliferation of prostate carcinoma PC-3 cells (11) and was suggested to function as a mediator of local growth and differentiation mechanisms. In the present study we did not observe any growth inhibition when bacterial recombinant ps20 was used to treat the same cell line. The discrepancy between our study and the previous one (11) is not clear. We believe that posttranslational modification of the ps20 protein plays an important role in determining its growth inhibitory activity. This hypothesis is supported by the observations that three specific bands of apparent molecular mass 24, 27, and 29 kDa are detected in CM of ps20-transfected MCF-7 cells. Similar results are observed when CM from rat primary uterine cells is analyzed by Western blot analysis. However, the 24-kDa form of ps20 becomes the major species when CM is treated with N-glycanase. This suggests that ps20 undergoes posttranslational modification before secretion.
In summary, our data demonstrate that ps20 gene expression in uterine tissue is a molecular marker that inversely correlates well with the positive or negative uterotropic effects of estrogen receptor antagonists and partial agonists. The characterization of ps20 protein provides new knowledge about the roles of ps20 protein in estradiol- and TAM-induced cellular proliferation and cancer in this tissue.
| Footnotes |
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First Published Online January 27, 2005
Abbreviations: CM, Conditioned medium; FBS, fetal bovine serum; OVX, ovariectomized; SRF, serum-free MEM; TAM, tamoxifen.
Received December 3, 2004.
Accepted for publication January 20, 2005.
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