Distant Bystander Effect of REIC/DKK3 Gene Therapy Through Immune System Stimulation in Thoracic Malignancies
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ANTICANCER RESEARCH 37 : 301-308 (2017) doi:10.21873/anticanres.11321 Distant Bystander Effect of REIC/DKK3 Gene Therapy Through Immune System Stimulation in Thoracic Malignancies KEN SUZAWA 1* , KAZUHIKO SHIEN 1,2* , HUANG PENG 3, MASAKIYO SAKAGUCHI 4, MASAMI WATANABE 5,6,7 , SHINSUKE HASHIDA 1,2 , YUHO MAKI 1, HIROMASA YAMAMOTO 1, SHUTA TOMIDA 8, JUNICHI SOH 1, HIROAKI ASANO 1, KAZUNORI TSUKUDA 1, YASUTOMO NASU 5,6,7 , HIROMI KUMON 3,5,7 , SHINICHIRO MIYOSHI 1 and SHINICHI TOYOOKA 1,2 Departments of 1Thoracic Surgery, 2Clinical Genomic Medicine and 4Cell Biology, 5Urology, 3Collaborative Research Center for Okayama Medical Innovation Center, and 8Biobank, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; 6Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan; 7Innovation Center Okayama for Nanobio-Targeted Therapy, Okayama University, Okayama, Japan Abstract. Background: Reduced expression in immortalized Both advanced-stage non-small cell lung cancer (NSCLC) cell (REIC)/Dickkoph-3 (DKK3) is a tumor-suppressor gene, and malignant mesothelioma (MM) are aggressive tumors and and its overexpression by adenovirus vector (Ad-REIC) present a dismal prognosis. Despite advances in treatment exhibits a remarkable therapeutic effect on various human regimens for both diseases, such as surgical resection, cancer types through a mechanism triggered by endoplasmic chemotherapy, molecular-targeted therapy and radiotherapy, reticulum stress. Materials and Methods: We examined the treatment outcome is still unsatisfactory. Gene therapy for direct anti-tumor effect of Ad-REIC gene therapy on lung thoracic malignancies represents a novel therapeutic approach cancer and malignant mesothelioma cell lines in vitro, and and has been evaluated in a number of clinical trials over the the distant bystander effect using immunocompetent mouse last two decades (1). Previously, we identified expression of allograft models with bilateral flank tumors. Results: Ad- the tumor-suppressor gene Reduced expression in REIC treatment showed antitumor effect in many lung cancer immortalized cell ( REIC )/Dickkoph-3 ( DKK3 ) as being and malignant mesothelioma cell lines in vitro. In an in vivo reduced in many human cancer types (2-6). However, the model, Ad-REIC treatment inhibited the growth not only of impact of REIC/DKK3 in thoracic malignancies, such as the directly treated tumors but also of distant untreated tumors. frequency of its decreased expression among the subtypes of By immunohistochemical analysis, infiltration of T-cells and lung cancer, and the relationship between its loss and other natural killer (NK) cells and expression of the major oncogenic driver mutations, is yet to be investigated. histocompatibility complex (MHC) class I molecules were We demonstrated that overexpression of REIC/DKK3 by observed in bilateral tumors. Conclusion: Ad-REIC treatment adenovirus (Ad-REIC) led to remarkable therapeutic effects not only had a direct antitumor effect but also an indirect on several human cancer types, but not on normal cells (3, bystander effect through stimulation of the immune system. 4, 7-9). As the REIC/DKK3 gene expression is absent from cancer cells, the REIC/DKK3 protein folding system in cancer cells does not function well when the protein is overexpressed by Ad-REIC, which leads to endoplasmic reticulum (ER) stress-induced apoptosis. The activation of c- *These Authors contributed equally to this study. JUN N-terminal kinase (JNK) pathway occurs downstream of ER stress signaling, which is a critical event in apoptosis Correspondence to: Shinich Toyooka, MD, Ph.D., Department of (3, 4, 7-11). In addition to this direct antitumor effect, we Clinical Genomic Medicine, Okayama University Graduate School also showed Ad-REIC to have a host-mediated bystander of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, effect on human prostate cancer and scirrhous gastric cancer Japan. Tel: +81 862357436, Fax: +81 862357437, e-mail: [email protected] via the induction of anticancer immunity (12-14). Secreted REIC/DKK3 protein differentiates monocyte into the Key Words: REIC/DKK3 , gene therapy, lung cancer, mesothelioma, dendritic cells-like phenotype and then activates cytotoxic T- bystander effect. lymphocytes (CTLs) (12). Furthermore, in normal 0250-7005/2017 $2.00+.40 301 ANTICANCER RESEARCH 37 : 301-308 (2017) fibroblasts, Ad-REIC treatment does not cause apoptosis, but a modified 3-[4,5-dimethylthiazol-2-yl]-5-[3-carboxymethoxyphenyl]- induces interleukin 7 (IL7) secretion. This enhanced IL7 2-[4-sulfophenyl]-2H-tetrazolium, inner salt (MTS) assay with secretion activates natural killer (NK) cells (13, 14). These CellTiter 96 Aqueous One Solution Reagent (Promega, Madison, WI, USA) according to the manufacturer’s instruction. mechanisms up-regulate systemic antitumor immunity. Given this evidence, a clinical trial of REIC gene therapy Western blotting. The total cell lysate was extracted from cell lines for prostatic cancer is ongoing (UMIN000004929; with lysis buffer, a mixture of RIPA buffer, phosphatase inhibitor NCT01931046). In a first study in Man (a phase I/IIa study cocktails 2 and 3 (Sigma-Aldrich, St. Louis, MO, USA), and of in situ Ad-REIC therapy for prostate cancer), direct and Complete Mini (Roche, Basel, Switzerland). Western blot analysis systemic antitumor effects were clearly detected in a patient was performed by conventional methods using the following with metastatic castration-resistant prostate cancer following primary antibodies: rabbit anti-human REIC/DKK3 antibody raised chemotherapy (15). in our laboratory, rabbit anti- stress-activated protein kinases (SAPK)/JNK, phospho-SAPK/JNK (Thr183/Tyr185), cleaved poly In this study, we examined potential direct and indirect (ADP-ribose) polymerase (PARP) (Cell Signaling Technology, bystander effects of Ad-REIC via activation of systemic Danvers, MA, USA), and mouse anti-actin (Merck Millipore, antitumor immunity in lung cancer and mesothelioma cells. Billerica, MA, USA). The following secondary antibodies were In order to examine the immune-mediated response in vivo , used: goat anti-rabbit or anti-mouse IgG-conjugated horseradish we used murine cancer cell lines and an immunocompetent peroxidase (Santa Cruz Biotechnology, Dallas, TX, USA). To detect mouse model. specific signals, membranes were examined using the ECL Prime Western Blotting Detection System (GE Healthcare, Amersham, Materials and Methods UK) and LAS-3000 (Fujifilm, Tokyo, Japan). Gene expression analysis of clinical lung cancer tissues. Messenger Animal models. This study was carried out in accordance with the RNA (mRNA) expression, histological subtype, and genetic mutation Guidelines of the Okayama University Animal Committee. profiling for 158 lung carcinomas and five normal lung tissues (16) Pathogen-free immunocompetent female BALB/c mice aged 6 to 8 were obtained from Gene Expression Omnibus public database weeks were purchased from CLEA Japan (Tokyo, Japan). AB12 cells (1×10 6) were suspended in 100 μl of serum-free DMEM, and (GEO; http://www.ncbi.nlm.nih.gov/geo/; accession number 6 GSE11969). We assessed the association between mRNA expression KLN205 cells (1×10 ) were suspended in 200 μl DMEM with of REIC/DKK3 and the histological subtype or mutation profile. Matrigel, and each cell line was injected subcutaneously into the bilateral flanks of mice (n=3 per group and n=4 per group, 3 Cell lines. Four human lung cancer cell lines (A549, HCC827, respectively). When the tumors reached a volume of 200-250 mm , H1975, and PC9), three murine lung cancer cell lines (CMT64, the mice received intratumoral injection of Ad-SGE-REIC at a dose KLN205, and LL/2), four human MM cell lines (H28, H290, of 109 plaque-forming units (pfu) into the right-flank tumor on days 1 and 8. Control mice were treated in an analogous manner with H2052, and MSTO-211H), and three murine MM cell lines (AB1, 9 AB12, and AC29) were used in this study. A549 and LL/2 were injection of either 10 pfu Ad-LacZ or 100 μl of PBS. During the purchased from American Type Culture Collection (Manassas, VA, course of the study, mice were monitored for signs of pain or USA). HCC827, H1975, and four human MM cell lines were kindly distress, and loss of body weight twice a week. Tumor growth was provided by Dr. Adi F. Gazdar (University of Texas Southwestern monitored twice a week, and individual tumor volumes were measured using a digital caliper and approximated according to the Medical Center, Dallas, TX, USA). PC9 was purchased from 2 Immuno-Biological Laboratories (Takasaki, Japan). CMT64 was formula V=1/2 ab (a being the long diameter and b being the short obtained from the European Collection of Cell Cultures (Porton diameter of the tumor). No mouse encountered difficulty moving or Down, UK). KLN205 was obtained from RIKEN BioResource accessing feed and water due to tumor size, had to be euthanized Center (Tsukuba, Japan). AB1, AB12, and AC29 were were kindly prior to the experimental endpoint for the health reasons, nor provided by Steven M. Albelda (University of Pennsylvania, became severely ill or died. All mice were sacrificed on day 22 by Philadelphia, PA, USA). All human cells were cultured in RPMI- cervical dislocation under ketamine and xylazine anesthesia. After 1640 medium supplemented with 10% fetal bovine serum (FBS) sacrifice, tumors were subsequently harvested, measured, and and all murine cells were cultured in Dulbecco’s