Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
Title: RXRα Inhibits the NRF2-ARE Signalling Pathway Through A Direct
Interaction With the Neh7 domain of NRF2
Running title: RXRα represses NRF2-mediated transcription
1,2 2 1 2 1 1 Hongyan Wang , Kaihua Liu , Miao Geng , Peng Gao , Xiaoyuan Wu , Yan Hai ,
Yangxia Li1, Yulong Li1, Lin Luo2, John D. Hayes3, Xiu Jun Wang2† and Xiuwen
Tang1†
1Department of Biochemistry and Genetics, 2Department of Pharmacology, School of
Medicine, Zhejiang University, Hangzhou, PR China, 310058, 3Division of Cancer
Research, Medical Research Institute, Ninewells Hospital & Medical School,
University of Dundee, Dundee DD1 9SY, Scotland, United Kingdom
Key words: RXRα, repressor, NRF2, ARE, drug resistance
†To whom correspondence should be addressed: PO BOX 18, The School of
Medicine, Zhejiang University, Hangzhou, PR China 310058. Tel: +0086-571-
88208266; Fax: +0086-571-88208266; E-mail: [email protected] (Xiu Jun Wang)
or [email protected] (Xiuwen Tang)
Word count: 4993
Total number of figures and tables: 6
The authors disclose no potential conflicts of interest.
Abbreviations: AKR1C, aldo-keto reductases 1C1 and 1C2; ARE, antioxidant response element; ATF3, activating transcription factor 3; BHA, butylated hydroxyanisole; CAR, constitutive androstane receptor; CBP, CREB, cAMP response element binding protein, binding protein; ChIP, chromatin immunoprecipitation; DAPI, 4’,6-diamidino-2-phenylindole; DBD, DNA-binding domain; DMSO, dimethyl sulfoxide; ERRβ, estrogen-related receptor beta; GAPDH, glyceraldehyde- 3-phosphate dehydrogenase; GFP, green fluorescent protein; GSH, reduced glutathione; GSK-3, glycogen synthase kinase-3; GST, glutathione S-transferase; HO- 1, heme oxygenase 1; KEAP1, Kelch-like ECH -associated protein 1; LBD, ligand- binding domain; Neh, NRF2-ECH homology; NQO1, NAD(P)H:quinone oxidoreductase 1; LXR, liver X receptor; NRF2, NF-E2 p45-related factor 2; NSCLC, non-small cell lung cancer; PBS, phosphate buffered saline; PXR, pregnane X receptor; RFP, red fluorescent protein; RNA Pol II, RNA polymerase II; ROS,
1
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
reactive oxygen species; RT-PCR, real-time quantitative PCR; RAR, retinoic acid receptor; RXRα, retinoid X receptor alpha; siRNA, small interfering RNA; tBHQ, tert-butylhydroquinone.
2
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
ABSTRACT
The transcription factor NRF2 (NFE2L2) is a pivotal activator of genes
encoding cytoprotective and detoxifying enzymes that limit the action of cytotoxic
therapies in cancer. NRF2 acts by binding antioxidant response elements (AREs) in
its target genes, but there is relatively limited knowledge about how it is negatively
controlled. Here we report that retinoic X receptor alpha (RXRα) is a hitherto
unrecognized repressor of NRF2. RNAi-mediated attenuation of RXRα increased
basal ARE-driven gene expression and induction of ARE-driven genes by the NRF2
activator tert-butylhydroquinone (tBHQ). Conversely, over expression of RXRα
attenuated ARE-driven gene expression. Biochemical investigations showed that
RXRα interacts physically with NRF2 in cancer cells and in murine small intestine
and liver tissues. Further, RXRα bound to ARE sequences in the promoters of NRF2-
regulated genes. RXRα loading onto AREs was concomitant with the presence of
NRF2, supporting the hypothesis that a direct interaction between the two proteins on
gene promoters accounts for the antagonism of ARE-driven gene expression.
Mutation analyses revealed that interaction between the two transcription factors
involves the DNA-binding domain of RXRα and a region comprising amino acids
209-316 in human NRF2 that had not been defined functionally, but that we now
designate as the NRF2-ECH homology (Neh7) domain. In non-small cell lung cancer
cells where NRF2 levels are elevated, RXRα expression downregulated NRF2 and
sensitized cells to the cytotoxic effects of therapeutic drugs. In summary, our findings
demonstrate that RXRα downmodulates cytoprotection by NRF2 by binding directly
to the newly defined Neh7 domain in NRF2.
3
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
INTRODUCTION
The human body is continuously threatened by reactive oxygen species (ROS)
and electrophiles that are generated by metabolism and by environmental agents. The
NF-E2 p45-related factor 2 (NRF2) is a cap’n’collar (CNC) basic-region leucine
zipper (bZIP) transcription factor which plays a major role in protecting cells from
prooxidants and electrophiles because it regulates basal and inducible expression of
genes that contain antioxidant response element (ARE) sequences in their promoter
regions. NRF2-target genes include those encoding antioxidant and detoxication
enzymes such as aldo-keto reductase (AKR), heme oxygenase 1 (HO-1), glutathione
S-transferase (GST), glutamate-cysteine ligase, and NADP(H):quinone
oxidoreductase-1 (NQO1) (1-3).
The ubiquitin ligase substrate adaptor kelch-like ECH-associated protein 1
(KEAP1) is a major repressor of NRF2. Under normal conditions, NRF2 is constantly
degraded via the ubiquitin-proteasome pathway in a KEAP1-dependent manner.
Under stressed conditions, ROS or eletrophiles modify cysteine residues in KEAP1
causing loss of its adaptor activity, and in turn failure to ubiquitylate NRF2. Upon
inactivation of KEAP1, NRF2 accumulates in the nucleus where it heterodimerizes
with small Maf proteins and activates ARE-driven genes (4, 5). Recent studies have
demonstrated that KEAP1-dependent ubiquitylation of NRF2 can be prevented by
protein-protein interactions: these include the binding of p21 to NRF2 or the binding
of p62/sequestosome-1 to KEAP1 (6, 7).
In contrast to the wealth of knowledge about the activation of NRF2, far less is
known about the mechanisms by which cells turn off or down-regulate NRF2 once it
has been activated. Importantly, several transcriptional repressors of NRF2 have been
identified, such as Bach1, P53, activating transcription factor 3 (ATF3), and estrogen-
4
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
related receptor beta (ERRβ) (8-11), suggesting that NRF2 activity is strictly
regulated even when KEAP1 is inactivated. Nonetheless, constitutive up-regulation of
NRF2 has been observed in various tumors, including non-small cell lung cancer
(NSCLC), and those of breast, head and neck, and gallbladder (12-14). Indeed, de-
regulation of NRF2 has been shown to contribute to tumorgenesis and drug resistance
(14-18). Thus, NRF2 is emerging as a new molecular target for the treatment of
certain cancers. It is therefore important to understand the molecular mechanisms by
which NRF2 activity can be suppressed because this might provide novel strategies
for therapeutic intervention.
In a previous study, we reported that retinoic acid receptor alpha (RARα)
antagonises NRF2 activity (19). Retinoid X receptor (RXR) is the obligatory
heterodimerization partner for RARα (20, 21), but its role in regulating the function
of NRF2 has not been investigated to date. In the present study we discovered that
RXRα can inhibit the transcriptional activity of NRF2 through a physical interaction
between the two factors. A RXRα-binding region, which is located between the
NRF2-ECH homology (Neh) 5 and Neh6 domains of human NRF2, has been
identified. Mutation analyses have revealed that the DNA-binding domain (DBD) of
RXRα is required for the interaction with NRF2. Moreover, we have provided
evidence that RXRα is capable of interacting with NRF2 on ARE sites in gene
promoters, demonstrating a previously unrecognised mechanism by which the CNC-
bZIP factor can be inhibited. Down-regulation of NRF2 via forced expression of
RXRα in NSCLC A549 cells, where the CNC-bZIP factor is constitutively active,
increased sensitivity to therapeutic drugs. Thus our data demonstrate a novel
mechanism by which RXRα can suppress drug resistance.
5
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
MATERIALS AND METHODS
Chemicals and cell culture
Unless otherwise stated, all chemicals were from Sigma-Aldrich Co., Ltd.
(Shanghai, China), and all antibodies were from Santa Cruz Biotechnology (Shanghai,
China). Antibody against mouse Nrf2 (H300) (sc-13032, Santa Cruz) was used for
this study. Actin and β-tubulin antibodies were purchased from Sigma (China). Alexa
Fluor 488 goat anti-rabbit IgG(H+L) was obtained from Invitrogen (Shanghai, China).
HEK293 (human embryonic kidney-293), MCF7 (human breast carcinoma), Caco2
(human colon cancer) and NSCLC A549 cell lines were from ATCC (China).
Animals
Five-week-old male C57BL/6 male mice were used in this study. The mice (n
= 8) were given butylated hydroxyanisole (BHA) by intragastric gavage (i.g.) at 200
mg/kg daily for 3 days. The equivalent volume of corn oil (vehicle) was given to the
control mice (n = 8). Mice were sacrificed and tissues were processed as described
previously (22). All animal procedures were performed in accordance with the
approval of Laboratory Animals Ethics Committee of Zhejiang University.
Plasmids
Plasmids encoding mouse (m) Nrf2 were provided by Dr Mike McMahon
(Medical Research Institute, University of Dundee, UK): these included
pcDNA3.1/V5-mNrf2 (full-length), pcDNA3.1/V5-mNrf2∆ETGE (lacking amino acids
79-82) and pcDNA3.1/V5-mNrf2∆DIDLID (lacking amino acids 17-32) (23). pHyg-EF-
hNRF2 encoding EGFP tagged full-length human (h) NRF2 was kindly provided by
Dr. Masayuki Yamamoto and Dr. Ken Itoh (Institute of Basic Medical Sciences,
University of Tsukuba, Japan). pSG5-mRXRα encoding full-length mRNAα was
6
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
generously provided by Dr. Pierre Chambon (Institut de Génétique et de Biologie
Molèculaire et Cellulaire, CNRS/INSERM/ULP, France). We generated a series of
plasmids expressing tagged hNRF2, mNrf2 or mRXRα wild-type or mutants (see
Supplementary Methods): as shown in Figure 2C, 6 plasmids expressing GST-
tagged hNRF2 mutants and 7 plasmids encoding GFP-tagged hNRF2 or mNrf2
mutants were created; as shown in Figure 3A, 4 plasmids expressing GST-tagged
mRXRα mutants were generated. All plasmids were verified by DNA sequencing.
Transfections, luciferase reporter gene activity
Lipofectamine 2000 (Invitrogen, China) was used for transfection (24). The
small interfering RNA (siRNA) against hRXRα (RXRα-siRNA) or non-targeting
negative control siRNA (scrambled-siRNA) were synthesized by TaKaRa
Biotechnology (Dalian, China). The sequences for RXRα-siRNA were 5’-
GGAGAUGCAUCUAUUUUAATT-3’ (forward) and 5’-
UUAAAAUAGAUGCAUCUCCTG-3’ (reverse). Empty vectors were used as
negative controls for transfection experiments with plasmids. Twenty-four or 48 hr
post transfection, the transfected cells were treated with xenobiotics for 6 hr to 24 hr
before being harvested for further analysis. The ARE-luciferase reporter plasmid
pGL-GSTA2.41bp-ARE was used and the dual luciferase activities were determined
as described elsewhere (25). Stable cell lines A549-mRXRα and A549-EGFP over-
expressing GFP-mRXRα and GFP, were generated as described in Supplementary
Methods.
Real-time quantitative PCR (RT-PCR)
Total RNA isolation and RT-PCR was performed as described previously (24).
7
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
Western blot analysis, GST pull-down assay and immunoprecipitation
Preparation of protein samples, SDS-PAGE gels and immunoblotting was
carried out using standard protocols (24). Immunoblotting with antibody against actin
or β-tubulin was performed to confirm equal loading for whole-cell extracts and
nuclear extracts, respectively. GST pull-down assay and immunoprecipitation was
performed to detect the interaction between NRF2 and mRXRα mutant GST or GFP
fusion proteins. The procedures are provided in Supplementary Methods.
Fluorescently tagged proteins and immunofluorescence
Cells were seeded on glass coverslips, and transiently transfected with the
indicated fluorescently labelled proteins. Forty-eight hr later, cells were fixed,
processed and examined as described previously (4, 5). Anti-RXRα antibody was
used to detect endogenous RXRα, followed by staining with Texas Red goat anti-
rabbit IgG(H+L). Counterstaining with 4’,6-diamidino-2-phenylindole (DAPI) was
used to verify the location and integrity of nuclei. The fluorescence images were
observed with a Zeiss LSM510 Meta laser-scanning confocal microscope (Carl Zeiss,
Inc, Germany).
Chromatin immunoprecipitation (ChIP) assay
ChIP assays were performed as described previously (24). The relative
binding of NRF2 or RXRα to ARE sites were calculated by quantification of band
® intensity with an Odyssey Infrared Imaging System (LI-COR Biosciences)
normalized to that of input.
Biotinylated ARE-binding assay
The preparation of nuclear extracts and the Bio-ARE pull-down assay was
performed as described previously (19). A double-stranded 5′-biotinylated ARE probe,
8
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
representing the 41 bp of nucleotides -682 to -722 in the rat GSTA2 gene promoter,
was synthesized by TaKaRa Biotechnology. NRF2 pre-depletion was performed by 1
hr incubation with antibody to NRF2 prior to the Bio-ARE pulldown procedures. The
pulled down mixture was analysed on SDS–PAGE followed by immunoblotting with
antibody against RXRα or NRF2.
Cytotoxicity assay
Cytotoxicity was determined as described previously (24). The IC50 and the
combination index for determining synergism were calculated as described elsewhere
(24).
Statistical analysis
Statistical comparisons were performed by unpaired Student’s t tests. A value
of p < 0.05 was considered statistically significant.
9
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
RESULTS
RXRα inhibits basal and inducible ARE-driven gene expression.
To evaluate the effect of RXRα on NRF2 and ARE-driven gene expression,
we transfected MCF7 cells with siRNA to knockdown RXRα; immunoblotting
confirmed successful knockdown of RXRα in these cells (Fig. 1A, upper panel). In
MCF7 cells cotransfected with the ARE-driven reporter plasmid pGL-GSTA2.41bp-
ARE, knockdown of RXRα was found to increase basal luciferase reporter activity
about 1.5-fold, and increased induction of the reporter gene activity by 20 μM tert-
butylhydroquinone (tBHQ) from 4-fold to 6-fold. To test whether this increase in
ARE-driven gene expression was a general effect, we also examined colon cancer
Caco2 cells (Fig. 1B, upper panel). Knockdown of RXRα in Caco2 cells resulted in a
2-fold increase in the basal levels of mRNA for endogenous AKR1C1 and HO-1, both
of which are NRF2-target genes. Treatment of Caco2 cells with 20 μM tBHQ in
which RXRα had been knocked down further increased AKR1C1 mRNA from 10-
fold to 14-fold, and HO-1 mRNA from 5-fold to 7-fold (Fig. 1B, lower panel). These
data indicate that loss of RXRα increases NRF2 activity
We next tested whether over-expression of RXRα might suppress ARE-driven
gene expression in Caco2 cells using the pEGFP-C1-mRXRα expression vector;
transient expression of exogenous GFP-mRXRα was confirmed by immunoblotting
with a specific antibody against RXRα (Fig. 1C). As anticipated, both basal and
inducible NRF2-target gene expression were inhibited by forced over-expression of
RXRα: the basal AKR1C1 and HO-1 mRNA levels were reduced by 20% and the
induction of AKR1C1 and HO-1 mRNA levels by tBHQ was decreased from 11-fold
10
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
to just 2- and 4-fold, respectively (Fig. 1D). These data demonstrate that NRF2-
regulated genes are the targets of RXRα-mediated repression, and RXRα can
suppress the expression of ARE-driven genes in a ligand-independent manner.
Antagonism of ARE-driven gene expression by RXRα is independent of KEAP1.
It is well established that KEAP1 is a major repressor of NRF2 activity (5). To
investigate whether KEAP1 plays any role in the antagonism of NRF2 by RXRα, we
carried out a further study in the A549 NSCLC cell line, which contains a loss-of-
function-mutation in KEAP1(14). RXRα-siRNA was transfected into A549 cells, and
knockdown of RXRα was confirmed by immuoblotting (Fig. 1E, left panel).
Consistent with our observations in MCF7 and Caco2 cells, knockdown of RXRα in
A549 cells increased AKR1C1 mRNA 2-fold and HO-1 mRNA 4-fold (Fig. 1E, right
panel). It also increased AKR1C1 and HO-1 protein levels significantly (Fig. 1E, left
panel). These findings suggest that RXRα inhibition of ARE-driven transcription
occurs independently of KEAP1.
RXRα and NRF2 physically interact in vitro.
To investigate the mechanism by which RXRα represses NRF2, we examined
the localization of the CNC-bZIP transcription factor and its abundance after over-
expression of RXRα. Using Caco2 and A549 cells, we found that RXRα altered
neither the nuclear accumulation of NRF2 nor its abundance (Fig. 1C & Fig. 6A). We
next considered whether RXRα-mediated repression of NRF2 might be a
consequence of a direct interaction between the two proteins. To test this possibility,
we generated a GST-tagged NRF2 construct, and performed GST-pulldown
experiments that tested its ability to interact with RXRα (Fig. 2A & B). The
recombinant full-length NRF2 (GST-hNRF2) interacted strongly with His-tagged
11
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
full-length RXRα protein (Fig. 2B, lane 1). In contrast, the GST control did not bind
specifically to RXRα (lane 2). An inverse GST-pulldown assay with recombinant
GST-RXRα and His-tagged NRF2 confirmed that the two proteins interact
specifically (Fig. 3B, lane 2). Thus, our data indicate that NRF2 and RXRα can form
a complex in vitro.
To determine the region of NRF2 that is required to interact with RXRα, a
series of NRF2 truncated proteins tagged with GST (see Fig. 2C) were expressed and
their abilities to interact with purified recombinant His-RXRα were tested by GST-
pulldown assay. We found RXRα interacted with the N-terminal NRF217-338 protein
(Fig. 2D, lane 2). In contrast, RXRα failed to interact with the C-terminal NRF2339-605
protein (Fig. 2D, lane 7), suggesting that the Neh6, Neh1 and Neh3 domains of NRF2
are not required for the interaction between the two factors. In addition, RXRα failed
to interact with the NRF217-110 or NRF2109-219 proteins, which contain Neh2 or Neh4
plus Neh5, respectively (Fig. 2D, lanes 4 and 5), suggesting that these individual
domains are not sufficient to enable NRF2 to bind RXRα. Remarkably, RXRα
interacted with NRF2109-338 and NRF2209-316 (lanes 3 and 6), whereas deletion of the
amino acids 209-316 completely abolished the interaction (Fig. S1A, lane 2 & 3).
These results indicate residues 209-316 of NRF2 are sufficient to support an
interaction with RXRα in vitro.
To further confirm that amino acids 209-316 of NRF2 are required for the
interaction with RXRα, we created a series of expression vectors encoding GFP-
tagged NRF2 mutants (Fig. 2C). The analyses were performed using purified His-
RXRα to co-immunoprecipitate material from lysates of HEK293 cells that had been
previously transiently transfected with the various NRF2 mutant expression plasmids.
12
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
Consistent with the GST-pulldown assay results, an antibody against RXRα could
coimmunoprecipitate the mNrf2∆ETGE, NRF217-316, and NRF2109-316 mutant proteins,
all of which contain amino acids 209-316 of NRF2 (Fig. 2E, lanes 1, 2 and 6). The
deletion of the amino acids 209-316 abolished this interaction (Fig. S1B, lane 3).
Moreover, residues 201-329 of mNrf2, which are orthologous to residues 209-316 of
hNRF2, could also be immunoprecipitated from the cell extracts (Fig. 2E, lane 7). As
a further control, we tested HEK293 cell extracts that expressed GFP alone, and
demonstrated that RXRα could not co-immunoprecipitate GFP (Fig. 3D & E).
Collectively, these results indicate that amino acids 209-316 of human NRF2 are
necessary for its interaction with RXRα in vitro.
The RXRα DBD is required for interaction with NRF2.
RXRα comprises three major domains: the N-terminal AF-1 domain, the well-
conserved DNA-binding domain (DBD), and the ligand-binding domain (LBD) that is
responsible for dimerization. It also contains the relatively small AF-2 region with a
ligand-dependent transactivation function (26-28) (Fig. 3A). To delineate which
region of RXRα is necessary for interaction with NRF2, four recombinant GST-
RXRα mutants (GST-∆RXRα) were expressed and purified, and their abilities to
interact with purified His-NRF2 were tested by GST-pulldown assay (Fig. 3A).
Mutant RXRα230-467, which contains the C-terminal ligand binding and dimerization
domains, failed to interact with NRF2 (Fig. 3B, lane 4). Likewise, NRF2 was unable
to bind to RXRα1-139, which represents the AF-1 region (lane 6). In contrast,
mRXRα1-229, representing the N-terminal amino acid region of RXRα, interacted well
with NRF2 (lane 3). Importantly, the mutant RXRα140-205 protein that comprises the
DBD domain, interacted strongly with NRF2 (lane 5). Accordingly, the GST-luc and
13
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
GST controls did not bind NRF2 (lanes 1 and 7). Taken together, our data indicate
that the DBD is sufficient to interact with NRF2.
RXRα and NRF2 directly interact in vivo.
To demonstrate whether a physical interaction occurs between RXRα and
NRF2 in vivo, we examined whether both proteins co-localise in cells. Plasmids
encoding GFP-tagged NRF2 and RFP-tagged mRXRα were transfected into HEK293
cells. Images obtained by confocal laser scanning microscopy revealed that singly
expressed GFP-NRF2 and RFP-RXRα were predominately localized in the nucleus of
the transfected cells (Fig. 4A, image a-d). As a control, we monitored the cellular
localization of the GFP and RFP proteins, both of which were distributed uniformly in
the cytoplasm and the nucleus (Fig. S2). When GFP-NRF2 and RFP-RXRα were co-
expressed, a substantial portion of both proteins co-existed in small foci-like
structures within the nucleus (Fig. 4A, image e-g). To confirm these observations, we
next tested whether the ectopically expressed GFP-NRF2 could localize with
endogenous RXRα. After pHyg-GFP-hNrf2 was transiently transfected into A549
cells alone, the cellular localization of endogenous RXRα was examined using
indirect immunofluorescence. Confocal laser scanning microscopy demonstrated a
similar nuclear co-localization of the two proteins (Fig. 4B, image c). Thus, these
results support our contention that NRF2 interacts with RXRα in the nucleus.
Moreover, we performed co-immunoprecitation experiments with total lysates
prepared from COS7 cells transfected with the expression vector for V5-tagged
mouse Nrf2 with a deletion of residues 17-32 in its Neh2 domain (mNrf2∆DIDLID-V5).
When precipitated with an anti-RXRα antibody, a strong mNrf2 band was detected
14
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
that suggested both transcription factors coexist in an immunoprecitable complex (Fig.
S3, upper blot, lane 4).
To examine whether an interaction occurs between endogenous NRF2 and
endogenous RXRα, we exposed MCF7 cells to 20 μM tBHQ for 24 hr.
Immunoprecipitation using antibodies against NRF2 and RXRα revealed the presence
of an immuno-complex in the MCF7 cell lysates between endogenous NRF2 and
RXRα, which could be increased further by tBHQ treatment (Fig. 4Ca & 4Cb, lane 3
& 4). The abundance of NRF2 (Fig. 4Cc, lane 2) and the expression of its target gene
AKR1C (Fig. S4, lane 2) was increased as reported previously (25). We next
performed similar studies with cell extracts prepared from mouse tissues. Strikingly,
we found the two transcription factors interacted strongly in both small intestine and
liver (Fig. 4Da & 4Db, lane 3). When the mice were treated with BHA, expression of
the Nrf2-target genes Nqo1 and Gstm1 was increased in the small intestine and liver
(Fig. S5A & S5B, lane 2) as expected (1, 22, 29, 30). Again, the interaction between
Nrf2 and RXRα was increased by BHA (Fig. 4Da & 4Db, lane 4), suggesting that
RXRα is important in regulating the function of Nrf2 in these tissues. Taken together,
these results establish that RXRα and NRF2 interact directly in vivo.
RXRα is recruited to the ARE in an NRF2-dependent manner.
To assess whether the interaction between RXRα and NRF2 occurs when the
factors are bound to DNA, we performed a ChIP assay with antibody against RXRα
or NRF2. As expected, increased NRF2 bound to ARE sequences in the promoters of
HO-1 and AKR1C1 after MCF7 cells had been exposed to 20 μM tBHQ for 6 hr (Fig.
5A, lanes 3 and 4). Interestingly, the ChIP assays revealed that RXRα was also able
to associate with ARE sites (Fig. 5A, lanes 5 and 6), though it was observed that the
15
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
DNA bands representing RXRα associated with ARE sequences were much weaker
than those representing NRF2. Upon exposure to tBHQ, the amount of RXRα that
associated with ARE sequences increased ~1.5-fold (Fig. 5A, lanes 5 and 6),
correlating with the increase in NRF2 on ARE sites (Fig. 5A, lane 3 & 4); this
occurred in spite of the fact that the abundance of RXRα protein remained unchanged,
as seen in MCF7 cells (Fig. 5B, lower blot, lanes 1 and 2). These results are specific
to ARE-containing gene promoters; a DNA sequence in the glyceraldehyde-3-
phosphate dehydrogenase (GAPDH) promoter was not detected in complexes
immunoprecipitated with either antibody (Fig. 5A). Our findings suggest that the
association of RXRα with ARE sequences possibly requires the presence of NRF2,
which in turn is able to recruit RXRα to the cis-element.
To further evaluate whether RXRα requires NRF2 in order to recognise AREs,
we carried out a biotinylated-ARE (Bio-ARE) oligonucleotide pull-down assay on
nuclear extracts from MCF7 cells treated with 20 μM tBHQ. Although tBHQ did not
influence the nuclear levels of RXRα (Fig. 5B, lower blot, lanes 1 and 2), only RXRα
from tBHQ-treated MCF7 cells bound strongly to Bio-ARE beads (Fig. 5B, lower
blot, lane 8). Such binding was concomitant with nuclear accumulation of NRF2 and
its increased binding to Bio-ARE beads (Fig. 5B, upper blot, lane 2 & 8). Importantly,
depletion of NRF2 from the nuclear extracts after pre-incubation with an antibody
against NRF2 (Fig. 5C, lane 3), not only abolished the binding of NRF2 to Bio-ARE
as expected (Fig. 5C, upper blot, lanes 8 and 9), but also significantly reduced the
binding of RXRα to Bio-ARE (Fig. 5C, lower blot, lanes 8 and 9). As a negative
control, an unrelated biotin-labelled double-stranded oligonucleotide failed to pull
down NRF2 or RXRα from the nuclear extracts (Fig. 5B, lane 16; 5C, lane 7). These
16
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
results suggest that RXRα can be tethered onto DNA by forming a heteromeric
protein-protein complex with NRF2.
In order to examine whether RXRα might form inactive complexes with
NRF2 on ARE sequences, we generated a stable MCF7 cell line, designated MCF7-
RXRα, which over-expresses RXRα from a pEGFP-mRXRα plasmid.
Immunoprecipitation confirmed that both the endogenous RXRα and exogenously
derived GFP-mRXRα associated with NRF2 in these stably-transfected cells (Fig. S6,
lane 4). In agreement with the observation following transient transfection of RXRα
(Fig. 1D), induction of HO-1 by tBHQ (20 μM) was nearly completely blocked in
MCF7-RXRα cells (Fig. 5D, lanes 3 and 4). We found comparable levels of nuclear
NRF2 and its binding to ARE sequences stimulated by tBHQ (Fig. 5D; Fig. S7, lanes
5 - 8). However, a ChIP assay revealed that the loading of CREB (cAMP Response
Element Binding protein) Binding protein (CBP) and RNA Polymerase II (RNA Pol
II) onto ARE-sites upon tBHQ treatment were markedly attenuated in MCF7-mRXRα
cells (Fig. 5E, lanes 7, 8, 11 and 12). This is in contrast to the situation in MCF7 cells,
where the levels of CBP and RNA Pol II on ARE site were dramatically increased
under the same conditions (Fig. 5E, lanes 5, 6, 9 and 10). Taken together, our data
suggest that the lack of transcriptional activity of NRF2 caused by RXRα over-
expression is likely due to direct negative interference by RXRα on ARE-sites,
leading to the disruption of the recruitment of CBP and RNA Pol II to the promoters.
Over-expression of RXRα in A549 cells down-regulates NRF2 and increases
sensitivity to anticancer drugs.
Recent studies have provided evidence that high constitutive expression of
NRF2 occurs in many cancer cells (31), and RNAi knockdown of the CNC-bZIP
17
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
factor can sensitize such cells to chemotherapeutic drugs (24, 32, 33). To test whether
the repression of NRF2 by RXRα has similar biological consequences, we generated
a cell line named A549-RXRα in which RXRα is stably expressed. As A549 cells
carry a somatic KEAP1 mutation, it contains supranormal levels of NRF2 and its
target genes are constitutively over-expressed, which in turn increases cell
proliferation and resistance to anticancer drugs (14, 32). Immunoblotting confirmed
transgene expression (Fig. 6A, lane 2). As expected, expression of the NRF2-target
gene HO-1 was diminished in A549-RXRα cells. Cytotoxicity revealed that the IC50
of A549-RXRα to the anticancer drug oxaliplatin was about 40 μmol/l, compared
with an IC50 of 100 μmol/l in A549 cells that stably expressed GFP, named A549-
GFP (Fig. 6B). The A549-RXRα cells also displayed increased sensitivity to
doxorubicin (Fig. 6C). Our results therefore suggest that the down-regulation of
cytoprotective genes regulated by NRF2 contributes to the increased sensitivity of
A549 cells by over-expression of RXRα.
18
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
DISCUSSION
Regulation of NRF2 by KEAP1 has been a subject of intense study and it is
relatively well characterized. However, little is known about other mechanisms by
which NRF2 activity is controlled. Herein, we have presented the first evidence that
RXRα functions as a repressor of ARE-driven gene expression. We found RXRα-
mediated repression of ARE-driven genes is ligand- and redox-independent, and
requires the presence of NRF2 to recruit RXRα to the promoters of target genes.
Importantly, we have discovered that amino acids 209-316 of human NRF2 are
necessary for its interaction with RXRα, and as this region has not previously been
shown to possess functional importance we have designated it the Neh7 domain.
Repression of NRF2 by RXRα was observed in five different cell types, as well as
mouse small intestine and liver, thereby indicating its general significance. To our
knowledge, it has not been reported previously that RXRα attenuates ARE-driven
gene transcription by directly targeting NRF2.
RXRs play an essential role in the regulation of multiple nuclear hormone-
signaling pathways through their ability to dimerize with other nuclear receptors.
RXRs mediate retinoid signalling through forming a heterodimer with RAR and by
forming a homodimer (21, 34). In addition, RXRs form heterodimers with many other
members of the subfamily of nuclear receptors, including peroxisome proliferator-
activated receptor, liver X receptor (LXR), pregnane X receptor (PXR) and
constitutive androstane receptor (CAR) (21, 34). Heterodimerization of RXR with its
partners dramatically enhances its DNA-binding activity (21, 34). Upon binding DNA,
some nuclear receptors repress transcription of target genes through their interaction
with transcriptional corepressors in the absence of ligands. Furthermore, ligand
binding by a transcriptional agonist causes conformational changes in corepressors,
19
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
allowing dissociation of transcriptional corepressors and association of transcriptional
coactivators (35). Herein we found that RXRα did not influence nuclear translocation
of NRF2 or its binding to ARE sequences. Instead, RXRα associated with ARE-
bound NRF2, suggesting that inhibition of NRF2 by RXRα is likely due to the direct
interference of recruitment by the CNC-bZIP factor of coactivators to gene promoters.
Significantly, we found that an RXRα mutant lacking its ligand binding and
heterodimerization domains was as efficient at interacting with NRF2 as the wild-type
protein, demonstrating that the nuclear receptor is able to repress NRF2 in a ligand-
independent manner.
Previously we reported that RARα mediates inhibition of NRF2 by all trans
retinoic acid through an undefined protein-protein interaction (19). Herein we have
described physical and functional interactions between RXRα and NRF2. Although
RXRα and RARα can heterodimerize, our in vitro GST-pull down study indicates
that RXRα binds NRF2 directly and that RARα is not necessary for the interaction
between RXRα and NRF2. Specifically, the physical interaction involves the DBD of
RXRα and the Neh7 domain of NRF2, and we failed to detect any interaction
between RXRα and the CNC-bZIP Neh1 domain of NRF2. This is distinct from other
interactions between nuclear hormone receptors and bZIP proteins such as jun and
BZLF1 (36, 37) in which the zinc finger DNA-binding domain of the receptor
interacts with the bZIP domain of the transcription factor. Thus our studies
demonstrate that both RARα and RXRα are repressors of NRF2 activity and
presumably act via distinct mechanisms.
Previous work has shown NRF2 contains six functional domains, named
Neh1-Neh6 (5). It is well known that the stability of NRF2 is controlled through
protein-protein interactions between its Neh2 domain and KEAP1. The stability of
20
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
NRF2 is also controlled by its Neh6 domain, and recently it has been found that this
involves β-TrCP-mediated ubiquitylation and phosphorylation of residues in Neh6 by
GSK-3 (23, 38). In contrast, the Neh4 and Neh5 regions, which lie adjacent to each
other, were found by Katoh et al to act together as a transactivation domain (39);
Neh4 and Neh5, both individually and cooperatively, bind CBP, and are indispensable
for maximal NRF2 transactivation. Subsequently, Zhang et al (40) reported that the
Neh4 and Neh5 domains of NRF2 recruit BRG1, a catalytic subunit of SWI2/SNF2-
like chromatin-remodeling complexes, to HO-1 enhancers for transcription initiation.
In the present study we identified a RXRα interaction domain in NRF2 (now called
Neh7), which abuts the Neh5 domain of NRF2. We found over-expression of RXRα
reduced the loading of CBP and RNA Pol II onto ARE sites, suggesting that the
binding of RXRα may disrupt the binding of CBP to the Neh4 and Neh5 domains of
NRF2, thereby suppressing transcriptional initiation. We therefore propose a model in
which protein-protein contact between RXRα and NRF2 prevents a productive
interaction between the transactivation domains of NRF2 and the basal transcription
machinery.
In adult mammalian liver, RXRα is the most abundant among the three RXR
isoforms (i.e. RXRα, -β, and -γ) and is an obligatory partner of two major xenobiotic
receptors, CAR and PXR (41). Previous studies have revealed that Nrf2 is also highly
expressed in the liver (22), and plays a key role in regulating the expression of phase
II drug-metabolizing enzymes and drug-efflux pumps (30, 33, 42, 43). In the present
study, we demonstrated that Nrf2 and RXRα interact in vivo. In agreement with our
observation, Dai et al (44) reported that in hepatocyte-specific RXRα knockout mice,
the expression of Gsta1 and/or Gsta2, Gstm1 and/or Gstm3, Gstm2 and Gstm4, all of
which are regulated by NRF2 (29, 30, 44), were increased compared to their levels in
21
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
the liver of wild-type mice, presumably due to loss of NRF2 suppression. Moreover,
the expression of these Gst subunits from hepatocyte-specific RXRα knockout mice
was further enhanced by acetaminophen, whose hepatotoxic metabolite was able to
directly activate the KEAP1-NRF2 pathway (45), demonstrating RXRα represses
NRF2/ARE signalling pathway in vivo. Taken together, we hypothesize that RXRα
plays a key role in linking xenobiotic metabolism with the NRF2-ARE cytoprotective
signaling pathway. Furthermore, several nuclear receptors besides RXRα repress
NRF2 (11, 46, 47). It is interesting to speculate that antagonism of NRF2 by RXRα
occurs because at some level the CNC-bZIP protein and nuclear receptors are
functionally incompatible, and that it might be advantageous to attenuate NRF2
activity.
Recent studies have revealed that NRF2 exhibits abnormal increased activity
in several types of tumor due to oncogene activation, or somatic mutation of KEAP1
or NRF2 (15, 17). The over-activation of NRF2-ARE signaling in cancer cells
promotes drug resistance and cell proliferation (31, 48). It has been reported that
RXRα is down-regulated in many tumors (49-51). Based on our study, it seems
plausible that a reduction of RXRα will up-regulate the NRF2-ARE signalling
pathway, thereby contributing to tumourgenesis and drug resistance. In this study, we
have shown that forced-expression of RXRα in NSCLC A549 cells down-regulated
the NRF2/ARE cytoprotective pathway and sensitized them to anticancer drugs,
suggesting that transcriptional repression by RXRα may be used as a mechanism to
attain an appropriate level of gene expression in NRF2 overactive cell types. Here we
describe the Neh7 domain in Nrf2 as a potential target by which the CNC-bZIP factor
can be inhibited.
22
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
In summary, in this report we describe the interaction of NRF2 with RXRα
introducing a new dimension to our understanding of the transcriptional hierarchy in
ARE-driven gene regulation. Our studies, therefore, suggest a novel, and as yet
unrecognized, function of RXRα as a putative transcriptional co-repressor of NRF2.
ACKNOWLEDGEMENTS
We are grateful to Professor Roland Wolf for his generosity in providing
reagents. We thank Ms Ai Xin for her technical assistance. This work was supported
by NSFC (30970581, 31170743 and 81172230), ZJKJT (2010C33156, 2010R50046
and 20112308) and ZJNSFC (LZ12H16001).
REFERENCES
1. Itoh K, Chiba T, Takahashi S, et al. An Nrf2/small Maf heterodimer mediates the induction of phase II detoxifying enzyme genes through antioxidant response elements. Biochem Biophys Res Commun 1997; 236: 313-22. 2. Wu KC, McDonald PR, Liu JJ, Chaguturu R, Klaassen CD. Implementation of a high-throughput screen for identifying small molecules to activate the Keap1-Nrf2- ARE pathway. PLoS One 2012; 7: e44686. 3. Yates MS, Kensler TW. Chemopreventive promise of targeting the Nrf2 pathway. Drug News Perspect 2007; 20: 109-17. 4. Dinkova-Kostova AT, Holtzclaw WD, Cole RN, et al. Direct evidence that sulfhydryl groups of Keap1 are the sensors regulating induction of phase 2 enzymes that protect against carcinogens and oxidants. Proc Natl Acad Sci U S A 2002; 99: 11908-13. 5. Itoh K, Wakabayashi N, Katoh Y, et al. Keap1 represses nuclear activation of antioxidant responsive elements by Nrf2 through binding to the amino-terminal Neh2 domain. Genes Dev 1999; 13: 76-86. 6. Chen W, Sun Z, Wang XJ, et al. Direct interaction between Nrf2 and p21(Cip1/WAF1) upregulates the Nrf2-mediated antioxidant response. Mol Cell 2009; 34: 663-73. 7. Komatsu M, Kurokawa H, Waguri S, et al. The selective autophagy substrate p62 activates the stress responsive transcription factor Nrf2 through inactivation of Keap1. Nat Cell Biol 2010; 12: 213-23. 8. Brown SL, Sekhar KR, Rachakonda G, Sasi S, Freeman ML. Activating transcription factor 3 is a novel repressor of the nuclear factor erythroid-derived 2- related factor 2 (Nrf2)-regulated stress pathway. Cancer Res 2008; 68: 364-8.
23
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
9. Faraonio R, Vergara P, Di Marzo D, et al. p53 suppresses the Nrf2-dependent transcription of antioxidant response genes. J Biol Chem 2006; 281: 39776-84. 10. Hoshino H, Kobayashi A, Yoshida M, et al. Oxidative stress abolishes leptomycin B-sensitive nuclear export of transcription repressor Bach2 that counteracts activation of Maf recognition element. J Biol Chem 2000; 275: 15370-6. 11. Zhou W, Lo SC, Liu JH, Hannink M, Lubahn DB. ERRbeta: a potent inhibitor of Nrf2 transcriptional activity. Mol Cell Endocrinol 2007; 278: 52-62. 12. Nioi P, Nguyen T. A mutation of Keap1 found in breast cancer impairs its ability to repress Nrf2 activity. Biochem Biophys Res Commun 2007; 362: 816-21. 13. Ohta T, Iijima K, Miyamoto M, et al. Loss of Keap1 function activates Nrf2 and provides advantages for lung cancer cell growth. Cancer Res 2008; 68: 1303-9. 14. Singh A, Misra V, Thimmulappa RK, et al. Dysfunctional KEAP1-NRF2 interaction in non-small-cell lung cancer. PLoS Med 2006; 3: e420. 15. DeNicola GM, Karreth FA, Humpton TJ, et al. Oncogene-induced Nrf2 transcription promotes ROS detoxification and tumorigenesis. Nature 2011; 475: 106- 9. 16. Morrow CS, Smitherman PK, Diah SK, Schneider E, Townsend AJ. Coordinated action of glutathione S-transferases (GSTs) and multidrug resistance protein 1 (MRP1) in antineoplastic drug detoxification. Mechanism of GST A1-1- and MRP1-associated resistance to chlorambucil in MCF7 breast carcinoma cells. J Biol Chem 1998; 273: 20114-20. 17. Shibata T, Kokubu A, Gotoh M, et al. Genetic alteration of Keap1 confers constitutive Nrf2 activation and resistance to chemotherapy in gallbladder cancer. Gastroenterology 2008; 135: 1358-68, 68 e1-4. 18. Tew KD. Glutathione-associated enzymes in anticancer drug resistance. Cancer Res 1994; 54: 4313-20. 19. Wang XJ, Hayes JD, Henderson CJ, Wolf CR. Identification of retinoic acid as an inhibitor of transcription factor Nrf2 through activation of retinoic acid receptor alpha. Proc Natl Acad Sci U S A 2007; 104: 19589-94. 20. Chambon P. A decade of molecular biology of retinoic acid receptors. FASEB J 1996; 10: 940-54. 21. Mangelsdorf DJ, Evans RM. The RXR heterodimers and orphan receptors. Cell 1995; 83: 841-50. 22. McMahon M, Itoh K, Yamamoto M, et al. The Cap'n'Collar basic leucine zipper transcription factor Nrf2 (NF-E2 p45-related factor 2) controls both constitutive and inducible expression of intestinal detoxification and glutathione biosynthetic enzymes. Cancer Res 2001; 61: 3299-307. 23. McMahon M, Thomas N, Itoh K, Yamamoto M, Hayes JD. Redox-regulated turnover of Nrf2 is determined by at least two separate protein domains, the redox- sensitive Neh2 degron and the redox-insensitive Neh6 degron. J Biol Chem 2004; 279: 31556-67. 24. Tang X, Wang H, Fan L, Wu X, Xin A, Wang XJ. Luteolin inhibits NRF2 leading to negative regulation of the NRF2/ARE pathway and sensitization of human lung carcinoma A549 cells to therapeutic drugs. Free Radic Biol Med 2011; 50: 1599- 609. 25. Wang XJ, Hayes JD, Wolf CR. Generation of a stable antioxidant response element-driven reporter gene cell line and its use to show redox-dependent activation of nrf2 by cancer chemotherapeutic agents. Cancer Res 2006; 66: 10983-94.
24
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
26. Lee MS, Kliewer SA, Provencal J, Wright PE, Evans RM. Structure of the retinoid X receptor alpha DNA binding domain: a helix required for homodimeric DNA binding. Science 1993; 260: 1117-21. 27. Rastinejad F, Wagner T, Zhao Q, Khorasanizadeh S. Structure of the RXR- RAR DNA-binding complex on the retinoic acid response element DR1. EMBO J 2000; 19: 1045-54. 28. Zechel C, Shen XQ, Chen JY, Chen ZP, Chambon P, Gronemeyer H. The dimerization interfaces formed between the DNA binding domains of RXR, RAR and TR determine the binding specificity and polarity of the full-length receptors to direct repeats. EMBO J 1994; 13: 1425-33. 29. Higgins LG, Hayes JD. Mechanisms of induction of cytosolic and microsomal glutathione transferase (GST) genes by xenobiotics and pro-inflammatory agents. Drug Metab Rev 2011; 43: 92-137. 30. Wu KC, Cui JY, Klaassen CD. Effect of graded Nrf2 activation on phase-I and -II drug metabolizing enzymes and transporters in mouse liver. PLoS One 2012; 7: e39006. 31. Hayes JD, McMahon M. NRF2 and KEAP1 mutations: permanent activation of an adaptive response in cancer. Trends in biochemical sciences 2009; 34: 176-88. 32. Singh A, Boldin-Adamsky S, Thimmulappa RK, et al. RNAi-mediated silencing of nuclear factor erythroid-2-related factor 2 gene expression in non-small cell lung cancer inhibits tumor growth and increases efficacy of chemotherapy. Cancer Res 2008; 68: 7975-84. 33. Anwar-Mohamed A, Degenhardt OS, El Gendy MA, Seubert JM, Kleeberger SR, El-Kadi AO. The effect of Nrf2 knockout on the constitutive expression of drug metabolizing enzymes and transporters in C57Bl/6 mice livers. Toxicol In Vitro 2011; 25: 785-95. 34. Kastner P, Mark M, Chambon P. Nonsteroid nuclear receptors: what are genetic studies telling us about their role in real life? Cell 1995; 83: 859-69. 35. Xu L, Glass CK, Rosenfeld MG. Coactivator and corepressor complexes in nuclear receptor function. Curr Opin Genet Dev 1999; 9: 140-7. 36. Pfahl M. Nuclear receptor/AP-1 interaction. Endocr Rev 1993; 14: 651-8. 37. Pfitzner E, Becker P, Rolke A, Schule R. Functional antagonism between the retinoic acid receptor and the viral transactivator BZLF1 is mediated by protein- protein interactions. Proc Natl Acad Sci U S A 1995; 92: 12265-9. 38. Rada P, Rojo AI, Chowdhry S, McMahon M, Hayes JD, Cuadrado A. SCF/{beta}-TrCP promotes glycogen synthase kinase 3-dependent degradation of the Nrf2 transcription factor in a Keap1-independent manner. Mol Cell Biol 2011; 31: 1121-33. 39. Katoh Y, Itoh K, Yoshida E, Miyagishi M, Fukamizu A, Yamamoto M. Two domains of Nrf2 cooperatively bind CBP, a CREB binding protein, and synergistically activate transcription. Genes Cells 2001; 6: 857-68. 40. Zhang J, Ohta T, Maruyama A, et al. BRG1 interacts with Nrf2 to selectively mediate HO-1 induction in response to oxidative stress. Mol Cell Biol 2006; 26: 7942-52. 41. Mangelsdorf DJ, Borgmeyer U, Heyman RA, et al. Characterization of three RXR genes that mediate the action of 9-cis retinoic acid. Genes Dev 1992; 6: 329-44. 42. Chanas SA, Jiang Q, McMahon M, et al. Loss of the Nrf2 transcription factor causes a marked reduction in constitutive and inducible expression of the glutathione S-transferase Gsta1, Gsta2, Gstm1, Gstm2, Gstm3 and Gstm4 genes in the livers of male and female mice. Biochem J 2002; 365: 405-16.
25
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
43. Cheng Q, Taguchi K, Aleksunes LM, et al. Constitutive activation of nuclear factor-E2-related factor 2 induces biotransformation enzyme and transporter expression in livers of mice with hepatocyte-specific deletion of Kelch-like ECH- associated protein 1. J Biochem Mol Toxicol 2011; 25: 320-9. 44. Dai G, Chou N, He L, et al. Retinoid X receptor alpha regulates the expression of glutathione S-transferase genes and modulates acetaminophen-glutathione conjugation in mouse liver. Mol Pharmacol 2005; 68: 1590-6. 45. Copple IM, Goldring CE, Jenkins RE, et al. The hepatotoxic metabolite of acetaminophen directly activates the Keap1-Nrf2 cell defense system. Hepatology 2008; 48: 1292-301. 46. Ansell PJ, Lo SC, Newton LG, et al. Repression of cancer protective genes by 17beta-estradiol: ligand-dependent interaction between human Nrf2 and estrogen receptor alpha. Mol Cell Endocrinol 2005; 243: 27-34. 47. Ikeda Y, Sugawara A, Taniyama Y, et al. Suppression of rat thromboxane synthase gene transcription by peroxisome proliferator-activated receptor γ in macrophages via an interaction with NRF2. J Biol Chem 2000; 275: 33142-50. 48. Kensler TW, Wakabayashi N. Nrf2: friend or foe for chemoprevention? Carcinogenesis 2010; 31: 90-9. 49. Brabender J, Danenberg KD, Metzger R, et al. The role of retinoid X receptor messenger RNA expression in curatively resected non-small cell lung cancer. Clin Cancer Res 2002; 8: 438-43. 50. Brabender J, Lord RV, Metzger R, et al. Role of retinoid X receptor mRNA expression in Barrett's esophagus. J Gastrointest Surg 2004; 8: 413-22. 51. Brabender J, Metzger R, Salonga D, et al. Comprehensive expression analysis of retinoic acid receptors and retinoid X receptors in non-small cell lung cancer: implications for tumor development and prognosis. Carcinogenesis 2005; 26: 525-30.
Figure legend
Figure 1 RXRα inhibits ARE-driven gene expression. (A) Knock-down of RXRα
in MCF7 cells enhanced both the basal and tBHQ-induced ARE-luciferase activity.
MCF7 cells were transiently transfected with RXRα-siRNA, the ARE reporter
plasmid pGL-GSTA2.41bp-ARE and the plasmid pRL-TK. Forty-eight hr later the
cells were treated with 20 μM tBHQ for 6 hr before they were harvested. The level of
RXRα protein in the lysed cells was determined by immunoblotting (upper panel).
Actin was used as a loading control. The relative luciferase activity in lysates was
determined as described in Materials and Methods (lower panel). The value for cells
26
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
transfected with scrambled siRNA and treated with DMSO, was used as control and
set at 1. (B) Knock-down of RXRα enhanced both the basal and tBHQ-induced
AKR1C1 and HO-1 mRNA levels in Caco2 cells. The Caco2 cells were transfected
with RXRα-siRNA. Forty-eight hr later cells were treated with 20 μM tBHQ, and
after 6 hr incubation they were harvested. The AKR1C1 and HO-1 mRNA levels
were determined by RT-PCR. The level of 18S rRNA was used as an internal
standard. The value for the same gene from the cells that had been transfected with
scrambled siRNA and treated with DMSO, was used as a control and set at 1. (C) &
(D) Over-expression of RXRα reduced AKR1C1 and HO-1 mRNA levels in Caco2
cells. The Caco2 cells were transiently transfected with pEGFP-mRXRα. After 24 hr
recovery, the cells were treated for 6 hr with 20 μM tBHQ. After lysis, the whole cell
extracts were subjected to SDS-PAGE analysis, and the protein levels of GFP-RXRα
and the endogenous RXRα were measured by Western blotting with antibody against
RXRα. The level of NRF2 protein was measured by Western blotting. Actin was used
as a loading control. Also, AKR1C1 and HO-1 mRNA levels were measured by RT-
PCR (D). The value for the same gene from cells that had been transfected with
pEGFP and treated with DMSO, was used as control and set at 1. (E) Knock-down of
RXRα in A549 cells increased the expression of AKR1C1 and HO-1. Forty-eight hr
after A549 cells were transfected with RXRα-siRNA, they were harvested. The levels
of RXRα, HO-1, AKR1C proteins were determined by immunoblotting with
individual antibodies. Actin was used as a loading control (left panel). The AKR1C1
and HO-1 mRNA levels were determined by RT-PCR (right panel). The amount of
18S rRNA was used as an internal standard. The value for the same gene from the
cells transfected with scrambled siRNA was used as control and set at 1. Values
27
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
shown are mean ± SD. *p < 0.05, **p < 0.005. The results are from three separate
experiments.
Figure 2 Mapping of the domain in NRF2 required for its interaction with
RXRα. (A) NRF2 was expressed in E. coli as a GST fusion protein, and purified on
glutathione (GSH)-Sepharose beads. The purified proteins were resolved on a 10%
SDS-PAGE gel and visualized by staining with Coomassie brilliant blue. (B) NRF2
and RXRα physically interact in vitro. Association of GST-NRF2 fusion protein with
His-RXRα was evaluated in a GST-pulldown assay. The same amounts of GST
protein or GST-NRF2 fusion protein, shown in (A), were incubated with his-RXRα.
The proteins bound to GSH-Sepharose were eluted, separated by SDS-PAGE and
subjected to immunoblotting using antibody against either RXRα or GST. The input
control represents 10% of the total amount used for GST-pulldown. (C) Schematic
illustration of the GST- or GFP-tagged NRF2 mutants and their interactions with
RXRα. In the cartoon, the regions within NRF2 that are of interest are indicated by
bars, and the amino acid residues involved are indicated by the polypeptide
designations. (D) Pull-down of his-RXRα with the indicated mutant hNRF2 proteins
fused at their N-termini with GST. The GSH-Sepharose-bound proteins were
separated by SDS-PAGE and subjected to immunoblotting using antibodies against
either RXRα or GST; both GST and GST-luc were used as negative controls. The
input represents 10% of the total amount of his-RXRα used for the GST pull-down
assay. (E) HEK293T cells were transfected with various pEGFPC1 plasmids
encoding GFP tagged to truncated forms of NRF2 as depicted in (C). Twenty-four hr
post-transfection, the whole cell extracts were incubated with purified His-RXRα.
The mixture was subjected to immunoprecipitation using antibody specific to RXRα.
28
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
The immunoprecipitates were separated by SDS-PAGE and immunoblotted using
antibodies against GFP or RXRα. The input represents 10% of the total amount of
cell lysate used for immunoprecipitation. Abbreviation: GST-luc, GST-luciferase.
NRF2 mutant proteins are indicated by * respectively. The molecular mass in kD is
indicated. IB, immunoblot. n.s., nonspecific bands. The results presented are typical
examples from at least three separate experiments.
Figure 3 Interaction of RXRα with NRF2 in vitro. (A) Schematic of GST-tagged
mRXRα mutants and their interactions with NRF2. In the cartoon, the regions within
RXRα that are of interest are indicated by bars, and the specific amino acid residues
are indicated by the polypeptide designations. (B) GST pull-down assay of his-NRF2
with GST-ΔRXRα fusion proteins. GST-ΔRXRα fusion proteins, as depicted in (A),
were incubated with GSH-Sepharose beads. The bound GST-ΔRXRα (b) was
incubated with purified His-NRF2 (c). The bound NRF2 was detected by
immunoblotting with antibody against NRF2 (a). The input represents 10% of the
total amount of his-NRF2 used for the GST pull-down assay. GST and GST-luc were
used as negative controls. Abbreviation: GST-luc, GST-luciferase. RXRα mutant
proteins are indicated by * respectively. The molecular mass in kD is indicated. IB,
immunoblot. The results shown are from at least three separate experiments.
Figure 4 NRF2 and RXRα interact in vivo. (A) Ectopic NRF2 and RXRα co-
localise in HEK293T cells. The HEK293T cells were transfected with pDsRed-
mRXRα together with phyg-EF-hNRF2, both of which encode fluorescently tagged
proteins. Forty-eight hr after transfection, the cells were fixed and examined. EGFP-
NRF2 is shown in green, DsReD-RXRα in red. Nuclei were stained by DAPI (blue).
29
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
Scale bar, 10 μm. (B) Ectopic NRF2 co-localises with endogenous RXRα in A549
cells. The A549 cells were grown on cover-slips and transfected with the expression
vector phyg-EF-hNRF2 for fluorescently-tagged NRF2 protein. Forty-eight hr post
transfection, the cells were fixed. Indirect immunofluorescence staining was
performed to visualize endogenous RXRα using a primary rabbit antibody against
RXRα, and followed by Texas Red goat anti-rabbit secondary antibody. The
endogenous RXRα signal is shown in red. Cell nuclei were stained with DAPI (blue).
The scale bars represent 10 μm. (C) Endogenous RXRα interacts with endogenous
NRF2 in MCF7 cells. The MCF7 cells were exposed to tBHQ (20 μM) for 24 hr (lane
2 & 4) before being harvested and lysed. Cell lysate was immunoprecipitated with
antibody specific to RXRα (a) or Nrf2 (b). IgG was used as negative control (lane 1
& 2). After washing, the immunoprecipitates were analysed by immunoblotting with
antibody specific to NRF2 or RXRα. Input, 5% of the cell lysate used for
immunoprecipitation; Beads, immunoprecipitates after the washing procedure. IB,
immunoblot. The results presented have been replicated over three separate
experiments. (D) Endogenous RXRα interacts with endogenous Nrf2 in mouse small
intestine and liver. WT mice were given BHA i.g. daily at a dose of 200 mg/kg for 3
days (lane 2 & 4), and corn oil (vehicle) was administered as negative control (lane 1
and 3). a, Each lane shows results from a pooled sample of soluble extract from the
small intestine of 2-3 mice. b, Each lane shows results from a sample of soluble liver
extract from a single mouse. The data represent immunoprecipitation results from
three separate experiments (n = 8).
30
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
Figure 5 RXRα can associate with ARE sequences. (A) ChIP analysis shows
RXRα can be recruited to ARE sequences in the promoter regions of AKR1C1 and
HO-1. MCF7 cells were treated with 20 μM tBHQ for 6 hr. The abilities of RXRα
and NRF2 to bind to ARE sites in the promoters of AKR1C1 and HO-1 were explored
by ChIP analysis (Upper panel). The relative abilities of NRF2 and RXRα to bind to
ARE sites were determined as described by Materials and Methods (Lower panel).
The value of NRF2 or RXRα from cells treated with DMSO was set at 1. GAPDH
was used as negative control. PCR reactions were not saturated. (B) Treatment with
tBHQ increases the binding of RXRα to immobilised Bio-ARE. MCF7 cells were
exposed to 20 μM tBHQ for 24 hr. The nuclear extracts were pre-cleared with protein
G-Sepharose, then incubated with a double stranded 5′-biotinylated ARE probe (Bio-
ARE) (lane 1-8), or a 5′-biotinylated negative control DNA probe (Bio-control) (lane
9-16), in the presence of streptavidin–agarose beads as described in Materials and
Methods. After washing, the pull-down mixture was analysed by immunoblotting
with specific antibodies against NRF2 or RXRα. (C) Depletion of NRF2 from cell
lysates abolishes RXRα binding to Bio-ARE. Pre-depletion of NRF2 protein from
cell lysates was performed by 1 hr incubation with antibody against NRF2 prior to the
Bio-ARE pulldown procedure, as described above. The lanes are labelled as follows:
Input, pre-cleared nuclear extract after incubating with protein G sepharose only; SN,
the supernatant after the pre-cleared nuclear extract mixed with the Bio-ARE probe or
Bio-negative control DNA and streptavidin–agarose beads; Wash, the supernatant
solution after the immunoprecipitation and the four washes of the beads; Beads,
immunoprecipitates after the washing procedure. (D) & (E) RXRα over-expression
inhibits CBP and RNA Pol II binding to the ARE site in the HO-1 promoter. A stable
31
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα represses NRF2-mediated transcription
cell line, designated MCF7-RXRα, was generated by over-expressing pEGF-mRXRα
as described in Materials and Methods. The MCF7-RXRα cells were treated with 20
μM tBHQ for 6 hr. The HO-1 and nuclear NRF2 levels were determined by Western
immunoblotting with specific antibodies against individual proteins. Tubulin and
actin were used as loading control for the nuclear and whole cell extracts, respectively.
(E) The binding of CBP and RNA Pol II to the ARE sites in the promoters of HO-1
was detected by ChIP analysis in MCF7-RXRα cells. GAPDH was used as a negative
control. PCR reactions were not saturated. Results show typical blots from at least
three separate experiments.
Figure 6 Over-expression of RXRα increased the sensitivity of A549 cells to
oxaliplatin and doxorubicin. The A549-mRXRα and A549-EGFP cell lines were
generated after stable transfection with pEGFP-mRXRα and pEGFP, respectively, as
described in Materials and Methods. (A) The levels of exogenous and endogenous
RXRα were determined by Western blotting with antibody specific to RXRα. The
levels of NRF2 and HO-1 were determined by immunoblotting with antibody against
NRF2 or HO-1. Actin was used as a loading control. A549-mRXRα or A549-EGFP
cells were exposed to oxaliplatin (1 - 100 μM) (B) or doxorubicin (0.1 – 2 μM) (C)
for 48 hr. The cell viability was determined with an MTS Cell Proliferating Assay Kit.
*p < 0.05, **p < 0.005. Results are from three separate experiments.
32
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 23, 2013; DOI: 10.1158/0008-5472.CAN-12-3386 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited.
RXRα Inhibits the NRF2-ARE Signalling Pathway Through A Direct Interaction With the Neh7 domain of NRF2
Hongyan Wang, Kaihua Liu, Miao Geng, et al.
Cancer Res Published OnlineFirst April 23, 2013.
Updated version Access the most recent version of this article at: doi:10.1158/0008-5472.CAN-12-3386
Supplementary Access the most recent supplemental material at: Material http://cancerres.aacrjournals.org/content/suppl/2013/04/23/0008-5472.CAN-12-3386.DC1
Author Author manuscripts have been peer reviewed and accepted for publication but have not yet been Manuscript edited.
E-mail alerts Sign up to receive free email-alerts related to this article or journal.
Reprints and To order reprints of this article or to subscribe to the journal, contact the AACR Publications Subscriptions Department at [email protected].
Permissions To request permission to re-use all or part of this article, use this link http://cancerres.aacrjournals.org/content/early/2013/04/23/0008-5472.CAN-12-3386. Click on "Request Permissions" which will take you to the Copyright Clearance Center's (CCC) Rightslink site.
Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 2013 American Association for Cancer Research.