Increased S100A15 Expression and Decreased DNA Methylation of Its Gene Promoter Are Involved in High Metastasis Potential and Poor Outcome of Lung Adenocarcinoma

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Increased S100A15 Expression and Decreased DNA Methylation of Its Gene Promoter Are Involved in High Metastasis Potential and Poor Outcome of Lung Adenocarcinoma www.impactjournals.com/oncotarget/ Oncotarget, 2017, Vol. 8, (No. 28), pp: 45710-45724 Research Paper Increased S100A15 expression and decreased DNA methylation of its gene promoter are involved in high metastasis potential and poor outcome of lung adenocarcinoma Yung-Che Chen1,6,*, Meng-Chih Lin1,6,*, Chang-Chun Hsiao6,7, Yi-Xin Zheng1, Kuang- Den Chen2, Ming-Tse Sung3, Chung-Jen Chen4, Ting-Ya Wang1, Yong-Yong Lin1, Huang-Chih Chang1,6, Yu-Mu Chen1 and Jen-Chieh Chang5 1Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan 2Center of Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan 3Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan 4Division of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan 5Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan 6Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan 7Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan *These authors have contributed equally to this work Correspondence to: Yung-Che Chen, email: [email protected] Meng-Chih Lin, email: [email protected] Chang-Chun Hsiao, email: [email protected] Keywords: lung adenocarcinoma, S100A15, DNA methylation, next generation sequencing Received: November 02, 2016 Accepted: April 10, 2017 Published: April 24, 2017 Copyright: Chen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ABSTRACT Purpose: This study aims to determine the functional role of S100A15 and its promoter DNA methylation patterns in lung cancer progression. Experimental Design: We analyzed 178 formalin-fixed paraffin embedded specimens from lung cancer patients, including 24 early stage and 91 advanced stage adenocarcinoma. S100A15 protein expression was evaluated by immunohistochemistry stain, and its DNA methylation levels were measured by pyrosequencing. Results: S100A15 nuclear staining was increased in lung adenocarcinoma patients with distant metastasis versus those without distant metastasis. There was reduced one/three-year overall survival in adenocarcinoma patients receiving first line target therapy and harboring high nuclear expressions of S100A15. Both DNA methylation levels over -423 and -248 CpG sites of the S100A15 gene promoter were decreased in adenocarcinoma patients with distant metastasis, and the former was associated with lower one-year overall survival. The highly invasive CL1-5 cell lines display decreased DNA methylation over –412/-248/-56 CpG sites of the S100A15 gene promoter and increased S100A15 gene/protein expressions as compared with the less invasive CL1-0 cell lines. Knockdown of S100A15 in CL1-5 cell line inhibited cell proliferation, migration, and invasion, while over-expression of S100A15 in CL1-0 cell line promoted cell proliferation, migration, and invasion. RNA sequencing analysis revealed potential www.impactjournals.com/oncotarget 45710 Oncotarget biological effects of S100A15 over-expression and knock-down with CTNNB1, ZEB1, CDC42, HSP90AA1, BST2, and PCNA being the pivotal down-stream mediators. Conclusions: Increased S100A15 expression and decreased DNA methylation of its gene promoter region were associated with high metastasis potential and poor outcome in lung adenocarcinoma, probably through triggering CTNNB1 -centered pathways. INTRODUCTION S100A15 on metastatic potential and down-stream mediators of lung adenocarcinoma was tested in vitro. The majority of non-small cell lung cancer patients present with advanced disease at diagnosis, and those RESULTS diagnosed with early stage disease often recur and experience metastatic disease eventually [1]. Metastasis S100A15 nuclear accumulation was increased represents the primary cause of death from lung cancer, is in lung adenocarcinoma patients with distant responsible for 90% of all morbidity, and involves several metastasis, and related to poor survival in those stages, including invasion, angiogenesis, and migration. [2]. receiving first line target therapy Human S100A15 (S100A7A; koebnerisin) is a novel member of the S100 family of EF-hand calcium- S100A15 IHC nuclear stain were performed and binding proteins and was recently identified in psoriasis, evaluated in 178 pathologically-diagnosed lung cancer where it is significantly up-regulated in lesion skin. It is patients, including 115 cases (64.6%) of adenocarcinoma, an antimicrobial protein, and regulated by E. coli through 50 cases (28.1%) of squamous cell carcinoma, and 13 cases Toll-like receptor 4 [3]. Both human S100A7 (psoriasin) (7.3%) of small cell carcinoma. The demographic and clinical and S100A15 transcripts are elevated in ER/PR negative data of these subjects are presented in Table 1. Stepwise breast cancers; however, hS100A15 protein is detected in forward multivariate Cox regression analysis showed that all cancer specimens, while hS100A7 protein is sporadically advanced tumor stage (HR 3.149, 95%CI 1.719-5.761, expressed [4, 5]. C-Fos transcriptionally controls S100A15 p<0.001), first line use of cisplatin-based chemotherapy (HR expression in keratinocytes, subsequently leading to CD4 0.323, 95%CI 0.203-0.513, p<0.001), and first-line use of T-cell recruitment to the skin, thereby promoting epidermal target therapy with erlotinib or gefitinib (HR 0.608, 95%CI squamous cell carcinoma that is likely induced by CD4+ 0.373-0.992, p=0.046) were independent factors predicting T-cell-derived IL-22 [6]. In our previous whole-genome one-year all-cause mortality. Furthermore, advanced tumor gene expression study, we found that nuclear accumulation stage (HR 2.188, 95%CI 1.074-4.457, p=0.031), N2/3 (HR of S100A15 were increased in advanced stage NSCLC 3.343/5.946, 95%CI 1.871-5.975/3.107-11.879, p<0.001), patients [1], but the potential of S100A15 as a determinant M1 (HR 2.095, 95%CI 1.381-3.179, p=0.001), ECOG of treatment outcomes, and the underlying mechanisms by which S100A15 would be involved in proliferation, PS (HR 1.182, 95%CI 1.022-1.367, p=0.025), first line migration, and invasion of lung cancer have not yet been use of cisplatin-based chemotherapy (HR 0.492, 95% CI understood [1, 7]. DNA methylation changes induced 0.333-0.728, p<0.001), and second line use of pemetrexed in oncogenes and tumor suppressor genes are of key chemotherapy (HR 0.214, 95% CI 0.064-0.712, p=0.012) are importance in the pathogenesis of lung cancer [8, 9]. Recent independent factors predicting three-year all-cause mortality. results indicate that changes in S100 protein expression In the 115 lung adenocarcinoma cases, total may depend on the extent of DNA methylation in the S100 score (4.77±1.1 versus 3.75±1.48, adjusted p=0.002, gene promoter regions [10]. The role of DNA methylation 95%CI 0.126-0.538), intensity score (1.56±0.56 versus patterns of the S100A15 promoter region in metastasis 1.29±0.55, adjusted p=0.025, 95%CI 0.015-0.209), and potential of lung cancer has not yet been determined [11]. percentage score (3.18±0.8 versus 2.46±1.14, adjusted We retrospectively examined S100A15 protein p<0.001, 95%CI 2.42-7.876) of S100A15 nuclear stain expression, as determined by immunohistochemistry (IHC) were all significantly increased in patients with advanced stain, in a cohort of 178 subjects with NSCLC diagnosed stage tumor (stage IIIB and IV, n = 91) compared with through bronchoscopy-guided biopsy, and correlated it with that in those with early stage tumor (stage I - IIIA, n their clinical characteristics, including tumor stage (TNM = 24, Figure 1A-C). Likewise, total score (4.79±1.14 staging), treatment response, and overall survival (1- and versus 4.05±1.34, adjusted p=0.012, 95%CI 0.154- 3-year). DNA methylation levels of 5 CpG sites over the 1.217), intensity score (1.52±0.57 versus 1.35±0.53, S100A15 gene promoter region and 1 CpG site over exon adjusted p=0.035, 95%CI 0.017-0.47), and percentage 1 of the S100A15 gene were measured in 51 DNA samples score (3.18±0.81 versus 2.68±1.04, adjusted p=0.041, extracted from the formalin fixed paraffin-embedded (FFPE) 95%CI 0.017-0.797) of S100A15 nuclear stain were tissues of lung adenocarcinoma. Furthermore, S100A15 significantly increased in lung adenocarcinoma patients expression and its gene promoter DNA methylation levels with distant metastasis (M1, n=77) as compared with in lung cancer cell lines were measured, and the effect of that in those without distant metastasis (M0, n=38, www.impactjournals.com/oncotarget 45711 Oncotarget Table 1: Baseline and clinical characteristics of all the lung cancer patients All Lung cancer Early stage (I-IIIA), Advanced stage P value* patients, N=178 Lung AC patients, (IIIB-IV), Lung AC N=24 patients, N = 91 Age, years 66.7±8.3 63.8±12 0.268 Male, n (%) 115 (64.6) 11 (45.8) 49 (53.8) 0.48 Smoking history, n (%) 57 (34) 5 (20.9) 24 (26.4) 0.426 TNM stage, n (%) T1 15 (8.4) 5 (20.8) 5 (5.5) <0.001 T2 67 (37.6) 16 (66.7) 31 (34.1) T3 17 (9.6) 1 (4.2) 8 (8.8) T4 79 (44.4) 2 (8.3) 47 (51.6) N0 33 (18.5) 14 (58.3) 10 (11) <0.001 N1 23 (12.9) 1 (4.2) 15 (16.5) N2 74 (41.6) 9 (37.5) 37 (40.7) N3 48 (27) 0 (0) 29 (31.9) M0 62 (35) 24 (100) 14 (15.38) <0.001 M1 116 (65) 0 (0) 77 (84.6) ECOG PS 0.003 0 36 (20.2) 11 (45.8) 14 (15.4) 1 85 (47.8) 11 (45.8) 45 (49.5) 2 27 (15.2) 0 (0) 18 (19.8) 3 13 (7.3) 2 (8.3) 4 (4.4) 4 17 (9.6) 0 (0) 10 (11) AC = adenocarcinoma; PS = performance status *Compared between early stage and advanced stage lung AC patients Figure 1D-F).
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