A Novel Role for the Retinoic Acid-Catabolizing Enzyme CYP26A1 in Barrett’S Associated Adenocarcinoma
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Oncogene (2008) 27, 2951–2960 & 2008 Nature Publishing Group All rights reserved 0950-9232/08 $30.00 www.nature.com/onc ORIGINAL ARTICLE A novel role for the retinoic acid-catabolizing enzyme CYP26A1 in Barrett’s associated adenocarcinoma C-L Chang1,2, E Hong1, P Lao-Sirieix1 and RC Fitzgerald1 1MRC-Cancer Cell Unit, MRC/Hutchison Research Centre, Cambridge, UK and 2Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan Vitamin A deficiency is associated with carcinogenesis, Introduction and upregulation of CYP26A1, a major retinoic acid (RA)-catabolizing enzyme, has recently been shown in The incidence of oesophageal adenocarcinoma has in- cancer. We have previously demonstrated alterations of creased rapidly in the western world over the last two RA biosynthesis in Barrett’s oesophagus, the precursor decades (Pohl and Welch, 2005). The 5-year survival rate is lesion to oesophageal adenocarcinoma. The aims of this an abysmal 13% because the majority of patients present study were to determine CYP26A1 expression levels and with locally advanced disease (Medical Research Council functional effects in Barrett’s associated carcinogenesis. Oesophageal Cancer Working (MRCOCW) Group, 2002). Retinoic acid response element reporter cells were used to Since most oesophageal adenocarcinomas arise on the determine RA levels in non-dysplastic and dysplastic background of Barrett’s metaplasia, which gradually Barrett’s cell lines and endoscopic biopsies. CYP26A1 progresses to carcinoma through a metaplasia–dyspla- expression levels, with or without induction by RA and sia–carcinoma sequence, this provides the opportunity lithocholic acid, were determined by quantitative reverse to intervene at an early stage. A greater understanding transcriptase-PCR (RT–PCR) and immunohistochemis- of the pathogenesis of Barrett’s associated cancer is try. CYP26A1 promoter activity was determined by a required to develop effective chemopreventive strategies. luciferase reporter construct. CYP26A1 was stably over- An association between vitamin A (retinoic acid, RA) expressed in GihTERT cells, which were evaluated for deficiency and carcinogenesis has been known since the gene-expression changes (pathway array and quantitative 1920s when vitamin A-deficient rats were observed to RT–PCR), cellular proliferation (cytometric DNA profile develop squamous metaplasia of the lung mimicking the and colorimetric assay) and invasion (in vitro matrigel changes caused by smoking (Wolbach and Howe, 1925). assay) with or without the CYP inhibitor ketaconazole. Since then, a number of experimental animal models have RA levels decreased progressively with the degree of demonstrated that vitamin A deficiency is associated with dysplasia (Po0.05) and were inversely correlated with increased susceptibility to carcinogenesis (Bertram, 1993; CYP26A1 gene levels and activity (Po0.01). CYP26A1 Avidan et al., 2002). In humans, epidemiological data expression was increased synergistically by RA and have demonstrated a relationship between low levels of lithocholic acid (Po0.05). Overexpression of CYP26A1 serum b-carotene and vitamin A intake and the risk of led to induction of c-Myc, epidermal growth factor various human cancers including cervical pre-cancerous receptor and matrix metalloproteinase 3 as well as lesions (Saffiotti et al., 1967; Wald et al., 1980; Smith and downregulation of tissue inhibitor metalloproteinase 1 Waller, 1991). These effects have been shown to occur and 3. Functional effects of CYP26A1 overexpression through defects in DNA repair (Webster et al., 1996), were increased proliferation (Po0.01) and invasion in increased cell proliferation (Reifen et al., 1998) and a vitro (Po0.01), which were inhibited by ketaconazole. number of genotoxic events (Klamt et al., 2003). Overexpression of CYP26A1 causes intracellular RA Disruption of normal retinoid signalling may occur as depletion and drives the cell into a highly proliferative and a result of reduced expression of retinoid receptors, invasive state with induction of other known oncogenes. reduced transcriptional responses of RA target genes Oncogene (2008) 27, 2951–2960; doi:10.1038/sj.onc.1210969; and increased RA metabolism (Freemantle et al., 2003). published online 3 December 2007 A member of the cytochrome P450 family, CYP26A1, has recently been identified as a major RA-catabolizing Keywords: vitamin A; oesophageal adenocarcinoma; enzyme, which converts RA to biologically inactive proliferation; invasion; bile acids hydroxylated retinoid derivatives (Niederreither et al., 2002). CYP26A1 has been shown to be upregulated in human familial adenomatous polyposis adenomas, sporadic colon cancers and primary ovarian cancer Correspondence: Dr RC Fitzgerald, MRC-Cancer Cell Unit, MRC/ (Downie et al., 2005; Shelton et al., 2006). Furthermore, Hutchison Research Centre, Hills Road, Cambridge, Cambs CB2 the pattern of retinoid gene expression, including 2XZ, UK. E-mail: [email protected] CYP26A1, has been shown to correlate with retinoid Received 3 May 2007; revised 11 October 2007; accepted 6 November sensitivity in a panel of breast and lung cancer cell lines 2007; published online 3 December 2007 (Liu et al., 2005). Role of CYP26A1 in Barrett’s carcinogenesis C-L Chang et al 2952 Apart from the connection between RA deficiency states and cancer, there are several reasons why CYP26A1 might be implicated in Barrett’s oesophagus and associated carcinogenesis. First, Barrett’s oesopha- gus may be considered as an abnormal re-activation of embryonic patterning since the oesophagus undergoes a columnar to squamous transition at 18 weeks gestation. CYP26A1 is necessary for the establishment of the anterior–posterior axis in embryogenesis (Abu-Abed et al., 1998), and we have recently shown that alterations in RA concentration levels can affect differentiation of human oesophagus ex vivo (Chang et al., 2007). Second, chronic exposure to duodeno-gastro-oesophageal reflux- ate is the only well-established risk factor for Barrett’s carcinogenesis (Winters et al., 1987), and the bile acid lithocholic acid (LCA) has recently been demonstrated to compete efficiently with 9-cis-RA for the retinoid X receptor (RXR)-binding sites on the promoter region of the CYP26A1 gene (Radominska-Pandya and Chen, 2002). Therefore, the specific aims of this study were to determine the relative levels of RA and CYP26A1 expression in neoplastic compared with non-neoplastic Barrett’s cells in vitro and in vivo, to evaluate the effects of LCA on CYP26A1 expression and to examine the molecular and functional effects of CYP26A1 over- expression using an in vitro model system. Results Decreased retinoid levels in neoplastic relative to non-dysplastic Barrett’s cells Figure 1 Retinoic acid concentration in a Barrett’s oesophagus First, we determined the relative levels of RA in cells and tissues. Cell lines representative of Barrett’s carcinogenic sequence (a) or Barrett’s metaplasia (BE) and adenocarcinoma (Ca) Barrett’s carcinogenesis. Barrett’s telomerase-immorta- patients (b) were cultured for 24 and 18 h respectively with 100 nM lized cell lines were treated with 10À7 M RA over 24 h and retinal in serum-free medium. The resultant medium (100 ml) from then examined for RA levels using retinoic acid response cell or biopsy culture was then added to a 96-well plate containing element (RARE) reporter cells. The results demon- 3T3 RARE-SEAP reporter cells and incubated for 24 h. SEAP concentration in the medium was determined by Great EscApe strated that non-dysplastic Barrett’s cell lines, BAR detection kit. Relative RA levels were calculated by comparison À11 À11 (7.16 Â 10 ±2.20 Â 10 M) and QhTERT (2.91 Â with a standard curve using serial RA concentrations and then 10À11±1.38 Â 10À11 M), had higher retinoid levels, com- adjusted for the protein content of the cells. In panel a, for each cell pared to dysplastic cell lines, ChTERT (1.51 Â 10À11± line, three biological replicates (each with three technical replicates) 0.09 Â 10À11 M), GohTERT (6.73 Â 10À12±4.29 Â were performed. For panel b, the level of RA was determined in triplicate in each biopsy sample (***Po0.0001 and **Po0.01). 10À12 M) and GihTERT (2.40 Â 10À12±1.53 Â 10À12 M, Po0.0001; Figure 1a), and transformed normal oeso- À12± À12 phagus cell lines Het1a (2.43 Â 10 1.28 Â 10 M) the expression levels of the main RA-producing enzyme À12± À12 and NES (1.60 Â 10 0.32 Â 10 M). We confirmed RALDH2 in Barrett’s cell lines and tissues did not the in vivo relevance of these changes using oesophageal reveal any differences (data not shown). Therefore, we tissues from patients with non-dysplastic Barrett’s and next examined the expression levels of the main adenocarcinoma. Specifically, the mean retinoid level in catabolizing enzyme, CYP26A1. The constitutive ex- Barrett’s oesophageal biopsies (5.92 Â 10À11±1.28 Â À11 pression of CYP26A1 in all the cell lines is very low, but 10 M) was increased 13-fold compared to normal detectable by real-time PCR. We demonstrated that À12± À12 oesophagus (1.94 Â 10 0.73 Â 10 M) and 5.5-fold CYP26A1 mRNA transcript levels were induced by RA compared to adenocarcinoma biopsies (1.04 Â 10À11± À11 in the GihTERT cell line in a dose-dependent manner 0.9 Â 10 M, P ¼ 0.033; Figure 1b). À5 À10 (10 –10 M all-trans retinoic acid (ATRA)), (data not shown) and therefore, 10À8 M was chosen for subsequent Increased CYP26A1 gene expression in Barrett’s experiments. Across the panel of cell lines, RA led to a carcinogenesis significant induction of this gene, which was most Cellular retinoid activity is modulated via the balance marked in the dysplastic cell lines (GohTERT, ChTERT between production and metabolism. Measurement of and GihTERT) compared to the non-dysplastic Oncogene Role of CYP26A1 in Barrett’s carcinogenesis C-L Chang et al 2953 Barrett’s cell lines, BAR and QhTERT (Po0.01; staining was also seen to increase in the epithelial Figure 2a). Measurement of the promoter activity, using compartment throughout the metaplasia–dysplasia– a luciferase reporter vector containing a 354-bp prox- adenocarcinoma sequence (Figure 3b).