Hindawi Canadian Journal of Gastroenterology and Hepatology Volume 2019, Article ID 8348967, 8 pages https://doi.org/10.1155/2019/8348967 Research Article Potential Role of HMGCS2 in Tumor Angiogenesis in Colorectal Cancer and Its Potential Use as a Diagnostic Marker Kejian Zou,1 Yan Hu,2 Musheng Li,3 Hongli Wang,3 Yuhua Zhang,4 Ling Huang,3 Yuanwen Xie,5 Songyu Li,6 Xingui Dai,7 Wanfu Xu ,3,8 Zhiyong Ke ,9 Sitang Gong ,3,8 and Yaodong Wang 10 1 Department of General Surgery, Hainan General Hospital, Haikou 570311, China 2 Department of Anesthesiology, Hainan General Hospital, Haikou 570311, China 3 Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510623, China 4 Department of Pediatrics, Te Ninety-Five Hospital of PLA, Putian 351164, China 5 Department of Anorectal, Qionghai Hospital of Traditional Chinese Medicine, Qionghai 571400, China 6 Department of Clinical Laboratory, Qionghai Hospital of Traditional Chinese Medicine, Qionghai 571400, China 7 Department of Critical Care Medicine, Institute of Transitional Medicine, Te First People’s Hospital of Chenzhou, Chenzhou 423000, China 8 Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510623, China 9 Department of Cell Biology, School of Basic Medical, Southern Medical University, Guangzhou 510515, China 10Kunshan Afliated Hospital of Nanjing University of Chinese Medicine, Kunshan 215300, China Correspondence should be addressed to Wanfu Xu; [email protected], Zhiyong Ke; [email protected], Sitang Gong; [email protected], and Yaodong Wang; [email protected] Received 12 February 2019; Revised 28 March 2019; Accepted 14 April 2019; Published 1 July 2019 Academic Editor: Joseph Feuerstein Copyright © 2019 Kejian Zou et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. HMGCS2 is the rate-limiting enzyme of ketogenesis, which is vital for tumor initiation or metastasis. Te aim of this study is to determine the relationship between HMGCS2 and tumor angiogenesis. Materials and Methods.Testudyconsistedof 100 cases with colorectal cancer and healthy control, the expression of HMGCS2 and the microvessel density (MVD) (marker: CD31) were analyzed by immunohistochemistry and tube formation, and the centration of �-hydroxybutyrate in serum was assessed by biochemical analysis. Results. Te results showed that HMGCS2 expression is signifcantly reduced in colorectal cancer compared with healthy control, which is inversely correlated with MVD in colorectal cancer by IHC analysis. What is more, knockdown HMGCS2 expression in HT-29 cells signifcantly contributed endothelial cell tube formation. Conclusion. Tese fndings implying HMGCS2 may have a negative regulation of tumor angiogenesis and provide an approach to inhibit tumor angiogenesis. 1. Introduction ketone body [3, 4]. Emerging evidence indicates that fun- damental diferences exist between the metabolic pathways Colorectal cancer is a characterized as a group of metabolic of normal and malignant cells [5, 6]. In contrast to normal reprogramming, an emerging hallmark of cancer cells [1], and cells, which derive most of their usable energy through immune-mediated disorders of intestinal tissue. Enhanced oxidative phosphorylation, cancer cells depend heavily on aerobic glycolysis (Warburg efect) is the main metabolic substrate phosphorylation pathways to meet energy demands characteristics of malignant tumors [2]. Accumulating evi- [1]. Te convincing evidence showed that lactate and suc- dence showed that metabolic rewiring in cancer not only is cinate, higher than normal levels in tumor cells, pro- limited to glucose metabolism, but also included lipid and mote tumor growth whereas �-hydroxybutyrate, lower than 2 Canadian Journal of Gastroenterology and Hepatology normal levels, suppresses tumor growth [7]. Interestingly, 2.2. Patients and Biopsies. Based on the declaration of the expression of the rate-limiting enzyme in the synthe- Helsinki as refected in a prior approval by the institution’s sis of �-hydroxybutyrate, 3-hydroxy-3-methyl glutaryl CoA human research committee, this study was conducted in a synthase 2 (HMGCS2), is repressed by the oncogene c- cohort of patients with colorectal cancer (CRC) in Hainan Myc [8], and SIRT3, associated with tumor suppression General Hospital approved by the Medical Ethical Review function, is responsible for the maintenance of HMGCS2 Board. A number of 100 cases (20 cases healthy control in the deacetylated state, thus keeping the enzyme in opti- vs80casesCRC)wereincludedinthisstudy;thedetailed mally active form [9]. All these fndings point to a tumor- information was supplied in Supplementary Materials Table suppressive role for �-hydroxybutyrate in colon. However, 1. Te intestinal tissue was drawn from each patient by elec- mitochondria are the sites of multiple metabolism, such as tronic colonoscopy afer we got the informed consent from pyruvate oxidation, citric acid cycle, oxidative phosphoryla- the patients diagnosed with CRC. Written informed consent tion, ketogenesis, and fatty acid oxidation, which is critical was obtained from all participants, which are not publicly role in tumorigenesis [7]. Dysfunction of mitochondrial available since the database is currently not anonymous and function is one hallmark of tumor that directly linked to contains all patient’s name; however, it could be available oncogenesis, angiogenesis, Warburg efect, and epigenet- upon request. ics. Recently, a large number of evidences showed that 2.3. Measurement of �-Hydroxybutyrate Level. Te blood was HMGCS2, a regulatory point converting acetyl-CoA to collected from the patients with colorectal cancer and ana- ketone bodies in the pathway [10, 11], enhanced invasion lyzed by biochemical analysis to detect �-hydroxybutyrate and metastasis via direct interaction with PPAR� to acti- level. vate Src signaling in colorectal cancer and oral cancer [12] and represented a potential novel prognostic biomarker for 2.4. Antibodies and Reagents. PBS and other chemical ESCC patients [13]. Expressed in liver and a number of reagents used in this study were from Sigma (St. Louis, extrahepatic tissues, like colon, HMGCS2 has also been MO, USA), HMGCS2 (E-AB-13296) was from Elabscience reported to play a crucial preventive role in several cancers, (Wuhan, China), and a-tubulin and CD31 (Abclonal, A11525) such as rectal cancer, breast cancer, and prostate cancer were purchased from Abclonal (Wuhan, China). [14–16]. What is more, a strong correlation between dis- tant metastasis in advanced CRC and tumor metabolism, 2.5. Immunohistochemistry. Slides were heated in an oven angiogenesis, and tumor vasculature is one of the pri- ∘ for 2 hours at 60 C, dewaxed, distilled with water for 2 mary targets for CRC therapy. Despite the strong research minutes, and followed by high pressure steam distillation. concerning the function of HMGCS2 in tumor, data are Afer blocking with a peroxidase in 3% H2O2 solution for lacking in the potential relationship between HMGCS2 and 10 minutes, washing 3 times with phosphate-bufered saline tumor angiogenesis. We aimed to seek evidence to eluci- (PBS) for 5 minutes, the mixture was supplemented with a date the possible relationship between HMGCS2 expres- ∘ primary antibody and incubated at 37 Cfor60minutes.Afer sion and colorectal cancer prognosis. In this study, we PBS washing in the same manner, secondary antibodies to aimed to seek evidence to elucidate the possible relationship HMGCS2 (Elabscience, E-AB-13296) and CD31 (Abclonal, between HMGCS2 and tumor angiogenesis in development ∘ A11525), respectively, were added. Afer incubation at 37 Cfor of CRC. 60 minutes in PBS, samples were washed 3 times with PBS for 5 minutes. Each section was colored by diaminobenzidine for 1 to 2 minutes. Each slice was photographed microscopically, 2. Materials and Methods and the images were analyzed by IPP6.0 image analysis 2.1. Cell Culture and siRNA Transfection. Te HT29 and sofware. HUVEC cell line was purchased from the Shanghai Insti- tute of Biological Sciences, Chinese Academy of Sciences 2.6. IHC Scoring and Microvascular Density. HMGCS2 stain- (Beijing, China), and cultured in Dulbecco’s modifed Eagle’s ing intensities with scores of 0 and 1 were defned as low medium (Termo Fisher Scientifc, Inc., Waltham, MA) expression of HMGCS2, while scores of 2 and 3 were supplemented with 10% fetal bovine serum (Termo Fisher defned as high expression. 5–8 felds of view were selected Scientifc, Inc.), Te HMGCS2-specifc siRNA was pur- and photographed from each section microvascular density chased from Genepharma (Shanghai, China) used in Hu (MVD). et.al study [17]. Te interfering sequences for HMGCS2 � wereasfollows:sense,5-GACUUCUACAAACCAAACUtt- 2.7. Tube Formation Assay by HUVEC Cocultured with HT29 � � � 3 and antisense, 5 -AGUUUGGUUUGUAGAAGUCtt-3 . Cells. Te tube formation assay was performed in pervious Te interfering sequences for nontargeting siRNA were as study [18, 19]. Briefy, tumor cells were cultured on Transwell � � follows:sense,5-UUCUUCGAACGUGUCACGUtt-3 and inserts (12 mm diameter, polycarbonate membranes with � � antisense, 5 -ACGUGACACGUUCGGAGAAtt-3 ,which 0.4 �m pores; Corning, Lowell, MA, USA). Afer 24 h the were used as the negative control. siRNA were transfected inserts