Abstract
Deregulation of matriptase is a consistent feature of human epithelial cancers and correlates with poor disease outcome. We have previously shown that matriptase promotes multi-stage squamous cell carcinogenesis in transgenic mice through dual activation of pro-hepatocyte growth factor-cMet-Akt-mTor proliferation/survival signaling and PAR-2-Gαi-NFκB inflammatory signaling. Matriptase was congenitally and constitutively deregulated in our prior studies, and therefore it was unclear if aberrant matriptase signaling supports only initiation of tumor formation or if it is also critical for the progression of established tumors. To determine this, we here have generated triple-transgenic mice with constitutive deregulation of matriptase and simultaneous inducible expression of the cognate matriptase inhibitor, hepatocyte growth factor inhibitor (HAI)-2. As expected, constitutive expression of HAI-2 suppressed the formation of matriptase-dependent tumors in 7,12-Dimethylbenz(a)anthracene (DMBA)-treated mouse skin. Interestingly, however, the induction of HAI-2 expression in already established tumors markedly impaired malignant progression and caused regression of individual tumors. Tumor regression correlated with reduced accumulation of tumor-associated inflammatory cells, likely caused by diminished expression of pro-tumorigenic inflammatory cytokines. The data suggest that matriptase-dependent signaling may be a therapeutic target for both squamous cell carcinoma chemoprevention and for the treatment of established tumors.
Keywords: hepatocyte growth factor activator inhibitor-2, matriptase, oncogenic protease signaling, squamous cell carcinoma, tumor regression
Introduction
The membrane-anchored serine protease, matriptase, has gathered considerable attention in the context of human carcinogenesis, because it is deregulated with unusually high frequency in the epithelial compartment of human carcinomas of diverse origin, because its expression is negatively correlated with clinical outcome in several human carcinomas and certain hematopoietic malignancies, and because matriptase promotes tumorigenesis in several animal models (1–22). In regard to the latter, we have previously shown that low-level, constitutive expression of matriptase in the basal keratinocyte compartment of transgenic mice suffices to induce spontaneous ras-independent multistage squamous cell carcinogenesis and to potentiate ras-dependent malignant transformation induced by 7,12-Dimethylbenz(a)anthracene (DMBA) (22). Malignant transformation of squamous epithelium, including DMBA-induced transformation of mouse epidermis, is a sequential process that occurs through distinct stages that include hyperplasia, dysplasia, papilloma, carcinoma in situ, invasive carcinoma, and metastatic disease (23). The contribution of deregulated matriptase activity to early stage squamous cell carcinogenesis was established in our previous studies by the lack of any pre-malignant progression in bi-transgenic mice that constitutively overexpress matriptase along with the cognate matriptase inhibitor, hepatocyte growth factor activator inhibitor (HAI)-1 (22). However, whether the membrane-anchored serine protease also supports late-stage progression of squamous cell carcinogenesis has not been determined. In this study, we therefore generated triple-transgenic mice with constitutive deregulation of matriptase and simultaneous inducible expression of the potent cognate matriptase inhibitor, hepatocyte growth factor activator inhibitor (HAI)-2 (19, 24, 25), specifically in matriptase overexpressing cells. This inducible expression of HAI-2 enabled the acute blunting of matriptase activity after epidermal tumors were established. Using this novel experimental setup, we now show that matriptase is a critical promoter of late stages of squamous cell carcinoma progression and induces pro-tumorigenic chemokine and cytokine release, and inflammatory cell accumulation into established tumors. Taken together, these data indicate that matriptase may be a suitable therapeutic target for both squamous cell carcinoma chemoprevention and for the treatment of established tumors.
Results and Discussion
To determine the stage-specific contribution of matriptase in squamous cell carcinogenesis, we generated two novel transgenic mouse strains. The first strain constitutively expressed an HA epitope-tagged murine Spint2 cDNA (encoding HAI-2) under control of the bovine keratin-5 promoter, hereafter referred to as K5-Spint2+/0 mice (figure 1a and b, data are shown for one established transgenic line used for all further experiments). Reverse transcriptase (RT)-PCR analysis of mRNA from skin extracts showed that K5-Spint2 mice displayed an increase in total Spint2 mRNA (figure 1b, compare lanes 1 with 2–4 and 5–7). This resulted in a marked increase in total epidermal HAI-2, as determined by Western blot using mouse HAI-2 antibodies (figure 1d, top panel, compare lanes 1 and 3). We next crossed K5-Spint2+/0 mice to previously generated K5-St14+/0 mice expressing a murine matriptase (St14) cDNA under control of the bovine keratin-5 promoter (22) to generate bi-transgenic K5-St14+/0; K5-Spint2+/0 mice and their single-transgenic and wildtype littermates (figure 1c). Western blot analysis showed that HAI-2 was well expressed in the bi-transgenic K5-St14+/0; K5-Spint2+/0 mice (figure 1d, top panel, compare lanes 3 and 4). Likewise, Western blot analysis using a matriptase antibody that recognizes the C-terminal serine protease domain showed that the level of total and activated epidermal matriptase was unaffected by the level of expression of HAI-2 (figure 1e, top panel, compare lanes 1 with 3 and 2 with 4). Finally, double immunofluorescence analysis using antibodies against the HA epitope tag of the transgenic HAI-2 fusion protein and antibodies against matriptase showed widespread co-localization of HAI-2 with matriptase in the basal keratinocyte compartment (compare figure 1f with i, g with j, examples with arrows in k).
To determine if constitutive HAI-2 expression impairs matriptase-dependent squamous cell carcinoma initiation, we next subjected the skin of cohorts of K5-St14+/0; K5-Spint2+/0 bi-transgenic mice and their associated K5-St14+/0, K5-Spint2+/0, and wildtype littermates to topical treatment with DMBA and followed tumor formation by outward inspection for 30 weeks (figure 1l). As previously reported (22, 26, 27), DMBA treatment did not result in tumor formation in wildtype mice (figure 1l, red lines). In sharp contrast, all mice overexpressing matriptase in basal keratinocytes developed tumors within seven weeks of treatment (figure 1l, blue lines) in agreement with previous studies (22). As described previously for HAI-1 (22), the rapid tumor formation caused by matriptase overexpression in basal keratinocytes was significantly blunted by the simultaneous overexpression of HAI-2 (figure 1l, green lines). No histological differences were apparent between tumors arising in K5-St14+/0 single transgenic mice and K5-St14+/0; K5-Spint2+/0 bi-transgenic mice (figure 1m and n, data not shown). Importantly, transgenic HAI-2 remained well expressed in the DMBA-induced tumors and co-localized with tumor cell-expressed matriptase, as determined by immunofluorescence with antibodies against matriptase and the HA epitope (figure 1o–t, examples with arrows in t) showing that transgenic HAI-2 is co-localized with matriptase in DMBA-induced tumors when expressed under the control of a keratin-5 promoter.
To investigate the role of matriptase in the later stages of squamous cell carcinoma progression, we next generated a second transgenic mouse line in which matriptase is constitutively expressed under the control of the Keratin-5 promoter and in which HAI-2 was also expressed in a Keratin-5 promoter-dependent, but in an inducible manner. For this purpose, we first generated a transgenic mouse strain in which the HA-tagged Spint2 cDNA was expressed under the control of a tetracycline-inducible promoter (Figure 2a, herafter pBig-Spint2+/0 mice). Studies in HEK293 cells confirmed that HAI-2 expression from this promoter was efficiently induced by the tetracycline-analogue, doxycycline, specifically in cells expressing a tetracycline transactivator (rtTA) protein consisting of the E. coli TetR (tetracycline repressor) fused to the Herpes Simplex Virus VP16 transactivation domain (28) (figure 2b). Southern blot using genomic DNA from wildtype and transgenic mice showed a successfully inserted fragment compatible in size with the Spint2 cDNA (figure 1c, lane 2). Consistent with this, when the pBig-Spint2+/0 mice were crossed to previously generated K5-TetOn+/0 mice expressing the rtTA protein under the control of the bovine keratin-5 promoter (29), HAI-2 expression could be specifically induced in the basal keratinocyte compartment by administration of doxycycline-containing chow to the ensuing pBig-Spint2+/0; K5TetOn+/0 bi-transgenic mice (figure 2d, examples with arrowheads in right panel).
The pBig-Spint2+/0; K5TetOn+/0 bi-transgenic mice next were crossed to K5-St14+/0 mice to generate triple-transgenic pBig-Spint2+/0; K5TetOn+/0; K5-St14+/0 mice. The mice were then subjected to DMBA treatment as described above to induce skin tumor formation (figure 3a). Once tumors emerged, the mice were randomly assigned to two groups. The first group continued to be fed normal chow, whereas the second group was fed doxycycline-containing chow to induce HAI-2 expression. Both treatment groups then were followed for an additional 14 weeks, and the change in tumor multiplicity and total tumor burden was then enumerated (figure 3b–e). As expected, a prolific progression of tumors was observed in mice fed normal chow. The median increase in tumor multiplicity was 6.5 and the median increase in total tumor burden was 0.4 g (figure 3d and e, golden squares). As also expected, all tumors visible at study initiation increased in size (examples with arrows in figure 3b and b′). Interestingly, however, tumor progression in mice fed doxycycline-containing chow was markedly blunted, with an increase in median tumor multiplicity of just 1 and an increase in median total tumor burden of just 0.05 g (figure 3d and e, red squares). Furthermore, tumors visible at study initiation often displayed obvious regression, indicative of a specific requirement of matriptase activity for continued tumor growth (examples with arrowheads in figure 3c and c′). Immunofluorescence analysis of tumors from doxycycline-fed and control mice using antibodies against the HA epitope tag of the HAI-2 fusion protein and antibodies against matriptase showed induction of HAI-2 expression by doxycycline and frequent co-localization of HAI-2 with matriptase in tumor cells (figure 1f–k, compare f with i and g with j). HAI-2 expression, however, was generally patchy, with some areas of the tumors showing intense staining (figure 3i, arrowheads) and other areas being devoid of staining. This non-homogeneous induction of HAI-2 provides a likely explanation for the relatively unimpeded growth of some tumor nodules and the occasional emergence of new tumors during doxycycline administration.
To mechanistically dissect how matriptase promotes the progression of established tumors, we performed a comparative histological analysis of tumor lesions and adjacent hyperplastic tissue of mice fed normal or doxycycline-containing chow (figure 4a–p). No significant effect of HAI-2 induction was observed on tumor cell proliferation (figure 4m). Interestingly, however, macrophage (examples in a–d, quantification in figure 4n), neutrophil (examples in figure 4e–h, quantification in figure 4o), and T lymphocyte infiltration (examples in figure 4i–l, quantification in 4p) into the tumors, as determined by, respectively, Mac1 [Cd11b], myeloperoxidase (MPO), and CD3 antibodies, were all significantly diminished, suggesting that HAI-2 induction impairs matriptase-dependent pro-inflammatory signaling. To investigate this, we analyzed the levels of the key keratinocyte pro-inflammatory chemokine and cytokine genes, chemokine (C-X-C motif) ligand 1 (Cxcl1), thymic stromal lymphopoietin (Tslp), and colony stimulating factor 2 (granulocyte-macrophage) (Csf2) in newborn K5-St14+/0; K5-Spint2+/0 bi-transgenic mice and their K5-St14+/0, K5-Spint2+/0, and wildtype littermates (figure 4q–s). We chose to analyze the three chemokine/cytokine genes because they were previously shown to be induced by matriptase in skin tumors (26), and we chose newborn mice because the skin is histologically normal at birth (22) and differences in cytokine expression, therefore, are more likely to be a direct consequence of matriptase-mediated inflammatory signaling. All three cytokine or chemokine genes displayed markedly increased expression in K5-St14+/0 mice as compared to wildtype littermates, although significance only was obtained for Cxcl1 (figure 4q–s, blue squares, compare with brown squares). Interestingly, however, this matriptase-mediated increase in inflammatory cytokine expression was abrogated by simultaneous HAI-2 expression (figure 4q–s, compare purple squares to brown and blue squares). Taken together, these data suggest that matriptase promotes the progression of established epidermal tumors at least in part through induction of pro-tumorigenic inflammatory cytokines.
Trypsin-like serine proteases with their extracellular location and well-known mechanism of catalysis and zymogen activation are long-established as excellent drug targets (30). The capacity of genetic downregulation of matriptase activity to induce stasis or regression of established tumors that we demonstrated in this study uncovers a critical contribution of the protease also to late stages of squamous cell carcinoma progression, and illustrates the potential utility of its pharmacological targeting for both squamous cell carcinoma chemoprevention and treatment of established tumors. Thus, even epidermal tumors in which ras is activated by topical DMBA application (22, 31–34) remained dependent on matriptase proteolytic activity for further expansion and often regressed in its absence. The exact cellular mechanism by which this tumor regression occurred remains to be established. We did not observe obvious differences in tumor cell proliferation, apoptosis (data not shown) or necrosis (data not shown), although it is conceivable that the histological procedures used to assess these parameters may not be sufficiently sensitive to detect subtle changes. Alternatively, tumor regression may be a rapid process that is not captured in the collected tumor samples. We previously identified two matriptase-dependent signaling pathways that each is essential for initiating malignant transformation of squamous epithelium: a) A cMet-Akt-mTor proliferation/survival signaling pathway, initiated by matriptase cleavage of keratinocyte cell surface-bound pro-hepatocyte growth factor, and, b) a Gαi-NFκB inflammatory signaling pathway, initiated by matriptase cleavage of keratinocyte protease-activated receptor-2 (26, 27). The marked reduction in the abundance of tumor-associated inflammatory cells observed after matriptase inhibition in established tumors would suggest that protease-activated receptor-2-dependent pro-inflammatory signaling represents at least one molecular component of matriptase-promotion of late stage carcinogenesis. However, matriptase also has been proposed to promote progression of other cancers through the activation of pro-macrophage-stimulating protein 1/pro-hepatocyte-like growth factor (35), receptor bound pro-urokinase plasminogen activator (36–38), src-associated transmembrane protein SIMA135/CDCP1/TRASK (39), and platelet-derived growth factor-D (40).
A considerable number of small molecule and macromolecular inhibitors of matriptase have been developed (41–48). The data presented in this paper should further stimulate ongoing efforts towards the development and use of inhibitors of matriptase for human cancer treatment.
Acknowledgments
We thank Dr. Mary Jo Danton and Dr. J. Silvio Gutkind for critically reviewing this manuscript. We also thank Andrew Cho and Dr. Ashok Kulkarni, NIDCR Gene Targeting Facility, for generation of transgenic mice. Histology was performed by Histoserv, Inc., Germantown, MD. The study was supported by the NIDCR Intramural Research Program (THB), Sao Paulo Research Foundation 2014/14311-0 (KUS), The Harboe Foundation, The Foundation of 17.12.1981, and the Lundbeck Foundation (SF)
Footnotes
Conflict of Interest
Authors have declared that no competing interests exist.
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