ABSTRACT
We intended to explore the effect of miR-202-5p and phosphatase and tensin homolog (PTEN) on doxorubicin (DOX) resistance of breast cancer cells. The result of quantitative reverse transcription-polymerase chain reaction (qRT-PCR) reveals that miR-202-5p was highly expressed in drug-resistant breast cancer tissues, while PTEN was expressed less. MiR-202-5p directly targeted PTEN. Further, it was found that the overexpression of miR-202-5p promoted the DOX resistance and proliferation as well as decreased apoptosis of MCF-7 cells. The lower expression of miR-202-5p inhibited DOX resistance and proliferation as well as increased the apoptosis of MCF-7/DOX cells. In vivo experiments showed that mice with downregulated miR-202-5p had smaller tumor volume and lower Ki67 level. The overexpression of PTEN declined the proliferation of MCF7 cells, while miR-202-5p's overexpression could offset the function of overexpression of PTEN. The knockdown of PTEN promoted MCF7/DOX cell proliferation that could be counteracted by miR-202-5p silence. Moreover, we also revealed that downregulated miR-202-5p expression inhibited PI3k/Akt signaling pathway-related protein by regulating expression of PTEN.
KEYWORDS: Breast cancer, miR-202-5p, PTEN, PI3K/Akt, doxorubicin
Introduction
Breast cancer primarily occurs among females and is one of most malignant neoplasia with the incidence increasing annually.1 Living quality, genetic factors and environmental factors have been believed to be associated with the incidence of breast cancer.2 The main therapies for breast cancer treatment included anticancer drugs, hormonal therapy, targeted drugs or a combination.3 As well known, researchers have found that drug resistance is a vital barrier in breast cancer treatment. Doxorubicin (DOX) is proved to be effective in reducing the recurrence and mortality of breast cancer patients; however, the acquired resistance to DOX results in poor outcomes.4 Therefore, more attention has been paid to the investigation of drug resistance.
MicroRNAs (miRNAs) are small non-coding RNA molecules, accounting for about 1% of the human genome.5 The main function of miRNAs is suppressing posttranscriptional gene expression to induce mRNA translation inhibition or degradation.4 Besides, it has been found that aberrant expression of miRNAs is associated with physiological and pathological processes of human cancers at cellular levels, such as proliferation, apoptosis, invasion and drug resistance.6–9 MiR-202 has been confirmed to be either a tumor suppressor or a regulator of oncogenes in many types of cancer. MiR-202-3p was downregulated in cervical squamous cell carcinoma, colorectal cancer and follicular lymphoma.10The highexpression of miR-202 in human endometrium and adipose tissue–derived stem cells might be linked to cell cycle control.11
As a well-recognized tumor suppressor gene, phosphatase and tensin homolog (PTEN) involved in tumor cell proliferation, migration, apoptosis, drug resistance and signaling pathway.4 Ectopic expression of PTEN has been found in a plethora of human neoplasms including breast cancer.12 Besides, PTEN can be modulated by various miRNAs in human cancers. For instance, miR-106b caused cell radio resistance in colorectal cancer through PTEN/PI3K/Akt signaling pathway.13 MiR-21 induced gemcitabine resistance via the PTEN/Akt pathway in breast cancer cells.14 MiR-222 promoted adriamycin resistance of breast cancer cells by PTEN/Akt/FOXO1 signaling.12
The expression levels of miR-202-5p and PTEN in breast cancer tissues and cells were determined. The target relationship between miR-202-5p and PTEN was also confirmed. Further, their influence on breast cancer cell proliferation, apoptosis and DOX resistance as well as the role of PI3K/Akt signaling pathway in resistance were also investigated. We may bring out novel therapy inspiration to explain the drug resistance in breast cancer treatment.
Results
Mir-202-5p was highly expressed in drug-resistant tissues and cells
MiR-202-5p overexpression was seen in DOX-resistant tissues (P < 0.05, Figure 1(a)). We also found that miR-202-5p was highly expressed in MCF-7 and MCF-7/DOX cells compared with MCF-10A cells. MCF-7/DOX cells had a much higher miR-202-5p level than MCF-7 (P < 0.05(Figure 1(b)). qRT-PCR results showed that the miR-202-5p expression level in MCF-7 cells was upregulated by miR-202-5p mimics, and the expression in MCF-7/DOX cells was downregulated by miR-202-5p inhibitor (P < 0.05(Supplementary Figure 1(a,b)).
PTEN was less expressed in drug-resistant breast cancer tissues and it was the target of mir-202-5p
PTEN under-expression was seen in DOX-resistant tissue samples and cells (P < 0.05, Figure 2(a,c)). PTEN mRNA level and miR-202-5p level were negatively correlated (Figure 2(b)). MiR-202-5p mimics significantly lowered PTEN level in MCF-7 cells, whereas miR-202-5p inhibitor significantly enhanced PTEN expression in MCF-7/DOX cells (P < 0.05, Figure 2(d)). Based on the predicted binding sites on miR-202-5p and wild-type PTEN (Figure 2(e)), we designed the dual-luciferase reporter gene assay. The results showed that miR-202-5p mimics significantly inhibited the relative luciferase activity of wild-type PTEN (P < 0.05, Figure 2(f)), suggesting that miR-202-5p targeted PTEN.
Overexpression of miR-202-5p promoted drug resistance and proliferation of breast cancer in vitro and in vivo
CCK8 results showed that the miR-202-5p mimics transfected cells promoted cell viability under different DOX concentrations (P < 0.05, Figure 3(a)). The upregulated miR-202-5p increased the IC50 value in MCF-7cells (P < 0.01, Figure 3(b)). Colony formation results indicated that miR-202-5p mimics increased colony formation rate to DOX of MCF-7 cells (Figure 3(c,d)). We also detected accelerated cell viability in miR-202-5p mimics transfected cells at 96 h (P < 0.01, Figure 3(e)). The results of immunofluorescence staining showed that Ki67 expression was upregulated by the overexpression of miR-202-5p (Figure 3(f)). Flow cytometry (FCM) indicated that the cell apoptosis was inhibited following miR-202-5p overexpression (P < 0.01, Figure 3(g,h)).
In vivo experiments showed that the tumor volume of miR-202-5p mimics group was significantly larger than that of the miR-NC group and Mock group, and a similar result was obtained after cells being treated with DOX (P < 0.05, Figure 4(a,b)). The overexpressed miR-202-5p increased the Ki67 expression level in mice tissues (P < 0.01, Figure 4(c,d)). Taken together, in vitro and in vivo results confirmed that the over-expressed miR-202-5p promoted the drug resistance and cell proliferation and inhibited cell apoptosis of MCF-7 cells.
Downregulation of miR-202-5p inhibited drug resistance and proliferation of breast cancer in vitro and in vivo
The result of CCK8 showed that the miR-202-5p inhibitor inhibited cell viability under different DOX concentrations (P < 0.05, Figure 5(a)). MiR-202-5p inhibitor significantly lowered the IC50 of MCF-7/DOX cells (P < 0.01, Figure 5(b)). Colony formation results indicated that miR-202-5p inhibitor decreased colony formation rate of MCF-7/DOX cells (Figure 5(c,d)). We also detected slow cell viability in miR-202-5p inhibitor transfected cells within 96 h (P < 0.01, Figure 5(e)). The results of immunofluorescence staining showed that Ki67 was downregulated after the inhibition of miR-202-5p (Figure 5(f)). FCM results indicated that the cell apoptosis was promoted by miR-202-5p inhibition (P < 0.01, Figure 5(g,h)). Animal experiment results showed that the tumor volume of miR-202-5p inhibitor group was significantly decreased. Also, mice treated with DOX showed smaller tumor volume. Mice of miR-202-5p inhibitor + DOX group had the smallest tumor volume (P < 0.05, Figure 6(a,b)). Mice of miR-202-5p inhibitor group showed significantly lower Ki67 level in tumor tissues (P < 0.01, Figure 6(a,b)). Taken together, in vitro and in vivo results confirmed that the downregulated miR-202-5p inhibited drug resistance and cell proliferation but promoted cell apoptosis of MCF-7/DOX cells.
Overexpression of miR-202-5p enhanced drug resistance and proliferation of MCF-7 cells via pten/pi3k/akt signaling pathway
The levels of p-Akt 308 and p-Akt 473 were significantly upregulated in miR-202-5p mimics group (Figure 7(a)). The total amount of Akt expression was not affected either (P < 0.05, Figure 7(b)). CCK8 results revealed that miR-202-5p mimics promoted the proliferation of MCF-7 cells with the change of DOX dose and treatment time, and the overexpressed PTEN inhibited cell proliferation. The addition of PTEN also prevented the proliferation induced by miR-202-5p mimics (P < 0.05, Figure 7(c,e)). MiR-202-5p mimics promoted the colony formation of MCF-7 cells, whereas PTEN overexpression inhibited it (P < 0.05, Figure 7(d,f)). These results demonstrated that miR-202-5p might upregulate PI3K/Akt signaling through silencing PTEN.
Downregulation of miR-202-5p decreased drug resistance and proliferation of MCF-7/DOX cells via pten/pi3k/Akt signaling
As shown in Figure 8(a), the protein levels of p-Akt 308 and p-Akt 473 in MCF-7/DOX cells were reduced after miR-202-5p inhibitor treatment, compared to the anti-miR-NC group (P < 0.01). Total Akt expression level was not changed. Changed p-Akt 308, p-Akt 473 and PTEN expressions were not detected in miR-202-5p inhibitor + siPTEN cells. The total amount of Akt expression was not affected either (P < 0.05, Figure 8(b)). MiR-202-5p inhibitor retarded the proliferation of MCF-7/DOX cells, whereas the knockdown of PTEN promoted it. The treatment of siPTEN also prevented the proliferation of inhibition induced by the miR-202-5p inhibitor (P < 0.05, Figure 8(c,e)). MiR-202-5p inhibitor decreased the colony formation of MCF-7/DOX cells, whereas siPTEN promoted it. At the same time, the addition of siPTEN induced the colony formation inhibited by the miR-202-5p inhibitor (P < 0.05, Figure 8(d–f)). These results demonstrated that miR-202-5p might upregulate PI3K/Akt signaling through silencing PTEN.
Discussion
MiR-202-5p was highly expressed in DOX resistance breast cancer tissues and cells, while PTEN was less expressed. We then proved that miR-202-5p targeted and downregulated PTEN. Overexpressed miR-202-5p promoted DOX resistance and cell proliferation as well as inhibited apoptosis of MCF-7 cells, while downregulated miR-202-5p performed opposite functions in MCF-7/DOX cells. It was unraveled that miR-202-5p enhanced DOX resistance of breast cancer cells through the PTEN/PI3K/Akt pathway.
Previous studies found that miR-202 was differentially expressed in various cancers. For instance, miR-202 was less expressed in multiple myeloma cells.15 Upregulated miR-202 was found in the serum of clear cell carcinomas of the ovary.16 Zhao et al. pointed out that miR-202-3p level was negatively correlated with the tumor size of gastric cancer (GC) patients with a significance of P= 0.013.10 Joosse et al. proved that high serum level of miR-202 was an independent prognostic factor of breast cancer.5 These conclusions indicated that miR-202 functioned as either a tumor suppressor or an oncogene, which depends on its expression level. In most cases, miRNAs performed functions by controlling the expression of target genes, such as inhibiting translation or activating mRNA degradation through complementary pairing with a 3ʹUTR sequence.11 PTEN was reported to be a tumor suppressor in a few human cancers and can be targeted by various miRNAs. For instance, PTEN was directly targeted by miR-222 in GC.12 Wang et al. found that miR-214 downregulated the PTEN expression level in breast cancer cells.17 Similarly, in our study, we detected a high miR-202-5p expression level and less expressed PTEN in drug-resistant breast cancer tissues and cells. Then, we conducted a dual-luciferase reporter gene and found that miR-202-5p regulated the wild-type PTEN by directly binding to its 3ʹUTR.
Accumulating evidence showed that miRNAs mediated several processes in malignant tumors, such as drug resistance, proliferation and apoptosis. As for drug resistance, miR-222 was reported to be significantly upregulated in DOX-resistant breast cancer cells, and the inhibition of miR-222 sensitized MCF-7/DOX cells to chemotherapy.18 Previous studies found that miR-224-3p was involved in the DOX resistance through regulating potential targets of breast cancer cells.19 Yuan et al. found that overexpressed miR-130b stimulated DOX resistance in MCF-7 cells.3 Besides, a few studies explored the function of miR-202 in various cancers. For instance, Lin et al. reported that miR-202 facilitated the cancer progression of osteosarcoma by suppressing cancer cells apoptosis and increasing DOX resistance.20 The study of Shen et al. revealed that miR-202 inhibited the growth and survival of multiple myeloma cells.15 MiR-202-3p significantly suppressed colorectal cancer cell proliferation by targeting ARL5A.21 In addition, the proliferation of GC was found to be inhibited by miR-202.10 However, the research of miR-202-5p in breast cancer cells is not sufficient. Our in vitro and in vivo experiments revealed that the overexpression of miR-202-5p promoted DOX resistance and proliferation of breast cancer cells.
It was proved that PI3K/Akt signaling pathway was connected with the processes of cell growth and programmed cell death, and its disrupted expression was frequently found in human cancers.22 Besides, related studies showed that miRNAs and PTEN might regulate PI3K/Akt signaling pathway. For instance, PTEN was recognized as a negative regulator of PI3K/Akt signaling pathway.23 Shen et al. found that upregulated miR-222 enhanced Akt phosphorylation and partially decreased the DOX sensitivity in breast cancer cells.12 PTEN/PI3K/Akt signaling was regulated by miR-214, which therefore promoted breast cancer cell survival and decreased the apoptosis.17 Thus, in our study, we detected the effect of PTEN/PI3K/Akt signaling pathway in the miR-202-5p-regulated cell proliferation and drug resistance. The results revealed that miR-202-5p decreased PTEN and increased p-Akt 308 and p-Akt 473 expressions. We further proved that upregulated miR-202-5p promoted DOX resistance and proliferation of breast cancer cells through PTEN/PI3K/Akt. These findings indicated that PTEN/PI3K/Akt pathway played vital roles in regulating cancer progression.
Our study may provide useful further study hints. For instance, the relationship between PTEN/PI3K/Akt signaling and miR-202-5p should be worth exploring in other human cancers. More target genes should also be included in further studies of breast cancer.
To sum up, miR-202-5p was high-expressed in breast cancer tissues and cells, targeted and downregulated PTEN expression. DOX-resistance of breast cancer cells was enhanced by miR-202-5p through PTEN/PI3K/Akt signaling. Our findings may bring up new strategies for breast cancer treatment.
Materials and methods
Human breast tissue samples
Human breast tissue samples were collected from 62 breast cancer patients that underwent surgery between March 2016 and October 2016 at Linyi People’s Hospital. Twenty-three patients were DOX-resistant, and 39 showed DOX sensitiveness. All patients signed on the experiment agreement.
Cell culture
MCF-10A (normal human mammary epithelial cell line) and MCF-7 (breast cancer cell line) were purchased from BeNa Culture Collection (Beijing, China). MCF-7 cell line with resistance to DOX (MCF-7/DOX) was successfully established by exposing MCF-7 (20 ng/ml) to gradually increased concentrations of DOX (5 nM a time, until 60 nM). MCF-10A cell line was cultured in RPMI 1640 (Invitrogen, USA) with 10% fetal bovine serum (FBS). MCF-7 cells were cultured in dulbecco’s modified eagle medium (Invitrogen, USA) with 10% FBS. MCF-7/DOX was cultured in RPMI 1640 (Invitrogen, USA) with 1 mg/L DOX.
Cell transfection
MiR-202-5p mimics, miR-NC, miR-202-5p inhibitor, anti-miR-NC, PTEN pEGFP-N2 (PTEN), control vector (vector), small interfering RNA of PTEN (siPTEN) and scramble siRNA of PTEN (siSCR) were purchased from FulenGen Co., Ltd (Shanghai, China). MiR-202-5p mimics, PTEN and vector were, respectively, transfected into MCF-7 cells, and miR-202-5p inhibitor, siPTEN and siSCR were transfected into MCF-7/DOX cells.
qRT-PCR
Total RNA was obtained from the cells using TRIzol reagent (Haoranbio, Shanghai, China). RNA was reverse-transcribed into cDNA using a reverse transcription (#BPI01030, Beijing Protein Innovation, Beijing, China). Then, approximately 2 µL cDNA was subjected to PCR using an UltraSYBR Mixture kit (#KW0957B, BOYAO, Shanghai, China). The primers were designed by Sangon Biomart (Shanghai, China). GAPDH and U6 were used to normalize mRNA and miRNA, respectively. Primers are listed in Table 1, and the relative expression was calculated by 2−ΔΔCt method.
Table 1.
Primers | Sequences |
---|---|
PTEN (forward) | 5ʹ- CAATG ACAGCCATCATCAAAGAG-3’ |
PTEN (reverse) | 5ʹ- GC TCAG ACT T TTGT AAT TTGT G-3’ |
MiR-202-5p (forward) | 5ʹ-ACACTCCAGCTGGG TTTCTTCATATACGT-3’ |
MiR-202-5p (reverse) | 5ʹ-TGGTGTCGTGGAGTCG-3’ |
U6 (forward) | 5ʹ-GCTTCGGCAGCACATATACTAAAAT-3’ |
U6 (reverse) | 5ʹ-CGCTTCACGAATTTGCGTGTCAT-3’ |
GAPDH (forward) | 5ʹ-GTCAACGGATTTGGTCTGTATT-3’ |
GAPDH (reverse) | 5ʹ-AGTCTTCTGGGTGGCAGTGAT-3’ |
Western blot assay
Total proteins were extracted and lysed with Radio-Immunoprecipitation Assay (RIPA) buffer (Solarbio, Beijing, China) containing 1% phenylmethanesulfonyl fluoride. Six hundred micrograms of proteins were electrophoretically separated and blotted onto a polyvinylidene fluoride membrane (BIOSCIENCE, Shanghai, China). The primary antibodies (anti-p-Akt 308, 1:1000, #ab38449; anti-p-Akt 473, 1:5000, #ab81283; anti-Akt, 1 μg/mL, #ab64148; anti-GAPDH, #ab8254, Abcam, Cambridge, MA, USA) were diluted with Tris Buffered saline Tween (TBST) and put into the membrane for an overnight incubation at 4 °C. Then, the membrane was incubated with Rabbit Anti-Human IgG H&L (HRP) (1:5000, Abcam, #ab6721, USA) for 2 h incubation. Chemiluminescence ECL detection kit (Millipore, Billerica, MA, USA) was used to visualize the protein bands.
FCM assay
Five microliters of Annexin V-FITC and 5 μL PI were added to the cell suspension and incubated for 20 min in dark.
Cell apoptosis was then measured by FCM. Annexin V-FITC and PI were purchased from Beyotime Biotechnology (Jiangsu, China).
Dual luciferase reporter gene assay
The MCF-7/DOX cells were grown in 6-well plates. pGL3-PTEN-3ʹUTR-wt or pGL3-PTEN-3ʹUTR-mut were constructed by inserting wild-type and mutated PTEN 3ʹUTR sequences into pGL3 vectors. The constructs were co-transfected with miR-202-5p mimics or negative control (NC). Two days later, the fluorescence activities of cells were detected.
Immunofluorescence staining
The cells were fixed in 4% paraformaldehyde for 30 min. Blocking was performed with 5% Bovine Serum Albumin (BSA) phosphate buffer solution (Solarbio, Beijing, China) for 1 h. After that, the cells were incubated with primary antibody (1 μg/mL, Santa Cruz, #sc-23900) and secondary antibodies (Santa Cruz, #sc-23900 PE). Subsequently, the cells were counterstained with 4,6-diamino-2-phenyl indole (DAPI) (Beyotime Biotechnology, Shanghai, China).
Nude mice experiments
Sixty male nude mice (4 weeks old) were purchased from Shanghai SLAC Experimental Animal Center (Shanghai, China). Thirty mice were randomly picked out, divided into six groups (Mock, miR-NC, miR-202-5p mimics, Mock + DOX, miR-NC + DOX, miR-202-5p mimics+DOX) and injected with different transfected MCF-7 cells (2 × 106 cells) through the right limb. The rest of the mice were also equally divided into six groups (Mock, anti-miR-NC, miR-202-5p inhibitor, Mock + DOX, anti-miR-NC + DOX, miR-202-5p inhibitor + DOX), injected with transfected MCF-7/DOX cells (2 × 106 cells) through right limb and treated with 7 mg/kg DOX every week. After 30 d, the mice were killed, the tumors were harvested. The tumor volume was calculated by 1/2 (length×width2).
Immunohistochemical staining and scoring
The mice tumor tissues were fixed in 4% paraformaldehyde, dehydrated in graded ethanol and embedded in paraffin. The tissues were sliced and peroxidase-deactivated, which were incubated with Ki67 antibody (2 µg/mL, Abcam, #ab15580) and streptavidin-HRP-conjugated antibody (Santa Cruz Biotech, USA). Ki67 expression was estimated by scoring system. Low-power magnification was used to observe the stained slides. For estimation, three areas were selected, including an area with a high labeling index, an area with a low labeling index and an overall representative area. Then, the positive ratios were estimated by breast pathologists, and the average ratio of the three areas was reported as the Ki67 score. Image-ProPlus 4.5 software (Media Cybernetics, USA) was used to assist with scoring.
Proliferation assay
Cell Counting Kit 8 (CCK8) was purchased from Beyotime (Jiangsu, China). Ten microliters of CCK8 were added to cell culture for 4 h.optical density (OD) value at 450 nm was measured every 24 h until 96 h using a microplate reader (Thermo Electron Corp, USA). In terms of colony formation assay, the cells grew for 14 days and were fixed with 10% formaldehyde. After fixation, cells were stained by 0.01% crystal violet. ImageJ (https://imagej.nih.gov/ij/) was used to assist with the colony counting.
Statistical analysis
GraphPad Prism 6.0 (https://www.graphpad.com/) was used for statistical analysis. Data were documented as mean± standard deviation. Student’s t-test and one-way analysis of variance were used for group comparison. P < 0.05 was considered to be statistically significant.
Funding Statement
None
Acknowledgments
None.
Conflict of interest
The authors confirm that there are no conflicts of interest.
Ethics approval and consent to participate
This study was authorized by Linyi People’s Hospital and obtained written informed consents from all the participants.
Supplementary material
Supplemental data for this article can be accessed on the publisher’s website
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