Abstract
Expression of phosphorylated v-raf murine sarcoma viral oncogene homolog B (pBRAF) and phosphorylated extracellular signal-regulated kinase1/2 (pERK1/2) were investigated in urothelial carcinoma (UC) in dogs with or without the BRAF gene mutation (V595E). Among the 10 cases of UC with V595E (−), cytoplasmic immunoreactivity against pBRAF of neoplastic cells was reported in 8, with 7 displaying moderate reactivity and 1 displaying intense reactivity. Nuclear immunoreactivity against pBRAF was detected in 5 cases; however, these reactivities were non-specific, due to pBRAF being limited in the cytoplasm. In addition, positive cytoplasmic immunoreactivity against pERK1/2 of neoplastic cells was detected in 7 cases and nuclear immunoreactivity against ERK1/2 was detected in 6 cases. Among the 13 cases of UC with V595E (+), cytoplasmic immunoreactivity against pBRAF of neoplastic cells was detected in all 13 cases and nuclear immunoreactivity against pBRAF was detected in 10 cases; however, the nuclear immunoreactivity was non-specific. Cytoplasmic immunoreactivity against pERK1/2 of neoplastic cells was detected in all 13 cases and nuclear immunoreactivity against pERK1/2 was also detected in all cases. As nuclear pERK1/2 indicates a progressive signaling process in the mitogen-activated protein kinase pathway, V595E (+) UC might be in its growing stage. Probable phosphorylated sites of pBRAF at Thr598/Ser601, detected in this study, are major and essential sites of the upstream rat sarcoma viral oncogene homolog (RAS) signaling pathway. In human cancers, the BRAF mutation never coincides with oncogenic RAS. To our knowledge, this is the first report on the simultaneous occurrence of the BRAF mutation (V595E) and pBRAF expression (at Thr598/Ser601) in dogs with UC with V595E (+).
Résumé
L’expression de l’homologue B de l’oncogène viral du sarcome murin phosphorylé v raf (pBRAF) et de la kinase1/2 régulée par le signal extracellulaire phosphorylé (pERK1/2) ont été étudiées dans le carcinome urothélial (CU) chez des chiens avec ou sans la mutation du gène BRAF (V595E). Parmi les 10 cas de CU avec V595E (−), une immunoréactivité cytoplasmique contre pBRAF de cellules néoplasiques a été rapportée chez huit, sept présentant une réactivité modérée et un présentant une réactivité intense. L’immunoréactivité nucléaire contre pBRAF a été détectée dans cinq cas; cependant, ces réactivités n’étaient pas spécifiques, car pBRAF était limité dans le cytoplasme. De plus, une immunoréactivité cytoplasmique positive contre pERK1/2 des cellules néoplasiques a été détectée dans sept cas et une immunoréactivité nucléaire contre ERK1/2 a été détectée dans six cas. Parmi les 13 cas de CU avec V595E (+), une immunoréactivité cytoplasmique contre pBRAF de cellules néoplasiques a été détectée dans les 13 cas et une immunoréactivité nucléaire contre pBRAF a été détectée dans 10 cas; cependant, l’immunoréactivité nucléaire était non spécifique. L’immunoréactivité cytoplasmique contre pERK1/2 des cellules néoplasiques a été détectée dans les 13 cas et l’immunoréactivité nucléaire contre pERK1/2 a également été détectée dans tous les cas. Comme le pERK1/2 nucléaire indique un processus de signalisation progressif dans la voie de la protéine kinase activée par les mitogènes, V595E (+) UC pourrait être dans sa phase de croissance. Les sites phosphorylés probables de pBRAF à Thr598/Ser601, détectés dans cette étude, sont des sites majeurs et essentiels de la voie de signalisation de l’oncogène viral (RAS) du sarcome de rat en amont. Dans les cancers humains, la mutation BRAF ne coïncide jamais avec le RAS oncogène. À notre connaissance, il s’agit du premier rapport sur la survenue simultanée de la mutation BRAF (V595E) et de l’expression de pBRAF (à Thr598/Ser601) chez des chiens atteints de CU avec V595E (+).
(Traduit par Docteur Serge Messier)
Introduction
Urothelial carcinoma (UC), well-known as transitional cell carcinoma, is the most common tumor in the urinary tract, especially in the urinary bladder in dogs. The tumor, originating from urinary tract epithelium cells, shows highly invasive behavior into the lamina propria and distant metastasis, including the lymph node, lung, bone, muscle, and skin (1–3). A definitive diagnosis is fundamentally made by histopathologic analysis of surgically resected tumor tissues and/or endoscopic tissue samples. Recently, the v-raf murine sarcoma viral oncogene homolog B (BRAF) gene mutation (V595E), corresponding to human V600E, was identified (4) and detected in various tumors in dogs (5), especially in those with UC, with high prevalence rates of 67 to 87% (4,6,7).
It is well-known that BRAF, one of the most important RAF family kinases, is a serine/threonine protein kinase that activates the mitogen-activated protein kinase (MAPK) signaling pathway. Activated BRAF, phosphorylated mainly by activated upstream the rat sarcoma viral oncogene homolog (RAS), and BRAF mutations phosphorylate related kinases, such as MAPK kinase (MEK) and its downstream extracellular signal-regulated kinase (ERK1/2), indicate oncogenicity and tumorigenicity in human cancers (8,9). Because over 90% of BRAF mutations are V600E, it is the most important and active oncogenic mutation (10–12). In canine UC, Decker et al (4) demonstrated that V595E induces the activation of the MAPK signaling pathway, including phosphorylated MEK and phosphorylated ERK1/2 (pERK1/2), and revealed its oncogenicity as the driver mutation of UC. In neoplastic cells, pERK1/2 (phospho-p44/42 MAPK) is translocated from the cytoplasm to the nucleus, which activates mitogenic factors (13,14).
This study investigates the expression of phosphorylated BRAF (pBRAF) and pERK1/2 in formalin-fixed tissue samples of UC in dogs with or without the BRAF mutation (V595E).
Materials and methods
Formalin-fixed tissue samples of UC in dogs
A total of 23 formalin-fixed and paraffin-embedded tissue samples of UC, none of which received treatment with BRAF inhibitors, were obtained from surgical cases at the Japan Animal Referral Medical Center and the Graduate School of Agricultural and Life Sciences Veterinary Medical Center at the University of Tokyo. An additional 4 cases of clinically healthy urinary bladder were obtained from necropsy cases from the Department of Veterinary Pathology at the University of Tokyo. All tissue samples were histopathologically confirmed as UC by 2 Board-certified veterinary pathologists at the Japanese College of Veterinary Pathologists. The UC samples were divided into 2 groups: with or without the BRAF mutation (V595E) detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).
Detection of BRAF mutation (V595E) by PCR-RFLP
Detection of V595E was performed according to previously reported PCR-RFLP method (4,6) with the original forward primer. Genomic DNA was extracted from 4-μm-thick sections for analysis of the BRAF gene mutation in exon 15 (V595E). Sections were deparaffinized by incubation with xylene at room temperature (RT) overnight. Xylene was removed in 100% ethanol at RT for 10 min. After centrifugation, ethanol was removed, and tissue pellets were dried up. The pellets were dissolved completely in lysis buffer (50 mM Tris-HCl, 100 mM NaCl, 10 mM EDTA, 1% SDS, pH 8.0) containing 100 ng/mL proteinase K at 70°C. The dissolving samples were added to an equal volume of phenol:chloroform:isoamyl alcohol (25:24:1, v/v), mixed thoroughly and centrifuged to separate the aqueous layer. The aqueous layer containing the genomic DNA was transferred to a new tube, an equal volume of 2-propanol was added, and the mixture was centrifuged to precipitate genomic DNA. The genomic DNA was washed with 70% ethanol, dried, and dissolved with Tris-EDTA buffer (10 mM Tris-HCl, 1 mM EDTA, pH 8.0).
The reverse primer, 5′-TGG CCT CAA TTC TTA CCA TCC AC-3′, designed by Decker et al (4) and the forward primer, 5′-GTA ATG CTT GCT TTG CTA GGA 3′, originally designed from genomic DNA, based on GenBank (accession No. NC_006598.2) were used for PCR. The PCR was performed using TaKaRa Ex Taq HS (Takara Bio, Shiga, Japan). The DNA sample (100 ng) was amplified in 50 μL of Tris-HCl buffer with 1.25 U TaKaRa Ex Taq HS, 200 μM dNTP, 2.0 mM of MgCl2, and 25 pM of each specific primer. The PCR conditions were 2 min at 94°C, followed by 35 (or 45) cycles of 20 s at 94°C, 20 s at 55°C, 20 s at 72°C, and finally, 10 min at 72°C for extension. The PCR products were detected by the 7.5% acrylamide gel electrophoresis and the target band was purified using LaboPassTM PCR (Hokkaido System Science, Sapporo, Hokkaido, Japan). Purified amplicons were submitted to the Fasmac (Atsugi, Kanagawa, Japan) for sequencing, using an ABI PRISM 3100 Genetic Analyzer (Applied Biosystems, Foster City, California, USA).
Using the primer pairs mentioned, a 196-base pair (bp) DNA fragment, corresponding to the human BRAF gene exon 15, was amplified. When V595E with a nucleotide substitution (c.1784T > A) corresponding to human V600E with a substitution of c.1799T > A was developed, the cleavage site of the BtsIMutl restriction enzyme (New England Biolabs Japan, Tokyo, Japan) sequencing CAGTG, disappeared (Figure 1 A, B). As PCR amplicons of the wild type (WT) BRAF gene were digested by BtsIMutI, V595E was clearly detected by PCR-RFLP analysis. The amplicon of the WT BRAF gene was digested into 2 DNA fragments of 122 and 74 bp, whereas the BRAF mutation (V595E) was not digested, demonstrating 3 fragments (Figure 1 C).
Figure 1.
Genomic DNA sequence, PCR-sequencing chromatogram, and PCR-RFLP electropherogram of BRAF exon 15 gene with or without V595E [mutant (Mu) or wild type (WT)]. A — DNA sequence of WT and Mu BRAF gene in human (NM_004333.4) (upper line) and in dog (NC_006598.2) (lower line). The sequences are highly conserved between humans and dogs, although 2 silent point mutations are observed (green band). Using the primer pairs mentioned, a 196-base pair (bp) DNA fragment corresponding to human BRAF exon 15 gene is amplified and sequenced (from c1726 to c1845). Squared 5 genomic bases, in which the 3 latter bases consist of codon 595 and include the mutant sequence (red character), are the digestion site of BtsIMutI restriction enzyme. B — Chromatogram of the WT (left) and Mu (right) sequence of BRAF in dogs. When V595E with substituted c.1784T > A, corresponding to human V600E with substituted c.1799T > A is developed, the restriction enzyme site sequencing CAGTG disappears. C — V595E is clearly detected on the PCR-RFLP electropherogram. The amplicons are digested to 2 fragments of 122 and 74 bp in WT sequence, whereas the amplicon is not digested in the Mu sequence, demonstrating 3 bands of 196, 122, and 74 bp fragments.
Immunohistochemical detection of pBRAF and pERK1/2
Expression of pBRAF and pERK1/2 was immunohistochemically examined using 4-μm tissue sections of UC. Antigen retrieval was performed by autoclaving tissue sections in citrate buffer (pH 6.0) at 121°C for 10 min. Endogenous peroxidase activity in the tissue sections were inactivated with 3% hydrogen peroxide in methanol at RT for 5 min. To block nonspecific reactions, the sections were incubated with 8% skimmed milk in Tris-buffered saline (TBS) at RT for 30 min. The sections were then incubated at 4°C overnight with each primary antibody: rabbit polyclonal anti-BRAF (phosphor Thr598/Ser601) (Cat GTX85596, 1:100; Gene Tex, Irvine, California, USA) and rabbit monoclonal anti-phospho-p44/42 MAPK (ERK1/2) (Thr 202/Tyr204) (20G11) (Cat #4376S, 1:400; CST Japan, Tokyo, Japan). After 3 washings with TBS, the sections were treated with Dako EnVision+ System-horseradish peroxidase (HRP)-labeled polymer anti-rabbit secondary antibodies (Agilent Technologies Japan, Tokyo, Japan) at 37°C for 40 min. The chromogen consisted of 0.05% 3-3′-diaminobenzidine and 0.03% hydrogen peroxide in TBS. The sections were counterstained with Mayer’s hematoxylin. For the pBRAF and pERK1/2 negative controls, the primary antibodies were replaced with TBS. The images of cytoplasmic immunoactivity were tentatively classified as negative, weak positive, moderately positive, and intensely positive against pBRAF and pERK1/2.
Results
Detection of BRAF mutation (V595E) in formalin-fixed tissue of UC
In 13 out of 23 (57%) cases in this study, V595E mutation was detected in formalin-fixed tissue sections of UC. Although the prevalence rate of V595E was low, the results of the PCR-RFLP analysis provided a clear genomic DNA sequence and PCR sequencing chromatogram of V595E (Table I; Figure 1).
Table 1.
Expression of pBRAF and pERK1/2 in urothelial carcinoma with BRAF mutation (V595E) in dogs.
| Immunoreactivity (cytoplasmic) | Urothelial carcinoma | Clinically healthy | |
|---|---|---|---|
|
| |||
| V595E (+) (n = 13) | V595E (−) (n = 10) | ||
| pBRAF | |||
| negative (−) | 2/10 (20%) | 3/4 (80%) | |
| weak positive (±) | 1/4 (20%) | ||
| moderately positive (+) | 2/13 (15%) | 7/10 (70%) | |
| intensely positive (++) | 11/13 (85%) | 1/10 (10%) | |
| pERK1/2 | |||
| negative (−) | 3/10 (30%) | ||
| weak positive (±) | |||
| moderately positive (+) | 1/13 (8%) | 2/10 (20%) | |
| intensely positive (++) | 12/13 (92%) | 5/10 (50%) | |
pBRAF: phosphorylated BRAF, pERK1/2: phosphorylated ERK1/2.
Expression of pBRAF and pERK1/2 in UC
Among the 4 cases of clinically healthy urinary bladder, weak positive cytoplasmic immunoreactivity against pBRAF was detected in the urothelial cell layer of 1 case. In the remaining 3 cases, neither cytoplasmic nor nuclear immunoreactivity against both pBRAF and pERK1/2 were observed (Figure 2).
Figure 2.
Expression of pBRAF and pERK1/2 in 4 cases of clinically healthy urinary bladder of dogs. Weak positive cytoplasmic immunoreactivity against pBRAF is detected in the urothelial cell layer of 1 case (C 2). In the remaining 3 cases, neither cytoplasmic nor nuclear immunoreactivity against both pBRAF and pERK1/2 is observed (left columns: H&E staining, bar = 500 nm; center columns: pBRAF; right columns: pERK1/2). Negative controls are represented in the bottom row.
All 13 cases of UC with V595E (+) revealed moderately or intensely positive cytoplasmic immunoreactivity against both pBRAF and pERK1/2, whereas 1 out of 10 cases with V595E (−) showed intensely positive immunoreactivity against pBRAF and 5 out of 10 cases showed intensely positive immunoreactivity against pERK1/2 (Table I).
Among the 10 cases of UC with V595E (−), cytoplasmic immunoreactivity against pBRAF of neoplastic cells was seen in 8 cases (7 moderately and 1 intensely). In the remaining 2 cases, there was no significant cytoplasmic immunoreactivity for pBRAF. Nuclear immunoreactivity against pBRAF was detected in 5 cases; however, these reactivities were non-specific, due to pBRAF being limited in cytoplasm. Positive cytoplasmic immunoreactivity against pERK1/2 of neoplastic cells was detected in 7 cases (2 moderately and 5 intensely). Nuclear immunoreactivity against ERK1/2 was detected in 6 cases (Figure 3).
Figure 3.
Expression of pBRAF and pERK1/2 in canine UC with V595E (−). Every case of UC with V595E (−) shows some typical histopathological features of UC (left columns, H&E staining). In the case of WT 2, neoplastic foci consisting of the solid proliferation of large pleomorphic tumor cells are formed in the lamina propria (bar = 500 nm). In the case of WT 5, the tumor cells formed papillary structures toward the lumen and glandular structures in the lamina propria (bar = 500 nm). In the case of WT 10, neoplastic foci consisting of the solid proliferation of large pleomorphic tumor cells are formed in the lamina propria (bar = 500 nm). The results of immunohistochemistry against pBRAF are represented in the center columns and those against pERK1/2 are represented in the right columns. Among 10 cases of UC with V595E (−), cytoplasmic immunoreactivity against pBRAF of neoplastic cells is seen in 8 cases (7 moderately: WT 1–3, 6–9; 1 intensely: WT 5). In the remaining 2 cases (WT 4 and 10), there is no significant cytoplasmic immunoreactivity for pBRAF. Nuclear immunoreactivity against pBRAF is detected in 5 cases (WT 2, 3, 5, 8, and 9); however, these reactivities are non–specific, due to pBRAF being limited in the cytoplasm. Positive cytoplasmic immunoreactivity against pERK1/2 of neoplastic cells is detected in 7 cases (2 moderately: WT 6 and 7; 5 intensely: WT 3, 5, 8–10). Nuclear immunoreactivity against ERK1/2 is detected in 6 cases (WT 3, 5, 7, 8–10).
Among the 13 cases of UC with V595E (+), cytoplasmic immunoreactivity against pBRAF of neoplastic cells was detected in 13 cases (2 moderately and 11 intensely). Nuclear immunoreactivity against pBRAF was detected in 10 cases; however, these reactivities were non-specific, like in V595E (−) cases. Cytoplasmic immunoreactivity against pERK1/2 of neoplastic cells was detected in 13 cases (1 moderately and 12 intensely). Nuclear immunoreactivity against pERK1/2 was detected in all 13 cases (Figure 4).
Figure 4.
Expression of pBRAF and pERK1/2 in canine UC with V595E (+). Every UC with V595E (+) shows typical histopathological features of UC (left columns, H&E staining), especially in Mu 1, Mu 2, and Mu 3, where the neoplastic cells formed papillary structures toward the lumen and glandular structures in the lamina propria (bar = 500 nm). In the case of Mu 8, neoplastic foci consisting of pleomorphic tumor cells formed glandular structures in the lamina propria (bar = 500 nm). In the case of Mu 12, eosinophilic atypical neoplastic cells with anisocytosis and anisokaryosis proliferated (bar = 300 nm). The results of immunochemistry against pBRAF are represented in the center columns and those against pERK1/2 are represented in the right columns. Cytoplasmic immunoreactivity against pBRAF of neoplastic cells is detected in all 13 cases of UC with V595E (+) (2 moderately: Mu 7 and 12; 11 intensely: Mu 1–6, 8–11, 13). Nuclear immunoreactivity against pBRAF is detected in 10 cases; however, these reactivities are nonspecific, like in V595E (−) cases. Cytoplasmic immunoreactivity against pERK1/2 of neoplastic cells is detected in 13 cases (1 moderately: Mu 7; 12 intensely: Mu 1–6, 8–13). Nuclear immunoreactivity against pERK1/2 is detected in all 13 cases.
Discussion
Although the incidence of UC is less than 2% of all malignant tumors in dogs, almost all of them (97%) are invasive malignant tumors (1,15). The tumor is quite similar in terms of histopathology, biological behavior, response to chemotherapy, and prognosis to human invasive UC (15–18). Various risk factors are reported in canine UC, including age of onset (over 10-years-old: 45%), sex predilection (female: twice as likely as a male), breed-associated predisposition (Scottish terrier: 21-fold increased risk), major histological features with a high grade papillary infiltrative tumor, high incidence of local and distant metastases (49%), and poor prognosis (median survival time of post-surgery: 125 d) (1,19,20). In addition, incidence rates of V595E mutation are reported in 67 to 87% of UC in dogs (4,5,7). In this study, a low prevalence rate of V595E (57%; 13/23 UC cases) was detected. Some risk factors, such as sex predilection (female), breed population (high risk in terrier breed), and size of samples (50, 67, and 80% in 16, 45, and 66 samples, respectively) (4–6), might be related to the low prevalence of V595E mutation in this study.
It is widely accepted that the MAPK signaling pathway consists of the ERK1/2 pathway, the regulating oncogenic pathway, and the Jun N-terminal kinase (JNK1/2/3) and P38 (P38α/β/γ/δ) pathway, regulating inflammation and the stress response (21,22). In the ERK1/2 pathway, the receptor tyrosine kinase (RTK)-rat sarcoma viral oncogene homolog (RAS)-RAF-MEK-ERK cascade, RTK-RAS-phosphatidylinositol-3-kinase-mammalian target of rapamycin cascade, or G protein coupled receptor-guanine nucleotide-binding protein (GNAG)-MEK-ERK1/2 cascade is closely related to the oncogenic driver in cancer (23–25). Especially the RTK-RAS-RAF-MEK-ERK1/2 cascade, which is the most important cascade for tumorigenesis (26,27).
All 13 cases of UC with V595E (+) revealed moderately or intensely positive immunoreactivity against pERK1/2, indicating activation of the MAPK signaling pathway. The V595E, like other BRAF mutations, can directly phosphorylate and activate MEK with subsequent activation of ERK1/2 by changing the conformation of the BRAF activating loop (28,29). In this study, immunoreactivity against pERK1/2, reflecting phosphor-p44/42 MAPK (ERK1/2), was detected in the cytoplasm and nucleus of neoplastic cells. In addition, 11 out of 13 cases of UC with V595E (+) revealed nuclear immunoreactivity against pERK1/2. Since nuclear pERK1/2 translocated from the cytoplasm indicates the progressive signaling process in the MAPK pathway (13,14), V595E (+) UC might be the growing stage of the tumor.
On the other hand, cytoplasmic immunoreactivity against pBRAF, indicating phosphor Thr598/Ser601 BRAF, was detected in all 13 cases of UC with V595E (+), with moderately or intensely positive reactivity, like those with pERK1/2 immunoreactivity. As pBRAF is fundamentally limited in cytoplasm (8,30), reactivity against nuclear pBRAF, observed in neoplastic cells of some cases in this study, is non-specific, except for inflammatory cells in WT 2. Phosphorylation sites of BRAF at Thr598/Ser601 are major and essential sites for activating upstream RAS signaling, consisting of the RKT-RAS-BRAF-MEK-ERK cascade (31,32). Whereas UC with V595E (−) showed negative to intensely positive immunoreactivity, probably because some of them had an activated RAS or GNAG (31–34). Interestingly, the BRAF gene mutation (V600E) never coincides with activated RAS, including the KRAS or HRAS mutations, resulting in pBRAF (phosphor Thr598/Ser601) in human cancers (12,35,36). In contrast, many researchers report that pBRAF is detected in melanoma cases with acquired resistance to BRAF inhibitors caused by the paradoxical activation of upstream signaling RTK or RAS through the ERK1/2 feedback mechanism (37–40).
To our knowledge, this is the first report on the BRAF mutation (V595E) coinciding with pBRAF expression (at Thr598/Ser601). Further studies are necessary to elucidate the pathophysiological meaning of pBRAF in canine UC with V595E (+).
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