Department of Medical Sciences, University of Turin, Turin, Italy.
Thyroid. 2013 Jul;23(7):838-46. doi: 10.1089/thy.2012.0359.
Anaplastic thyroid cancers (ATCs) represent only 1%-2% of all thyroid tumors, but they account for up to 50% of the mortality. Treatment of differentiated thyroid carcinomas is well standardized and the use of radioiodine represents an essential step; in contrast, there is no standardized therapeutic approach for anaplastic tumors and their prognosis is poor. The resistance of ATC to radioiodine treatment is principally due to the absence of expression of the sodium iodide symporter (NIS), mainly due to epigenetic silencing. The acetylation status of histones is involved in the epigenetic control of gene expression and is usually disrupted in advanced thyroid cancer. Histone deacetylase inhibitors have been demonstrated as potent anticancer drugs with several different effects on cell viability and differentiation.
Stabilized ATC cell lines (BHT-101 and CAL-62) and primary cultures from patients who underwent thyroidectomy for ATC were treated with the histone deacetylase inhibitor LBH589. After treatment, we evaluated the expression and function of NIS. Gene expression was evaluated by real-time polymerase chain reaction (RT-PCR), NIS promoter activity was determined with a luciferase reporter assay, and protein expression was assessed through immunofluorescence. We tested the protein function by (125)I uptake and efflux experiments; finally the cytotoxic effect of (131)I was determined with a clonogenic assay.
Our results demonstrate that treatment with LBH589 leads to NIS RNA expression as shown by RT-PCR and luciferase assay, and to protein expression as determined by immunofluorescence in vitro and by immunohistochemistry in xenograft tumors. Moreover, (125)I uptake and efflux experiments show the correct protein function and iodine retention, which translate into cytotoxicity effects, as demonstrated by a clonogenic assay with (131)I.
This study supplies a new potential strategy for the treatment of ATC by modifying gene expression with the aim of inducing responsiveness towards radioiodine therapy.
间变性甲状腺癌(ATC)仅占所有甲状腺肿瘤的 1%-2%,但却占死亡率的 50%。分化型甲状腺癌的治疗已得到很好的规范,放射性碘的应用是一个重要步骤;相比之下,间变性肿瘤没有标准化的治疗方法,其预后较差。ATC 对放射性碘治疗的耐药性主要是由于钠碘转运体(NIS)表达缺失所致,主要是由于表观遗传沉默。组蛋白的乙酰化状态参与基因表达的表观遗传调控,在晚期甲状腺癌中通常被打乱。组蛋白去乙酰化酶抑制剂已被证明是有效的抗癌药物,对细胞活力和分化有多种不同的作用。
我们用组蛋白去乙酰化酶抑制剂 LBH589 处理稳定的 ATC 细胞系(BHT-101 和 CAL-62)和因 ATC 而行甲状腺切除术的患者的原代培养物。治疗后,我们评估了 NIS 的表达和功能。通过实时聚合酶链反应(RT-PCR)评估基因表达,通过荧光素酶报告基因测定评估 NIS 启动子活性,通过免疫荧光评估蛋白表达。我们通过(125)I 摄取和外排实验测试蛋白功能;最后通过集落形成实验确定(131)I 的细胞毒性作用。
我们的结果表明,LBH589 治疗导致 NIS RNA 表达增加,如 RT-PCR 和荧光素酶测定所示,并导致体外免疫荧光和异种移植瘤免疫组化中蛋白表达增加。此外,(125)I 摄取和外排实验显示正确的蛋白功能和碘保留,这转化为细胞毒性作用,如(131)I 的集落形成实验所示。
这项研究提供了一种通过修饰基因表达来治疗 ATC 的新潜在策略,目的是诱导对放射性碘治疗的反应性。