1] Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan [2] Reserch Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Lab Invest. 2015 Feb;95(2):193-206. doi: 10.1038/labinvest.2014.138. Epub 2014 Nov 24.
Anterior gradient 2 (AGR2), a member of the protein disulfide isomerase family, has been implicated in various cancers including pancreatic ductal adenocarcinoma (PDAC) and is known to promote cancer progression. However, the prognostic value of AGR2 expression and the interaction with epithelial-mesenchymal transition (EMT) remain unclear. We investigated the clinical significance of AGR2 and EMT markers in PDAC patients by immunohistochemical analyses. Although AGR2 expression was not observed in normal pancreas, all pancreatic precursor neoplastic lesions were positive for AGR2, even at the earliest stages, including pancreatic intraepithelial neoplasia-1A, AGR2 expression was reduced in 27.7% (54/195 cases) of PDAC patients. AGR2 downregulation correlated with EMT markers (vimentin overexpression and reduced membranous E-cadherin expression), high Union for International Cancer Control stage (P<0.0001), high histological cellular grade (P<0.0001), and adverse outcome (P<0.0001). In vitro, targeted silencing of AGR2 in cancer cells using siRNA reduced cell proliferation, colony formation, cell invasiveness, and migration, but did not alter EMT markers. To confer a more aggressive phenotype and induce EMT in PDAC cells, we co-cultured PDAC cell lines with primary-cultured pancreatic stellate cells (PSCs) and found that AGR2 was downregulated in co-cultured PDAC cells compared with PDAC monocultures. Treatment with transforming growth factor beta-1 (TGF-β), secreted from PSCs, decreased AGR2 expression, whereas inhibition of TGF-β signaling using recombinant soluble human TGF-β receptor type II and TGF-β-neutralizing antibodies restored AGR2 expression. We conclude that AGR2 downregulation is a useful prognostic marker, induced by EMT, and that secreted TGF-β from PSCs may partially contribute to AGR2 downregulation in PDAC patients. AGR2 downregulation does not induce EMT or a more aggressive phenotype, but is a secondary effect of these processes in advanced PDAC.
先前梯度 2(AGR2)是蛋白质二硫键异构酶家族的成员,已被牵连到各种癌症中,包括胰腺导管腺癌(PDAC),并已知促进癌症进展。然而,AGR2 表达的预后价值及其与上皮-间充质转化(EMT)的相互作用尚不清楚。我们通过免疫组织化学分析研究了 AGR2 和 EMT 标志物在 PDAC 患者中的临床意义。尽管 AGR2 在正常胰腺中没有表达,但所有胰腺前体肿瘤病变均为 AGR2 阳性,甚至在最早的阶段,包括胰腺上皮内瘤变 1A,AGR2 的表达在 27.7%(54/195 例)的 PDAC 患者中降低。AGR2 的下调与 EMT 标志物(波形蛋白过表达和膜 E-钙黏蛋白表达减少)、国际抗癌联盟高分期(P<0.0001)、高组织细胞分级(P<0.0001)和不良预后(P<0.0001)相关。在体外,使用 siRNA 靶向沉默癌细胞中的 AGR2 可降低细胞增殖、集落形成、细胞侵袭和迁移,但不会改变 EMT 标志物。为了赋予 PDAC 细胞更具侵袭性的表型并诱导 EMT,我们将 PDAC 细胞系与原代培养的胰腺星状细胞(PSC)共培养,发现与 PDAC 单培养相比,共培养的 PDAC 细胞中 AGR2 下调。来自 PSC 的转化生长因子β-1(TGF-β)的处理降低了 AGR2 的表达,而使用重组可溶性人 TGF-β受体 II 和 TGF-β 中和抗体抑制 TGF-β 信号可恢复 AGR2 的表达。我们得出结论,AGR2 的下调是一个有用的预后标志物,由 EMT 诱导,来自 PSC 的分泌 TGF-β 可能部分导致 PDAC 患者中 AGR2 的下调。AGR2 的下调不会诱导 EMT 或更具侵袭性的表型,但在晚期 PDAC 中是这些过程的继发效应。
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