Lai Xiang-Me, Liu Shu-Yu, Tsai Yi-Ta, Sun Guang-Huan, Chang Sun-Yran, Huang Shih-Ming, Cha Tai-Lung
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Oncotarget. 2017 Jul 25;8(30):49713-49724. doi: 10.18632/oncotarget.17923.
Anti-angiogenesis has emerged as a standard of care for metastatic renal cell carcinoma. However, long-lasting efficacy is seldom reached, and evasive resistance eventually occurs under anti-angiogenic tyrosine kinase inhibitor (TKI) therapy. To establish new therapeutic strategies, investigating the molecular mechanism of resistance is critically important. In our study, human umbilical vascular endothelial cells (HUVECs) were incubated with TKI treatment in conditioned medium derived from renal cancer cells (RCCs) to demonstrate cell viability. Quantitative real time PCR or Western blotting analysis detected the fluctuation of transcriptional factors HIF-1α and HIF-2α in RCCs under TKI treatment. We demonstrated the alteration of a specific cytokine produced from RCCs under normoxia or hypoxia incubation by utilizing a cytokine RT-PCR primer array. We found that the anti-angiogenic TKI sunitinib disrupted the balance between HIF-1α and HIF-2α in RCCs and led to a protective effect on HUVECs against sunitinib treatment when cultured with conditioned medium. Mechanistically, RCCs treated with sunitinib resulted in down-regulation of HIF-1α, but not HIF-2α, through reduction of both mRNA and protein levels. The down-regulation of HIF-1α by sunitinib occurred via hypoxia associated factor (HAF), which also enhanced HIF-2α transactivation activity to increase the production of pro-angiogenic factors and cytokines and promote HUVEC proliferation. This phenomenon was observed in ACHN and A498 cells, which express both HIF-1α and HIF-2α, but was not observed in 786-O cells, which express only HIF-2α. Our results illustrated that targeting both angiogenesis and hypoxia pathways might provide a resolution to dealing with the devastating effects of anti-angiogenesis resistance.
抗血管生成已成为转移性肾细胞癌的一种治疗标准。然而,很少能达到持久的疗效,并且在抗血管生成酪氨酸激酶抑制剂(TKI)治疗下最终会出现逃避性耐药。为了建立新的治疗策略,研究耐药的分子机制至关重要。在我们的研究中,将人脐静脉内皮细胞(HUVECs)与来自肾癌细胞(RCCs)的条件培养基中的TKI处理一起孵育以证明细胞活力。定量实时PCR或蛋白质印迹分析检测了TKI处理下RCCs中转录因子HIF-1α和HIF-2α的波动。我们通过使用细胞因子RT-PCR引物阵列证明了在常氧或低氧孵育下RCCs产生的特定细胞因子的改变。我们发现抗血管生成TKI舒尼替尼破坏了RCCs中HIF-1α和HIF-2α之间的平衡,并在用条件培养基培养时对HUVECs产生了针对舒尼替尼治疗的保护作用。机制上,用舒尼替尼处理的RCCs通过降低mRNA和蛋白质水平导致HIF-1α下调,但不影响HIF-2α。舒尼替尼对HIF-1α的下调通过缺氧相关因子(HAF)发生,HAF还增强了HIF-2α的反式激活活性,以增加促血管生成因子和细胞因子的产生并促进HUVEC增殖。在同时表达HIF-1α和HIF-2α的ACHN和A498细胞中观察到了这种现象,但在仅表达HIF-2α的786-O细胞中未观察到。我们的结果表明,同时靶向血管生成和缺氧途径可能为应对抗血管生成耐药的破坏性影响提供一种解决方案。