Ohwada A, Takahashi H, Nagaoka I, Iwabuchi K, Mikami O, Kira S
Department of Respiratory Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Thorax. 1995 Jun;50(6):651-7. doi: 10.1136/thx.50.6.651.
The concentration of carcinoembryonic antigen (CEA), known as a marker of malignant transformation and chronic inflammation, is increased in bronchoalveolar lavage fluid obtained from smokers compared with fluid from non-smokers. This study investigated the mechanism and biological significance of CEA production in the lungs of smokers by evaluating protein and mRNA expression in non-carcinomatous lung parenchymal tissues and in cell lines derived from human fetal lung.
Lung parenchymal tissue free from cancer or an inflammatory lesion was obtained from five non-smokers (four with lung cancer, one with pulmonary mycetoma), five ex-smokers (all with lung cancer except for one with mesothelioma), and 14 smokers (nine with lung cancer, five with emphysema) at surgery or necropsy. Cancer tissue was also collected simultaneously from the subjects with lung cancer. CEA protein in the tissue homogenates was measured by enzyme linked immunoassay. CEA mRNA expression in the non-carcinomatous parenchymal tissue and cancer tissue was evaluated by in situ hybridisation using CEA specific riboprobe and was semiquantitated by counting the number of silver grains per cell. CEA mRNA expression was also compared in three cell lines derived from human fetal lung (IMR-90, MRC-9, and CCD-14Br) after in vitro stimulation with medium exposed to cigarette smoke or air. Chemoattractant activity of purified CEA for neutrophils and monocytes was also studied in vitro.
CEA content in non-carcinomatous lung tissue was increased in smokers with emphysema (mean (SD) 38.0 (9.2) ng/mg protein) or with lung cancer (38.2 (21.6)) compared with non-smokers (11.0 (5.4)) or ex-smokers (5.9 (2.2)). CEA mRNA expression in non-carcinomatous tissue, expressed by average number of grains per cell, was also increased in smokers with emphysema (mean (SD) 11.2 (4.1)) or with lung cancer (14.0 (8.4)) compared with non-smokers (3.1 (0.6)) or ex-smokers (4.0 (1.7)). CEA content in carcinomatous tissues was 42.8 (37.3) for non-smokers, 38.2 (42.4)) for ex-smokers, and 59.0 (22.5) for smokers. The CEA content in carcinomatous tissue was higher than in non-carcinomatous tissue, but there was no difference between non-smokers, ex-smokers, and smokers. The numbers of grains per cell in carcinomatous tissue were higher than in non-carcinomatous tissues, but not different among non-smokers (30.3 (3.9)), ex-smokers (38.3 (13.8)), and smokers (44.3 (5.2)). CEA mRNA expression in the cell lines was upregulated after the incubation with smoke-treated medium. Purified CEA was chemoattractant for neutrophils but not for monocytes in vitro.
mRNA and protein expression of CEA were increased in the normal lung tissue from smokers compared with non-smokers or ex-smokers. Since CEA content and mRNA expression were no different between smokers with non-small cell lung cancer and those with non-carcinomatous disease, it is unlikely that CEA expression in non-carcinomatous lung parenchymal tissue was influenced by the presence of the tumour and is consistent with the effect of smoking. This is supported by in vitro studies which show that cigarette smoke could induce CEA mRNA expression in fetal lung derived cells. In addition, CEA might play a part in recruitment of neutrophils into the lower respiratory tract.
癌胚抗原(CEA)作为恶性转化和慢性炎症的标志物,与非吸烟者相比,吸烟者支气管肺泡灌洗液中CEA浓度升高。本研究通过评估非癌性肺实质组织和人胎儿肺来源的细胞系中的蛋白质和mRNA表达,探讨吸烟者肺中CEA产生的机制及生物学意义。
在手术或尸检时,从5名非吸烟者(4例肺癌患者,1例肺真菌瘤患者)、5名已戒烟者(除1例间皮瘤患者外均为肺癌患者)和14名吸烟者(9例肺癌患者,5例肺气肿患者)获取无癌症或炎性病变的肺实质组织。同时也从肺癌患者体内采集癌组织。通过酶联免疫吸附测定法测量组织匀浆中的CEA蛋白。使用CEA特异性核糖探针通过原位杂交评估非癌实质组织和癌组织中CEA mRNA的表达,并通过计算每个细胞的银粒数量进行半定量分析。在体外分别用暴露于香烟烟雾或空气的培养基刺激人胎儿肺来源的三种细胞系(IMR - 90、MRC - 9和CCD - 14Br)后,比较CEA mRNA的表达。还在体外研究了纯化的CEA对中性粒细胞和单核细胞的趋化活性。
与非吸烟者(11.0(5.4)ng/mg蛋白质)或已戒烟者(5.9(2.2))相比,患有肺气肿的吸烟者(平均(标准差)38.0(9.2)ng/mg蛋白质)或肺癌患者(38.2(21.6))的非癌性肺组织中CEA含量增加。以每个细胞的平均银粒数表示,患有肺气肿的吸烟者(平均(标准差)11.2(4.1))或肺癌患者(14.0(8.4))的非癌性组织中CEA mRNA表达也高于非吸烟者(3.1(0.6))或已戒烟者(4.0(1.7))。非吸烟者癌组织中的CEA含量为42.8(37.3),已戒烟者为38.2(42.4),吸烟者为59.0(22.5)。癌组织中的CEA含量高于非癌组织,但非吸烟者、已戒烟者和吸烟者之间无差异。癌组织中每个细胞的银粒数高于非癌组织,但非吸烟者(30.3(3.9))、已戒烟者(38.3(13.8))和吸烟者(44.3(5.2))之间无差异。用烟雾处理过的培养基孵育后,细胞系中的CEA mRNA表达上调。纯化的CEA在体外对中性粒细胞有趋化作用,但对单核细胞无趋化作用。
与非吸烟者或已戒烟者相比,吸烟者正常肺组织中CEA的mRNA和蛋白表达增加。由于非小细胞肺癌吸烟者和非癌性疾病吸烟者的CEA含量和mRNA表达无差异,非癌性肺实质组织中CEA的表达不太可能受肿瘤存在的影响,这与吸烟的作用一致。体外研究表明香烟烟雾可诱导胎儿肺来源细胞中CEA mRNA表达,支持了这一观点。此外,CEA可能在中性粒细胞募集到下呼吸道过程中起作用。