Androgen deprivation therapy has been used for decades in the treatment of prostate
cancer (Huggins, 1967). However, although this treatment is initially very effective
in these hormone-dependent cancers, they invariably become hormone-refractory and
metastasise, leading to the death of patients. Recently, Feldman and Feldman (2001)
reviewed possible mechanisms by which prostate cancer can escape androgen deprivation
therapy. While the androgen receptor (AR) is activated by testosterone-induced phosphorylation
in hormone-dependent prostate tumours, hormone-independent growth might be due to
the activation of AR via a phosphorylation event induced by other growth factor receptors,
such as HER1 (EGFR) and HER2 (Her2/neu) (Kwong and Hung, 1998; Yeh et al, 1999). In
addition, several recent studies have linked the IGF-1 receptor pathway to the stimulation
of the androgen-signalling pathway in hormone-refractory prostate cancer (Culig et
al, 1994; Bubendorf et al, 1999). Hormone-independent growth of prostate tumours has
also been associated with biological changes such as mucinous and neuroendocrine differentiation.
Neuroendocrine differentiation has been observed in prostate cancer and has been correlated
with tumoural aggressiveness, short survival and poor response to endocrine therapy
(McWilliam et al, 1997), and was considered to be an early marker of progression toward
hormone independence (Cohen et al, 1991; Di sant’Agnese and Cockett, 1996; Noordzij
et al, 1996). Although true mucinous or colloid prostatic adenocarcinoma, with extensive
mucin production, remains a rare entity (Epstein and Lieberman, 1985; Nagakura et
al, 1986), production of neutral mucin as assessed by immunohistochemistry is found
in up to 55% of prostate carcinomas (Sentinelli, 1993). A total of 19 different mucin
genes (MUC1–MUC4, MUC5B, MUC5AC, MUC6–MUC18) have been identified to date and divided
into two groups: those coding for membranous mucins such as MUC1, MUC3 and MUC4, and
those coding for secreted mucins such as MUC2, MUC5AC, MUC5B and MUC6. Secreted mucins
are glycoproteins constituting the major macromolecular component of mucus, while
membrane-associated mucins contribute to epithelial cell–cell interactions. Their
pattern of expression, especially for the secreted mucins, appears to be relatively
tissue-specific. However, the distribution and type of mucin produced by normal prostatic
tissue and prostatic carcinomas are not well documented (Daher et al, 1990), though
focal mucin production in conventional prostatic adenocarcinomas has been recognised
for many years (Pinder and McMahon, 1990). Mucin expression has also been observed
in a few cases of prostatic intraepithelial neoplasia (PIN) (Sentinelli, 1993).
MUC1, designated also as the CA19.9 marker, is frequently expressed in many types
of cancer (Chu and Chang, 1999), and was found to be highly expressed in normal prostatic
glandular tissue and in prostatic adenocarcinoma (Ho et al, 1993). Its detection in
the blood is a good indicator of the presence and burden of the tumour, but its biological
role in cancer is poorly understood. In a recent study, its expression was detected
in 94% of prostate tumours examined, and the intensity of the cytoplasm staining was
significantly correlated with the tumour grade and stage (Kirschenbaum et al, 1999).
MUC2 is not expressed in any prostatic tissues (Ho et al, 1993), but in the majority
of colon adenocarcinomas, particularly those of colloid type (Hanski et al, 1997).
MUC5AC is highly expressed in normal prostatic glandular tissue (Daher et al, 1990)
and in colon adenocarcinomas (Bara et al, 1991), while MUC4, MUC5B and MUC6 are not
expressed in prostatic glandular tissue.
In this study, we have used a xenograft model of human prostate cancer to explore
the changes in histology and mucin expression patterns occurring during the progression
to hormone independence. PAC120 is a human prostate cancer xenograft obtained by urethral
resection of a recurrent prostate cancer, and direct subcutaneous engraftment into
nude mice (de Pinieux et al, 2001). PAC120 is androgen-responsive, but recurs as hormone-refractory
disease following transplantation in castrated mice. We have compared the hormone-responsive
PAC120 parental tumour with several independently obtained hormone-refractory tumour
variants for their mucinous and neuroendocrine histological components, and analysed
the relationship between these phenotypic changes and the expression of mucins at
the RNA and protein levels.
MATERIALS AND METHODS
Prostate tumour xenografts
All the experiments were realised in vivo and have been carried out with ethical committee
approval, and meet the standards required by the UKCCR guidelines (Workman et al,
1998).
The parental tumour PAC120, a hormone-dependent human prostate cancer xenograft transplantable
into nude mice, was established in our laboratory (de Pinieux et al, 2001). The original
PAC120 tumour appeared 7 months after grafting, and was maintained by serial transplantation
during several passages (p4–p29) by subcutaneous implantation of tumour fragments.
The mean delays between two passages were of 5 months. HIDs are hormone-independent
variants that were obtained in nude mice after surgical castration. PAC120-bearing
mice were castrated when the local tumours reached 250–500 mm3. After a variable latency,
HID tumours started to grow again. Seven HID variants were independently isolated.
The recurrence latencies were 16, 7, 8 months for HID25, HID28, HID33, respectively,
and 12 months for the four later variants HID16, HID19, HID34 and HID35. Delays before
the second passage in precastrated males were between 3 and 6 months. One variant,
HID28, was transplanted into both castrated and uncastrated male mice.
Immunochemical studies
Two PAC120 tumour samples (passages p4 and p20) and the seven HID tumours were removed
from mice and immediately fixed in a 95% ethanol solution for immunohistological studies
of MUC1, MUC2, MUC5AC (Daher et al, 1990), MUC5B and MUC6 expression; this fixation
is known to protect the integrity of mucin epitopes. All tumour samples were screened
for mucin production with alcian blue (pH 2.5) and periodic acid Schiff stains. The
antibodies used for immunohistochemical (IHC) studies, their sources and dilutions
are listed in Table 1
Table 1
Immunoreagents used in the immunohistochemical analysis
Reagent
Source
Dilution
Positive control
Anti-MUC1 (monoclonal H23)
Transgene (Strasbourg, France)
1 : 100
Breast cancer
Anti-MUC1 (monoclonal M8)
A gift from S Gendler (Gendler and Spicer, 1995)
1 : 10
Gastric mucosa
Anti-MUC2 (polyclonal Lum 2–3)
I Carstedt
1 : 1000
Colonic mucosa
Anti-MUC5B (monoclonal EU1)
D Swallow
1 : 10
Bronchial epithelium
Anti-MUC5B (polyclonal Lum 5B-2)
I Carstedt
1 : 1000
Anti-MUC5AC (monoclonal 21M1)
A gift from J Bara (Daher et al, 1990)
1 : 10
Gastric mucosa
Anti-MUC6 (monoclonal F8)
P Real
1 : 10
Gastric mucosa
. Tissues employed as positive controls are indicated in the same table.
Standard immunohistochemistry by avidin–biotin complex (ABC) immunoperoxidase technique
was done as follows. Paraffin-embedded sections, 4-μm thick, were used for light microscopy
examination after haematoxylin–eosin–safran (HES) staining, and for immunohistochemistry.
Immunohistochemical study of MUC1, MUC2, MUC5B, MUC5AC and MUC6 mucin expression was
performed on all tumour samples.
Immunostaining was performed on sections, mounted onto silane coated slides, air dried,
deparaffinised in xylene and rehydrated. Slides were washed three times in phosphate-buffered
saline (PBS, pH 7.4) between each incubation step of the procedures. Endogenous peroxidase
activity was blocked by incubation of samples in 0.3% hydrogen peroxide in methanol
for 30 min. Tissue slides were microwaved in 0.01 M sodium citrate buffer (pH 6) near
boiling for 20 min, and cooled for 30 min in the buffer before incubation with the
primary antibodies. Sections were then incubated with normal serum (1 : 20 in PBS)
for 20 min to block nonspecific serum-binding sites. Primary antibodies were incubated
on tissue sections at room temperature for 1 h. After incubation with a biotinylated
secondary antibody, the immunohistochemical reaction was visualised using ABC (Vectastain
Elite kit, Vector Laboratories, Burlingame, CA, USA) with the chromogen amino-ethylcarbazol
(AEC). Sections were counterstained by Mayer's haematein solution. In each case, appropriate
positive and negative controls were tested simultaneously. Staining intensity was
assessed semiquantitatively as 0 (negative), +(weak to moderate) and ++(strong). The
pattern distribution of staining was focal (F) or diffuse (D).
Detection of mRNA transcripts by reverse transcriptase (RT)–PCR
Xenograft samples were harvested 6–8 weeks after grafting and snap-frozen in liquid
nitrogen for subsequent RNA extraction. RNA was prepared using a commercially available
kit (Trizol, Invitrogen, Gercy Pontoise, France). RNA quality was confirmed by gel
electrophoresis and ethidium bromide staining, or by RNA 6000 Assay (Agilent Technologies
2100 Bioanalyser, Massy, France). Reverse transcription of RNA was performed in a
final volume of 20 μl containing 5 × RT buffer (Invitrogen), 100 mM DTT, 200 ng ml−1
oligodT, 2.5 mM dNTP and 200 units l−1 of reverse transcriptase. The samples were
incubated at 42°C for 1 h, and then kept frozen until use. A measure of 100 ng of
cDNA was used for each PCR reaction. PCR amplification was performed using human tubulin-β2
primers as control, and MUC1, MUC2 and MUC4 primers (Table 2
Table 2
Primers used for the study of mucin genes by RT–PCR
Genes
Primers 5′ → 3′
Position
bp
GENBANK Accession no
MUC1
S:ACTCTGATACTCCTACCACCCTTG
830–853
406
X52228
AS:CACCCAGAACTGTACCTGAACTTA
1235–1212
MUC2
5:CTGCACCAAGACCGTCCTCATG
15291–15312
401
L21998
AS:GCAAGGACTGAACAAAGACTCAGAC
15667–15699
MUC4
S:CGCGGTGGTGGAGGCGTTCTT
3094–3114
596
AJ24246
AS:GAAGAATCCTGACAGCCTTCA
3670–3690
Tubulin-β2
5:CGAAGCTCTCTACGACATT
669–688
489
NM 006088
AS:GAAGGTGGCGGACATTTTTAG
1139–1158
). The thermal cycling conditions comprised 40 cycles at 94°C for 1 min, 60°C for
1 min and 72°C for 1 min.
For real-time RT–PCR, RT of RNA was realised by random priming (cDNA cycle Kit, Invitrogen).
Primers for the MUC1 mRNA were designed with the Primer Express (ABI, Les Ulysses,
France) and ClustalX softwares. We conducted BLASTN searches to confirm the gene specificity
of the nucleotide sequences chosen (Table 3
Table 3
Primers used for the study of MUC1 gene by real-time RT–PCR
Genes
Primers 5′ → 3′
Position
bp
GENBANK Accession no
HPRT
S: GCTTTCCTTGGTCAGGCAGTATAA
523–546
141
NM 000194
AS: AAGGGCATATCCTACAACAAACTT
641–664
MUC1
S: CTTTCTTCCTGCTGCTGCTCCT
22–44
95
NM 002456
AS: AGCCGAAGTCTCCTTTTCTCCA
96–117
). To avoid amplification of contaminating genomic DNA, one of the two primers was
placed across a splice junction. QPCR was performed using the qPCR™ Core Kit for Sybr™
Green I (Eurogentec, Seraing, Belgium) to quantify the MUC1 transcripts. DNAc (50 ng)
was used for each PCR. The thermal cycling conditions comprised an initial denaturation
step at 95°C for 10 min and 45 cycles at 95°C for 15 s and 60°C for 1 min. Experiments
were performed in triplicate for each data point. We quantified HPRT transcripts (human
hypoxanthine phosphoribosyltransferase) as an endogenous RNA control, and each sample
was normalised on the basis of its HPRT content. Biologically significant variations
were defined for genes with a ratio ⩾2.
RESULTS
Histological features of PAC120 and HID tumour xenografts
The histological features of PAC120 xenografts were those of a poorly differentiated,
Gleason score 9 (5+4), conventional prostate adenocarcinoma, without any evidence
of mucus secretion. PAC120 reproduced the morphological and biological characteristics
of the original tumour as published (de Pinieux et al, 2001), with a compact, lobular
pattern and sparse gland lumens (Figure 1A
Figure 1
Histology of human prostate cancer after xenografting, PAC120 and HID variants. (A)
PAC120, compact with glandular differentiation (HES × 200). (B) HID28, a microscopic
pattern similar to that of the PAC120 tumour (HES × 200). (C) HID16, focal neuroendocrine-like
pattern (HES × 200). (D) HID25, a fully mucoid adenocarcinoma (HES × 200).
). During serial transplantation, PAC120 displayed a very stable morphology and histology
(neither mucinous nor neuroendocrine differentiation were observed), and remained
hormone-dependent for 29 passages over 7 years.
Castration of tumour-bearing hosts induced tumour growth arrest, followed by a decrease
in tumour size. Tumours recurred after various prolonged delays, from 7 to 16 months.
The recurrent tumours kept growing upon transplantation into castrated mice, confirming
their hormone independence. Seven hormone-independent variants (HID) were obtained
independently from PAC120. Compared to the parental hormone-dependent PAC120 tumour,
HIDs displayed distinctive histological changes typical of advanced prostate cancer,
such as mucinous, neuroendocrine-like or mixed differentiation features. Several tumours
originating from the same variants were studied. The histological pattern of HID28
(Figure 1B) and HID16 was close to that of PAC120, with few areas exhibiting a neuroendocrine-type
pattern (Figure 1C) or mucinous areas. Growth of HID28 tumours in intact animals did
not alter tumour morphology, although their growth was accelerated (de Pinieux et
al, 2001). HID25 contained principally signet-ring cells (Figure 1D), while HID33
was mucinous. HID19 consisted of a clear-cut juxtaposition of areas of compact poorly
differentiated carcinoma and mucinous adenocarcinoma. In HID19, the less-differentiated
tumoural component showed pleiomorphic tumour cells arranged in large sheets, without
glandular differentiation. HID34 and HID35 tumours exhibited focal areas, with a morphological
pattern associating neuroendocrine-type with mucinous areas. The histological patterns
of these different tumour variants are summarised in Table 4
Table 4
Expression patterns of mucins in xenografts of PAC120 prostate adenocarcinoma and
of its HID variants (Immunohistochemistry detection)
Tumours
Histological pattern
MUC1
MUC2
MUC5AC
MUC5B
MUC6
PAC120
Compact area
++a
,
c
+b
,
c
+b
,
c
0
0
Mixedd
HID16
Compact area
++a
,
c
+b
,
c
0
0
0
Neuroendocrine area
++a
,
c
0
0
0
0
Mixed:
HID28
Compact area
+b
,
e
+b
,
e
0
+b
,
e
0
Neuroendocrine area
0
++f
,
g
0
+g
++g
HID25
Mucinous area
+a
,
e
++f
,
g
0
+g
++g
HID33
Mucinous area
++a
,
c
+b
,
c
0
0
0
Mixed:
HID19
Compact area
++a
,
c
0
0
0
0
Mucinous area
+a
,
e
++f
,
g
0
+g
++g
HID34
Mixed:
HID35
Neuroendocrine area
++a
,
c
0
0
0
0
Mucinous area
0
++f
,
g
0
+g
++g
Staining intensity: 0: negative; +: low to moderate; ++: strong. Immunostaining:
a
focal
b
on rare cells;
c
cytoplasmic;
d
tumour samples exhibiting different patterns of differentiation with or without testosterone
support;
e
membranous;
f
signet-ring cells;
g
extracellular mucin lakes.
. Four of the seven HID variants presented a dominant neuroendocrine differentiation
and five a dominant mucinous phenotype. In all cases, the mucinous tumours contained
signet-ring cells, extracellular mucin lakes (colloid carcinoma areas) and glandular
structures delimited by a layer of mucin-secreting tumour cells. Intra- and extracellular
mucin stained positively for alcian blue pH 2.5 (Figure 2A
Figure 2
Expression patterns of different mucins in xenografts PAC120 and HID variants by immunohistochemistry.
(A) Alcian blue pH 2.5 in HID-19: signet-ring cells staining positively (HES × 400)
(B) MUC1 expression in PAC120: cytoplasmic immunostaining in a fraction of the tumour
cells (HES × 400). (C) MUC1 expression in HID25: scattered tumour cells staining positively
for MUC1 with a cytoplasmic pattern (HES × 400). (D) MUC2 expression in PAC120 p4:
rare tumour cells exhibiting cytoplasmic staining (HES × 400). (E) MUC2 expression
in HID16: rare tumour cells exhibiting cytoplasmic staining (HES × 100). (F) MUC2
expression in HID25: uniform and strong intracytoplasmic positivity of signet-ring
cells (HES × 100). (G) MUC6 expression in HID35, mucinous areas: strong staining of
extracellular mucin lakes (HES × 100). (H) MUC5B expression in HID19, mucinous areas:
strong staining of extra cellular mucin lakes (HES × 100).
) and periodic acid Schiff.
Immunohistochemical detection of mucins
MUC1 was detected in PAC120 tumours, the anti-MUC1 antibody staining focally the cytoplasm
of 10–20% of tumour cells (Figure 2B). The anti-MUC2 and anti-MUC5AC antibodies stained
the cytoplasm of very few tumour cells in the compact areas (data not shown). Anti-MUC5B
and anti-MUC6 antibodies did not stain PAC120 tumours (data not shown). It should
be emphasised that staining of mucins by the selected antibodies was strictly dependent
on the tissue-fixation method, as we used a 95% ethanol solution, a technical published
by one of us (Daher et al, 1990).
In the HID variants, MUC1 was expressed focally with cytoplasm positivity in HID16,
HID19, HID33, or membrane positivity in HID19, HID25, HID28, and in the neuroendocrine-type
tumour foci of HID16, HID34 and HID35. MUC1 immunoreactivity was observed at the apex
of occasional tumour cells delimiting mucosecreting glandular tubes in HID25 (Figure
2C) and in HID19 tumours. MUC1 and MUC2 mucins were not simultaneously expressed in
tumour cells. Anti-MUC2 antibodies stained rare tumour cells in PAC120 p4 (Figure
2D) and in HID16 (Figure 2E), HID28 and HID33, while signet-ring cells were uniformly
stained in HID25 (Figure 2F) and in the other HID variants. Extracellular mucin lakes
were strongly stained by the anti-MUC2 and anti-MUC6 antibodies (Figure 2G), and weakly
by the anti-MUC5B antibodies (Figure 2H). MUC5AC mucin was not expressed in the HID
xenografts. There was no significant modification in mucin expression between HID28
tumours with or without testosterone supply. Colorectal mucosa was used as positive
controls for MUC2, gastric mucosa for MUC1, MUC5AC, MUC6 and bronchial mucosa for
MUC5B (Table 1). MUC2 was not detected in normal prostate tissue, except in cells
derived from the duct utriculum (data not shown). The immunohistochemical localisation
of different mucins is reported in Table 4.
Evaluation of mRNA transcript levels by RT–PCR
Evaluation of the expression of the mucin genes at the RNA level was done in the same
samples that were used for immunohistochemistry, and in samples derived from successive
transplantations. Expression of the different mucins was investigated by semiquantitative
RT–PCR using oligonucleotides specific for human MUC1, MUC2 and MUC4 (Figure 3A
Figure 3
RT–PCR analysis of mucin genes expression in PAC120 and HID variants. (A) mRNA transcripts
of human MUC1, MUC2 and tubulin-β2 genes by RT–PCR. mRNA was extracted from hormone-dependent
and -independent tumours. Products of RT–PCR of PAC120, HID variants and normal prostate
tissue were deposited successively. (B) Expression of MUC1 transcripts by real-time
PCR into the different samples, compared to HPRT gene. Products of RT–PCR of PAC120
and HID variants were deposited successively.
). Expression of tubulin-β2 was used as endogenous control. The MUC1 transcript was
detected at low levels in HID16, HID19, HID33 and HID35 and at higher levels in the
other variants, while MUC2 was expressed at high levels in PAC120 and in all HID variants.
No MUC4 expression was detected, while a small-cell lung tumour (SCLC-6) used as control
was positive. MUC1 mRNA expression was also assessed by real-time RT–PCR, using HPRT
as the reference gene against which MUC1 mRNA levels were normalised (Figure 3B).
Again, MUC1 expression was moderate to high in hormone-dependent xenografts, and variable
in hormone-independent prostate xenografts, according to the semiquantitative RT–PCR
results. Analysis of real-time PCR data showed that MUC1 expression decreased when
HID28 grew in intact animals, that is, with testosterone support.
DISCUSSION
Tumour escape from hormone deprivation therapy is a major obstacle in the clinical
management of prostate cancer. However, the biological basis of the acquisition of
hormone independence by these tumours is still poorly understood. This is in part
due to the difficulty in obtaining clinical samples at the various stages of prostate
tumour progression, and also to the fact that only a few experimental systems are
amenable to the study of prostate cancer hormonal escape (Nagabhushan et al, 1996).
PAC120 is a hormone-dependent poorly differentiated prostate adenocarcinoma xenograft
that displayed no major morphological changes along successive transplantations (passages
p4–p29), and from which several distinct HID variants have been obtained in vivo (de
Pinieux et al, 2001). It is noteworthy that the hormone-dependent phenotype of PAC120
was consistently maintained for 7 years. Morphological changes appeared as a consequence
of hormonal escape after surgical castration. HID tumour variants presented three
different phenotypes: neuroendocrine, mucinous or mixed. The neuroendocrine type was
characterised by tumour cells arranged in large tumoural cords intermingled in a conjunctiva-vascular
stroma. The mucinous differentiation associates glandular structures delimited by
a layer of mucin-secreting tumour cells, extracellular mucin lakes and independent
signet-ring cells. In HID variants, the neuroendocrine tumours presenting a variable
contingent of neuroendocrine areas (four out of seven) and the mucinous variants (five
out of seven) were frequent and stable during successive passages. Some variants presented
as poorly differentiated adenocarcinomas, as observed in the parental PAC120 tumour.
The significance of these morphological changes remains unknown, though they must
be somehow related to tissue suffering and survival as a consequence of hormone deprivation.
Neuroendocrine and mucinous differentiation appeared in almost all HID variants, with
a predominance of one phenotype but frequently mixed, as if a superior degree of tumour
heterogeneity was reached by HID in the course of hormonal escape. In the present
study, we focused on the analysis of the changes in the mucin expression pattern associated
with the acquisition of hormone independence. Mucinous differentiation in adenocarcinomas
is recognised as characteristic of advanced tumoural stage, especially in prostate
and breast cancers. Production of focal mucus, detected by histochemistry, was observed
in 43–61% of prostatic adenocarcinomas (Ro et al, 1988; Pinder and McMahon, 1990).
A true mucinous differentiation, involving more than 50% of tumour cells, is rare
and is a marker of poor prognosis (Pinder and McMahon, 1990). In colon and breast
adenocarcinomas, expression of mucins was also associated with a low survival rate
(Nakamori et al, 1994; McGuckin et al, 1995). Mucin expression may contribute to cancer
cell survival during tumour progression and hypoxic conditions found at advanced tumour
stages. Although mucinous differentiation has been observed in patients with advanced
stage prostate cancer (Ro et al, 1988; Pinder and McMahon, 1990), this was the first
observation of such changes being directly related to hormone deprivation and the
acquisition of hormone independence.
Human mucin genes constitute a family of 19 glycoproteins, which can be divided into
two groups: membrane-bound mucins (MUC1, MUC3 and MUC4) and secreted mucins (MUC2,
MUC5AC, MUC5B and MUC6). The expression profile of mucins differs according to the
glandular tissue type. Mucins are encoded by genes located on distinct chromosomes;
MUC1, MUC3, MUC4, MUC7, MUC8 are located on chromosome 1, 7, 3, 4, 12, respectively,
while MUC2, MUC5AC, MUC5B, MUC6 are clustered in chromosome 11p15. Expression of membrane-bound
mucins MUC1 and MUC4 was analysed in our model. MUC1 mRNA was detected in PAC120 xenografts,
although at variable levels and regardless of the morphological pattern. By immunohistochemistry,
the expression profile of MUC1 in the hormone-independent poorly differentiated, neuroendocrine
and mucosecreting subtypes was similar to that of hormone-dependent tumours. A focal
and intracytoplasmic MUC1 immunostaining was observed in 10–20% of tumour cells. There
was no quantitative relationship between the MUC1 mRNA and protein expression level.
A hypothesis was that HID cells displayed an adaptation to the environmental conditions,
which implicated the activation of some genes necessary to their survival during hormonal
escape. MUC1 expression was found in most adenocarcinomas of the breast, lung, stomach,
pancreas, prostate and ovary (Ho et al, 1993), and a diffuse cytoplasm MUC1 immunostaining
was associated with a high Gleason score (Kirschenbaum et al, 1999). MUC4 mRNA, which
was expressed in various epithelial tissues, was not expressed in PAC120. MUC4 was
expressed particularly in lung carcinomas (Copin et al, 2001) and, interestingly,
it was proposed as a ligand for HER2 (Moniaux et al, 1999; Carraway et al, 2002),
a growth factor receptor of the tyrosine kinase family, putatively implicated in hormonal
escape of breast and prostate cancers. Thus, in the present study, these membrane-bound
mucins do not seem to be involved in the acquisition of hormone independence, since
MUC4 was not expressed and MUC1 expression was not associated with any particular
morphological pattern.
Actually, the biological role of MUC1 is unclear. It was suggested that MUC1, a mucin
detected in an important proportion of prostate cancers (Kirschenbaum et al, 1999),
was associated with a decrease of cell to cell (Ligtenberg et al, 1992) or cell to
extracellular matrix (van de Wiel-van Kemenade et al, 1993; Wesseling et al, 1996)
interactions, by masking cellular adhesion molecules. In addition, the cytoplasmic
domain of MUC1 is involved in signalling pathways through its interaction with β-catenin
(Li et al, 1998; Carraway et al, 2002), this interaction being dependent on their
phosphorylation by the glycogen synthase kinase 3β (GSK3β) (Li et al, 1998; Pignatelli,
1998; Lickert et al, 2000). The variations of phosphorylation might induce variations
of β-catenin affinity for its substrates and therefore its nuclear transfer. β-catenin
significantly enhances androgen-stimulated transcriptional activation by the AR. The
coimmunoprecipitation of β-catenin with AR from LnCaP cells showed that the two molecules
are present in the same complex, this binding being dependent on androgen (Truica
et al, 2000).
Regarding secreted mucins, MUC2 epitopes were not expressed in normal prostatic tissue
(Ho et al, 1993) except near the utriculum, but were expressed in prostate cancer.
Although the mRNA of MUC2 was expressed at constant levels in PAC120 and HID tumours,
a variable expression of the MUC2 protein was observed. While only a few tumour cells
of PAC120 expressed MUC2, the HID variants contained much more cells staining positive
for MUC2. Such a discrepancy between mRNA and protein levels suggests that MUC2 expression
is subject to differential post-transcriptional regulation in hormone-dependent (HD)
and HID tumours. The mucosecreting tumoural subtypes presented a completely different
pattern of mucin expression, including a high and predominant MUC2 expression. MUC2
expression was characterised by both an intracellular accumulation in signet-ring
cells and an extracellular localisation in mucin lakes. This profile was similar to
that of mucinous or colloid mucinous adenocarcinomas observed in advanced cancers
of various origins, such as the gastrointestinal tract, ovary or breast (Hanski et
al, 1997). This observation suggests that acquisition by tumour cells of a mucinous
phenotype belongs to a pathway of hormonal escape in prostate cancer. Mucosecreting
cells positive for MUC5AC were present in the Cowper's glands and prostatic urethral
epithelium near the utriculum (Daher et al, 1990). Anti-MUC5AC antibodies stained
the cytoplasm of rare cells in PAC120 and did not stain HID variants. MUC5B and MUC6
were detected in the mucin lakes of mucinous differentiated variants. So, these secreted
mucins were independently secreted and expressed in a cell type-specific manner. Overall,
MUC2, MUC5B and MUC6 were associated with mucinous morphology, and were expressed
in HID prostate tumour variants. These three mucins are encoded by genes colocated
in the chromosome 11p15. Their de novo expression seemed to be concomitant, suggesting
either an amplification of this region or a deregulated expression, which lends further
support to the possibility that these mucins are involved in hormonal escape. Mucin
secretion may affect interactions with the extracellular environment, which could
directly or indirectly influence proliferation and/or apoptosis of prostate cancer
cells. Additionally, secreted mucins may directly affect tumour cell behaviour through
interactions with membrane components. Indeed, a recent study revealed the role of
MUC5AC, MUC1 and proteoglycans in the inhibition of E-cadherin function associated
with invasiveness of HT-29 colon adenocarcinoma cell variants (Truant et al, 2003).
We are currently investigating the link between the expression of secreted mucins,
E-cadherin function and perturbations of the androgen receptor signalling pathway
in hormone-independent prostate tumours.
In conclusion, the loss of hormone dependence in this prostate cancer xenograft model
is marked by irreversible histological alterations, mucinous or neuroendocrine, that
are associated with a constant increase in the expression of secretory MUC2, MUC5B
and MUC6, which might participate in an unknown pathway of hormone escape in prostate
cancer. These data point to mucinous differentiation as an important step in the acquisition
of hormone independence in prostate cancer.