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PrPC-induced drug resistance in gastric cancer cellsJie Liang*, Fulin Ge*, Changcun Guo, Guanhong Luo, Xin Wang, Guohong Han, Dexin Zhang, Jianhong Wang, Kai Li, Yanglin Pan, Liping Yao,

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PrPC-induced drug resistance in gastric cancer cells

Jie Liang*, Fulin Ge*, Changcun Guo, Guanhong Luo, Xin Wang, Guohong Han, Dexin Zhang, Jianhong Wang, Kai Li, Yanglin Pan, Liping Yao, Zhanxin Yin, Xuegang Guo, Kaichun Wu, Jie Ding and Daiming Fan

State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, Shaanxi, China

Cellular prion protein (PrPC) is a ubiquitous

glyco-protein that is localized at the cell surface via a

glycosyl-phosphatidylinositol-anchored membrane

pro-tein, whose pathogenic isoform, PrPSc, has attracted

worldwide attention due to its involvement in the

path-ogenesis of bovine spongiform encephalopathy and

Creutzfeldt–Jakob disease in human beings [1] PrPCis

highly conserved in mammalian species, and has

been postulated to be involved in one or more of the

following activities: neurotransmitter metabolism, cell adhesion, signal transduction, antioxidant activity and programmed cell death [2] However, the exact biologi-cal function of normal PrPCis still unknown [3]

In our previous studies, PrPC was identified as an upregulated gene in the adriamycin (ADR)-resistant gastric carcinoma cell line SGC7901/ADR compared

to its parental cell line SGC7901 by subtractive hybrid-ization and RT-PCR [4] PrPCwas further found to be

Keywords

drug resistance; gastric cancer; P-gp;

PI3K/Akt; prion protein

Correspondence

J Ding, State Key Laboratory of Cancer

Biology and Xijing Hospital of Digestive

Diseases, Fourth Military Medical University,

Xi’an 710032, China

Fax: +86 29 82539041

Tel: +86 29 84771504

E-mail: dingjie@fmmu.edu.cn

D Fan, State Key Laboratory of Cancer

Biology and Xijing Hospital of Digestive

Diseases, Fourth Military Medical University,

Xi’an 710032, China

Fax: +86 29 82539041

Tel: +86 29 84775221

E-mail: fandaim@fmmu.edu.cn

*These authors contributed equally to this

work

(Received 1 October 2008, revised 16

November 2008, accepted 24 November

2008)

doi:10.1111/j.1742-4658.2008.06816.x

Cellular prion protein (PrPC), a glycosyl-phosphatidylinositol-anchored membrane protein with unclear physiological function, was previous found

to be upregulated in adriamycin (ADR)-resistant gastric carcinoma cell line SGC7901/ADR compared to its parental cell line SGC7901 Overexpres-sion of PrPC in gastric cancer has certain effects on drug accumulation through upregulation of P-glycoprotein (P-gp), which is suggested to play

an important role in determining the sensitivity of tumor cells to chemo-therapy and is linked to activation of the phosphatidylinositol-3-kinase/Akt (PI3K/Akt) pathway In the present study, we further investigate the role

of the PI3K/Akt pathway in PrPC-induced multidrug-resistance (MDR) in gastric cancer Immunohistochemistry and confocal microscope detection suggest a positive correlation between PrPC and phosphorylated Akt (p-Akt) expression in gastric cancer Using established stable PrPC transfec-tant cell lines, we demonstrated that the level of p-Akt was increased in PrPC-transfected cells Inhibition of PrPC expression by RNA interference resulted in decreased p-Akt expression Inhibition of the PI3K/Akt path-way by one of its specific inhibitors, LY294002, or by Akt small interfering RNA (siRNA) resulted in decreased multidrug resistance of SGC7901 cells, partly through downregulation of P-gp induced by PrPC Taken together, our results suggest that PrPC-induced MDR in gastric cancer is associated with activation of the PI3K/Akt pathway Inhibition of PI3K/Akt by LY2940002 or Akt siRNA leads to inhibition of PrPC-induced drug resis-tance and P-gp upregulation in gastric cancer cells, indicating a possible novel mechanism by which PrPCregulates gastric cancer cell survival

Abbreviations

ADR, adriamycin; IR, immunoreactivity; MDR, multidrug-resistance; MTT, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide; P-gp, P-glycoprotein; PI3K/Akt, phosphatidylinositol-3-kinase/Akt; PrP C , cellular prion protein; siRNA, small interfering RNA; VCR, vincristine.

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highly expressed in the gastric cancer cell lines

SGC7901/ADR and SGC7901/VCR Its

overexpres-sion played a certain role in drug accumulation in

gastric cancer cells, which could induce drug resistance

in SGC7901 cells by decreasing accumulation and

increasing release of these drugs (ADR and VCR) [5]

PrPC-mediated multidrug resistance (MDR) was

thought to be related to upregulation of P-glycoprotein

(P-gp) [6] and inhibition of apoptosis [6–9]; these

stud-ies were the first reports that PrPC can induce the

MDR phenotype in gastric cancer cells

Activation of the phosphatidylinositol-3-kinase/Akt

(PI3K/Akt) pathway is a critical step in determining

the sensitivity of tumor cells to chemotherapy [10]

A previous study demonstrated that MDR in gastric

cancer could be reversed by downregulation of Akt1

by Akt1 small interfering RNA (siRNA) [11] Other

studies strongly suggested that the PI3K/Akt

path-way is involved in certain functions of PrP [12,13]

Some differentially expressed genes involved in the

PI3K/Akt pathway were found to be overexpressed

in breast cancer cell line MCF7, together with

17-fold upregulation of PrP [14]

In present study, we hypothesized that the PI3K/Akt

pathway is involved in PrPC-mediated MDR in gastric

cancer To test this hypothesis, the expression of Akt

and PrPCwas examined by immunohistochemistry and

confocal microscope in human gastric cancer cases and

cell lines Expression of total and p-Akt was detected in

cells transfected with PrPC The effects of PI3K/Akt on

PrPC-induced MDR in gastric cancer were then

exam-ined by a drug sensitivity assay that involved adding the

PI3K/Akt-specific inhibitor LY294002 or

co-transfec-tion with Akt siRNA The underlying mechanisms were

further explored by RT-PCR, Western blotting and the

luciferase reporter assay

Results

Co-expression of PrPCand Akt in gastric cancer

Immunohistochemical staining showed that PrPC was

expressed in the cytoplasm of neoplastic cells in 70.6%

(60/85) of gastric cancer tissues Although PrPC also

showed expression in adjacent nontumor gastric tissue,

this was significantly lower than in gastric cancer cells

(P < 0.05) Phosphorylated Akt (p-Akt)

immuno-reactivity was observed in 88.2% (75/85) of gastric

cancer tissues, with positive signals mainly in the

cyto-plasm of neoplastic cells As PrPC and p-Akt

expres-sion coexisted in gastric cancer tissues, we analyzed

their correlation in 60 cases of PrPC-positive gastric

cancer tissues Spearman analysis showed that there

was a significant correlation between PrPC and p-Akt immunoreactivity, with rs = 0.514, P < 0.01 (Fig 1A) The correlation of p-Akt with PrPC in gastric cancer tissues suggests possible co-expression

To test this hypothesis, PrPC and p-Akt were co-expressed in SGC7901/ADR cells The yellow stain-ing in dual-labelstain-ing experiments indicated overlappstain-ing areas of red and green fluorescence, suggesting co-expression of p-Akt with PrPCin the cytoplasm of SGC7901/ADR cells (Fig 1B) These results suggested

a positive correlation between PrPCand p-Akt expres-sion in gastric cancer

Induced activation of p-Akt in PrPC-transfected cells

Our previous work has shown that PrPC expression was detected in several different histological types of human gastric cancer cell lines, and is relatively low in SGC7901 cells and high in AGS To upregulate or downregulate PrPC expression, the PRNP gene was stably transfected into human gastric cancer cells of line SGC7901 or blocked by siRNA in AGS After cell transfection and antibiotic screening for more than

2 months, multiple resistance clones were selected, and expression of PrPCin the cells was confirmed by Wes-tern blotting (Fig 2A) As close correlation of p-Akt with PrPCwas found in gastric cancer tissues, we won-dered whether PrPC could regulate the expression of Akt in transfected cells As shown in Fig 2B, there was higher expression of the phosphorylated form of Akt (Thr308) in SGC7901 transfected with PrPC (SGC7901/PrPC) than in SGC7901 transfected with empty pcDNA3.1B (SGC7901/pcDNA3.1B) or non-transfected SGC7901, which did not affect the expres-sion of total Akt As the siRNA affected translation but not post-translational events, both the total and phosphorylated Akt levels decreased in AGS/PrPC (RNAi) These results indicate that alteration of PrPC expression led to a corresponding change in the PI3K/ Akt pathway in gastric cancer cells lines, and con-firmed that PrPC regulates the expression of p-Akt

in vitro, consistent with the above in vivo findings

PI3K/Akt is involved in PrPC-mediated MDR in gastric cancer

In order to study whether activation of the PI3K/Akt signaling pathway played a role in PrPC-induced MDR

in gastric cancer cells, the PrPC-overexpressing cell line and the corresponding controls were treated with LY294002, a selective inhibitor of PI3K, or by co-transfection with Akt siRNA [13] The in vitro

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effects of the anticancer drugs on the growth of

SGC7901/PrPC, SGC7901/pcDNA3.1B and SGC7901

were evaluated by the

3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay As

shown in Table 1, in the absence of LY294002 or Akt

siRNA, the control and parental cells showed higher

sensitivity to ADR and VCR than adding LY294002

or Akt siRNA However, the inhibitory rate in cells

transfected with PrPCwas significantly different to that

in control cells (P < 0.05) When the cells were treated

with a high dose of the inhibitor LY294002 (40 lm) or

co-transfected with Akt siRNA (1 lg) for 24 h, the

relative inhibitory rate in SGC7901/PrPC was

decreased to levels similar to the controls because of

their toxicity in cell death (P > 0.05)

The effects of LY294002 on adriamycin

accumula-tion and retenaccumula-tion in SGC7901/PrPCcells were further

determined by flow cytometric analysis The

adria-mycin-releasing index in gastric cancer SGC7901 cells

was calculated as follows: releasing index =

(accumu-lation value) retention value)/accumulation value

The results showed less adriamycin accumulation and

retention in SGC7901/PrPC cells compared with that

in controls When the cells were treated with

LY294002 or co-transfected with Akt siRNA for 24 h,

the accumulation and retention of adriamycin

increased in both cell lines, but was more significant in

SGC7901/PrPC (P < 0.05) The above results

indi-cated a partly dose-dependent effect, but the effect

more significant at concentrations of 10 lm LY294002

or 0.2 lg Akt siRNA The releasing index also decreased more sharply at 10 lm LY294002 or 0.2 lg Akt siRNA in SGC7901/PrPC The highest concentra-tions of LY294002 (40 lm) or Akt siRNA (1 lg) resulted in similar releasing rates to each other because

of their toxicity effect (P > 0.05) (Fig 3) The results indicated that inhibition of the PI3K/Akt signaling pathway leads to inhibition of PrPC-induced cell drug resistance in gastric cancer cells

PI3K/Akt is involved in the activation of P-gp by PrPCin gastric cancer

To further investigate the underlying mechanism of PI3K/Akt-mediated PrPC-induced gastric cancer MDR, the PrPC-overexpressing cell lines (SGC7901/PrPC) and corresponding controls (SGC7901/pcDNA) were trea-ted with LY294002 or Akt siRNA to screen the down-stream molecules PrPC-transfected gastric cancer cells were treated with LY294002 (10 lm) or Akt siRNA (0.2 lg), and exhibited downregulation of P-gp at both the mRNA and protein levels (Fig 4A) Inhibition of the PI3K/Akt pathway decreased the expression of P-gp induced by PrPCat both the mRNA and protein levels, suggesting transcriptional regulation of P-gp by PI3K/ Akt in PrPC-transfected gastric cancer cells Therefore, the promoter sequence of MDR-1 ()136 to 10) was amplified, and the luciferase reporter assay was performed to investigate the transcriptional regulation

of P-gp by PI3K/Akt The luciferase activity of P-gp

A

B

(c)

Fig 1 Co-expression of PrPCand Akt in

gastric cancer (A) Serial sections of gastric

cancer tissue were stained with antibodies

against PrPC(3F4, Sigma) or p-Akt (Thr 308;

Cell Signaling Technology) (a) Gastric

can-cer tissue stained with anti-p-Akt (Thr 308).

(b) Gastric cancer tissue stained with

anti-PrP C (c) Negative control (original

magnifica-tion, ·200) (B) Co-expression of PrP C with

p-Akt in SGC7901/ADR cells (a) Confocal

microscopic imaging of p-Akt, stained with

monoclonal antibody against p-Akt and

FITC-conjugated goat anti-mouse IgG (green) (b)

Confocal microscopic imaging of PrPC,

stained with polyclonal antibody against PrP

(Santa Cruz Biotechnology) and tetraethyl

rhodamine isothiocyanate-labeled rabbit

anti-goat IgG (red) (c) Co-expression of p-Akt

with PrP C results in yellow staining (d)

Co-expression of p-Akt with PrPC, with

nuclear staining by

4¢,6-diamidino-2-phenylin-dole (DAPI) (blue) (original magnification,

·400).

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promoter in gastric cancer cells decreased with or

with-out PrPC transfection by adding LY294002 or

co-transfection with Akt siRNA However, SGC7901

transfected with PrPC showed significantly decreased P-gp promoter activity compared with the control cells (SGC7901/pcDNA and SGC7901 cells) after addition

of LY294002 or co-transfection with Akt siRNA (Fig 4B) PI3K/Akt might therefore be involved in transcriptional activation of P-gp in gastric cancer cells transfected with PrPC Inhibition of the PI3K/Akt path-way by its specific inhibitor or Akt siRNA could reverse the PrPC-induced MDR effect, partly through decreas-ing transcriptional activation of P-gp

Discussion

In the present study, we present the first evidence that PI3K/Akt may be involved in the transcriptional acti-vation of P-gp in gastric cancer cells transfected with PrPC Inhibition of the PI3K/Akt pathway by its spe-cific inhibitor or Akt siRNA reverses PrPC-induced MDR in gastric cancer cells, partly by decreasing the transcriptional activation of P-gp Continuing from our previous work, it further reveals the function of PrPCin the MDR of cancers

Over recent years, many investigations have focused

on the physiological and pathological processes of PrPC [3] Recently, PrPC has been reported to play a positive role in MDR of many types of human cancers [15] Levenson et al [16] analyzed cell lines in which MDR had been induced by genetic suppressor ele-ments of cDNA array hybridization, and found that the transcription level of PrPCwas increased Our pre-vious studies had shown that PrPC is ubiquitously expressed in gastric carcinoma cell lines and tissues but

is weakly or not expressed in normal gastric mucosa [6,7,9,13] In vitro and in vivo drug sensitivity assays indicated that PrPC could promote the drug resistance

of a gastric cancer cell line [5] However, little is known about the molecular mechanism involved in this process

A

B

Fig 2 The inducible effect of PrPCon Akt (A) Western blot

analy-sis of the cells transfected with the empty vector or with PrP C

b-actin was used as a loading control (B) Expression of p-Akt and

total Akt were determined in gastric cancer cells by Western blot.

b-actin was used as an internal control Autoradiograms were

quantified by densitometry and p-Akt protein levels were calculated

relative to the amount of b-actin protein.

Table 1 IC50values (lgÆmL)1) for anticancer drugs for gastric cancer cells Survival rates of gastric cancer cells treated with anticancer drugs were evaluated by the MTT assay as described in Experimental procedures Dose–effect curves for the anticancer drugs were plotted

on semi-logarithmic coordinate paper, and IC 50 values were determined Data are means ± SD of three independent experiments.

Cell lines

Adriamycin

SGC7901/PrP C 6.87 ± 0.79 4.12 ± 0.64 2.58 ± 0.34 0.84 ± 0.17 6.87 ± 0.79 4.92 ± 0.74 3.76 ± 0.49 1.39 ± 0.25 SGC7901/pcDNA3.1B 0.43 ± 0.03 0.37 ± 0.05 0.28 ± 0.02 0.20 ± 0.03 0.43 ± 0.03 0.38 ± 0.06 0.30 ± 0.03 0.24 ± 0.04 SGC7901 0.31 ± 0.03 0.29 ± 0.04 0.25 ± 0.03 0.19 ± 0.02 0.31 ± 0.03 0.32 ± 0.05 0.26 ± 0.02 0.22 ± 0.04 Vincristine

SGC7901/PrP C 7.38 ± 0.78 5.21 ± 0.56 2.69 ± 0.38 0.34 ± 0.21 7.38 ± 0.78 5.83 ± 0.59 3.16 ± 0.43 0.83 ± 0.35 SGC7901/pcDNA3.1B 0.24 ± 0.02 0.20 ± 0.03 0.17 ± 0.02 0.09 ± 0.01 0.24 ± 0.02 0.22 ± 0.06 0.18 ± 0.04 0.12 ± 0.03 SGC7901 0.14 ± 0.02 0.12 ± 0.04 0.10 ± 0.03 0.08 ± 0.02 0.14 ± 0.02 0.13 ± 0.05 0.11 ± 0.04 0.09 ± 0.02

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P > 0.05

P < 0.05

P < 0.05

P > 0.05

0.45 0.4 0.35 0.3 0.25 0.2 0.15 0.1 0.05 0

P > 0.05

P < 0.05

P < 0.05

P > 0.05

SGC7901/PrP SGC7901/pcDNA

25 20 30

15 10 5

Fluorescence intensity 0

0 µ M 10 µ M 20 µ M

LY294002

40 µ M

0 µg 0.2 µg 0.4 µg

siRNA of Akt

siRNA of Akt

1 µg

0 µ M 10 µ M 20 µ M

LY294002

40 µ M

25

20

15

10

5

0

P < 0.05

P < 0.05

0.4 0.35 0.3 0.25 0.2 0.15 0.1 0.05 0

P > 0.05

P > 0.05

P < 0.05

P < 0.05

SGC7901/PrP SGC7901/pcDNA

SGC7901/PrP SGC7901/pcDNA

SGC7901/PrP SGC7901/pcDNA

Fig 3 Fluorescence intensity and releasing index of adriamycin in gastric cancer cells Gastric cancer cells were treated with or without LY294002 (10, 20 or 40 lM) or co-transfected with Akt siRNA (0.2, 0.4 or 1 lg) for 24 h Adriamycin was added to cells in log phase to a final concentration of 5 lgÆmL)1 After 1 h, cells were harvested (for detection of adriamycin accumulation) or cultured in drug-free

RPMI-1640 for another 30 min, followed by harvesting (for detection of adriamycin retention) The fluorescence intensity of intracellular adriamycin was determined using flow cytometry with an excitation wavelength of 488 nm and an emission wavelength of 575 nm (A) Fluorescence intensity analysis of intracellular adriamycin in gastric cancer cells (B) Adriamycin releasing index of gastric cancer cells The releasing index = (accumulation value ) retention value)/accumulation value.

Fig 4 PI3K/Akt is involved in the activation of P-gp by PrPCin gastric cancer (A) Expression of P-gp at both the mRNA and protein levels was investigated in PrP C -transfected gastric cancer cells treated with LY294002 (10 lM) or Akt siRNA (0.2 lg) b-actin was used as a loading control Autoradiograms were quantified by densitometry, and gene or protein levels were calculated relative to the amount of b-actin gene

or protein (B) Luciferase reporter assay to determine the regulatory effect of PI3K/Akt on MDR-1 promoter activity in PrPC-transfected cells.

A dual luciferase system was used in this assay The promoter activity was measured in terms of relative luminescence units (RLU), calculated using the following formula: RLU = luminescence intensity of the Firefy luciferase/luminescence intensity of the Renilla luciferase Control, cells co-transfected with empty pcDNA3.1 vector or parental cells SGC7901, pGL-MDR vector and pRL-TK vector; PrP C , cells co-transfected with empty pcDNA3.1B/PrPCvector treated with or without LY294002 (10 lM) or Akt siRNA (0.2 lg), pGL-MDR vector and pRL-TK vector The luciferase activities of each reporter plasmid were measured in triplicate and are expressed as fold inductions after normalization.

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Multidrug resistance (MDR) is one of the major

causes of failure of chemotherapy of human

malignan-cies Studies have shown that cellular drug resistance is

mediated by various mechanisms operating at various

steps in the cytotoxic activity of the drug, from a

decrease of drug accumulation in the cell to abrogation

of apoptosis induced by the chemical substance Often

several different mechanisms were switched on in the

cells, but usually one major mechanism was operating

MDR-1 (ABCB1, P-glycoprotein) is known to

signifi-cantly alter the extent of drug absorption and

excre-tion, which play a key role in the MDR of cancers

[17] Previous studies identified P-gp as an important

molecule in gastric cancer [4–6,18–20] and leukemia

MDR [20]

PI3K/Akt signal transduction pathway has been

reported to be involved in the neuroprotective effect of

humanin on cerebral ischemia/reperfusion injury [21]

Activation of the PI3K/Akt pathway is one of the

critical steps in cell survival and MDR [22] The

present study focuses on whether the PI3K/Akt

path-way contributes to the PrPC-induced MDR phenotype

in gastric cancer cells We show that PrPC and Akt

are co-expressed in gastric carcinoma, and whose

expression was related to MDR in gastric cancer

PrPC-transfected cell lines showed increased expression

of phosphorylated Akt, indicating that PrP may serve

as a positive upstream regulator of PI3K/Akt in gastric

cancer cells By inhibiting the PI3K/Akt pathway using

LY294002 or co-transfection with Akt siRNA, the

drug sensitivity and accumulation in SGC7901/PrPC

cells were significantly increased The results indicate

that inhibition of the PI3K/Akt signaling pathway

may lead to inhibition of the MDR induced by PrPC

in gastric cancer cells

The mechanism underlying PI3K/Akt-mediated

PrPC-induced MDR in gastric cancer was further

inves-tigated PrPC-transfected gastric cancer cell lines and

corresponding controls were treated with LY294002 or

Akt siRNA as described previously [6] PrPC-transfected

cells treated with an inhibitor of Akt exhibited

downre-gulation of P-gp at both the mRNA and protein levels;

this was proven to be due to transcriptional inhibition

of MDR-1 using a luciferase reporter assay Thus the

PI3K/Akt pathway may be involved in transcriptional

activation of P-gp in PrPC-transfected gastric cancer

cells, inhibition of which would reverse gastric cancer

MDR, partly by decreasing the transcriptional

activa-tion of P-gp This model of a PrPC/PI3K/P-gp signal

agrees with other reported findings on prion protein

sig-naling It was found that the Fyn protein governed a

number of the PrPC-induced pathways that converged

to the PI3K module in neurons [23] PI3K is known to

physically associate with Fyn to transducing differen-tiation signals [24] It has also been demonstrated that constitutively activated PI3K enhances activation of the MDR-1 promoter by 2-acetylaminofluorene [25]

In the present study, we report for the first time that activation of PI3K/Akt signaling pathway plays an essential role in PrP-induced MDR in gastric cancer cells Inhibition of the PI3K/Akt signaling pathway by LY2940002 or Akt siRNA leads to inhibition of PrPC -induced cell drug resistance and P-gp upregulation in gastric cancer cells, which indicated a possible novel mechanism by which PrPC regulates gastric cancer cell survival

Experimental procedures

Antibodies and reagents SP-9000 Histostain-Plus kits were obtained from Zhong-shan Goldbridge Biotechnology (Beijing, China) The drugs vincristine (VCR) and adriamycin (ADR) were purchased from Farmitalia Carlo Erba (Milan, Italy) and Minsheng Pharmaceutical Company (Hangzhou, China), respectively The antibodies rabbit anti-human t-Akt, mouse anti-human p-Akt and mouse anti-human P-gp, and the PI3K/Akt-specific inhibitor LY294002 were obtained from Cell Signal-ing Technology (Beverly, MA, USA) Mouse anti-human monoclonal PrPC serum (3F4) was purchased from Sigma (St Louis, MO, USA) and rabbit anti-human polyclonal PrP was purchased from Santa Cruz Biotechnology (Santa Cruz, CA, USA) The Sp1 immunohistochemistry kit and fluorescein isothiocyanate (FITC)-labeled goat anti-rabbit and goat anti-mouse IgG were purchased from Zhongshan Goldbridge Biotechnology (Beijing, China)

Clinical samples Eighty-five gastric carcinoma patients (34 females, 51 males; mean age 56.1 ± 11.5 years; range 29–78 years) were included from a population-based case-controlled study conducted in Xijing Hospital, Xi’an, China Patients whose surgical tissue was used for the study signed informed consent All cases of gastric cancer were clini-cally and pathologiclini-cally proved The protocols used in the study were approved by the hospital’s Protection of Human Subjects Committee Formalin-fixed paraffin-embedded tissue sections were retrieved from archives at the Department of Pathology Demographic and clinico-pathological information was obtained from our popula-tion-based database, and tumor staging was carried out for each case according to the classification at the time of surgery Thirty cases were classified as well-differentiated,

43 as moderately differentiated and 12 as poorly differen-tiated gastric cancers

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Immunohistochemistry analysis

Tissue sections from gastric carcinoma were immunostained

using SP-9000 Histostain-Plus kits The slides were

depa-raffinized, rehydrated, blocked and then primary antibody

was added as described previously [7] Biotinylated goat

anti-mouse IgG was applied to the cell sections, which were

then incubated at room temperature for 30 min After

washing with NaCl/Pifor 10min, the tissues were incubated

with avidin dehydrogenase/biotinylated peroxidase for

30 min Color was developed by immersion of the sections

in a peroxidase substrate diaminobezidin solution

Evaluation of immunostaining

All sections were examined independently by two observers

with respect to the various histopathological characteristics

and specific immunoreactivity (IR) The staining was

semi-quantitatively evaluated by assigning a score for the

inten-sity of the IR and for the proportion of cells positively

stained The intensity of IR (intensity score) was divided

into four categories: 0, no IR; 1, weak IR (+); 2, moderate

IR (++); 3, strong IR (+++) The proportion of

posi-tive cells was classified into five groups: 0, no tumor cells

exhibiting IR; 1, < 25% of the tumor cells exhibiting IR;

2, 25–50% of the tumor cells exhibiting IR; 3, 50–75% of

the tumor cells exhibiting IR; 4, > 75% of the tumor cells

exhibiting IR The overall score was the multiplication of

the two The scores were then classified as negative (score 0

or 1) or positive (score‡ 2)

Cell culture

The human gastric adenocarcinoma cell line SGC7901 was

obtained from Academy of Military Medical Science

(Beij-ing, China) SGC7901/ADR was selected from SGC7901 by

increasing ADR stepwise from 0.01 to 0.8 lgÆmL)1, and

has been characterized previously [26] The cells were

maintained in RPMI-1640 containing 10% heat-inactivated

newborn bovine serum (SiJiQing, Hangzhou China) at 37 C in a humidified atmosphere of 5% CO2and 95% air

Double immunofluorescence staining Double immunostaining for antigen co-localization was per-formed using FITC-conjugated goat anti-mouse IgG (Chem-icon, Billerica, MA, USA; 1 : 80) and tetraethylrhodamine isothiocyanate-labeled rabbit anti-goat IgG (Chemicon,

1 : 100) Cells were nuclear-stained using 4¢,6-diamidino-2-phenylindole (DAPI) The primary antibody combinations consisted of monoclonal antibody against p-Akt and mono-clonal antibody against PrP SGC7901/ADR cells were incu-bated on glass coverslips for 24 h and fixed with 4% paraformaldehyde in NaCl/Pi The fixed cells were stained and examined using a FLUOVIEW FV1000 laser scanning confocal microscope (Olympus, Tokyo, Japan)

Plasmid construction and transfection The target sequences were aligned to the human genome database by a blast search to ensure that the chosen sequences were not highly homologous to those of other genes The primers were designed using primer.5 software (Premier Co., Edmonton, Canada) or the siRNA target finder at https://www.genscript.com/ssl-bin/app/rnai, and are listed in Table 2 siRNAs for PrP, Akt and control were chemically synthesized (Invitrogen, Carlsbad, CA, USA) and the target sequences were as previously reported [5– 7,9,13,15] SGC7901 cells were transfected with the plasmids and maintained in medium supplied with 400 lgÆmL)1of the neomycin analogue G418 (Life Technologies Inc., Gaithers-burg, MD, USA) The expression levels of PrPC in G418-resistant clones were evaluated by Western blot analysis

RNA extraction and semi-quantitative RT-PCR Total RNA was extracted from SGC7901/PrPC and SGC7901/pcDNA, and DNase was used to decrease the

Table 2 Primers for plasmid construction.

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contamination of genomic DNA The PCR primers and

reaction parameters used for MDR-1 amplification are

listed in Table 1 The reaction conditions for PCR of

MDR-1 were as follows: initial denaturation at 94 C for

10 min, and 35 cycles of denaturation at 94 C for 30 s,

annealing at 55 C for 30 s and extension at 72 C for 30 s

on a Touchgene gradient thermal cycler (Techne,

Cam-bridge, UK) Appropriate numbers of cycles were chosen to

ensure completion of PCR amplification before reaching

the stable stage in each reaction Gene expression was

quantified as the relative yield of the PCR product from

target sequences compared to that from the b-actin gene

PCR products were loaded onto a 1.5% agarose gel and

separated electrophoretically The gel was then visualized

under ultraviolet light following ethidium bromide staining

Autoradiograms were quantified by densitometry Relative

RNA levels were calculated relative to the levels for the

b-actin gene

Western blot analysis

Cells in log phase were harvested and washed twice for

10 min with NaCl/Pi, then lyzed in lysis buffer (150 mmolÆ

L)1 Tris/HCl pH 8.0, 50 mmolÆL)1 NaCl, 0.2 mmolÆL)1

EDTA, 0.1 mmolÆL)1 phenylmethanesulfonyl fluoride and

10 gÆL)1 Nonidet P-40) Fifty micrograms of protein from

each cell lysate were separated by 12% SDS–PAGE under

denaturing conditions, and transferred to nitrocellulose

membrane (Amersham, Pittsburgh, PA, USA) The

mem-brane was blocked with 10% non-fat dry milk in NaCl/

Tris-T (20 mm Tris/HCl, 100 mm NaCl, 0.1% Tween-20)

for 2 h at room temperature, probed with the primary

anti-bodies against Akt (1 : 1000), p-Akt (Thr308; 1 : 1000),

P-gp (1 : 1000), and PrPC3F4 (1 : 1000) overnight at 4 C

and subsequently incubated with horseradish

peroxidase-linked secondary antibodies in NaCl/Tris-T (with 5%

non-fat dry milk) Bound antibodies were visualized by

chemiluminescent substrate as described by the

manufac-turer (Zhongshan Goldbridge Biotechnology)

Autoradio-grams were quantified by densitometry Protein levels were

calculated relative to the amount of b-actin protein

In vitro drug sensitivity assay

The P-gp-affecting drugs adriamycin (ADR) and vincristine

(VCR) were both freshly prepared before each experiment

Drug sensitivity was evaluated using the

3-(4,5-dim-ethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT)

assay Cells in the log growth phase were diluted with

200 lL RPMI-1640 supplemented with 100 mLÆL)1

new-born bovine serum, and seeded into 96-well plates (Costar,

New York, NY, USA) at a density of 8· 103

cells/well

After 24 h, the medium was replaced with fresh growth

medium containing various concentrations of drugs and 10,

20 or 40 lm LY294002 or dimethylsulfoxide (solvent

control) After 48 h growth in the presence of drugs, 20 lL MTT reagent (final concentration 5 gÆL)1) was added to each well, the supernatant was discarded after 4 h, and

150 lL dimethylsulfoxide was added to melt the crystals The absorbance of the formazan product was measured using an ELISA reader (Bio-Rad, Hercules, CA, USA) at a wavelength of 492 nm The drug concentration that pro-duced 50% inhibition of growth (IC50) was estimated using relative survival curves The survival rate was calculated as mean A490 of treated wells/mean A490 of untreated wells· 100%, where A490 indicates the absorbance of the solution at 490 nm Finally, dose–effect curves for the anti-cancer drugs were plotted on semi-logarithmic coordinate paper and IC50 values were determined Each study was performed in triplicate and repeated three times

Flow cytometric analysis Cells were cultured in six-well culture plates at 37 C for

24 h, and ADR was added to a final concentration of

5 mgÆL)1 After further culture for 1 h, various concentra-tions of LY294002 (10, 20 or 40 lm) were added and the mixtures were incubated for 1 h Dimethylsulfoxide was used for the negative control Cells were harvested, or cul-tured in drug-free medium for another 30 min and then harvested The harvested cells were suspended in cold NaCl/Pi, and the intracellular adriamycin fluorescence intensity was determined by flow cytometric analysis with excitation and emission wavelengths of 488 and 575 nm, respectively

Luciferase reporter assay The promoter sequence of MDR-1 ()136 to 10) was ampli-fied from the genomic DNA of peripheral blood mono-nuclear cells by PCR [27] The primers used are shown in Table 1 The promoter sequences were then cloned into a pGL3 enhancer vector (Promega, Madison, WI, USA) to construct the reporter vector pGL-MDR SGC7901 cells were passaged into 24-well plates at a density of

5· 105cells/well, and incubated until they reached 90% confluence pcDNA3.1/PrPC or empty pcDNA3.1/V5-his B plasmids were transfected into SGC7901 cells with pGL-MDR using Lipofectamine 2000 reagent (Invitrogen) pRL-TK was used as a control for transfection efficiency Luciferase reporter assays were performed using the dual-luciferase reporter assay system (Promega) according to the manufacturer’s instructions Each experiment was per-formed in triplicate and repeated three times

Statistical analysis Each experiment was repeated at least three times Numerical data are presented as the means ± SD The significance of the difference between means was

Trang 9

deter-mined using Student’s t test The Wilcoxon signed-rank

test was used to evaluate the intensity of IR and the

pro-portion of cells staining positively in the

immunohisto-chemical assay Correlation between two groups was

assessed by Spearman analysis All statistical analyses

were performed using spss11.0 software (SPSS, Chicago,

IL, USA) A P value < 0.05 was considered statistically

significant

Acknowledgements

This study was supported in part by grants from the

Chinese National Foundation of National Sciences

(30572134 and 30872965) and the National Basic

Rsearch Program of China (2009CB521703) We thank

Professor Jie Liu for the pSilencer vector plasmid used

for siRNA construction We are also grateful to Bo

Huang (Department of Biochemistry, Fourth Military

Medical University, Xi’an, Shaanxi, China) for help

with the luciferase activity analyses, Dan Chen

(Department of Microscope, Fourth Military Medical

University, Xi’an, Shaanxi, China) for help with

confo-cal microscope detection, and technicians Taidong

Qiao, Zhen Chen, Baojun Chen and Baohua Song for

their excellent technical assistance

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