Abstract
Purpose
Epithelial to mesenchymal transition (EMT) is pivotal in embryonic development and wound healing, whereas in cancer it inflicts malignancy and drug resistance. The recognition of an EMT-like process in glioma is relatively new and its clinical and therapeutic significance has, as yet, not been fully elucidated. Here, we aimed to delineate the clinical significance of the EMT-like process in glioma and its therapeutic relevance to rabeprazole.
Methods
We investigated the expression profiles of EMT-associated proteins in primary glioma biopsies through Western blotting and immunohistochemistry, and correlated them with various clinicopathological features and data listed in the cancer genome atlas (TCGA). In addition, the anticancer efficacy of rabeprazole and its therapeutic relevance to EMT along with temozolomide chemo-sensitization were assessed using multiple cell-based assays, Western blotting and confocal imaging. For in vivo assessment, we used a stereotaxic C6-rat glioma model.
Results
Expression analysis of EMT-associated proteins in glioma biopsies, in conjunction with clinicopathological and TCGA dataset analyses, revealed non-canonical expression of E/N-cadherin and upregulation of GFAP, vimentin and β-catenin. The increased expression of EMT-associated proteins may attribute to glioma malignancy and a poor patient prognosis. Subsequent in vitro studies revealed that rabeprazole treatment attenuated glioma cell growth and migration, and induced apoptosis. Rabeprazole suppressed EMT by impeding AKT/GSK3β phosphorylation and/or NF-κB signaling and sensitized temozolomide resistance. Additional in vivo studies showed restricted tumor growth and inhibited expression of EMT-associated proteins after rabeprazole treatment.
Conclusions
Our data revealed (i) a clinical association of the EMT-like process with glioma malignancy and a poor survival and (ii) an anticancer and temozolomide sensitizing effect of rabeprazole by repressing EMT.
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Data availability
All data are available in the paper and/or its supplementary files.
Abbreviations
- GBM:
-
Glioblastoma multiforme
- EMT:
-
epithelial to mesenchymal transition
- PPI:
-
Proton pump inhibitor
- NF-κB:
-
Nuclear factor kappa light chain enhancer of activated B cells
- AKT:
-
Protein kinase B
- GSK3β:
-
Glycogen synthase kinase-3β
- TMZ:
-
Temozolomide
References
Q.T. Ostrom, H. Gittleman, J. Xu, C. Kromer, Y. Wolinsky, C. Kruchko, J.S. Barnholtz-Sloan, CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2009–2013. Neuro-Oncology 18 (suppl_5), v1-v75 (2016). https://doi.org/10.1093/neuonc/now207
D. Beier, J.B. Schulz, C.P. Beier, Chemoresistance of glioblastoma cancer stem cells–much more complex than expected. Mol. Cancer. 10, 128 (2011). https://doi.org/10.1186/1476-4598-10-128
F.B. Furnari, T. Fenton, R.M. Bachoo, A. Mukasa, J.M. Stommel, A. Stegh, W.C. Hahn, K.L. Ligon, D.N. Louis, C. Brennan, L. Chin, R.A. DePinho, W.K. Cavenee, Malignant astrocytic glioma: genetics, biology, and paths to treatment. Genes. Dev. 21, 2683–2710 (2007). https://doi.org/10.1101/gad.1596707
Y.P. Ramirez, J.L. Weatherbee, R.T. Wheelhouse, A.H. Ross, Glioblastoma multiforme therapy and mechanisms of resistance. Pharmaceuticals. (Basel). 6(12), 1475–1506 (2013). https://doi.org/10.3390/ph6121475
F. Marcucci, G. Stassi, R. De Maria, Epithelial-mesenchymal transition: a new target in anticancer drug discovery. Nat. Rev. Drug Discov. 15(5), 311–325 (2016). https://doi.org/10.1038/nrd.2015.13
K. Polyak, R.A. Weinberg, Transitions between epithelial and mesenchymal states: acquisition of malignant and stem cell traits. Nat. Rev. Cancer 9, 265–273 (2009). https://doi.org/10.1038/nrc2620
I.C. Iser, M.B. Pereira, G. Lenz, M.R. Wink, The epithelial-to-mesenchymal transition-like process in glioblastoma: an updated systematic review and in silico investigation. Med. Res. Rev. 37, 271–313 (2017). https://doi.org/10.1002/med.21408
R. Mahabir, M. Tanino, A. Elmansuri, L. Wang, T. Kimura, T. Itoh, Y. Ohba, H. Nishihara, H. Shirato, M. Tsuda, S. Tanaka, Sustained elevation of Snail promotes glial-mesenchymal transition after irradiation in malignant glioma. Neuro. Oncol. 16, 671–685 (2014). https://doi.org/10.1093/neuonc/not239
C.L. Tso, P. Shintaku, J. Chen, Q. Liu, J. Liu, Z. Chen, K. Yoshimoto, P.S. Mischel, T.F. Cloughesy, L.M. Liau, S.F. Nelson, Primary glioblastomas express mesenchymal stem-like properties. Mol. Cancer Res. 4, 607–619 (2006). https://doi.org/10.1158/1541-7786.MCR-06-0005
F. Marcucci, M. Bellone, C.A. Caserta, A. Corti, Pushing tumor cells towards a malignant phenotype: stimuli from the microenvironment, intercellular communications and alternative roads. Int. J. Cancer 135, 1265–1276 (2014). https://doi.org/10.1002/ijc.28572
R. Martinez-Zaguilan, E.A. Seftor, R.E. Seftor, Y.W. Chu, R.J. Gillies, M.J. Hendrix, Acidic pH enhances the invasive behavior of human melanoma cells. Clin. Exp. Metastasis 14, 176–186 (1996)
C. Sahlgren, M.V. Gustafsson, S. Jin, L. Poellinger, U. Lendahl, Notch signaling mediates hypoxia-induced tumor cell migration and invasion. Proc. Natl. Acad. Sci. U. S. A. 105, 6392–6397 (2008). https://doi.org/10.1073/pnas.0802047105
S.A. Mikheeva, A.M. Mikheev, A. Petit, R. Beyer, R.G. Oxford, L. Khorasani, J.P. Maxwell, C.A. Glackin, H. Wakimoto, I. Gonzalez-Herrero, I. Sanchez-Garcia, J.R. Silber, P.J. Horner, R.C. Rostomily, TWIST1 promotes invasion through mesenchymal change in human glioblastoma. Mol. Cancer 9, 194 (2010). https://doi.org/10.1186/1476-4598-9-194
M. Priester, E. Copanaki, V. Vafaizadeh, S. Hensel, C. Bernreuther, M. Glatzel, V. Seifert, B. Groner, D. Kogel, J. Weissenberger, STAT3 silencing inhibits glioma single cell infiltration and tumor growth. Neuro. Oncol. 15, 840–852 (2013). https://doi.org/10.1093/neuonc/not025
B.B. Aggarwal, Nuclear factor-kappaB: the enemy within. Cancer Cell 6, 203–208 (2004). https://doi.org/10.1016/j.ccr.2004.09.003
B. Chen, J. Liu, T.T. Ho, X. Ding, Y.Y. Mo, ERK-mediated NF-kappaB activation through ASIC1 in response to acidosis. Oncogenesis 5, e279 (2016). https://doi.org/10.1038/oncsis.2016.81
E.R. Fearon, B. Vogelstein, A genetic model for colorectal tumorigenesis. Cell 61, 759–767 (1990)
R.A. Gatenby, R.J. Gillies, Why do cancers have high aerobic glycolysis? Nat. Rev. Cancer 4, 891–899 (2004). https://doi.org/10.1038/nrc1478
A. Di Cristofori, S. Ferrero, I. Bertolini, G. Gaudioso, M.V. Russo, V. Berno, M. Vanini, M. Locatelli, M. Zavanone, P. Rampini, T. Vaccari, M. Caroli, V. Vaira, The vacuolar H + ATPase is a novel therapeutic target for glioblastoma. Oncotarget 6, 17514–17531 (2015). https://doi.org/10.18632/oncotarget.4239
A.H. Lee, I.F. Tannock, Heterogeneity of intracellular pH and of mechanisms that regulate intracellular pH in populations of cultured cells. Cancer Res. 58, 1901–1908 (1998)
R. Martinez-Zaguilan, N. Raghunand, R.M. Lynch, W. Bellamy, G.M. Martinez, B. Rojas, D. Smith, W.S. Dalton, R.J. Gillies, pH and drug resistance. I. Functional expression of plasmalemmal V-type H+-ATPase in drug-resistant human breast carcinoma cell lines. Biochem. Pharmacol. 57, 1037–1046 (1999)
N. Robertson, C. Potter, A.L. Harris, Role of carbonic anhydrase IX in human tumor cell growth, survival, and invasion. Cancer Res. 64, 6160–6165 (2004). https://doi.org/10.1158/0008-5472.CAN-03-2224
C.A. Stedman, M.L. Barclay, Review article: comparison of the pharmacokinetics, acid suppression and efficacy of proton pump inhibitors. Aliment. Pharmacol. Ther. 14, 963–978 (2000)
A.B. Thomson, M.D. Sauve, N. Kassam, H. Kamitakahara, Safety of the long-term use of proton pump inhibitors. World J. Gastroenterol. 16, 2323–2330 (2010)
J.M. Shin, G. Sachs, Pharmacology of proton pump inhibitors. Curr. Gastroenterol. Rep. 10, 528–534 (2008)
A. Canitano, E. Iessi, E.P. Spugnini, C. Federici, S. Fais, Proton pump inhibitors induce a caspase-independent antitumor effect against human multiple myeloma. Cancer Lett. 376, 278–283 (2016). https://doi.org/10.1016/j.canlet.2016.04.015
T. Song, H.K. Jeon, J.E. Hong, J.J. Choi, T.J. Kim, C.H. Choi, D.S. Bae, B.G. Kim, J.W. Lee, Proton pump inhibition enhances the cytotoxicity of paclitaxel in cervical cancer. Cancer Res. Treat. 49, 595-606 (2017). https://doi.org/10.4143/crt.2016.034
B. Zhang, Y. Yang, X. Shi, W. Liao, M. Chen, A.S. Cheng, H. Yan, C. Fang, S. Zhang, G. Xu, S. Shen, S. Huang, G. Chen, Y. Lv, T. Ling, X. Zhang, L. Wang, Y. Zhuge, X. Zou, Proton pump inhibitor pantoprazole abrogates adriamycin-resistant gastric cancer cell invasiveness via suppression of Akt/GSK-beta/beta-catenin signaling and epithelial-mesenchymal transition. Cancer Lett. 356, 704–712 (2015). https://doi.org/10.1016/j.canlet.2014.10.016
A. Morocutti, M. Merrouche, T. Bjaaland, T. Humphries, M. Mignon, An open-label study of rabeprazole in patients with Zollinger-Ellison syndrome or idiopathic gastric acid hypersecretion. Aliment. Pharmacol. Ther. 24, 1439–1444 (2006). https://doi.org/10.1111/j.1365-2036.2006.03137.x
D. Pantoflickova, G. Dorta, M. Ravic, P. Jornod, A.L. Blum, Acid inhibition on the first day of dosing: comparison of four proton pump inhibitors. Aliment. Pharmacol. Ther. 17, 1507–1514 (2003)
Y.M. Hu, Q. Mei, X.H. Xu, X.P. Hu, N.Z. Hu, J.M. Xu, Pharmacodynamic and kinetic effect of rabeprazole on serum gastrin level in relation to CYP2C19 polymorphism in Chinese Hans. World J. Gastroenterol. 12, 4750–4753 (2006). https://doi.org/10.3748/wjg.v12.i29.4750
M. Gu, Y. Zhang, X. Zhou, H. Ma, H. Yao, F. Ji, Rabeprazole exhibits antiproliferative effects on human gastric cancer cell lines. Oncol. Lett. 8, 1739–1744 (2014). https://doi.org/10.3892/ol.2014.2354
S. Feng, Z. Zheng, L. Feng, L. Yang, Z. Chen, Y. Lin, Y. Gao, Y. Chen, Proton pump inhibitor pantoprazole inhibits the proliferation, selfrenewal and chemoresistance of gastric cancer stem cells via the EMT/betacatenin pathways. Oncol. Rep. 36, 3207–3214 (2016). https://doi.org/10.3892/or.2016.5154
D.N. Louis, H. Ohgaki, O.D. Wiestler, W.K. Cavenee, P.C. Burger, A. Jouvet, B.W. Scheithauer, P. Kleihues, The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114, 97–109 (2007). https://doi.org/10.1007/s00401-007-0243-4
L. Du, C.S. Lyle, T.B. Obey, W.A. Gaarde, J.A. Muir, B.L. Bennett, T.C. Chambers, Inhibition of cell proliferation and cell cycle progression by specific inhibition of basal JNK activity: evidence that mitotic Bcl-2 phosphorylation is JNK-independent. J. Biol. Chem. 279, 11957–11966 (2004). https://doi.org/10.1074/jbc.M304935200
G.R. Sareddy, K. Geeviman, C. Ramulu, P.P. Babu, The nonsteroidal anti-inflammatory drug celecoxib suppresses the growth and induces apoptosis of human glioblastoma cells via the NF-kappaB pathway. J. Neurooncol. 106, 99–109 (2012). https://doi.org/10.1007/s11060-011-0662-x
T. Azzarito, G. Venturi, A. Cesolini, S. Fais, Lansoprazole induces sensitivity to suboptimal doses of paclitaxel in human melanoma. Cancer Lett. 356, 697–703 (2015). https://doi.org/10.1016/j.canlet.2014.10.017
Y.G. Yeung, E.R. Stanley, A solution for stripping antibodies from polyvinylidene fluoride immunoblots for multiple reprobing. Anal. Biochem. 389, 89–91 (2009). https://doi.org/10.1016/j.ab.2009.03.017
H.M. Smilowitz, J. Weissenberger, J. Weis, J.D. Brown, R.J. O’Neill, J.A. Laissue, Orthotopic transplantation of v-src-expressing glioma cell lines into immunocompetent mice: establishment of a new transplantable in vivo model for malignant glioma. J. Neurosurg. 106, 652–659 (2007). https://doi.org/10.3171/jns.2007.106.4.652
G.J. Gage, D.R. Kipke, W. Shain, Whole animal perfusion fixation for rodents. J. Vis. Exp. 30, 3564 (2012). https://doi.org/10.3791/3564
G.R. Sareddy, M. Panigrahi, S. Challa, A. Mahadevan, P.P. Babu, Activation of Wnt/beta-catenin/Tcf signaling pathway in human astrocytomas. Neurochem. Int. 55, 307–317 (2009). https://doi.org/10.1016/j.neuint.2009.03.016
D.S. Chandrashekar, B. Bashel, S.A.H. Balasubramanya, C.J. Creighton, I. Ponce-Rodriguez, B. Chakravarthi, S. Varambally, UALCAN: a portal for facilitating tumor subgroup gene expression and survival analyses. Neoplasia 19, 649–658 (2017). https://doi.org/10.1016/j.neo.2017.05.002
C.W. Li, W. Xia, L. Huo, S.O. Lim, Y. Wu, J.L. Hsu, C.H. Chao, H. Yamaguchi, N.K. Yang, Q. Ding, Y. Wang, Y.J. Lai, A.M. LaBaff, T.J. Wu, B.R. Lin, M.H. Yang, G.N. Hortobagyi, M.C. Hung, Epithelial-mesenchymal transition induced by TNF-alpha requires NF-kappaB-mediated transcriptional upregulation of Twist1. Cancer Res. 72, 1290–1300 (2012). https://doi.org/10.1158/0008-5472.CAN-11-3123
S. Ferrari, F. Perut, F. Fagioli, A. Brach Del Prever, C. Meazza, A. Parafioriti, P. Picci, M. Gambarotti, S. Avnet, N. Baldini, S. Fais, Proton pump inhibitor chemosensitization in human osteosarcoma: from the bench to the patients’ bed. J. Transl. Med. 11, 268 (2013). https://doi.org/10.1186/1479-5876-11-268
C. Happold, P. Roth, W. Wick, N. Schmidt, A.M. Florea, M. Silginer, G. Reifenberger, M. Weller, Distinct molecular mechanisms of acquired resistance to temozolomide in glioblastoma cells. J. Neurochem. 122, 444–455 (2012). https://doi.org/10.1111/j.1471-4159.2012.07781.x
T.C. Chou, Drug combination studies and their synergy quantification using the Chou-Talalay method. Cancer Res. 70, 440–446 (2010). https://doi.org/10.1158/0008-5472.CAN-09-1947
D. Hanahan, R.A. Weinberg, Hallmarks of cancer: the next generation. Cell 144, 646–674 (2011). https://doi.org/10.1016/j.cell.2011.02.013
I.C. Iser, G. Lenz, M.R. Wink, EMT-like process in glioblastomas and reactive astrocytes. Neurochem. Int. 122, 139–143 (2019). https://doi.org/10.1016/j.neuint.2018.11.016
S. Utsuki, Y. Sato, H. Oka, B. Tsuchiya, S. Suzuki, K. Fujii, Relationship between the expression of E-, N-cadherins and beta-catenin and tumor grade in astrocytomas. J. Neurooncol. 57, 187–192 (2002)
M. Yeo, D.K. Kim, Y.B. Kim, T.Y. Oh, J.E. Lee, S.W. Cho, H.C. Kim, K.B. Hahm, Selective induction of apoptosis with proton pump inhibitor in gastric cancer cells. Clin. Cancer Res. 10, 8687–8696 (2004). https://doi.org/10.1158/1078-0432.CCR-04-1065
S. Zhang, Y. Wang, S.J. Li, Lansoprazole induces apoptosis of breast cancer cells through inhibition of intracellular proton extrusion. Biochem. Biophys. Res. Commun. 448, 424–429 (2014). https://doi.org/10.1016/j.bbrc.2014.04.127
K. Geeviman, D. Babu, P. Prakash Babu, Pantoprazole Induces Mitochondrial Apoptosis and Attenuates NF-kappaB Signaling in Glioma Cells. Cell. Mol. Neurobiol. 38(8), 1491–1504 (2018). https://doi.org/10.1007/s10571-018-0623-4
P. Breedveld, J.H. Beijnen, J.H. Schellens, Use of P-glycoprotein and BCRP inhibitors to improve oral bioavailability and CNS penetration of anticancer drugs. Trends Pharmacol. Sci. 27(1), 17–24 (2006). https://doi.org/10.1016/j.tips.2005.11.009
A. De Milito, R. Canese, M.L. Marino, M. Borghi, M. Iero, A. Villa, G. Venturi, F. Lozupone, E. Iessi, M. Logozzi, P. Della Mina, M. Santinami, M. Rodolfo, F. Podo, L. Rivoltini, S. Fais, pH-dependent antitumor activity of proton pump inhibitors against human melanoma is mediated by inhibition of tumor acidity. Int. J. Cancer 127, 207–219 (2010). https://doi.org/10.1002/ijc.25009
R.E. Kast, N. Skuli, G. Karpel-Massler, G. Frosina, T. Ryken, M.E. Halatsch, Blocking epithelial-to-mesenchymal transition in glioblastoma with a sextet of repurposed drugs: the EIS regimen. Oncotarget 8, 60727–60749 (2017). https://doi.org/10.18632/oncotarget.18337
J.P. Thiery, Epithelial-mesenchymal transitions in tumour progression. Nat. Rev. Cancer 2, 442–454 (2002). https://doi.org/10.1038/nrc822
R.E. Bachelder, S.O. Yoon, C. Franci, A.G. de Herreros, A.M. Mercurio, Glycogen synthase kinase-3 is an endogenous inhibitor of Snail transcription: implications for the epithelial-mesenchymal transition. J. Cell Biol. 168, 29–33 (2005). https://doi.org/10.1083/jcb.200409067
Acknowledgements
We thank Dr. Chintal Ramulu for his assistance in the animal experiments.
Funding
The authors acknowledge the financial support of the Department of Science and Technology (DST- India), CSRI (Grant No. SR/CSRI/196/2016), Science & Engineering Research Board (SERB)(Grant No. CRG/2020/005021, and the Department of Biotechnology (DBT-India) (Grant No. BT/PR18168/MED/29/1064/2016. The authors also thank DST- FIST and UGC-SAP of the DoBB. DB thanks the Department of Biotechnology-India for a student fellowship (Award no: DBT/2013/UOH/79). AM acknowledges funding from DST-Women scientist- A (Grant No. SR/WOS-A/CS-31/2019(G)
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DB and PPB made hypothesis. DB, AM and NY performed all cell-based experiments. DB performed the animal experiments. DB, AM, NY, ChYBVK, MP and PPB analyzed the data. Patient samples from the Department of Neurosurgery, Krishna Institute of Medical Sciences (KIMS) were collected and analyzed by DB, ChYBVK and MP. DB and AM wrote the original draft of the manuscript. DB, AM, NY, ChYBVK, MP and PPB critically reviewed the manuscript and approved its submission.
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The Institutional Ethics Committee (IEC) (reference number UH/IEC/2016/180) and Institutional Animal Ethics Committee (IAEC) (reference number UH/IAEC/PPB/2017-I/P7), University of Hyderabad, Hyderabad (500 046) approved all procedures involving human tissue and animal-related experiments.
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Babu, D., Mudiraj, A., Yadav, N. et al. Rabeprazole has efficacy per se and reduces resistance to temozolomide in glioma via EMT inhibition. Cell Oncol. 44, 889–905 (2021). https://doi.org/10.1007/s13402-021-00609-w
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DOI: https://doi.org/10.1007/s13402-021-00609-w