Background
Thyroid carcinomas arising from thyroid follicular cells include papillary thyroid carcinoma (PTC), follicular thyroid carcinoma as well as the less common anaplastic thyroid carcinoma[
1‐
3]. PTC is a well-differentiated, slow growing and treatable tumor. The tumor is usually removed by surgery and treated by iodine 131-radiation therapy, however a few PTC carriers develop recurrences and distant metastases[
4,
5].
To look for genes potentially involved in the neoplastic transformation of the thyroid gland, we conducted a transcriptome microarray screening[
6]. Among the genes highly up-regulated in PTC, we focused on Anterior gradient protein 2 (AGR2). AGR2, also known as hAG-2 or Gob-4, is the human orthologue of the
Xenopus laevis protein XAG-2. In the frog embryo XAG-2 induces cement gland differentiation[
7,
8]. Several studies have shown a significant function for AGR2 in biological pathways including cell migration and transformation[
9,
10]. AGR2 protein is up-regulated in several human carcinomas, including breast, pancreatic, ovarian, lung and prostate ones, and is associated with a metastatic phenotype and poor prognosis[
11‐
16].
AGR2 was found up-regulated in several published PTC microarrays[
17‐
21]. Delys and colleagues produced a list of genes modulated in PTC, by comparing their data sets with two independent PTC microarray data sets, and AGR2 scored as one of the genes commonly up-regulated in PTC[
19].
Over-expression or suppression of AGR2, in different cancer model systems, affects cell proliferation, invasion, survival and metastasis[
9,
10].
Recently, AGR2 has been shown to have structural characteristics of the protein disulfide isomerase (PDI) family, including a carboxyl-terminal endoplasmic reticulum (ER) retention signal (KTEL) and a single thioredoxin-like domain with a CXXS motif[
22]. PDI proteins catalyze formation, reduction, and isomerization of disulfide bonds, thereby facilitating the maturation of proteins in the ER and ensure correct folding and multimerization of proteins[
23,
24].
During tumorigenesis, the high proliferation rate of cancer cells requires increased ER protein folding, assembly, and transport, a condition that can induce ER stress[
25,
26]. Importantly, AGR2 knock out mice showed elevated ER stress[
27]. AGR2 expression is induced by ER stress, and siRNA-mediated knockdown of AGR2 increased ER stress response[
27,
28]. It has been shown that AGR2 exists in monomer/dimer equilibrium and that intermolecular salt bridges involving glutamic acid 60 or cysteine 81 (in the thioredoxin domain of AGR2) stabilize the dimer[
29‐
31]. Importantly, it was demonstrated that dimerization of AGR2 is crucial in mediating the ER stress signaling pathway[
29]. AGR2 localizes in the ER of normal intestinal epithelial cells and is essential for
in vivo production of mucus[
32,
33]. Indeed, AGR2 mediates processing of the intestinal MUC2 through formation of mixed disulfide bonds[
33].
In this work, we analyzed the expression of AGR2 in PTC and its functional role.
Discussion
AGR2 is a protein disulfide isomerase that is over-expressed in several human carcinomas and stimulates cancer cell proliferation, survival, invasion, and metastasis[
9,
10]. In the present study, we demonstrated that AGR2 is over-expressed in PTC. Our data are in agreement with thyroid carcinoma microarray screenings that isolated AGR2 as a gene up-regulated in PTC[
17‐
21].
We investigated the functional role of AGR2 using gain and loss-of-function approaches. Knockdown of AGR2 in PTC cells decreased cell survival, migration and invasion. On the other hand, forced AGR2 expression in non-transformed thyroid Nthy-ori 3–1 cells, resulted in increased cell migration and invasion and protection from ER stress.
Proteins that fail to fold properly are retained in the ER and their accumulation may constitute a form of stress to the cell. Several signaling pathways, collectively known as unfolded protein response (UPR), have evolved to detect the accumulation of misfolded proteins in the ER and activate a cellular response to maintain homeostasis[
25,
26]. As a member of the protein disulfide isomerase family, AGR2 aids protein folding and assembly by catalyzing the formation, reduction, and isomerization of disulfide bonds, thereby stabilizing intermediate conformations during protein maturation in the ER.
Accordingly, here we demonstrated in vitro that AGR2 acts as a disulfide isomerase in Nthy-ori 3–1 cells. By evaluating the aggregation of insulin as a result of reduction of disulfide bonds catalyzed by protein disulfide isomerase, we demonstrated that AGR2 over-expressing cells have an increased disulfide isomerase activity compared to control cells, an increased levels of GSSG and GSH and a decreased level of H2O2.
Further, we showed that wild type AGR2 is dimeric in transfected Nthy-ori 3–1 cells treated with DSS. Interestingly, it was recently demonstrated that dimerization of AGR2 attenuates ER stress-induced cell death through the association with BiP/GRP78[
29‐
31].
Increased expression of the UPR components, including GADD153 has been detected in breast, lung, gastric, and esophageal carcinomas[
38‐
40]. In this context, our hypothesis is that AGR2 is up-regulated by PTC cells to cope with the ER stress. Thus, as shown for other ER resident proteins[
25,
26], increased AGR2 expression in PTC could enhance ER folding capacity and allow cancer cells to cope with increased protein production and secretion[
41,
42].
Methods
Tissue samples
Tumor (n = 39) and normal (n = 25) thyroid tissue samples for immunohistochemical analysis were retrieved from the Pathology Department of the Istituto Pascale, Naples, Italy. In addition, RNA from frozen tissues of 10 PTC cases and 10 normal matched thyroid controls was obtained from the Chernobyl Tissue Bank (
http://www.chernobyltissuebank.com)[
43]. A set of 43 PTC and 15 normal thyroid tissues, also obtained from Chernobyl Tissue Bank, was used in the DNA array study (HG-U133 Plus 2.0, Handkiewicz Junak et al., manuscript submitted for publication) carried out in MSC Memorial Cancer Center and Institute of Oncology, Gliwice, Poland. In all cases, the respective Institutional review boards approved the study. The samples were classified according to the diagnostic criteria required for the identification of PTC[
44].
Immunohistochemical staining
Sections of paraffin-embedded samples were stained with hematoxylin and eosin for histological examination[
44]. For immunohistochemistry, 2 μm paraffin sections were deparaffinized and placed in a solution of 0.3% hydrogen peroxide in absolute methanol for 30 minutes and then washed in phosphate buffered saline (PBS) before immunoperoxidase staining. The slides were then incubated overnight at 4°C in a humidified chamber with mouse monoclonal antibody against AGR2 (PO1, Abnova, Taipei City, Taiwan) diluted 1:100 in PBS. The slides were subsequently incubated with biotinylated goat anti-mouse IgG for 20 minutes (Vectostain ABC kits, Vector Laboratories) and then with premixed reagent ABC (Vector) for 20 minutes. The immunostaining was performed by incubating the slides in diaminobenzidine (DAB, DAKO) solution containing 0.06 mM DAB and 2 mM hydrogen peroxide in 0.05% PBS, pH 7.6, for 5 minutes, and after chromogen development, the slides were washed, dehydrated with alcohol and xylene and mounted with coverslips using a permanent mounting medium (Permount). Micrographs were taken on Kodak Ektachrome film with a Zeiss system. Negative controls were performed in each case by incubating tissue slides with secondary antibody only. The expression of AGR2 was categorized as positive (staining of ≥10% of the tumor cells) or negative (staining of < 10% of the tumor cells). The staining intensity was further graded in: score 1 (10-50% of positive cells), score 2 (51-75% of positive cells) and score 3 (76-100% of positive cells). Score values were independently assigned by two blinded investigators (G.C. and M.M.) and a consensus was reached on all scores used for computation.
Cell cultures
Human papillary thyroid cancer cell line TPC-1 was obtained from M. Nagao (Carcinogenesis Division, National Cancer Center Research Institute, Tokyo, Japan) and identified based on the presence of the RET/PTC1 rearrangement. TPC-1 cell line was grown Dulbecco’s modified Eagle’s medium (DMEM) (Invitrogen) supplemented with 10% fetal bovine serum (FBS), L-glutamine and penicillin/streptomycin (Invitrogen). Nthy-ori 3–1 cells are non-transformed human thyrocytes immortalized by the Large T of SV40 and were obtained from the European Tissue Culture collection (Sigma Aldrich, St. Louis, MO, USA). Nthy-ori 3–1 cell line was grown in Roswell Park Memorial Institute (RPMI) 1640 medium supplemented with 10% fetal bovine serum (FBS), L-glutamine and penicillin/streptomycin (Invitrogen, Carlsbad, California, USA).
Reagents
Bortezomib was obtained from Millenium (Cambridge, MA, USA). Human insulin, disuccinimidyl suberate (DSS) and dithiothreitol (DTT) were from Sigma Aldrich (St. Louis, MO, USA). Glutathione reduced and oxidized assay kit was obtained from Bioassay Systems (Hayward, CA, USA).
Cell viability
For cell viability determination, cells were collected by trypsinization stained for 10 minutes with 0.4% trypan-blue (Sigma Aldrich) according to manufacturer’s instructions, and counted in triplicate.
Chemoinvasion
Cell invasion was examined using a reconstituted extracellular matrix (Matrigel, BD Biosciences, San Jose, CA). The cell suspension (1 × 105 cells per well) was added to the upper chamber of transwell cell culture chambers on a prehydrated polycarbonate membrane filter of 8 μm pore size (Costar, Cambridge, MA) coated with 35 μg of Matrigel (BD Biosciences). The lower chamber was filled with 10% medium. After incubation at 37°C, non-migrating cells on the upper side of the filter were wiped-off. Invading cells were mounted on glass slides using mounting medium and stained with Hoechst (Sigma Aldrich). Cell migration was quantified by counting the number of stained nuclei in three individual fields in each transwell membrane, by fluorescence microscopy, in duplicate.
Wound closure assay
A wound was introduced on the confluent monolayer cells using a micropipette tip. Photographs were taken at 40 X magnification using phase-contrast microscopy immediately after wound incision and at selected time-points. Wound closure was measured by calculating pixel densities in the wound area by Cella software (Olympus Biosystem Gmb, Hamburg, Germany) and expressed as percentage of wound closure of triplicate areas ± SD.
RNA silencing
A pool of 4 small inhibitor duplex RNAs (ON-TARGETplus siRNA SMARTpool) targeting human AGR2 (#L-003626-00), and a non-targeting pool (ON-TARGETplus Non-Targeting Pool) control (#D 001810-10-20) were purchased from Dharmacon RNAi Technologies (Dharmacon Inc., Chicago, IL, USA). Cells were grown under standard conditions. TPC-1 cells were plated in 60-mm dishes in complete medium without antibiotics and electroporated using MicroPorator (MP-100, Digital Bio, Euroclone, Milan, Italy) according to the manufacturer’s instructions. Cells were harvested at different time points after transfection, counted and analyzed for protein expression.
Protein studies
Immunoblotting was carried out according to standard procedures. Anti-AGR2 (PO1) monoclonal antibody was from Abnova (Taipei City, Taiwan); anti-GADD153 (B-3, sc-7351) and anti-α-tubulin monoclonal antibody was from Sigma-Aldrich. Secondary anti-mouse and anti-rabbit antibodies coupled to horseradish peroxidase were from Santa Cruz Biotechnology.
Generation of stable AGR2 transfectants
cDNA containing the complete coding sequence of human AGR2 was produced by reverse transcription of RNA from HT29 colon adenocarcinoma cells (American Type Culture Collection, Rockville, MD, USA) using the following primers:
AGR2 Cl For: 5′-ATCCTCGAGCGATCATGGAGAAAATTCCA-3′;
AGR2 Cl Rev: 5′-ATCGGATCCCAATTCAGTCTTCAGCAA-3′ (annealing temperature: 60°C).
AGR2 cDNA was cloned into pcDNA3.1 (named pcDNA) (Invitrogen) by using BamHI and XhoI restriction enzymes and verified by sequencing.
Point mutations in AGR2 that changed the cysteine at position 81 to serine (C → S) and glutamic acid at position 60 to alanine (E → A) were introduced in the pcDNA-AGR2 plasmid by the Stratagene QuikChange site-directed mutagenesis kit (Agilent Technologies, Inc. Life Sciences and Chemical Analysis Group, Santa Clara, CA, USA).
The following oligonucleotides were used:
AGR2 C81S For: 5′- CATCACTTGGATGAGTCCCCACACAGTCAAGC-3′;
AGR2 C81S Rev: 5′-GCTTGACTGTGTGGGGACTCATCCAAGTGATG-3′ (annealing temperature: 55°C).
AGR2 E60A For: 5′- CTGGACTCAGACATATGAAGCAGCTCTATATAAATCCAAGAC-3′;
AGR2 E60A Rev: 5′-GTCTTGGATTTATATAGAGCTGCTTCTTCATATGTGTCCAG-3′ (annealing temperature: 55°C).
The Nthy-ori 3–1 and the TPC-1 cells were transfected with pcDNA-AGR2, AGR2 (C → S), AGR2 (E → A) or the empty vector (pcDNA) using the Lipofectamine Reagent (Invitrogen) according to the instructions of the manufacturer. Two days later, G418 (Invitrogen) was added at concentration of 0.3 mg/ml (Nthy-ori 3–1) or of 1.2 mg/ml (TPC-1). Several clones and mass populations of transfectants were isolated, expanded and screened for AGR2 expression by Western blotting.
Chemical crosslinking
Nthy-ori 3–1 AGR2 transfected cells were treated with 1 mM disuccinimidyl suberate (DSS). Cells were harvested and washed 3 times with ice-cold PBS. The cross-linked cells were incubated for 60 minutes with mild shaking at room temperature, and then quenched by quenching buffer (1 M Tris, pH 7.5) to a final concentration of 10 mM for 15 min at room temperature to stop the chemical reaction. The chemically cross-linked cells were subjected to Western blotting analysis.
Evaluation of GSSG, GSH and H2O2 levels
To measure the oxidized glutathione (GSSG) and reduced glutathione (GSH), the EnzyChrom™ GSH and GSSG Assay Kit (EGTT-100) (Bioassay Systems, Hayward, CA, USA) was used according to manufacturer’s instructions. Intracellular hydrogen peroxide levels were determined using the cell-permeable probe 2′,7′-dichlorodihydrofluorescein diacetate (H2DCFDA) that upon cleavage of the acetate groups by intracellular esterases and oxidation is converted to 2′,7′-dichlorofluorescein (DCF) (Invitrogen, Carlsbad, CA). DCF is a highly fluorescent compound that can be detected by fluorescence spectroscopy using excitation and emission wavelength of 485 nm and 538 nm, respectively. Cells were incubated with H2DCFDA (100 μM) in complete media for 1 hour at 37°C. After that, cells were washed twice in PBS and fluorescence intensity was quantified by microplate reader (Perkin-Elmer Envision 2103 multilabel reader).
Insulin reduction assay
The disulfide isomerase activity was measured by the reduction of disulfide bonds in human insulin in the presence of DTT, giving rise to the aggregation of its β chain, a process that can be followed by turbidimetry[
32]. The assay mixture was prepared in a cuvette by addition of 60 μl of insulin (10 mg/ml) to cell lysates in a buffer containing 100 mM sodium EDTA pH7 and 100 mM sodium phosphate pH 7 to give a final volume of 500 μl. The reaction started with the addition of 2 mM DTT and was followed kinetically by the increase of absorbance at 650 nm, due to insulin β chain precipitation. The absorbance at 650 nm was plotted.
RNA extraction and expression studies
Total RNA was isolated with the RNeasy Kit (Qiagen, Crawley, West Sussex, UK). The quality of the RNAs was verified by the 2100 Bioanalyzer (Agilent Technologies, Waldbronn, Germany); only samples with RNA integrity number (RIN) value > 7 were used for further analysis. One μg of RNA from each sample was reverse-transcribed with the QuantiTect® Reverse Transcription (Qiagen).
Quantitative RT-PCR
Quantitative RT-PCR was applied to study AGR2 expression in PTC samples (n = 10) and normal thyroid control (n = 10). RNA from each sample was reverse-transcribed with the QuantiTect® Reverse Transcription (Qiagen). For quantitative RT-PCR, we used the Human ProbeLibray™ system (Roche). AGR2 and RNA polymerase 2 primers sequences were:
AGR2 For: 5′-CTG GCC AGA GAT ACC ACA GTC-3′;
AGR2 Rev: 5′-AGT TGG TCA CCC CAA CCT C-3′;
RNA pol-For: 5′-GCGATGAGAACAAGATGCAA-3′;
RNA pol-Rev: 5′-CGCAGGAAGACATCATCATC-3′.
PCR reactions were performed in triplicate and fold changes were calculated with the formula: 2-(sample 1 ΔCt - sample 2 ΔCt), where ΔCt is the difference between the amplification fluorescent thresholds of the mRNA of interest and the mRNA of RNA polymerase 2 used as an internal reference. Sample 1 represented each single PTC sample, and sample 2 was the average of all (n = 10) normal thyroid samples.
Statistical analysis
Data are presented as mean ± standard deviations. Two-tailed unpaired Student’s t test was used for all statistical analysis. Mann–Whitney U test was used only for DNA array data analysis. P < 0.05 was considered statistically significant. Statistical analyses were carried out using the Graph Pad InStat (version 3.1a, La Jolla, CA, USA).
Competing interests
None of the authors of this manuscript had any conflict of interest regarding the study.
Authors’ contributions
GDM, FMO, MRM and PS performed functional experiments. MM and GC performed immunohistochemistry studies; KU, GT, MOW and BJ contributed to the expression studies. GDM, MS and GS designed the experiments. All authors read and approved the final manuscript.