Background
Interleukin-6 (IL-6) is an immunomodulatory cytokine [
1], which also plays a role in growth stimulation, metastasis, and angiogenesis in secondary tumours in a variety of malignancies [
2], including colorectal cancer [
3‐
7]. IL-6 can be released from tumour infiltrating leukocytes [
8], but is produced to a large extent by tumour cells themselves: In human colon cancer, IL-6 expression parallels tumour progression, reaching a maximum in high grade cancerous lesions [
5]. Only still differentiated colon carcinoma cells are responsive to the growth stimulatory action of IL-6 [
5]. We therefore reasoned that IL-6, when released from rather undifferentiated colon carcinoma cells, may aid tumour progression by a paracrine-induced proliferation of still differentiated neoplastic cells [
5]. In addition, IL-6 increases invasiveness of colon cancer cells [
6] and likely promotes secondary tumour formation through its angiogenic potency. How effective IL-6 is in promoting progression and metastatic spread of colon cancer, depends not only on the extent of basal but, importantly, on the extent of inducible IL-6 expression at certain stages of tumour development.
IL-6 expression is highly inducible in different cell types by a variety of cytokines, particularly IL-1β [
9‐
12], by prostaglandins [
12,
13], steroid hormones, such as estrogen [
14] or 1,25-dihydroxyvitamin D
3 [
13,
15]. Although these substances influence colon carcinoma cell growth, their ability to regulate
IL-6 activity in this cell type has not yet been evaluated in detail. The present study was initiated to assess the potential of the aforementioned agents in modulating
IL-6 transcriptional activity and protein synthesis at different stages of human colon cancer progression.
Discussion
The purpose of the present study was to evaluate the regulation of
IL-6 activity in human colon carcinoma cells by classical modulators in respect to possible consequences for tumour progression. In this regard, it is important to note that each of the cell clones used in the present study, i.e., Caco-2/AQ, COGA-1A, and COGA-13, according to the characteristics shown in Table
1, represents a valid model system for studies on differentiation-related changes of human colon cancer cell functions during tumour progression.
Overexpression of
IL-6 seems to be a hallmark of advanced tumour progression, since it has been observed, apart from colon cancer [
5], also in other human malignancies, e. g., multiple myeloma, Kaposi's sarcoma [
9], or glioblastoma [
27]. From data reported in Figure
1 it is clear that human colon carcinoma cell clones derived from well to moderately differentiated tumours, i.e. Caco-2/AQ and COGA-1A, express relatively little IL-6, particularly when compared to the rather undifferentiated clone COGA-13. Not only
IL-6 gene activity differs according to the degree of differentiation, but also the extent of unstimulated translation into protein is at least four times higher in COGA-13 than in Caco-2 or COGA-1A (Table
2).
The promoter region of the
IL-6 gene contains a number of binding sites for transcription factors such as NFIL6 (C/EBPβ), NFκB, Fos/Jun (AP-1), CRBP, CREB etc. [
9‐
12]. This explains the basic sensitivity of
IL-6 towards classical transcription modulating factors such as prostaglandins, cytokines, steroid hormones etc. It is interesting to note that PGE
2 at 10
-7 M had no effect on
IL-6 expression and protein synthesis in Caco-2 and COGA-1A cells, and induced only a relatively small change in COGA-13 cells (Table
2). Insensitivity of
IL-6 to PGE
2 can be deduced also from the observation that in all three cell clones, though they are endowed with cyclooxygenase-2 (COX-2) activity [
28], suppression of endogenous PG synthesis by indomethacin or NS398 had no effect on basal and IL-1β-stimulated
IL-6 expression and protein secretion (Table
2). We conclude from this that in human colon cancer cells, endogenous PG production, even when stimulated by IL-1β [
28], is too low to affect IL-6 production, and that, conversely, the chemopreventive effect on colon cancer development of COX-2 inhibitors [
29] does not involve changes of
IL-6 expression.
Although all cell types investigated had been shown to express ER-α and -β as well as the VDR (cf. Table
1),
IL-6 expression in human colon carcinoma cells was only modestly, if at all, influenced by the steroid hormones 17β-E
2 and 1,25-(OH)
2D
3 (Figure
1; Table
2). 17β-E
2 had no effect on IL-6 synthesis in Caco-2/AQ and COGA-1A cells, and inhibited IL-6 production by highly undifferentiated COGA-13 cells only to an extent which makes efficient suppression of IL-6 production in high grade cancers by oestrogens very unlikely. This implies that prevention of human colorectal cancer by oestrogens [
30] does not involve any direct effect on
IL-6 expression.
Resistance to 1,25-(OH)
2D
3 in VDR-positive cells can be due to rapid degradation of the steroid catalysed by the 25-(OH)-D-24-hydroxylase (cf. Table
1). This could explain why 1,25-(OH)
2D
3 has no effect on IL-6 production in COGA-13, or only a marginal one in COGA-1A cells, but this is certainly not valid for Caco-2 cells, which are generally responsive to VDR-mediated actions of 1,25-(OH)
2D
3 [
19]. The small 1,25-(OH)
2D
3-related increment of IL-6 production by COGA-1A cells seems to be without relevance for the anti-mitogenic and pro-differentiating effects of the hormone in human colon carcinoma cells [
19], since 1,25-(OH)
2D
3 effectively suppressed IL-6-induced growth in differentiated Caco-2 cells (Figure
3). At the same time, the pro-differentiating action of 1,25-(OH)
2D
3 was completely preserved, even at extremely high IL-6 concentrations (Figure
4).
The inefficiency of 17β-E
2 and 1,25-(OH)
2D
3 in modulating
IL-6 transcriptional activity could result from impaired or abrogated signal transduction downstream of the ER-β or VDR, respectively, but may also be due to clone-specific expression of
IL-6 gene variants. This could be the consequence of acquisition of mutations during tumour development and progression, or, respectively, caused by specific polymorphisms in the
IL-6 promoter. Terry
et al. [
9] had identified four polymorphic sites, which influence not only basal but also regulatable transcription in a complex cooperative manner [
12]. For example, the -174C
IL-6 haplotype is less efficiently translated into protein than its -174G counterpart, and conveys resistance of
IL-6 to the stimulatory action of IL-1 [
12]. This may be the reason why Belluco
et al. [
31] found that colon cancer patients carrying the -174G polymorphic
IL-6 gene had significantly higher IL-6 serum levels than patients with the -174C genotype, particularly in the presence of hepatic metastases.
Our search for promoter polymorphisms (Table
3) showed that all cell clones investigated express
IL-6 variants which were identical only at -572 but different from each other at sites -597 and -174. The -597A/-572G/-174C haplotype, as solely present in COGA-13 cells, has been identified by Terry
et al. [
9] as the one which, when transfected in ECV304 cells, shows a comparable high transcriptional activity (cf. also [
12]). This may explain why COGA-13 cells, particularly since they overexpress
IL-6, produce significantly more IL-6 than Caco-2 or COGA-1A cells (Table
2). However, the same -597A/-572G/-174C haplotype shows the least sensitivity to IL-1β [
9]. Therefore, the striking difference in the regulation of transcriptional activity of
IL-6 by IL-1β (cf. Table
2) could only be due to cooperativity with still unknown promoter polymorphisms or, much more likely, due to mutational changes in the
IL-6 gene acquired during progression through the adenoma/carcinoma sequence. These questions can only be answered when more information on polymorphic sites and cancer-related mutations in the IL-6 gene will be available.
From the results of the present study it is conceivable that a highly critical situation for colon cancer patients may arise, when COGA-13-type cells become abundant in a cancerous lesion. If unopposed, massive release of IL-6 under the stimulation by IL-1β might accelerate tumour progression to high stage malignancy by paracrine proliferative action on IL-6-responsive, i.e., still differentiated cells. At present, we are unaware of any means by which IL-6 secretion from undifferentiated colon cancer cells can be effectively suppressed. Alternatively, development of anti-IL-6 or anti-IL-6 receptor monoclonal antibodies could be beneficial for future adjuvant immune therapy for cancer patients with genetic predisposition for IL-6 overexpression. In any case, screening for carriers of IL-6 gene variants with high susceptibility to transcriptional dysregulation by IL-1β should be considered for identification of individuals with high-risk for therapy-resistant colorectal cancer.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
WB carried out the proliferation assays, RT-PCR and protein analyses, and performed the statistical analyses, GB helped with the cell culture experiments for characterisation of the colon carcinoma cell clones, GF carried out the analyses of polymorphisms in the IL-6 gene promoter, HSC participated in the design of the study and coordinated all the experimental work, MP conceived of the study, participated in its design and drafted the manuscript. All authors read and approved the final manuscript.