Background
Breast cancer is the leading cause of invasive cancer in women. The lifetime risk of breast cancer in women is estimated at 1 in 8 (13% of women) [
1]. Factors that decrease cancer cell invasion and tumor growth have the potential for translation into novel therapeutic approaches for lessening breast cancer morbidity and mortality. Extracellular sulfatases appear to have a significant role in cancer biology. Heparan sulfate-like glycosaminoglycans, along with structural proteins, are important regulators at the cell surface-extracellular matrix (ECM) interface [
2,
3]. Human Sulfatase 1 (hSulf1) and Sulfatase 2 (hSulf2) are heparan sulfate 6-
O-endosulfatases, a family of secreted enzymes that are either localized on the cell surface or released into the ECM. HSulf1 and hSulf2 cleave 6-
O-sulfate moieties of heparan sulfate, thereby affecting composition and function of the glycosaminoglycans. Because glycosaminoglycans regulate cytokine signaling, heparan sulfate sulfation patterns and pattern-dependent cell signaling events rely on activity of sulfatase enzymes. HSPGs are key components of the ECM that are involved in tumor progression by regulation of growth factor signaling pathways. Most of the molecular events associated with tumor growth, neovascularization, and metastases are influenced by interactions between cells and their ECM. There is mounting evidence for the role of two secreted human extracellular sulfatases, hSulf1 and hSulf2, in modulating the growth factor signaling pathways needed for tumor angiogenesis and progression [
4]. However, much of the data that exists on the role of hSulf1 and hSulf2 is context dependent to distinct cancer types and cellular environment [
5‐
8].
HSulf1 and hSulf2 have overlapping yet distinct roles both in development and cancer progression. Mouse knockout models of Sulfatase 1 or Sulfatase 2 display a normal phenotype by nearly all criteria examined [
9]. Combined knockout of Sulfatase 1 and 2 in mice, however, leads to ~50% neonatal lethality and ~80% postnatal lethality with prominent skeletal and renal developmental defects [
9]. Cancer models also display evidence of context-specific sulfatase activity. HSulf1 expression is decreased in 82% of hepatocellular carcinoma (HCC) cell lines, leading to increased HSPG sulfation, enhanced FGF-mediated and hepatocyte growth factor (HGF)-mediated signaling, and increased cell growth [
10]. Forced expression of hSulf1 decreases sulfation, inhibits growth factor signaling, and sensitizes HCC cells to chemotherapeutic apoptosis [
10]. While previous study of overexpression of hSulf1 in the estrogen receptor negative MDA-MB-468 cell line has been shown to decrease tumor burden in athymic nude mice
in vivo, few data are available regarding the therapeutic role of forced expression of hSulf2 on
in vivo tumor burden.
We hypothesized that hSulf2 might have an effect in inhibiting cancer cell growth and invasion
in vitro and
in vivo. In order to further understand the role of hSulf2 in breast cancer, we chose the human breast cancer cell line MDA-MB-231, a well characterized and established model for human breast cancer growth. Although reports in the literature describe variable levels of sulfatase expression in MDA-MB-231 cells [
6,
11], we did not detect endogenous expression of hSulf1 or hSulf2 in our MDA-MB-231 population, using RT-PCR. We therefore chose the MDA-MB-231 cell line for gain-of-function studies by creating transfected pools that stably express human sulfatases. Given that hSulf1 has been established as an inhibitor of tumorigenesis [
8], we used overexpression of hSulf1 as a positive control and also tested hSulf1 in conjunction with hSulf2. For delivery of rhSulf2, intratumoral injection was chosen as the initial approach for two reasons. The first was based on
in vivo data about the anticipated effect of hSulf2 on the stromal component. The second was based on attempt to avoid first pass metabolism through the liver and deliver maximal protein to the tumor site.
In vitro studies provide evidence that expression or delivery of hSulf2 decreases proliferation and tumor cell invasion through the ECM. In vivo studies show that hSulf2 expression is effective in suppressing xenograft growth. In our system, this effect appears to be independent of an angiogenic effect, because tumor growth was significantly suppressed without dramatic changes in the angiogenic response to the xenograft. Further studies are needed to better characterize and validate the role of hSulf2 in inhibiting tumor growth and progression in vivo.
Methods
Materials
FGF2 and HB-EGF-2 were obtained from Sigma (St. Louis, MO). EGFR inhibitor PD153035 was obtained from EMD Biosciences (San Diego, CA). Total ERK and phospho-ERK antibodies were purchased from R&D Systems (Minneapolis, MN). Growth factor reduced Matrigel was obtained from BD Biosciences (San Jose, CA). CD31 (PECAM) antibody was obtained from BD Pharmingen. Ki-67 antibody was obtained from Ventana Corporation (Tucson, AZ).
Recombinant protein production
An expression vector with full-length human Sulfatase 2 cDNA was transfected into HT1080 cells by electroporation. HT1080 cells were grown and maintained in a serum-free DMEM/F-12 based custom media (Invitrogen, Carlsbad, CA) at 37°C in a 5% CO2 incubator. Transfection with a neomycin resistance cassette allowed for the selection of stably transfected clones. Clones were expanded and cell supernatants examined for expressed hSulf2 protein. Conditioned medium was processed by copper binding followed by gel filtration. Selected gel filtration fractions were pooled and dialyzed against 20 mM sodium phosphate, 0.5 M NaCl, 10% glycerol, 0.5 mg/ml Pefabloc at pH = 7.5. RhSulf2 was visualized by Coomassie staining (GelCode Blue Stain Reagent, Pierce, Rockford, IL) of 8-16% tris-glycine SDS-PAGE gels (Invitrogen, Carlsbad, CA). Glycerol and Pefabloc were removed by dialysis into a final buffer of 500 mM NaCl, 20 mM NaPO4 pH = 7.
Cell Culture
MDA-MB-231 (HTB-26) and MDA-MB-435 S (HTB-129) cell lines were obtained from ATCC. MDA-MB-231 cells stably expressing control vector, human Sulfatase 1 (hSulf1), human Sulfatase 2 (hSulf2), or a combination of human Sulfatase1 and 2 (hSulf1/hSulf2) were established. Specific clones of transfected hSulf1 and hSulf2 cells were selected based on the strength of respective hSulf protein and phenotypic validation in vitro of reduced cell proliferation and migration. MDA-MB-231 and MDA-MB-435 S cells for in vitro experiments were cultured in minimal essential media (MEM) supplemented with 10% FBS, 2 mM L-glutamine and 0.01 mg/ml insulin at 37°C, 5% CO2. For the invasion assay, cells were cultured in MEM supplemented with 5% charcoal-stripped FBS, 2 mM L-Glutamine and 0.01 mg/ml insulin 24 hours prior to assay. On the day of the assay, cells were suspended in migration media (serum-free basal media) and placed in the top well of invasion chambers (Chemicon ECM554). Chemoattractant (10% FBS) was placed in the lower chamber in migration media. Cells were allowed to invade for 24 hours at 37°C. Cells were harvested and invasion rate was determined according to manufacturer's protocol. For MTT assays, cells were seeded at 40,000 cells/cm2 into 48-well plates in complete growth medium. After 24 h, cells were rinsed and treated with either rhSulf2 formulation buffer or with varying concentrations of rhSulf2. On days 1, 2 and 3, 5 mg/ml MTT was added to the cells for 4 hours at 37°C. After the incubation the media was aspirated, DMSO was added and the OD at 570 nm was measured. Cell count and viability was assessed using a Cell sorter (Cedex, Innovatis-Roche, Germany). For tumor xenograft implantation, MDA-MB-231 cell populations expressing human sulfatases were cultured in MEM supplemented with 10% FBS, 1% non-essential amino acids, and 0.5% gentamicin.
RT-PCR
Primers used for hSulf1 were S1fw 5' ACGGGGGAGCTGGAGAATACTTAC 3'/S1rev 5' GCCACTTCTGCCCCGGTTGTTCAC 3', for hSulf2 there were 2 sets of primers S2fw 5' CCGCCCAGCCCCGAAACC 3'/S2rev 5' CTCCCGCAACAGCCACACCTT 3' as well as S2fw 5' CTCCGTTTTCCTTTGTGAGC 3'/S2rev 5' GAATTTGCAACTGGCTTCCT 3' and for β-actin 5' AGAAAATCTGGCACCACACC 3'/5' CTCCTTAATGTCACGCACGA 3' was used. One Step RT-PCR kit (Invitrogen, Carlsbad, CA) was used according to manufacturer's instruction for sulfatase determination in cells.
Stable transfectant tumor xenograft production
All animal studies were performed in accordance with established protocols approved by the Maine Medical Center Institutional Animal Care and Use Committee. Three groups of stably transfected MDA-MB-231 cells were prepared for
in vivo tumor xenograft growth in comparison with control vector-transfected cells: cells expressing both hSulf1 and hSulf2, only hSulf1, or only hSulf2. Thirty-two litter-matched female NCr homozygous
nu/nu mice (Taconic) at nine weeks of age were chosen as xenograft hosts. These were randomized by cage into four groups of eight mice each. The first group was injected with the control vector-transfected cells, the second group was injected with cells expressing both hSulf1 and hSulf2, the third group was injected with cells expressing only hSulf1, and the fourth group was injected with cells expressing only hSulf2. Injections were placed subcutaneously into the left flank and contained 5 million MDA-MB-231 cells suspended in 200 μl of PBS. Measurements were obtained by caliper length and width measurements at 2-3 day intervals for the duration of the experiment. Tumor volume was calculated from the pi-based ellipsoid volume formula π/6*length*width*height [
12], assuming ellipsoid shape with equal width and height. The average value and standard deviation are based on calculated tumor volumes from the eight mice in each group. Tumor xenografts recovered from mice were fixed in 4% paraformaldehyde and embedded in paraffin. Tissue sections were stained with Masson's trichrome staining for visualization of collagen, CD31 (PECAM) staining for visualization of tumor vasculature, or Ki-67 staining for mitotic index. Average mitotic index quantification was obtained by counting 5 high-power fields per tumor using ImageJ software [
13].
Tumor xenograft production for exogenous therapy with purified recombinant human Sulfatase 2 (rhSulf2)
For production of tumor xenografts for the exogenous treatment arm of the study, 200 μl of a 1:1 Matrigel:buffer suspension containing 8.5 million MDA-MB-231 cells was subcutaneously injected into the left flank of 32 female litter-matched nude mice. Four additional female litter-matched nude mice were injected with 200 μl of the Matrigel:buffer suspension only, and four remaining female litter-matched nude mice were left un-manipulated as experimental controls. Following a 48 hour window to allow establishment of tumor xenografts in mice injected with tumor cells, intratumoral injections of rhSulf2 were administered to the 16 mice randomized to the treatment group. Each injection contained 0.1 mg rhSulf2 based on an estimated 5 mg/kg dose in an average 20 g nude mouse. An equal volume of control buffer vehicle was administered intratumorally to the 16 mice in the treatment control group.
High resolution ultrasound imaging of tumor xenografts
Mice were anesthetized by inhaled isoflurane prior to ultrasound scanning with a VisualSonics Vevo 770 high-resolution imaging system. Tumors were initially scanned free hand to establish approximate tumor size and morphology. Images for tumor reconstruction were acquired by 3D motor stage in alignment with the long axis of the tumor. After scanning, images were processed on a high-definition monitor for obtaining volumetric measurements. Successive tracings of tumor contour were taken which enabled the computer software to generate a 3D image and volume for each tumor. For comparison to external caliper measurements, × axis (length) was assigned to the longest visible dimension of the tumor. From there, y axis (width) was assigned to 90 perpendicular axis, and Z axis (height) assigned to tumor depth. The pi-based ellipsoid equation π/6*length*width*height has previously been validated as the best equation for estimating subcutaneous tumor size in athymic nude mice [
12]. However, tracking of tumor size by estimation of standard caliper measurements
in vivo involves the assumption of width equaling depth, given that only two dimensions can be measured
in vivo. Here we report methodology for making these measurements more precise by non-invasively capturing depth component through high resolution
in vivo ultrasound imaging.
Statistical Analysis
Statistical analyses were performed using Student's t test, with a significant difference determined as p < 0.05. Where appropriate, data are represented as means ± SD.
Discussion and Conclusions
The results presented in this study suggest a potential role for hSulf2 in inhibiting cancer growth and metastases. We have demonstrated that cell invasion through an ECM-enriched matrigel is strongly inhibited when the cells are expressing hSulf2 or are in the presence of rhSulf2, and this effect is dose-dependent. The inhibitory effect of hSulf2 on MDA-MD-231 cells is comparable to the one observed with the classical EGFR-dependent kinase inhibitor PD153035. HSulf2 inhibits cell growth and proliferation of cells, and it does so by interfering with growth factor signaling.
Until recently, investigations into the action of hSulf1 and hSulf2 focused on growth factor modulation and angiogenesis. In the non-sulfatase expressing breast cancer cell line MDA-MB-468, forced expression of hSulf1 led to inhibition of angiogenesis and tumorigenesis in xenografts [
8]. While there is consensus regarding the action of hSulf1 and hSulf2 in the desulfation of heparan sulfate, there is controversy over whether this effect is pro-angiogenic [
6,
21] or anti-angiogenic [
4,
6,
8,
10,
21]. Specifically, studies in carcinoma cell lines producing hSulf2 demonstrate that MCF-7-derived hSulf2 decreases heparin sequestration of VEGF, FGF1 and selected chemokines to promote growth factor activity by prevention of binding and dissociation of complexes that are already bound [
21]. Similarly, Sulf2 promotes angiogenesis in the chick chorioallantoic membrane assay [
6]. In contrast, studies of other breast, pancreatic, renal, and hepatocellular carcinoma cell lines in which Sulf1 is down-regulated, suggest that endosulfatase activity inhibits angiogenesis. One potential explanation for this is that sulfatases may display additional effects beyond modulation of angiogenesis in specific contexts.
Interestingly, hSulf2 has recently been identified as a novel transcriptional target of the tumor suppressor gene p53 indicating that it may be a p53 downstream effector molecule [
8]. This finding is particularly significant in the context of mutant p53 status in MDA-MB-231 and MDA-MB-468 cells and wild-type p53 status in MCF-7 breast cancer cell lines [
22,
23]. Knockdown of mutant p53 by RNA interference causes massive apoptosis in mutant p53 breast cancer cell lines but not in wild-type p53 breast cancer cell lines, indicating that mutant p53 may confer oncogenic potential as well as loss of tumor suppressor activity [
23]. Knock-down of Sulf2 in MDA-MB-231 cells confers enhanced survival characterized by increased proliferation and anchorage-independent growth [
11]. Our data are consistent with this work, because expression of hSulf2 had the opposite phenotype in decreasing tumor cell growth. Our findings extend the
in vitro work to provide the first description of
in vivo breast cancer xenograft growth inhibition by sulfatases.
Ai
et al. [
24] demonstrated that avian endosulfatases, Sulf1 and Sulf2, associate with the cell membrane and are enzymatically active on the cell surface to desulfate HSPG. Desulfation of HSPG by endosulfatases has been shown to impair growth factor signaling through FGF and EGF receptors [
4,
7]. In this study we have demonstrated that rhSulf2 decreases ERK1/2 phosphorylation as previously found for hSulf1 and hSulf2. Therefore, our data support decreased growth factor signaling as the mechanism of inhibition of tumor growth. Combinatorial therapy using conventional chemotherapy and hSulf2 could provide an alternative and more effective option, although further study is needed to determine whether hSulf2 could potentially be an effective exogenous therapy for specific subtypes of breast adenocarcinoma.
While data from sulfatase-transfected tumors are promising, a detailed in vivo study is required to reproduce these results with exogenous administration of rhSulf2. Although short term intratumoral administration of rhSulf2 was not efficient in inhibiting tumor growth, our data suggest that constant production of hSulf2 is required for a theraupeutic effect. In addition, secretion of hSulf2 in stable transfectants from early stages of xenograft growth may have modified the tumor cells or microenvironment. Although we performed a pilot study to administer rhSulf 2 by intravenous tail vein injection, this approach was limited by the high osmolarity of buffer vehicle in a tail vein injection distal enough to allow for adequate proximal intravenous access for subsequent daily delivery (data not shown). In addition, the concentrations of purified proteins were not sufficiently high to allow for injection of small enough volumes. While this could potentially be circumvented by jugular venous cannulation for central line access, the concentration of protein accumulated at the tumor site is predicted to be much lower than compared to intratumoral injection. Development of strategies for therapeutic exogenous administration of sulfatases requires in depth pharmacokinetic analysis for determination of volume of distribution, rate of metabolism, and dose-response curves in different contexts. Given the complexity of cellular events during malignant transformation and tumor progression in addition to the context-dependent nature of sulfatase activity, it is not surprising that the delivery method is critical to tumor response. Potential complicating factors to be considered in the future include active concentrations in the tumor microenvironment, the timing and duration of sulfatase administration, and a requirement for tumor cell expression for intrinsic growth effect. However, our studies provide proof of principle that sulfatase within a human breast cancer xenograft can lead to tumor suppression and indeed regression of established tumors.
Acknowledgements
We gratefully acknowledge the support of the Maine Medical Center Research Institute Histopathology Core (Dr. Volkhard Lindner and Kathleen Carrier).
Financial Support: Shire, The Histopathology Core Facility at Maine Medical Center Research Institute is supported by P20RR181789 (PI: D. Wojchowski) from the National Center for Research Resources at NIH.
Competing interests
Financial disclosure: Project funding was provided by Shire Pharmaceuticals. AI, LC, AR, AN, AG-Y, MWH, MFC, and PGVM are current employees of Shire Human Genetic Therapies Inc.
Authors' contributions
PGVM conceived the idea of this study. PGVM, AI, LC, AN, AR, MFC, MWH and AGY designed and/or performed the in vitro experiments. SMP, KT, and LL designed and performed the in vivo experiments. SMP and LL drafted the initial manuscript, prepared the figures, an edited subsequent revisions. MJ performed the histopathology analysis. PGVM critically revised the manuscript. All authors read and approved the final manuscript.