Background
Breast cancer is the most common malignant tumor in women [
1]. Despite advances in diagnosis and treatment approaches, the mortality due to breast cancer still remains very high. This is attributable to the fact that cancer cells are able to develop mechanisms of resistance to the therapeutic treatment, a process known as chemoresistance, which continues to be a major clinical obstacle to the successful treatment of cancer [
2,
3]. It may be caused by drug efflux by transporters, inactivation by detoxification enzymes, the altered expression of pro-antiapoptotic proteins, changes in tumor suppressor gene expression, or the increased activity of DNA repair mechanisms [
4‐
6]. Recent evidence has demonstrated that microRNAs (miRNAs) take part in these processes.
miRNAs is a type of endogenous non-coding RNA (ncRNA). They modulate protein expression by promoting RNA degradation and inhibiting transcription after binding to the 3′-untranslated region (3′-UTR) of mRNA [
7]. Accumulating evidence has demonstrated that miRNAs are responsible for post-transcriptional regulation and participate in nearly all biological processes [
8]. miRNAs play an important role in tumorigenesis, with some able to act as oncogenes, others as tumor suppressors and others displaying either oncogenic or tumor-suppressive activities, depending on the tissue and tumor context [
9,
10]. They have recently emerged as diagnostic and prognostic markers for successful therapeutic responses. Recent investigations have revealed that miRNAs are involved in the development of drug resistance, for example, miR-520 h directly affects cell chemosensitivity in breast cancer cells [
11]. miR-130a plays a role in chemosensitivity in prostate [
12] and ovarian cancer [
13], and the expression of miR-124 is associated with chemosensitivity in tongue squamous cell carcinoma(TSCC) patients [
14].
Bearing in mind that the 3′ UTR of a single gene is frequently targeted by several different miRNAs, and that any one given miRNA can have several targets, some belonging to the same functional network or signaling pathway. A coordinated action of miRNAs on their targets was proposed. For example, for the known targets of miR-375, a combined addition of miR-124 and let-7b led to a synergy in target inhibition [
15]. Similarly, the expression of miR-16, miR-34a and miR-106b altered the cell cycle. Combining these miRNAs resulted in cell cycle arrest that was stronger than for each of the miRNAs alone [
16]. The regulation of the tumor suppressor FUS1 in cancer cells depends on the presence of at least three miRNAs (miR-93, miR-98,miR-197 and additional unidentified miRNAs) [
17]. To date, the specific miRNAs involved in the cooperatively regulating drug resistance have yet to be characterized. In our previous study, we performed miRNA microarray analysis to investigate the differential miRNA expression profiling in parental MCF-7 cells and its derivative mitoxantrone(MX)-resistant MCF-7/MX cells. We found that miR-302S family including miR-302a, miR-302b, miR-302c, and miR-302d was significantly downregulated in MCF-7/MX cells. We also found that miR-302 inhibit BCRP-mediated MX resistance
in vitro and
in vivo study [
18]. However, the involvement of miR-302S in the development of other drug resistance usually used in breast cancer therapy is unclear.
In this study, a multiple-drug resistant cell line, MCF-7/Adriamycin (ADR), was derived from MCF-7 cells by exposing them to gradually increasing concentrations of adriamycin (ADR). We experimentally demonstrated that miR-302 cluster, including miR-302a, miR-302b, miR-302c and miR-302d exert a combinatorial effect on the reverse the drug resistance of breast cancer cells. The four miRNAs cooperatively downregulate P-glycoprotein (P-gp)expression in regulating drug sensitivity. However, our results showed that the suppression of P-gp expression by miR-302a, miR-302b, miR-302c and miR-302d is not through typical miRNA-mediated mRNA degradation but at the level of protein and transcription. Further, we demonstrate that the four miRNAs directly bind to and down-regulate levels of MAP/ERK kinase kinase 1 (MEKK1), a member of the MAPK Kinase (MAP2K) Kinase (MAP3K) family. In cancer cells, miR-302S showed combinatorial effects on MEKK1 repression and MEKK1-mediated ERK pathway. Importantly, the suppression of P-gp by miR-302 was reversed by MEKK1 overexpression, suggesting that miR-302 cooperatively sensitizes breast cancer cells to adriamycin via suppressing P-gp by targeting MEKK1 of ERK pathway. Altogether, our results identify four specific miRNAs that regulate drug sensitivity and indicated the combination of miRNAs is required as an effective therapeutic strategy, and further elucidated the functional significance of the four miRNA combination.
Methods
Cell lines
The human breast cancer MCF-7 cell line was purchased from the American Type Culture Collection. The adriamycin (ADR)-resistant MCF-7 cells (MCF-7/ADR) were derived from the human breast cancer cell line MCF-7, was maintained in the presence of 1 μM adriamycin. A series of MCF-7 cells with incremental resistance to adriamycin were established by doxorubicin challenge at the starting concentration of 1 nM. After cells were tolerable, a double concentration of adriamycin was applied. The process was repeatedly performed to increase cell tolerance to adriamycin. The resulting 12th generations, MCF-7/ADR were cultured in DMEM (Invitrogen, Carlsbad, CA) supplemented with 10 % FCS and were added with the indicated adriamycin concentrations for resistance maintenance.
Cell transfection
MCF-7 and MCF-7/ADR cells were transfected with 20 nM miR-302a, miR-302b, miR-302c, miR-302d, and miR-302S (miR-302a-d) mimics or negative control miRNAs (NC) using Lipofectamine 2000, according to the manufacturer’s instruction. After transfection for 48 h, cells were used for Western blot and qRT-PCR.
MTS assay for proliferation activity
MCF-7 and MCF-7/ADR cells were seeded onto 96-well plates at a density of 1,000 cells/well. After culture for 24 h, cells were transfected with 20 nM miR-302 mimics for 24 h. Then, cells were treated with serial dilutions of drugs for 48 h, followed by treatment with MTS (5 mg/ml, Promega, WI, USA) for 2 h. The absorbance at 490 nm was measured using a multi-mode reader (LD942, Beijing, China). The IC50 (50 % inhibitory concentration) value, which represents the concentration of the drug that demonstrates 50 % of cell growth inhibition, was calculated by normal probability transforms according to the relationship of drug concentration and inhibition rate. The probit regression models of SPSS 16.0 software were used for computation.
Quantitative reverse transcription-PCR
Quantitative reverse transcription-PCR (qRT-PCR) was performed to detect the relative expression of mRNA. Briefly, total RNA was isolated from MCF-7 or MCF-7/ADR cells using Trizol reagents (Invitrogen, CA, USA) according to the manufacture’s protocol. RNA was reverse transcribed into complementary DNA using M-MLV reverse transcriptase (Promega, WI, USA). RT-PCR was performed using SYBR Premix Ex Taq™ II kit (Takara, Dalian, China) in a final volume of 10 μl mixture containing 1 μl cDNA, 0.5 μl of each primer, and 5 μl SYBRGreen. The reaction condition was as follows: 37 °C, 15 min, 85 °C, 5 s; 95 °C 5 min, followed by 95 °C, 10 s, 56 °C, 45 s and 72 °C, 20 s for 45 cycles of amplification. Relative mRNA expression was normalized to GAPDH expression.
Luciferase report gene detection
The human P-gp 3′-UTR (380 bp) or MEKK1 3′-UTR (2472 bp) was cloned into the XbaI site of the pGL3 vector (Promega, WI, USA). Mutations in the miRNA-binding site were generated using RCR-based mutagenesis (Takara, Dalian, China). Luciferase reporter vectors (control), or vectors containing wild type (pGL3- P-gp -3′UTR-Full or pGL3- MEKK1 -3′UTR-Full) or mutated (pGL3-MEKK1-3′UTR-Mut) 3′-UTRs of MEKK1 mRNA were co-transfected into HEK-293T cells with miR-302a, miR-302b, miR-302c, miR-302d, or miR-302S mimics, using Lipofectamine 2000. After 24 h, luciferase activity was detected using the Dual Luciferase Reporter Gene Assay kit (Promega, WI, USA). Relative luciferase activity normalized to the negative control was used for comparison among groups.
Western blotting
MCF-7 or MCF-7/ADR cells were washed with ice-cold PBS for 2 times, added RIPA lysis buffer, lysed on ice for 30 min, scrapped off, transferred into EP tube and centrifuged at 4 °C, 12,000 × g for 30 min. The supernatants were collected and protein concentration was determined using BCA protein quantitation kit. Each sample with 60 μg protein was added 1× SDS sample buffer [100 mmol/L Tri-HCl (pH 6.8), 4 % SDS, 0.2 % bromophenol blue, 20 % glycerol, 200 mmol/L β-mercaptoethanol], and denatured at 95 °C for 5 min. Proteins were separated by 10 % SDS-PAGE electrophoresis and transferred to 0.45 μm NC membrane. Membrane was blocked with 5 % skim milk for 1 h, and incubated with monoclonal antibodies (1:1,000 to 1:2,000 dilution) at 4 °C overnight. The membrane was then incubated with horseradish peroxidase-linked goat anti-rabbit secondary antibodies (Santa cruz, CA, USA) at room temperature for 1 h, washed with PBST three times, and detected with a chemiluminescent detecting system (Amersham, Freiburg, Germany).
ADR accumulation assay
ADR accumulation assay was performed as described previously [
19] with modifications. Briefly, cells were exposed with 5 μM ADR for 2 h at 37 °C in the darkness. The ADR accumulation was stopped by addition of ice-cold phosphate-buffered saline (PBS). The intracellular ADR level was determined by measuring ADR fluorescence using a flow cytometer (Becton–Dickinson).
RNA degradation analysis
48 h after MCF-7/ADR cells were transfected with 20 nM miR-302 mimics, actinomycin D (Sigma, CA, USA) was added to a final concentration of 5 mg/mL to block de novo RNA synthesis. Cells were harvested at 0, 2, 4, 6, and 8 h following actinomycin D treatment. P-gp or MEKK1 mRNA levels were determined by qRT-PCR, and normalized to GAPDH mRNA levels. All treatments were conducted in triplicate.
Statistical analysis
Data were analyzed using the SPSS statistics 16.0 software package. Results are presented as mean ± standard deviation (SD). One-way ANOVA was used to compare differences among groups, followed by LSD post-hoc tests. The P values < 0.05 were considered statistically significant.
Discussions
Although chemotherapy has greatly improved the prognosis of breast cancer, drug-resistance still remains as the main obstacle of successful treatment. Recently, miRNAs were reported to be differentially expressed in drug resistant cancers and could regulate the drug resistance. In the present study, we found that miR-302 cluster were differentially expressed between MCF-7/ADR and MCF-7. In the transfection experiments, we found alteration of miR-302 expression could change the degree of ADR, PAC and VP-16 resistance in MCF-7 and MCF-7/ADR. Previous studies showed that miR-302 cluster are highly expressed in embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), and their expression levels rapidly decline as pluripotent stem cells begin to differentiate [
24]. Recent studies have shown that miR-302 targets epigenetic regulators (AOF1/2, MECP1-p66, MECP2 and MBD2) [
25], cell-cycle regulators (Cyclin D1/D2, CDK2, BMI-1 and PTEN [
26]), TGF-β regulators (Lefty1/2 [
27] and TGFBR2 [
28]), BMP inhibitors (DAZAP2, SLAIN1, and TOB2) [
29] and NR2F2 [
30]. Most studies about the role of miR-302 have been done in ESCs, but the function of miR-302 in cancer has not been studied. Currently, a few studies focused on the role of miR-302 in tumor, Yang CM et al. found that expression of the miR-302/367 cluster in glioblastoma cells suppresses tumorigenic gene expression patterns and abolishes transformation related phenotypes [
31]. The results of the current study provide the evidence to suggest that miR-302 play an important role in drug sensitivity.
Furthermore, we also found that ectopic the miR-302a/b/c/d combination expression sensitizes MCF-7/ADR cells to ADR more efficiently than inducing an individual miRNA. This effect cannot be attributed to the miRNA dose, since the same amount of total miRNA was used irrespective of whether they were transfected alone or in combination. We show that the combined overexpression of miRNAs (miR-302a, miR-302b, miR-302c and miR-302d) could potentially be used as a therapy for breast cancer. However, additional animal and human studies are warranted. Based this results, we highlighted the importance of a combination of miRNAs as a therapeutic target, a concept that could be used successfully to promote sensitivity in other cancers.
Our study found the expression of P-gp levels in the MCF-7/ADR was significantly higher than that in the MCF-7, suggesting that over-expression of P-gp may be one of mechanism of drug resistance formation in MCF-7/ADR cells. P-gp is an ATP-dependent membrane pump that transports the drug out of cells, resulting in multidrug resistance. Therefore, inhibition of P-gp transporter function or inhibition of its expression may reverse the MDR phenotype through enhancing intracellular accumulation of anticancer drugs. There has been a worldwide effort investigating chemical agents for their ability to overcome MDR through interacting with P-gp and inhibiting its transporter function. These MDR modulators include calcium channel blockers [
32], calmodulin inhibitors [
33], and other classes of compounds [
34]. Recently, several miRNAs have been identified as critical regulators of P-gp mediated drug resistance in many cancer. For instance, miR-451 overcame the doxorubicin resistance by downregulating P-gp expression in the doxorubicin resistant breast cancer cell lines MCF-7/ADR [
35]. Inhibition of miR-27a enhanced the paclitaxel sensitivity in A2780/Taxol by modulating MDR1/P-gp expression [
36]. Inhibiting the expression of miR-130a resulted in down-regulating of MDR1 mRNA and P-gp in A2780/DDP ovarian cancer cell line [
13]. In this study, we proved that overexpression of miR-302 resulted in down-regulating of MDR1 mRNA and P-gp. ADR accumulation was also increased in miR-302 mimic-transfected MCF-7 and MCF-7/ADR cells. These results indicate that miR-302 reduces the efflux of cytotoxic drugs by downregulating the expression of the ABC transporter P-gp.
However, bioinformatics analysis and luciferase reporter assay experiment showed no direct binding site of miR-302 in MDR1 mRNA-3′UTR, How might P-gp expression be down-regulated by elevated miR-302? Here, we identified MEKK1 as the functional target, through which miR-302 regulates P-gp expression and chemoresistance. The interaction of miR-302 with the 3′UTR of the MEKK1 mRNA was confirmed by the luciferase assay, in which the luciferase activity of the reporter gene harboring 3′UTR of MEKK1 mRNA was significantly inhibited by miR-302. Furthermore, we found that miR-302a, miR-302b, miR-302c and miR-302d mimics inhibited the expression of MEKK1 in MCF-7 and MCF-7/ADR cells, further suggesting that miR-302 specifically down-regulated MEKK1. To directly demonstrate that suppression of MEKK1 by miR-302 was responsible for the decreased P-gp expression, we performed a rescue experiment by expressing MEKK1 cDNA in MCF-7 and MCF-7/ADR cells. Strikingly, expression of the MEKK1 rescued the down-regulatory effect of miR-302 on P-gp in MCF-7/ADR cells. Thus, these results indicated a crucial requirement for MEKK1 in mediating miR-302-induced down-regulation of P-gp.
MEKK1 is an upstream activator of p38, JNK and ERK1/2 through its kinase domain [
37]. Previous studies have shown that activation of p38,JNK and ERK cooperatively increase transport activity of P-gp and induce a multidrug resistant phenotype [
38], we showed in this study that miR-302 decreased ERK activation in the MCF-7 and MCF-7/ADR cells. It is therefore very likely that miR-302 inhibited MEKK1 expression via binding to the 3′ UTR of MEKK1 mRNA, which in turn decreased ERK activation, thereby leading to the repression of MDR1 mRNA expression and ultimately the repression of P-gp protein expression.
Several studies have shown that different miRNAs can cooperatively regulate the same target gene. For example, Georges et al. reported that miR-192 and miR-215 cooperatively regulated cell cycle transcripts [
39]. Frampton et al. showed that miR-21, miR-23a, and miR-27a cooperatively inhibited tumor suppressor genes to promote pancreatic tumor growth and progression. Kotani et al. found that miR-128b and miR-221 cooperatively sensitized MLL-AF4 acute lymphocytic leukemia cells to glucocorticoids [
40]. Our study showed that miR-302S exhibited more strong effects on inhibition of P-gp and MEKK1 expression than each individual member alone, suggesting that miR-302 members cooperatively inhibited P-gp and MEKK1 expression. Several studies have shown that miRNAs reduce protein expression predominantly by destabilization of the target mRNA. In the present study, we found that miR-302S accelerated the decay of MEKK1 mRNA compared with miR-302b and miR-302c, suggesting that miR-302 members may cooperatively promote degradation of MEKK1 mRNA.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
LZ, MJW, and MH conceived the study design, participated in its design and in the acquisition of data. LZ, YW, LYJ and MTM carried out the experiments, participated in the acquisition of data, analysis and interpretation, drafted the manuscript. LFY have been involved in analyzing the data and drafting the manuscript. MJW helped to draft and revise the manuscript. All authors read and approved the final manuscript.