Background
Non-small cell lung cancer (NSCLC) is the leading cause of cancer death for men and women worldwide. With availability of more sensitive radiological imaging studies, more NSCLC patients will be diagnosed while the disease is still at early stage [
1,
2]. The standard of care for NSCLC is surgery, often followed by chemotherapy [
1]. However, approximately 84% of those diagnosed with lung cancer will die within five years [
1]. Furthermore, the current chemotherapies often have toxicity in normal host tissues, whereas tumor cells rapidly develop resistance to anticancer agents. The developments of biomarkers for identifying NSCLC patients at high risk of recurrence after surgery, and therapeutic targets for safe and effective treatment of lung cancer are clinically important.
The existence of tumor-initiating cells (TICs), also known as cancer stem cells, could explain why the current chemotherapies cannot consistently eradicate tumors, because the therapies only target the bulk of tumor cells and are unable to eliminate TICs [
3]. Furthermore, residual lung TICs may regenerate a cancer cell population, leading to tumor relapse after therapy. TICs have been identified in lung cancer by using several approaches such as CD133, a cell surface marker [
4]. We have recently characterized ALDH1+ cancer cells are TICS, as the ALDH1+ cancer cells have extensive self-renewal, proliferative, and
in vivo tumorigenic potentials [
5‐
7]. The analysis of molecular aberrations that characterize TICs would deep our understanding of lung tumor biology. Furthermore, the molecular changes could be developed as a new diagnostic system for monitoring outcome of NSCLC. In addition, the TIC-related molecular changes may enable the development of specific agents for eradicating the tumor-maintaining cells, and thus provide efficient therapeutic approaches for lung cancer.
Non-coding RNAs (ncRNAs) are functional transcripts that do not code for proteins, however, play a crucial role in regulating gene expression [
8]. ncRNAs include small nucleolar RNAs (snoRNAs), microRNAs (miRNAs), short interfering RNAs (siRNAs), piwi-associated RNAs, small Cajal body-specific RNAs (scaRNAs), snRNAs (small nuclear RNAs), and long ncRNAs [
8]. Of the small ncRNAs, miRNAs have extensively been studied in carcinogenesis [
9,
10]. Dysregulation of some miRNAs is associated with features of TICs. For example, elevated miR-181 clusters were identified as vital regulators in hepatic TICs [
11]. Furthermore, up-regulation of miR-199b-5p impaired the development of TICs of medulloblastoma though repression of HES1 [
12]. In addition, the restoration of miR-34 expression suppressed the self-renewal of pancreatic TICs [
13].
Recently, new and unexpected functions of other types of small ncRNAs have been discovered, revealing that the molecules have highly diverse roles and are actively involved in the processes of carcinogenesis than previously thought [
10]. In particular, several studies including our own data suggest that snoRNAs exhibit differential expression patterns in lung tumor and have capability to affect cell transformation, tumorigenesis, and metastasis of NSCLC [
10,
14,
15]. snoRNAs range between 60–150 nucleotides in length [
16]. There are two classes of snoRNAs: box C/D snoRNAs (snoRDs) and box H/ACA snoRNAs (snoRAs) [
16]. snoRDs serve as guides for the 2′-O-ribose methylation of rRNAs or snRNAs, whereas snoRAs are guides for the isomerization of uridine residues into pseudouridine [
17]. Accumulated evidence suggests that snoRNAs can target other RNAs including snRNAs and messenger RNAs [
17]. For instance, HBII-52 regulates alternative splicing of 5-HT2CR by binding to a silencing element in exon Vb [
18,
19]. Therefore, profiling the expression patterns of snoRNAs in lung TICs may help comprehend the functional repercussions of the ncRNAs in the development and progression of NSCLC, and hence provide diagnostic biomarkers and therapeutic targets for the disease.
We propose to determine if aberrant snoRNAs have important function in lung TICs by: 1) profiling and comparing snoRNA expression patterns in lung ALDH1+/- cells of primary NSCLC tissues to identify signatures of TICs; 2) determining prognostic significance of the signatures by analyzing the expression in NSCLC tissues; 3) functionally investigating if the snoRNA signatures may contribute to stemness of lung TICs.
Discussion
Cancer arises from a tumorigenic subpopulation of TICs. The identification of molecular signatures of lung TICs provide a key standpoint for better understanding tumorigenesis and developing prognostic biomarkers and targeted therapy [
22]. For instance, methylation of TIC-associated Wnt target genes were identified in colorectal tumors and showed the potential for predicting a poor prognosis of colon cancer patients [
23]. Yet few molecular signatures of TICs in lung cancer have been identified. By conducting transcriptomic profiling ALDH1+/-NSCLC cells of primary tumor tissues, here we successfully identify 22 novel snoRNA signatures of lung TICs.
Although only two (snoRA3 and snoRNA42) of 22 snoRNAs are evaluated in the present study, the results indicate that the aberrant expression of the TIC-snoRNAs is associated with aggressive biological behavior of NSCLC. Importantly, expression of the snoRNAs was inversely associated with overall survival of the patients. Therefore, the assessment of the TIC-snoRNA signatures might provide a potential approach for predicting outcome of NSCLC. However, as lung tumor is a heterogeneous disease, the analysis of the two TIC-snoRNA signatures cannot achieve the accuracy required to move forward for a clinical trial. Multiple biomarkers may provide more accuracy in prediction of outcome of lung cancer. From the identified 22 snoRNA signatures of lung TICs, we are optimizing a panel of biomarkers that can more precisely predict recurrence of NSCLC in our ongoing study.
snoRNAs have long been believed to modify and stabilize rRNAs for ribosome production. Several recent studies including our own observations demonstrate that dysregulation of snoRNAs is a common molecular event in carcinogenesis [
14,
15]. We previously found that snoRA42 activation promoted lung cancer development and progression [
14]. The critic role of snoRA42 in TICs is first supported by that expression of snoRA42 is significantly elevated in CD133+ lung cancer cells compared with CD133- lung cancer cells. Furthermore, CD133- lung cancer cells with forced snoRA42 expression have the capacity to enhance the in vitro tumorigenicity, whereas the CD133- cells without forced snoRA42 expression do not. In addition, siRNA-mediated depletion of snoRA42 causes reduction of expression of stem cell-related genes, suppression of xenograft tumor formation, and inhibition of cellular proliferation and self-renewal of TICs in vitro. The inhibition of cell proliferation and self-renewal of lung TICs by snoRA42 dysregulation may be attained through inducing caspase 3-dependent apoptosis. Moreover, forced expression of snoRA42 in CD133- lung cancer cells produces higher cell proliferation and expression levels of stem cell-associated genes compared with CD133- lung cancer cells transduced with empty vector. Therefore, the present study extends the previous discoveries by finding that snoRA42 plays an important role in regulating stemness of lung TICs, and hence contributes to invasiveness and metastasis of NSCLC. Targeting snoRA42 in future may serve as an effective and specific therapeutic approach for lung cancer treatment. Nevertheless, investigating how the stem cell-core factors are regulated by snoRA42, and if other snoRNA signatures are also responsible to stemness features of TICs is warranted. In fact, we are functionally characterizing snoRA3 by using in vitro and in vivo approaches to determine if snoRA3 has a significant role in regulating stemness of lung TICs.
Methods
Patients and clinical specimens
To prepare single primary tumor cells, we obtained 28 lung tumor tissue specimens of NSCLC patents who underwent surgical resection in the University of Maryland Medical Center under appropriate institutional review board approval. All cases were diagnosed with histologically confirmed stage I NSCLC, comprising 15 patients with AC and 13 patients with SCC. Furthermore, to validate expression of snoRNAs in tumor tissue specimens, 82 frozen NSCLC tumor tissues were obtained. Clinical characteristics and histopathological data of the specimens are shown in Table
2. None of the patients had received preoperative adjuvant chemotherapy or radiotherapy before they received treatments.
Table 2
Demographic and clinical characteristics of 82 NSCLC patients
Age at diagnosis | 65.3 ± 9.5 |
Sex | |
Male | 53 (64.6) |
Female | 29 (3.45) |
Race | |
White | 58 (70.7) |
Black | 19 (23.2) |
Others | 75 (6.1) |
Smoker | |
Yes | 75 (91.5) |
No | 7 (8.5) |
Tumor histology | |
Squamous cell carcinoma | 34 (41.5) |
Adenocarcinoma | 48 (58.5) |
T stage | |
I | 27 (32.9) |
II | 28 (34.2) |
III-IV | 27 (32.9) |
Tissue process and cell culture
The surgical tumor specimens were processed for preparing single dissociated cells as previously described [
4]. Briefly, the surgical specimens were washed three times and left 12 hours in DMEM-F12 medium supplemented with penicillin/streptomycin and amphotericin B. Tissue dissociation was performed by adding enzymatic digestion with collagenase II (Gibco-Invitrogen, Carlsbad, CA) for two hours at 37°C. The dissociated cells were processed for flow cytometric isolation of TICs based on ALDH enzymatic activity as described below.
All NSCLC cell lines including A549, H299, H1792, H226, H522, H-1944, Calu-1, and H460 were purchased from the ATCC (Manassas, VA, USA). The cell lines were maintained as monolayer cultures in high glucose Dulbecco’s Modified Eagle Medium (DMEM) supplemented with 10% fetal bovine serum (FBS) and 50 μg/mL normocin (Invivogen, San Diego, CA) at 37°C in a humidified incubator with 5%.
Flow cytometry isolation of ALDH1+ and ALDH1- cells
We isolated ALDH1 + cells from single dissociated cells of lung tumors using an Aldefluor assay kit (Aldagen Inc., Durham, NC) as described in our previous reports [
5‐
7]. 1 × 10
6 cells per well were suspended in Aldefluor assay buffer containing ALDH substrate, BAAA (1 μmol/L). Cells stained with 50 mmol/L of the specific ALDH inhibitor diethylaminobenzaldehyde (DEAB) were used as a negative control. Flow cytometric sorting was carried out using a FACSAria (Becton Dickinson, Mountain View, CA). Aldefluor fluorescence was excited at 488 nm, and fluorescence emission was detected using a fluorescein isothiocyanate (FITC) 530/30-nm band-pass filter by a FACS calibre machine (BD Biosciences, San Jose, CA).
Flow cytometry isolation of CD133+ and CD133- cells from NSCLC cell lines
CD133+ and CD133- cells were isolated from NSCLC cell lines as previously described [
4]. Briefly, cells were derived after trypsinization of adherent NSCLC cells. Cells were washed twice with magnetic automated cell sorting (MACS) buffer (Miltenyi Biotec Inc., San Diego, CA). Cell pellets were then resuspended in 300 μl of MACS buffer followed by addition of 100 μl of FcR blocking reagent (Miltenyi Biotec Inc.), 100 μl CD133 of microbeads (Miltenyi Biotec Inc.), and 50 μl of CD133/2-PE antibody (Miltenyi Biotec Inc.). The cells were washed with MACS buffer and MACS-assisted purification was performed according to manufacturer’s instructions. Purity of CD133+ cells and CD133- cells were checked by flowcytometry.
TIC-conditioned suspension culture for sphere production
For sphere-forming cultures, cells were plated at a density of 2 × 10
4 cells per well in six-well ultra-low attachment plates (Corning Inc., Corning, NY) in serum free Bronchial Epithelial Cell Basal Medium (BEBM), supplemented with the following growth supplements: BPE, Hydrocortisone, hEGF, Epinephrine, Transferrin, Insulin, Retinoic Acid, Triiodothyronine, and GA-1000, provided as BEGM prepackaged SingleQuots (Lonza, Walkersville, MD) plus rhEGF (Sigma, St Louis, MO), bFGF (Sigma). Fresh aliquots of EGF and bFGF were added every three days. Floating spheres were subjected to mechanical dissociation, followed by replating of single cells for propagation into a second, and subsequently into a third batch of suspension culture as described in our previous reports [
5‐
7].
RNA isolation
We used a mirVana miRNA Isolation Kit (Ambion, Austin, TX) to isolate RNA containing small RNA from cells and tissue specimens as described in our previous studies [
24,
25,
15].
snoRNA profiling of lung TICs
snoRNA profiling was performed by using GeneChipR Array (Affymetrix, Inc, Santa Clara, CA) as described in our previous report [
15]. Microarray experiments were done with matched ALDH1+ and ALDH1- cells. One μg total RNA was labeled with Biotin FlashTag Biotin Labeling Kit (Affymetrix, Inc). The labeling reaction was hybridized on the arrays in Affymetrix Hybridization Oven 640 (Affymetrix, Inc) for 16 hours. The arrays were stained with Fluidics Station 450 using fluidics script FS450_0003 (Affymetrix, Inc), and then scanned on a microarray scanner (Axon Instruments Inc, Foster City, CA). snoRNA probe outliers were defined as per the manufacturer’s instructions (Affymetrix, Inc) and further analyzed for data summarization, normalization, and quality control by using the web-based QC Tool software (
http://www.affymetrix.com). The normalized microarray data underwent further analysis as described in our previous study [
15]. We performed tree visualization by using Java Treeview 1.0 (Stanford University School of Medicine, Stanford, CA).
Quantification of snoRNA expression by qRT-PCR
Expressions of snoRNAs were determined by using real-time SYBR green RT-qPCR assay as described in our previous studies [
14,
15]. All PCR reactions were run on a CFX96 Real-Time qPCR detection system (Bio-Rad, Hercules, CA) using Brilliant SYBR green qPCR master mix (Agilent Technologies, Chelmsford, MA). U6 was used as an internal control gene. ΔCt was calculated by subtracting the Ct values of U6 from those of the snoRNA tested, and fold-change of each snoRNA was determined by the equation 2–ΔΔCt. qRT-PCR was also performed to decide expression levels of stem cell-associated genes, which included
ACTBF, ABCB1, ABCG2, CD133, Nanog, Nestin, Notch, Oct4, Smo, and Sox2. The primer sequences are included in Additional file
1: Table S3.
RNA interference assays
RNA interference assays were performed as described in our previous study [
14]. Briefly, specific target site of designed siRNA in RNA sequence of snoRA42 (NCBI accession number NR_002974) was a 19 nucleotide stretch as follows: 5′-GTACCCATGCCATAGCAAA-3′. Corresponding non-targeting scrambled sequence was also designed. Transfection was performed by using Opti-MEM and Lipofectamine™ RNAiMAX Reagent (Invitrogen, CA, USA) as described elsewhere [
26].
snoRA42 overexpression vector construction and transduction with the vector
pCMV (pSilencer CMV 4.1; Ambion, Carlsbad, CA)-snoRA42 vector was constructed for ectopic snoRA42 expression as described previously [
14]. A vector comprising sequence that showed no significant homology to the human genome databases was used as a control. Transduction of cells with the vectors was performed as described in our previous study [
14].
Methylthiazol tetrazolium (MTT), 5-bromo-2'-deoxyuridine (BrdU) incorporation, colony formation, transmigration, and wound healing assays
MTT and BrdU incorporation assays were performed as previously described [
24,
14]. Cells were seeded in 96-well plates at 1 × 10
4 cells per well. Colony formation was determined by using 3D soft gar matrix with a 0.8% of soft agar (noble agar) base layer followed by 0.4% top agar layer containing cells at a density of 1 × 10
4 with different treatments in 24-well culture plates. Colonies were counted using inverted light microscopy. For transmigration assay, the ability of migration and invasion of cells was examined using BD BioCoat Matrigel Invasion Chambers (BD Biosciences) according to manufacturer’s instruction. After 24 h, the migrated cells were pelleted and counted using a hematocytometer. To further confirm cell migration, a wound healing assay was performed in 12 well plates (1 × 10
5 per well). When the cells were grown to 90 to 95% confluences, tranfection of CD133+ cells with siRNA-snoRA42 and scrambled siRNA, as well as mock transfection were performed. Wound lines were created manually by scratching the monolayer with a sterile 200 ml pipette tip and migration of the cells was assessed after 24 hours. Pictures were taken using Nikon inverted phase-contrast microscope (Nikon, Melville, NY). The distance between the parallel lines was measured using ImageJ software. All experiments were carried out at least three times.
Apoptosis assay
Cell apoptosis was determined by two-color immunofluorescence staining followed by flowcytometric analysis. Cells were trypsinized without EDTA (Sigma) followed by two washing steps with phosphate buffered saline. 2 × 10
5 cells per well were then incubated with 5 μl of FITC Annexin V (BD Pharmingen) and 5 μl of propidium iodide (BD Pharmingen) in 400 μl of 1 × binding buffer for 15 min at room temperature. Data acquisition and analysis were performed on a FACScan flowcytometer (Becton-Dickinson) using BD analysis software as described previously [
14].
Cleaved caspase ELISA
Cleaved caspase 3 ELISA was performed by using PathScan Sandwich ELISA kit (Cell signaling Technology, Inc., MA) according to manufacturer’s instructions. Cytochrome c-treated jurkat cell lysate was used as cleave caspase 3 positive control, whereas untreated jurkat cell lysate was used as cleaved caspase 3 negative control (Cell signaling Technology, Inc.). Cleaved caspase index was calculated as follows: (sample O.D. - negative control O.D./positive control O.D.-negative control O.D.)/100.
Tumorigenicity assays in vivo
The animal study protocol was performed in accordance with the guidelines of University of Maryland School of Medicine Institutional Animal Care and Use Committee. Six 6-week old female SCID/Beige mice per group were subcutaneously inoculated with 5 × 10
5 Calu-1-derived CD133+ cells with different treatments. The mice were observed for six weeks and then euthanized with CO
2. Tumor volume was calculated by using the formula: width × width × length × 0.52 [
5‐
7,
14].
Statistical analysis
Both univariate and multivariate Cox proportional hazard models were applied to assess the effect of various clinically and histopathologically interesting variants, and snoRNA expression on overall survival data of patients. Association of expression of the snoRNAs with overall survival rate was also analyzed using the Kaplan-Meier method. All P-values were determined by two-sided tests.
Acknowledgements
This work was supported in part by NCI R01CA161837, VA merit Award I01 CX000512, LUNGevity/Upstage Foundation Early Detection Award, and University of Maryland Cancer Epidemiology Alliance Seed Grant (F.J.).Multidisciplinary Research Career Development Program, and an exploratory research grant from Maryland Stem Cell Fund (F. J.).
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
FJ designed the study, performed research, analyzed data and wrote the paper. KM, JL, and JS performed microarray and RT-qPCR, in vitro and in vivo analyses. ZL analyzed data. All authors have read and approved the final manuscript.