Background
Lung cancer is the second cancer diagnosed and the first leading cause of cancer-related death. Among these cases, non-small-cell lung cancer (NSCLC)accounts for 80–85% of the total incidence in the world [
1]. Major reasons for a poor prognosis are associated with aggressive phenotypes that result in a preference to metastasis at early stage [
2‐
4]. Despite of recent advances in the treatment for NSCLC, there are growing requirements for innovative therapeutic strategies to decrease the mortality of lung cancer [
1,
5,
6].
It is well-known that tumor microenvironment is important for cancer development and metastasis. Macrophages are essential immune cells that play a critical role in carcinogenesis and tumor progression in the tumor microenvironment [
7], which can be divided into two subsets: the classical subtype of activated macrophage (M1) and the alternative subtype of activated macrophages (M2) [
8]. These tumor-associated macrophages (TAMs) may have potential with anti-tumor (M1) or pro-tumor (M2) functions depending on the cytokine milieu of the tumor microenvironment [
9]. Of note, more evidence supports that TAMs with M2 phenotype promote tumor progression through complex autocrine and paracrine pathways which are closely associated with tumor malignant proliferation, invasion, and metastasis [
8,
9]. Among these factors, matrix metalloproteinases (MMPs) are known to generate a variety of anti-angiogenic peptides. In addition, M2 phenotype of TAMs can also accumulate fibrin, collagen, degrade extracellular matrix (ECM) and promoting tumor growth and metastasis. Moreover, accumulating evidence suggests that TAMs are responsible for releasing several growth factors, cytokines, chemokines, inflammatory mediators and other molecules [
10‐
12]. Many of these molecules including vascular endothelial growth factor(VEGF), platelet derived growth factor (PDGF) and interleukin-10 (IL-10) are associated with tumor growth, poor prognosis and metastasis, [
13]. Among these factors, VEGF is a key mediator of tumor-associated metastasis [
13].
G-Rh2, a major bioactive ingredient in ginseng, has been shown to have anti-tumor activities against human hepatoma cells, lung cancer cells, and leukemia cells [
14‐
16]. Many reports have demonstrated that mechanisms underlying G-Rh2 to against cancer mainly via arresting cell cycles at G1 phase and activating apoptosis-related pathways, such as Bcl2 family members and caspase signaling [
14‐
16]. Recently,G-Rh2 is reported to inhibit lung cancer cell growth by blocking the PI3K-Akt signaling pathway [
17]. Furthermore, the anti-inflammation function of G-Rh2 has attracted many attentions mainly through regulating a critical inflammatory mediator, NF-kappa B (NF-κB) [
18]. However, it remains unclear whether G-Rh2 could modulate the macrophage polarization and alter the communication between macrophages and NSCLC, thereby affecting lung cancer progress.
In the present study, we demonstrated that G-Rh2converts the differentiation of macrophages from M2 to M1 phenotype that results in decreasing the levels of MMPs and VEGF and preventing the metastasis of NSCLC cells. Overall, our findings suggest that G-Rh2 has a potential to improve the tumor microenvironment and emphasize the importance of TAMs in cancer progress. This study provides an important rationale for the development of a novel therapeutic strategy in NSCLC patients through the skewing of TAMs phenotype.
Methods
Materials
G-Rh2 was obtained from National Standard Material Center (Beijing, China). Dulbecco’s modified Eagle’s medium (DMEM), fetal bovine serum (FBS), and trypsin were bought from GIBCO/BRL (Grand Island, NY, USA). VEGF-ELISA kit was purchased from R&D Systems (Minneapolis, MN, USA). VEGF antibody was from Santa Cruz Biotechnology (Santa Cruz, CA, USA).MMP9 and MMP2antibodies were purchased from Abcam (Cambridge, UK). The flow cytometry antibodies CD206, CD16/32were purchased from Peprotech (New Jersey, NJ, USA). Lipopolysaccharide (LPS) was from Sigma-Aldrich (St. Louis, MO, USA).Interferon-γ (IFN-γ) and interleukin-4 (IL-4) were produced by BioLegend (San Diego, CA, USA).
Cell lines
The murine macrophage-like cell line RAW264.7, human lung adenocarcinoma cell lines A549 and H1299, and human THP-1 cells were purchased from Shanghai Institute of Biological Science (Catalogue Number TCM13, TCHu150, TCHu160 and SCSP-648, respectively. Shanghai, China).
Cell culture and polarization of macrophages
These cells were cultured in DMEM media supplemented with 10% FBS,100 U/mL of penicillin, 100 μg/mL of streptomycin at 37 °C in a humidified atmosphere containing 5% CO2.RAW264.7 and THP-1cells were polarized into M1 and M2 macrophages with different stimulation. Combination LPS (100 ng/mL) and IFN-γ(20 ng/mL) were used to generate M1 subset macrophages. IL-4 (20 ng/mL) was used to differentiate cells into M2 subset macrophages.
Co-culture method
Transwell plate from Corning (NY, USA) with a pore size 0.4 μM was used as a co-culture system. RAW264.7 (5 × 105/mL) or THP-1 (1.5 × 105/mL) were loaded on the upper chamber. Cells were treated with IL-4 (20 ng/mL) for 48 h to differentiate into M2 macrophages. Lung cancer cells A549 or H1299 (2.5 × 105/mL) were loaded in the lower chamber for 24 h. Then, M2 macrophages and lung cancer cells were co-cultured under conditions without serum for 24 h to generate co-cultured lung cancer cells, using lung cancer cells without co-cultured as control. These cells were used for further experiments to be treated with G-Rh2.
Flow cytometry
After 48 h stimulation, differentiated cells were harvested and identified by flow cytometry with specific makers i.e. CD16/32 for M1 and CD206 for M2 macrophages. M2 macrophages were sorted out using flow cytometry with CD206 marker for further co-culture experiment.
Cell proliferation assay
In brief, A549, H1299 cells, and respective co-cultured cells were seeded in 96-well plates (3 × 103 cells/well) at the logarithmic phase. After 24 h, cells were treated with different concentrations of G-Rh2 (5, 10, 20, 40, 60, 80, 100, 120 μM) for 72 h. Then, the proliferation of the cells was determined by CCK-8 assay according to manufacturer’s instruction.
Wound healing assay
The cells were seeded in a 12-well plate to form a monolayer one day before the assay. After making a uniform straight scratch with a pipette tip, cells were incubated for 24 h. Cell motility was assessed by measuring the speed of wound closure at intervals. Each experiment was performed in triplicate.
Enzyme-linked immunosorbent assay (ELISA)
The concentration of VEGF in the supernatant was determined by ELISA Kit (R&D System). Samples from each group were collected in sterile tubes and centrifuged at 1500 rpm for 15 min to obtain supernatants. The supernatants were analyzed according to the manufacturer’s instructions. Results were presented as picograms of VEGF per milliliter.
Western blot analysis
Briefly, cells were washed twice with ice-cold phosphate buffer saline(PBS) after treatment with G-Rh2 for 24 h. Next, cells were harvested with ice-cold lysis buffer. Then, cell lysates were centrifuged at 12,000×g for 10 min at 4 °C and collected the supernatant. The total of 50 μg protein per sample was separated by electrophoresis on 8 to 10% SDS-PAGE gel. Then, protein was transferred onto a nitrocellulose membrane. The membrane was blocked with 5% non-fat dry milk for 1 h and incubated with MMP2, MMP9, and VEGF-C (1:1000) primary antibodies overnight at 4 °C. β-actin was used as a loading control.
Quantitative real-time reverse transcription-PCR
Total RNA isolated from cells using an RNeasy Micro kit (Qiagen) was converted to first-strand cDNA using a high-capacity cDNA reverse transcription kit (Applied Biosystem). Quantitative real-time PCR assays were performed with SYBR Green PCR Master Mix (Applied Biosystems) and a 7900HT Fast Real-time PCR System (Applied Biosystems). All primers were synthesized in Huada Biotechnology Corporation (Shenzhen, China). The sequence of primers was shown in the Table
1. All data were normalized by β-actin.
Table 1
RT-qPCR primers used in the study
β-actin | 5’-CTGGAACGGTGAAGGTGACA-3’ |
5’-AAGGGACTTCCTGTAACAACGCA-3’ |
MMP2 | 5’-GCTGGAGACAAATTCTGGAGATACA-3’ |
5’-GTATCGAAGGCAGTGGAGAGGA-3’ |
MMP9 | 5’-GTATCGAAGGCAGTGGAGAGGA-3’ |
5’-CAGGGACAGTTGCTTCTGGA −3’ |
VEGF | 5’-CAGGGACAGTTGCTTCTGGA − 3’ |
5’-CAGGGACAGTTGCTTCTGGA − 3’ |
TNFα | 5’-CCCCAAAGGGATGAGAAGTT-3’ |
5’-CACTTGGTGGTTTGCTACGA − 3′ |
iNOS | 5′-GTTCTCAGCCCAACAATACAAGA-3′ |
5′-GTGGACGGGTCGATGTCAC-3′ |
ARG-1 | 5′-CAGAAGAATGGAAGAGTCAG-3′ |
5′-CAGAI’ATGCAGGGAGTCACC-3′ |
Immunohistochemistry
It was performed as previously described [
11]. Briefly, paraffin-embedded tumor samples were cut into 4 μm-thick sections and mounted on polylysine-coated slides. Samples were dewaxed in xylene and rehydrated using a graded series of ethanol solutions. After deparaffinization, endogenous peroxidase activity was blocked by incubation with 3% peroxide-methanol solution at room temperature (RT) for 10 min, and then antigen retrieval was performed at 100 °C in an autoclave for 7 min. After washing with PBS, sections were incubated with primary antibodies against theCD206 monoclonal antibody (clone 10D6, Zhongshan Goldenbridge Biotechnology Co., LTD., Beijing, China) and VEGF-C (Santa Cruz Biotechnology, Santa Cruz, CA, USA)overnight at 4 °C. Next, sections were incubated with aDAKO EnVision kit (DAKO, Glostrup, Denmark) following the manufacturer’s instructions. Finally, sections were faintly counter-stained with hematoxylin and mounted with glycerol gelatin.
Animal experiments
Female 5-week-old C57BL/6 mice (n = 14) were purchased from Shanghai Silaike Experiment Animal Co., Ltd. (Shanghai, China). Animal experiments were conducted in animal room with Specific Pathogen Free (SPF) standards. All animal experiment protocols were approved by Institutional Animal Care and Use Committee. Each mouse was subcutaneously injected 5 × 105 murine lewis lung carcinoma (LLC) cells on right should blade. Then, mice were randomly divided into two groups: vehicle control (n = 7) and G-Rh2 (n = 7) which was administered i.p. at 40 mg kg− 1 daily for 21 days. Tumor size was measured daily. Then mice were sacrificed after CO2 anesthesia. Tumor tissues were isolated and fixed in formalin immediately for further immunohistochemistry experiments.
Statistical analysis
Statistical analysis was performed using the SPSS statistical package (version 13.0; SPSS Inc., Chicago, IL, USA). All of the data from the quantitative assays are expressed as means ± standard deviation. The significant differences between the groups were evaluated by one-way analysis of variance (ANOVA) and χ2 test. Results were considered statistically significant if the P value was less than 0.05.
Discussion
The complex communication between tumor cells and TAMs within the tumor microenvironment affects the cancer development [
2,
27]. TAMs can be either pro- or anti-tumorigenic in response to different environmental cues [
2,
28,
29]. Thus, how to polarization macrophages towards therapeutic effects is a desired strategy for cancer treatment. Our findings demonstrate that M2 subset of macrophages are potent to increase migration and upregulate expression of angiogenesis and invasion associated factors such as VEGF and MMPs in lung cancer cells. Importantly, G-Rh2 significantly induces M2 macrophage differentiation into the M1 phenotype which leads to the prevention of migration and less expression of these angiogenetic factors by lung cancer cells. All of these suggest that G-Rh2 is a therapeutic candidate to improve the microenvironment of lung cancer.
Growing evidence has shown that G-Rh2 activates apoptosis-related signal pathways to inhibit cancer cell growth [
14‐
16]. In agreement with those results, we also observe that G-Rh2 significantly inhibits lung cancer cell growth in vitro and in vivo. Importantly, we provide a novel mechanistic finding that G-Rh2 has a potential to inhibit invasion and migration of lung cancer cells via modulation the phenotypes of macrophages. Our results indicate that alternative differentiation of the M2 phenotype of macrophage into the M1 subset by G-Rh2 benefits the therapy for lung cancer. Nevertheless, it is still unclear how G-Rh2 affects the polarization of macrophages. Xie et al. reported that G-Rh2 can inhibit the PI3K/Akt signal pathway [
17], which might be a candidate signal being involved in the regulation of macrophage differentiation [
30]. Of note, macrophages display remarkable plasticity and can change their physiology in response to environmental changes. These alterations can give rise to different populations of cells with distinct functions [
31,
32].
Functionally, macrophages are broadly classified into two groups, proinflammatoryM1 and anti-inflammatoryM2 according to the secreted cytokines [
31‐
33]. Interestingly, M1 macrophages have anti-tumor activities, whereas M2 subset exhibits pro-tumorigenic features [
31‐
33]. These distinct functions of M1 and M2 macrophages in inflammation and cancer provide an important rationale for the clinic to generate a personized macrophages differentiation strategy according to different diseases [
34‐
36]. However, it should be pointed out here that differentiation of macrophages is a complicated processing with multiple growth factors and cytokines secreted by macrophages and cancer cells [
31‐
33]. Among these factors, VEGF is a key angiogenic factor secreted by tumors, as well as by macrophages in the tumor microenvironment [
33] which has been confirmed to be associated with poor prognosis for cancer patients [
12,
26,
37]. Moreover, the distribution of TAMs is affected by these angiogenic factors. Despite of the fact that TAMs widely distribute in the tumor microenvironment including the invasive tumor edge, center of tumor mass, and perivascular areas [
20],the enrichment of perivascular macrophages has been shown to correlate with increased tumor angiogenesis, distant metastasis, and poor prognosis [
20,
38‐
40]. Consistent with these findings, our results demonstrate that M2 macrophages significantly upregulate expression levels of angiogenesis-related molecules such as VEGF, MMP2, and MMP9 after being co-cultured with lung cancer cells, resulting in the poor prognosis of lung cancer [
41,
42]. A clinical relevant finding in the present study is that G-Rh2 has a potential to remarkably downregulate the expression of these factors.
Acknowledgements
The authors thank for the Center Laboratory at Shanghai Tenth People’s Hospital for providing experimental platform, and thank for Dr. Qingyuan Yang in the Center Laboratory at Shanghai Tenth People’s Hospital for providing valuable technical guidance and support.