Introduction
Estrogen receptor-alpha-positive (ERα
+) and progesterone receptor-positive (PR
+) breast cancer account for approximately 60% to 70% of the breast cancer cases diagnosed in humans [
1,
2]. The majority of these tumors exhibit a molecular signature that is characteristic of the luminal subtype [
3]. The standard of care for luminal breast cancer is either to inhibit ERα signaling using selective ER modulators or to deprive the tumors of estradiol (E2) by ovarian ablation or aromatase inhibition [
4]. Despite the advances in the treatment of luminal breast cancers, progress has been hampered by a significant deficit in murine models that fully reproduce the hormonal responsiveness and dependency of human ERα
+/PR
+ breast cancers [
5‐
8] and that can be used to develop better methods to follow the disease after treatment.
STAT1 is a transcription factor that plays a critical role in interferon (IFN) signaling [
9]. Cells lacking STAT1 respond aberrantly to IFNα/β and IFNγ, and STAT1
-/- mice display immune defects rendering them highly susceptible to infection [
10,
11] and tumor development [
12,
13]. The latter finding shows that STAT1 is important in manifesting the IFN-dependent, cell-extrinsic tumor suppressor actions of immunity (that is, the elimination phase of cancer immunoediting [
14]). Other studies have also suggested that STAT1 can function as a cell-intrinsic tumor suppressor by maintaining basal expression levels of caspases [
15], upregulating p27
Kip1 expression [
16,
17], or interacting with p53 or BRCA1 [
18‐
20]. However, these latter studies were conducted mostly with cell lines
in vitro and have not been validated by
in vivo approaches. Most recently,
in vivo studies indicated that STAT1 could suppress tumor development in the ErbB2/Neu-driven mammary tumor models [
21,
22], although its action in other types of mammary tumors remains undefined. Paradoxically, others have proposed that STAT1 can facilitate tumor outgrowth since elevated levels of STAT1 in melanoma cell lines result in their acquisition of resistance to radiation or chemotherapy [
23,
24]. This apparent paradox has also been observed in biopsies of human breast cancers [
25,
26]. However, it remains unclear whether the altered STAT1 levels were present in the breast cancer cells themselves or in stromal cells. Thus, the physiological role of STAT1 during cancer development remains poorly understood and may be context-dependent.
Here, we show that STAT1 expression is lost or significantly diminished in the neoplastic cells of a subset of human patients with ERα+/PR+ breast cancer relative to normal breast epithelium, suggesting that downregulation of STAT1 is associated with tumor progression. To further investigate this observation, we followed female mice lacking STAT1 longitudinally and found that they spontaneously develop ERα+/PR+, hormone-responsive mammary gland cancers of the luminal subtype, thus closely recapitulating the characteristics of human ERα+/PR+ luminal breast cancers.
Immunohistochemistry and immunofluorescence analyses on murine tumor samples
Tumors were harvested and fixed in 10% neutral buffered formalin for 1 to 2 days. Paraffin blocks were made, and slides were stained with hematoxylin and eosin (H&E) for histological examination. To examine the presence of ERα and PR, slides were deparaffinized, serially rehydrated, and stained in accordance with the routine procedures in the Mutant Mouse Pathology Laboratory of the University of California at Davis. For the immunofluoresence assay determining the presence of fibroblasts, SSM tumor cells were plated on coverslips and allowed to attach overnight. Cells were then fixed and permeablized with ice-cold methanol and then acetone for 10 minutes each at -20°C. Coverslips were washed extensively with 1× phosphate-buffered saline (PBS) and blocked with 5.5% normal donkey serum and 2% bovine serum albumin in PBS. Cells were incubated with anti-cytokeratin (anti-CK) (wide spectrum) (Z0622, 1:200; Dako) or anti-vimentin (sc-7557, 1:50; Santa Cruz Biotechnology, Inc.) for 1 hour at room temperature. Donkey anti-rabbit conjugated with Cy2 and donkey anti-goat conjugated with Cy3 (1:200; Jackson ImmunoResearch Laboratories, Inc., West Grove, PA, USA) were used for the detection of CK and vimentin, respectively. To examine the expression of ERα, tumor cells were plated on coverslips, fixed in 4% paraformaldehyde, and permeablized in 0.5% Triton X-100. Monoclonal antibody against ERα (6F11, 1:40; Novocastra, now part of Leica, Wetzlar, Germany) and donkey anti-mouse conjugated with Cy3 were used. DAPI (4'-6-diamidino-2-phenylindole) was used to identify nuclei in all immunofluoresence assays (Molecular Probes, now part of Life Technologies, Grand Island, NY, USA).
Southern blotting
Southern blot analysis was performed as described previously [
29]. The probe was prepared by digesting a plasmid containing the MMTV long terminal repeat with BamHI (the MMTV-LTR plasmid was a generous gift from Elena Buetti of the Swiss Institute for Experimental Cancer Research in Switzerland) [
30].
MTT
MCF7, SSM1, SSM2, or SSM3 was plated in 96-well plates in phenol red-free media with 10% charcoal-treated FBS (HyClone, Logan, UT, USA) supplemented with hydrocortisone, insulin, and transferrin and with or without 10 nM 17-β-estradiol (Sigma-Aldrich). Cell proliferation was determined by using 3-(4,5-dimethyl-2-thiazlyl)-2,5-diphenyl-2H-tetrasolium bromide (MTT) assays in accordance with the instructions of the manufacturer (Promega Corporation, Madison, WI, USA).
Western blotting
SSM1, SSM2, SSM3, and NMuMG cells were lysed in RIPA buffer (R0278; Sigma-Aldrich) with 2 mM sodium vanadate, protease inhibitor cocktail (P8340, 1:500; Sigma-Aldrich), and phosphatase inhibitor cocktail (P5726, 1:100; Sigma-Aldrich). Cleared lysate (200 μg) was resolved on SDS-PAGE and transferred onto nitrocellulose membranes. ERα expression was detected by incubating blots with the monoclonal antibody 6F11 against ERα (VP-E613, 1:500; Vector Laboratories, Burlingame, CA, USA). PR expression was examined with a PR antibody against the C terminus of both PR-A and PR-B (sc-538, 1:500; Santa Cruz Biotechnology, Inc.).
Ovariectomy and tumor transplantation
Female WT or STAT1-/- mice were either sham-operated or ovariectomized at 6 to 8 weeks of age under general anesthesia. Two weeks after the surgery, 105 SSM1, SSM2, or SSM3 mammary tumor cells in 10 μL were injected into the inguinal fat pads of the mice. Alternatively, tumor fragments of about 1 mm in size were transplanted into the inguinal fat pads. Tumor growth was monitored by palpation once every 3 to 6 days and measured at two perpendicular diameters. The average of the two perpendicular measurements was plotted. In experiments in which exogenous E2 was supplemented to ovariectomized mice, 60-day release E2 pellets at 0.5 mg per pellet were used (Innovative Research of America, Sarasota, FL, USA). In the endocrine treatment experiment, nu/nu mice or STAT1-/- mice were transplanted with 106 SSM3 tumor cells or tumor fragments, respectively. When the established tumors reached 5 mm in diameter, the animals were either sham-operated or ovariectomized. Tumor growth was monitored as described above.
Immunophenotypic analyses on STAT1-/-mammary glands
Mammary glands were harvested from 10- to 14-month-old STAT1
-/- female mice and digested in collagenase and hyaluronidase solution, as described in [
31]. Single-cell suspension was prepared after dissociated tissues were treated with trypsin/DNase for 1 minute and dispase/DNase for 2 minutes and passed through 40-μm cell strainers. Cells were first blocked with anti-CD16 and anti-CD32 Fcγ receptors and normal rat serum and then stained with anti-TER119-PE/Cy7 (BioLegend, San Diego, CA, USA), anti-CD31-PE/Cy7 (BioLegend), anti-CD45-PE/Cy7 (BioLegend), anti-CD24-APC (BioLegend), or anti-CD49f-biotin (BioLegend) for 20 minutes at 4°C. Streptavidin-APC/Cy7 (BioLegend) was added, and cells were incubated for 20 minutes at 4°C. Stained cells were collected by using an LSRII flow cytometer (BD Biosciences, San Jose, CA, USA). Dead cells were gated out by using DAPI (Invitrogen Corporation). Cells depleted of CD31, CD45, and TER119 were further analyzed on the basis of their CD49f and CD24 surface expression. Myoepithelial cells were defined as CD49f
hi CD24
int, whereas luminal epithelial cells were CD49f
int CD24
hi, as established previously [
31‐
33]. Flow cytometry profiles were analyzed by using FloJo software (TreeStar Inc., Ashland, OR, USA).
STAT1 reconstitution
Retrovirus expressing GFP alone, STAT1.IRES.GFP, and STAT1 mutants Y701F.IRES.GFP and S727A.IRES.GFP was prepared by co-transfecting Phoenix cells with the retrovirus plasmid and pCMV.VSVg by using FuGENE HD (Roche, Basel, Switzerland). Supernatant was harvested 48 and 72 hours after transfection and overlayed on NMuMG, SSM1, SSM2, or SSM3 cells in the presence of 8 μg/mL of polybrene for 6 to 8 hours. Infection was carried out for 2 consecutive days. The infected cells were harvested on day 2 after infection for Western blotting to confirm expression and on day 3 for flow cytometry to quantitate the percentages of cells undergoing early apoptosis. Apoptosis was measured by a flow cytometry-based annexin V-binding assay in accordance with the instructions of the manufacturer (BD Biosciences). Only the early apoptotic cells (annexin V-positive, 7AAD-negative) were analyzed.
Gene expression profiling analysis
Total RNAs were isolated from normal mammary glands of primary STAT1
-/- mammary tumors by using Trizol in accordance with the procedure of the manufacturer (Invitrogen Corporation). RNA integrity was confirmed by using an Agilent bioanalyzer (Agilent Technologies, Inc., Santa Clara, CA, USA). Labeled target cRNAs were synthesized and hybridized to Affymetrix GeneChip MOE 430 2.0 arrays in accordance with the instructions of the manufacturer. Raw data were modeled and normalized by using dChip [
34]. Well-annotated mouse and human orthologs were identified by using the Mouse Genome Informatics database [
35], and medians were used in cases of redundant probesets. The Herschkowitz data matrix contains 232 human breast cancer datasets and 122 murine datasets from 13 different mammary tumor models, which were analyzed by using 106 intrinsic genes common to the two species [
36]. To combine our STAT1
-/- mammary tumor datasets with the Herschkowitz datasets, 96 of the 106 intrinsic genes were used because of platform differences. Gene-wise normalization was carried out separately with each dataset such that each gene has median zero and unit standard deviation. Distance-weighted discrimination (DWD) was used to merge our datasets with the Herschkowitz datasets to eliminate large systematic biases arising from different RNA purification procedures and distinct microarray platforms [
37,
38]. For unsupervised cluster analysis, the average linkage hierarchical clustering algorithm was then applied to the merged datasets by using XCluster [
39] with the centered correlation coefficient as the similarity/dissimilarity metric. The gene expression heatmap and dendrogram were generated in Java TreeView [
40] to visualize the relationship between the human breast cancer subtypes and murine mammary tumor models according to the gene expression intensities of the 96 genes. Gene expression profiling data have been deposited in the National Center for Biotechnology Information's Gene Expression Omnibus (GEO) under accession number GEO:GSE31942 [
41].
sigClust
sigClust examines the significance of a given clustering by testing the null hypothesis that the datasets are from the same Gaussian distribution [
42]. We applied sigClust to five STAT1
-/- primary tumor samples and 63 human luminal breast cancer samples by using the 96-gene intrinsic gene list. The resulting
P value is 0.99998, which indicates that the STAT1
-/- mammary tumors are highly likely to be in the same cluster with the human luminal breast cancer datasets. In addition, we applied sigClust on the MMTV_Neu and MMTV_PyMT datasets from the Herschkowitz study [
36]. To avoid potential bias due to different sample sizes, we drew a set of five samples out of these two sets of data through 200 iterations and implemented the test on the set of five samples and the human luminal breast cancer datasets. The average
P values were 0.9110 (MMTV_Neu), 0.9630 (MMTV_PyMT), and 0.9665 (both mouse models combined). These results indicate that the STAT1
-/- mammary tumor model exhibits a higher degree of resemblance to human luminal breast cancers at the gene expression level than the MMTV-Neu and MMTV-PyMT models do.
Consensus clustering
To investigate the stability of clustering between STAT1
-/- mammary tumors and human luminal breast cancer, consensus clustering, which is a re-sampling-based technique that uses perturbation to simulate a set of new samples from the original merged dataset, was employed [
43]. Consensus index on empirical clustering results across all perturbed datasets was then summarized by the normalized proportion of times that two samples were assigned to the same cluster. The underlying assumption is that the induced cluster composition is more trustworthy if the clustering is robust to sampling variability. We re-sampled 1,000 times and considered the number of clusters ranging from two to 15 for assessment. Using the 96-gene intrinsic gene list, we found that the five STAT1
-/- mammary tumors belong to the same cluster 95% of the time after 1,000 re-samplings with an interquartile range (IQR) of 0.9128 to 0.9775 (range = 0.8964 to 1.0), which indicates that the STAT1
-/- mammary tumors are molecularly homogeneous. The STAT1
-/- mammary tumors and human luminal breast cancers cluster together 62% out of 1,000 re-samplings with an IQR of 0.57 to 0.67 (range = 0.32 to 0.78). In contrast, the MMTV-Neu and MMTV-PyMT mouse models cluster with the human luminal breast cancer datasets only 42% out of 1,000 re-samplings with an IQR of 0.44 to 0.48 (range = 0.01 to0.64). These results further demonstrate that the molecular signature of the STAT1
-/- mammary tumors significantly overlaps with that of human luminal breast cancers.
Statistical analyses
Time to onset was analyzed by the Kaplan-Meier product limit method, which generated the Kaplan-Meier survival curves.
P values were reported by log-rank test. All numerical results are presented as mean and standard error of mean and represent data from a minimum of three independent experiments unless otherwise stated. Tumor growth curves were analyzed by a distribution-free test [
44]. The unpaired
t test for two independent samples was used to determine the statistical significance between the experimental groups and control groups. Wilcoxon signed rank test was used to compare STAT1 intensity levels in tumor samples and adjacent normal breast tissues. Association between clinicopathological characteristics and ERα status was tested by chi-squared test or Fisher exact test, whichever was appropriate. All tests were two-sided, and a
P value of not more than 0.05 was considered significant. GraphPad Prism (GraphPad Software, Inc., La Jolla, CA, USA), SAS 9.2 (SAS Institute Inc., Cary, NC, USA), and R 2.11.1 [
45] were used for all statistical analyses.
Discussion
Current dogma, based on gene expression analyses of intact breast cancer biopsies, holds that STAT1 mRNA levels are elevated in breast cancer tissues compared with normal breast tissues [
3], leading to the hypothesis that STAT1 might facilitate tumor outgrowth. Here, we have presented a novel finding demonstrating a selective loss of STAT1 expression in neoplastic epithelial cells, but not in the surrounding stromal cells, compared with normal mammary epithelium. Additionally, this tumor cell-specific effect was observed more frequently in ERα
+ than in ERα
- human breast cancers. Therefore, an increase in STAT1 mRNA levels in the subset of breast cancer cases that exhibit low STAT1 expression in the neoplastic cells could be explained by a selective upregulation of STAT1 transcription in the stromal cells alone. Our findings thus indicate that the regulation of STAT1 expression is cell context-dependent and a STAT1 activation signature in whole-tumor biopsy might not reflect the biology of the entire tumor microenvironment. The clinical implication of these findings is that caution should be taken in interpreting the involvement of STAT1 in treatment outcomes when STAT1 activation signature in whole-tumor biopsies is used as a prognostic indicator.
Since downregulation of STAT1 expression is restricted to the neoplastic epithelial cells but not to the surrounding stromal cells, somatic silencing of STAT1 transcription may occur preferentially in the breast cancer cells. STAT1 promoter methylation in squamous cell carcinomas and prostate cancers has been proposed to be a mechanism whereby STAT1 transcription is repressed during transformation [
56,
57]. It is conceivable that STAT1 promoter methylation is likewise in action during breast cancer progression. However, we cannot eliminate the possibility that STAT1 downregulation occurs at the post-transcriptional level. Investigation undertaken to differentiate these possibilities and to determine whether STAT1 loss correlates with clinical outcome is ongoing.
To investigate the role of STAT1 in mammary tumorigenesis, we employed a novel murine system that provided mechanistic insights into the physiological consequence of loss of STAT1 expression. Specifically, we find, much to our surprise, that STAT1
-/- female mice spontaneously develop mammary gland adenocarcinomas that show remarkable similarities to human ERα
+ luminal breast cancers. Pathologically, the STAT1
-/- mammary tumors progress from a preneoplastic state classified as mammary intraepithelial neoplasia to adenocarcinoma, mirroring the progression of human breast cancer from atypical hyperplasia to ductal carcinoma
in situ and finally to invasive carcinoma. The hormone receptor status of the STAT1
-/- mammary tumors also shows a remarkable parallel to human ERα
+/PR
+ breast cancers. Biologically, STAT1
-/- mammary tumor cells depend on ovarian hormones for both the initiation and the maintenance of tumor growth. CD49f
int CD24
hi luminal epithelial cells are enriched for hormone receptor-positive cells that are rarely found in the myoepithelial cell subset [
58]. It is tempting to speculate that the tumor-initiating cells in the STAT1
-/- mammary tumors reside in the luminal epithelial subset because of the significant expansion of these cells in the preneoplastic lesions. Future work will be focused on elucidating the nature of these tumor-initiating cells.
The penetrance of multiparous STAT1
-/- mice is remarkably close to 100%, suggesting that pregnancy-associated hormones can accelerate tumorigenesis. At present, it is not possible to conclude that these hormones are required for the tumorigenesis of the STAT1
-/- mammary glands since nulliparous STAT1
-/- mice also develop mammary tumors. While elucidating the roles of pregnancy-associated hormones in mammary tumorigenesis will be the target for future investigation, work investigating the mechanism by which STAT1 suppresses tumor formation has begun. We employed a classic approach that has been used to validate tumor suppressors in the past [
54]. Similar to the classic tumor suppressors, restoration of WT STAT1 in the STAT1
-/- mammary tumor cells spontaneously causes tumor cell death. Our findings thus demonstrate that the tumor suppressor function of STAT1 is cell-autonomous. A mutant form of STAT1 lacking the functionally critical Tyr 701 residue is defective in this function, suggesting that STAT1 suppresses tumor formation by regulating the transcription of its target genes. Since phosphorylation in Ser 727 is functionally distinct from and independent of that in Tyr 701 [
55,
59,
60], the inability of the S727A mutant to abrogate cell death suggests that tumor suppression mediated by STAT1 does not require S727-dependent target genes, like
GBP-1 [
55]. Although we cannot completely eliminate the possibility that STAT1 can also act as an extrinsic tumor suppressor via its ability to mediate functional anti-tumor immunity, the cell-intrinsic effect of STAT1 is consistent with recent studies demonstrating a role for STAT1 in suppressing ErbB2/Neu-driven tumor formation [
21,
22]. Epithelial-specific deletion of STAT1 accelerates tumor development in the ErbB2/Neu tumor model. Therefore, STAT1 might exert a broader tumor suppression function against multiple oncogenic pathways. It is then noteworthy that STAT1 expression is also diminished in the neoplastic cells of 22% of the human HER2
+ breast cancer cases that we examined in this study.
Although the current repertoire of endocrine therapy is remarkably effective in treating ERα
+ breast cancers, about 30% to 50% of the patients still suffer from recurrences [
61‐
63]. Novel therapeutic targets for the treatment of ERα
+ breast cancers are, therefore, still needed. Preclinical models of human ERα
+/PR
+ breast cancers are essential for the testing of new treatments. However, only a limited number of models produce tumors that contain a significant proportion of hormone-dependent ERα
+/PR
+ tumor cells [
5‐
8]. In addition, very little is known about the molecular characteristics of the few existing mouse ERα
+/PR
+ tumor cell lines and thus it has not been possible to establish their genetic relationship to human luminal breast cancers. In contrast, STAT1
-/- mammary tumors exhibit well-defined tumor progression kinetics and a set of highly reproducible and homogeneous histopathological, biological, and molecular characteristics that closely resemble human luminal breast cancers. Most importantly, STAT1
-/- mammary tumors express elevated levels of ERα, PR, GATA3, AREG, XBP1, and FOXA1, all of which are regulated by the transcriptional control of ERα. In agreement with this activated ERα genetic signature, STAT1
-/- mammary tumor is also a unique preclinical model because of its sensitivity to standard endocrine therapy, including estrogen deprivation therapy (this study) and treatment targeting ERα (AM Fowler and MJ Welch, manuscript in preparation). Furthermore, STAT1
-/- mammary tumor cells are transplantable orthotopically into both immunocompetent and immunodeficient mice, facilitating the examination of immune-based therapies, which otherwise would not be possible in xenograft models using ERα
+/PR
+ human breast cancer cell lines. Thus, this model not only allows one to study the entire developmental program of luminal mammary tumorigenesis but also permits short-term experiments using a tumor cell transplantation approach. For these reasons, the STAT1
-/- mammary tumor is an exceptional model for human ERα
+ PR
+ luminal breast cancers.
Acknowledgements
The authors thank Drs. Paul Allen, Barry Sleckman, Emil Unanue, Ravi Uppaluri, Matthew Vesely (Washington University School of Medicine), Mark Smyth (Peter McCallum Cancer Centre), and Michel Aguet (Swiss Institute for Experimental Cancer Research) for critical review of the manuscript. The authors are grateful to Dr. Charles M Perou (University of North Carolina at Chapel Hill) for providing datasets for human breast cancers and mouse mammary tumors, Drs. David Wang and Kathie Mihindukulasuriya (Washington University School of Medicine) for performing viral microarray analyses, and Jessica Archambault and James Michael White (Washington University School of Medicine), Katie Bell (University of California, Davis), and Wei Zhu (New York University School of Medicine) for their excellent technical assistance. This work was supported by a Susan G Komen Foundation Postdoctoral Fellowship Award (SRC), a Finnel Family Fund Grant from the Cancer Research Institute (RDS), and grants from the National Cancer Institute (MJW, RDC, and RDS), National Institute of Allergy and Infectious Diseases (DEL), the Ludwig Institute for Cancer Research (RDS), and Fondazione Beretta (Brescia, Italy) (WV).
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
SRC conceived and planned the study, analyzed data, wrote the paper, analyzed the results, monitored mammary tumor development in different cohorts of mice, generated the SSM cell lines, and performed all of the biochemical, molecular, and in vivo studies. RDS conceived and planned the study, analyzed data, and wrote the paper. SL performed immunohistochemical studies on the human breast cancer biopsies. WV and LL analyzed the results. DEL monitored mammary tumor development in different cohorts of mice. JL performed gene expression profiling analyses and oversaw all statistical analyses. LJTY performed whole-mount analyses. CR performed Southern blotting. CA performed molecular studies. AMF and MJW contributed to study design. RDC analyzed the pathology of the STAT1-/- mammary tumors. All authors read and approved the final manuscript.