Bases inmunológicas de la hipopigmentación vitiligoide asociada a melanoma

Vitiligo is a skin condition characterized by white, hypopigmented macules. Melanocyte loss is a feature of the disease, and it has been hypothesized that an autoimmune mechanism could be responsible for the depigmentation. Melanoma is a malignancy that develops in melanocytes; if not detected and treated early, it is often deadly. Leukoderma, a condition characterized by depigmentation of the skin, is sometimes associated with malignant melanoma. An immune response against melanocyte antigens leading to destruction of either melanoma cells or melanocytes has been observed in both vitiligo and melanoma. Studies in animal models and humans have shown that humoral and cell-mediated immune responses are involved in modulating cytotoxic activity against tumor cells and normal melanocytes. The study of factors associated with anti-tumor immunopathogenic mechanisms —autoimmunity for example— may provide us with tools for the diagnosis and treatment of diseases such as vitiligo and malignant melanoma.     

白癜风与黑素瘤关系的研究进展

白癜风是以皮肤黑素细胞破坏导致的获得性色素脱失性疾病;黑素瘤是皮肤、黏膜黑素细胞异常增生导致的一种恶性肿瘤。近年来研究发现黑素瘤患者的白癜风发生率远远高出正常人群,这一现象的发生可能是机体抗黑素瘤的细胞及体液免疫应答作用于正常黑素细胞的结果。     

恶性黑素瘤与黑素干细胞

恶性黑素瘤是高度转移性肿瘤,对传统的治疗抵抗,黑素瘤的发生涉及遗传和环境因素。大多数黑素瘤为原发性,但部分黑素瘤从黑素细胞痣发展而来。以往认为,长期暴露于紫外线、皮肤黑素细胞逐渐积累致癌基因、肿瘤抑制基因发生突变导致了黑素细胞的增殖,并获得侵袭性和转移的能力,成为黑素瘤。另有假说认为,黑素瘤起源于毛囊外真皮黑素干细胞,紫外线诱导的突变可能会改变正常黑素干细胞自我更新、扩展和分化的过程,导致黑素瘤的形成。深入了解黑素瘤的发生机制,有利于寻求更好的治疗方案。     

Identification of genes specifically regulated in human melanoma cells

In order to improve the characterization of human malignant melanoma cells and their variant gene expression in vitro, a search for specifically regulated genes was performed. Four melanoma cell lines (M5, MEWO, IGR39, SKMEL13) and newly cultured normal human melanocytes were included in a comparative hybridization (differential screening) of a human melanoma cDNA-library. Six cDNAs were isolated showing a stronger expression (four genes) or a weaker expression (two genes) in melanoma cells than in normal human melanocytes. Quantification of the expression patterns of the two repressed genes in Northern blots revealed general expression in all melanocyte cultures examined, no expression in three cell lines (M5, IGR39, SKMEL13) and weak expression in MEWO. The four induced genes were found to be only weakly expressed in normal human melanocytes, but showed an elevated expression in all of the four melanoma cell lines tested. Thus, using the technique of differential screening, consistent gene regulation at the messenger RNA level was identified, which distinguishes the four melanoma cell lines tested from normal melanocytes. We conclude from the expression patterns that specific gene regulation in melanoma cells in vitro is characterized both by strong repression of some melanocyte genes, as well as by the induction of other genes, but there was no indication of new expression of genes specific for melanoma cells. Because of the uniform induction or repression in different melanoma cell lines, it is conceivable that the cloned genes may be involved in the malignant transformation of melanocytic cells.     

Recognition of melanoma cell antigens with antibodies present in sera from patients with vitiligo

BACKGROUND: Patients with vitiligo show specific losses of integumentary melanocytes, probably due to autoimmunity against melanocytes. We attempted to determine the presence of antibodies against pigment cell antigens in the sera of vitiligo patients. METHODS: Detergent-solubilized human melanoma cells were submitted to electrophoretic separation and immunoblotted against serum samples obtained from 19 patients with vitiligo and from 20 age- and sex-matched healthy individuals. RESULTS: Eighty-nine per cent of patients with vitiligo had antibodies to one or more pigment cell antigens. Similar antibodies were detected in 20% of healthy individuals. Antigens of 165, 90, and 68 kDa were recognized by the antibodies present in sera from 11%, 26%, and 37% of vitiligo patients, respectively, and in none of the normal sera. All patients with familial vitiligo also had antibodies to these three proteins. CONCLUSIONS: Proteins of 165, 90, and 68 kDa are specifically recognized by antibodies present in the sera of vitiligo patients and in all patients with genetic vitiligo. Whether or not these proteins might be implicated in the destruction of melanocytes by the immune system in vitiligo remains to be evaluated.     

Expression of vitiligo antigen on a revertant line of hamster melanoma cells

Our laboratory has recently reported that over 80% of patients with common vitiligo have circulating antibodies to cell-surface antigens on normal human melanocytes. The slow growth rate of these cells limits the assays that can be performed for antibody detection. We now have found that the antigens defined by vitiligo sera on melanocytes are also expressed on FF cells, a revertant line of hamster melanoma cells. These antigens can be detected both by indirect immunofluorescence and specific immunoprecipitation assays. The presence of "vitiligo" antigens on hamster FF cells will aid further study of the abnormal immune response in vitiligo.     

Inducible nitric oxide synthase is expressed in normal human melanocytes but not in melanoma cells in response to tumor necrosis factor-alpha,interferon-gamma,and lipopolysaccharide

Nitric oxide is a gaseous messenger involved in the regulation of several physiologic processes in various cell types, including skin cells. Three different nitric oxide synthases (neuronal nitric oxide synthase, endothelial nitric oxide synthase, inducible nitric oxide synthase) have been identified in human cells. For inducible nitric oxide synthase, an inducibility by cytokines and lipopolysaccharides have been found. For murine melanoma cells, a connection between elevated levels of nitric oxide after inducible nitric oxide synthase induction and consequent apoptosis had been described. By northern analysis, we detected inducible nitric oxide synthase mRNA in four of 15 human melanoma cell lines cultured without inducible nitric oxide synthase inducing cytokines. Induction of inducible nitric oxide synthase mRNA by tumor necrosis factor-alpha, interferon-gamma, and lipopolysaccharides was seen in normal human melanocytes but not in melanoma cell lines. In accordance, inducible nitric oxide synthase protein expression was clearly inducible in cultures of normal melanocytes, whereas in six melanoma cell lines investigated, inducible nitric oxide synthase was found weakly expressed already before treatment with tumor necrosis factor-alpha, interferon-gamma, and lipopolysaccharides, and its expression was not inducible. The apoptotic rates both in normal melanocytes and in two melanoma cell lines (SK-Mel-19 and O-Mel-2) were increased by treatment with tumor necrosis factor-alpha, interferon-gamma, and lipopolysaccharides; however, these effects could not be prevented by the specific nitric oxide synthase inhibitor N(G)-monomethyl-L-arginine. These data reveal a clear-cut difference between human melanoma cell lines and cultured normal human melanocytes with respect to inducible nitric oxide synthase inducibility. Although the data do not support the hypothesis that inducible nitric oxide synthase is an important regulator for apoptosis in human melanoma cells, the regulation deficiency found for melanoma cells may be of importance for melanocytic transformation and tumor progression.     

Detection of antibodies to melanocytes in vitiligo by specific immunoprecipitation

Immunoprecipitation was used to assay for antibodies to normal human melanocytes in the sera of 12 patients with common vitiligo and 12 normal individuals. The procedure is based on the specific immunoprecipitation using protein A-sepharose of antibodies binding to detergent-soluble, radioiodinated macromolecules of normal human melanocytes grown in culture. Antibodies to melanocytes were found in all 12 patients with vitiligo but in none of the normal sera. None of the sera reacted specifically to normal human fibroblasts or to human melanoma cells radioiodinated in a similar manner. These observations suggest that antibodies to melanocyte-associated antigens are present in common vitiligo.     

Notch and NOXA-related pathways in melanoma cells

Notch receptor-mediated intracellular events represent an ancient cell signaling system, and alterations in Notch expression are associated with various malignancies in which Notch may function as an oncogene or less commonly as a tumor suppressor. Notch signaling regulates cell fate decisions in the epidermis, including influencing stem cell dynamics and growth/differentiation control of cells in skin. Because of increasing evidence that the Notch signaling network is deregulated in human malignancies, Notch receptors have become attractive targets for selective killing of malignant cells. Compared with proliferating normal human melanocytes, melanoma cell lines are characterized by markedly enhanced levels of activated Notch-1 receptor. By using a small molecule gamma-secretase inhibitor (GSI) consisting of a tripeptide aldehyde, N-benzyloxycarbonyl-Leu-Leu-Nle-CHO, which can block processing and activation of all four different Notch receptors, we identified a specific apoptotic vulnerability in melanoma cells. GSI triggers apoptosis in melanoma cells, but only G2/M growth arrest in melanocytes without subsequent cell death. Moreover, GSI treatment induced a pro-apoptotic BH3-only protein, NOXA, in melanoma cells but not in normal melanocytes. The use of GSI to induce NOXA induction overcomes the apoptotic resistance of melanoma cells, which commonly express numerous cell survival proteins such as Mcl-1, Bcl-2, and survivin. Taken together, these results highlight the concept of synthetic lethality in which exposure to GSI, in combination with melanoma cells overexpressing activated Notch receptors, has lethal consequences, producing selective killing of melanoma cells, while sparing normal melanocytes. By identifying signaling pathways that contribute to the transformation of melanoma cells (e.g. Notch signaling), and anti-cancer agents that achieve tumor selectivity (e.g., GSI-induced NOXA), this experimental approach provides a useful framework for future therapeutic strategies in cutaneous oncology.     

Identification of progenitor cancer stem cell in lentigo maligna melanoma

ABSTRACT:  The potential role of stem cells in neoplasia has aroused considerable interest over the past few years. A number of known biologic characteristics of melanomas support the theory that they may originate in a mutated stem cell. Melanocytic stem cell markers have been described recently. Moreover, the CD133 cells that show surface markers for CD34 are stem cells primitive. These stem cells are capable of differentiating into neurons, glia, keratinocytes, smooth muscle cells, and melanocytes in vitro. The identification of cancer stem/initiating cells with a crucial role in tumor formation may open up new pharmacologic perspectives. The purpose of this study is to detect the expression of CD133 and CD34, two putative markers of cancer stem cells in the lentigo maligna melanoma. Thirty cases of lentigo maligna melanoma were analyzed using indirect immunohistochemical staining. The vast majority of the samples analyzed showed the presence of rare cells, which were clearly positive for CD133 and CD34. Strong CD133 and CD34 staining was found in the outer root sheath of the mid-lower hair follicles, intermixed with atypical melanocytes extending along layers of the hair follicles. A number of these staminal cells were adjacent and intermixed with melanoma cells. This study supports the stem cell origin of this tumor and suggests that the precursor of the melanoma in question is a stem-like cell rather than the primitive melanoblast committed to be exclusively involved in melanocytic differentiation.     

Identification of progenitor cancer stem cell in lentigo maligna melanoma

The potential role of stem cells in neoplasia has aroused considerable interest over the past few years. A number of known biologic characteristics of melanomas support the theory that they may originate in a mutated stem cell. Melanocytic stem cell markers have been described recently. Moreover, the CD133 cells that show surface markers for CD34 are stem cells primitive. These stem cells are capable of differentiating into neurons, glia, keratinocytes, smooth muscle cells, and melanocytes in vitro. The identification of cancer stem/initiating cells with a crucial role in tumor formation may open up new pharmacologic perspectives. The purpose of this study is to detect the expression of CD133 and CD34, two putative markers of cancer stem cells in the lentigo maligna melanoma. Thirty cases of lentigo maligna melanoma were analyzed using indirect immunohistochemical staining. The vast majority of the samples analyzed showed the presence of rare cells, which were clearly positive for CD133 and CD34. Strong CD133 and CD34 staining was found in the outer root sheath of the mid-lower hair follicles, intermixed with atypical melanocytes extending along layers of the hair follicles. A number of these staminal cells were adjacent and intermixed with melanoma cells. This study supports the stem cell origin of this tumor and suggests that the precursor of the melanoma in question is a stem-like cell rather than the primitive melanoblast committed to be exclusively involved in melanocytic differentiation.     

Bcl-2 and bcl-xL antisense oligonucleotides induce apoptosis in melanoma cells of different clinical stages

Recent clinical studies have shown the promise of bcl-2 antisense therapy in patients with melanoma. To further demonstrate the importance of bcl-2 and validate the related antiapoptotic protein bcl-xL as targets for antisense therapy in melanoma, their implication as survival factors in melanoma cells of different clinical stages as well as in normal melanocytes was investigated. Primary cell cultures derived from 17 melanomas, the cell line A375, and normal melanocytes from healthy donors were treated with antisense oligonucleotides targeting either the bcl-xL mRNA or the bcl-2 and the bcl-xL mRNAs simultaneously. Bcl-2 and bcl-xL expression in cells was analyzed by real-time polymerase chain reaction and Western blotting. Cell viability was assessed in 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and apoptosis assays. Bcl-2 expression was low in melanoma cells of stages I, II, and III, hardly detectable in A375 cells, but high in normal melanocytes. Bcl-xL expression was high in all cell types tested. As shown in A375 cells and the stage III melanoma cells 0513, both the bcl-xL monospecific oligonucleotide 4259 and the bcl-2/bcl-xL bispecific oligonucleotide 4625 effectively reduced tumor cell viability by induction of apoptosis with IC50 values ranging from 200 to 350 nM. Oligonucleotide 4625 proved to be superior to 4259, as it significantly reduced the viability of cells from all melanoma stages. Both oligonucleotides reduced also the viability of normal melanocytes. Our data suggest that bcl-2 and bcl-xL are promising targets for antisense therapy of melanoma, and that the simultaneous downregulation of their expression may provide additional clinical benefit.     

Identification of a melanoma progression antigen as integrin VLA-2

The expression of the integrin receptors VLA-1, -2, -3, and -6 was studied in normal cultured melanocytes and in five melanoma cell lines. Normal melanocytes synthesized VLA-3, but did not reveal detectable levels of VLA-1, -2, and -6. All melanoma cell lines, however, expressed VLA-2, -3, and -6. VLA-1 was synthesized by two of five melanoma lines. In parallel, we had analyzed the expression of four previously characterized melanoma cell surface antigens. One of them (antigen A.1.43), which is associated with tumor progression of human melanoma, revealed a striking similarity to VLA-2. In sequential immunoprecipitation experiments, we show that A.1.43 is identical with the integrin VLA-2, a cell surface receptor for collagen, laminin, and fibronectin.     

Differentiation antigens of melanocytes and melanoma: analysis of melanosome and cell surface markers of human pigmented cells with monoclonal antibodies

Three mouse monoclonal antibodies (mAbs) recognizing antigens of human melanocytic cells were used to study a large panel of cultured normal and tumor cells and fresh tissues. Two of the monoclonal antibodies (designated TA99 and CF21) detect melanosomal antigens, whereas mAbC350 recognizes a cell surface antigen. Among cultured cells the three mAbs reacted exclusively with normal melanocytes and pigmented melanomas, but not with nonpigmented melanomas or cells of other lineage. Immunohistochemical assays using mAbTA99 and mAbCF21 on fresh-frozen sections from a large panel of normal tissues revealed a characteristic pattern of reactivity restricted to pigmented cells. mAbC350 did not react with any normal tissues. All nevi and primary melanoma specimens and 93% of metastatic melanomas were reactive with at least one of these three monoclonal antibodies. No reactivity was found with 62 nonmelanoma tumors. An inverse correlation was observed between TA99 expression and stage of tumor progression. These markers are useful for studies of melanocyte differentiation and malignant transformation, subsetting of melanocytic lesions, and identification of tumors of melanocytic origin.     

Aberrant expression of the maspin gene associated with epigenetic modification in melanoma cells

Maspin, a mammary serine protease inhibitor, was originally reported to be a tumor suppressor gene in breast and prostate cancers. The expression pattern of the maspin gene differs among cancer types and normal tissue however, and its significance as a tumor suppressor has been questioned. In this study, maspin expression and/or allele-specific methylation status were investigated in five melanoma cell lines and a normal human epidermal melanocyte (NHEM) cell line, and 80 surgically resected tumors (40 melanomas and 40 melanocytic nevi). One (HMV-I) of five melanoma cell lines overexpressed maspin protein whereas the remaining four melanoma cell lines and NHEM did not. The 19 CpG sites of the maspin promoter region were extensively hypomethylated in HMV-I, a maspin-positive cell line, and those of the remaining four melanoma and NHEM cell lines were hypermethylated. Furthermore, maspin-negative cell lines exhibited activation after treatment with 5-aza-2'-deoxycytidine, a DNA demethylating agent. Immunoreactivity for maspin was negative in normal skin melanocytes and 40 melanocytic nevi, but five (12.5%) of 40 melanomas were positive. The methylation status judged by the methylation-specific PCR method was inversely correlated with maspin protein expression in vitro and in vivo. These results suggest that maspin expression in normal skin melanocytes and melanocytic nevi may be repressed in a cell-type-specific manner, whereas maspin is expressed aberrantly in a subset of melanoma cells by epigenetic modification. Further investigations are required to determine the significance of aberrant maspin expression.