Deregulation of the p14ARF/Mdm2/p53 pathway and G1/S transition in two glioblastoma sets

Sixty-one glioblastomas have been studied, subdivided into the categories of classic glioblastomas (GBM) and glioblastomas with astrocytic (GBA) and oligodendroglial (GBO) differentiated areas. On surgical samples, TP53, Mdm2, CDKN2A/p16–p14 alterations were studied by molecular biology techniques and by immunohistochemistry. It has been found that Mdm2 amplification was more frequent in GBM than in GBA and GBO, that p14^ARF was inactivated in a high percentage of cases in the three tumor categories. Both these and other alterations did not reach a statistical significance, with the exception of CDKN2A/p16 homozygous deletion which showed the highest frequency in GBO. The latter finding could be in line with the observation that CDKN2A/p16 inactivation is a step in the molecular pathway to tumor progression in oligodendrogliomas. TP53 mutations and Mdm2 amplifications were mutually exclusive, whereas TP53 mutations and CDKN2A/p14 inactivation coexisted in 5 cases. The alterations of the p53/Mdm2/p14^ARF pathway occurred in 73% of cases and in 80% of cases if CDKN2A homozygous deletions were associated. All glioblastomas with gemistocytic areas showed p14^ARF inactivation. Immunohistochemistry showed higher percentages of positivity in comparison with molecular genetics, but with similar variations.     

Expression of p14ARF overcomes tumor resistance to p53

Tumors without p53 mutation are often resistant to p53 gene therapy. We examined the mechanism using p53-resistant A549 cells and p53-sensitive H1299 cells. We found that p53 delivered by adenovirus is poorly expressed in A549 (ARF-null) cells but efficiently expressed in H1299 cells (ARF-positive). Strong p53 expression and apoptosis can be achieved in A549 cells using a p53 mutant resistant to degradation by MDM2 or by coexpression of ARF. The results suggest that enhanced MDM2 activity attributable to loss of ARF contributes to p53 resistance. Surprisingly, tumor cell lines with MDM2 gene amplification are still deficient for ARF expression, suggesting that MDM2 amplification does not substitute for ARF inactivation during tumor development.     

Human tumor suppressor ARF impedes S-phase progression independent of p53

Using alternative reading frames, the human ARF-INK4a locus encodes two unrelated proteins that both function in tumor suppression. p16(INK4a) maintains the retinoblastoma protein in its growth-suppressive state through inhibition of cyclin D-dependent kinase activity, whereas ARF binds with MDM2 and stabilizes p53. The majority of the activity of ARF to date is ascribed to its ability to activate p53, resulting in a G(1) cell cycle arrest or apoptosis. We show here that ARF colocalizes with DNA replication protein A (RPA32) and that overexpression of ARF reduces the rate of DNA synthesis resulting in accumulation of an S-phase cell population. Impediment of DNA synthesis by ARF can occur and becomes more evident in the absence of p53. Hence, the biological consequence of ARF induction varies dependent on cellular p53 status, inducing predominantly a G(1) arrest or apoptosis in p53-positive cells or causing S-phase retardation when p53 function is comprised.     

Expression of the p14ARF tumor suppressor predicts survival in acute myeloid leukemia.

Cell cycle aberrations are associated with therapy outcome in many types of cancer. We analyzed mRNA expression levels of 18 cell cycle-related genes in bone marrow samples from 78 acute myeloid leukemia (AML) patients and six controls using high-throughput quantitative RT-PCR. Samples of AML patients contained significantly increased mRNA expression levels of the mdm2 and c-myc oncogenes. Also, the average expression levels of p14ARF and p16INK4A were higher in patient samples compared to controls. Leukemic blasts and control bone marrow samples did not differ significantly in the expression levels of proliferation-associated genes such as cyclin A2 and pcna. When single genes were analyzed for prognostic significance in Kaplan-Meier and Cox regression analyses, a low p14ARF level emerged as a strong and independent predictor for poor survival (P=0.04 and 0.029). Subsequently, p14ARF mRNA levels were analyzed in a second, independent patient population (n=57). Again, low p14ARF levels were associated with a worse outcome. Finally, immunohistochemistry analysis of AML tissue arrays confirmed the widespread expression of c-myc and p14ARF in AML on the protein level. Taken together, the expression of the p53 regulators mdm2 and p14ARF are altered in AML, and low p14ARF levels indicate a poor prognosis.     

p14ARF和p53在子宫内膜癌组织中的表达及其临床意义

目的研究子宫内膜癌组织中p14ARF和p53的表达及意义.方法采用免疫组化LSAB法,检测118例子宫内膜癌及30例正常宫内膜组织中p14ARF及p53的表达.结果p14ARF阴性、弱阳性、中度阳性和强阳性表达率在子宫内膜癌中分别为25.4%(30/118)、38.1%(45/118)、14.4%(17/118)和22.0%(26/118),与正常内膜0(0/30)、56.7%(17/30)、33.3%(10/30)和10.0%(3/30)相比差异有统计学意义,P<0.001,子宫内膜癌中p14ARF表达缺失的比例高于正常宫内膜;p14ARF表达水平与手术病理分期、宫颈间质受累和淋巴结转移相关;与病理分级、组织学类型和肌层侵犯深度无关;不同p14ARF表达水平患者生存率差异无统计学意义,P=0.578 1.p53阴性、弱阳性、中度阳性和强阳性表达率在子宫内膜癌中分别为13.6%(16/118)、40.1%(48/118)、28.0%(33/118)和17.8%(21/118);与正常内膜相比分别为36.7%(11/30)、36.7%(11/30)、16.2%(5/30)和10.0%(3/30)差异有统计学意义,P=0.01,子宫内膜癌中p53阳性表达的比例高于正常宫内膜;p53表达与肿瘤分期、盆腔淋巴结转移和肌层侵犯深度相关,与病理分级、组织学类型和宫颈间质受累无关;不同p53表达水平患者生存率差异无统计学意义,P=0.416 6;在子宫内膜癌组织中p14ARF与p53表达呈负相关,r＝-0.243,P＝0.008.结论p14ARF和p53异常表达与子宫内膜癌发生密切相关,但对其预后的影响有待进一步的研究.     

Deregulation of the p14ARF/MDM2/p53 pathway is a prerequisite for human astrocytic gliomas with G1-S transition control gene abnormalities

Deregulation of G1-S transition control in cell cycle is one of the important mechanisms in the development of human tumors including astrocytic gliomas. We have previously reported that approximately two-thirds of glioblastomas (GBs) had abnormalities of G1-S transition control either by mutation/homozygous deletion of RB1 or CDKN2A p16INK4A), or amplification of CDK4 (K. Ichimura et al., Oncogene, 13: 1065-1072, 1996). However, abnormalities of G1-S transition control genes may induce p53-dependent apoptosis in cells. Recent investigations suggest that p14ARF is induced in response to abnormal cell cycle entry and results in p53 accumulation by inhibiting MDM2-mediated transactivational silencing and degradation of p53. To investigate the roles of the G1-S transition control system and the p14ARF/MDM2/p53 pathway in the development of astrocytic gliomas, we examined abnormalities of genes involved in these regulatory pathways in a total of 190 primary human astrocytic gliomas of different malignancy grades [136 GBs, 39 anaplastic astrocytomas (AAs) and 15 astrocytomas (As)]. Sixty-seven percent of GBs (91/136) and 21% of AAs (8/39) had abnormalities of the G1-S control system either by mutation/homozygous deletion of RB1, CDKN2A or CDKN2B, or amplification of CDK4. Seventy-six percent of GBs (103 of 136), 72% of AAs (28 of 39), and 67% of As (10 of 15) had deregulated p53 pathway either by mutation of TP53, amplification of MDM2, or homozygous deletion/mutation of p14ARF. When all of the data were combined and compared, 96% of GBs (87 of 91) and 88% of AAs (7 of 8) with abnormal G1-S transition control also had deregulated p53 pathway. Thus, we demonstrate that deregulation of the G1-S transition control system was almost always accompanied by inactivation of the p53 pathway, clearly illustrating the cooperative roles of these two systems in the development/progression of primary human astrocytic gliomas.     

Detection of somatic TP53 splice site mutations in diffuse astrocytomas

Alteration in TP53 is the most common genetic event reported for many tumors, including astrocytomas. The majority of studies, on analyzing TP53 mutations, have not included all splice junctions. Consequently, splice site mutations are thought to be relatively infrequent. TP53 were examined for mutations by polymerase chain reaction, single strand conformation polymorphism and direct sequencing in cases of diffuse astrocytomas. We found TP53 mutations in 17.8% (8 out of 45) of the tumors tested: 3 splicing, 3 missense and 2 silent mutations. We have shown that splice site mutations of TP53 are more frequent than previously reported. These findings emphasize the importance of thorough screening of TP53 mutations in gliomas.     

TP53 and p53 statuses and their clinical impact in diffuse low grade gliomas

TP53 is a pivotal gene frequently mutated in diffuse gliomas and particularly in astrocytic tumors. The majority of studies dedicated to TP53 in gliomas were focused on mutational hotspots located in exons 5–8. Recent studies have suggested that TP53 is also mutated outside the classic mutational hotspots reported in gliomas. Therefore, we have sequenced all TP53 coding exons in a retrospective series of 61 low grade gliomas (LGG) using high throughput sequencing technology. In addition, TP53 mutational status was correlated with: (i) p53 expression, (ii) tumor type, (iii) chromosome arms 1p/19q status and (iv) clinical features of patients. The cohort included 32 oligodendrogliomas (O), 21 oligoastrocytomas (M) and 8 astrocytomas (A). TP53 mutation was detected in 52.4 % (32/61) of tumors (34 % of O, 71.4 % of M and 75 % of A). All mutations (38 mutations in 32 samples) were detected in exons 4, 5, 6, 7, 8 and 10. Missense and non-missense mutations, including seven novel mutations, were detected in 42.6 and 9.8 % of tumors respectively. TP53 mutations were almost mutually exclusive with 1p/19q co-deletion and were associated with: (i) astrocytic phenotype, (ii) younger age, (iii) p53 expression. Using a threshold of 10 % p53-positive tumor cells, p53 expression is an interesting surrogate marker for missense TP53 mutations (Se = 92 %; Sp = 79.4 %) but not for non-missense mutation (18.4 % of mutations). TP53 and p53 statuses were not prognostic in LGG. In conclusion, we have identified novel TP53 mutations in LGG. TP53 mutations outside exons 4–8 are rare. Although it remains imperfect, p53 expression with a threshold of 10 % is a good surrogate marker for missense TP53 mutations and appears helpful in the setting of LGG phenotype diagnosis.     

ONYX-015 selectivity and the p14ARF pathway.

ONYX-015, dl1520, is an adenovirus that lacks the E1B 55K gene and therefore lacks the capacity to neutralize p53 during infection. This virus induces high levels of p53 and fails to grow efficiently in primary epithelial cells. However, it does replicate in many tumor cells, including those expressing wild-type p53. In these cells, ONYX-015 fails to induce active p53. This is because the pathway from Ela to p53 is disrupted through loss of p14ARF. We propose that high levels of Mdm2 activity resulting from loss of p14ARF, and high levels of Mdm2 protein resulting from activated Ras prevent accumulation of functional p53 during infection of tumor cells that retain wild-type p53.     

Enhanced tumor suppression by a p14ARF/p53 bicistronic adenovirus through increased p53 protein translation and stability

The p53 tumor suppressor controls a cell cycle arrest and apoptosis pathway that is central to tumor suppression and often disrupted in cancer. The accumulation and activity of p53 are positively controlled by the p14/ARF tumor suppressor and full restoration of the pathway in cancer cells may require that both p53 and p14ARF be supplied [corrected]. To address this issue, we have constructed a bicistronic adenoviral vector encoding the two proteins (Adp14/p53) and compared its tumor suppressor activity with that of a single gene vector for p53 (Adp53). We find that tumor cells treated with Adp14/p53 undergo a much sharper decrease in viability with increasing multiplicities of infection than do cells treated with Adp53, even when cells express endogenous p14ARF. Adp14/p53 is also more effective than is a combination of single gene vectors for p14 and p53. The sharper decrease in cell viability after treatment of cells with Adp14/p53 correlates with an increased rate of p53 protein synthesis and a decreased rate of p53 protein turnover, leading to increased steady-state levels of p53 protein and increased levels of p53 downstream targets mdm2, p21waf1, and bax. Adp14/p53 treatment leads to an elevated bax:bcl2 ratio and induction of apoptosis in vitro and in vivo, coupled with a failure of the tumor cells to induce neovascularization in vivo. The results indicate that endogenous p14ARF expression may be insufficient to ensure efficient accumulation of ectopic p53 after gene transfer and demonstrate that for tumor suppression, bicistronic coexpression of p14ARF and p53 is superior to p53 alone. The results show that in this setting, p14ARF promotes p53 accumulation by increasing p53 protein synthesis, in addition to its well-characterized ability to oppose mdm2-mediated degradation of p53.     

Dysfunction of the p53 tumor suppressor pathway in head and neck cancer

It is important to examine the abnormality of the entire p53 tumor suppressor pathway in head and neck cancer. We examined the mRNA expressions of p53 regulatory factors, p33ING1 and p14ARF, and a p53-target gene, p21WAF1 in head and neck cancer. Nine of 14 benign pleomorphic adenomas (PAs) and 7 of 8 malignant salivary gland tumors (MSGTs) expressed p33ING1 mRNA. Thirteen of 14 PAs expressed p14ARF mRNA, however, only 1 of 8 MSGTs expressed p14ARF mRNA. Eight of 14 PAs and 7 of 8 MSGTs expressed p21WAF1 mRNA. In salivary gland tumors, there was clear correlation between the expression of p33ING1 and p21WAF1 (p<0.0001, r2=0.53). However, there was no correlation between the expression of p14ARF and p21WAF1 (p=0.6543, r2=0.009). Twenty-six of 28 oral squamous cell carcinomas (SCCs) expressed p33ING1 mRNA. Nineteen of 28 oral SCCs expressed p14ARF mRNA. All of the oral SCCs expressed p21WAF1 mRNA. In oral SCCs, the expressions of both p33ING1 (p=0.009, r2=0.181) and p14ARF (p=0.0009, r2=0.271) correlated with the expression of p21WAF1. Interestingly, 24 of 26 oral SCCs (92%) showed either abnormality of p53 itself or loss of expression of p53 regulatory factors, p33ING or p14ARF. These results suggest that head and neck cancer often involve the dysfunction of p53 tumor suppressor pathway.     

p53 protein in low-grade astrocytomas: a study with long-term follow-up.

The immunohistochemical expression of p53 protein (p53) was examined in 52 patients out of a series of 66 patients with low-grade astrocytomas with long-term follow-up. All patients were also evaluated for several clinical and histological features, among which only preoperative Karnofsky score and the extent of surgery were statistically significant parameters to predict outcome on multivariate analysis. p53 accumulation was seen in 46.1% of patients, with a wide range of percentage of positive cells. Median survival for p53-positive and p53-negative patients was 41 and 37 months respectively. The survival curves of p53-positive and -negative patients were not statistically different. However, the curves showed a trend towards a more aggressive course in p53-positive patients beginning 3-4 years after surgery. Five years after diagnosis the survival estimate with the Kaplan-Meier method was 21.2% for patients with p53-positive tumours and 45.9% for patients with p53-negative tumours. This trend is not due to different distribution of major clinical prognostic factors (age, incomplete resection or Karnofsky status). The trend could be related to the time needed by the p53-positive clone to outgrow the rest of the p53-negative neoplastic cell population. This hypothesis is further supported by the fact that the five recurrences which were surgically removed (one anaplastic astrocytoma and four glioblastomas) derived from p53-positive tumours and were themselves intensely p53 positive.     

抑癌基因P53在中晚期肝细胞癌中的表达及预后意义

目的探讨抑癌基因P53在中晚期肝细胞癌中的表达及其预后价值。方法应用免疫组化法(LSAB法)检测P53在45例肝癌组织中表达。结果P53在肝癌细胞中的阳性表达率为44.4%(20/45),癌旁组织无表达;P53在肝癌细胞高中分化组中阳性率为34.3%(12/35),而低分化组中为80%(8/10),两者差异显著(P<0.05);肝癌术后生存期≤1年组中P53阳性率为65%(11/17),而>1年组为32%(9/28),两者差异显著(P<0.05)。结论抑癌基因P53的突变是部分肝细胞癌变原因之一,且P53的检测可为临床评价肝癌细胞分化程度和患者的预后提供客观参考     

Multiple roles of the tumor suppressor p53.

The tumor suppressor p53 controls numerous downstream targets that can result in variable outcomes, including apoptosis, transient growth arrest, and sustained growth arrest or senescence. The activation of p53, followed by its ability to play multiple roles in the control of genomic integrity or the elimination of damaged or tumorigenic cells, is performed by a complex process of cross-talk orchestrated to occur in the different compartments of the cell. Controlling performance of the many roles of p53 is a goal of many research groups and the focus of this review.     

Overexpression of leukocyte marker CD43 causes activation of the tumor suppressor proteins p53 and ARF

CD43 or leukosialin is a transmembrane sialoglycoprotein, whose extracellular domain participates in cell adhesiveness and the cytoplasmic tail regulates a variety of intracellular signal transduction pathways involved in cell proliferation. CD43 is abundantly expressed on the surface of hematopoietic cells, but CD43 expression is also frequently found in the tumor cells of nonhematopoietic origin. In the early stages of some tumors, the accumulation of tumor suppressor protein p53 has been described. Here, we show that the expression of CD43 causes the induction of functionally active p53 protein. Moreover, we found that the activation of p53 by CD43 is mediated by tumor suppressor protein ARF. The coexpression of CD43 and ARF in ARF-null mouse embryonic fibroblasts resulted in programmed cell death, but that was not the case when CD43 alone was expressed in these cells. These data provide the first evidence of the connection between p53- and CD43-dependent pathways.     

p14ARF在宫颈癌中的表达及其与p53表达相关性的研究

目的探讨宫颈癌组织p14ARF蛋白的表达及其与p53表达的相关性.方法应用免疫组化方法检测p14ARF、p53基因在41例宫颈癌及20例正常宫颈组织中的表达.结果p14ARF在正常宫颈组织中不表达,41例宫颈癌中35例表达阳性,占85.4%.病理分级为G1、G2级的宫颈癌的p4ARF阳性表达率为68.4%,G3级为100%,两者比较,有显著性差异(P＜0.05).宫颈癌组织中p53蛋白表达阳、阴性者中p14ARF蛋白表达阳性率分别为75.0%(12/16)和92.0%(23/25),两者比较,无显著性差异,p14ARF与p53表达不相关.结论p14ARF在宫颈癌中高表达有一定的诊断和估测预后价值,可能是宫颈癌新的肿瘤标志物.     

Trans-regulated silencing and reactivation of TP53 tumor suppressor gene in malignant transformation and its reversion.

Despite growing interest in the methylation-mediated silencing of tumor suppressor genes in the neoplastic process, its signaling mechanism remains largely unknown. Here we show in a cultured murine cell line system that the silencing and reactivation of tumor suppressor gene TP53 were reversibly controlled by a trans-acting regulatory mechanism. The gene product p53, which was constitutively expressed and activated upon X-ray irradiation in non-malignant parental cell line, was undetectable in its X-ray-induced malignant transformants, while they retained a wild-type TP53. The silencing was cancelled by transferring a human chromosome 11 and the expression of p53 was restored. The non-malignant revertants thus obtained were again susceptible to transformation by X-irradiation, giving rise to re-transformants, in which p53 was again repressed while the human chromosome 11 retained the ability to turn on TP53 when it was transferred into other malignant clone. The silent TP53 could be reactivated by treatment with the demethylating agent 5-azadeoxycytidine. These observations indicate the presence of a trans-acting signaling mechanism in the methylation-mediated regulation of TP53 expression which is associated with the acquisition of malignancy.     

O6-methylguanine-DNA methyltransferase methylation and TP53 mutation in malignant astrocytomas and their relationships with clinical course

Epigenetic silencing of O(6)-methylguanine-DNA methyltransferase (MGMT) by promoter methylation can confer cancer cells with an increased sensitivity to alkylating chemotherapeutic agents and a higher susceptibility to TP53 transition mutations. The aim of our study was to assess the correlation of promoter methylation of the MGMT gene with TP53 mutations and the clinical characteristics of malignant astrocytomas. We analyzed the MGMT promoter methylation and TP53 mutations in 45 malignant astrocytomas (16 anaplastic astrocytomas and 29 glioblastomas multiforme) treated prospectively with 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-2(2-chloroethyl)-3-nitrosourea, interferon-beta and radiation therapy, and evaluated their clinical usefulness. MGMT promoter methylation was found in 17 (38%) of the 45 newly diagnosed malignant astrocytomas. A clear trend existed between MGMT methylation and G:C to A:T transition mutations of TP53 (p = 0.0596). Patients with MGMT-methylated tumors displayed a greater chance of responding to adjuvant therapy as compared with those with MGMT-unmethylated tumors (p = 0.0393). TP53 mutation was not significantly associated with the clinical response (p = 0.1310). While neither MGMT methylation nor TP53 mutation had a significant effect on prognosis of the whole population, the presence of MGMT methylation emerged as a significant predictor of a longer survival when exclusively analyzing 29 patients with glioblastomas multiforme. These findings highlight the importance of MGMT methylation as a specific predictive factor for responsiveness to nitrosourea chemotherapy.