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ICANCER RESEARCH56. 4063-4070. September 1. 19961 E-Cadherin Expression in Human Breast Cancer Cells Suppresses the Development of Osteolytic Bone Metastases in an Experimental Metastasis Model' Gabriel Mbalaviele, Cohn R. Dunstan, Akira Sasaki, Paul J. Williams, Gregory R. Mundy, and Toshiyuki Yoneda2 Unirersitv of Texas Health Science Center, Department of Medicine. Division of Endocrinology and Metabolism. San Antonio, Texas 78284-7877 1G. M., C. R. D.. P. J. W.. G. R.M., T. Y.J,andDepartmentof Oral andMaxillofacialSurgeryII, OkayamaUniversitySchoolof Dentistry.Okayama700,JapanIA. 5.1 ABSTRACT The molecular mechanisms by which human cancer cells spread to bone are largely unexplored. The process likely involves cell adhesion molecules (CAMs) that are responsible for homophilic and heterophilic cell-cell interactions. One relevant CAM may be the calcium-dependent transmembrane glycoprotein E-cadherin. To investigate the involvement of E-cadherin in breast cancer metastasis to bone, we used an in vivo model in which osteolytic bone metastases preferentially occur after ever, they do not show whether E-cadherin expression affects the behavior of cancer cells per se during invasion and metastasis. Treatment of noninvasive epithelial Madin-Darby canine kidney cells with monoclonal antibodies to E-cadherin in vitro rendered these cells more invasive (12). Expression of the E-cadherin gene in highly invasive cancer cells dramatically suppressed conversely, introduction of E-cadherin-specific their invasiveness and, antisense RNA ren dered noninvasive epithelial cells invasive in vitro ( 13). E-cadherin in jections ofcancer cells directly into the arterial circulation through the left ventricle of the hearts of nude mice. We have found that E-cadherin negative human breast cancer cells MDA-MB-231 (MDA-231) develop radiographically detectable multiple osteolytic bone metastases and ca chexia in this model. However, MDA-231 breast cancer cells that were transfected with E-cadherin cDNA showed a dramatically impaired Ca pacity to form osteolytic metastases and induce cachexia. Histological and histomorphometrical analyses of bones of mice bearing mock-transfected MDA-231 revealed aggressive metastatic tumor, whereas metastatic tu mor burden was significantly decreased in the bones of mice bearing was strongly expressed in breast cancer cells with reduced invasive ness, whereas relatively low levels of E-cadherin were detected in E-cadherin-expressing likely that the expression of E-cadherin inhibits detachment and invasion of cancer cells at the primary sites before the step of intrav asation. Conversely, however, it is also possible that, subsequent to intravasation, E-cadherin may rather facilitate the arrest of cancer fected MDA.231. MDA-231 breast cancer Nude mice cells survived bearing longer E-cadherin-trans than mice bearing mock-transfected MDA-231 breast cancer cells. Anchorage-dependent and -independent growth in culture and tumor enlargement in the mam mary fat pad of nude mice were unchanged between mock-transfected and E-cadherin-expressing MDA-231, suggesting that these differences in met astatic behavior are not due to an impairment highly invasive human breast cancer cells (14). These experimental results show the inhibitory effects of E-cadherin on the local inva siveness of cancer cells and are consistent with the notion that E cadherin is an “invasionsuppressor gene―( 13). However, they do not demonstrate whether E-cadherin expression also suppresses cancer metastasis organs. Because multiple sequential steps are cells at metastatic sites or coaggregation of cancer cells with platelets in capillaries, of cell growth and tumor igenicity. Our results show the suppressive effects of E-cadherin expres sion on bone metastasis by circulating breast cancer cells and suggest that the modulation of expression of this CAM may reduce the destructive effects of breast cancer cells on bone. to distant required for cancer cells to advance to achieve distant metastasis, it is resulting in a promotion of metastasis. Determining whether this is the case seems to be important to our understanding of the role of E-cadherin expression in distant metastasis of cancer. We have recently developed an experimental metastasis model in nude mice in which inoculation of cancer cells into arterial circulation through the left cardiac ventricle selectively results in osteolytic bone metastases INTRODUCTION (15), based on the method described by Arguello et a!. (16). Using this model of bone metastasis, we examined the role of E-cadherin in bone metastasis of human breast cancer because breast E-cadherin (uvomorulin) is a Mr 120,000 transmembrane glycopro tein involved in calcium-dependent cell-cell adhesion. Cell-cell adhe cancer frequently colonizes bone (17, 18). The E-cadherin-negative homotypic or heterotypic cell aggregation, which is likely important in controlling embryogenesis, morphogenesis, and tissue-specific im munity (1 , 2). Recently, evidence has accumulated that E-cadherin human breast cancer cell line MDA-23 1â€w̃as transfected with mouse E-cadherin cDNA and studied for the capacity of these cells to develop osteolytic bone metastases. Our data provide in vivo experi mental evidence that functional E-cadherin expression in MDA-23 I also plays a key role in cancer invasion and metastasis. Immunohis tochemical examination of clinical tumor specimens of the head and breast cancer cells caused a marked decrease metastases even after these cells were directly neck (3), prostate (4), stomach (5), kidney (6), and other organs (7) has shown that E-cadherin expression is decreased in invasive and metastatic cancers and that decreased E-cadherin expression is asso blood stream. The results suggest that E-cadherin might have sup pressive effects not only on the local invasiveness of cancer cells at primary sites but also on the metastasis of circulating cancer cells to distant organs such as bone. sion mediated ciated by E-cadherin with poor prognosis differentiated cadherin clinical is homophilic or heterophilic, (6, 8). It has also been shown causing that poorly metastatic breast cancers express lower levels of E than studies do well-differentiated suggest breast that E-cadherin cancers expression (9—11). These is inversely MATERIALS corre lated with the invasiveness and metastatic potential of cancer. How Received 4/22/96; accepted 7/2/96. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. by NIH Grants P0 1-CA40035, CA58 I 83 (Specialized Program whom requests for reprints breast was cultured be addressed, at Department of cell line MDA-23l (Ref. 19; kindly provided by Dr. C. in DMEM (Hazleton Biologics, Inc., Lenexa, KS) supplemented with 10% FCS (Hyclone Laboratories, Logan, UT) and 1% penicillin-strepto solution atmosphere should cancer Kent Osborne, University of Texas Health Science Center, San Antonio, TX) mycin of Re search Excellence), and CA63628. 2 To AND METHODS MDA-231: A Human Breast Cancer Cell Line. The E-cadherin-negative human I Supported in osteolytic bone introduced into the (Life Technologies, Inc., Grand Island, NY) in a humidified of 5% CO2 in air. Medicine/ Endocrinology, University of Texas Health Science Center. 7703 Floyd Curl Drive, San Antonio, TX 78284-7877. Phone: (210) 567-4900; Fax: (210) 567-6693; E-mail: [email protected] 3 The abbreviations used are: MDA-23 I, MDA-MB-23 I human breast cancer cell line: MMP, matrix metalloproteinase: lBS. Iris-buffered saline. 4063 Downloaded from cancerres.aacrjournals.org on June 16, 2017. © 1996 American Association for Cancer Research. E-CADHERIN IN BREAST CANCER METASTASIS TO BONE and transferred to polyvinylidene difluoride membranes (Immobilon-P; Milli Transfection of Mouse E-Cadherin eDNA. MDA-231 (1 X l0@)cells grown in DMEM supplemented with 10% FCS were cotransfected with 20 @xg of full-length mouse E-cadherin cDNA (in pBATEM2 plasmid driven under the control ofthe chicken 13-actinpromoter; Ref. 20) and 1 @xg ofpSV2neo (21) for neomycin resistance by calcium-phosphate coprecipitation method (22). As a control, cells were also transfected with 2 @xg of pSV2neo. The E-cadherin expression plasmid, pBATEM2, was a generous gift of Dr. M. Takeichi (Kyoto University, Kyoto, Japan). The neomycin expression vector, pSV2neo, was purchased from Invitrogen (San Diego, CA). After 24 h of incubation, cells were fed with fresh medium, grown for an additional 24 h, split and seeded into 100-mm dishes, and cultured in the presence of 470 @xg/ml of antibiotic G418 (Life Technologies, Inc.). G4l8-resistant colonies pore, Bedford, 20% Staining of E-Cadherin. (pH 8.0)]. The buffer membranes [20 mM Tris, were 150 mist glycine, incubated overnight and with blocking buffer [5% BSA in 50 mrviTris, 150 mrviNaCI, and 10 mMCaCI2]and then with monoclonal antibodies to mouse E-cadherin (Transduction Labora tories, Lexington, KY) diluted I :5000 in the same buffer for 2 h, washed once with TBS + 0.05% Tween 20 (TBST), then twice with TBS, and incubated with horseradish peroxidase-conjugated goat anti-mouse IgG (Capel, Durham, NC; diluted 1:1500 in TBS containing 5% nonfat dry milk) for 1 h. After the membranes were washed three times with TBST and then three times with TBS, the signal was visualized with an enhanced chemiluminescence detection system (DuPont NEN, Boston, MA). Colony Formation Assay. Anchorage-independentgrowth of MDA-231 were iso lated and cloned by limiting dilution twice. Immunofluorescent MA) in transblotting methanol cells was determined Cells were fixed with a as described previously (23). One ml of agarose (Sea fresh solution of 3.7% (w/v) formaldehyde in PBS at room temperature for 30 mm, incubated with the primary antibodies (ECCD-2; Zymed Laboratories, Inc., San Francisco, CA) at a 1:200dilution in PBS containing 1%rabbit serum at 37°Cfor 1.5 h in humidified atmosphere, washed three times with PBS, and incubated with 1:80-diluted affinity-purified rabbit anti-rat IgG conjugated Plaque; FMC Bioproducts, Rockland, ME) at 0.4% (wlv) in DMEM supple mented with 10% FCS containing 300 cells was overlaid on a 1-mi bottom layer of 0.6% agarose in the same culture medium in 35-mm tissue culture plates with a grid at the bottom (Sarstedt, Newton, NC). Plates were incubated with fluorescein 5-isothiocyanate 100 ,xm in diameter were manually counted under an inverted microscope. Cell Growth in Monolayer. Cells (1 x l05/well, 6-well plate; Falcon; Becton Dickinson Labware, Lincoln Park, NJ) were cultured in DMEM washing with PBS, examined under cells for 14 days in a humidified CO2 incubator at 37°C,and colonies larger than (Sigma Chemical Co., St. Louis, MO). After were mounted a fluorescence in PBS-glycerol microscope (Nikon solution (1:1) Inc. Instrument and Division, GardenCity, NY). Immunoblotting. Cells were lysed in lysis buffer [20 mMTris (pH 8.0), 2 mM CaCl2, 150 mrsi NaC1, 1% NP4O, 0.1% mM leupeptin, SDS, and protease 1 mM phenylmethylsulfonylfluoride, inhibitors and 1% aprotinin)] supplemented with 10% FCS. After the indicated time of culture, cells were trypsinized and counted on a hemocytometer under an inverted microscope. Intracardiac (20 Injections of MDA-231 Cells in Nude Mice. Intracardiac injection of MDA-23l cells was performed according to the technique de at 4°C and centrifuged at 10,000 X g for 10 ruin at 4°C,and protein amounts were scribed determined medium 24 h before intracardiac injections. Cells (1 X l0@)were suspended in using the Bio-Rad DC protein assay (Bio-Rad Laboratories, Her cules, CA). The lysates were boiled for 5 mm, separated on 7.5% SDS-PAGE, I previously 0.1 ml of PBS 2 3 (24). Subconfluent and injected 4 using MDA-23l a 27-gauge 5 6 cells needle were fed with fresh into the left heart 7 kDa -195 — -@Ti @ :@ -112 -84 -63 Fig. 1. E-cadherin expression in MDA-231 cells in Western blotting (top) and immunofluorescence (bottom). Top: Lane 1, MCF-7 as positive control; Lane 2, Neo-MDA-231; Lanes 3-7, 231 subclones. Bottom, phase-contrast C A E-cad-MDA microscopy (A and C) and immunofluorescence (B and D). Neo-MDA-23l showed no E-cadherin expression (top, Lane 2; bottom, A and B). In contrast, E-cad MDA-231 subclones strongly expressed E-cadherin [top, Lanes 3-7; bottom, C and D (subclone 4)]. 4064 Downloaded from cancerres.aacrjournals.org on June 16, 2017. © 1996 American Association for Cancer Research. E-CADHERIN IN BREAST CANCER METASTASIS TO BONE Determination A of the Number and Area of Bone Metastases The num ber of osteolytic bone metastases was enumerated on radiographs as described Cell Numberx105 (15, 24). Animals were anesthetized deeply, placed in prone and lateral positions against the films (22 X 27 cm; X-OMAT AR; KOdak, Rochester, NY), and exposed to an X-ray at 35 kV for 6 s using a Faxitron radiographic 15 0 Neo-MDA-231 inspection unit (Model 43855A; Faxitron X-ray Corporation, Buffalo Grove, IL). Films were developed using a KOdak RP X-OMAT processor (Model M6b). All of the radiographs of bones in nude mice were evaluated extensively and carefully by three individuals (including one radiologist) who had no ]E-cad-MDA-231 knowledge of the experimental protocols. On radiographs, the number and area of osteolytic metastatic foci as small as 0.5 mm in diameter, which were recognized as demarcated radiolucent lesions in the bone, were quantitatively assessed using a computer-assisted Jandel Video Analysis (JAVA) image analysis system (Jandel Scientific, Corte Madera, CA). Tumorigenicity of MDA-231 Cells in Nude Mice. Cells (2 X 106)were suspended 0 24 0 72 48 in 0.2 ml of the mixture (1:1) of PBS and Matrigel (Collaborative Research, Bedford, MA)andinoculated intotherightthoracic mammary fat pad of female nude mice using 23-gauge needles as described previously (26). Four weeks later, the tumors formed were excised and their weights were CultureTime(h) determined. B Histological, Histomorphometrical, and Stereological Examination of Metastatic Cancer Burden. The details of these methods were described Colony/well previously (24). In brief, forelimbs and hind limbs from animals in each treatment group were fixed with 10% formalin in PBS (pH 7.2) and decalcified in 14% EDTA solution for 2—3weeks. Paraffin sections were conventional methods. The area of metastatic cancer infiltrations T@ made using was meas ured in the distal femoral and proximal tibial metaphyses of both limbs in longitudinal decalcified sections stained by H&E. A level showing the full width of the growth plate and shaft was selected for measurement. All metastatic cancer cells from the joint surface to a point 4 mm down the shaft were measured in both the bone and where it had expanded into the surround 200 1@ ing soft tissues. Metastases in the epiphyses were also included. Statistical Analysis. All data were analyzed by Mann-Whitney test for nonparametric — Neo-MDA-231 C mals was samples. The statistical difference of survival rate of the ani analyzed by generalized Wilcoxon test. All data were presented as the mean ±SE. E-Cad-MDA-231 RESULTS Tumor Weight (9) 2.0 Transfection of E-Cadherin cDNA into MDA-231 Cells. Subse quent to transfection, G4l8 selection, and cloning by limiting dilution, several subclones of MDA-23 1 breast cancer cells were obtained. MDA-231 subclones transfected with E-cadherin cDNA were desig nated E-cad-MDA-23l, and MDA-23l subclones transfected with pSV2neo were designated neo-MDA-23 1 and used as controls in the following experiments. E-cad-MDA-231 cells expressed E-cadherin I 1', Body weight (g) Neo-MDA-231 E-Cad-MDA-231 @, Fig. 2. A, growth curve of neo-MDA-23 I and E-cad-MDA-23 1 (subclones 4-7 of Fig. 1. top) in monolayer. Cells (1000/cm2) were plated and cultured for 24, 48, and 72 h. Cell number was counted manually after trypsinization on a hemocytometer (n = 4). B, anchorage-independent growth of neo-MDA-231 (0) and E-cad-MDA-23I subclone 4 (U).Threehundred cellswereplatedin softagarin 35-mmtissueculturedishes, andthe number of colonies larger than 100 p@min diameter was counted microscopically after 14 days of culture (n = 6). C, growth of neo-MDA-23 1 (0) and E-cad-MDA-23 I subclone 4 (U) in nude mice. Two X 106 cells in the mixture of PBS and Matrigel (1:1) were inoculated in the right thoracic mammary fat pad of4 week-old female nude mice. Tumors formed were excised, and their weight was determined 4 weeks after inoculation as described in the text. Each group had four animals. Values shown are mean ±SE. * * 20• 15• . 10• 5 0 - --.- @ =_J._ I . . . ventricles of 4-week-old female BALB/c-nu/nu mice (Harlan Industries, Hous ton, TX) under anesthesia with pentobarbital (0.05 mg/g). Animals were kept . . . . . . . in our animal facilities for 4-7 weeks as descnbed (25). The weight of animals and excised tumors was determined by using a Lum@O@GramTM (Ohaus Scale Corporation, Florham Park, NJ). Neo-MDA-231 6 -- 7@ E.cad-MDA-231 Fig.3. Bodyweightof nudemicebearingneo-MDA-23 1andE-cad-MDA-23 1. Data shown in Figs. 3, 4, 5, and 6 were obtained from the same experiments and experiments . . were repeated twice. Four E-cad-MDA-231 subclones (see Fig. I . top) were examined. Valuesshownaremean±SE(n = 5 X 2 experiments).*, significantlydifferentfromthe neo-MDA-231group(P < 0.01). 4065 Downloaded from cancerres.aacrjournals.org on June 16, 2017. © 1996 American Association for Cancer Research. E-CADHERIN IN BREAST CANCER METASTASIS TO BONE Neo-MDA-231 vitro and in vivo results convincingly E-cad-MDA-231 I @, / _1@ -@ trabecular @ — @@AI ‘L'5'@ E-cad-MDA-231 demonstrate that transfection of E-cadherin cDNA did not impair the capacity of growth and tumor igenicity of MDA-23 1 cells. Development of Cachexia and Osteolytic Bone Metastases. Nude mice injected with neo-MDA-23 1 cells into the left ventricle of the heart showed profound cachexia (loss of muscle, fat, and body weight; Fig. 3 and Fig. 4, top) and multiple osteolytic lesions in the upper and lower extremities (Fig. 4, bottom and Fig. 5) 3—4weeks after inoculation, as we reported previously (15, 24). On the other hand, nude mice inoculated with E-cad-MDA-23l cells demonstrated a marked impairment of cachexia (Fig. 3) and a significant decrease in osteolytic bone metastases (Fig. 4, bottom and Fig. 5). Histological View of Bones with Metastatic MDA-231 Cells. Neo-MDA-23l cells almost completely destroyed the marrow archi tecture, including the primary and secondary spongiosa of tibial bone, and occupied the entire marrow cavity with frequent extension to the surrounding soft tissue (Fig. 6). In contrast, E-cad-MDA-23 1 coloni zation was relatively limited in the marrow cavity, and the majority of bone and primary and secondary spongiosa remained intact (Fig. 6). In both groups, enhanced osteoclastic bone resorption along the endosteal surface of bone was observed adjacent to metastatic MDA-231 cells (Fig. 6). The osteoclast number and bone resorption surface area determined by histomorphometry were not different in bones of E-cad-MDA-231- and neo-MDA-23l-bearing mice (data not shown). Histomorphometrical Analysis of Metastatic Cancer Burden in Bone. Consistent with the histological view, histomorphometrical analysis of bones with neo-MDA-23 1 cells showed a larger metastatic cancer burden than bones with E-cad-MDA-23 1 cells (Fig. 7). Metastasis in Non-Bone Organs. As a characteristic feature of this experimental metastasis model and by yet-unexplained mecha Lesion number 10 4@I p .@ -- p 7.5 4' 5@ Fig. 4. Representative pictures (top) and radiographs (bottom) of nude mice bearing neo (left)- and E-cad (right; subclone 4 of Fig. 1, top)-MDA-231 cancer. Arrows, osteolytic bone metastases. Pictures and radiographs were taken 4 weeks after cell inoculation. Note the differences in cachexia (loss of fat, muscle, and body weight) and the number of osteolytic bone metastases between both groups. 2.5 * 1@ * * -I- 0 4 as determined by immunoblotting (Fig. 1, top) and immunofluores cence (Fig. 1, bottom) and showed polygonal shape and increased cell-cell contact (Fig. 1, bottom), suggesting that the E-cadherin transfected was functional in MDA-231. Neo-MDA-231 cells showed elongated shape and expressed undetectable levels of E-cadherin (Fig.1). Anchorage-dependent and -independent Growth and Tumori genicity of E-cad-MDA-231 Cells. To determine whether E-cad hem expression affects the growth of MDA-23l cells, the growth curve of E-cad-MDA-23l cells was compared to that of neo-MDA 23 1 cells in monolayer culture. There was no difference anchorage-independent growth 4 3 7 + 2 * * I in the growth of neo-MDA-231 6 5 I _ * pattern between E-cad-MDA-23 1 and neo-MDA-23 1 cells (Fig. 2A). Furthermore, 5 Le@ on area (mm @) 0 14 and E-cad-MDA-23l cells assessed by colony formation in soft agar was not significantly different (Fig. 2B). More importantly, the weight of E-cad-MDA-23l tumors formed in the mammary fat pad of nude mice 4 weeks after the inoculation was not different from that of neo-MDA-23l tumors (Fig. 2C). These in Neo-MDA-231 5 6 7 i E-cad-MDA-231 Fig. 5. The number and area of osteolytic bone metastases in nude mice bearing neo (EThandE-cad(U)-MDA-23 I cancer. Thenumber andareaofosteolytic bonemetastases were scored 4 weeks after cell inoculation on radiographs using quantitative image analysis. Each group had five mice. Values shown are mean ± SE (si = 10). *. significantly different from the neo-MDA-231 group (P < 0.005). 4066 Downloaded from cancerres.aacrjournals.org on June 16, 2017. © 1996 American Association for Cancer Research. @ S @ • ° E-CADHERIN IN BREAST CANCER METASTASIS TO BONE @ ?:. A @@4:@;r -k B @ . @ . -@,:r@4°' . .@. .,.@ I • ••1 :‘‘ @ ,t@ @ -: @: . . @?. C .@ ., ., . .“ ,.,‘ @ , °@‘ .@. , . @;-:@t@ I @: @@:%j. @ %@ $e*@ •1 @v@1.: * , ,_ @, @,w..,@ @ . Bone , -‘ 11Z@; ‘S ‘ Fig. 6. Histological view of the proximal tibiae of nude mice bearing no cancer (A), neo-MDA-23l (B), and E-cad-MDA-23l (C; subclone 4 of Fig. 1, top). Almost all the primary andsecondaryspongiosawerereplacedby metastaticbreastcancer(7) in miceinoculatedwithneo-MDA-231 (B)as comparedto theboneof non-tumor-bearing normalmice(A).In contrast, colonization of E-cad-MDA-23l (7) in the tibiae was localized, and the majority of the marrow cavity remained intact (C). with an appearance similar to that of non-tumor-bearing normal mice. H&E staining, X40. Osteoclastic bone resorption along the endosteal surface of bone of nude mice bearing neo-MDA-23 1 (D) and E-cad-MDA-231 (5) at higher magnification.Osteoclasts(arrows) are presentbetween metastaticMDA-231 cells (7) and bone. H&E staining, X200. nisms, very few metastases in other organs such as lungs, kidney, brain (data not shown), and liver were detected in both groups (Table 1). Therefore, it was not possible to statistically analyze the died of cancer with osteolytic bone metastases (with analogous radio graphical and histological views to those of neo-MDA-23 1-bearing animals) 8 weeks after the inoculation. The results indicate that effects E-cad-MDA-23l of E-cadherin expression on MDA-23l metastasis to non-bone organs. Survival of Animals. Nude mice inoculated with E-cad-MDA-23l cells survived significantly longer than animals injected with nontransfected MDA-231 cells or neo-MDA-231 cells (Fig. 8). However, it should be noted that all animals bearing E-cad-MDA-231 cells also cells did not lose the capacity to develop bone metastases, but that the capacity is impaired, presumably due to E-cadherin expression. Production of Bone-destroying Activity. To determine whether E-cad-MDA-23l cells produce greater levels of osteolytic activities than do neo-MDA-231 cells, serum-free culture supernatants were 4067 Downloaded from cancerres.aacrjournals.org on June 16, 2017. © 1996 American Association for Cancer Research. E-CADHERIN IN BREAST CANCER METASTASIS TO BONE E-cadherin in E-cadherin-negative MDA-23l human breast cancer cells suppresses metastasis to bone even after the cells have entered the systemic circulation, diminishes loss of body weight, and prolongs the life span of MDA-231 breast cancer-bearing animals. The results provide experimental evidence that E-cadherin has a suppressive action on distant metastasis of breast cancer cells to bone in vivo. The mechanisms by which E-cadherin expression decreases osteo lyric bone metastases in this animal model remain to be elucidated. In this study, several subclones of MDA-23 1 cells that were transfected with E-cadherin cDNA exhibited decreased formation of osteolytic bone metastases, indicating that the results obtained here reflect the phenotype of E-cadherin-expressing MDA-231 cells and are not due to the clonal difference. Our data also demonstrate that E-cadherin expression had no effects on the growth and tumorigenicity of MDA 231 cells. Frixen and Nagamine (31) have reported that E-cadherin expression is associated with decreased secretion of proteolytic en zymes. In our study, however, there was no change in MMP secretion and bone-destroying activity in the absence or presence of E-cadherin expression. Subsequent to entry into the systemic circulation, there are still multiple diverse and complex steps including directional migra tion, escape from host immune cell surveillance, and extravasation Areaof Individualtumor @ 4 I —r- 3' 2' * 1' 0' 4 Neo-MDA-231 E-cad-MDA-231 Fig. 7. Histomorphometrical analysis of metastatic cancer burden of two ([1)- and E-cad (U; subclone 4 of Fig. I, top)-MDA-231 in bone (proximal tibia). Values shown are mean ±SE (n = 20 bones).*, significantlydifferentfromthe neo-MDA-231group (P < 0.005). through harvested and examined for their activity in bone resorption assay using 45Ca-labeled fetal rat long bones, as described (27). There was no difference in the secretion of bone-destroying activity between E-cad-MDA-231 and neo-MDA-23l cells (data not shown). More over, we also examined MMP activity in the culture supernatants by zymography. However, we did not observe a significant change MMP secretion between E-cad-MDA-231 and neo-MDA-23l (data not shown). experimental and clinicopathological studies have is rare. Although the mechanisms underlying in cells mdi the preference for bone to non-bone organs in this experimental metastasis model remain unknown, this technique allows us to study the role of E cadherin in the development of osteolytic bone metastases by human breast cancer cells that are directly introduced into the arterial blood stream. The data presented here clearly show that the expression of Table 1 Dissemination cells must progress ±—---E-cad-MDA-231 (n = 15) (n = 15) +++ + to bone ++ ± they arrest in bone. demon Clump between metastatic cancer cells and osteoclasts that are modulated by either soluble factors or direct cell-cell contact or both in the bone microenvironment seems to be necessary for the development of osteolytic metastases. Along this line, it is noteworthy that our recent data demonstrate that osteoclasts express E-cadherin (27). However, of MDA-231 in the o of nud mice MDA-23 1 cells (1 X lOs) were inoculated into the left cardiac ventricle. Four weeks after the inoc ulation, eache organwas +),Muscle metastasis-positive: (—),metastasis-negative; (±), occasionally metastasis-positive.rgans adjacentBone glandsBrainKidneyLungLiverOvaryNeo-MDA-23l before may involve the alteration of cell-cell adhesion ing or clustering of MDA-23l cells may affect dispersion and migra tion capacity in the circulation and reduce cancer cell passage through bone capillary beds. Recent studies have described that much stronger shear forces are required to dissociate the aggregates of E-cadherin positive breast cancer cells than E-cadherin-negative breast cancer cells (32) and that E-cadherin expression is inversely correlated with cell motility (33). E-cadherin has been shown to mediate not only homophilic but also heterophilic and heterotypic cell-cell contact (34) and cell-substratum adhesion (35). Therefore, it is possible that the interactions of MDA-23 1 cells with host cells and microenvironments are modulated by E-cadherin expression, leading to decreased bone metastases. To further study the role of E-cadherin in MDA-23l metastasis to bone, we are currently examining chemotactic migra tion, invasiveness, and adherence to various types of extracellular matrix in neo- and E-cad-MDA-231 cells, using Boyden chamber assay, Matrigel, and extracellular matrix-coated culture plates, respectively. There is a characteristic Step ifl bone metastasis that is not relevant in metastasis to non-bone organs. Because the majority of bone consists of calcified matrix and cancer cells do not apparently possess an intrinsic capacity to destroy bone, the cooperative assistance of osteoclasts, the only cells capable of resorbing bone, is required for cancer cells to grow progressively in bone (17, 18). Thus, as a mechanism specific for bone metastasis, a functional association cated that E-cadherin impairs the local invasion of cancer cells into surrounding tissue at the primary sites (3, 7, 11—14,28—30),which may eventually result in the suppression of distant metastasis. How ever, to date, little is known in regard to whether E-cadherin decreases the metastasis of circulating cancer cells that have achieved intrava sation. We attempted to address this question specifically for breast cancer metastasis to bone because bone is the most common site of metastasis in breast cancer (17, 18). To study this, we took advantage of an experimental metastasis model in which the inoculation of cancer cells into arterial circulation through the left heart ventricle of female nude mice causes selective development of metastases in bone. Nakai et a!. ( 15) and Sasaki et a!. (24) have already reported that, as a characteristic feature of this model, cancer cells inoculated using this technique preferentially metastasize to bone and develop osteolytic lesions, whereas metastasis to other organs such as lung, liver, and kidney cancer between MDA-23 I cells. E-cad-MDA-23 I cells in culture strated changes in morphology and increased cell-cell contact. DISCUSSION Previous which One mechanism examined macroscopically and microscopically. Adrenal —————— 4068 Downloaded from cancerres.aacrjournals.org on June 16, 2017. © 1996 American Association for Cancer Research. ( E-CADHERIN IN BREAST CANCER METASTASIS TO BONE adhesion molecule E-cadherin is reduced or absent in high-grade prostate cancer. Survival Rate (%) Cancer Res., 52: 5104—5109,1992. 5. Mayer. B.. Johnson, J. P.. Leitl, F., Jauch, K. W., Heiss. M. M.. Schildberg. F. W.. Birchmeier, W., and Funke, I. E-cadherin expression in primary and metastatic gastric cancer: down-regulation correlates with cellular differentiation and glandular disin tegration. Cancer Res.. 53: 1690—1695. 1993. 6. Katagiri. A., Watanabe, R.. and Tomita, Y. E-cadherin expression in renal cell cancer and its significance in metastasis and survival. Br. J. Cancer, 71: 376—379, 1995. 7. Takeichi, M. Cadherins in cancer: implications for invasion and metastasis. Cuff. Opin. Cell. 8. Umba, R., Oosterhof, expression Biol., 5: 806—811, 1993. Isaacs. W. B., Bringuier. P. P., Schaafsma, H. E., Karthaus. H. F. M., G. 0. N., Debruyne, F. M. J., and Shalken, J. A. Decreased E-cadherin is associated with poor prognosis in patients with prostate cancer. Cancer Res., 54: 3929—3933,1994. 9. Shiozaki, H., Tahara, H., K.. Doki, Y., Hirano, S., tive E-cadherin adhesion I 991. 10. Gamolla, C., Palacios, J., Oka, H., Miyata, M., Kobayashi. K.. Tamura. S., Lihara, Takeichi, M., and Mon. T. Expression of immunoreac molecules in human cancer. Am. J. Pathol., 139: 17—23, Suarez, A., Pizarro, A., Navarro, P., Quintanilla, M., and Cano, A. Correlation of E-cadherin expression with differentiation grade and histo logical type in breast carcinoma. Am. J. Pathol.. 142: 987—993, 1993. I I . Oka, H., Shiozaki, H., Kobayashi. K., Inouc, M.. Tahara. H., Kobayashi. T., Takatsuka, Y., Matsuyoshi. N.. Hirano, S., Takeichi. M., and Mon. I. Expression of Weeks Fig. 8. Survival of nude mice bearing neo (broken line)- and E-cad (solid line: subclone 4 of Fig. I, top)-MDA-231 cancer. There were 14 mice in each group. *. significantly E-cadherin cell adhesion molecules in human breast cancer tissues and its relationship different from the neo-MDA-231 group (P < 0.01). 12. our results demonstrated that E-cadherin expression did not alter the production of osteolytic activity and MMP secretion in MDA-23 I cells in culture. Thus, it seems unlikely that E-cadherin expression modulates the Secretion of soluble factors by metastatic MDA-23 I breast cancer cells that stimulate osteoclastic bone destruction. Enhanced cell-cell aggregation in E-cad-MDA-23 1 cells also mdi cates that the transfected E-cadherin cDNA is functional, and that downstream signaling molecules, including catenins (36), are intact in MDA-231 cells. In fact, a recent study has demonstrated moderate expression of a- and @-cateninin MDA-23 I cells (37). Because cadherin-mediated cell-cell adhesion requires an association of cad hem with catenins (36) and evidence that catenins also play a critical role in cancer invasiveness and metastasis is accumulating (38—41), the involvement of catenins in MDA-23 1 metastasis to bone needs to be explored. In conclusion, we have found in the present study that the expression of E-cadherin inhibits the metastasis of circulating human breast cancer cells to bone in vivo. 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Brooks, P. C., Montgomery, A. M. P., Rosenfeld, M., Reisfeld, R. A., Hu, T., Klier, G.. and Cheresh, D. A. Integrin aj33 antagonists promote tumor regression by inducing apoptosis of angiogenic blood vessels. Cell, 79: 1157—1 164, 1994. 4070 Downloaded from cancerres.aacrjournals.org on June 16, 2017. © 1996 American Association for Cancer Research. E-Cadherin Expression in Human Breast Cancer Cells Suppresses the Development of Osteolytic Bone Metastases in an Experimental Metastasis Model Gabriel Mbalaviele, Colin R. Dunstan, Akira Sasaki, et al. Cancer Res 1996;56:4063-4070. Updated version E-mail alerts Reprints and Subscriptions Permissions Access the most recent version of this article at: http://cancerres.aacrjournals.org/content/56/17/4063 Sign up to receive free email-alerts related to this article or journal. To order reprints of this article or to subscribe to the journal, contact the AACR Publications Department at [email protected]. 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