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Mol Cell Biol, May 1998, p. 2845-2854, Vol. 18, No. 5
0270-7306/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Regulation of Proliferation-Survival Decisions
during Tumor Cell Hypoxia
Cornelius
Schmaltz,1,2,
Patricia
Harrigan
Hardenbergh,1,2,3,
Audrey
Wells,1 and
David E.
Fisher1,2,4,*
Dana-Farber Cancer
Institute,1
Children's
Hospital,4
Joint Center for
Radiation Therapy,3 and
Harvard Medical
School,2 Boston, Massachusetts 02115
Received 29 July 1997/Returned for modification 26 September
1997/Accepted 29 January 1998
Hypoxia may influence tumor biology in paradoxically opposing ways:
it is lethal as a direct stress trigger, yet hypoxic zones in solid
tumors harbor viable cells which are particularly resistant to
treatment and contribute importantly to disease relapse.
To examine mechanisms underlying growth-survival decisions during hypoxia, we have compared genetically related transformed and untransformed fibroblast cells in vitro for proliferation, survival, clonogenicity, cell cycle, and p53 expression. Hypoxia induces G0/G1 arrest in primary fibroblasts but
triggers apoptosis in oncogene-transformed derivatives. Unexpectedly,
the mechanism of apoptosis is seen to require accumulated acidosis and
is rescued by enhanced buffering. The direct effect of hypoxia under
nonacidotic conditions is unique to transformed cells in that they
override the hypoxic G0/G1 arrest of primary
cells. Moreover, when uncoupled from acidosis, hypoxia enhances tumor
cell viability and clonogenicity relative to normoxia. p53 is
correspondingly upregulated in response to hypoxia-induced acidosis but
downregulated during hypoxia without acidosis. Hypoxia may thus produce
both treatment resistance and a growth advantage. Given strong evidence
that hypoxic regions in solid tumors are often nonacidotic (G. Helmlinger, F. Yuan, M. Dellian, and R. K. Jain, Nat. Med.
3:177-182, 1997), this behavior may influence relapse and implicates
such cells as potentially important therapeutic targets.
*
Corresponding author. Mailing address: Department of
Pediatric Oncology, Dana Farber Cancer Institute, 44 Binney St.,
Boston, MA 02115. Phone: (617) 632-4916. Fax: (617) 632-2085. E-mail: david_fisher{at}dfci.harvard.edu.

Present address: University Children's Hospital, 79106 Freiburg,
Germany.

Present address: Department of Radiation Oncology, Duke University
Medical School, Durham, NC 27710.
Mol Cell Biol, May 1998, p. 2845-2854, Vol. 18, No. 5
0270-7306/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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