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Molecular and Cellular Biology, February 2007, p. 1495-1504, Vol. 27, No. 4
0270-7306/07/$08.00+0 doi:10.1128/MCB.01764-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
Xin-Hai Pei,
Toru Nishikawa,
Matthew D. Smith, and
Yue Xiong*
Lineberger Comprehensive Cancer Center, Department of Biochemistry and Biophysics, Program in Molecular Biology and Biotechnology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7295
Received 18 September 2006/ Returned for modification 22 October 2006/ Accepted 25 November 2006
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A long-standing puzzle from the studies of mice is that, despite the fundamental function of the Rb pathway in cell cycle control and frequent mutations in many different types of human cancers, mice with mutations impairing the Rb pathway develop tumors predominantly in neuroendocrine organs. Characteristic intermediate lobe pituitary tumors develop in mice heterozygous for Rb (12, 17), chimeric for Rb/ (19, 25, 35), and deficient for CDK inhibitors p18Ink4c (8, 9, 16) and p27Kip1 (7, 15, 24). Furthermore, mice with compounded mutations in both Rb1 and p53 genes develop tumors with high penetrance in the pituitary, pancreatic islets, and thyroid (5, 10, 35). More strikingly, mice carrying a INK4-insensitive mutation (R24C) in CDK4 or mice carrying simultaneous deletions of both the CDK inhibitors p18Ink4c and p27Kip1 develop tumors in multiple endocrine organs, including the pituitary, thyroid, parathyroid, adrenal glands, pancreas, and testis (9, 30), a tumor spectrum that is congruous with the human multiple endocrine neoplasia (MEN) syndrome. Many major tumor types which sustain frequent mutations targeting the genes on the Rb pathway in humans, such as glioblastoma and cancer of the breast, lung, skin, bone, head, and neck, are rarely observed in mice with mutations targeting the Rb pathway.
Endocrine glands include seven so-called classical tissues or organs (pituitary, thyroid, parathyroid, pancreatic islets, adrenals, testes, and ovaries), as well as various other tissue systems (e.g., lung and gastrointestinal carcinoid) that are not usually considered endocrine glands but that contain cells that produce and secrete hormones, cytokines, and secondary messengers (31). Clinical diagnoses of hereditary MEN syndromes include the multiplicity of tumors in a given endocrine organ and the multiplicity of endocrine organs developing tumors in an individual. The recognition of Mendelian inheritance within MEN syndromes has led efforts over the past decade to identify causal genes by linkage analysis and positional cloning, including the type 1 MEN gene, Men1, which encodes a nuclear transcriptional regulator protein, known as menin (4). Despite the widespread expression of menin in nearly all tissues during embryonal development and in adults (32), loss of function of the Men1 gene, perplexingly, causes a unique and restricted pattern of endocrine tumors in both humans and mice. Germ line mutations in Men1 predispose humans to endocrine tumor development, predominantly in the anterior lobe of pituitary, parathyroid, and pancreatic islet cells (21). Likewise, mice heterozygous for Men1 developed multiple endocrine tumors with a spectrum very similar to human Men1 kindred (2, 6). Both the biochemical function of menin and the cellular pathway that Men1 regulates are currently under investigation. In particular, how Men1 may genetically interact with other genes involved in tumor suppression has not been examined.
Development of multiple neuroendocrine tumors in p18-p27 double mutant mice led us to determine how Men1 genetically interacts with p18 and p27. These genetic, histological, and pathological studies revealed that p18, but not p27, genetically collaborates with Men1 to suppress the development of multiple types of endocrine tumors.
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TABLE 1. Spontaneous tumor formation and incidence in p18/, p27/, Men1+/, p18/, Men1+/, and p27/; Men1+/ micea
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LCM and loss-of-heterozygosity (LOH) analysis. Laser capture microdissection (LCM) was used to obtain pure cell populations of selected areas from formalin-fixed, paraffin-embedded tissue sections. Ten-micrometer sections were deparaffinized and lightly stained with hematoxylin. Using a PixCell lle Laser Capture Microdissection system (Arcturus, Mountain View, CA), the lesions that were clearly separated from normal tissues were isolated from the slides. Particular care was taken to avoid contamination by surrounding tissue. DNA isolation from the microdissected tissue samples was performed as described before (1).
Pancreatic islet size determination. Pancreatic islet size (number of cells/islet section) was measured as previously reported (20). Briefly, islet size was determined in at least three cut sections from matched pancreatic regions of three animals per genotype at each stage of development. Sections were more than 500 µm apart from each other to avoid the overestimation of large islets in this analysis. For pancreatic islet number counting, the whole pancreas was dissected together with the surrounding spleen and stomach tissue to preserve the shape of the pancreas during subsequent procedures of fixation and paraffin embedding. Dissected pancreases were flatly embedded, with similar orientations and maximized surface areas showing. Islet number per section was determined from age-matched pancreases of three animals per genotype and averaged from at least six sections (two each from the top, the center, and the bottom of the pancreas).
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Consistent with previous reporting, histological and pathological examination revealed that specific lesions developed predominantly in multiple endocrine organs of p18, p27, and Men1 single mutant mice, including the pituitary, thyroid, parathyroid, pancreas, adrenal, and testis. Compared to these single mutant mice, tumor phenotypes in nearly all these endocrine organs were accelerated in double mutant p18/; Men1+/ mice but not in p27/; Men1+/ mice (Table 1 and Fig. 1) (see also Fig. 2 to 4).
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FIG. 1. p18, not p27, collaborates with Men1 to suppress pituitary tumors. Age-matched pituitary glands from different genotypes of mice were microscopically examined after hematoxylin-eosin staining. Anterior lobe (A), intermediate lobe (I), neurohypophysis (N), and tumor (T) are indicated. Note the tumors in both intermediate and anterior lobes of p18/-Men1+/ pituitary.
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FIG. 2. p18, not p27, collaborates with Men1 to suppress testis, thyroid, and parathyroid tumors. (A) Age-matched testis glands from different genotypes of mice were microscopically examined after hematoxylin-eosin staining. Leydig cell hyperplasia (H) and Leydig cell tumor (T) are indicated. (B) hematoxylin-eosin staining of thyroid (Th) and parathyroid (Pth) from different genotypes of mice at 12 months of age. Hyperplasia (H) and tumor (T) are indicated. Frame e shows a parathyroid tumor, and frame f shows a thyroid tumor from the same p18/-Men1+/ mouse (frame d is the same area at lower magnification).
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FIG. 4. Combined p18 and Men1 mutations increased cell proliferation and apoptosis. Sections from pituitary glands and pancreases from different genotypes of mice at 9 to 12 months of age were examined for cell proliferation by immunostaining with an antibody recognizing phosphorylated histone H3 (A and C) and for apoptotic cell death by TUNEL assay (B and D). At least three mice for each genotype were examined. Pancreatic islets in the top row (A) are magnified in the respective insets. Blue, cells positive for PH3; brown, cells positive in TUNEL assay. Positive cells for PH3 and TUNEL were counted in 10 randomly chosen fields. The P value is less than 0.05 for p18/; Men1+/ versus either p18/ or Men1+/ samples and larger than 0.05 for p27/; Men1+/ versus either p27/ or Men1+/.
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Anterior lobe pituitary tumors were not found in the p18/ mice up to 22 months of age. In Men1 heterozygotes, only 1 of 18 (6%) developed pituitary tumors in the anterior lobe at 1 year of age, a frequency that increased to 3 of 7 (43%) in mice older than 1 year. Anterior lobe pituitary tumors were found in 20% of p18/; Men1+/ mice (n = 20) prior to 1 year and 80% (n = 5) thereafter. In these animals, we also noted the formation of adenomas and adenocarcinomas in both anterior and intermediate lobes. Although developed at similar incidences, the anterior lobe pituitary tumors in the p18/; Men1+/ mice exhibited aggressive features, including hemorrhaging, necrosis, and invasion into adjacent tissues (Fig. 1), that were not noted in either p18/ or Men1+/ mice. This result indicates that p18, in addition to suppressing intermediate lobe pituitary tumors, also plays a role in suppressing anterior lobe pituitary tumors. By contrast, the frequency of pituitary tumors did not differ significantly between p27/; Men1+/ and p27/ single mutant mice (n = 12) (data not shown). Collectively, these results demonstrate a functional collaboration between Men1 and p18 but not between Men1 and p27 in suppression of pituitary tumors.
p18, not p27, collaborates with Men1 to suppress testis Leydig cell tumors. Before 1 year of age, no testis Leydig cell tumors were found in any mutant mice lacking p18 or p27 or in Men1 heterozygotes. Although half of the p18 null mice (after 1 year) developed evident hyperplasia in the testis (Fig. 2A), no Leydig cell tumors were found in p18/ mice, even in mice 2 years of age (Table 1 and Fig. 2A). When the mice aged beyond 1 year, two of nine (22%) Men1+/ mice developed Leydig cell adenoma in the testis and three of six p18/; Men1+/ male mice (50%) developed Leydig tumors (one adenoma and two adenocarcinomas; both adenocarcinomas metastasized to the lung). No Leydig cell hyperplasia or tumors were detected in p27/ mice, even in mice 2 years of age (Table 1), nor was there any evidence that p27 loss accelerates the Leydig tumor phenotype in Men1+/ mice (Fig. 2A). These results also provide evidence supporting a functional collaboration between p18, but not p27, and Men1 in suppressing Leydig cell tumors in the testis.
p18, not p27, collaborates with Men1 to suppress thyroid and parathyroid tumors. Neither p18/, p27/, nor Men1+/ mice developed a significant tumor phenotype in the thyroid up to 22 months of age. In the p18/; Men1+/mice, 4 of 5 (80%) developed thyroid adenoma by the age of 22 months, while only 1 of 16 (6%) p27/; Men1+/ mice developed thyroid tumors at 12 months of age (Table 1 and Fig. 2B). Ninety percent of MEN1 patients over 40 years old have parathyroid tumors, making this the most common tumor of this syndrome in humans (21). In Men1+/ mice, 3 of 12 (25%) developed detectable parathyroid tumors by the age of 22 months. p18 loss alone did not result in parathyroid tumors but increased the incidence of parathyroid adenomas from 25% in Men1+/ mice to 80% in p18/; Men1+/ mice (n = 5). All parathyroid and thyroid adenomas developed concurrently in p18/; Men1+/ mice (Fig. 2B). The underlying basis for this concurrent parathyroid and thyroid tumor formation in p18/; Men1+/ mice is not clear. As for pituitary tumor development, p27 deficiency alone did not result in parathyroid tumors, nor did it increase the incidence of parathyroid tumors in Men1+/ background mice (Table 1).
p18, not p27, collaborates with Men1 to suppress pancreatic islet insulinomas. Both p18/ and Men1+/ mice developed an islet ß-cell tumor phenotype in the pancreas before 1 year of age. (2, 6, 26) (Table 1). Islet tumors developed in 15% (n = 13) of p18/ and 22% (n = 18) of Men1+/ mice between 9 to 12 months of age; the incidence was increased to 45% (n = 20) in p18/; Men1+/ mice, and the onset time was shortened to as early as 3 months of age (Table 1 and Fig. 2). After 12 months of age, islet tumors were found in all p18/; Men1+/ mice (n = 5), compared to 33% (n = 6) of p18/ mice and 43% (n = 7) of Men1+/ mice (Table 1). Despite their hyperplastic or dysplastic appearance, islet tumors were highly immunoreactive for insulin (Fig. 3A), consistent with the ß-cell origin of these tumors. Detailed analysis revealed that tumor masses were comparably enlarged in p18/; Men1+/ pancreases. Two of five insulinomas that developed in older (12 to 22 months) p18/; Men1+/ mice had features of multifocal islet carcinomas (Fig. 3A), while no carcinomas were found in mice of other genotypes. In contrast to these effects from p18 mutation, loss of p27 alone did not result in islet hyperplasia (7, 15, 24) (Table 1), nor did p27 deficiency have any additional effects on islet hyperplasia and tumor frequency (Table 1 and Fig. 3A).
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FIG. 3. p18, not p27, collaborates with Men1 to suppress insulinoma development and to regulate pancreatic ß islet cell proliferation. (A) Results of hematoxylin-eosin staining of pancreatic sections obtained from different genotypes of mice at 12 months of age are shown (top). The islet cell carcinoma shown in frame f has been magnified in the inset. Mitotic figures (black arrows) and tumor cells invading a blood vessel (yellow arrow) are indicated. Pancreatic sections from 12-month-old mice of the indicated genotypes were stained with an antibody to insulin (bottom). (B) The number of pancreatic islets per section was determined as described in Materials and Methods from 12-month-old mice of the indicated genotypes. (C) A total of 250 islets from wild-type and mutant pancreases from mice at 1 year of age were counted. Islets are categorized into three groups, small (containing less than 40 cells), medium (containing 41 to 400 cells), and large (containing more than 400 cells), and percentages of each group are plotted.
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There is an evident increase in the size of islets in p18/; Men1+/ mice. There could be two different cellular mechanisms accounting for the increase in islet size: an increase in the size and/or the cell number of islet ß cells. Microscopic examination did not show any visible difference in cell size. We therefore counted the cell numbers in 250 randomly chosen islets from mice of six different genotypes and divided them into three groups: small (less than 40 cells per islet), medium (40 to 400 cells), and large (more than 400 cells) islets. The percentage of medium- and large-sized islets increased from 25% ± 8% and 21% ± 11% in p18/ mice and 22% ± 6% and 26% ± 8% in Men1+/ mice to 26% ± 2% and 40% ± 6% in p18/; Men1+/ mice, respectively (Fig. 3C). By contrast with Men1+/ mice, the p27/-Men1+/ mice, while having a slight increase in medium islets (30% ± 2%), had a substantially decreased number of large islets (5% ± 1%). Altogether, these data suggest that p18, but not p27, functionally collaborates with Men1 to control ß islet cell number and to suppress insulinoma development in the pancreas.
Increased proliferation and apoptosis in pituitary and pancreatic tumors of p18/; Men1+/ mice. To determine the cellular basis for the functional collaboration of p18 and Men1, we examined two cellular processes that are often deregulated during tumor growthcell proliferation and apoptosis. Mitotic index, as determined by the immunostaining of anti-phospho-histone H3 (PH3), was low at baseline in the wild-type pancreases and pituitaries but increased in all three single mutant mice (Fig. 4A). Consistent with pathological analysis, there were further substantial increases of the mitotic index in both p18/; Men1+/ pancreases and pituitaries but not in p27/; Men1+/ pancreases and pituitaries.
The increase in cell proliferation following loss of p18, p27, and Men1 correlated with an increased level of apoptosis in the pituitary and pancreas, as assessed by TUNEL assay. A higher number of TUNEL-positive cells was detected in p18/; Men1+/ pancreases and pituitaries than in either p18/ or Men1+/ mice (Fig. 4B). There was no detectable increase in apoptotic cells in either p27/-Men1+/ pancreases or pituitaries.
p18 deficiency protects the loss of wild-type Men1 allele. MEN1 patients typically inherit loss-of-function mutations in the Men1 gene, and tumors arise after loss of the remaining wild-type allele, which appears to fit the classical definition of a "two-hit" tumor suppressor. Development of tumors from Men1 heterozygotes offered an opportunity to address the issue of Men1 haploinsufficiency in tumor suppression. We took two approaches to this end: IHC of Men1 and LOH analysis of the remaining Men1 wild-type alleles. As determined by IHC, menin expression was lost in most pancreatic tumors (five of seven) and all pituitary (three of three) tumors that we examined (Fig. 5A and C), indicating that the remaining wild-type Men1 allele was lost in most tumor cells. In contrast, menin protein expression was retained in most pancreatic (9 of 10) and pituitary (5 of 6) tumors developed in p18/; Men1+/ mice, suggesting that loss of the wild-type Men1 allele in p18/; Men1+/ mice is protected by p18 loss.
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FIG. 5. p18 deficiency protects loss of the wild-type Men1 allele. (A) Sections of pancreatic tumors and pituitary tumors derived from Men1+/ and p18/; Men1+/ mice were immunostained with an antibody against menin. Note the strong menin staining in the tumors from p18/; Men1+/ mice and very faint (or negative) menin staining in the tumors from Men1+/ mice. Frames a and b, pancreatic tumors at a magnification of x100 (inset, x400); frame c, pituitary anterior lobe tumor from Men1+/ mouse at a magnification of x100 (inset, x400); frame d, pituitary intermediate lobe and anterior lobe tumors from p18/ Men1+/ mouse at a magnification of x100 (inset x400). (B) DNA extracted from the microdissected tumors of different genotypes was amplified by PCR to detect wild-type (wt) and mutant (mt) alleles of Men1 and p18, respectively. Lane 1, tail DNA; lanes 2 and 3, pituitary tumors; lanes 4 to 8, pancreatic tumors. (C) Summary of loss of menin expression by IHC and of wild-type Men1 allele by PCR analysis for tumors from the pancreas and pituitary. The results are shown as the number of menin-negative staining tumors or absence of wild-type Men1 allele divided by the number of total samples examined.
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Phosphorylation of Rb protein at CDK2 and CDK4/6 sites was increased in p18/; Men1+/ but not in p27/-Men1+/ cells. To search for the underlying biochemical basis for the different genetic interactions between p18, p27, and Men1, we examined the kinase activity of CDK2 and CDK4/6, three major targets of p18 and p27, in normal and tumor cells of different genotypes. Taking advantage of the availability of several well-characterized antibodies specifically recognizing Rb proteins phosphorylated by CDK at different sites and their suitability for immunostaining of embedded tissue samples, we directly examined two representative organs, the pituitary and pancreatic islet, where p18 but not p27 exhibited an evident functional interaction with Men1. Two well-characterized phosphorylation sites in the Rb protein, S608 phosphorylated by CDK4 and CDK6 and T821 phosphorylated by CDK2 (14, 37), were examined. A visible increase of Rb phosphorylations at both CDK2 site T821 and CDK4/6 site S608 were detected in pituitaries of p18/, p27/, and Men1+/ mice (Fig. 6A and B). In pancreatic islets, p18/, p27/, and Men1+/ mutations all evidently increased S608 phosphorylation of Rb, but an increase of T821 phosphorylation was less pronounced in all three mutants. Combined mutation of p18/ and Men1+/ substantially increased phosphorylation of Rb at both T821 and S608 sites in both the pituitary and pancreatic islet. Combined mutations of p27/ and Men1+/, on the other hand, caused no significant change of T821 phosphorylation in either tissue type but a surprisingly evident decrease of S608 phosphorylation in both pituitary and islet (Fig. 6). Together, these results are consistent with the pathological analyses showing that cell proliferation and tumor growth were synergistically stimulated in p18/; Men1+/ tissues but were either not enhanced (in pituitary) or actually alleviated (in islet) in p27/; Men1+/ tissues.
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FIG. 6. Combined p18 and Men1, but not p27 and Men1, mutations stimulate pRB phosphorylation at CDK sites. Sections of normal and tumorigenic pituitary and pancreatic islets of different genotypes of mice at 12 months of age were examined for pRb protein phosphorylation at two CDK sites, S608 phosphorylated by CDK4 and CDK6 and T821 phosphorylated by CDK2. Counterstaining is blue, and positive staining is brown.
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In all five endocrine organs, p18/; Men1+/ mice developed tumors at an earlier age and with increased incidence; these tumors are more aggressive than those found in either p18/ or Men1+/ mice, further supporting p18 as a critical regulator of tumor progression in endocrine neoplasms. Mutations in Men1 have been frequently found in familial MEN1 patients and in sporadic neuroendocrine tumors. Mutations in the p18 gene, however, have rarely been detected in human cancers, raising the question of whether p18 may play different roles in endocrine tumor suppression between human and mouse. Two lines of evidence, however, argue against this possibility and support a function of p18 in suppressing human tumors. p18 is haploinsufficient for tumor suppression in mice (1), suggesting that a complete inactivation of both alleles by classical two-hit mutational event criteria is not necessary for tumor development. Consistent with this p18 haploinsufficiency, loss or reduced expression of p18 has been observed in several types of human cancers, including Hodgkin lymphomas (27), parathyroid tumors (3), hepatocellular carcinomas (23), and medulloblastomas (33).
One surprising conclusion derived from this study is that Men1 genetically interacts with p18 and p27 differently; while an increased tumorigenesis is seen in five different organs in p18/; Men1+/ mice, no evidence was obtained to support a similar functional collaboration between Men1 and p27 in suppressing endocrine tumors. Men1 encodes a 76-kDa nuclear protein (4, 18) and associates with mixed lineage leukemia family proteins of a histone methyltransferase (HMTase) complex (11, 36). Genome-wide analysis of genomic occupancy revealed that menin can potentially regulate the expression of a large number of target genes, possibly by recruiting HMTase (28). A direct binding by menin and increase of histone H3 lysine 4 methylation have been demonstrated for five genes, including HOX cluster genes HOXA9, c6, and c8 (11, 36) and, notably, both p18 and p27 (13, 22, 28). Loss of menin is conversely associated with the reduction of both p18 and p27 gene expression (13, 22).
Why, then, are the genetic results that p18 but not p27 interacts with Men1 inconsistent with the biochemical studies illustrating that both genes are targets regulated by menin? Loss of one allele of Men1 reduced the expression of both p18 and p27 in pancreatic islet cells as mice aged, without causing any appreciable change to the four other CDK inhibitor genes examined (p15, p19, p21, and p16 were not detectably expressed) (13), suggesting that, at least in pancreatic islet cells, a differential compensation between INK4 and CIP/KIP proteins is unlikely to have contributed to the different tumor phenotypes developed in p18/; Men1+/ and p27/; Men1+/ mice. The mRNA and protein levels of both p18 and p27 were reduced to an undetectably low level in the islets of Men1+/ mice after 28 weeks (13), arguing against the possibility that a differential effect of Men1 heterozygosity on p18 and p27 transcription is the explanation for the functional collaboration of Men1 with p18 but not p27. Given the potentially large number of genes regulated by menin-associated HMTases, we speculate that another menin target gene, whose level is affected by Men1 heterozygosity, differentially interacts with p18 and p27. One possible scenario is that Men1 activity may negatively regulate a factor(s) that functions in stimulating CDK activity and that an increased expression of this factor in Men1 mutant cells may antagonistically inhibit the increase of CDK activity caused by p27 loss.
F.B. is supported in part by a U.S. Department of Defense Career Postdoctoral fellowship. This study was supported by NIH grant CA68377 to Y.X.
Published ahead of print on 4 December 2006. ![]()
F.B. and X.-H.P. contributed equally to this work. ![]()
Present address: Division of Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kawasaki, Japan. ![]()
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