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Grp78 as a therapeutic target for refractory head–neck cancer with CD24CD44+ stemness phenotype

Abstract

Cancer stem cells are refractory to conventional therapy, which result to cancer metastasis and chemo-radioresistance. Grp78 is known to have important roles in cytoprotection and tumorigenesis in several cancers. We therefore examined whether Grp78 can serve as a therapeutic target for refractory stemness phenotype of head and neck cancer (HNC). Six HNC cell lines were used. Fluorescence-activated cell sorting (FACS) analysis was used to sort CD24CD44+ and Grp78+ cells. The small interfering RNA (siRNA) knockdown and cDNA transfection were applied to examine the effects of Grp78 on cellular function. Western blot and confocol microscopy were used to determine the effects of downstream protein expressions. Xenografted mouse tumors and immunohistochemistry were used to validate the results. We found that Grp78 regulated the conversion of CD24CD44+ cells, a characteristic of HNC stem cells. The CD24CD44+Grp78+ cells showed superior chemo-radioresistance and invasion ability compared with CD24CD44+, Grp78+ or the parental cells. Silencing Grp78 increased chemo-radiosensitivity, inhibited cell invasion, reverse epithelial–mesenchymal transition, suppressed cancer stemness, withdrew CD24CD44+ cell conversion and induced differentiated phenotype. Study in xenografted mice further showed that CD24CD44+Grp78+ cells exhibited highest tumorigenesis, compared with CD24CD44+ CD24+CD44+ or the parental cells. Grp78 knockdown dramatically restrained tumor growth along with the inhibition of stem cell regulatory proteins Oct-4 and Slug. Grp78 may serve as a molecular target that can be further developed for eradication of refractory HNC with stemness phenotype.

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Acknowledgements

This study was supported by grants from Chang Gung Memorial Hospital (CMRPD1A0642 and CMRPG190393) and from the Department of Health of Taiwan (DOH99-TD-C-111-006).

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Correspondence to A-J Cheng.

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Chiu, CC., Lee, LY., Li, YC. et al. Grp78 as a therapeutic target for refractory head–neck cancer with CD24CD44+ stemness phenotype. Cancer Gene Ther 20, 606–615 (2013). https://doi.org/10.1038/cgt.2013.64

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