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Introduction The cancer therapeutic and preventive action of retinoids is very well established in a large number of in vitro and animal systems, and addition of retinoic acid (RA) to the therapeutic protocol of acute promyelocytic leukemia (APL) has led to a dramatically increased cure rate of APL patients (Melnick and Licht, 1999; Minucci and Pelicci, 1999; Altucci and Gronemeyer, 2001; Piazza et al, 2001; Altucci and Gronemeyer, 2004). APL originates from multiple signaling aberrations caused by the PML-RAR oncofusion. These comprise in addition to a block of differentiation due to the aberrant formation of heterochromatin over RA target genes (Minucci and Pelicci, 1999), increased blast survival due to the inhibition of p53 by deacetylation and increased self-renewal of stem cells (Pearson et al, 2000; Alcalay et al, 2003, PG Pelicci, personal communication). While RA therapy of APL is the prototypic cancer 'differentiation therapy', it must not be overlooked that retinoids have cancer therapeutic activities beyond the induction of differentiation (Altucci and Gronemeyer, 2001; Sun and Lotan, 2002; Altucci and Gronemeyer, 2004). For example, RA not only induces blast differentiation but also triggers blast eradication through apoptosis by inducing tumor necrosis factor-related apoptosis-inducing ligand (TRAIL, also referred to as Apo2L or TNFSF10) (Altucci et al, 2001). TRAIL is a fascinating member of the TNF family because it has a dual role in tumor defense: (i) in a cell autonomous manner TRAIL induces apoptosis selectively in the cancer cells, while normal cells are largely insensitive to TRAIL-mediated killing (Ashkenazi and Dixit, 1999; Walczak et al, 1999; Wang and El-Deiry, 2003b); and (ii) TRAIL signaling is critically involved in immune surveillance against tumor development (Takeda et al, 2001, 2002, 2004) and is also required for optimal graft-versus-tumor activity of T cells (Schmaltz et al, 2002). The therapeutic value and possible toxicity of recombinant soluble TRAIL are intensively discussed and require further assessment in suitable in vivo systems (for further information and references, see Supplementary Material). Irrespective of these discussions, it has been convincingly demonstrated that TRAIL-/- mice display no overt phenotype but an increased susceptibility to tumor initiation and metastasis (Cretney et al, 2002; Sedger et al, 2002). While these results support a central role of TRAIL signaling in tumor defense, the mechanism by which TRAIL and its receptors induce cancer-selective death has remained elusive despite the identification of a plethora of modulators of TRAIL-mediated apoptosis (Burns and El-Deiry, 2001; Aza-Blanc et al, 2003).
Retinoids signal through multiple receptor isotypes ( , , ) of the RAR and RXR families; it is generally believed that RAR–RXR heterodimers are the species transmitting the signal in vivo (for details and references, see Laudet and Gronemeyer, 2002). In addition to the unknown mechanistic link between apoptosis induction and RA action described above, several questions linked to the anticancer action of retinoids are unresolved; one concerns the nature and specific action of the RAR isotype that exerts a growth regulatory action. For example, in myeloid cells, it is generally RAR that mediates the differentiative and apoptogenic response even though RAR is equally expressed (Chen et al, 1996). Conversely, in keratinocytes, RAR is the principal receptor contributing to all-trans-RA-mediated growth arrest (Goyette et al, 2000). Finally, primitive endodermal differentiation of F9 embryo carcinoma cells requires RAR 2, while parietal differentiation requires RAR 2 and RAR 1 (Taneja et al, 1997). The second unresolved question concerns the tumor suppressive function of RAR 2, which is frequently deleted or epigenetically silenced during cancer progression (reviewed by Altucci and Gronemeyer, 2001) and may be related to particularities of RAR (Germain et al, 2002). The third issue concerns the role and mechanistic basis of AP1 transrepression. It has been shown that RA blocks tumor promotion in models of chemical skin carcinogenesis (reviewed by Altucci and Gronemeyer, 2001). The corresponding mechanistic basis remains to be established.
IFNs, antiviral and immunomodulatory proteins, are also important negative growth factors that inhibit cell proliferation and induce apoptosis (Belardelli et al, 2002; Ikeda et al, 2002). Genetic studies have confirmed their role in cancer immunosurveillance (Dunn et al, 2002). Notably, the TRAIL signaling pathway is critically involved in natural killer cell-mediated and IFN -dependent tumor surveillance (Takeda et al, 2001, 2002, 2004; Smyth et al, 2003).
Interestingly, there is evidence that IFNs and RA can synergize in their antiproliferative activity in vitro and mouse xenograft models, and that combination therapies may be effective in some solid tumors, such as squamous cell carcinomas (Lippman et al, 1997; Altucci and Gronemeyer, 2001). Indeed, several clinical trials are ongoing (Ortiz et al, 2002).
In the present study, we reveal the molecular mechanism by which RA induces TRAIL expression in a cell autonomous manner. We observe that in both NB4 promyelocytic and breast cancer cells RA-induced interferon regulatory factor-1 (IRF-1) causes TRAIL promoter activation and that IFNs synergize with RA. Synergistically induced TRAIL strongly increases the killing of heterologous tumor cells in a paracrine mode of action, while normal cells are not affected. Our results indicate the existence of cancer surveillance by the TRAIL signaling pathway that can be activated by known cancer therapeutics to act in a cell autonomous manner. Apparently, TRAIL acts as a central executor of the tumor-selective apoptogenic component of a diverse set of anticancer drugs and their corresponding signaling pathways.
Results Treatment with 9-cis-RA of NB4 APL or SK-BR-3 breast cancer cells leads to the ligand-dependent appearance of a DNase I hypersensitive site (DHS site I*) in the promoter (schematically illustrated in Figure 1A and B) of the tumor necrosis factor-related apoptosis-inducing ligand TRAIL/Apo2L (Bodmer et al, 2002), while two more distal DHS sites (II and III in Figure 1B) were ligand independent and were seen only in breast cancer cells. Transient transfection into SK-BR-3 cells of a chimeric luciferase reporter gene (pTRL1) driven by the TRAIL promoter confirmed that the 2 kb sequence upstream of the transcription initiation site (Gong and Almasan, 2000; Wang et al, 2000) contains RA-inducible elements (Figure 1C). Promoter mapping narrowed these elements down to 165 bp and revealed similar 6.5-fold RA inducibility of pTRL1, 2 and 3. Notably, pTRL4, which contains only 35 bp upstream of the transcription initiation, retained RA inducibility but displayed severely impaired basal activity. Removal of sequences between –1905 and –165 increased basal but not RA-induced transcriptional activity of the reporter (Figure 1C; compare pTRL1 and pTRL3). These results indicated that (i) the 35 bp upstream sequence contains at least one element that can mediate RA inducibility, (ii) additional constitutively or RA-inducible elements between –35 and –165 cooperate with this element(s) to increase basal and RA-induced activities and (iii) elements upstream of -165 silence TRAIL promoter activity.
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Discussion It is well established that retinoids have cancer chemotherapeutic and preventive activities beyond the mere induction of differentiation in leukemic cell models in vitro and APL patients in vivo (Altucci and Gronemeyer, 2001; Sporn and Suh, 2002; also see Introduction). Indeed, we have recently provided evidence that the induction of TRAIL, a death ligand that has been shown to kill selectively cancer in a variety of in vitro and in vivo settings (Almasan and Ashkenazi, 2003), contributes to the antileukemic action of RA (Altucci et al, 2001). In this study, we set out to identify the molecular pathway responsible for the induction of TRAIL. Importantly, we observed that RA induces TRAIL expression not only in hematopoietic but also in breast cancer cells. Our study identifies IRF-1 as the factor critically involved in mediating the retinoid response to TRAIL. Using promoter mapping, RNA interference and ChIP, we show that in both breast cancer and myeloid cells RA-induced IRF-1 binds to bona fide IRF-E and ISRE elements in the proximal region of the TRAIL promoter, thereby causing induction of TRAIL expression. In addition to IRF-1, IRF-2 is also bound to the TRAIL promoter; however, we did not observe any modulation of its TRAIL promoter association in response to RA and/or IFN. Thus, as it has been reported for the cell cycle regulation in NIH 3T3 cells (Tanaka and Taniguchi, 2000), it is apparently the modulation of the IRF-1:IRF-2 ratio that triggers TRAIL expression.
The apparent convergence of the RA and IFN signaling pathways on TRAIL was reminiscent of observations demonstrating that combination of RA and IFN results in synergistic inhibition of cell proliferation in many cancer cell systems. Indeed, RA has shown promise for cancer therapy outside of the hematopoietic system, often in combination with other cancer therapeutic compounds, for example, IFNs or chemotherapy (for review, see Altucci and Gronemeyer, 2001). The basis of this synergism is not well understood, but it had been observed that RA induces IRF-1 expression in several different types of tumor cells in culture (Matikainen et al, 1996; Pelicano et al, 1997; Percario et al, 1999; Um et al, 2000). We rationalized that synergistic induction of IRF-1 by RA and IFN may lead to synergistic induction of TRAIL, which would then cause the antiproliferative effect. Therefore, we explored the effect of using both signaling molecules on TRAIL expression in breast cancer cells, as a model for solid cancers. At the molecular level, the combination of both agents indeed resulted in synergistic recruitment of IRF-1 to the TRAIL promoter, most likely due to the cooperative binding of IRF-1 to multiple GAAA repeats (Escalante et al, 1998; Fujii et al, 1999), and concomitant increase in histone acetylation. Surprisingly, we observed that whereas the individual signals resulted in recruitment of IRF-1, we found only small increases in CBP recruitment, suggesting that other coactivators may contribute to IRF-1-mediated transactivation. In other systems, such as the IFN enhanceosome, CBP has been shown to bind to IRF family members, including IRF-1, and to be involved in IFN transactivation; however, in this case, IRF-1 acts in concert with a plethora of other transcription and architectural factors (Thanos and Maniatis, 1995). Other IRF family members, in particular IRF-3/IRF-7, are known to recruit CBP for activation only under conditions where they have formed hetero- and/or homodimers or are bound to DNA as multimers (Wathelet et al, 1998; Morin et al, 2002). Such a scenario could also explain the strong recruitment of CBP under the conditions of cotreatment where much higher levels of IRF-1 are bound at the TRAIL promoter. Moreover, our results show that other factors binding to nearby cis-acting elements (such as the GC boxes) contribute to the magnitude of the response, as well as to the basal level of TRAIL expression. In this respect, it is worth noting that IRF-1 has been observed to crosstalk to SP1 on the human CDK2 promoter (Xie et al, 2003) but the corresponding molecular mechanism has remained elusive. Collectively, these results suggest that (a) complex interactive structure(s) resembling the IFN enhanceosome (Thanos and Maniatis, 1995) may form at the TRAIL promoter. Thus, it is likely that, as in the case of IFN where only the stereospecific assembly of several factors allows the efficient recruitment of CBP (Merika et al, 1998), the synergistic activation of TRAIL expression requires the establishment of a similar structure to warrant efficient CBP recruitment.
The link between IRF-1 and TRAIL provides a novel insight into molecular mechanisms by which IRF-1 exerts its tumor suppressor activity in various systems (Tanaka and Taniguchi, 2000). Indeed, while initial gene deletion experiments suggested that IRF-1 acted as a 'tumor susceptibility gene' (Nozawa et al, 1999), recent data obtained with older IRF-1-/- mice (Eason et al, 2003) and the frequent loss or epigenetic modification of the IRF-1 locus in hematopoietic and solid cancers indicate that IRF-1 is a bona fide tumor suppressor. The molecular basis underlying the tumor suppressive activity of IRF-1 is still incompletely understood, albeit some features have been worked out. These include (i) the deficiency of IRF-1-/- mouse embryo fibroblasts (MEFs) in their ability to undergo DNA damage-induced cell cycle arrest, most probably due to the presence of both IRF-1-and p53-binding sites in the p21 promoter (Tanaka et al, 1996), (ii) the p53-independent DNA damage-induced apoptosis in activated mature T lymphocytes (Tamura et al, 1995), (iii) the reversion of oncogene-transformed cells by ectopic expression of IRF-1 (Tanaka et al, 1994b) and (iv) the elimination of activated ras-transformed MEFs by apoptosis upon DNA damage induction, which was not seen in IRF-1-/- cells under otherwise identical conditions (Tanaka et al, 1994a). Our finding that TRAIL is activated by IRF-1 may contribute to these tumor suppressor activities and explain the p53-independent IRF-1-dependent apoptosis of oncogene-transformed cells. Moreover, the synergy between IRF-1 and p53 should be reconsidered in view of the p53-induced expression of the TRAIL receptor DR5 (Wu et al, 1997; Kim et al, 2001; Wang and El-Deiry, 2003a) and the observation that IFNs induce p53 at the transcriptional level (Takaoka et al, 2003).
We show that synergy between RA and IFN results in a potent paracrine cell death of heterologous cancer cells. This paracrine killing has important implications, because (i) tumor cells resistant against one or both of the inducers can be nevertheless eliminated by neighboring cells that express TRAIL, (ii) normal cells are apparently resistant to TRAIL (also see Supplementary Material) but may express it (it will be interesting to study in this context if there are any differences in the TRAIL induction between cancer and normal cells) and (iii) combining two synergizing drugs has the advantage that the concentrations of the individual drugs can be reduced to limit side effects.
In parallel to these studies, we and others have observed that histone deacetylase inhibitors (HDACi) induce TRAIL expression in acute myeloid leukemia (AML) cells in vitro, AML patients blasts ex vivo and in AML leukemia mouse models (Insinga et al, 2004; Nebbioso et al, 2004). Together with the data presented here, these studies identify TRAIL as a central executor of the cancer cell-selective apoptogenic action of several known anticancer drugs and their corresponding signaling pathways, which form an intricate tumor suppressive signaling network (Figure 7). It is important to point out that these actions occur in a cell autonomous manner and represent a drug-modulable tumor defense system that acts independently of, and adds to the immunosurveillance through NK cells, which also involves TRAIL. The recognition of TRAIL and its receptor(s) as key mediators of the antitumor activities of certain retinoids, IFNs or HDAC inhibitors, and its link to two established tumor suppressors, IRF-1 and p53, supports the central role of this death signaling pathway in tumor defense and may pave the way toward novel apoptogenic anticancer therapies.
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Materials and methods Cell lines and cell culture
SK-BR-3 and MCF7 cells were maintained in DMEM supplemented with 10% FCS, 100 U/ml penicillin and 100 g/ml streptomycin. Jurkat, H3396 and NB4 cells were maintained in RPMI medium supplemented with 2 mM L-glutamine (Life Technologies), 10% FCS and antibiotics. Cryopreserved cord blood CD4+ T cells (Cambrex) were thawed, washed and placed in culture at 106 cells/ml in RPMI with 10% human serum, 100 U/ml penicillin and 100 g/ml streptomycin. Cells were kept in culture for no more than 6 days.
Plasmids, reagents and antibodies
pTRL reporters were constructed as follows: the -3907 to +56 region of the human TRAIL promoter was amplified from human genomic DNA by PCR and inserted into pGEM-T Easy (Promega) to generate pGEM-TR. All pTRL reporters are derivatives of this sequence inserted into pGL3 basic (Promega). Sequences of primers used for cloning or mutagenesis and details of plasmid constructions are available upon request. The following reagents were used: RA (9-cis-RA) (Sigma) at 1 M, human recombinant IFN (15 ng/ml) and IFN (1000 U/ml; Sigma). Rabbit polyclonal antibodies against acetylhistone H4 and H3 (Upstate), IRF-1, IRF-2, actin, CBP, PolII (Santa Cruz), Stat1 (Santa Cruz, Cell Signalling) and TRAIL (R&D) were used for ChIPs, immunoblots and EMSAs.
Reporter assays
Briefly, 1 day after seeding, SK-BR-3 or H3396 cells were transfected using Fugene (Roche). At 16 h after transfection, cells were treated with ligands (see figure legends) for 24 h. Cells were lysed and luciferase assays were performed (Promega). A CMV-driven -galactosidase expression vector was used to monitor transfection efficiencies. Normalized values are reported as the mean s.d.; each value originates from at least three transfections performed in duplicate.
DNase I hypersensitive mapping
DNase I hypersensitive mapping of the TRAIL locus was performed on SK-BR-3 and NB4 cells treated with RA for 48 and 72 h, respectively. Nuclei were isolated and aliquots were treated with increasing amounts of DNase I. Genomic DNA was digested with BglI, followed by overnight digestion with proteinase K, phenol/chloroform extraction and ethanol precipitation. In all, 50 g of digested sample was run on a 0.8% agarose gel and transferred to Hybond-N+ paper. The blot was incubated with 107 cpm 32P-labeled probe (Figure 1B), washed extensively with SSC and exposed to Kodak Biomax for 3–5 days.
Electrophoretic mobility assay and Western blot analysis
EMSAs were performed by incubating 6 g of nuclear extract with or without anti-IRF-1, anti-IRF-2 or anti-STAT1 antibodies (Santa Cruz Biotechnology), cold TRAIL-IRF-E (100 or 200 ), cold consensus IRF-E (200 ) or consensus GAS (200 ) probes for 20 min on ice. In all, 50 000 cpm of 32P-labeled TRAIL IRF-E (5'-ACAACTCATTCGCTTTCATTTCCTCACTGA-3') was added and reactions were incubated for 15 min at room temperature. The total volume of the reaction was 20 l. Protein–DNA complexes were resolved on nondenaturing 5% polyacrylamide gels in 0.5 TBE. For immunoblot analysis, 30 g aliquots of whole-cell extracts in Laemmli sample buffer were separated by 10% SDS–PAGE and immunoblotted according to standard procedures.
Chromatin immunoprecipitation
ChIP assays for the IRF-1 and GAPDH promoters were performed with the anti-acetylhistone H3 and H4 assay kit as recommended (Upstate). ChIP assays for TRAIL and HSP70 genes were carried out as described (Nissen and Yamamoto, 2000). Amplified products were run on a 1.2% agarose gel and visualized on a Typhoon Scanner. Quantitative real-time PCR was performed on a Roche 'Lightcycler'. All primer sequences will be provided on request.
Reverse transcriptase polymerase chain reaction
Total RNA was isolated (TRIZOL) from treated cells and 5 g of RNA was used in a reverse transcription reaction recommended (Invitrogen). PCR was performed using equal amounts of cDNA with primers for TRAIL or GAPDH mRNAs. PCR products were run on a 1.2% agarose gel and visualized on a Typhoon Scanner.
Paracrine death induction assays
Jurkat and cord blood CD4+ T cells were labeled with Cell Tracker Green CMFDA (Molecular Probes) according to the supplier's instructions. Cell Tracker-labeled cells were incubated with SK-BR-3 cells in the absence or presence of 1 M RA and/or 15 ng/ml IFN as illustrated in Figure 5A and C. Floating cells (T cells and detached SK-BR-3) were collected, pelleted, resuspended in PBS containing 1 g/ml PI and analyzed by FACS. CMFDA-positive cells were regarded as target (Jurkat or CD4+ T) cells, and CMFDA-negative cells as effector (SK-BR-3) cells. PI-negative cells were considered as living, and PI-positive cells as dead. For neutralization experiments, 1 g/ml of either TRAIL-R2:Fc, FAS:Fc or TNF:Fc chimeras (R&D) was added twice to the coculture, 48 and 24 h before FACS analysis.
RNA interference
H3396 cells were seeded 24 h before transfecting (Oligofectamine, Invitrogen) them with 200 nM siRNA for IRF-1 (Dharmacon) according to the manufacturer's instructions and retransfecting them after 24 h. After 16 h, cells were treated with RA for 36 h and lysed for RNA or protein extraction.
Supplementary data
Supplementary data are available at The EMBO Journal Online.
Acknowledgements
We are grateful to Lucia Altucci for multiple discussions and suggestions throughout these studies, and for critical reading of the manuscript. We thank Cathie Erb, Michele Lieb and Astrid Pornon for technical assistance and Keiko Ozato for providing the IRF-1 cDNA. NC was supported by the Association pour la Recherche sur le Cancer, AJ-L by a Marie Curie and EV by a MENRT fellowship. This work was supported by the INSERM, the CNRS, the Hôpital Universitaire de Strasbourg, the AICR, the ARC, the Fondation de France, the European Community (QLG1-CT2001-01935 and QLK3-CT2002-02029) and Bristol-Myers Squibb.
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