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As integrin alpha-9 has been previously shown to be involved in lymphatic vessel formation (Huang et al, 2000), and because integrins are important mediators of endothelial cell migration (Senger et al, 1997), we looked to see whether integrin alpha-9 is required for HGF-induced LEC migration. Incubation of LEC with an integrin alpha-9-specific blocking antibody blocked HGF-induced migration (P=0.0143) to roughly the same extent as LEC treated with an HGF-R-specific blocking antibody (P=0.0074). In contrast, incubation with an HGF-R-blocking antibody or with an integrin alpha-9-blocking antibody did not affect the migration of LEC in the absence of HGF (Figure 8B). Treatment with a control IgG or with blocking antibodies against both the integrin alpha-1 and alpha-2—that have previously been shown to inhibit VEGF-A-induced LEC migration (Hong et al, 2004b)—did not inhibit LEC migration in response to HGF treatment. Together, these findings indicate that integrin alpha-9 is an important mediator of HGF-induced migration of LEC.
Discussion In a search for regulators of lymphangiogenesis, we have used gene expression analysis, in vitro and in vivo studies to identify HGF as a potent lymphangiogenic factor. We found that the HGF-R is expressed by LEC more strongly than by BVEC in vitro, that HGF-R is expressed by activated lymphatic endothelium in vivo, and that HGF directly promotes proliferation, migration, and tube formation in cultured LEC. Furthermore, HGF promotes formation of new lymphatic vessels in vivo, and the promigratory effects of HGF on LEC are largely mediated by the integrin alpha-9. Blockade of the HGF–HGF-R signalling pathway might therefore serve as a new strategy to inhibit unwanted lymphatic vessel growth.
It has been a challenge to identify factors that regulate lymphangiogenesis because of a lack of reliable markers to distinguish between lymphatic and blood vascular differentiation. Moreover, the lack of suitable in vitro models for the selective cultivation of both vascular cell types prevented comparative functional studies. The recent identification of lymphatic-specific genes (for a review, see Oliver and Detmar, 2002) cleared the path for molecular investigations of lineage-specific vascular differentiation and function, and for the reliable isolation and expansion of LEC and BVEC.
FGF-2 has been shown to induce lymphangiogenesis indirectly, via stimulation of the release of the lymphangiogenic factor VEGF-C, and FGF-2's effects on lymphangiogenesis can be prevented by blockade of VEGFR-3 signalling (Kubo et al, 2002; Chang et al, 2004). HGF, in contrast, directly stimulates LEC proliferation, and does not require VEGFR-3 signalling, but can be completely prevented by blockade of the HGF-R. Moreover, HGF treatment did not increase LEC expression of the VEGFR-3 ligands VEGF-C or VEGF-D (data not shown). So, HGF–HGF-R signalling, in addition to the VEGF-C/-D–VEGFR-3 (Jussila and Alitalo, 2002) and the PDGF-BB–PDGFR pathways (Cao et al, 2004), acts as a third lymphangiogenesis growth factor system.
How does HGF mediate its effects on LEC migration? Based on transcriptional profiling studies, we identified the integrin alpha-9 as a factor that is highly upregulated in LEC after HGF treatment. Previous studies have shown that integrin alpha-9 is required for the normal development of the lymphatic system (Huang et al, 2000), and that mice that lack this transmembrane signalling protein develop chylothorax—a sign of impaired lymphatic transport. Our finding that HGF-induced LEC migration, but not migration of LEC in the absence of HGF, was inhibited by a blocking antibody against integrin alpha-9, along with recent findings that integrin alpha-9 is specifically upregulated in cultured LEC (Petrova et al, 2002), indicate that this integrin might be required for the LEC motility that occurs during lymphangiogenesis. In fact, interaction of the integrin alpha-9 with the lymphangiogenic factor VEGF-C has been recently reported (Vlahakis et al, 2005). Other integrins, such as integrins alpha-1 and alpha-2, have been shown to be expressed by cultured LEC and to mediate VEGF-A-induced LEC migration (Hong et al, 2004b); however, blockade of these integrins did not inhibit HGF-induced LEC migration. The distinct functional roles and in vivo expression patterns of these individual integrins in different lymphatic vessel types remain to be established.
What is the role of HGF-R signalling during normal embryonic development? During embryogenesis, Prox1-positive lymphatic progenitor cells bud from the CV and migrate out beginning at E10.5 to form the embryonic lymph sacs and, consequently, the lymphatic vascular network (Wigle et al, 2002). We found that HGF-R was expressed on LYVE-1-positive endothelial cells of the anterior CV by E12.5, but also occasionally by the LYVE-1-positive LEC that line the primitive lymph sacs. By E14.5, HGF-R was strongly expressed by the majority of LYVE-1- and Prox1-positive endothelial cells of the lymph sacs, revealing that HGF-R is expressed at a later stage of lymphatic development than Prox1 or LYVE-1. This expression pattern is similar to that of neuropilin-2 receptor and podoplanin (Yuan et al, 2002; Schacht et al, 2003), indicating a possible role of HGF-R during the later stages of lymphatic network formation and maturation.
HGF also appears to function in the lymphangiogenesis that occurs during cutaneous tissue repair. In a model of mouse wound healing (Hong et al, 2004b), we found that lymphangiogenic LYVE-1-positive vessels expressed high levels of HGF-R, whereas lymphatic vessels in normal skin expressed little or no HGF-R. Similarly, we found that HGF-R was strongly expressed by enlarged lymphatic vessels in a mouse model of chronic skin inflammation (Kunstfeld et al, 2004). Together, these findings indicate that HGF-R is preferentially expressed by activated, proliferating lymphatic endothelium, but not by quiescent lymphatic vessels in normal skin, a finding with important implications for the potential use of targeted HGF-R-blocking therapeutic strategies.
Our findings that transgenic overexpression of HGF, as well as implantation of HGF-containing Matrigels or slow-release pellets, induced pronounced formation of new lymphatic vessels are the first demonstration that HGF acts as a potent lymphangiogenesis factor in vivo. HGF also has important effects on lymphatic vessel function, since blockade of HGF-R signalling prevents lymphatic enlargement during cutaneous inflammation and also impairs lymphatic transport. Alternatively, direct intradermal injection of HGF into ear skin promotes lymphatic flow, as demonstrated by in vivo confocal microcopy (K Kajiya, unpublished results). Importantly, HGF-R blockade has only minor effects on blood vessel activation in the same experimental models, in accordance with our findings that activation of HGF-R by HGF stimulated LEC proliferation more potently than BVEC proliferation. Similarly, it has been found that VEGF-C, the first identified lymphangiogenesis factor, specifically promotes LEC proliferation, with only minor effects on BVEC (Alitalo and Carmeliet, 2002).
The expression of the lymphangiogenic factors VEGF-C and -D has been correlated with metastasis of many human tumour types (Stacker et al, 2002). Our preliminary data that tumour-associated LYVE-1-positive lymphatic vessels strongly express HGF-R (K Kajiya, unpublished results), together with the correlation between tumour expression of HGF and metastasis of human tumours to the lymph nodes (Birchmeier et al, 2003), raise the possibility that HGF, in addition to its direct effects on some tumour cells, also contributes to tumour progression by promoting lymphangiogenesis. Therefore, HGF and HGF-R might represent promising new targets for the therapeutic blockade of lymphatic cancer spread.
Materials and methods Cells
Human dermal BVEC and LEC were isolated from neonatal human foreskins, as previously described (Hirakawa et al, 2003), with slight modifications. Briefly, in order to remove fibrocytes, CD45-negative selection was performed using an immunomagnetic beads-conjugated anti-human CD45 antibody (Dynal, Lake Success, NY) before isolating CD34-positive BVEC. Thereafter, the remaining CD34-negative cells were incubated with an immunomagnetic beads-conjugated anti-human CD31 antibody (Dynal) to isolate LEC.
Quantitative real-time RT–PCR
The methods used are described in Supplementary data 3.
Immunoblotting
For Western blot analyses of HGF-R and phosphotyrosine, confluent BVEC and LEC were homogenized in lysis buffer, and protein concentrations were determined using the BCA-Kit (Pierce Biotechnology, Rockford, IL). The lysates (300 g total protein each) were immunoprecipitated with a goat polyclonal antibody against HGF-R (R&D Systems, Minneapolis, MN) and then immunoblotted with a rabbit polyclonal antibody against HGF-R (Santa Cruz Biotechnology, Santa Cruz, CA). To assess tyrosine phosphorylation levels, LEC were cultured with HGF (30 ng/ml) for 15 min, followed by homogenization in lysis buffer. Untreated cells were prepared as controls in the same manner. Cell lysates (300 g total protein each) were immunoprecipitated with a goat polyclonal antibody against HGF-R (R&D Systems) and then immunoblotted with an anti-phosphotyrosine antibody (PY99; Santa Cruz Biotechnology). In additional studies, LEC were incubated with 1 g/ml of anti-human VEGFR-3 antibody (clone hF4-3C5, kind gift of Dr B Pytowski, Imclone Systems Inc., New York, NY) or with 1 g/ml of control IgG for 2 h, and were then treated or not with 500 ng/ml VEGF-C (R&D Systems) for 10 min, followed by homogenization in lysis buffer and immunoprecipitation (300 g total protein) with antiphosphotyrosine antibodies PY99 or 4G10 (Upstate, Lake Placid, NY) or with an anti-VEGFR-3 antibody (Santa Cruz Biotechnology), and then immunoblotted with anti-VEGFR-3 antibody. Specific binding was detected by the enhanced chemiluminescence system (Amersham Biosciences, Piscataway, NJ).
Immunofluorescence analyses
Immunofluorescence analyses were performed on 6- m cryostat sections of mouse tissues or on 10- m sections of mouse embryos as described (Hong et al, 2004b; Kunstfeld et al, 2004), using polyclonal antibodies against murine LYVE-1 (kindly provided by Dr D Jackson, Oxford, UK), murine HGF-R (R&D Systems), murine CD4, CD8, CD11b and CD31 (all from BD Biosciences, Bedford, MA), HGF (Santa Cruz Biotechnology, Santa Cruz, CA) and Prox1 (kindly provided by Dr K Alitalo, Helsinki, Finland). Immunohistochemical analyses for podoplanin were performed on 6- m 4% paraformaldehyde-fixed skin sections as described previously (Schacht et al, 2003), using the hamster antibody 8.1.1 (Developmental Studies Hybridoma Bank, University of Iowa). Paraffin sections were also obtained from the formaldehyde-fixed skin, duodenum, liver and ileum of 8-weeks-old transgenic FVB mice, with overexpression of HGF under control of the mouse metallothionin I promoter (n=4; kindly provided by Dr Glenn Merlino, National Institutes of Health, Bethesda, USA) (Takayama et al, 1996) and from age-matched wild-type FVB mice, and were stained for podoplanin. Corresponding secondary antibodies were labeled with AlexaFluor488 or AlexaFluor594 (Molecular Probes, Eugene, OR). Sections were examined by a Nikon E-600 microscope (Nikon, Melville, NY) and images were captured with a SPOT digital camera (Diagnostic Instruments, Sterling Heights, MI). Computer-assisted morphometric vessel analyses of representative LYVE-1 and CD31 double-stained sections were performed as described (Hirakawa et al, 2005b).
Proliferation, migration and tube formation assays
BVEC or LEC (2 103) were seeded onto fibronectin-coated 96-well plates. Quinduplicate wells were treated or not with several concentrations of recombinant human HGF (R&D Systems) in EBM containing 2% fetal bovine serum. LEC were also incubated with HGF (30 ng/ml) together with anti-human HGF-R (R&D Systems), anti-human Flt4 (kind gift of Dr B Pytowski, Imclone Systems Inc., New York, NY), or control IgG (1 g/ml, respectively). After 72 h, cells were incubated with 5-methylumbelliferylheptanoate as described (Detmar et al, 1992). The fluorescence intensity, proportional to the number of viable cells, was measured using a Victor2 Fluorometer (Perkin-Elmer, Boston, MA). Haptotatic cell migration was performed as described (Hong et al, 2004b), using 24-well FluoroBlok inserts of 8 m pore size (Falcon, Franklin Lakes, NJ). The bottom sides of the inserts were coated with 10 g/ml fibronectin (BD Biosciences, Bedford, MA) for 1 h, followed by incubation with 100 g/ml bovine serum albumin (BSA). Cells (105 cells in 100 l) were seeded in serum-free EBM containing 0.2% delipidized BSA into the upper chambers, and were incubated for 3 h at 37°C in the presence or absence of human recombinant VEGF (20 ng/ml) or HGF (0.03–30 ng/ml). In additional studies, cells were incubated with 10 g/ml of a blocking anti-integrin alpha-9 antibody (clone Y9A2, Chemicon, Temecula, CA), an anti-HGF-R antibody (R&D Systems), blocking antibodies against the integrins alpha-1 (Upstate) and alpha-2 (Chemicon, Temecula, CA), or control IgG for 60 min. Cells were then seeded into the upper chambers and were incubated for 3 h in the presence or absence of human recombinant HGF (30 ng/ml). Cells on the underside of inserts were stained with Hoechst 33342 (Molecular Probes). Three different digital images per well were taken, and the number of migrated cells was counted. Tube formation assays were performed as described (Schacht et al, 2003). LEC or BVEC were grown on fibronectin-coated 24 well plates until confluence. In all, 0.5 ml of neutralized isotonic bovine dermal collagen type I (Vitrogen, Palo Alto, CA) in the absence or presence of HGF (3 or 30 ng/ml) was added to the cells. After incubation at 37°C for 6 h, cells were fixed with 4% paraformaldehyde for 30 min at 4°C. Representative images were captured and the total length of tube-like structures per area was measured using the IP-LAB software. All studies were performed in triplicate. Statistical analyses were performed using the unpaired Student's t-test.
In vivo lymphangiogenesis and HGF-R blocking assays
FVB wild-type mice (male, 10 weeks old) were subcutaneously injected with 250 l of Matrigel (BD Bioscience; 9 mg/ml) containing or not 1 mg/ml HGF. After 7 days, mice were killed and tissues were fixed for 24 h in 4% paraformaldehyde and then embedded in paraffin. Immunohistochemistry for mouse podoplanin was performed as described above. In addition, delayed-type hypersensitivity reactions were induced in FVB mice as described (Kunstfeld et al, 2004). Mice (female, 8 weeks old) were sensitized by topical application of oxazolone to the paws and the shaved abdomen 5 days before challenge with topical application of oxazolone to the ears (Kunstfeld et al, 2004). At 1 day before oxazolone challenge, 100 g of a goat anti-mouse HGF-R antibody (R&D Systems) or of control goat IgG was intraperitoneally injected (n=5 per group). At 1 day after challenge, mice were killed and ears were embedded and frozen in OCT compound (Sakura Finetek, Torrance, CA). To confirm the blocking activity of the anti-HGF-R antibody, murine B16 melanoma cells (0.5 103) were seeded onto 96-well plates and quinduplidate wells were treated or not with 3 ng/ml of HGF (R&D Systems) together with the anti-mouse HGF-R antibody or with control IgG (10 g/ml) in DMEM containing 5% FBS. After 72 h, cell proliferation was assessed as described above for LEC. HGF treatment promoted B16 cell proliferation (33.6 5.08%), whereas incubation with the anti-HGF antibody prevented HGF-induced stimulation of cell proliferation (6.26 7.72%; P<0.01). In additional studies, slow-release pellets containing or not recombinant HGF (500 ng/pellet) were implanted subcutaneously into the ears of 8-weeks-old female FVB mice as described previously (Hirakawa et al, 2005a). Beginning at 4 days after implantation, mice bearing HGF pellets were injected i.p. with 600 g of control IgG (Sigma) or of rat anti-mouse VEGFR-3 neutralizing antibody (clone mF4-31C1, Imclone Inc.) (Pytowski et al, 2005) every 2 days. Mice with control pellets were injected with control IgG (n=5 per group). Mouse ears were harvested at 14 days after implantation and were snap-frozen for histological analysis. All animal studies were approved by the Massachusetts General Hospital Subcommittee on Research Animal Care.
Supplementary data
Supplementary data are available at The EMBO Journal Online.
Acknowledgements
We thank M Constant and L Janes for expert technical assistance. This work was supported by NIH grants CA69184, CA86410, CA92644 (MD), American Cancer Society Research Project Grant 99-23901 (MD), Swiss National Fund project grant 3100A0-108207 (MD), FWF grant S9408-B11, and by the Cutaneous Biology Research Center through the Massachusetts General Hospital/Shiseido Co. Ltd Agreement (MD).
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