Originally published as JHC exPRESS on May 27, 2008. doi:10.1369/jhc.2008.951095
Volume 56 (9): 819-829, 2008 Copyright ©The Histochemical Society, Inc. Expression of Integrin-linked Kinase Is Increased in Differentiated Cells
OncoRay–Center for Radiation Research in Oncology (MH,CCG,IE,SH,NC) and Department of Pathology (GBB), Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany Correspondence to: Nils Cordes, OncoRay–Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Fetscherstrasse 74/PF 86, 01307 Dresden, Germany. E-mail: nils.cordes{at}oncoray.de
Integrin-linked kinase (ILK), a mediator of β integrin signals, has emerged as a therapeutic target in malignant tumors. Because malignant transformation is accompanied by dedifferentiation, ILK expression was evaluated in diverse normal and tumor tissue samples with regard to tissue differentiation. In single sections and in a tissue microarray (323 tumor tissues, 181 normal tissues), immunohistochemistry was performed [ILK, Akt, phospho-Akt-S473, loricrin, transforming growth factor β2 (TGFβ2)], and staining intensities were semiquantitatively scored. Increased ILK expression was clearly associated with increased differentiation in normal gastrointestinal, neural, bone marrow, renal tissue, and in more differentiated areas of malignant tumors. ILK colocalized with its putative downstream target Akt and with loricrin or TGFβ2. Our findings clearly show that elevated levels of ILK are associated with cellular differentiation in high turnover tissues but not generally with a malignant phenotype. Our study indicates that ILK is not a general molecular target for cancer therapy but rather an indicator of differentiation. This manuscript contains online supplemental material at http://www.jhc.org. Please visit this article online to view these materials. (J Histochem Cytochem 56:819–829, 2008)
Key Words: integrin-linked kinase differentiation tumor normal tissue tissue microarray
CURRENT CONVENTIONAL anticancer strategies using radio- and chemotherapy are applied without discriminating between tumor and normal cells. Novel molecular therapeutics targeting, for example, cell surface receptors or intracellular signaling proteins have been designed, on the one hand, to specifically eradicate malignant cells when given as monotherapy and, on the other hand, to improve tumor control when given in combination with conventional radio- or chemotherapy (Ragnhammar et al. 2001
Recently, integrin-linked kinase (ILK) has been reported as new potent target molecule in cancer (Hannigan et al. 2005
Concerning former histological analysis of ILK expression in cancer, ILK seems to be overexpressed in a number of human cancers (Persad and Dedhar 2003
In addition to this controversy, the role of ILK in cell survival on exposure to cytotoxic drugs or ionizing radiation also remains to be clarified. On exposure to X-rays, overexpression of wild-type ILK or an ILK mutant with a constitutively active kinase domain significantly reduced clonogenic cell survival of human lung cancer, squamous cell carcinoma, and leukemia cells (Cordes 2004
Taking these discrepancies in histological examinations and cell survival into account, this study was performed to elucidate whether ILK upregulation correlates with dedifferentiation/loss of differentiation representing a critical characteristic of malignant tumors. Besides ILK, expression of the differentiation markers loricrin and transforming growth factor β2 (TGFβ2) (Mehrel et al. 1990
Tissue Specimens and Tissue Microarray Human tissues were obtained from pathology archival material in a blinded fashion as approved by the ethics committee of the Dresden University of Technology (Dresden, Germany). The human squamous cell carcinoma (SCC) cell lines UT-SCC14 and UT-SCC15 were grown in NMRI nude mice. Animal experiments were approved by the animal committee of the Dresden University of Technology and by the State of Saxony. For the production of tissue microarrays (TMAs), an AlphaMetrix device (AlphaMetrix; Rödermark, Germany) was used according to the manufacturer's instructions. The TMA consisted of 504 tissue samples (323 tumor + 181 normal; ST1) placed on four different tissue blocks.
Immunohistochemistry and Immunofluorescence
Intensity Evaluation, Scoring, and Statistical Analysis
Western Blotting
Localization of ILK in Normal and Tumor Tissues of the Gastrointestinal Tract At first, because of its high hierarchic differentiation order, different epithelia of the gastrointestinal tract were examined for ILK expression. In the epithelium of the esophagus, the basal layer (Figures 1A and 1B, arrows) contained less ILK than the layers above. The layers directly above the basal layer showed a diffuse cytoplasmic staining, whereas in the middle layers of the epithelium, ILK was accentuated at the cell membrane. In the small intestine, crypt cells contained much less ILK than the cells of the upper parts of the villi (Figures 1C and 1D, arrow). Similar findings were obtained in the colon (Figure 1E). In particular, the surface epithelium showed an ILK positivity (arrows) comparable to the intensity of the lamina muscularis mucosae (Figure 1E). In a human SCC xenograft model in nude mice, which delineated areas of spontaneous differentiation, ILK expression was intense in these differentiated areas (Figure 1F, arrows) in contrast to surrounding more immature tumor cells.
Localization of ILK in Tissues and Tumors Derived From Different Germ Layers We next sought to study tissues from all three germ layers (endoderm, mesoderm, neuroectoderm) to present further supportive evidence for the observed association of ILK and differentiation. At first, in addition to the endoderm-derived intestinal tissues described above, the endoderm-derived epithelium of the prostate was examined. In general, the epithelial cells of prostate adenocarcinomas contained less ILK [including cases with no ILK expression: Figure 2A ) compared with the three ILK-positive tissues, i.e., blood vessels (Figure 2A, arrow), surrounding connective tissue (Figure 2A, double arrowhead) and normal prostate epithelium (Figure 2B, arrows). Second, the mesoderm-derived hematopoietic system (i.e., bone marrow) was evaluated for ILK expression. Tumor tissue of immature hematopoietic cells showed weak ILK staining in cells from human acute myeloblastic leukemia (Figure 2C), whereas mature megakaryocytes in this tissue contained high amounts of ILK (Figure 2C, white arrow). Mature bone marrow was highly positive for ILK including neutrophil granulocytes and megakaryocytes (Figure 2D). Third, the ectoderm-derived neural tissue was explored showing immature neuroectodermal cells from a human neuroblastoma to be marginally positive for ILK (Figure 2E). In contrast, cells from more mature ganglioneuroblastomas contain pronouncedly more ILK (Figure 2F), which was similar in mature ganglions (data not shown). With regard to the intracellular localization of ILK, most cell types showed a cytoplasmic ILK staining. A distinct cell membrane staining of ILK could only be found in squamous epithelial cells of normal tissue (see Figure 1A) and more differentiated cells within a subgroup of SCCs (see Figure 1F) as well as for most clear cell (conventional) renal cell carcinomas (see below).
ILK Is Coexpressed With Differentiation Markers To further assess the association of ILK with differentiation, different tissue samples were double stained with ILK and the differentiation markers loricrin or TGFβ2. In the mouse skin, both ILK (Figure 3A ) and loricrin (Figure 3B) were coexpressed and colocalized in the upper layers of the skin. In differentiated areas of the SCC xenografts, ILK (Figure 3D) and loricrin (Figure 3E) were also coexpressed but not colocalized within the cells. Here, loricrin was mainly cytoplasmic and ILK was membranous. Co-staining of ILK with TGFβ2 indicated a similar observation in the more differentiated tumor areas of SCC xenografts (Figures 3G–3I).
ILK Is Colocalized With Phosphorylated Akt-S473 Because ILK is believed to phosphorylate Akt at S473, we next examined the colocalization of ILK with Akt or its S473-phosphorylated form in normal epithelium of the esophagus, representing the strongest differentiation hierarchy. Whereas the basal layer of the epithelium per se showed a low Akt expression (Figure 4A , arrow), Akt expression was higher in more differentiated squamous epithelial cells (Figure 4A). Stromal cells generally showed a high Akt expression (Figure 4A). Both, the staining intensity and localization of phosphorylated Akt-S473 correlated with total Akt (Figure 4B, arrow). These findings were confirmed by immunofluorescence double labeling of ILK plus Akt or phosphorylated Akt-S473 (Figures 4C–4L).
Comparison of ILK Expression Between Normal and Tumor Tissues and Between Different Tumor Tissues In the following, an immunohistochemistry analysis on ILK was performed using a self-designed TMA (323 tumor, 181 normal; see supplementary information). Overall, we found no significant difference in ILK expression between all normal and tumor tissues implemented in the TMA (see supplementary information; Figure 5A ). Adenocarcinomas had a slightly lower ILK expression compared with squamous cell carcinomas, which was not statistically significant (Figure 5B). The mean ILK expression of squamous cell carcinomas is 10% higher than in normal squamous epithelium, but this difference is not statistically significant (Figure 5C). In contrast, the mean ILK expression in renal cell carcinomas is reduced by 35% compared with normal kidney tissue, which is statistically highly significant (Figure 5D; p<0.001). In consideration of a large number of renal tissues in the TMA, the corrected statistical analysis of ILK expression in normal tissues other than kidney vs tumor tissues other than kidney showed to be significantly increased in the tumor tissues (Figure 5E). In contrast to the majority of renal cell carcinomas showing this strongly reduced ILK expression, a small number indicated a moderate and distinct cell membrane localized ILK staining (Figures 6A–6F
). Western blot analysis of human normal fibroblast protein lysates showed the polyclonal anti-ILK antibody (Stressgen) to recognize a major band at 60 kDa, which corresponds to ILK. The specificity of the anti-ILK mouse monoclonal antibody (Santa Cruz) has been shown in the datasheet of the company.
ILK is currently under intense investigation with regard to its role as a therapeutic target in anticancer treatment. The findings on ILK's prosurvival effects and on the differential expression of ILK in tumor vs normal tissue are controversial. Because of these facts and the clinical relevance of a differential ILK expression in tumor vs normal tissues, this study was carried out using single tissue sections and a TMA. ILK expression was evaluated in different tumor and normal tissues with special focus on the relationship between ILK and differentiation. Cellular differentiation can be concluded from the localization of a cell in a tissue (i.e., tissue architecture) and the expression of specific differentiation marker proteins such as loricrin and TGFβ2. The hierarchical structures present in the different tissues examined were used for the histological examinations. The findings of this study clearly indicate that ILK is strongly associated with cellular differentiation and coexpressed/colocalized with loricrin and TGFβ2 in the specific tissues investigated. This was shown with different anti-ILK antibodies. In our study, ILK expression was significantly overexpressed in tumors of diverse origin (difference in statistical analysis between Figures 5A and 5E because of exclusion of kidney tissue), but the biological importance underlying this overexpression is questionable because of its minor extent, which is highly unlikely to affect the therapeutic ratio. In our study, we found no tumor type with exceptionally high expression of ILK, which means that there is no tumor type that would be a candidate for specific targeting of ILK as a therapeutic option. In some cases (e.g., renal cell carcinoma), ILK mean staining intensity is pronouncedly decreased compared with normal tissue and with SCCs or adenocarcinomas. Whether the tumor grade is correlative to ILK positivity should be evaluated in further studies. An important finding, which confirms published data, is the association of ILK with its putative downstream target Akt and the level of Akt-S473 phosphorylation.
A role of ILK in differentiation is known from different studies in hepatocytes, kidney, and brain (Belvindrah et al. 2006
Using a TMA containing most normal tissues and all major types of malignant tumors, no significant difference between ILK expression in normal and tumor tissues was observed. Our findings partly corroborate the report by Chung et al. (1998)
ILK binds to the cytoplasmic tail of β1 integrins, which suggests that the cellular distribution of both proteins should be similar (Hehlgans et al. 2007b
In agreement with published data, ILK and Akt are coexpressed in the examined tissues, resulting in an association of ILK with phosphorylated Akt-S473. Because this coexpression also correlates with the grade of differentiation, our data are consistent with the theory of a relationship between grade of cellular differentiation and radioresistance or chemoresistance (Pirollo et al. 1993 In conclusion, this study clearly showed a hierarchical expression of ILK in many tissues and that ILK expression is associated with cellular differentiation. Our findings generated in a large set of tumor and normal tissues may have potential clinical applicability with regard to the use of novel therapeutic targeting strategies against ILK. Unless pathologically evaluated on an individual basis, ILK seems not to represent a reasonable target molecule in most types of tumors.
The authors and research were supported by the Federal Ministry of Education and Science (BMBF-03ZIK041). Tumor samples from UT-SCC 14 and 15 mouse xenografts were kindly provided by Dr. M. Baumann (Dresden University of Technology, Dresden, Germany). The authors thank Daniela Tschuck for excellent technical assistance and Wolf Dietrich Meyer (Dresden University of Technology, Dresden, Germany) for help with statistical analysis.
Received for publication February 11, 2008; accepted May 13, 2008
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