Originally published as JHC exPRESS on March 30, 2009. doi:10.1369/jhc.2009.953547
Volume 57 (7): 701-708, 2009 Copyright ©The Histochemical Society, Inc. Quantitative In Situ Detection of Phosphoproteins in Fixed Tissues Using Quantum Dot Technology
Department of Clinical Pathology, Cleveland Clinic, Cleveland, Ohio Correspondence to: Eric D. Hsi, MD, Department of Clinical Pathology, L-11 Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195. E-mail: hsie{at}ccf.org
Detection and quantitation of phosphoproteins (PPs) in fixed tissues will become increasingly important as additional inhibitors of protein kinases enter clinical use and new disease entities are defined by molecular changes affecting PP levels. We characterize fixation conditions suitable for accurate PP quantitation that are achievable in a clinical laboratory and illustrate the utility of in situ quantitation of PPs by quantum dot (QD) nanocrystals in two models: (1) a therapeutic model demonstrating effects of a targeted therapeutic (quantitative reduction of phospho-GSK3β) in xenografts treated with enzastaurin; and (2) a diagnostic model that identifies elevated levels of nuclear phospho-STAT5 in routine bone marrow biopsies from patients with acute myeloid leukemia based on the presence of the activating FLT3-ITD mutation. Finally, we document production of a well-characterized tissue microarray of widely available cell lines as a multilevel calibrator for validating numerous phosphoprotein assays. QD immunofluorescence is an ideal method for in situ quantitation of PPs in fixed samples, providing valuable cell type–specific and subcellular information about pathway activation in primary tissues. (J Histochem Cytochem 57:701–708, 2009)
Key Words: phosphoprotein immunofluorescence quantum dot FLT3 pSTAT5
PHOSPHOPROTEINS (PPS) ARE IMPORTANT in mediating signal transduction (Hunter 1987
Immunofluorescence (IF) microscopy is a well-characterized technique for the detection of proteins and antigens in tissue sections. However, commonly used organic fluorescent dyes are limited by photobleaching, broad emission spectra, and variable quantum yield (Ono et al. 2001 In this study, tissue handling conditions are explored that allow accurate quantitation of PPs in fixed tissues. We then show successful application of QD IF quantitation of PPs in fixed tissues using in vitro and in vivo models as proof of principle. Our results provide a foundation for understanding tissue handling requirements for in situ PP detection in primary human tissues in the clinical setting. This represents an expanding area of investigation (functional phenotyping) that may have implications for pathologists in disease diagnosis, disease classification, therapy selection, and therapeutic monitoring.
Materials and Cell Lines LR3-IGF-1 was purchased from GroPep (Adelaide, Australia). Enzastaurin was kindly provided by Eli-Lilly (Indianapolis, IN). Streptavidin-conjugated QDs (605 and 655 nm) were obtained from Ventana Medical Systems (Tucson, AZ). Fixatives used: 10% buffered formalin (Cardinal Health; Dublin, OH), Zn formalin, B5 (Poly Scientific; Bayshore, NY), UMFIX (Tissue-Tek Xpress; Sakura, Torrance, CA), and Prefer (Anatech; Battle Creek, MI). All anti-phospho-protein antibodies, other than rabbit anti-phospho-PS6KB1 (T389) (Epitomics; Burlingame, CA), were obtained from Cell Signaling Technology (Danvers, MA). PC-3, MCF-7, and UT7/erythropoietin (EPO) cell lines were kindly provided by Dr. Lindner and Dr. Schade (Cancer Center, Cleveland Clinic; Cleveland, OH). SU-DHL-6 and Karpass 299 cell lines were purchased from DSMZ (Braunschweig, Germany). The rest of the cell lines come from ATCC (Manassas, VA).
Cell Blocks, Tissue Microarray, and Case Selection
Tumor Xenografts
IHC
Quantitation of Fluorescence Signal
Western Blot Analysis
Kinetworks PP Screen
Statistical Analysis
QD-based Quantitative IF in Fixed Cells Correlates With Western Blot Quantitation To validate QD staining, pSTAT5 detection in the EPO-dependent UT7/EPO cell line and pAKT detection in the colon cancer cell line HT-29 were chosen as models. These PPs were picked for the following attributes: examples of nuclear (pSTAT5) and cytoplasmic (pAKT) localization for active forms of the protein; and examples of phosphotyrosine (pSTAT5) and phosphoserine (pAKT) moieties. Aliquots for fresh cell lysates and formalin-fixed paraffin-embedded cell blocks were derived from the same cultured samples and simultaneously prepared for Western blot (WB) analysis and QD staining. To examine the relationship between WB results and the IF quantitation, we performed five replicate experiments for each analyte. Each replicate consisted of four different PP levels produced by varying culture conditions. These studies show that QD IF quantitation of paraffin-embedded samples correlates very well with WB data (Figure 1 ). The Pearson's correlation coefficients were 0.96 for the UT7/EPO cell model and 0.93 for the HT-29 cell model (p<0.001). The Spearman's rank order correlation coefficients were 0.91 for the UT7/EPO cell model and 0.90 for the HT-29 cell model (p<0.001). As further evidence that quantitation was robust and that sufficient numbers of fields were measured to give an accurate picture of PP quantitation, the variance of the running mean of each cell's IF quantitation for a representative experimental condition was not higher than 3.7% and 2.9% for the UT7/EPO and HT29 models, respectively.
Changes in PP Levels Prior to Fixation Highlight the Importance of Rapid Processing Freshly harvested xenograft tumor sections were either snap-frozen in liquid nitrogen or held in PBS at room temperature for various times prior to freezing (Figure 2A ). In the first model, WB analysis of HCT116 xenografts showed that 15 min after harvest, there was a significant increase of phosphorylation of CREB1 (S133), ERK1/2 (T202/Y204), 4EBP1 (T37/46), and S6RP (S235/236), followed by marked diminution of signal after 2 hr. PPs such as mTOR (S2448), RPS6KB1 (T389), Src (S527), I B (S32/36), or S6RP (S240/244) did not significantly change phosphorylation status until 45 min. AKT (S473) and GSK3β (S9) were considered the most-sensitive PPs. After 15 min of delay in freezing, a 50% decrease in PP levels was detected.
Similarly, in a second model, WB analysis of HEL xenografts with high basal pSTAT5 (Y694) due to homozygous activating, JAK2 V617F mutations showed 40% reduction of phosphosignal after a 10-min delay prior to cryopreservation.
Formalin Is an Appropriate Fixative for PP Detection in Tumor Tissue An experiment comparing overnight fixation, using formalin or Zn formalin (18 hr) vs fixation over a weekend (60 hr) showed no statistically significant changes in PP levels (data not shown). However, using an alcohol-based fixative (Prefer) resulted in a significant diminution of signal (53.0 ± 2.5%) when samples were fixed over the weekend, as compared with standard overnight-fixed samples (p<0.05, data not shown). To validate QD IF quantitation in fixed tumor sections of known PP status, HT-29 xenograft–bearing mice were treated in vivo with LR3-IGF-1 to modulate pAKT levels (Figure 2C). This model showed a dose-dependent increase in pAKT levels due to LR3-IGF-1 stimulation, as shown by paired WB and QD IF, thus validating this technology in a tumor system manipulated to show varying levels of analyte. Compared with immediately processed serial tumor sections, a substantial decrease in PP signal was seen by WB and QD IF upon 2-hr fixation delay, confirming lability that had been observed in the previous experiment.
Construction of a Multilevel Control TMA We therefore characterized a panel of widely available cell lines via quantitative high-throughput Kinetworks PP screen 1.3 (Kinexus Bioinformatics Corporation). Levels of several PPs included in the Kinetworks screen, such as pCREB1, pERK1, pGSK3β, pAKT, pSTAT1, pSTAT5, and pSrc, were confirmed by WB in our laboratory (data not shown). A heat map based on expression of each marker across the different cell lines was constructed (Figure 3 ). Paired formalin-fixed cell blocks were made from the same cultures used to produce the lysates used for Kinexus quantitation. A TMA of these blocks was constructed to serve as calibrator material for PP QD IF assays. Quantitation of pSTAT1 (T701), pERK (T202/Y204), pGSK3β (S9), and pSTAT5 (Y694) was done using the method developed above. QD IF quantitation of these PPs showed good correlation with Kinetworks data. The Pearson correlation coefficients were 0.84 for pSTAT1, 0.91 for pERK, 0.96 for pGSK3β, and 0.81 for pSTAT5 detection (p<0.005). Thus, the TMA could be used to validate an IF assay by demonstrating good correlation with known relative levels. Indeed, we used the correlations seen here for pGSK3β and pSTAT5 as confirmation of the quantitative nature of the assay method for the studies below.
Potential Applications of PP Quantitation In the era of targeted pathway-specific therapy, it may be useful to examine tumor cells for an intended therapeutic effect via PP detection and quantitation. As a first model for an application of QD IF quantitation, mice bearing human colon cancer HCT116 xenografts were treated with the PKCβ pathway inhibitor enzastaurin (Figure 4A ). This agent is now in phase 3 clinical trials in hematologic malignancies (diffuse large B-cell lymphoma) and solid tumors (gliomas). After 10 days of enzastaurin treatment, mice were sacrificed, and tumors were harvested at 0.5, 2, and 4 hr after the last dose. As a control, tumors from untreated mice were used. Levels of pGSK3β (S9) were normalized to the cell TMA. The basal level of pGSK3β in untreated samples was comparable to the level in HH (CTCL) cells. Enzastaurin treatment induced a significant diminution of phosphosignal, with maximal inhibitory effect at 4 hr after the last dose. This lowest level was analogous to pGSK3β-negative UT7/EPO cells as seen in the TMA (Kinetworks screen).
STAT5 is phosphorylated (activated) by the FLT3 tyrosine kinase. Having suggested that pSTAT5 levels varied in AML blasts using brightfield IHC (Gilliland and Griffin 2002 50% lower.
Evaluating predictive and prognostic biomarkers in individual tumors will be a challenge that must be met to realize the expectations of personalized medicine (True and Gao 2007
QD IF assay was chosen as a platform because this might allow simple quantitative analysis in fixed tissues, cellular and subcellular localization, and because QDs provide the advantages of good sensitivity, a narrow emission spectrum allowing multiplexing, and photostability (True and Gao 2007
To ensure that quantitative in situ PP analysis represents a "snapshot" of the in vivo situation, it is important to understand the variables in tissue handling that affect PP levels. The phosphorylation status of any given protein is determined by a complex interplay of kinases and phosphatases (Kurosawa 1994 To assist in validating the quantitative nature of QD IF assays, we also produced a well-characterized multilevel control in a TMA format. We confirmed a good correlation between the data derived from quantitative Kinexus analysis and QD IF for analytes used in the models presented. This TMA will be a valuable tool for rapid verification of individual QD IF assays for PP quantitation. Indeed, this multilevel control could be used as an external calibrator for quantitative assays, with results expressed in fluorescence relative to a selected cell line. Use of a common characterized calibration reference standard would allow quantitation across assays and laboratories.
Proof of principle for QD IF quantitation of PPs was shown in a murine xenograft model and in primary human tissues. In a colon cancer xenograft treatment model using the PKCβ inhibitor enzastaurin (Graff et al. 2005 In summary, we have characterized general conditions that allow accurate PP determination in fixed tissues using a QD IF assay. This type of assay has the advantage of morphologic evaluation that allows specific analysis of tumor cells and subcellular compartments (nuclear vs. cytoplasmic) that is not possible using WB or other tissue extraction–based methods. Fortunately, neutral buffered formalin fixations for durations typically used in clinical practice are satisfactory for quantitative assays. Importantly, decreases and increases in PP levels may occur with even minimal delays in exposing the specimen to fixative, resulting in unreliable data.
The authors acknowledge Roxanne Steinle for her technical expertise in immunostaining and Rebecca Haney for her help with xenograft tumors. We also acknowledge the assistance of Gary Pestano (Ventana Medical Systems) and his kind provision of QD reagents; and Dr. M. Nassiri (University of Miami) for assistance in tissue processing.
This work was supported by National Institutes of Health Grant R21CA123006 and by Eli Lilly and Company.. Received for publication January 14, 2009; accepted March 19, 2009
Aboudola S, Murugesan G, Szpurka H, Ramsingh G, Zhao X, Prescott N, Tubbs RR, et al. (2007) Bone marrow phospho-STAT5 expression in non-CML chronic myeloproliferative disorders correlates with JAK2 V617F mutation and provides evidence of in vivo JAK2 activation. Am J Surg Pathol 31:233–239[CrossRef][Medline] Andre F, Nahta R, Conforti R, Boulet T, Aziz M, Yuan LX, Meslin F, et al. (2008) Expression patterns and predictive value of phosphorylated AKT in early-stage breast cancer. Ann Oncol 19:315–320 Baker AF, Dragovich T, Ihle NT, Williams R, Fenoglio-Preiser C, Powis G (2005) Stability of phosphoprotein as a biological marker of tumor signaling. Clin Cancer Res 11:4338–4340 Birle DC, Hedley DW (2006) Signaling interactions of rapamycin combined with erlotinib in cervical carcinoma xenografts. Mol Cancer Ther 5:2494–2502 Bodo J, Jakubikova J, Chalupa I, Bartosova Z, Horakova K, Floch L, Sedlak J (2006) Apoptotic effect of ethyl-4-isothiocyanatobutanoate is associated with DNA damage, proteasomal activity and induction of p53 and p21cip1/waf1. Apoptosis 11:1299–1310[CrossRef][Medline] Bunting KD, Xie XY, Warshawsky I, Hsi ED (2007) Cytoplasmic localization of phosphorylated STAT5 in human acute myeloid leukemia is inversely correlated with Flt3-ITD. Blood 110:2775–2776 Burns JA, Li Y, Cheney CA, Ou Y, Franlin-Pfeifer LL, Kuklin N, Zhang ZQ (2009) Choice of fixative is crucial to successful immunohistochemical detection of phosphoproteins in paraffin-embedded tumor tissues. J Histochem Cytochem 57:257–264 Chan WC, Maxwell DJ, Gao X, Bailey RE, Han M, Nie S (2002) Luminescent quantum dots for multiplexed biological detection and imaging. Curr Opin Biotechnol 13:40–46[CrossRef][Medline] Crossman LC, O'Brien SG (2004) Imatinib therapy in chronic myeloid leukemia. Hematol Oncol Clin North Am 18:605–617[CrossRef][Medline] Cunningham MP, Essapen S, Thomas H, Green M, Lovell DP, Topham C, Marks C, et al. (2005) Coexpression, prognostic significance and predictive value of EGFR, EGFRvIII and phosphorylated EGFR in colorectal cancer. Int J Oncol 27:317–325[Medline] Espina V, Edmiston KH, Heiby M, Pierobon M, Sciro M, Merritt B, Banks S, et al. (2008) A portrait of tissue phosphoprotein stability in the clinical tissue procurement process. Mol Cell Proteomics 7:1998–2018 Flaherty KT (2007) Sorafenib in renal cell carcinoma. Clin Cancer Res 13:747s–752s Furukawa Y, Vu HA, Akutsu M, Odgerel T, Izumi T, Tsunoda S, Matsuo Y, et al. (2007) Divergent cytotoxic effects of PKC412 in combination with conventional antileukemic agents in FLT3 mutation-positive versus -negative leukemia cell lines. Leukemia 21:1005–1014[Medline] Gao X, Cui Y, Levenson RM, Chung LW, Nie S (2004) In vivo cancer targeting and imaging with semiconductor quantum dots. Nat Biotechnol 22:969–976[CrossRef][Medline] Gao X, Nie S (2003) Molecular profiling of single cells and tissue specimens with quantum dots. Trends Biotechnol 21:371–373[CrossRef][Medline] Ghazani AA, Lee JA, Klostranec J, Xiang Q, Dacosta RS, Wilson BC, Tsao MS, et al. (2006) High throughput quantification of protein expression of cancer antigens in tissue microarray using quantum dot nanocrystals. Nano Lett 6:2881–2886[CrossRef][Medline] Ghosh PM, Malik S, Bedolla R, Kreisberg JI (2003) Akt in prostate cancer: possible role in androgen-independence. Curr Drug Metab 4:487–496[CrossRef][Medline] Ghosh PM, Malik SN, Bedolla RG, Wang Y, Mikhailova M, Prihoda TJ, Troyer DA, et al. (2005) Signal transduction pathways in androgen-dependent and -independent prostate cancer cell proliferation. Endocr Relat Cancer 12:119–134 Gilliland DG, Griffin JD (2002) Role of FLT3 in leukemia. Curr Opin Hematol 9:274–281[CrossRef][Medline] Graff JR, McNulty AM, Hanna KR, Konicek BW, Lynch RL, Bailey SN, Banks C, et al. (2005) The protein kinase Cbeta-selective inhibitor, Enzastaurin (LY317615.HCl), suppresses signaling through the AKT pathway, induces apoptosis, and suppresses growth of human colon cancer and glioblastoma xenografts. Cancer Res 65:7462–7469 Hudelist G, Kostler WJ, Czerwenka K, Kubista E, Attems J, Muller R, Gschwantler-Kaulich D, et al. (2006) Her-2/neu and EGFR tyrosine kinase activation predict the efficacy of trastuzumab-based therapy in patients with metastatic breast cancer. Int J Cancer 118:1126–1134[CrossRef][Medline] Hunter T (1987) A thousand and one protein kinases. Cell 50:823–829[CrossRef][Medline] Irish JM, Hovland R, Krutzik PO, Perez OD, Bruserud O, Gjertsen BT, Nolan GP (2004) Single cell profiling of potentiated phospho-protein networks in cancer cells. Cell 118:217–228[CrossRef][Medline] Jovin TM (2003) Quantum dots finally come of age. Nat Biotechnol 21:32–33[CrossRef][Medline] Kreisberg JI, Malik SN, Prihoda TJ, Bedolla RG, Troyer DA, Kreisberg S, Ghosh PM (2004) Phosphorylation of Akt (Ser473) is an excellent predictor of poor clinical outcome in prostate cancer. Cancer Res 64:5232–5236 Kurosawa M (1994) Phosphorylation and dephosphorylation of protein in regulating cellular function. J Pharmacol Toxicol Methods 31:135–139[CrossRef][Medline] Lee AV, Taylor ST, Greenall J, Mills JD, Tonge DW, Zhang P, George J, et al. (2003) Rapid induction of IGF-IR signaling in normal and tumor tissue following intravenous injection of IGF-I in mice. Horm Metab Res 35:651–655[CrossRef][Medline] Lidke DS, Nagy P, Heintzmann R, Arndt-Jovin DJ, Post JN, Grecco HE, Jares-Erijman EA, et al. (2004) Quantum dot ligands provide new insights into erbB/HER receptor-mediated signal transduction. Nat Biotechnol 22:198–203[CrossRef][Medline] Malik SN, Brattain M, Ghosh PM, Troyer DA, Prihoda T, Bedolla R, Kreisberg JI (2002) Immunohistochemical demonstration of phospho-Akt in high Gleason grade prostate cancer. Clin Cancer Res 8:1168–1171 Mitsiades CS, Negri J, McMullan C, McMillin DW, Sozopoulos E, Fanourakis G, Voutsinas G, et al. (2007) Targeting BRAFV600E in thyroid carcinoma: therapeutic implications. Mol Cancer Ther 6:1070–1078 Ono M, Murakami T, Kudo A, Isshiki M, Sawada H, Segawa A (2001) Quantitative comparison of anti-fading mounting media for confocal laser scanning microscopy. J Histochem Cytochem 49:305–312 Piloto O, Wright M, Brown P, Kim KT, Levis M, Small D (2007) Prolonged exposure to FLT3 inhibitors leads to resistance via activation of parallel signaling pathways. Blood 109:1643–1652 Schiffer CA (2007) BCR-ABL tyrosine kinase inhibitors for chronic myelogenous leukemia. N Engl J Med 357:258–265 Slamon D, Pegram M (2001) Rationale for trastuzumab (Herceptin) in adjuvant breast cancer trials. Semin Oncol 28(suppl 3):13–19[Medline] Stone RM, DeAngelo DJ, Klimek V, Galinsky I, Estey E, Nimer SD, Grandin W, et al. (2005) Patients with acute myeloid leukemia and an activating mutation in FLT3 respond to a small-molecule FLT3 tyrosine kinase inhibitor, PKC412. Blood 105:54–60 Tholouli E, Sweeney E, Barrow E, Clay V, Hoyland JA, Byers RJ (2008) Quantum dots light up pathology. J Pathol 216:275–285[CrossRef][Medline] True LD, Gao X (2007) Quantum dots for molecular pathology: their time has arrived. J Mol Diagn 9:7–11 Wainer H (2006) Finding what is not there through the unfortunate binding the results: the Mendel effect. Chance 19:49–56 Zuluaga TT, Hsieh FH, Bodo J, Dong HY, Hsi ED (2007) Detection of phospho-STAT5 in mast cells: a reliable phenotypic marker of systemic mast cell disease that reflects constitutive tyrosine kinase activation. Br J Haematol 139:31–40[CrossRef][Medline]
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