Research Paper Jagged2 Progressively Increased Expression .

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Int. J. Biol. Sci. 2020, Vol. 16IvyspringInternational Publisher2648International Journal of Biological SciencesResearch Paper2020; 16(14): 2648-2662. doi: 10.7150/ijbs.48358Jagged2 progressively increased expression from Stage I to IIIof Bladder Cancer and Melatonin-mediated downregulation ofNotch/Jagged2 suppresses the Bladder Tumorigenesis viainhibiting PI3K/AKT/mTOR/MMPs signalingYen-Ta Chen1,2, Chi-Ruei Huang2,3, Chia-Lo Chang4, John Y. Chiang5,6, Chi-Wen Luo7, Hong-Hwa Chen4 andHon-Kan Yip2,3,8,9,10,11 1.2.3.Division of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung,Taiwan.4. Division of Colorectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung,Taiwan.5. Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan.6. Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.7. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.8. Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital Kaohsiung, Taiwan.9. Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.10. Department of Nursing, Asia University Taichung, Taiwan.11. Division of Cardiology, Department of Internal Medicine, Xiamen Chang Gung Hospital, Xiamen, Fujian, China. Corresponding author: Hong-Hwa Chen, MD. Division of Colorectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang GungUniversity College of Medicine, Kaohsiung, Taiwan., No.123, Dapi Rd., Niaosong Dist., Kaohsiung City 83301, Taiwan. Tel.: 886-7-7317123; Fax: 886-7-7354309; E-mail:ma2561@cgmh.org.tw. Hon-Kan Yip, MD. Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang GungUniversity College of Medicine, 123, Dapi Road, Niaosung Dist., Kaohsiung city, 83301, Taiwan. Tel.: 886-7-7317123; Fax: 886-7-7322402; E-mail: han.gung@msa.hinet.net. The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).See http://ivyspring.com/terms for full terms and conditions.Received: 2020.05.18; Accepted: 2020.07.13; Published: 2020.07.23AbstractBackground: This study assessed the expression of Jagged2 in human bladder cancer (BC) tested thehypothesis that melatonin (Mel) inhibited the tumorigenesis of BC cells mainly through downregulating theNotch/Jagged2 and PI3K/AKT/mTOR/MMPs(2&9) signaling pathways.Methods and Results: Tissue array from BC patients showed that the gene and protein expressions ofJAG2/Jagged2 were significantly upregulated from T1 to T3 (primary tumor size) and from stage I to III (allp 0.001). In vitro study showed that in BC cell line of UMUC3, the cellular and protein expressions of Jagged2were significantly attenuated in Mel-treated UMUC3 and further attenuated in UMUC3 shRNA silencedNotch/JAG2 (UMUC3KD) than in UMUC3 only (all p 0.0001). The protein expressions o of LC3BII/LC3B-I were significantly progressivelyreduced from UMUC3 to UMUC3 Mel/1.0mM, further to UMUC3 Mel/2.0mM and furthermore toUMUC3KD (all p 0.0001). The cell proliferation/invasion/colony formation/healing-process were significantlyinhibited in Mel-treated/2.0mM UMUC3 and further significantly inhibited in UMUC3KD regardless of Meltreatment as compared with UMUC3 only (all p 0.0001). By day 28 after UMUC3 implanted into nude mouseback, the BC weight/volume were significantly reduced in UMUC3 Mel (100 mg/kg/day) and furthermorereduced in UMUC3KD (all p 0.0001) as compared with UMUC3 only (all p 0.0001). The cellular(MMPs(2&9)/Notch/Jagged2) and protein (Notch/Jagged2/PI3K/p-AKT/mTOR/MMPs(2&9)) exhibited a similartrend, whereas the PTEN protein level exhibited an opposite pattern of PI3K among three groups (allp 0.0001).Conclusion: Notch/Jagged-PI3K/p-AKT/mTOR/MMPs is one essential signaling pathway for BC survival,proliferation and invasion that were remarkably suppressed by Mel treatment.Key words: Notch/Jagged2, bladder cancer, cell-stress signaling, matrix metalloproteinaseshttp://www.ijbs.com

Int. J. Biol. Sci. 2020, Vol. 16IntroductionBladder cancer (BC) is the 9th most commonmalignant tumor worldwide, with an estimate ofmore than 430,000 new cases and 165,000 deathsglobally per year [1, 2]. The patients are often latelydiagnosed as an incurable invasive disease [3, 4].Transitional cell carcinoma (TCC), also known asurothelial carcinoma, is the most common type ofbladder cancer which begins in urothelial cells thatline the inside of the bladder.Solid tumors are usually surrounded bydistinctive structural barriers of basement membrane,a specialized thickening form of the extracellularmatrix (ECM), that physically separate tumor fromother tissue compartments [5]. Metastasis represents amulti-step cell-biological process by which tumor cellsdisseminate from the primary tumor, invade throughthe basement membrane, spread into the circulatorysystem, and settle in secondary tissues where theirgrowth continues [6]. Metastasis is responsible oftumor recurrence in most cases, and more than 80% ofTCC-related deaths are the result from secondarylocal or distant disease [7].The Notch signaling pathway plays animportant role in cell fate determination, proliferation,death, and cell-cell communication [8]. Studies havefurther demonstrated that aberrant expression ofNotch signaling was associated with a number ofhematopoietic and epithelial human tumors includingcolorectal, prostate, skin, breast, cervical, lungcancers, leukemia, and neuroblastoma [9-16].Nevertheless, since the activation of Notch signalingupon the receptor-ligand engagement, the exact roleof Notch activation in tumor microenvironmentremains to be explored.Study has previously demonstrated depletion ofJAG2 gene intensely inhibited pancreatic cancer cellmigration, invasion and metastasis withoutinfluencing cell proliferation [17]. Presently, nearly90% pancreatic cancer cells of Notch activation areidentified to be almost always dependent uponJagged2 ligand engagement [18]. Activation of JAG2(i.e., gene expression) in breast tumor cells inducedEMT and cell survival [19]. Jagged2 (i.e., proteinexpression) was also found to be significantlyelevated in bone marrow stromal cells under hypoxiaand promoted the self-renewal of cancer stem-likecells by activating Notch signaling [20]. Additionally,the fact that expression status of Notch ligand Jagged2was closely correlated with different grades ofmetastatic and recurrent bladder carcinomasuggested that Jagged2 plays an important role intumor metastasis in bladder cancer [21]. We haveanalyzed data from clinical research Oncomine2649database and tissue array demonstrating that JAG2gen and Jagged2 protein expressions wereupregulated in bladder cancer patients (refer toFigures 1 and 2). These evidences suggested thatJAG2/Jgged2 could play an important role on bladdertumor proliferation and invasion.Melatonin (Mel), synthesized in mitochondriaand thus, most cells in human being can synthesizethis small molecule [22], has been identified to be arobust antioxidant [23, 24] that strongly suppressedthe formation of reactive oxygen species andattenuated inflammation. Plentiful data report thatMel protects against the development of malignancy[25-30] principally via its oncostatic features includingpotentiality to induce apoptosis, inhibit oxidativestress, draw forth immunomodulation as well assuppress angiogenesis and metastasis [31, 32].Furthermore, previous experimental studies haverevealed that Mel could reduce migration andinvasiveness of glioma, hepatoma, and breast cancercells [33-35]. These findings [23-35] suggest that Melmay play a critical role on regulating the BC cellmigration and tumor growth.Materials and MethodsEthics statementAll animal procedures were approved by theInstitute of Animal Care and Use Committee atKaohsiung Chang Gung Memorial Hospital (Affidavitof Approval of Animal Use Protocol No. 2016122203)and performed in accordance with the Guide for theCare and Use of Laboratory Animals.Animals were housed in an Association forAssessment and Accreditation of Laboratory AnimalCare International (AAALAC; Frederick, MD,USA)-approved animal facility in our hospital withcontrolled temperature and light cycles (24 oC and12/12 light cycle).Animal grouping, time courses of Meltreatment and tumor size measurementPathogen-free, 12-week-old male nude mice (n 30) weighing 22 - 25 g (Charles River Technology,BioLASCO, Taiwan) were equally categorized intothree groups: group 1 [subcutaneous injection ofUMUC3 cells, i.e., BC cell line (2.0 x 105 cells) at theback of nude mouse], group 2 [subcutaneous injectionof UMUC3 cells (2.0 x 105 cells) at the back of nudemouse Mel (100 mg/kg/day since days 8 to 24 afterBC cell line injection for a total of 17 days) viaintra-peritoneal injection] and group 3 [subcutaneousinjection of UMUC3 cell line with knockdown(KD)Notch/JAG2 gene (2.0 x 105 cells) at the back of nudemouse].http://www.ijbs.com

Int. J. Biol. Sci. 2020, Vol. 16The BC growth in living animals were measured(i.e., expressed as tumor volume with the valuecalculated as: width2 x length) at the time points ofdays 10, 14, 18, 21, 25 and 28 after the implantation ofUMUC3 cell line in the left and right backs of nudemice.The tumors were removed immediately aftereuthanizing the animals at day 28 after implantationof BC cell line of UMUC3. After tumor measurement,the specimens were cut into pieces and fixed withOCT (Tissue-Tek) for immunohistochemical (IHC)staining. The dosage of Mel was based on ourprevious report [36] with some modifications.shRNA clone transfectionshRNA clones were obtained from the NationalRNAi Core Facility Platform located at the Institute ofMolecular Biology/Genomic Research Center,Academia Sinica, supported by the National CoreFacility Program for Biotechnology Grants of NSC(NSC 100–2319-B-001–002). Individual clone wasidentified by its unique TRC number (e.g. ient transfection of cells with plasmids wasperformed with Lipofectamine 3000 (Invitrogen, Lifetechnologies, Carlsbad, CA, USA) according to themanufacturer’s instructions with slight modifications.Briefly, 1 106 cells were seeding to 10 cm plastic dishovernight. For use in transfection, 4 μl ofLipofectamine 3000 was incubated with 2 μg ofindicated plasmid at room temperature. Cells wereincubated at 37 C in a humidified atmosphere of 5%CO2. Following additional incubation of transfectedcells overnight, transfected cells were selected with 1μg/mL puromycin. qRT-PCR technique wasperformed to evaluate the efficiency of JAG2 silenced.siNotch1 transfectionTransient transfection of cells with siNotch1 wasperformedwithLipofectamine RNAiMAXTransfection Reagent (Invitrogen, Life technologies,Carlsbad, CA, USA) according to the manufacturer’sinstructions with minimal modification. Briefly, 50%confluent cells were growing to 6-cm plastic dishovernight. For use in transfection, 18μl ofLipofectamine RNAiMAX Transfection Reagent wasincubated with 60 pmol of siNotch1 at roomtemperature for 5 minutes. After the complex wasadded to the cells, the cells were incubated at 37 C ina humidified atmosphere of 5% CO2 for 72 hours.qRT-PCR technique was performed to evaluate theefficiency of Notch1 silenced.Cell cultureThe BC cell lines of HT1197, HT1376, RT4 (Bioresource Collection and Research Center, Taiwan) and2650UM-UC-3 (i.e., UMUC3) [ATCC CRL-1749 (American Type Culture Collection, USA)], andnormal bladder cell line of SV-HUC-1 (BioresourceCollection and Research Center, Taiwan) were grownin Dulbecco’s modified Eagle’s medium (highglucose) supplemented with 10% fetal bovine serumand l% penicillin/streptomycin. All cultured cellswere grown at 37 C and 5% CO2.MTT cell viability assayCell growth was determined by the MTT assay.About 2 103 cells in 100 µL of medium were seededinto wells of a 96-well plate and incubated for theindicated duration. At the end of incubation, MTTsolution was added into each well. After incubation,the purple crystal sediment was dissolved in DMSOand read at 540 nm in an ELISA reader. Theabsorbance value was used to represent the cellnumber.Assessment of colony formationTo determine the colony formation, 2000 cellsper well were seeded in 6‐well dish with or withoutMel (2.0 mM). After 7 day’s seeding, the cells werefixed and permeabilized with methanol. Followingwashing twice with PBS, the colony was identified bymicroscope after 10% Giemsa solution (SigmaCorporation, Cream Ridge, NJ, USA) staining.Wound healing assayFor wound healing assay, 3.5 x 104 cells wereseeded in 12 wells with linear spacer inserts.Following overnight cell culture, a regular anddefined “wound” within the cell monolayer wascreated by removing the linear spacer inserts. Afterphosphate‐buffered saline wash, the wells were eitherleft untreated or treated with Mel (2.0 mM). After 24‐hour incubation, the migration of cells into thedenuded areas in the marked region was monitored.The migration was captured with microphotography,and the total migration distance was determinedusing Image J software (National Institutes of Health,Bethesda, MD, USA).Transwell migration assayCells were first trypsinized and 5 104 cells werethen added to the Boyden chambers (8 µm pore size;Millipore, Billerica, MA, USA) with 0.5% FBScontaining medium and assay media that contained10% FBS was added to the culture plates. After 24hour incubation, the nonmotile cells at the top of thefilter were removed and the motile cells at the bottomof the filter were fixed with methanol and stainedwith one‐tenth dilution of Giemsa (SigmaCorporation). The number of migrated cells in eachchamber was carefully counted in five randomlyhttp://www.ijbs.com

Int. J. Biol. Sci. 2020, Vol. 16chosen fields under the microscope for threeindependent experiments.Transwell invasion assayCells were plated in 0.5% FBS‐containingmedium on the upper Boyden chamber coated with100 μL of 10% Matrigel and 10% FBS‐containingmedium in the lower chamber. Two days later, cellson the apical side of each insert were scraped off, andthose of invading cells on the basolateral side of themembrane were fixed and stained the same asTranswell migration assay. The number of invadingcells was counted in five randomly chosen fieldsunder the microscope for three independentexperiments.Western blot analysisEqual amounts (30 µg) of protein extracts wereseparated by 8-12% SDS-PAGE. After electrophoresis,the separated proteins were transferred onto a polyvinylidene difiuoride (PVDF) membrane (AmershamBiosciences, Amersham, UK). Nonspecific sites wereblocked by incubation of the membrane in blockingbuffer [5% nonfat dry milk in T-TBS (TBS containing0.05%Tween 20)] at room temperature for one hour.Then the membranes were incubated with theindicated primary antibodies [Notch (1:1000, Abcam),Jagged2 (1:1000, Signa Aldrich), matrix metalloproteinase (MMP)-2 (1:1000, Cell Signaling), MMP-9(1:1000, Abcam), nuclear factor (NF)-κB (1:1000,Abcam), tumor necrosis factor (TNF)-α (1:1000, CellSignaling), AKT (1: 1000, Cell Signaling),phosphorylated (p)-AKT (1: 1000, Cell Signaling),phospho-p38 (1: 1000, Cell Signaling), phosphomTOR (1:1000, Cell Signaling), p53 (1:1000, CellSignaling), cleaved caspase3 (1:1000, Cell Signaling),mitochondrial Bax (1:1000, Abcam), Bcl-2 (1:1000,biorbyt), Blc-xL (1:1000, Abcam), LC3B (1:1000, CellSignaling), Cox IV (1:10000, Abcam) and GAPDH (1:10000, Cell Signaling)] for 1 hour at roomtemperature. Horseradish peroxidase-conjugatedanti-rabbit or anti-mouse immunoglobulin IgG(1:2000, Cell Signaling, Danvers, MA, USA) was usedas a secondary antibody for one-hour incubation atroom temperature. After being washed, the Immunoreactive membranes were visualized by enhancedchemiluminescence (ECL; Amersham Biosciences,Amersham, UK) and were exposed to medical X-rayfilm (FUAJI).Immunohistochemical (IHC) andimmunofluorescent (IF) stainingIn detail, for those of IHC and IF staining,rehydrated paraffin sections were first treated with3% H2O2 for 30 minutes and incubated with2651Immuno-Block reagent (BioSB, Santa Barbara, CA,USA) for 30 minutes at room temperature. Sectionswere then incubated with primary antibodiesspecifically against MMP-2 (1:200, Invitrogen, CA,USA), MMP-9 (1:200, Invitrogen, CA, USA), Jagged2(1:100, Abcam, Cambridge, UK) and Notch (1:150,Abcam, Cambridge, UK), while sections incubatedwith the use of irrelevant antibodies served ascontrols. Immunoreactive were visualized byenhanced DAB kit (Abcam).Statistical analysisQuantitative data were expressed as mean SEM. Statistical analysis was adequately performedby ANOVA followed by Bonferroni multiplecomparison post hoc test. SAS statistical software forWindows version 8.2 (SAS Institute, Cary, NC, USA)was utilized. A probability value 0.05 wasconsidered statistically significant.ResultsThe Jagged2 expression were significantly andprogressively enhanced from T1 to T3 (i.e.,primary tumor size) and from stage I to IIITo elucidate whether a good correlation betweenthe primary tumor size and the intensity of Jagged2expression, the tissue array of human BC was utilizedthe study. As was expected, the Jagged2 expressionthe primary tumor was significantly progressivelyupregulated from T1 to T3 (Figure 1). Additionally, tofurther assess whether there also had a goodassociation between the BC Stage and the intensity ofJagged2 expression, we further analysis with thetissue array. Consistently, the Jagged2 expression wassignificantly progressively augmented from stage I toIII. These findings highlighted that Jagged2 proteincould played a crucial role on BC growth,proliferation and invasion.The JAG2 gene expression in carcinoma ofurogenital organTo furthermore elucidate the JAG2 geneexpression in urothelial carcinoma, data mining wasperformed from the cancer microarray databaseOncomine 4.0 (Oncomine DB at http://www.oncomine.org) [37, 38]. The result demonstrated thatthe JAG2 RNA expression (i.e., from microarraydatabase) was significantly higher in infiltrating BC(i.e., TCC) and further higher in superficial BC thanthe normal control (Figure 2). This finding furthersupported that there had a strongly positivecorrelation between the Jagged2 expression and theBC stage.http://www.ijbs.com

Int. J. Biol. Sci. 2020, Vol. 162652Figure 1. The correlation between Jagged2 expression and tumor stage and primary tumor size in tissue array. A) Illustrating immunohistochemical (IHC)staining of the tissue array for identification of Jagged2 expression. Green circle indicated the stage I bladder cancer (BC); Blue circle indicated stage II BC; Red circle indicatedstage III BC. B to D) Showing the IHC stain for histopathologic finding for clarifying the BC in stage I (B), stage II (C) and stage III (D), respectively. E) Analytical result of intensityJagged2 expression (i.e., scoring) in BC stages, vs. stage I, P 0.01; vs. stage I, p 0.001. F) Analytical result of intensity Jagged2 expression (i.e., scoring) in primary tumor size, vs. T1, P 0.01; vs. T1, p 0.001; vs. T1, p 0.0001.http://www.ijbs.com

Int. J. Biol. Sci. 2020, Vol. 16Figure 2. The JAG2 gene expression in bladder cancer (BC). Analyticalresult of JAG2 RNA expression was significantly higher in infiltrating type (i.e.,localized in muscle layer) of BC and further higher in superfici

Research Paper Jagged2 progressively increased expression from Stage I to III . 2. Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. 3. Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine .

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