Aberrant beta-catenin and LEF1 expression may predict the clinical outcome for patients with oropharyngeal cancer.

Beta-catenin, normally expressed on the epithelial cell surface, plays a crucial role in cadherin-mediated cell adhesion. Recent evidence suggests that beta-catenin is also involved in other functions such as intracellular signaling via the Wnt pathway by creating a nuclear complex with members of the Lymphoid-Enhancer-Factor/T-Cell-Factor (LEF/TCF) family of transcription factors, and gene regulation that it is implicated in the development of several tumors. Little information is available on beta-catenin expression and its main partner in the Wnt signaling pathway, LEF1, in oropharyngeal squamous cell carcinomas (OP-SCCs). The aim of this study is to investigate the expression of beta-catenin and LEF1 expression in human primary OP-SCCs and to evaluate their clinical and prognostic significance. OP-SCCs and normal peritumoral areas were analyzed by immunohistochemistry, Western-blot and RT-PCR. Beta-catenin was overexpressed in tumors in comparison to normal peritumoral areas and displayed predominantly intracellular (cytosolic/nuclear) localization in 62% of the tumors. Immunoreactivity was correlated with clinicopathological parameters and long-term follow-up, and a significant association was found between protein expression and development of local recurrences (P =0.03). The OP-SCCs with poor clinical outcome, which displayed intracellular beta-catenin expression, were also strongly positive for LEF1, with their co-expression statistically significant (P = 0.040). All (100%) advanced (stages 3+4) SCCs, 66.7% of the SCCs with positive lymph nodes and 80% of the SSCs that developed local recurrences were LEF1 positive. Cox regression analysis confirmed a poorer overall survival in cases with high expression of beta-catenin and LEF1. Our results suggest that assessing intracellular beta-catenin and LEF1 expression might help in patient risk stratification and outcome prediction, and serve as novel therapeutic targets in advanced OP-SCC.

H-7 and fetal calf serum (FCS) act synergistically to increase apoptosis in the KB line of human oral carcinoma cells.

There is a high incidence of oral squamous cell carcinoma (SCC) worldwide. The survival rate is among the lowest of the major cancers and has not improved significantly over the past two decades. The KB line of human oral carcinoma cells is a useful experimental system for studies of the biology of oral SCC. In a previous study, we reported inhibition of KB cell proliferation and stimulation of desmosome formation in confluent cultures treated with 20 microM H-7 (1-(5-isoquinolinylsulfonyl)-2-methylpiperazine). In the present study, the effects of this protein kinase C (PKC) inhibitor on the survival of KB cells were investigated. Apoptotic cells were detected using a combination of Hoechst 33258 nuclear stain, TUNEL technique and ultrastructural analysis. Our results indicated that H-7 significantly increased apoptosis in KB cells in a dose-dependent manner. Maximal stimulation occurred at 100 microM, the highest dose of H-7 tested. Apoptotic cells exhibited nuclear fragmentation, chromatin condensation and apoptotic bodies. Interestingly, H-7 and fetal calf serum (FCS) acted synergistically to increase apoptosis in KB cells, suggesting that there is a serum activated subpopulation of H-7 target cells in the cultures. The underlying mechanism of activation remains to be elucidated. Our study suggests that the PKC inhibitor H-7 is a potentially useful cytostatic agent for oral carcinoma cells.

Involvement of desmoplakin phosphorylation in the regulation of desmosomes by protein kinase C, in HeLa cells.

In the present study, we have examined how modulation of protein kinase C (PKC) activity affected desmosome organization in HeLa cells. Immunofluorescence and electron microscopy showed that PKC activation upon short exposure to 12-O-tetradecanoylphorbol 13-acetate (TPA) resulted in a reduction of intercellular contacts, splitting of desmosomes and dislocation of desmosomal components from the cell periphery towards the cytoplasm. As determined by immunoblot analysis of Triton X-100-soluble and -insoluble pools of proteins, these morphological changes were not correlated with modifications in the extractability of both desmoglein and plakoglobin, but involved almost complete solubilization of the desmosomal plaque protein, desmoplakin. Immunoprecipitation experiments and immunoblotting with anti-phosphoserine, antiphosphothreonine and anti-phosphotyrosine antibodies revealed that desmoplakin was mainly phosphorylated on serine and tyrosine residues in both treated and untreated cells. While phosphotyrosine content was not affected by PKC activation, phosphorylation on serine residues was increased by about two-fold. This enhanced serine phosphorylation coincided with the increase in the protein solubility, suggesting that phosphorylation of desmoplakin may be a mechanism by which PKC mediates desmosome disassembly. Consistent with the loss of PKC activity, we also showed that down-modulation of the kinase (in response to prolonged TPA treatment) or its specific inhibition (by GF 109203X) had opposite effects and increased desmosome formation. Taken together, these results clearly demonstrate an important role for PKC in the regulation ofdesmosomal junctions in HeLa cells, and identify serine phosphorylation of desmoplakin as a crucial event in this pathway.

Down-regulation of desmosomal molecules in oral and pharyngeal squamous cell carcinomas as a marker for tumour growth and distant metastasis.

Down-regulation of adhesion molecules has been observed in a number of squamous cell carcinomas (SCC) and is considered to be associated with tumour invasiveness and lymph node metastasis. The present prospective investigation aimed at analyzing the expression patterns of desmosomal markers in oral and pharyngeal SCC and correlations that may exist between these patterns and tumour behaviour. Two constitutive desmosomal molecules, desmoplakin (Dp) and plakoglobin (Pg), were examined in 26 samples of primary carcinoma of the head and neck. The correlation between Dp and Pg expression was only moderate, reflecting functional differences between the two proteins. Whereas decreased Dp and Pg expression was closely associated with distant metastasis formation, reduced Pg expression was correlated to the development of large tumours. There were also variable relationships between the expression of these markers and lymph node invasion, histological differentiation, or survival of the patients. Biochemical analysis of cytoskeletal fractions confirmed the decrease in desmosomal proteins, particularly in tumours which later developed metastases. Down-regulation of Dp and Pg in oral and pharyngeal SCC may represent a reliable marker for extensive tumour growth and the risk of distant metastasis formation, Dp and Pg apparently having metastasis- and tumour-suppressor properties, respectively.

Cytokeratin alterations as diagnostic and prognostic markers of oral and pharyngeal carcinomas. A prospective study.

Cytokeratin (CK) alterations have been reported in carcinomas from different anatomical sites, and these have been associated with specific aspects of tumour behaviour. In order to assess the relationships between CK modifications and future tumour behaviour, we conducted the present prospective study on 26 squamous cell carcinomas (SCC) of oral and pharyngeal mucosae and corresponding controls. Cytokeratins were investigated using two-dimensional gel electrophoresis and immunofluorescence techniques. All healthy tissues, oral lining and oropharyngeal mucosae, expressed the oesophageal type CKs, including CK 19. Other simple epithelial CKs (7, 8, 17 and 18) were not detected. In carcinomas originating from corresponding sites, expression of oesophageal CKs varied widely from one specimen to another, and simple epithelial keratins were often found. Statistical analysis indicated correlations between CK expression and the clinicopathological data of SCC patients. Small tumour size was strongly associated with the expression of CKs 10 and 19. Interestingly, an absence of lymph node involvement was significantly associated with CK 18 expression. Tumours giving rise to recurrences, metachronous tumours, and distant metastasis were significantly associated with an absence of CK 13. These results suggest that CKs 10, 19, 18 and 13 could be reliable diagnostic and prognostic markers in the assessment of oral and pharyngeal squamous carcinomas.

H-7 stimulates desmosome formation and inhibits growth in KB oral carcinoma cells.

Protein kinase inhibitor H-7 was reported to stimulate desmosome formation in normal keratinocytes and to inhibit proliferation of neural cell lines. In the present study, the effects of this inhibitor on adhesion and growth of KB human oral carcinoma cells were investigated. H-7 was found to enhance desmosome assembly, as evidenced by an increased punctate labeling for the major desmosomal markers. Immunogold labeling confirmed the formation of desmosomes both at the cell surface and in the cytoplasm. In order to assess cell proliferation and possible correlation with adhesion, confluent cultures were treated and both adherert and detached cell fractions were counted. Under serum-free conditions, H-7 significantly reduced cell detachment. In contrast, EGF stimulated cell detachment, and this effect was abolished when cells were simultaneously treated with both EGF and H-7. Total cell counts were also significantly reduced by H-7, both in the presence and absence of EGF. Using the TUNEL technique, labeled cells were increased after H-7 treatment, thus implicating protein kinase inhibition in cell death. These results indicate that H-7 inhibits growth and stimulates adhesion of KB carcinoma cells.

Cytoplasmic desmosome formation by H-7 and EGF treatment in cultured fetal rat keratinocytes.

Cytoplasmic desmosomes (CD) are classically found in dyskeratotic cells of many epithelial tumors. Their significance and mechanism of formation remain largely speculative. Recently, we have reported the induction of these structures in rat keratinocytes following a brief treatment with acrylamide, and proposed that protein kinase inhibition may be implicated in their formation. In the present study, we show that protein kinase inhibitor H-7 in the presence of EGF is able to induce CD in rat keratinocytes within half an hour. In serum free medium containing 20 ng/ml of EGF, desmosomal structures at different stages of assembly were obtained using H-7 at concentrations ranging between 20 and 80 microM. No such structures were found at lower concentrations. The plaque diameters were significantly small in comparison with plasma membrane plaques. EGF induced plakoglobin positive membrane invaginations and in the presence of H-7, desmosomal plaques assembled on these membranes as either half desmosomes or as symmetric ones. The present results implicate protein kinase inhibition in CD formation and suggest that EGF provides tubular membrane structures in the cytoplasm on which desmosomes may assemble.

Quantitative ultrastructural study of acrylamide induced cytoplasmic desmosome-like structures in cultured rat keratinocytes.

Although present in many tumours, the mechanism of formation and the significance of the so-called 'cytoplasmic desmosome' (CD) remain speculative. Recently, we reported an in vitro model for the induction of CD in rat keratinocytes following acrylamide treatment. In the present study and based on quantitative and qualitative evidence, CD could be divided into two categories. The first comprised individually scattered desmosomes always located in the cortical cytoplasm and associated with tonofilament bundles. Their sizes were comparable with those of intercellular desmosomes (ID) in control cells. The second category comprised clusters of homogeneously small-size desmosomes that may be located deep in the cytoplasm and were not always associated with tonofilament bundles. Whilst the latter group may be formed de novo in the cytoplasm as a result of the acrylamide-induced inhibition of protein kinases, the first group may be the result of internalization of surface desmosomes by certain tonofilaments under tension. In order to assess this possibility, we examined tonofilament organization following wounding of the epithelial sheet. Injured cells exhibited spiral-form tonofilaments extending close to the cell membrane. This retraction could be justified ultrastructurally by direct association between tonofilaments and microfilaments.

Cytoplasmic desmosomes and intermediate filament disturbance following acrylamide treatment in cultured rat keratinocytes.

The present paper describes disturbances in the organization of tonofilaments and desmosomes of rat lingual and epidermal keratinocytes after treatment of the cells with acrylamide in culture. This treatment induced changes in cell shape, reduction of intercellular adhesion and a perinuclear accumulation of cytoplasmic organelles. Using specific antibodies for cytokeratins, the filaments were disorganized particularly in the perinuclear region. In untreated cells, keratin filament labelling was very weak or absent above and below the nucleus thus leaving a black nuclear space in fluorescine microscopy. Following acrylamide treatment, the keratin filament labelling covered the nuclear space which indicated the accumulation of these filaments all around the nucleus. Furthermore, the desmosomal junctions were often associated with thick keratin bundles. Antibodies for desmoplakins revealed a reduction in intercellular labelling and stronger cytoplasmic labelling. Ultrastructurally, well-developed long tonofilaments were found to associate with large desmosomal junctions. Furthermore, small-sized desmosomal structures were identified within the cytoplasm. Morphologically, these were identical to cell surface desmosomes and were almost always associated with well-developed tonofilaments. The effect of acrylamide on the protein kinase A activity might be implicated in the disturbances of the desmosome-intermediate filament complex and in the initiation of contractile forces necessary for perinuclear accumulation of intermediate filaments and for the formation of intact cytoplasmic desmosomes. The acrylamide-induced intermediate filament and desmosomal changes may provide valuable information on the mechanism of intact cytoplasmic desmosome formation in several skin diseases and in squamous cell carcinoma.

[Cytokeratins, markers of epithelial cell differentiation: expression in normal epithelia]. / Les cytokératines, marqueurs de la différenciation des cellules épithéliales: expression dans les épithéliums sains.

Intermediate filaments, the most stable of cytoskeleton components, are extremely diverse and usually correlate with the histological subtype since in nearly all cell types a single type of intermediate filament (IF) is found. The cytokeratins, which are specific of epithelia, are the largest and most diverse class of intermediate filaments. Twenty different cytokeratin polypeptides have been identified in humans and separated on the basis of isoelectrical pH and apparent molecular weight using two-dimensional electrophoresis. These data have been used to establish a cytokeratin catalogue which currently serves as a reference [43, 48]. The number of cytokeratin polypeptides expressed ranges from 2 to 5 for each epithelial cell and from 2 to 10 for each epithelium and even of each cell layer within a given epithelium. A broad spectrum of anticytokeratin antibodies with subgroup or single polypeptide specificity is currently available. The distribution of cytokeratins in normal epithelia is reviewed herein and commercially available anti-cytokeratin antibodies are listed.

A switch in cytokeratin expression and intermediate filament organization associated with epithelial stratification.

Low density gingival epithelial cells were cultured on the side of glass slides facing rat's tail collagen lattices. Under these conditions and in the presence of physiological level of calcium, colony formation was enhanced and stratification was slowed down. The strong attachment of the cells to glass slides permitted immunocytochemical examination of cytokeratin (CK) expression and their organization within individual cells during the different stages of epithelial maturation. The present results showed that during the stage of cell migration and colony formation, the cells express the same set of cytokeratins (basal cell marker 14, simple epithelial markers 8, 18 and 19, and marker of hyperproliferation 16) which forms a well-defined network of organized filaments. At the stratification stage, the filament network became dense by the additional expression of the markers of differentiation in non-keratinized stratified epithelia (CK 4 and 13). These appeared once individual cells started to overlap the basal cells, a period during which the cell-temporarily changed morphology. Whilst the suprabasal cells exhibited dense filament network labelled for CK 4 and 13, the density of labelled filaments for CK 14, 8 and 18 was much lower, indicating that these cells contained newly-formed filaments lacking the basal and simple epithelial keratins. The simple epithelial cytokeratins became weakly labelled in older cultures. The uncoupling of paired expression of cytokeratins 4 and 13 was observed in non-colony forming aged cells. This provides an example of altered program of cytokeratin expression during epithelial maturation.

Characterization of cytokeratin patterns in the developing human tongue.

The characterization of cytokeratin (CK) in adult oral mucosa and developing teeth have been well documented in human. Cytokeratin distribution in developing oral mucosa has not yet been described. The aim of this study was to identify the expression of CK in human fetal tongue (week 10 to week 23) and to correlate the results with morphological maturation. Simple epithelial CK are expressed in all cell layers during the early stages, essentially in peridermal cells. From the 14th week, CK 18 is present only in the taste buds, making this polypeptide a reliable marker for this sensory organ. CK 4 and 13 are expressed from the 10th to the 23rd week by both ventral and dorsal lingual epithelia. Terminal differentiation keratins (CK 1, 2 and 10-11) can only be detected immunohistochemically at the 14th week in some cells on the external surface of some papillae. The number of these papillae and positive cells increase at the 19th and 23rd weeks. The terminal differentiation markers are expressed several weeks earlier than the formation of a well-distinguished keratinized layer.

Cytokeratin patterns of human oral mucosae in histiotypic culture.

In a three-dimensional culture model, oral epithelial differentiation was investigated ultrastructurally and biochemically for cytokeratin expression. Epithelia from the hard palate, gingiva and alveolar mucosa grown on freely floating collagen lattices populated with fibroblasts from homotypic origins, and fed with medium containing 10% delipidized fetal calf serum for 21 days before analysis, stratified and differentiated to basal cuboidal cells, polyhydral spinous cells and elongated superficial cells. The epithelium of palatal origin had non-nucleated superficial cells resembling orthokeratinized cells. The upper spinous cells had keratohyalin-like granules. The corresponding cells of gingival and alveolar mucosal origins retained their nuclei and had smaller numbers of keratohyalin-like granules. Basal cell keratins (CK 5 and 14) and those of hyperproliferation (CK 6 and 16) were consistently found in all epithelia. Furthermore, simple epithelial keratins (CK 18 and 19) were variably expressed by cells from different oral origins. In epithelial cells from the alveolar mucosa, CK 13 and 19 formed major bands, which correlates with their expression in vivo. In contrast, these polypeptides were either absent or formed minor bands in extracts of gingival and hard palatal cells. Although in small quantities, keratins of terminal differentiation (CK 1, 2, 10 and 11) were detected in gels prepared from palatal epithelia. This expression correlates with the higher morphological differentiation of these cells in this model. The model is of interest for studies of epithelial differentiation, as the differentiation markers of keratinized epithelia (CK 1 and 10) were expressed by cells from palatal origin, and those of non-keratinized epithelia (CK 4, 13 and 19) were prominent in cells from alveolar mucosal origin.

Cytokeratin expression in human tongue epithelium.

The epithelium of the human tongue shows diverse morphological variations from one site to another and even within the epithelium of the same papilla. This complexity has led to confusion regarding tongue epithelium as being orthokeratinized, parakeratinized, or nonkeratinized. Cytokeratins have been shown to characterize different epithelia. The present paper describes cytokeratin expression by adult tongue epithelia and relates their distribution to morphology. Six healthy human tongue specimens were obtained after plastic surgery and cytokeratin expression was investigated immunohistochemically, using a panel of 15 antibodies for cytoskeletal proteins, and biochemically using two-dimensional gel electrophoresis. The results showed that the ventral and lateral surfaces of the tongue are related to the nonkeratinizing stratified squamous epithelia, esophageal type, whereas the dorsal surface showed mixed expression of cytokeratins. In the tip of filiform and on the surface of fungiform papillae, cytokeratins of terminal differentiation are expressed as skin type; and in the rest of the papillae as well as in interpapillary areas, the epithelium expresses esophageal type cytokeratins. Certain simple epithelial cytokeratins were found in taste buds. Cytokeratin 19 was also detected in the basal cell layer of all esophageal type epithelia in the tongue. The present results provide basis for studies on the biological events in epithelial differentiation during development and in pathology.

Changes in cytokeratin expression in gingiva during inflammation.

Cytokeratins represent specific markers of certain pathways of epithelial differentiation. The purpose of this study was to describe the alterations of cytokeratin pattern and topographical distribution of individual cytokeratins in inflamed gingiva. Five healthy and 15 inflammatory samples of human gingiva were studied. From each biopsy, cryostat sections allowed histological staining, immunofluorescence microscopy using a battery of monoclonal antibodies to cytokeratins, and gel electrophoresis. The results show marked differences in cytokeratin expression by healthy epithelia as compared with inflamed gingiva: in suprabasal cell layers there were reductions or disappearance of cytokeratins 1, 2 and 10, 11--specific for terminal differentiation--and increased expression of cytokeratins 4 and 13, as well as--in basal and parabasal cell layers--expression of cytokeratin 19. These alterations might represent an adaptation of involved epithelia to the alterations brought about by the inflammatory process.

Morphometric analysis of suprabasal cells in oral white lesions.

Surgical specimens from the cheek mucosa of 73 patients with white lesions were studied to determine various morphometric parameters that would help differentiate between the various types of oral mucosal white lesions that carry a risk of malignant change. Four cell types were represented: traumatic keratosis, leucoplakia, candidal leucoplakia and lichen planus, in addition to a control group of normal mucosa. The shape and size of the epithelial cells in two cell compartments, parabasal and spinous, were investigated by an interactive image analysis system (IBAS-1). The results showed an increase in the cell size in the parabasal cell compartment of all the white lesions compared with the normal mucosa. In the spinous cell compartment there was an increase in the cell size in lichen planus and traumatic keratosis; leucoplakia and candidal leucoplakia showed a slight decrease in cell size compared with the normal mucosa. Attempts to discriminate between the four groups of white lesions showed that these parameters can provide a high level of separation between lichen planus and the three other groups, but not between leucoplakia, candidal leucoplakia, and traumatic keratosis.

A comparative biochemical and immunological analysis of cytokeratin patterns in the oral epithelium of the miniature pig and man.

In man, cytokeratin constitutes a family of 19 polypeptides that show different but distinct distribution patterns in the various epithelia. Changes in these patterns may occur during epithelial development and differentiation. The cytokeratin patterns in the oral mucosa of the miniature pig, an animal used in studies of wound healing, were investigated. Surgical biopsies were obtained from the gingiva, hard palate and alveolar mucosa of both man and pig. The cytokeratins were analysed by immunofluorescence, two-dimensional gel electrophoresis and by immunoblotting. Nine monoclonal antibodies were used to identify the different cytokeratin polypeptides in cryostat sections. Two-dimensional gel electrophoresis showed that pig oral mucosa contains at least 10 different polypeptides, five of the acidic type I and five of the basic type II cytokeratins. These were different from the human cytokeratin polypeptides and accordingly were designated P1-P10, according to their molecular weight and isoelectric mobility. Their molecular weight varied between 48 and 69 kdalton and the pHi varied between 5 and 7.3. Immunoblotting showed the monoclonal antibody Ks 13.1 (anticytokeratins Nos 13 and 14) to cross-react with the pig polypeptides P10 and P8. Immunolocalization showed that all the antibodies cross-reacted with the pig tissue except Ks 19.1 (anticytokeratin No. 19). It was possible to differentiate between pig alveolar mucosa, which expressed only P3, P4, P5, P8 and P10, and the gingival and hard palatal mucosae, which expressed all 10 polypeptides except P5. This distinction was made by antibody 6B10 (anticytokeratin No. 4), which reacted only with alveolar mucosa; antibody Ks 13.1, which strongly reacted with uncornified mucosa but weakly with cornified mucosa (gingiva and palate); and any of RKSE60, Kk 8.60 or EE21.6 (anticytokeratin No. 10, anticytokeratins Nos 10 and 11 and anticytokeratins Nos 1, 2, 10 and 11, respectively), which reacted strongly with cornified mucosa but weakly, if at all, with uncornified mucosa. These findings provide a baseline for studies on epithelial differentiation in the miniature pig such as in wound healing.

Morphometric analysis of basal cell layer in oral premalignant white lesions and squamous cell carcinoma.

The size and shape of the cells in the basal cell layer of the oral epithelium in 100 specimens from oral mucosa were studied by using an interactive image analysis system (IBAS-1). Four groups of white lesions (traumatic keratosis, lichen planus, leucoplakia, and a "risk group") in addition to two control groups (normal mucosa and squamous cell carcinoma) were studied retrospectively. The results showed a progressive increase in the dimensions (area, perimeter, and maximum diameter) of the nuclei from normal mucosa through traumatic keratosis, lichen planus, leucoplakia and the "risk group" to carcinoma, with considerable differences. The nucleus in squamous cell carcinoma was twice as large as in normal mucosa. A substantial increase in the dimensions of both the cell and the nucleus was found in the "risk group." The nucleo:cytoplasmic ratio, contrary to what might have been anticipated in risk lesions, did not show considerable differences between the diagnostic groups. Furthermore, it was slightly decreased in the risk group compared with the normal mucosa. The shape factors (form PE and contour index) seemed to be less helpful in the identification of the "risk group." The size of the basal cell and its nucleus can be of diagnostic value for lesions with a high risk of malignant transformation.