Abstract

Urothelial cell carcinoma (UCC) is the second most common genitourinary malignant disease in the USA, and tobacco smoking is the major known risk factor for UCC development. Exposure to carcinogens, such as those contained in tobacco smoke, is known to directly or indirectly damage DNA, causing mutations, chromosomal deletion events and epigenetic alterations in UCC. Molecular studies have shown that chromosome 9 alterations and P53, RAS, RB and PTEN mutations are among the most frequent events in UCC. Recent studies suggested that continuous tobacco carcinogen exposure drives and enhances the selection of epigenetically altered cells in UCC, predominantly in the invasive form of the disease. However, the sequence of molecular events that leads to UCC after exposure to tobacco smoke is not well understood. To elucidate molecular events that lead to UCC oncogenesis and progression after tobacco exposure, we developed an in vitro cellular model for smoking-induced UCC. SV-40 immortalized normal HUC1 human bladder epithelial cells were continuously exposed to 0.1% cigarette smoke extract (CSE) until transformation occurred. Morphological alterations and increased cell proliferation of non-malignant urothelial cells were observed after 4 months (mo) of treatment with CSE. Anchorage-independent growth assessed by soft agar assay and increase in the migratory and invasive potential was observed in urothelial cells after 6 mo of CSE treatment. By performing a PCR mRNA expression array specific to the PI3K-AKT pathway, we found that 26 genes were upregulated and 22 genes were downregulated after 6 mo of CSE exposure of HUC1 cells. Among the altered genes, PTEN, FOXO1, MAPK1 and PDK1 were downregulated in the transformed cells, while AKT1, AKT2, HRAS, RAC1 were upregulated. Validation by RT-PCR and western blot analysis was then performed. Furthermore, genome-wide methylation analysis revealed MCAM, DCC and HIC1 are hypermethylated in CSE-treated urothelial cells when compared with non-CSE exposed cells. The methylation status of these genes was validated using quantitative methylation-specific PCR (QMSP), confirming an increase in methylation of CSE-treated urothelial cells compared to untreated controls. Therefore, our findings suggest that a tobacco signature could emerge from distinctive patterns of genetic and epigenetic alterations and can be identified using an in vitro cellular model for the development of smoking-induced cancer.

Highlights

  • Urothelial cell cancer (UCC) is the second most common urological malignancy in the United States, with an estimated 74,000 new cases and with 15,000 deaths in 2012.1 One-third to half of all UCC are believed to be caused by smoking, the mechanisms of action are less clearly understood.[2]

  • By performing a PCR mRNA expression array specific to the phosphatidylinositol 3-kinase (PI3K)-AKT pathway, we found that 26 genes were upregulated and 22 genes were downregulated after 6 mo of cigarette smoke extract (CSE) exposure of HUC1 cells

  • Cells can be exposed to cigarette smoke (CS) total particulate matter (TPM), aqueous CSE containing components of the particulate and vapor phase or whole smoke

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Summary

Introduction

Urothelial cell cancer (UCC) is the second most common urological malignancy in the United States, with an estimated 74,000 new cases and with 15,000 deaths in 2012.1 One-third to half of all UCC are believed to be caused by smoking, the mechanisms of action are less clearly understood.[2] Smokers have a three to five times higher risk of developing UCC than non-smokers.[3]. The higher risk can be attributed to tobacco-related carcinogens that enter the body after inhalation, are absorbed into the bloodstream and eventually reach the bladder. The bladder epithelium is exposed to these carcinogens for several hours before they are expelled. Several environmental agents such as cigarette smoke, arsenic and nicotine have been well studied and have been shown to affect gene expression through genetic and epigenetic changes.[4,5] Recent evidence indicates that methylation and allelic

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