Abstract

BackgroundSquamous cell carcinoma of the head and neck (SCCHN) often contain highly radioresistant hypoxic regions, nonetheless, radiotherapy is a common treatment modality for these tumours. Reoxygenation during fractionated radiotherapy is desired to render these hypoxic tumour regions more radiosensitive. Hypoxia additionally leads to up-regulation of PAI-1, a protein involved in tumour progression and an established prognostic marker for poor outcome. However, the impact of reoxygenation and radiation on PAI-1 levels is not yet clear. Therefore, we investigated the kinetics of PAI-1 expression and secretion after hypoxia and reoxygenation, and determined the influence of ionizing radiation on PAI-1 levels in the two human SCCHN cell lines, BHY and FaDu.MethodsHIF-1α immunoblot was used to visualize the degree of hypoxia in the two cell lines. Cellular PAI-1 expression was investigated by immunofluorescence microscopy. ELISA was used to quantify relative changes in PAI-1 expression (cell lysates) and secretion (cell culture supernatants) in response to various lengths (2 – 4 h) of hypoxic exposure (< 0.66 % O2), reoxygenation (24 h, 20 % O2), and radiation (0, 2, 5 and 10 Gy).ResultsHIF-1α expression was induced between 2 and 24 h of hypoxic exposure. Intracellular PAI-1 expression was significantly increased in BHY and FaDu cells as early as 4 h after hypoxic exposure. A significant induction in secreted PAI-1 was seen after 12 to 24 h (BHY) and 8 to 24 h (FaDu) hypoxia, as compared to the normoxic control. A 24 h reoxygenation period caused significantly less PAI-1 secretion than a 24 h hypoxia period in FaDu cells. Irradiation led to an up-regulation of PAI-1 expression and secretion in both, BHY and FaDu cells.ConclusionOur data suggest that both, short-term (~4 – 8 h) and long-term (~20 – 24 h) hypoxic exposure could increase PAI-1 levels in SCCHN in vivo. Importantly, radiation itself could lead to PAI-1 up-regulation in head and neck tumours, whereas reoxygenation of hypoxic tumour cells during fractionated radiotherapy could counteract the increased PAI-1 levels.

Highlights

  • The adverse effects o f tum our hypoxia on the outcome after radiotherapy are well established for many different tum our types and in particular for SCCHN [1,2,3,4]

  • Intracellular PAI-l expression was significantly increased in BHY and FaDu cells as early as 4 h after hypoxic exposure

  • Radiation itself could lead to PAI-l up-regulation in head and neck tumours, whereas reoxygenation of hypoxic tumour cells during fractionated radiotherapy could counteract the increased PAI-l levels

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Summary

Introduction

The adverse effects o f tum our hypoxia on the outcome after radiotherapy are well established for many different tum our types and in particular for SCCHN [1,2,3,4]. Despite its inhibiting function of uPA, num erous clinical studies demonstrate a strong correlation between high tissue levels of PAI-1 and poor prognosis for several tum our entities [7], including squa­ m ous cell carcinomas of the head and neck [8,9]. This par­ adoxical finding might be explained by further biological functions of PAI-1 in prom oting migration and angiogenesis and in inhibiting apoptosis o f tum our cells [10,11,12,13]

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