Relatively little is known about the molecular events associated with the initiation of prostate carcinoma. PIN is widely regarded as a precursor of human prostate cancer (
5). Our results, in conjunction with other recent reports (
3,
8), have identified
Nkx3.1 as a gene with an important role in the initiation of prostate cancer. As
Nkx3.1 also plays a key role in the development and differentiation of the prostatic epithelium, it provides an important link between development and carcinogenesis in the prostate gland.
Several groups have recently reported on the generation of
Nkx3.1-deficient mice by conventional gene knockout techniques (
3,
30,
35). In all cases, the animals developed prostatic epithelial hyperplasia in the setting of developmental abnormalities of the prostate. Because of the prominence of the developmental abnormalities in
Nkx3.1-deficient mice and the fact that the hyperplastic and dysplastic lesions that develop in these animals do not progress to frank carcinoma, the precise role of
Nkx3.1 in prostate carcinogenesis has remained unclear (
35). By using conditional gene targeting to delete
Nkx3.1 specifically in the mature prostate, we circumvent the complicating effects of developmental abnormalities on the interpretation of the prostate phenotype of mice lacking
Nkx3.1. This was possible because the
PSA promoter fragment we used to drive Cre expression becomes active in transgenic mice only after puberty has been attained (
9).
The lesions that developed in conditional
Nkx3.1-deficient mice resemble human preinvasive PIN in several respects. In addition to the histopathological similarities, the lesions showed a similar pattern of Ki-67 expression, E-cadherin localization, and partial disruption of basal cells, as is seen with human PIN lesions. Thus, conditional loss of
Nkx3.1 in adult mice models the predicted consequences of loss of 8p21 in humans in the initiation of prostate cancer. All of the mice we studied with conditional deletion of one
Nkx3.1 allele develop focal epithelial hyperplasia. In a subset of these animals PIN lesions were also observed, and these PIN lesions showed loss of expression of the wild-type allele as determined by immunohistochemistry. Thus, loss of one
Nkx3.1 allele is sufficient to initiate epithelial hyperplasia, indicating haploinsufficiency for this phenotype. Further progression to PIN is associated with silencing of the second allele, as determined by loss of protein expression. The mechanisms by which loss of expression of the second allele is achieved are presently unclear, but they may involve promoter hypermethylation or posttranscriptional mechanisms. The latter possibility is particularly intriguing, as studies suggest a discordance between NKX3.1 transcript and protein levels in human prostate tumors (
8,
27,
38).
We have shown that in both the mature human and mouse prostates, Nkx3.1 expression is limited to the luminal epithelial cell layer. Luminal epithelial cells of the prostate are terminally differentiated postmitotic cells and are believed to be renewed by stem cells from the basal cell compartment (
18). Our results suggest that deletion of
Nkx3.1 in the luminal cells is permissive for dedifferentiation and reentry into the cell cycle, subsequently leading to the development of PIN. However, during development precursor cells that are presumably also rapidly proliferating do express Nkx3.1 (
3). The mechanism by which Nkx3.1 engages the cell cycle machinery in prostate cells in the different developmental stages of the prostate gland and in carcinoma is an interesting subject that warrants further investigation. Additional unanswered questions include whether the PIN lesions in conditional
Nkx3.1 knockout mice can progress to invasive carcinoma and metastases with aging or other hormonal or genetic manipulations. We have observed only one isolated case of early microinvasion in analysis of more than 25 conditional
Nkx3.1-deficient mice of up to 35 weeks of age. Further studies, which include variables such as aging for longer periods and hormonal treatment, are in progress to address this question.
Several transgenic mouse models of prostate cancer are presently available, most of which make use of prostate-specific promoter elements to direct expression of oncogenes to the prostate. Expression of the simian virus 40 T antigen has been targeted to various cell types in the prostate by using elements from the
probasin promoter (
16,
25), the
C3 (
1) promoter (
32), the fetal Gγ-globin promoter (
28), the
gp91-
phox promoter (
33), and the
cryptdin2 promoter (
15). In these mice, tumor progression usually proceeds from PIN to invasive carcinoma and, in some cases, distant metastases.
Although T-antigen-derived models have proved useful in dissecting some of the pathways involved in prostate tumorigenesis, the fact that T antigen has no known role in the human disease has stimulated interest in the generation of newer models based on genes that are altered in human prostate cancer. Disruption of a few putative tumor suppressors in mice has been reported to result in prostatic epithelial hyperplasia and dysplasia. For example, mice carrying mutations in the
Nkx3.1,
Pten,
Cdkn1, or
Mxi1 gene all develop various degrees of prostatic hyperplasia and dysplasia (
3,
12,
14,
29,
31). Notably, p27 (encoded by
Cdkn1) and Pten have been reported to cooperate in prostate tumor suppression (
11). Nevertheless, the roles of most of these tumor suppressor genes in the prostate gland may be masked by developmental defects or tumors that develop more rapidly in other organs, resulting in early lethality before the prostate pathology is fully developed. Conditional gene targeting will provide a useful methodology for circumventing these difficulties. To this end, our conditional
Nkx3.1 mutant mice can provide a useful starting point for investigating the impact of prostate-specific deletions of additional tumor suppressor genes that may play important roles in distinct stages of prostate carcinogenesis.