The concept that sustained activation of cap-dependent translation initiation is oncogenic is now firmly established (
5–
7). Unproved was its logical corollary - that a translational control checkpoint exists in the tumor defense system, and that the 4E-BP protein family functions at this checkpoint. Using mice genetically engineered to lack two of the three 4E-BP family members; and a high fidelity tobacco carcinogen mouse model of lung cancer, here we report that 4E-BP deficiency sensitizes mice to NNK-induced lung tumorigenesis, establishing a role for the 4E-BPs at a translational control checkpoint in lung tumor defense.
Evidence for the role of eIF4F activation in cancer has been accumulating for more than a decade (
35,
36). Since the 4E-BPs are the primary negative regulators of eIF4F function, our hypothesis that
4ebp1−/−/
4ebp2−/− mice would be sensitized to NNK-induced lung tumorigenesis had strong antecedent experimental grounding (
7,
8). Indeed, as we predicted, our study shows an increase in the sensitivity of
4ebp1−/−/
4ebp2−/− mice to NNK, establishing a role for the 4E-BP family of cap-dependent translation repressors in tumor defense.
Morphological analysis of tumors revealed a striking increase in tumor microvessel density in
4ebp1−/−/
4ebp2−/− mice; a result identifying a role for the 4E-BPs in restraint of tumor neovascularization. Activation of eIF4F is known to selectively activate translation of the angiogenic protein VEGF (
29). At baseline before NNK treatment, we found increased recruitment of ribosomes to
Vegf mRNA in
4ebp1−/−/
4ebp2−/− mice; creating a primed state for increased neovascularization of NNK-triggered tumors. However, we note that translational control of angiogenesis in not simply unidirectional. In breast carcinoma, high level over expression of 4E-BP1 promotes angiogenesis by triggering a switch from cap-dependent to internal ribosome entry site (IRES) mediated translation (
37). This leads to translational activation of VEGF which can be translated in a cap-independent as well as a cap-dependent manner – giving it a selective advantage to recruit ribosomes when cap-dependent translation is repressed. These data highlight the importance of translational control in governing the propensity of tumors to progress by recruiting a circulation, and provide a molecular mechanism for the increased vascularity we observed in the lung tumors from
4ebp1−/−/
4ebp2−/− mice.
To elucidate the molecular mechanism by which 4E-BP deficiency sensitizes mice to NNK, we analyzed the baseline lung RNA ribosome recruitment pattern genome-wide. There was a marked skewing of the
4ebp1−/−/
4ebp2−/− molecular landscape towards translational activation of genes governing growth and proliferation; as well as for genes related to transcription. These data are in accord with genome-wide
in vitro studies that reveal selective translation of genes belonging to proliferation pathways - and those governing gene expression itself - when the translation initiation machinery is activated (
20,
38). Our findings reveal what may be considered a cancer-primed state in
4ebp1−/−/
4ebp2−/− mice, since unstressed mice do not show a cancer phenotype, but do have a translational profile for key cancer related functions that is significantly different from normal; and display a lower NNK-threshold for tumorigenesis. Based on our findings, it is tempting to speculate that a similar shift in the global translational profile towards cancer may be recapitulated in the smoker’s lung; a possibility in accord with the clinical finding that hyperphosphorylated 4E-BP1 (i.e. the inactive form) is a negative prognostic factor in breast, ovarian, and prostate cancer (
39).
Our most unexpected finding was that
4ebp1−/−/
4ebp2−/− mice were more efficient at catalyzing NNK into carcinogenic metabolites, and that this resulted in increased methylated DNA adducts. The mechanism involved translational activation of CYP2A5, the primary enzyme catalyzing NNK into its carcinogenic metabolites in the lung (
40). Thus we have identified a novel role for the 4E-BPs in regulating the cytochrome P450 enzyme system – a finding with important clinical implications. Combining the published literature with our current findings, we may have unveiled a pernicious feed-forward loop that can operate in human smokers (). When smoking commences, physiological levels of CYP2A5 in the lung catalyze NNK into active carcinogens forming DNA adducts, preferentially creating codon 12 gain-of-function mutations in RAS (
41). Oncogenic Ras activates the PI3K/Akt/mTOR pathway which in turn phosphorylates the 4E-BPs (
42), i.e. a
4ebp1−/−/
4ebp2−/− phenocopy. We show here that CYP2A5 is translationally activated in the 4E-BP deficient state, increasing the catalysis of NNK into carcinogenic metabolites, resulting in accelerated accumulation of DNA adducts (). We speculate that such a feed-forward loop in human smokers may help explain the carcinogenic potency of cigarette smoke and the exponential relationship between lung cancer incidence and smoking duration (
43,
44).
Although our study does not definitively establish a role for the 4E-BP family of proteins in defense against malignancies other than adenocarcinoma of the lung; together with the published literature, it strongly suggests a more general role in cancer defense. Our findings, therefore, provide impetus for current efforts to develop new classes of cancer therapeutics aimed at normalizing translational control and reestablishing integrity of the translational control checkpoint. These efforts include mTOR inhibitors designed to restore 4E-BP function and compounds targeting the integrity or activity of the eIF4F complex (
45–
47). Our data also support the potential utility of array-based translational profiling to begin identifying and stratifying at-risk states for the development of lung and other malignancies.