The participation of CDK4 in the neoplastic process was suggested by its amplification and/or overexpression in human gliomas (
He et al., 1994;
Lam et al., 2000;
Schmit et al., 1994;
Sonoda et al., 1995), sporadic breast carcinomas (
An et al., 1999), lipomatous tumors (
Dei Tos et al., 2000) and sarcomas (
Kanoe et al., 1998). In addition, a point mutation in cdk4 (R24C) that abrogates the binding of the product of the tumor suppressor gene, p16
Ink4a, was identified in patients with familial melanoma (
Wölfel et al., 1995;
Zuo, 1996).
In this report, we have studied the effect of CDK4 overexpression in skin tumor development. We have used a transgenic mouse model that expresses human CDK4 in the basal cell layer of epidermis. These mice have shown increased CDK4 and CDK2 kinase activities, associated with hyperproliferation, hyperplasia and hypertrophy of the epidermis (
Miliani de Marval et al., 2001). Here, we have determined that transgenic mice showed a mild increase in the number of benign lesions (papillomas) after topical application of the genotoxic carcinogen DMBA followed by multiple applications of the tumor promoter TPA. The increased number of apoptotic cells in papillomas of transgenic mice showed that CDK4 overexpression not only triggers a proliferative response in the affect tissue, but in fact, CDK4 transgenic mice showed a 7-fold increase in the rate of apoptosis compared with normal siblings. However, the total number of proliferating cells is superior to the total number of apoptotic cells in transgenic tumors, favoring a faster growth of tumors in transgenic mice. The size of benign tumors (papillomas) is worth mentioning, as they were similar in transgenic and wild type siblings, but the size of squamous cell carcinomas increased in transgenic mice (data non shown). However, several other phenomena must be involved determining the size of SCC because we detected much variability in this parameter.
Dramatic changes in the incidence of SCC were observed in K5-CDK4 mice compared with wild type siblings. Most of the K5-CDK4 mice developed carcinomas, while the incidence in wild type mice was only 20%. The fact that increased expression of CDK4 in our transgenic mice resulted in elevated CDK4/cyclin D1 complex formation in late tumors led us to hypothesize that the activity of this complex is involved in the observed malignant tumor progression. However, the double transgenic K5-CDK4/K5-cyclin D1 did not increase malignant progression nor did it develop earlier carcinomas. Thus, increased CDK4 expression may act in a fashion other than direct activation through the binding to cyclin D1. In fact, we have shown that CDK4 bind and sequester two inhibitors of CDK2 (p21
Cip1 and p27
Kip1). CDk4/p27
Kip1 and CDK4/p21
Cip1 complexes increased two and 3.7 times in transgenic compared with wild type papillomas. Thus, redistribution of these inhibitors from CDK2 to CDK4 can be an important step in malignant progression. These effects were also observed in K5-CDK4 mouse epidermis (
Miliani de Marval et al., 2001) with increased kinase activity of CDK2. A direct evidence of activation of CDK2 in mouse skin tumors was difficult to assay because the non-epithelial components of these tumors unmask the potential increase in the CDK2 kinase activity in the epidermal compartment of transgenic papillomas. Altogether, these results show that the action of CDK4 is independent of the level of CDK4/cyclin D1 complexes although we cannot rule out that complexes with other D-type cyclins could also be involved in the increased rate of malignant progression. These results are consistent with several reports in which amplification or overexpression of CDK4 in human tumors has been observed without deregulation of D-type cyclins (
He et al., 1995;
Holland et al., 1998;
Kanoe et al., 1998). Consistent with this study He et al. have showed that amplification of CDK4 and cyclin D1 in primary glial tumors are mutually exclusive (
He et al., 1994). On the other hand, several pieces of evidence have suggested that CDK4 can act in an alternative unknown pathway in carcinogenesis. Kanoe et al (
Kanoe et al., 1998) have shown that contrary to the prevailing theory that CDK4 amplification is an alternative mechanism for Rb gene mutation, the cdk4-gene is amplified in osteosarcomas that also showed loss of expression of RB protein. These redundancies of mutations indicate that CDK4 may have some roles other than inactivation of RB. In addition, CDK4 plays an important role in myogenesis, blocking the muscle differentiation by binding the MyoD transcription factor, showing again that alternative roles for CDK4 cannot be ruled out (
Zhang et al., 1999). Interestingly, overexpression of CDK4 in astrocytes allow them to escape from senescence and convert to a tetraploid state (
Holland et al., 1998). This data is consistent with the phenotype of our previously described K5-CDK4 transgenic mice which develop epidermal hypertrophy with the histopathological appearance of polyploid keratinocytes (
Miliani de Marval et al., 2001).
Our results also showed histopathological evidence that CDK4 overexpression has a strong effect in early papilloma progression. We subdivided the papillomas into four groups according to the degree of atypia as was previously reported by Aldaz et al. (
Aldaz & Conti, 1989). We observed foci of anaplastic cells in papillomas at 30 weeks of promotion. Clearly, the papillomas from K5-CDK4 mice showed increased foci of malignant progression whereas most of the papillomas occurring in wild type mice were regular or moderately dysplastic.
In a recent paper, Lazarov et al. (
Lazarov et al., 2002) described the effect of combined expression of ras and CDK4 in human epidermal cells. They concluded that CDK4 expression can overcome the arrest induced by ras expression and results in rapid development of tumors. They also observed that co-transformation of CDK4 and cyclin D1 did not synergize in tumor development (
Lazarov et al., 2002) supporting our results of the tumorigenic activity of CDK4 that is independent of the level of cyclin D1. Consistent with these results, our experimental
in vivo model showed that CDK4 expression synergizes with ras mutation by increasing the rate of malignant progression. In addition, we have showed that CDK4 overexpression can also support keratinocyte hyperproliferation leading to SCC development without application of a tumor promoter. On the other hand, in the absence of ras mutation (no DMBA application), overexpression of CDK4 did not result in papilloma development demonstrating that CDK4 per se cannot induce tumorigenesis. Rane et al. have also shown that mice bearing a CDK4 activating mutation (R24C) did not develop skin tumors when DMBA application was not followed by application of a tumor promoter, however it is not reported whether SCC development was observed under those conditions (
Rane et al., 2002). On the other hand, mice bearing the CDK4(R24C) mutation showed increased incidence in papilloma development after DMBA/TPA regimen (
Rane et al., 2002). These data, suggest that lack of binding to p16
Ink4a in the CDK4(R24C) mice affects mainly the stage of papilloma development. In contrast, our transgenic mice increased the malignant progression of papillomas to SCC. It is possible that overexpression of wild type CDK4 results in overactivation of CDK2 by sequestering of p27
Kip1 and p21
Cip1, and also favor the activity of CDK6 by sequestering p16
Ink4a. The implications of lack of p16
Ink4a binding warrant further investigation.
It is noteworthy that CDK4 overexpression can bypass the telomere-dependent replicative senescence in human primary culture of keratinocyte, but maintain their ability to differentiate (
Ramirez et al., 2003). Supporting this fact, the epidermis of the K5-CDK4 mice showed a normal pattern of epidermal differentiation (
Miliani de Marval et al., 2001). Analysis of papillomas at various time-points showed that forced expression of CDK4 did not affect the state of differentiation, in which the expression of keratins associated with proliferation (K5 and K14) and differentiation (K1 and K10) was normal (data not shown)
. Whether forced expression of CDK4 in mouse epidermis allows keratinocytes to escape the senescence resulting in elevated rates of malignant conversion is an intriguing issue that remains to be analyzed. In this sense, mouse embryo fibroblasts derived from CDK4(R24C) mice also displayed the escape of replicative senescence (
Rane et al., 2002).
In the last few years, other mouse models have been developed to study the role of CDK4
in vivo. The CDK4(R24C) mice showed normal development although they developed a wide spectrum of tumors with the most common being lymphoma, endocrine tumors and hemangiosarcomas (
Rane et al., 2002;
Sotillo et al., 2001a). In addition, these mice developed invasive melanoma upon DMBA/TPA treatment (
Sotillo et al., 2001b) and an increased incidence of papillomas (
Rane et al., 2002). Our results showed that overexpression of wild type CDK4 has very different effects in comparison to the expression of the mutated form CDK4(R24C). Overexpression of CDK4 results in enhanced carcinoma development. In fact, both models represent different deregulation forms of the CDK4 gene in human tumors. While the CDK4(R24C) mutated form appears exclusively in some cases of sporadic and familial melanomas (
Ohta et al., 1994;
Soufir et al., 1998;
Wölfel et al., 1995;
Zuo, 1996), amplification and/or overexpression of CDK4 have been found in a wide spectrum of human tumors (
He et al., 1995;
Holland et al., 1998;
Kanoe et al., 1998;
Nikitakis et al., 2002). Surprisingly, Morris et al (
Morris et al., 2002) have shown that the CDK4(R24C) produced no additional growth advantage compared with CDK4 overexpressing forms in human fibroblasts; indeed CDK4(R24C) was less effective than wild type CDK4 (
Morris et al., 2002). These results support the observation that CDK4(R24C) mutation is restricted to melanoma development where escape of the p16
Ink4a inhibitory effect appear to be indispensable, while overexpression of CDK4 may be a more general mechanisms for an acquired growth advantage (
An et al., 1999;
Dei Tos et al., 2000;
He et al., 1994;
Kanoe et al., 1998;
Lam et al., 2000;
Schmit et al., 1994;
Sonoda et al., 1995).