This study showed that mutant NBS1 transfer significantly increased chemosensitivity to cisplatin
in vivo. These effects are most likely due to molecular disruption of the MRN complex through the expression of mutant NBS1. The mutant NBS1 used in this study preserves the MRE11 interaction domain, but loses a central region that includes several phosphorylation sites by ATM and ATR kinases, and the forkhead-associated and BRCA1 C-terminus domains. These lost regions have the functions of ATM activation, H2AX phosphorylation, MRN complex recruitment to damaged sites of DSBs, cell cycle arrest and DSB repair initiation (
Rogers et al, 1997;
Kobayashi et al, 2004;
Czornak et al, 2008). Hence, a successful induction and expression of mutant NBS1 results in losing many functions related to DNA DSB repair. In this study, we showed that using Co-IP and western blot the mutant NBS1 retains the binding ability to MRE11 and competitively inhibits the binding of wild-type NBS1 to MRE11. Also, we showed the downregulation of wild-type NBS1 and RAD50 after Ad-NBS1 induction. These results are supposed to have occurred by the loss of NBS1 functions, such as H2AX phosphorylation or MRN complex recruitment to damaged sites of DSBs, and consequently induces a dominant-negative downregulation of MRN complex, possibly through inhibition of ATM activation and H2AX phosphorylation (
Kobayashi et al, 2004;
Czornak et al, 2008). These results support our hypothesis that mutant NBS1 disrupts MRN function. Indeed, our previous report indicated significantly increased cisplatin-induced DNA DSBs
in vitro after mutant NBS1 transduction (
Tran et al, 2004).
This study proved the benefit of the FGF2-targeting system, which has high transduction efficiency and enables a lower titre viral administration while still maintaining
in vitro and
in vivo tumour suppressive effect of cisplatin equivalent to a higher titre non-targeting transfer. Although adenovirus-mediated gene transfer is appealing, the infection of normal tissues and systemic toxicities, mainly caused by viral entrance into the bloodstream and viral trapping in the liver, limits the move into human clinical trials. To overcome these issues, the FGF2-targeted adenoviral system will be the most efficacious when applied to cells that have low CAR and high FGFRs expression. In our previous study, FGFR1 and FGFR2 expression was widely observed in both tumour cells and ECs of the human HNSCC xenograft model (
Saito et al, 2009). Several studies have described a two- to 34-fold increase in intratumoral transduction efficiency (
Rancourt et al, 1998;
Doukas et al, 1999;
Qin et al, 2005) and a two-fold increased transduction efficiency of adenoviral
TK gene was observed for human HNSCC (
Saito et al, 2009). Our results also support the benefit of FGF2 target with regard to intratumoral transduction efficiency.
In addition, our results showed that the number of apoptotic cells was not increased and microvessel density was decreased after FGF2-Ad-NBS1/cisplatin treatment, suggesting successful transduction into not only tumour cells, but also ECs by the FGF2-targeted adenovirus system. The FGF2-targeted system has been shown to induce highly efficient transduction in ECs that express relatively low levels of CAR receptor (
Gupta et al, 2006;
Saito et al, 2009). It has been reported that angiogenesis is enhanced and the expression levels of FGFR1 and FGFR2 are upregulated in cancer cells and ECs in HNSCC (
Dellacono et al, 1997;
Riedel et al, 2000). Although a direct effect in ECs as a result of mutant NBS1 gene transfer is supposed to be one mechanism for antiangiogenesis effect, downregulation of NF-
κB expression after FGF2-targeted Ad-NBS1 transduction that is seen in our study suggests other suppression mechanisms.
NF-
κB is a well-known transcription factor that is responsible for regulating many genes, including angiogenesis and apoptosis (
Sun and Zhang, 2007). The NF-
κB transcription factor family is composed of p50, p52, RelA/p65, c-rel and Rel B. The homodimers and heterodimers are sequestered in the cytoplasm as an inactive form by the inhibitor of kappa B (I
κB). Upon stimulation, the I
κB kinase complex phosphorylates the
κB inhibitor, which then releases NF-
κB and allows its phosphorylation, nuclear translocation, binding and subsequent activation of target genes involved in the regulation of cell proliferation, survival, angiogenesis and metastasis (
Brown et al, 1995). The inhibitor of NF-
κB had significant antitumour effects on oesophagus SCC by promoting apoptosis, and inhibiting proliferation and angiogenesis, as well as reduced the metastasis (
Li et al, 2009). Furthermore, downregulation of NF-
κB might consolidate DNA damage and apoptosis induction because NF-
κB orchestrates a cell survival pathway together with the activation of cell cycle checkpoints and DNA repair (
Janssens and Tschopp, 2006). However, it is not clear as to how NBS1 relates to the NF-
κB. Some reports indicate that when DSBs are generated by radiation, NBS-deficient cells exhibit a delayed and strongly reduced level of NF-
κB induction (
Habraken and Piette, 2006) and one cascade for NF-
κB activation depends on ATM, which closely interacts with NBS1 (
Habraken and Piette, 2006).
In this report, we have not shown the effect of FGF2-targeted Ad-NBS1 gene transduction to the PI3K/AKT/HIF angiogenesis pathway. However, many reports suggest that there is an interaction of NBS1 with key proteins involved in tumour angiogenesis induction pathway such as PI3K and HDM2 (
Alt et al, 2005;
Chen et al, 2008). We suppose that PI3K might be activated by NBS1, but might be inactivated by mutant NBS1. It has been reported that the reduced PI3K activity in NBS
−/− lymphoblasts is caused by an impaired expression of the SRC family kinases (
Sagan et al, 2008). Similarly to our mutant NBS1, the NBS lymphoblastoid cell line used in this report expressed NBS1 with the common 657del5 mutation, which preserves PI3K activation domain. Therefore, our mutant NBS1 might have the potential to reduce PI3K activity and may result in the inactivation of the PI3K/AKT angiogenesis pathway. In fact, we have data with regard to the downregulation of HIF-1
α in vivo, which is the major factor in PI3K/AKT pathway and regulates VEGF activation, after FGF2-targeted Ad-NBS1 gene transduction (data not shown). Downregulation of both Ras/MEK pathway and PI3K/AKT pathway may have synergistic effects in inducing tumour angiogenesis (
Jiang and Liu, 2008), and with NF-
κB downregulation, a potent inhibition of tumour angiogenesis can be expected after FGF2-targeted Ad-NBS1 transduction.
Viral trapping in the liver is a major concern and an indicator for systemic toxicity in the systemic administration of adenoviral vector. It is reported that a majority of the adenoviral vector accumulates in the liver, which can cause severe liver toxicity, and that the liver is the most important organ to eliminate adenoviral vector genome through the innate immune system (
Akiyama et al, 2004;
Yao et al, 2010). Although the liver is the major site of adenoviral localisation owing to its high CAR expression, the FGF2-targeted adenoviral system can alter the distribution of the virus and deterge the viral vector from the liver. The amount of FGF2-targeted adenovirus delivery to the liver was shown as a 10- to 20-fold decrease, whereas an increase of transgene expression in the tumour tissue was observed after systemic administration (
Printz et al, 2000). This decrease in liver deposition translates into a significant reduction in subsequent toxicity. In this study, a large systemic distribution of adenovirus was not expected because the virus was administered via intratumoral injection (
Sewell et al, 1997). Nevertheless, the results confirmed adenovirus existence with high rates in the liver after Ad-NBS1 administration and absence of FGF2-targeted adenovirus. These results indicate that the FGF2-targeted adenoviral system results in a more efficient system with reduced viral titre application by its high transduction efficiency into cancer cells and with concomitant lower levels of liver toxicity.
This study proves the efficacy of Ad-NBS1 gene transduction in vivo to sensitise cisplatin chemotherapy by disrupting MRN function in DNA DSBs repair systems. Furthermore, our findings suggest that a more significant antitumour effect can be achieved through not only enhanced tumour cytotoxicity, but also antiangiogenetic effects when Ad-NBS1 is targeted to FGFRs. Concurrently, FGF2-targeted system can reduce liver toxicity by preventing adenoviral distribution. The great benefit of this strategy supports further clinical trials in the treatment of human HNSCC.