It is well known that PDX-1 is required for embryologic development of the pancreas and for maintenance of hormone expression in the adult islet
35–40. PDX-1 has also been found to regulate proliferation of islet cells in mice
15 as well as proliferation and invasion of pancreatic cancer cells
in vitro14–16. Re-expression of PDX-1 in adult duct cells, under certain conditions such as pancreatectomy and pancreatitis, suggests that PDX-1 may be associated with the regenerative responses that accompany these conditions. It has been demonstrated to be a key regulator of the induction of cell differentiation from non islet cells to insulin-secreting cells
41, especially acinar to ductal cell metaplasia, a common cellular change that may progress to malignancy
22. These studies, together with the finding that PDX-1 is overexpressed in most solid cancers, which is associated with advanced clinical pathological stages and poor prognosis of patients with pancreas cancer, suggests that PDX-1 could be playing a role in oncogenesis
25, 26, 29, 31, 32. To test the hypothesis that PDX-1 is an oncogene, we utilized techniques similar to those performed on Kras, which is a well known pancreas cancer oncogene that induces malignant cellular transformation when over-expressed as an activating point mutation at codon 12( Kras
G12D)
1, 2, 42–44. Our cumulative data show that over-expression of PDX-1, in addition to affecting cell proliferation and invasion in both benign and malignant human cell lines, induced significant cell transformation by colony formation and promoted tumor growth
in vivo, strongly supporting the role of PDX-1 as a potential oncogene. An opposite view has been mentioned in one study in which PDX-1 was considered as a tumor suppressor gene in human gastric cancer
45. Further studies are needed to clarify this issue, since most studies showed high level of PDX-1 in gastric cancer specimens
46–50, as opposite to this study showing low expression of PDX-1 in a single human gastric cancer cell line.
To strengthen the evidence of PDX-1’s role in tumorigenesis, we also utilized visualized PDX-1 expression and PDX-1 siRNA knockdown techniques for
in vitro studies in multiple human cell lines. HEK 293 cells are routinely used as a “normal” utility cell to test the function of oncogenic or tumor suppressor genes
51. HPDE cells, which originate from human pancreatic ductal epithelial, have been widely used as tool to investigate the oncogenic property in pancreatic cancer studies
52, 53. MIA PaCa2 cells and PANC-1 cells are human pancreatic cancer cell lines with low and high endogenous expression of PDX-1, respectively. Consistent results were obtained from different human cell lines, demonstrating reliable approaches used in the study, emphasizing the crucial role of PDX-1 in mediating tumorigenesis. Secondly, visualized PDX-1 expression offered kinetic observation of cellular responses to PDX-1 expression. It was particularly useful in monitoring PDX-1 expression in colony formation of PDX-1-transformed cells. Lastly, RNAi technique was used to validate the role of PDX-1 in regulating cell proliferation and invasion. By knockdown of PDX-1 expression, the effectiveness of PDX-1 induction was accordingly reversed, providing confirmative evidence of PDX-1’s role in cell proliferation and invasion. In combination of three approaches, the study provides reliable evidence to demonstrate that PDX-1 mediates tumorigenesis and further support our previous view that PDX-1 is therapeutic target for pancreatic cancer
28. Using a xenograft human cell-SCID mouse model, this study demonstrates
in vivo evidence that PDX-1 overexpression induces tumor formation and growth. HEK 293 cells harboring PDX-1 expression grew large tumors in all implanted mice, whereas HEK 293 control cells developed only a very small tumor in one of five mice. The results are consistence with other studies using HEK 293 cells to study the function of other oncogenes
51, 54. PDX-1 also promoted MIA PaCa2 cell tumor growth in SCID mice, indicating PDX-1 also has a cumulative effect on tumorigenesis, as MIA PaCa2 control cells have low endogenous PDX-1 expression. These data further support the hypothesis that PDX-1 is an oncogene.
In terms of the mechanism by which PDX-1 is involved in pancreas cancer tumorigenesis, we have shown that overexpression mouse PDX-1 in human pancreas cancer cell lines, as well as PDX-1 shRNA knock down of PDX-1, results in disruption of cell cycle proteins
28. Previous PDX-1 studies have shown dependence on several signal transduction pathways such as those involving Stat3
22, MAPK
55, and phosphatidylinositol 3-kinase/Akt/mTOR signaling pathways
56. There is great deal of overlap between these transduction cascades and those described in SHH regulation of proliferation in pancreatic cancer
57. The data in this study demonstrate PDX-1 up-regulates expression of Cdk2, cyclin E, and down-regulation of p27, p21 and P53 expression in human PDX-1 overexpressed HEK 293 cells both
in vivo and
in vitro; these data are consistent with our previous observations in other cell lines, addressing the role of PDX-1 on G1 to S transition of cell cycle, emphasizing the critical role of PDX-1 in the mediation of cell proliferation.
Further mechanistic evidence was obtained from microarray analysis of genes involving in signaling pathways following PDX-1 knockdown in human PANC-1 cells, which have high endogenous expression of PDX-1. The computerized analysis of the microarray data also helped to identify additional potential molecular targets involved in the PDX-1 pathway, which provides potential insight into the molecular mechanism of PDX-1 in tumorigenesis. These data are consistent with our findings that PDX-1 regulates proliferation and invasion of PC cells and that suppression of PDX-1 expression via PDX-1 shRNA activates apoptotic pathways, as well as suppression of proliferation and invasion pathways
28. However, further studies are needed to determine precisely how PDX-1 regulates transformation.
In conclusion, the data in the present study demonstrate that PDX-1 overexpression resulted in: i) increased cell proliferation and invasion, as well as transformation of non malignant human cells; ii) promotion of tumor formation and growth of human cells implanted in SCID mice; and iii) disruption of the cell cycle in non malignant cells. These data, along with the demonstration that PDX-1 is over-expressed in more than 80 pancreatic cancer specimens, support the hypothesis that PDX-1 is an oncogene mediating tumorigenesis in pancreatic cancer.