This study describes a comprehensive analysis of gene expression and genomic alterations in
in vitro and xenograft models of RCC metastasis in order to elucidate the genetic mechanisms and associated biological functions that empower tumor cells with the ability to colonize distant sites. Molecular profiling of tumor cells in the xenograft model and RCC tumor biopsies uncovered a mesenchymal signature as the most significant feature linked to high metastatic activity. Unexpectedly, tumor cell invasion was not significantly increased in the highly metastatic populations. These results prompted us to search for alternative mechanisms by which a mesenchymal phenotype may be of advantage at the metastatic site. Detailed analysis of the gene functions associated with the mesenchymal signature revealed a substantial enrichment for pro-fibrotic genes suggesting that metastatic spread imposes a selective pressure for cells with a myofibroblastic makeup. We therefore suggest that an important function of tumor EMT is to generate cells with properties of stromal fibroblasts. It is logical to presume that a tumor cell endowed with such a phenotype would be highly effective at colonizing distant organs because it could bypass the requirement of an activated “compatible” stroma in the initial stages of metastatic establishment. Myofibroblasts produce and modify the extracellular matrix (ECM), secrete angiogenic and proinflammatory factors, and stimulate epithelial cell proliferation and invasion. Myofibroblasts were originally characterized by their role in wound healing (
31) and its induction has been associated with diverse types of organ fibrosis (
32). Myofibroblasts are also abundant in the reactive tumor stroma and are an established source of tumor promoting factors such as cell surface proteins, secreted growth factors, and extracellular matrix proteins (
33–
34). A direct pro-metastatic effect of tumor associated myofibroblasts was also recently implied (
35). Consistent with our hypothesis, It has also been suggested that myofibroblasts are derived from malignant or normal epithelial cells undergoing EMT (
36). Additional support for this hypothesis comes from the fact that increased levels of collagens and laminins have been associated with an increased likelihood of clinical metastasis of multiple human solid tumors (
13). In order to substantiate the relevance of the mesenchymal signature we selected
S100A4 for functional validation. Enforced repression of this factor profoundly affected metastatic activity in agreement with previous studies that demonstrated that
S100A4 is a crucial myofibroblast-expressed factor regulating metastasis (
37). Furthermore, the expression of
S100A4 in renal tubular epithelium undergoing EMT during fibrosis (
38), together with the fact that proximal tubules arise from the differentiation of mesenchymal cells, suggest a model wherein RCC epithelial cells reverse this developmental process back to the original mesenchymal state, in order to metastasize. The plasticity of the renal epithelial cell has been further supported by studies of the role of the developmental gene,
GREM1, which is reactivated in adult renal fibrotic disease (
39). Remarkably,
GREM1 is also a component of the myofibroblastic signature identified in our
in vitro model of RCC progression. Although deregulation of gene expression during tumor progression is relatively well characterized, the associated genetic and molecular mechanisms are largely unknown. In addition, while the sequence of genetic events that drive the establishment of primary tumors has begun to emerge, the subsequent events that lead to metastasis have remained generally obscure. As a consequence, few mutations, genomic alterations, or allelic imbalances are currently known to distinctively endow tumor cells with metastatic functions (
40). We reasoned that by studying the mechanisms by which RCC genomes are deranged during metastatic conversion, we would be able to improve the ability to pinpoint critical genes involved in this process. By analyzing mRNA expression levels and DNA copy number changes in parallel, we found that changes in gene dosage have a modest effect on gene expression. These results suggest that during the evolution toward a metastatic phenotype, these cells acquire a set of chromosomal losses and gains that are perhaps associated with retention or otherwise of specific cell clones within the cell population. Although, none of the genes mapped to regions of genomic imbalance related to mesenchymal functions, we cannot exclude that these changes do not indirectly impact the mesenchymal signature.
In addition to changes in DNA sequence, gene expression can be modulated by aberrations in the patterns of DNA methylation. However, the pattern of DNA methylation abnormalities in cancer cells seems paradoxical. Compared with normal cells, cancer cells are concomitantly hypermethylated at specific CpG island sequences but hypomethylated at CpGs found in most other sites, resulting in a net loss of genomic 5meC content (
41). Understanding the relative timing of DNA hypermethylation and hypomethylation alterations in cancer is crucial to understanding the importance of these changes during tumor progression. We found that a number of mesenchymal- associated genes were reactivated upon 5’-AZA treatment suggesting that they were hypermethylated in the poorly metastatic cells.
S100A4 showed complete methylation of the intronic CpG sites analyzed in the poorly metastatic cells, consistent with its epigenetic transcriptional silencing. Some of those genes, including
S100A4, COL1A1 and
GREM1, have previously been shown to be methylated in other tumor models as well as in RCC (
42–
44). The proposed impact of promoter methylation on EMT is not unprecedented in the literature as altered methylation of some gene promoters have been reported to be one of the principal causes of EMT during tumor progression (
45) or during epithelial to myofibroblast transition (
46).
Several bioinformatic algorithms have been constructed to predict miRNA gene targets. These algorithms predict hundreds of potential gene targets, which cannot all be experimentally validated. Integration of putative targets with mRNA expression date provides a rational method to prioritize functionally relevant targets. Interestingly, the most significant correlation in this study was found between
Let-7 and
COL1A1, COLA1A2, COL3A1, COL9A3. In consonance with our results,
Let-7 is widely viewed as a tumor suppressor miRNA (
47–
48).
Our findings revealing the lack of major genetic and epigenetic alterations accounting for the direct deregulation of miRNA expression suggest that miRNAs alterations are likely to be induced indirectly as a consequence of the dysregulation of specific transcription factors. Moreover, this observation argues that miRNA may be downstream targets of pathways that are commonly dysregulated in cancer and not initiating events during tumor progression.
In summary, in this study, we have proposed and provided proof of principle for a new mechanism of tumor progression in RCC based on acquisition of a myofibroblastic trait by tumor cells. We also showed that this approach that cross-references multiple whole-genome data sets can identify targets and genetic mechanisms important for tumor progression.