Our study evaluates for the first time the canine PRLR expression in non-neoplastic, benign and malignant canine mammary tissue both at the protein (immunohistochemistry) and the mRNA level (semi-quantitative real time PCR). Expression was detected in all tissue types, and expression levels were highest in normal mammary epithelial tissue, as demonstrated quantitatively by real time PCR. Moreover, real time PCR showed a significant reduction in PRLR expression both in benign neoplastic lesions and even more marked in malignant lesions.
To the authors’ knowledge there are only two other studies analyzing PRLR expression in canine mammary tumor cells
[
34,
35]. Rutteman et al. also found reduced PRLR expression in malignant mammary tumors compared to benign ones
[
34]. In this study, all cases of normal tissue and benign lesions were receptor positive, but positivity was found only in a few malignant lesions
[
34]. The radioimmunoassay technique used involved binding of radiolabeled PRL to tissues in order to detect the presence and quantify the relative expression level of PRLR. However, in the meantime, modern PCR-based approaches were shown to be more specific and more sensitive in human breast cancer studies
[
40]. Van Garderen et al. used RT-PCR to demonstrate expression of PRLR in the canine mammary tumor cell line CMT-U335
[
35]. But the expression rate was not quantitatively compared to normal canine mammary epithelial cells. In most studies evaluating human breast cancer, PRLR expression level in malignant tumors was equal or decreased compared to benign lesions and normal tissue
[
11,
13,
16,
17]. However, a few studies demonstrated a higher PRLR expression in malignant lesions
[
12,
15]. The heterogeneous subcellular distribution of the PRLR (variously including cytoplasm, nucleus, sometimes luminal borders of the epithelial cells), labeling of myoepithelial cells and weak labeling of individual connective tissue cells found in our study is in agreement with most human medicine reports
[
11,
12,
16,
17,
41]. In contrast to the findings of Gill et al. and Ferreira et al., we were not able to demonstrate a variation of PRLR expression at different subcellular locations between non-neoplastic cells and benign and malignant mammary tumor cells
[
13,
15]. Gill et al. found that PRLR expression was mainly limited to luminal cell borders in normal female mammary tissue, while it was both luminal and cytoplasmatic in benign lesions and mostly cytoplasmatic in malignant lesions. Ferreira et al. reported similar results in pathological tissues from male individuals. In gynecomastia, PRLR expression was mainly seen along luminal cell borders, while in mammary carcinomas from males signals were mostly cytoplasmatic
[
13,
15]. Similar to others, we observed staining of endothelial cells and smooth muscle cells of some intratumoral blood vessels, which might be related to the angiogenic effect of prolactin
[
11,
17].
Queiroga et al. investigated PRL tissue levels in tissue homogenates of normal canine mammary tissue, benign and malignant mammary tumors. They found PRL tissue levels to be significantly associated with the malignancy of tumors, with malignant tumors expressing the highest levels
[
36]. However, it remains to be demonstrated whether PRL tissue levels correlate with PRLR status. Neither PRLR nor possible local PRL expression was analyzed in this study
[
36].
A plausible explanation for the fact that PRLR expression was highest in canine normal mammary tissue and lowest in malignant tumors is that PRLR expression may be a differentiation marker of mammary epithelial cells and that loss of this marker may be a characteristic of dedifferentiation. While PRL acts as a pro-oncogene in early neoplastic transformation and is certainly involved in cellular neoplastic progression and resistance to breast cancer treatment, it is also well characterized as a terminal differentiation factor for mammary epithelial cells and as essential regulator of epithelial plasticity and invasion and metastasis suppressor hormone
[
8,
9,
42-
47]. Similarly, steroid hormone receptors are considered cell differentiation markers as well, and their expression decreases with increasing malignancy of canine mammary tumors, and is absent in metastases
[
20]. In this context, the findings of Queiroga et al. are surprising, because not only PRL levels, but also steroid hormone levels were higher in tissue homogenates of malignant tumors compared to benign lesions and non-neoplastic tissue
[
36]. It should be noted, however, that an increase of the local concentration of hormones does not necessarily need to be associated with increased expression of their receptors in tumor tissues. Even a very low expression level of the receptor is sufficient to mediate PRL responsiveness in human breast cancer cell lines
[
40]. Furthermore, alterations of intracellular PRL signaling could be crucially involved in carcinogenesis, as PRL signaling pathways have an essential role in maintaining physiological cell differentiation and in the regulation of cell cycle and apoptosis
[
14,
47-
49].
Small sample size was the major limitation of this study. To exclude external variables as well as possible, only tissue samples from intact female dogs were included. Unfortunately, it was not possible to retrospectively identify the exact stage of estrous cycle in the bitches due to the lack of a gynecological examination, vaginal cytology and hormone assays
[
50]. It seems however highly unlikely that the mammary tumors used in this study were removed during estrus, i.e. under estrogen influence, because all patients were clinically diagnosed as not in heat. Therefore, it cannot be excluded with certainty that some of the tumors were removed during metestrus, i.e. under progesterone influence. In the female pig, only estrogen, but not progesterone alone or in combination with estrogen has an effect on PRLR expression
[
51]. Since the stage of estrous cycle was not determined in any of the animal or human studies (analyzing pre-menopausal women) known to the authors, we consider the data presented in this work to be comparable to previous investigations. Another possible limitation of this study is the fact that we used non-affected mammary tissue from dogs with mammary tumors as normal samples. Even if this approach is consistent with Rutteman et al. 1986
[
34] and many human studies, which also compared findings in mammary tumors with the findings in adjacent normal tissue
[
10-
12,
14], we cannot completely exclude genetic or endocrine alterations in our macro- and microscopically unremarkable samples.
Due to the retrospective nature of our study, we were not able to evaluate serum PRL levels of the patients. While previous reports indicated no difference in serum PRL level between bitches affected by benign or malignant mammary tumors
[
32,
52], a recent study reported significantly higher serum PRL levels in bitches with malignant tumors
[
36]. A prospective study already in progress will show if female dogs affected by malignant tumors in fact have increased PRL levels in addition to decreased tumorous PRLR expression. However, as PRL serum levels are extremely difficult to compare in small study populations (pulsatile PRL secretion, massive fluctuation due to season, stage of estrous cycle and individual influences) and are moreover breed-dependent
[
2,
53-
59], a high patient number is needed to address this question.