Immunohistochemical detection of PPARgamma receptors in the human pituitary adenomas: correlation with PCNA

The occurrence of peroxisome proliferator-activated receptors gamma (PPARgamma) was investigated in 51 human pituitary adenomas and in 6 non-tumoral human pituitary tissue samples. Moreover, the correlation between PPARgamma and the proliferating cells nuclear antigen (PCNA)--immunocytochemical proliferation marker was evaluated. The receptors and PCNA were detected by immunohistochemical methods using the polyclonal anti-PPARgamma and the monoclonal anti-PCNA antibodies, respectively. PPARgamma were found in all examined tissues. The mean percentage of cells with positive nuclear reaction was 3-fold higher in pituitary adenomas in comparison with non-tumoral pituitary tissues. The strongest expression of PPARgamma was observed in somatotropinomas. Besides the nuclear reaction, which is typical for PPARgamma, positive immunostaining was also observed in the cytoplasm. It was clearly stronger in pituitary adenomas than in non-tumoral pituitary tissues. A slight, statistically insignificant tendency towards negative correlation between PPARgamma and PCNA was found in somatotropinomas, prolactinomas, corticotropinomas and gonadotropinomas. On the other hand, in null cell adenomas and "silent" corticotropinomas, a strong positve correlation between the expression of PPARgamma and PCNA was observed. The strong expression of PPARgamma in human pituitary adenomas and its possible involvement in control of cell proliferation in these tumors give a good reason for the attempts of their treatment with PPARgamma ligands.     

Immunohistochemical detection of angiotensin receptors AT1 and AT2 in adrenal tumors

Angiotensin II is well known to affect the adrenal cell growth and function. Angiotensin receptors AT1 and AT2 were found to be present in the normal adrenal gland. However, the data on the expression of the angiotensin receptors in the adrenal tumors are very scarce. To overcome this gap, the paraffin sections of the adrenal cortical tumors and of pheochromocytomas from the archival material were immunostained with antibodies raised against AT1 (sc-1173) and AT2 (sc-9040) receptor proteins. In hyperplasia of the adrenal cortex and in benign adrenocortical adenomas, both functioning and non-functioning, the AT1 immunostaining was present mainly in the cell membranes. A positive immunoreaction was also found in the subpopulation of cell nuclei and within the cytoplasm. In the adrenal cancer, as well as in pheochromocytomas, neither cell membranes nor cell nuclei were immunostained with anti-AT1 antibody. However, a weak AT1 immunostaining was present within the cytoplasm of tumoral cells. With anti-AT2 antibody, in all tumors investigated, the tumoral cells were immunonegative but moderate to strong AT2 immunostaining was observed in the walls of intratumoral blood vessels and in the interstitial tissue. Our data indicates that the expression of AT1 receptors is altered in adrenal cancer and in pheochromocytomas. The expression of AT2 receptors, in turn, may be connected with the process of tumoral neo-angiogenesis.     

Activation of DRD5 (dopamine receptor D5) inhibits tumor growth by autophagic cell death

Dopamine agonists such as bromocriptine and cabergoline have been successfully used in the treatment of pituitary prolactinomas and other neuroendocrine tumors. However, their therapeutic mechanisms are not fully understood. In this study we demonstrated that DRD5 (dopamine receptor D5) agonists were potent inhibitors of pituitary tumor growth. We further found that DRD5 activation increased production of reactive oxygen species (ROS), inhibited the MTOR pathway, induced macroautophagy/autophagy, and led to autophagic cell death (ACD) in vitro and in vivo. In addition, DRD5 protein was highly expressed in the majority of human pituitary adenomas, and treatment of different human pituitary tumor cell cultures with the DRD5 agonist SKF83959 resulted in growth suppression, and the efficacy was correlated with the expression levels of DRD5 in the tumors. Furthermore, we found that DRD5 was expressed in other human cancer cells such as glioblastomas, colon cancer, and gastric cancer. DRD5 activation in these cell lines suppressed their growth, inhibited MTOR activity, and induced autophagy. Finally, in vivo SKF83959 also inhibited human gastric cancer cell growth in nude mice. Our studies revealed novel mechanisms for the tumor suppressive effects of DRD5 agonists, and suggested a potential use of DRD5 agonists as a novel therapeutic approach in the treatment of different human tumors and cancers.     

Serum alpha-subunit elevation after TRH administration: a valuable test in presurgical diagnosis of gonadotropinoma?

OBJECTIVES: Clinically nonfunctioning pituitary adenomas (CNFPAs) represent about 30% of pituitary macroadenomas, gonadotropinomas being the most frequent among them. The aim of the present study is to re-evaluate the usefulness of the measurement of alpha-SU serum level in response to TRH stimulation in detecting the gonadotropic nature of nonfunctioning pituitary adenomas before the neurosurgical treatment. MATERIAL AND METHODS: We have studied 14 patients with CNFPAs. The response of alpha-SU to the administration of TRH was studied in each patient before the surgery. alpha-SU blood serum level increase over 50% of the baseline level after TRH treatment was considered to be significant. RESULTS: The patients were divided into 2 groups, each including 7 subjects. The first group included the patients with gonadotropinomas (tumors immunopositive for FSH and/or LH or their free subunits). The second group included the patients with adenomas immunonegative for gonadotropins and alpha-SU. The basal level of alpha-SU was elevated over the upper limit of normal range in two patients of the first group (gonadotroph adenomas) and in one in the second group. All but one patient from the first group and none of seven patients with tumors immunonegative for FSH, LH or alpha-SU, had a significant alpha-SU (over 50%) response to TRH. In three of seven patients with gonadotropins immunonegative tumors a decrease of alpha-SU serum level after TRH was observed. CONCLUSION: The measurement of alpha-SU serum level in response to TRH administration seems to be useful in preoperative identification of gonadotroph adenomas among other nonfunctioning pituitary adenomas.     

Chromogranin A in pituitary adenomas: immunohistochemical detection and plasma concentrations

Forty one pituitary adenomas excised surgically were immunostained to reveal pituitary hormones and chromogranin A (CgA). In 23 patients, plasma CgA concentration was determined before surgery by ELISA method. The CgA immunopositivity was found in 70.7% of investigated tumors. It was observed in all tumors of gonadotropinoma type and in the majority of null cell adenomas. Elevated (>18 U/L) plasma CgA concentration was observed in approx. a half of the examined patients, being more frequent in gonadotropinomas and null cell adenomas. It may have some, although limited, diagnostic value in these types of pituitary tumors.     

Proliferating cell nuclear antigen (PCNA) expression in pituitary adenomas: relationship to the endocrine phenotype of adenoma

The expression of proliferating cell nuclear antigen (PCNA) correlates to cell proliferation and for this reason it is commonly considered as one of proliferation markers. Since proliferation rate is an important factor determining the tumor aggressiveness, the evaluation of PCNA index (the percentage of PCNA-immunopositive nuclei in the investigated tumor sample) is suggested as useful in predicting pituitary adenoma outcome. Seventy three unselected, surgically removed pituitary adenomas were immunostained with antibodies against the pituitary hormones or their subunits and against the proliferating cell nuclear antigen (PCNA). The highest PCNA index was found in ACTH-immunopositive tumors without the manifestation of the Cushing's disease ("silent" corticotropinomas). This value was significantly different in comparison to other adenoma subtypes including corticotropinomas manifesting themselves by Cushing's disease. The lowest PCNA index was noticed in monohormonal GH-secreting tumors. The adenomas which express more than one hormone (plurihormonal adenomas) seem to have a higher PCNA indices than monohormonal ones; the difference was significant in the case of mono- and plurihormonal prolactinomas. The recurrent tumors presented a higher mean PCNA index as compared to the primary tumors, although the difference was significant only in the case of prolactinomas. These findings suggest that the proliferative potential of pituitary adenomas is related to the tumor recurrence and hormone expression.     

LRIG2蛋白在人催乳素腺瘤细胞中的表达研究

目的:明确LRIG2蛋白在人催乳素腺瘤细胞中的表达与定位。方法:采用免疫细胞化学方法检测LRIG2蛋白在人催乳素腺瘤原代细胞中表达情况,人胶质瘤细胞系U87细胞设为阳性对照。结果:LRIG2蛋白在原代培养的人催乳素腺瘤细胞中高表达(86.6±2.15)%,与其在U87细胞中表达率无明显统计学差异;同时免疫细胞化学结果提示LRIG2蛋白在人催乳素腺瘤细胞中定位于胞浆,也与其在U87细胞中表达一致。结论:LRIG2蛋白在人催乳素腺瘤细胞中高表达,定位于胞浆,提示其可能在垂体腺瘤发生、发展过程中发挥作用,为进一步研究垂体腺瘤发生机制奠定基础。     

Effect of 9-cis retinoic acid on dopamine D2 receptor expression in pituitary adenoma cells

The dopamine receptor subtype 2 (D2R) promoter contains a functional retinoic acid response element involved in the control of D2R expression. The aim of the study was to evaluate the effect of 9-cis retinoic acid (9-cis RA) on D2R protein expression in human pituitary adenomas and GH3 cell line. Treatment with 9-cis RA (100 nM for 48 hrs) caused a 109 +/- 32% increase of basal D2R levels in five of eight growth hormone (GH)-secreting adenomas (GH-omas), a 129 +/- 28% increase in 7 of 11 nonfunctioning adenomas, and no effect in two resistant prolactinomas by Western blotting. The lack of D2R induction in some tumors was not associated with a different pattern of retinoid x receptor (RXR) and retinoic acid receptor (RAR) isoform expression that was similar in all tumors by immunohistochemistry. While the induction of D2R did not affect the slight but significant inhibitory effect exerted by dopamine (10 nM) on in vitro GH release by GH-oma cultured cells, in pituitary GH3 cell lines cis-9 RA enhanced the dopamine-induced inhibition of in vitro GH release (% inhibition: 16 +/- 2 versus 26 +/- 5, P < 0.05), cell proliferation (25 +/- 2% versus 44 +/- 5%, P < 0.05) and cell viability (16 +/- 0.8% versus 29 +/- 1%, P < 0.05), likely by activating caspase-3 (28 +/- 3% versus basal, P < 0.05). In conclusion, this study provides novel evidence for a permissive role of retinoids on the expression of D2R in a good proportion of pituitary tumors and on the generation of pro-apoptotic signals in GH3 cell line.     

Differential expression of the neural cell adhesion molecule NCAM 140 in human pituitary tumors

We have analyzed the expression of the intracellular marker protein neuron specific enolase (NSE), synaptophysin (SYN) and of the cell surface marker NCAM (neural cell adhesion molecule) in both normal hypophysis and in pituitary adenomas in order to explore their potential use as diagnostic tools. All adenomas (4 prolactinomas, 3 growth hormone (GH) producing adenomas and 4 inactive adenomas) showed SYN and NSE immunoreactivity on tissue sections and this was confirmed by immunoblots. NCAM 140 (an isoform of NCAM with molecular mass 140 kDa) was detected by immunoblotting in normal human adenohypophysis, in all GH adenomas, and in three out of four inactive adenomas, but not in prolactinomas. Using highly sensitive techniques, NCAM immunoreactivity was observed by electron microscopy in all adenomas. These data indicate that NCAM 140 is a constituent of the cell surface of endocrine cells in both normal human adenohypophysis and its tumors. Since prolactinomas express very low levels of NCAM 140 compared to other hypophyseal tumors its virtual absence could be used for differential diagnosis. A combined analysis of NCAM, SYN and NSE could be useful to characterize inactive adenomas which are not immunoreactive for pituitary hormones and which may contain no or only low levels of the alpha chain of the glycoprotein hormones.     

垂体瘤微环境免疫细胞浸润与肿瘤侵袭性的相关性研究

目的:探讨垂体瘤免疫微环境中免疫细胞浸润情况及其与垂体瘤侵袭性的相关性。方法:选取35例垂体瘤病理组织切片,通过免疫组化染色分析巨噬细胞、T细胞以及中性粒细胞的特异性标记蛋白CD68、CD4、CD8和MPO的表达情况。结合临床和影像学数据分析,分析生长激素腺瘤、泌乳素腺瘤和无功能腺瘤的侵袭性与免疫细胞浸润数量的相关性。结果:在15例生长激素腺瘤,10例泌乳素腺瘤和10例无功能性腺瘤患者中,侵袭性垂体瘤中有更多的巨噬细胞浸润(P分别为0.014,0.032和0.032)。侵袭性促生长激素腺瘤、泌乳素腺瘤和无功能性腺瘤巨噬细胞浸润数量均明显多于非侵袭性促生长激素腺瘤、泌乳素腺瘤和无功能性腺瘤(P0.05)。结论:在垂体腺瘤中,巨噬细胞是肿瘤免疫微环境的主体。巨噬细胞浸润可能促进垂体瘤的进展。     

Estrogen receptors in human pituitary tumors.

The relationship between the presence of estrogen receptors in pituitary adenomas and the post surgical evolution of the patients in order to find another prognostic parameter for these tumors have been studied to improve the treatment selection. Estrogen receptors were studied by immunocytochemistry in histological sections of paraffin embedded 42 pituitary adenomas. Only 19% of these tumors were positive for estrogen receptors. As expected, the higher concentration (60%) was found in prolactin secreting adenomas, although we found estrogen receptors in one somatotroph and in one nonsecreting. The most aggressive tumors were those negative for estrogen receptors within the prolactinomas and the positive somatotrophinoma. The results of this work suggest that the determination of estrogen receptors in pituitary tumors might help as a prognostic factor in these adenomas.     

A modified immunohistochemical procedure for the detection of estrogen receptor in mouse tissues

Summary A horseradish peroxidase (HRP) labeled antibody method was developed for use with a monoclonal antibody to detect estrogen receptor (ER) in mouse tissue. Combined use of HRP labeled F(ab)₂ fragment absorbed with mouse liver protein to minimize background staining and imidazol-DAB reaction gave the most reliable and sensitive immunostaining.The method was applied to uterine, vaginal, pituitary and liver tissues in ovariectomized adult mice. In uterus and vagina, ER was recognized in nuclei of epithelial cells, stromal cells and smooth muscle cells of the muscle layer and blood vessels. Liver tissue showed positive nuclear immunostaining in parenchymal cells; however, no reaction was present in endothelial cells, Kupffer cells, bile ductal cells, and smooth muscle cells of blood vessels. ER was localized in the nuclei of anterior pituitary cells while weak reaction was also recognized in cells of the intermediate lobe. No staining was detected in the posterior pituitary.Results demonstrate that both occupied and unoccupied ER are localized in the cell nucleus from several target tissues. Weak immunostaining in samples could not be enhanced by multiple procedures. It is suggested that nuclear ER is partially hidden by nuclear components such as nuclei acid and chromatin proteins.     

The effect of selective sst1, sst2, sst5 somatostatin receptors agonists, a somatostatin/dopamine (SST/DA) chimera and bromocriptine on the "clinically non-functioning" pituitary adenomas in vitro

The aim of the work was to investigate the effects of somatostatin analogs acting selectively on sst1 (BIM-23926), sst2 (BIM-23120) and sst5 (BIM-23206) receptor subtypes on the viability of "clinically non-functioning" pituitary adenomas in vitro. The effects of native SST (SST-14), a SST/DA chimera (BIM-23A387) and a D(2)-dopamine receptor agonist bromocriptine (BC) were also examined. The study was performed on 10 surgically removed pituitary macroadenomas, diagnosed before surgery as "non-functioning". A part of each tumor was mechanically dispersed and digested with collagenase to isolate the tumoral cells. Another part of each tumor was fixed, embedded in paraffin and immunostained to reveal the pituitary hormones and SST receptor subtypes (sst1, sst2A, sst2B, sst3, sst4, sst5). The tumoral cell suspensions were incubated for 24 h with the substances mentioned above. The quantity of viable cells was estimated using the EZ4U system. The results were compared with the immunohistochemical evaluation of the hormonal profile of adenoma and the sst receptor subtype immunoreactivities present. The findings indicate that selective sst1, sst2 and sst5 receptors agonists, SST/DA chimera and D(2)-dopamine receptor agonist bromocriptine affect the viability of some, but not all, "clinically non-functioning" pituitary adenomas in vitro. The most effective was bromocriptine. The investigated somatostatin analogs including SST/DA chimera exerted roughly similar inhibitory effects. Further studies are needed to fully evaluate the potential usefulness of these compounds in the pharmacological treatment of "non-functioning" pituitary tumors.     

A modified immunohistochemical procedure for the detection of estrogen receptor in mouse tissues

A horseradish peroxidase (HRP) labeled antibody method was developed for use with a monoclonal antibody to detect estrogen receptor (ER) in mouse tissue. Combined use of HRP labeled F(ab')2 fragment absorbed with mouse liver protein to minimize background staining and imidazol-DAB reaction gave the most reliable and sensitive immunostaining. The method was applied to uterine, vaginal, pituitary and liver tissues in ovariectomized adult mice. In uterus and vagina, ER was recognized in nuclei of epithelial cells, stromal cells and smooth muscle cells of the muscle layer and blood vessels. Liver tissue showed positive nuclear immunostaining in parenchymal cells; however, no reaction was present in endothelial cells, Kupffer cells, bile ductal cells, and smooth muscle cells of blood vessels. ER was localized in the nuclei of anterior pituitary cells while weak reaction was also recognized in cells of the intermediate lobe. No staining was detected in the posterior pituitary. Results demonstrate that both occupied and unoccupied ER are localized in the cell nucleus from several target tissues. Weak immunostaining in samples could not be enhanced by multiple procedures. It is suggested that nuclear ER is partially hidden by nuclear components such as nucleic acid and chromatin proteins.     

Phenotypical and Pharmacological Characterization of Stem-Like Cells in Human Pituitary Adenomas

The presence and functional role of tumor stem cells in benign tumors, and in human pituitary adenomas in particular, is a debated issue that still lacks a definitive formal demonstration. Fifty-six surgical specimens of human pituitary adenomas were processed to establish tumor stem-like cultures by selection and expansion in stem cell-permissive medium or isolating CD133-expressing cells. Phenotypic and functional characterization of these cells was performed (1) ex vivo, by immunohistochemistry analysis on paraffin-embedded tissues; (2) in vitro, attesting marker expression, proliferation, self-renewal, differentiation, and drug sensitivity; and (3) in vivo, using a zebrafish model. Within pituitary adenomas, we identified rare cell populations expressing stem cell markers but not pituitary hormones; we isolated and expanded in vitro these cells, obtaining fibroblast-free, stem-like cultures from 38 pituitary adenoma samples. These cells grow as spheroids, express stem cell markers (Oct4, Sox2, CD133, and nestin), show sustained in vitro proliferation as compared to primary cultures of differentiated pituitary adenoma cells, and are able to differentiate in hormone-expressing pituitary cells. Besides, pituisphere cells, apparently not tumorigenic in mice, engrafted in zebrafish embryos, inducing pro-angiogenic and invasive responses. Finally, pituitary adenoma stem-like cells express regulatory pituitary receptors (D2R, SSTR2, and SSTR5), whose activation by a dopamine/somatostatin chimeric agonist exerts antiproliferative effects. In conclusion, we provide evidence that human pituitary adenomas contain a subpopulation fulfilling biological and phenotypical signatures of tumor stem cells that may represent novel therapeutic targets for therapy-resistant tumors.     

Comparative cytomorphology of pituitary adenomas and oligodendrogliomas in intraoperative crush preparations.

Minute fresh tissue fragments from 20 pituitary adenomas and 18 oligodendrogliomas were crushed between two glass slides and stained with hematoxylin and eosin for cytologic examination. These two tumor types displayed distinctive cytologic features that may permit their correct identification. Pituitary adenomas were characterized by single and clustered tumor cells with monomorphic, round or vesicular nuclei that were commonly denuded of cytoplasm. Rare well-preserved tumor cells showed well- or ill-defined, variable and granular cytoplasm. Oligodendrogliomas showed cells with monomorphic or slightly pleomorphic nuclei and scant, fibrillary, wispy cytoplasm, commonly arranged in clusters or around circular and empty spaces.     

Effect of LHRH on plasma 7B2 in patients with gonadotropin-producing pituitary adenomas.

Plasma immunoreactive (IR)-7B2 was measured in four patients with gonadotropin-producing pituitary adenomas. The basal level of plasma IR-7B2 was elevated in one of the four patients. Hyperresponse of plasma IR-7B2 to LHRH or LHRH/TRH was noted in two patients tested. 7B2 was positively stained in a paraffin-embedded section of gonadotropin-producing pituitary adenoma obtained at surgery. These findings suggest that 7B2 is produced in gonadotropin-producing pituitary adenomas and secreted into the blood stream under certain conditions. 7B2 may be a useful marker for gonadotropin-producing pituitary adenomas.     

Fetal Alcohol Exposure Reduces Dopamine Receptor D2 and Increases Pituitary Weight and Prolactin Production via Epigenetic Mechanisms

Recent evidence indicated that alcohol exposure during the fetal period increases the susceptibility to tumor development in mammary and prostate tissues. Whether fetal alcohol exposure increases the susceptibility to prolactin-producing tumor (prolactinoma) development in the pituitary was studied by employing the animal model of estradiol-induced prolactinomas in Fischer 344 female rats. We employed an animal model of fetal alcohol exposure that simulates binge alcohol drinking during the first two trimesters of human pregnancy and involves feeding pregnant rats with a liquid diet containing 6.7% alcohol during gestational day 7 to day 21. Control rats were pair-fed with isocaloric liquid diet or fed ad libitum with rat chow diet. Adult alcohol exposed and control female offspring rats were used in this study on the day of estrus or after estrogen treatment. Results show that fetal alcohol-exposed rats had increased levels of pituitary weight, pituitary prolactin (PRL) protein and mRNA, and plasma PRL. However, these rats show decreased pituitary levels of dopamine D2 receptor (D2R) mRNA and protein and increased pituitary levels of D2R promoter methylation. Also, they show elevated pituitary mRNA levels of DNA methylating genes (DNMT1, DNMT3b, MeCP2) and histone modifying genes (HDAC2, HDAC4, G9a). When fetal alcohol exposed rats were treated neonatally with a DNA methylation inhibitor 5-Aza deoxycytidine and/or a HDAC inhibitor trichostatin-A their pituitary D2R mRNA, pituitary weights and plasma PRL levels were normalized. These data suggest that fetal alcohol exposure programs the pituitary to increase the susceptibility to the development of prolactinomas possibly by enhancing the methylation of the D2R gene promoter and repressing the synthesis and control of D2R on PRL-producing cells.     

Dopaminergic inhibition of DNA synthesis in pituitary tumor cells is associated with phosphotyrosine phosphatase activity.

Dopaminergic D2 receptor agonists, such as bromocriptine, are potent anti-proliferative agents in the treatment of human pituitary adenomas. We have reproduced the anti-proliferative effect of dopamine in an established pituitary cell line stably transfected with the rat D2 dopamine receptor cDNA. We found that dopaminergic inhibition of DNA synthesis parallels the stimulation of a phosphotyrosine phosphatase activity. Both actions are blocked by pertussis toxin and by the phosphotyrosine phosphatase inhibitor, vanadate. We suggest that the anti-proliferative action of dopamine is mediated, at least in part, by the dopaminergic stimulation of a phosphotyrosine phosphatase.