Prognostic value of tumoral sialyltransferase expression and circulating E-selectin concentrations in node-negative breast cancer patients

AIMS AND BACKGROUND: A crucial step in the metastatic process is the interaction between the endothelial molecule E-selectin and its tumoral ligands sialyl-Lewis- and sialyl-Lewis. Sialyltranferases are involved in the biosynthesis of these ligands. The aim of this study was to assess the prognostic value of tumoral sialyltransferase expression and of circulating soluble E-selectin (sE-selectin) in node-negative breast cancer patients. METHODS: Using a multiplex RT-PCR method, we measured the expression of five sialyltransferases (ST3Gal III, ST6Gal I, ST3Gal IV, ST3Gal I and ST3Gal II) in tumors of 135 surgically treated node-negative breast cancer patients. Circulating sE-selectin concentrations were measured by an ELISA method prior to surgery. We also analyzed tumor size, histoprognostic grading and steroid hormone receptor status. RESULTS: The median follow-up was 7.5 years. Expression of estrogen receptors was associated with a good prognosis for relapse-free survival in univariate analysis. A high ST3Gal III/ST6Gal I ratio and a high sE-selectin concentration were associated with a bad prognosis for relapse-free survival and overall survival in univariate and multivariate analysis. CONCLUSION: In the present study, tumoral sialyltransferase expression and circulating sE-selectin concentrations had prognostic value in patients with node-negative breast cancer. This result provides further evidence for the important role of these agents in the metastatic process.     

Expression of Cell Adhesion Molecules, their Ligands and Tumour Necrosis Factor α in the Liver of Patients with Metastatic Gastrointestinal Carcinomas

The expression of the following cell adhesion molecules, their β1 and β2 integrin ligands and the cytokine tumour necrosis factor-α (TNF-α) was investigated by light and electron microscope immunohistochemistry in the liver tissue in 20 patients with colorectal and gastric cancer also presenting with liver metastases: intercellular adhesion molecule-1 (ICAM-1), vascular endothelial adhesion molecule-1 (VCAM-1), E-selectin, leucocyte function-associated antigen-1 (LFA-1), macrophage antigen-1 (Mac-1), and very late antigen-4 (VLA-4). We have found a parallel enhancement of the adhesion molecules and of TNF-α in liver sinusoids surrounding metastases. The expression of ICAM-1 was enhanced on sinusoidal cells in all zones of the acinus. VCAM-1 immune reactivity was diffuse but less intensive in the lobule. E-selectin expression was observed in sinusoidal cells attached to metastases. In tumour metastases the expression of ICAM-1, VCAM-1, and E-selectin was visible on the tumour vascular endothelium. Tumour infiltrating host cells sowing positive immunoreactivity for ICAM-1, VCAM-1, LFA-1, Mac-1, and VLA-4 were located mainly at the boundary between liver parenchyma and the metastasis. At the ultrastructural level, ICAM-1-positive immune deposits were observed on the cellular membrane and in some transport vesicles of gastric metastatic cells. Further, the expression of all adhesion molecules was confirmed to sinusoidal endothelial cells and tumour vessels. It is concluded that the enhanced expression of adhesion molecules in liver sinusoids could be a marker for the assessment of the ability of sinusoidal endothelial cells to control the recruitment of leukocytes and monocytes to the metastatic site. They could also direct the adhesion of new circulating tumour cells to sinusoidal endothelium.     

Serum Concentration and Chemotactic Activity of E-selectin (CD62E) in Inflammatory Bowel Disease

E-selectin (CD62E) is an endothelial specific glycoprotein belonging to the selectin family of adhesion molecules. Because a high expression of this molecule at intestinal mucosal surfaces in inflammatory bowel disease (IBD) has been described earlier, the aim was to assess serum levels of E-selectin (sE-selectin) and to correlate it to disease activity, and further to evaluate its chemotactic properties at physiological concentrations. Levels of sEselectin were measured by a sandwich ELISA technique in 31 IBD patients together with 15 healthy volunteers. In ulcerative colitis the median value was 0.46 nM (0.16-0.75), in Crohn's disease 0.47 nM (0.22-1.24), and in healthy controls 0.34 nM (0.22-0.83). No statistically significant differences in sE-selectin were revealed between these groups (p > 0.05). The in vitro chemotactic capabilities of E-selectin (in the concentration range of 0.10-31.4 nM) were assessed using the leading front technique. A significantly increased migratory response was found at concentrations of 1.00 (p < 0.05) and 3.14 nM (p < 0.02). It is concluded that sE-selectin in contrast to sICAM-1 does not act as a sensitive indicator of local immune activation in IBD. However, E-selectin may be important for recruitment and accumulation of neutrophilic granulocytes and other phagocytes involved in the inflammatory process seen in IBD. Future investigations are encouraged in order to reveal its in vivo effects.     

Expression of cell adhesion molecules,their ligands and tumour necrosis factor alpha in the liver of patients with metastatic gastrointestinal carcinomas

The expression of the following cell adhesion molecules, their 1 and 2 integrin ligands and the cytokine tumour necrosis factor- (TNF-) was investigated by light and electron microscope immunohistochemistry in the liver tissue in 20 patients with colorectal and gastric cancer also presenting with liver metastases: intercellular adhesion molecule-1 (ICAM-1), vascular endothelial adhesion molecule-1 (VCAM-1), E-selectin, leucocyte function-associated antigen-1 (LFA-1), macrophage antigen-1 (Mac-1), and very late antigen-4 (VLA-4). We have found a parallel enhancement of the adhesion molecules and of TNF- in liver sinusoids surrounding metastases. The expression of ICAM-1 was enhanced on sinusoidal cells in all zones of the acinus. VCAM-1 immune reactivity was diffuse but less intensive in the lobule. E-selectin expression was observed in sinusoidal cells attached to metastases. In tumour metastases the expression of ICAM-1, VCAM-1, and E-selectin was visible on the tumour vascular endothelium. Tumour infiltrating host cells sowing positive immunoreactivity for ICAM-1, VCAM-1, LFA-1, Mac-1, and VLA-4 were located mainly at the boundary between liver parenchyma and the metastasis. At the ultrastructural level, ICAM-1-positive immune deposits were observed on the cellular membrane and in some transport vesicles of gastric metastatic cells. Further, the expression of all adhesion molecules was confirmed to sinusoidal endothelial cells and tumour vessels. It is concluded that the enhanced expression of adhesion molecules in liver sinusoids could be a marker for the assessment of the ability of sinusoidal endothelial cells to control the recruitment of leukocytes and monocytes to the metastatic site. They could also direct the adhesion of new circulating tumour cells to sinusoidal endothelium.     

E-selectin modulates the malignant properties of T84 colon carcinoma cells

The extravasation of metastatic cells is regulated by molecular events involving the initial adhesion of tumor cells to the endothelium and subsequently the migration of cells in the host connective tissue. E-selectin on endothelial cells and sialyl Lewis X carbohydrate component on tumor cells are mainly involved in the adhesion of colon carcinoma cells to the endothelium of target organ. Interaction of T84 colon cancer cells to purified E-selectin in vitro caused an increase in the tyrosine phosphorylation of a number of proteins as well as the modulation of cellular properties correlated to the metastatic phenotype. Specifically, E-selectin-stimulated actin reorganization, increased collagenase secretion, and induced cell migration. Treatment of T84 cells with herbimycin A inhibited cell adhesion as well as selectin-induced increase of cell migration, and cytoskeleton assembly. Our data demonstrate that binding of cancer cells to E-selectin starts signal transduction pathways which may affect the tumor metastatic abilities.     

Adhesive force of human hepatoma HepG2 cells to endothelial cells and expression of E-selectin

Expression of adhesion molecules may play an important role in the interaction of tumor cells with vascular endothelial cells during tumor invasion and metastasis. In this study, the adhesive force of human hepatoma HepG2 cells to human umbilical vein endothelial cells (HUVECs) was investigated using a micropipette aspiration technique. Expression of an adhesion molecule, E-selectin, was also observed by immunofluorescence microscopy. In particular, the adhesive force after stimulation of HUVECs with recombinant human interleukin-1beta (rhIL-1beta) was examined. The results demonstrated that the adhesive force of HepG2 cells to stimulated HUVECs is significantly higher than that of unstimulated control cells, and that immunofluorescence of E-selectin in stimulated HUVECs showed a higher fluorescent intensity compared to control cells. Moreover, addition of monoclonal anti-human E-selectin decreased the adhesive force of HepG2 cells to stimulated HUVECs by 50%. These results suggest that endothelial E-selectin may be a main mediator of carcinoma metastasis of malignant tumor through blood circulation, possibly increasing the adhesive force of human hepatoma HepG2 cells to HUVECs in the early stage of metastases.     

Circulating Tumor Cells from Prostate Cancer Patients Interact with E-Selectin under Physiologic Blood Flow

Hematogenous metastasis accounts for the majority of cancer-related deaths, yet the mechanism remains unclear. Circulating tumor cells (CTCs) in blood may employ different pathways to cross blood endothelial barrier and establish a metastatic niche. Several studies provide evidence that prostate cancer (PCa) cell tethering and rolling on microvascular endothelium via E-selectin/E-selectin ligand interactions under shear flow theoretically promote extravasation and contribute to the development of metastases. However, it is unknown if CTCs from PCa patients interact with E-selectin expressed on endothelium, initiating a route for tumor metastases. Here we report that CTCs derived from PCa patients showed interactions with E-selectin and E-selectin expressing endothelial cells. To examine E-selectin-mediated interactions of PCa cell lines and CTCs derived from metastatic PCa patients, we used fluorescently-labeled anti-prostate specific membrane antigen (PSMA) monoclonal antibody J591-488 which is internalized following cell-surface binding. We employed a microscale flow device consisting of E-selectin-coated microtubes and human umbilical vein endothelial cells (HUVECs) on parallel-plate flow chamber simulating vascular endothelium. We observed that J591-488 did not significantly alter the rolling behavior in PCa cells at shear stresses below 3 dyn/cm². CTCs obtained from 31 PCa patient samples showed that CTCs tether and stably interact with E-selectin and E-selectin expressing HUVECs at physiological shear stress. Interestingly, samples collected during disease progression demonstrated significantly more CTC/E-selectin interactions than samples during times of therapeutic response (p=0.016). Analysis of the expression of sialyl Lewis X (sLe^x) in patient samples showed that a small subset comprising 1.9-18.8% of CTCs possess high sLe^x expression. Furthermore, E-selectin-mediated interactions between prostate CTCs and HUVECs were diminished in the presence of anti-E-selectin neutralizing antibody. CTC-Endothelial interactions provide a novel insight into potential adhesive mechanisms of prostate CTCs as a means to initiate metastasis.     

Tumor-Associated Endothelial Cells Promote Tumor Metastasis by Chaperoning Circulating Tumor Cells and Protecting Them from Anoikis

Tumor metastasis is a highly inefficient biological process as millions of tumor cells are released in circulation each day and only a few of them are able to successfully form distal metastatic nodules. This could be due to the fact that most of the epithelial origin cancer cells are anchorage-dependent and undergo rapid anoikis in harsh circulating conditions. A number of studies have shown that in addition to tumor cells, activated endothelial cells are also released into the blood circulation from the primary tumors. However, the precise role of these activated circulating endothelial cells (CECs) in tumor metastasis process is not known. Therefore, we performed a series of experiments to examine if CECs promoted tumor metastasis by chaperoning the tumor cells to distal sites. Our results demonstrate that blood samples from head and neck cancer patients contain significantly higher Bcl-2-positive CECs as compared to healthy volunteers. Technically, it is challenging to know the origin of CECs in patient blood samples, therefore we used an orthotopic SCID mouse model and co-implanted GFP-labeled endothelial cells along with tumor cells. Our results suggest that activated CECs (Bcl-2-positive) were released from primary tumors and they co-migrated with tumor cells to distal sites. Bcl-2 overexpression in endothelial cells (EC-Bcl-2) significantly enhanced adhesion molecule expression and tumor cell binding that was predominantly mediated by E-selectin. In addition, tumor cells bound to EC-Bcl-2 showed a significantly higher anoikis resistance via the activation of Src-FAK pathway. In our in vivo experiments, we observed significantly higher lung metastasis when tumor cells were co-injected with EC-Bcl-2 as compared to EC-VC. E-selectin knockdown in EC-Bcl-2 cells or FAK/FUT3 knockdown in tumor cells significantly reversed EC-Bcl-2-mediated tumor metastasis. Taken together, our results suggest a novel role for CECs in protecting the tumor cells in circulation and chaperoning them to distal sites.     

Enhanced activity of meprin-α, a pro-migratory and pro-angiogenic protease, in colorectal cancer

Meprin-α is a metalloprotease overexpressed in cancer cells, leading to the accumulation of this protease in a subset of colorectal tumors. The impact of increased meprin-α levels on tumor progression is not known. We investigated the effect of this protease on cell migration and angiogenesis in vitro and studied the expression of meprin-α mRNA, protein and proteolytic activity in primary tumors at progressive stages and in liver metastases of patients with colorectal cancer, as well as inhibitory activity towards meprin-α in sera of cancer patient as compared to healthy controls. We found that the hepatocyte growth factor (HGF)-induced migratory response of meprin-transfected epithelial cells was increased compared to wild-type cells in the presence of plasminogen, and that the angiogenic response in organ-cultured rat aortic explants was enhanced in the presence of exogenous human meprin-α. In patients, meprin-α mRNA was expressed in colonic adenomas, primary tumors UICC (International Union Against Cancer) stage I, II, III and IV, as well as in liver metastases. In contrast, the corresponding protein accumulated only in primary tumors and liver metastases, but not in adenomas. However, liver metastases lacked meprin-α activity despite increased expression of the corresponding protein, which correlated with inefficient zymogen activation. Sera from cancer patients exhibited reduced meprin-α inhibition compared to healthy controls. In conclusion, meprin-α activity is regulated differently in primary tumors and metastases, leading to high proteolytic activity in primary tumors and low activity in liver metastases. By virtue of its pro-migratory and pro-angiogenic activity, meprin-α may promote tumor progression in colorectal cancer.     

Sialyl Lewis(a): a tumor-associated carbohydrate antigen involved in adhesion and metastatic potential of cancer cells

Neoplastic transformation is often associated with characteristic changes in the expression of the sialyl Lewis(a) and sialyl Lewis(x) antigens, representing typical tumor-associated carbohydrate antigens. High amounts of sialyl Lewis(a) are present in human adenocarcinomas of the colon, pancreas and stomach. A growing amount of data suggests that this carbohydrate structure is the ligand for E-selectin. Sialylated Lewis structures present on the surface of tumor cells are carried by the carbohydrate chains of glycoproteins and glycolipids. There are several lines of evidence showing that sialyl Lewis(a) is responsible for the adhesion of human cancer cells to endothelium. E-selectin present on endothelial cells mediates these interactions. Selectins and their carbohydrate ligands can thus play an important role in the selective homing of tumor cells during metastasis. However, the presence of sialyl Lewis(a) antigen on the surface of tumor cells and their adhesion to E-selectin-expressing cells in in vitro adhesion assay by itself can not be directly related to metastatic properties of all cancer cells.     

Markers of vascular endothelial cell damage and P. falciparum malaria: association between levels of both sE-selectin and thrombomodulin, and cytokines, hemoglobin and clinical presentation

We investigated associations between markers of damage of vascular endothelial cells (MDVECs) and plasma cytokine levels, hemoglobin level and temperature in individuals with acute uncomplicated malaria, as well as healthy controls, using enzyme linked immunosorbent assay (ELISA) for the presence of soluble endothelial cell adhesion molecule-1 (sE-selectin), circulating granule membrane protein-140 (sP-selectin), circulating thrombomodulin (TM), circulating von Willebrand factor (VWf), interferon gamma (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha). Significant differences were observed between falciparum malaria patients and the healthy people in term of levels of both sE-selectin and TM. The serum levels of sP-selectin and VWf were comparable between the two groups. The levels of both sE-Selectin and TM correlated positively with temperature, levels of IFN-gamma and levels of TNF-alpha; and negatively with hemoglobin levels. Trends of positive correlations were observed between level of sP-selectin or VWf and temperature. Furthermore, sE-selectin levels correlated with vomiting. These data suggest that sE-selectin and TM might be useful markers of endothelium activation in in vivo studies. Moreover, our results highlight the use of both sE-selctin and TM as markers of anemia.     

A novel effect of polymorphonuclear leukocytes in the facilitation of angiogenesis

The purpose of this study was to examine whether the adhesion of polymorphonuclear leukocytes (PMNs) to endothelial cells and/or reactive oxygen species (ROS) released from PMNs are responsible for inducing angiogenesis. Angiogenesis was assessed by tube formation using endothelial cells obtained from bovine thoracic aorta (BAECs) grown on a layer of collagen type I. Addition of PMNs to BAECs weakly induced angiogenesis. The angiogenesis induced by PMNs alone was further enhanced by treatment of the PMNs with N-formyl-methionyl-leucyl-phenylalanine (FMLP), a selective activator of PMN. The involvement of PMN adhesion to BAECs via adhesion molecules in angiogenesis was investigated by using monoclonal antibodies against E-selectin and intercellular adhesion molecule-1 (ICAM-1). These antibodies blocked both the PMN adhesion to BAECs and the enhancement of angiogenesis induced by FMLP-treated PMNs. Furthermore, the enhancement of angiogenesis by FMLP-treated PMNs was blocked by catalase, a scavenging enzyme of H2O2, but not by superoxide dismutase (SOD). These results suggest that PMNs induce angiogenesis in vitro, and that the mechanism of stimulation of angiogenesis by PMNs may involve the adherence of PMNs to endothelial cells via E-selectin and ICAM-1, and H2O2, but not superoxide. Thus, activated PMNs in pathological states may not only induce tissue injury, but may also function as regulators of angiogenesis.     

Role of calcium in E-selectin induced phenotype of T84 colon carcinoma cells

The adhesion of cancer cells to the endothelium during the metastatic process involves the interaction of specific cell-cell adhesion receptors on the cell surface. E-selectin on endothelial cells and sialyl Lewis X carbohydrate component on tumor cells are mainly implicated in the adhesion of colon carcinoma cells to the endothelium of target organ. In this paper we show that binding of E-selectin to T84 colon tumor cells causes approximately a twofold increase in intracellular calcium concentration. In particular, using two inhibitors of receptor operated calcium channels, CAI and SK&F 96365, we present evidences that the augmentation in cytoplasmic calcium originates from ionic influx from extracellular sources. Furthermore, we demonstrated that modulation of [Ca2+]i by engagement of E-selectin receptor starts signal transduction pathways that affect cell spreading, tyrosine phosphorylation signaling, and cancer cell motility.     

Levels of soluble VCAM-1, soluble ICAM-1, and soluble E-selectin in patients with tuberculous pleuritis

Tuberculosis is characterized by the presence of activated mononuclear cells both in the peripheral circulation and in pleural fluid. Expression and up-regulation of adhesion molecules is the basis of cell-cell adhesion in granuloma formation and in leukocyte migration to the inflammatory site. Soluble isoforms of adhesion molecules have been described, and their expression at high levels indicated an activated state. The purpose of this study was to evaluate levels of soluble adhesion molecules in serum and pleural fluid from patients with tuberculous pleural effusions, compared with non-tuberculous pleural effusions. We analysed levels of soluble vascular cell adhesion molecule-1 (s.VCAM-1), soluble intercellular adhesion molecule-1 (s.ICAM-1), and soluble E-selectin (sE-selectin) in serum and pleural fluid from patients with tuberculous pleuritis, by sandwich ELISA. Serum levels of s.ICAM-1 and s.VCAM-1 in patients with tuberculosis were higher than those in healthy controls (p < 0.001). Levels of sE-selectin levels were in the normal range compared with control groups. In pleural fluid, levels of s.VCAM-1 and s.ICAM-1 were increased in pleural effusions. Patients with tuberculous pleural effusion exhibited high levels of s.ICAM-1 compared with patients with neoplastic pleural involvement. Up-regulation of s.VCAM-1 and s.ICAM-1 in serum, along with increased levels of sE-selectin in pleural effusions from tuberculous patients, may result in transmigration of activated inflammatory cells inducing pleural damage, which may contribute to the pathological processes involved.     

Expression of adhesion molecules during cadmium hepatotoxicity

Inflammatory processes play a major role in the secondary injury of the liver produced by cadmium (Cd), and infiltration of neutrophils at the site of necrosis is a common observation. Although the infiltration of leukocytes (mainly neutrophils) into sites of injuried tissue within liver during Cd toxicity is mediated by adhesion molecules, little is known about expression of these adhesion molecules during Cd hepatotoxicity. In the present study, the expression of E-, P-selectin, intracellular adhesion molecule-1 (ICAM-1) and platelet-endothelial adhesion molecule-1 (PECAM-1) was analyzed by immunohistochemistry and immunofluoresence during Cd-induced hepatotoxicity in male rats. In contrast to E-, and P-selectin, ICAM-1 and PECAM-1 were constitutively expressed on sinusoidal endothelial cells of control liver. However, P-selectin was not induced within the liver by Cd administration, whereas E-selectin expression was induced in the liver with a marked increase in immunostaining on sinusoidal endothelial cells from 12 h to 7 days. Also, there was an upregulation in ICAM-1 immunostaining on sinusoidal endothelial cells from 12 h to 7 days after Cd administration, whereas there was no obvious change of PECAM-1 immunostaining on sinusoidal endothelial cells until 24 h. However, PECAM-1 expression was markedly decreased at 48 h but significantly increased at 7 days after Cd administration compared to control liver. Taken together, upregulation of E-selectin and ICAM-1 with biphasic changes in PECAM-1 expression within liver after Cd administration suggests an important role for these adhesion molecules during Cd hepatoxicity.     

Heparan sulfate and chondroitin sulfate proteoglycans inhibit E-selectin binding to endothelial cells

E-selectin is a cell adhesion molecule involved in the initial rolling and adhesion of leukocytes to the endothelium during inflammation. In addition, in vitro studies have suggested that an interaction between E-selectin and binding sites such as sialyl Lewis X-containing oligosaccharides on endothelial cells may be important for angiogenesis. In order to investigate the binding of E-selectin to endothelial cells, we developed an ELISA assay using chimeric E-selectin-Ig molecules and endothelial cells fixed on poly-L-lysine coated plates. Our results indicate that E-selectin-Ig binds to both bovine capillary endothelial cells and human dermal microvascular endothelial cells in a calcium-dependent and saturable manner. The binding is inhibited markedly by heparin and by syndecan-1 ectodomain, and moderately by chondroitin sulfate, but not by sialyl Lewis X-containing oligosaccharides. These results suggest that heparan sulfate and chondroitin sulfate proteoglycans on endothelial cells are potential ligands for E-selectin.     

Crossing the endothelium: E-selectin regulates tumor cell migration under flow conditions

Diapedesis is a vital part of tumor metastasis, whereby tumor cells attach to and cross the endothelium to enter the circulation. Specific adhesion molecules, expressed by both the tumor and endothelial cells, mediate this process. This review summarizes recent findings regarding the mechanisms by which colon cancer cells migrate through the endothelium under flow conditions mediated by E-selectin. Using a laminar flow chamber and a tissue engineered human blood vessel, E-selectin was found to regulate initial attachment and rolling of colon cancer cells and also the subsequent diapedesis through the endothelium. Three different mechanisms of diapedesis were reported to be regulated by E-selectin; the formation of a mosaic chimeric layer of tissue, paracellular diapedesis between endothelial cells and transcellular diapedesis, in which tumor cells were transported via large vacuoles within the endothelial cells. Moreover activation of extracellular signal-regulated kinase (ERK) mitogen-activated protein kinase by E-selectin was further required for paracellular diapedesis. This study is the first to report these observations under dynamic and shear stress conditions.Key words: E-selectin, endothelium, tumor cells, diapedesis, site-specific metastasisDuring metastasis, tumor cells must complete a number of stages to successfully migrate from one site in the body to another. These include detachment of cells from the primary tumor, degradation and migration through the surrounding extra cellular matrix, extravasation and survival in the circulation and arrest in distant capillaries.¹ Once at the secondary site, they must undergo the reverse process before initiating growth and angiogenesis to support their development. This is a highly inefficient process, with few cells completing all stages to establish metastases.²The process of extravasation involves the diapedesis of tumor cells across the endothelium (‘dia’ meaning through and ‘pèdan’ meaning to leap). Similar to neutrophil extravasation at sites of inflammation, tumor cells initially adhere to the endothelium forming loose interactions via adhesion molecules before rolling and finally forming firm attachments, prior to diapedesis. Site-specific metastasis has been described for a number of tumors, with specific interactions between the tumor and endothelial cells potentially playing a pivotal role. Expression of E-selectin by endothelial cells following activation by inflammatory cytokines for example, is reported to be involved with the homing of colon cancer cells to the liver.^3–5 This review summarizes recent findings by Tremblay et al. (2008), published in Cancer Research, in which three distinct mechanisms of transendothelial migration by colon cancer cells are described, ultilizing E-selectin adhesion molecules on the endothelium (Fig. 1): (1) paracellular diapedesis at endothelial junctions, (2) formation of mosaic chimeric tissue of tumor and endothelial cells and (3) transcellular diapedesis.⁶Open in a separate windowFigure 1Schematic representation of the three mechanisms that colon cancer cells use during diapedesis of the endothelium. Under flow conditions, tumor cells initially form loose attachments with the endothelium, prior to rolling and forming firm attachments, mediated by specific adhesion molecules such as E-selectin. Following firm adhesion, tumor cells initiate diapedesis by (1) migrating between the junctions of endothelial cells (paracellular diapedesis), (2) forming a mosaic chimeric layer of both cell types (although this may not lead to complete diapedesis) and (3) passaging through the endothelial cells in large vacuoles (transcellular diapedesis).To demonstrate the importance of E-selectin in the adhesion of colon cancer cells to the endothelium, a laminar flow chamber was initially used. Human umbilical vein endothelial cells (HUVECs), expressing WT or a truncated form of E-selectin (with a cytoplasmic domain deleted) (ES-ΔICD) grown as a monolayer on glass slides, were treated for four hours with IL-1β to induce E-selectin expression. Cultures were then placed in a laminar flow chamber with culture medium and shear stress applied. HT29 colon cancer cells were then injected into the flow chamber, video sequences were recorded after 10 and 30 minutes and the subsequent HT29 cells that had adhered to the HUVECs was counted. The results demonstrated that colon cancer cells adhered to the endothelium under flow conditions using E-selectin, but only following treatment with IL-β. Blocking E-selectin and mutating the intracellular domain of E-selectin both prevented tumor cell adhesion. Similar results were also generated using a tissue-engineered human blood vessel, to more closely mimic the in vivo situation.⁷ Using these systems, the authors verified that E-selectin activation by circulating colon cancer cells is involved in p38 and ERK activation, via the intracellular domain.Using HT29 cells labeled with Vybrant Di1, the authors next used time-lapse microscopy over a 24-hour period to investigate the mechanisms by which colon cancer cells migrate through the endothelium under flow conditions. With endothelial cells expressing WT and truncated E-selectin, E-selectin was found to mediate initial attachment and rolling of the HT29 cells on the endothelial layer, in support of their previous results. Interestingly, most adhered tumor cells penetrated the endothelium, with 75% inserting themselves within the endothelial cell layer, creating a chimeric mosaic (Fig. 1). Many of these cells however did not complete migration through the endothelium and this was especially the case when using endothelial cells expressing E-selectin with the truncated intracellular domain, suggesting that this region was required for tumor cells to complete diapedesis.Of the cells that penetrated the endothelium, only 25% of the colon cancer cells completed diapedesis. This process was observed by two different mechanisms (Fig. 1). Firstly, at the junction of three endothelial cells, HT29 cells migrated between the cells (i.e., paracellular diapedesis); this required E-selectin signaling to ERK. Secondly, transcellular migration was also observed, in which tumor cells attached to the endothelial cells (not at the cell junctions) and induced endothelial cell retraction and blebbing. As a result tumor cells were engulfed within large vacuoles in the endothelial cells and transported across the cell. This was accompanied by loss of endothelial contact with the extracellular matrix. Interestingly this process was not fatal for all endothelial cells and some remained in the culture medium.In conclusion, this is the first paper to demonstrate three different mechanisms by which colon cancer cells migrate through the endothelium under conditions of shear stress, in an E-selectin-dependent fashion. Although a large proportion of tumor cells remained within the endothelium as a mosaic layer and did not complete diapedesis, the authors concluded that such cells form a subpopulation of tumor cells that are capable of initiating, but not completing extravasation, potentially due to nature of the tight junctions between the endothelial cells.^8,9 If proliferation is then stimulated, such cells may further be responsible for the development of local metastases within the vessel. A small percentage of tumor cells however completed diapedesis. This occurred either at the junction of endothelial cells (paracellular) or of particular interest whereby tumor cells crossed through the endothelial cells (transcellular). Similar data have been described previously for neutrophils,¹⁰ but this is the first study to demonstrate this phenomenon with tumor cells via E-selectin. This work provides new insights in understanding the mechanisms by which tumor cells cross blood vessel walls and the metastatic process.     

Transendothelial migration of colon carcinoma cells requires expression of E-selectin by endothelial cells and activation of stress-activated protein kinase-2 (SAPK2/p38) in the tumor cells.

Adhesion and migration of tumor cells on and through the vascular endothelium are critical steps of the metastatic invasion. We investigated the roles of E-selectin and of stress-activated protein kinase-2 (SAPK2/p38) in modulating endothelial adhesion and transendothelial migration of HT-29 colon carcinoma cells. Tumor necrosis factor alpha (TNF alpha) strongly increased the expression of E-selectin in human umbilical vein endothelial cells (HUVEC). This effect was independent of the activation of SAPK2/p38 induced by TNF alpha. Adhesion of HT-29 cells on a monolayer of HUVEC pretreated with TNF alpha was dependent on E-selectin expression but was independent of SAPK2/p38 activity of both HUVEC and tumor cells. The adhesion of HT-29 cells to E-selectin-expressing HUVEC led to the activation of SAPK2/p38 in the tumor cells as reflected by the increased phosphorylation of the actin-polymerizing factor HSP27 by mitogen-activated protein kinase 2/3, a direct target of SAPK2/p38. Moreover, a recombinant E-selectin/Fc chimera quickly increased the activation of SAPK2/p38 in HT-29 cells. Blocking the increased activity of SAPK2/p38 of HT-29 cells by SB203580 or by expressing a dominant negative form of SAPK2/p38 inhibited their transendothelial migration. Similarly, HeLa cells stably expressing a kinase-inactive mutant of SAPK2/p38 showed a decreased capacity to cross a layer of HUVEC. Overall, our results suggest that the regulation of transendothelial migration of tumor cells involves two essential steps as follows: adhesion to the endothelium through adhesion molecules, such as E-selectin, and increased motogenic potential through adhesion-mediated activation of the SAPK2/p38 pathway.