Aldehyde dehydrogenase activity selects for the holoclone phenotype in prostate cancer cells

Aldehyde dehydrogenase 1 (ALDH) activity is considered to be a marker of cancer stem cells (CSCs) in many tumour models, since these cells are more proliferative and tumourigenic than ALDH^Lo cells in experimental models. However it is unclear whether all CSC-like cells are within the ALDH^Hi population, or whether all ALDH^Hi cells are highly proliferative and tumourigenic. The ability to establish a stem cell hierarchy in vitro, whereby sub-populations of cells have differing proliferative and differentiation capacities, is an alternate indication of the presence of stem cell-like populations within cell lines. In this study, we have examined the interaction between ALDH status and the ability to establish a stem cell hierarchy in PC3 prostate cancer cells. We demonstrate that PC3 cells contain a stem cell hierarchy, and isolation of ALDH^Hi cells enriches for the most primitive holoclone population, however holoclone formation is not restricted to ALDH^Hi cells. In addition, we show that ALDH activity undergoes phenotypic plasticity, since the ALDH^Lo population can develop ALDH^Hi populations comparable to parental cells within 2 weeks in culture. Furthermore, we show that the majority of ALDH^Hi cells are found within the least primitive paraclone population, which is circumvented by culturing PC3 cells as spheroids in defined medium favouring stem cell characteristics. Although ALDH^Hi status enriches for holoclone formation, this activity may be mediated by a minority of ALDH^Hi cells.