Probing the O-Glycoproteome of Gastric Cancer Cell Lines for Biomarker Discovery

Circulating O-glycoproteins shed from cancer cells represent important serum biomarkers for diagnostic and prognostic purposes. We have recently shown that selective detection of cancer-associated aberrant glycoforms of circulating O-glycoprotein biomarkers can increase specificity of cancer biomarker assays. However, the current knowledge of secreted and circulating O-glycoproteins is limited. Here, we used the COSMC KO “SimpleCell” (SC) strategy to characterize the O-glycoproteome of two gastric cancer SimpleCell lines (AGS, MKN45) as well as a gastric cell line (KATO III) which naturally expresses at least partially truncated O-glycans. Overall, we identified 499 O-glycoproteins and 1236 O-glycosites in gastric cancer SimpleCells, and a total 47 O-glycoproteins and 73 O-glycosites in the KATO III cell line. We next modified the glycoproteomic strategy to apply it to pools of sera from gastric cancer and healthy individuals to identify circulating O-glycoproteins with the STn glycoform. We identified 37 O-glycoproteins in the pool of cancer sera, and only nine of these were also found in sera from healthy individuals. Two identified candidate O-glycoprotein biomarkers (CD44 and GalNAc-T5) circulating with the STn glycoform were further validated as being expressed in gastric cancer tissue. A proximity ligation assay was used to show that CD44 was expressed with the STn glycoform in gastric cancer tissues. The study provides a discovery strategy for aberrantly glycosylated O-glycoproteins and a set of O-glycoprotein candidates with biomarker potential in gastric cancer.Most broad proteomic studies for discovery of cancer biomarkers in serum have been designed to interrogate the proteome and not taking into account that cancer cells often produce aberrant glycoforms (1). Many cancer biomarkers currently used in the clinic are based on circulating O-glycoproteins that are detected in established serological assays (CA125, CA15–3, CEA, and CA19.9) (2). In addition to being overexpressed in cancer, these proteins also carry aberrant glycans, which open for the opportunity to selectively detect aberrant glycoforms. An inherent problem with most cancer biomarker assays is that they often have poor specificity because the detected glycoprotein is found in elevated levels in nonmalignant conditions (2, 3). We recently found that the specificity of the widely used CA125 biomarker assay can be increased by selectively detecting aberrant O-glycoforms of the MUC16 mucin probed in the CA125 assay (4). Thus, the truncated O-glycan STn (NeuAcα2–6GalNAcα1-O-Ser/Thr)¹ (Fig. 1) was particularly suited for discrimination of MUC16 circulating in cancer patients in contrast to MUC16 circulating in benign conditions (4).Open in a separate windowFig. 1.Schematic depiction of the initial biosynthetic pathways of O-linked protein glycosylation. Overview of the O-linked protein glycosylation. O-GalNAc glycosylation is initiated by up to 20 different GalNAc-transferases. The addition of GalNAc to serines or threonines (or tyrosines) forms the Tn structure that can be sialylated by ST6GalNAc-I or further elongated to form up to four core structures. The core structures can be further elongated.One of the most characteristic phenotypes of cancer cells is the expression of truncated O-glycans, and the structures T (Galβ1–3GalNAcα1-O-Ser/Thr), STn, and Tn (GalNAcα1-O-Ser/Thr) (Fig. 1) are considered pancarcinoma antigens (2, 5). These truncated O-glycans are essentially not produced in normal and benign cells, which suggests that circulating O-glycoproteins in normal and benign conditions should have more mature O-glycans, whereas O-glycoproteins shed from cancer cells are expected to display truncated glycan structures. Cancer cells produce, secrete, and shed many different O-glycoproteins with truncated O-glycans, and provided these glycoproteins reach the circulation they may be detectable in serum. However, it is also known that nonsialylated glycoproteins are cleared from circulation through innate immune lectin receptors (6). In fact, we were previously unable to detect circulating T and Tn glycoforms of MUC1 and MUC16, while the sialylated ST (NeuAcα2–3Galβ1–3NeuAcα2–6]_±GalNAcα1-O-Ser/Thr) and STn glycoforms were readily detectable (4, 7). Furthermore, two classical serological biomarker assays, CA19–9 (8) and CA72.4 (9–11), are based on the detection of sialylated O-glycans, and especially the latter that detects STn shows that proteins expressing the STn glycoform circulate in serum of cancer patients. Interestingly, although CA72.4 has been used for decades, it is still largely unknown which O-glycoproteins carry STn and are detected by the CA72.4 assay (9, 10).The truncated STn O-glycan has attracted much attention because it is highly expressed in most gastric (12), colorectal (13), ovarian (14), breast (15), pancreatic (16), and bladder (17) carcinomas, whereas expression of STn on normal tissues is highly restricted (11, 18). In addition, STn expression is associated with carcinoma aggressiveness and poor prognosis (15, 19). We have recently described the presence of a few STn bearing glycoproteins in serum from individuals with gastric cancer and gastric cancer precursor lesions (20). The biosynthetic and genetic mechanisms underlying the expression of this truncated O-glycan in cancer have remained poorly understood, and a number of mechanisms have been proposed that may not be mutually exclusive. One mechanism is the altered expression of the sialyltransferase ST6GalNAc-I, which is believed to be the main STn synthase (21, 22) (Fig. 1), and in fact overexpression of this enzyme in cell lines appears to override the normal O-glycan elongation machinery and result in expression of STn (22, 23). Another mechanism may be reduced core1 elongation that leads to accumulation of Tn, which serves as substrate for ST6GalNAc-I (22). The core1 synthase C1GALT1 is dependent on a private chaperone Cosmc, and several studies have reported that somatic mutations in COSMC gene (24), or hypermethylation of COSMC gene in cancer (25) lead to increased expression of Tn and STn. We have further shown that knockout (KO) of COSMC in a number of human cancer cell lines produce cells that express different levels of Tn and STn truncated O-glycans ranging from exclusive Tn to exclusive STn (26). A third potential mechanism offered recently may be related to cancer-associated relocation of the polypeptide GalNAc-transferases (GalNAc-Ts) that initiate O-glycosylation (Fig. 1) from Golgi to ER, which appear to induce expression of the Tn truncated O-glycans, although expression of STn has not been explored yet (27).In the present study, we applied a glycoproteomics strategy to explore potential biomarker O-glycoproteins with the STn glycoform in gastric cancer. We first characterized the O-glycoproteome and including the secretome of two gastric cancer cell lines, AGS (intestinal type gastric carcinoma) and MKN45 (diffuse type gastric carcinoma), using our SimpleCell (SC) discovery platform where we identified a total of 499 O-glycoproteins (1236 O-glycosites). This strategy involves genetic engineering of cell lines to produce homogenous truncated O-glycans (Tn and/or STn) by KO of COSMC, followed by Vicia Villosa lectin (VVA) enrichment of Tn glycoproteins and/or glycopeptides for sensitive identification of O-glycoproteins and O-glycosites by mass spectrometry (26, 28) (Fig. 1). We applied the same glycoproteomics workflow to a wild type (wt) gastric cancer cell line, KATO III (diffuse type gastric carcinoma), which naturally expresses Tn and STn O-glycans in a mixture with more complex structures, and identified a significantly smaller O-glycoproteome (total of 47 O-glycoproteins) compared with SimpleCells (total of 499 O-glycoproteins). We next modified the strategy to enrich for STn O-glycoproteins in pools of serum from cancer patients and normal controls using pretreatment with neuraminidase to remove sialic acid and expose Tn for VVA capture. This approach enabled us to isolate and identify 37 O-glycoproteins (49 O-glycosites) in gastric cancer serum. Finally, we confirmed that two of the identified serum O-glycoproteins (CD44 and GalNAc-T5) were expressed in gastric cancer tumors by immunohistology, and further used proximity ligation assay (PLA) to show that STn glycoforms of CD44 was expressed in cancer tissue. This study clearly shows that cancer patients have a variety of circulating O-glycoproteins with the STn glycoform, and supports the hypothesis that these glycoproteins originate from the cancer tissue. The identified secreted and circulating aberrant O-glycoproteins serve as a discovery set for biomarkers of gastric cancer.