(CANCER RESEARCH 55, 3438-3443. August I. 1995] Autocrine Growth of Transitional Cell Carcinoma of the Bladder Induced by Granulocyte-Colony Stimulating Factor1 Masaaki Tachibana,2 Ayako Miyakawa, Hiroshi Tazaki, Kayoko Nakamura, Atsushi Kubo, Jun-ichi Hata, Tatsunari Nishi, and Yasuhiro Amano Departments of Urology ¡M.T.. A. M., H. T.], Radiology [K. N., A. K.I, and Pathology fj-i. ti.}. School of Medicine, Keio University, 35-Shinanomachi. Japan, and Tokyo Research Laboratories, Kyowa Hakko Kogyo Co., Liti., Tokyo, Japan [T. N., Y. A.] functional ABSTRACT Granulocyte-colony stimulating factor (G-CSF) produced by nonhema- topoietic malignant cells has been reported to be capable of inducing a leukemoid reaction in the host through intense stimulation of leukocyte production. Furthermore, this is frequently associated with aggressive tumor cell growth and a detrimental clinical outcome. In this study, we identified bladder cancer cells producing G-CSF with the expression of the functional receptor, which provides direct evidence of autocrine growth of bladder cancer cells induced by G-CSF. The cancer cells used in this study were obtained from a 76-year-old man who had a metastatic transitional cell carcinoma of the bladder and who demonstrated marked leukocytosis; his peripheral blood leukocyte count was 94,900 leukocytes/ mm3, and his serum G-CSF level was 103 pg/ml. The culture medium in which the cancer cells were grown exclusively contained a significant amount of G-CSF (5560 pg/ml). Significant G-CSF inKN A expression and G-CSF receptor mRNA expression in the cultured cells were demon strated by the reverse transcription-PCR method. In addition, binding studies with the use of radiolabeled recombinant G-CSF demonstrated the presence of high-affinity G-CSF binding receptors on the cultured cancer cells. Finally, the proliferation of the cultured cancer cells was stimulated by exogenous G-CSF administration, and this stimulation was inhibited by adding anti-G-CSF antibody, as demonstrated by both the flow cytometric bromodeoxyuridine incorporation technique and the | 'lI |lh\miilinc incor poration assay. These results strongly suggest that G-CSF production by cell carcinoma Tokyo, of the bladder (16). The above observations lead naturally to the tempting speculation that simultaneous acquisition of the ligand (G-CSF) production and its receptor expression by a malignant tumor may provide a strong autocrine growth advantage. This study addresses our recent obser vations, which strongly suggest that such autocrine growth promotion of malignant tumor cells by G-CSF does, in fact, take place. MATERIALS AND METHODS The cancer cells used in this study were obtained from a 76-year-old man with metastatic transitional cell carcinoma of the bladder who demonstrated marked leukocytosis; his peripheral blood leukocyte count was 94.900 leukocytes/mttr', and his serum G-CSF level was 103 pg/ml. Immunohistochemical study of the cancer tissue obtained by biopsy with the use of a mAb against recombinant human G-CSF was performed to identify the exact cell type responsible for G-CSF production. Sections of the 5% formalin-fixed and paraffin-embedded bladder tumor tissue specimen were studied by using the avidin-biotin-peroxidase method. Mouse anti-human G-CSF mAb (KW341) provided by Kyowa Hakkou Co, Ltd. (Tokyo, Japan) was used as the primary antibody at a dilution of 1:50. To confirm the specificity of the immunohistochemical study, tumor specimens from SCID mice implanted with CHO cells transfected with human G-CSF cDNA (17) were examined as a positive control, and as a negative control, mouse IgG was used as the primary antibody instead of anti-G-CSF antibody. The tumor tissue was minced into 1-mm3 pieces, placed on a culture flask (25 cm2), and maintained in culture medium [RPMI 1640 and Eagle's MEM the bladder cancer cells studied augments autocrine growth. Therefore, we recommend exercising caution in the clinical use of G-CSF for bladder cancer patients. diluted 1:1, supplemented with 10% heat-inactivated PCS, 1% insulin-transferine-sodium selenite medium supplement (Sigma, Japan), 100 (xg/ml strep INTRODUCTION G-CSF3 produced by nonhematopoietic G-CSF receptors in transitional Shinjukit-ku, tomycin, and 100 international units/ml penicillin] in an atmosphere of 5% CO, for additional culture. Exponential growth of the cells was seen approximately 3 weeks after the primary culture. Subsequently, the cells were subcultured with a split ratio of 1:10 every 4-6 days. G-CSF concentrations in the culture medium, on which malignant cells has been reported to be capable of inducing a leukemoid reaction in the host through intense stimulation of leukocyte production (1-11). This is frequently associated with aggressive tumor cell growth and a detri mental clinical outcome (8-12). Varieties of nonhematopoietic malignant tumors, including bladder carcinoma (2-4), hepatoma (5), mesothelioma (6), squamous cell carcinoma of the oropharynx (7), melanoma (8), glioblastoma (9), and sarcoma (10, 11), have been demonstrated to secrete G-CSF in amounts large enough to cause a significant systemic hematopoietic effect. In addition, receptors for G-CSF have also been confirmed on the cell surfaces of several nonhematopoietic cell types, including human placenta and trophoblastic cells (13), human vascular endo- Received 2/10/95; accepted 5/30/95. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore he hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. 1 This work was supported in part by Grants-in-Aid 04404064 and 04454409 for the cancer cells were grown exclusively, were measured by ELISA. Both G-CSF and G-CSF receptor mRNA expression on the cultured cancer cells were studied with the use of the RT-PCR method. Total RNA samples were purified from the cultured cancer cells by the acid guanidine phenolchloroform method (18). The respective RNA (5 /ig) samples were converted into cDNA with the use of oligo(dT) primers and reverse transcriptase (code 8089SA; Life Technologies) diluted with H2O to obtain 100 fj.1of the cDNA preparation. Five-fil samples were subjected to the following PCR: («)the ß-actin-specific fragment was detected by PCR (20 cycles at 94°Cfor 1 min, 65°C for 1 min, and 72°C for 3 min) with primers 5'-GATATCGCCGCGTCGTCGTCGAC-3' (forward primer) and 5'-CAGGAAGGAAGGCTGGAAGAGTGC-3' (reverse primer); (b) the G-CSF-specific 278-bp fragment was detected by PCR (40 cycles at 94°Cfor 1 min, and 50°Cfor 1 min) with 5'-CTGTGTGCCACCTACAAG-3' (forward primer) and 5'-GCCATTCCCAGTTCTTCC-3' (reverse primer); and (c) the G-CSF receptor a-chain 727-bp fragment was detected by PCR (35 cycles at 94°Cfor 1 min, 65°Cfor 1 min, and 72°Cfor 1 min) with 5'-ACAGTCCTCACCCTGATGACCT-3' (forward primer) and 5'-TGCCTCTTAAAGGCCTGAGCTA-3' Scientific Research from the Ministry of Education, Science and Culture. Japan. 2 To whom requests for reprints should be addressed. 'The abbreviations used are: G-CSF, granulocyte-colony-stimulating factor; GMCSF. granulocyte-macrophage colony-stimulating factor; RT-PCR, reverse transcriptionPCR; BrdUrd, bromodeoxyuridine; LI, labeling index; SCID, severe combined immuno deficiency; CHO, Chinese hamster ovary. (reverse primer). In addition, as markers of other hematopoietic growth factors, GM-CSF and GM-CSF receptor mRNA expression on the cultured cancer cells were studied by RT-PCR; (d) the 441-bp GM-CSF-specific fragment was detected by PCR (43 cycles at 94°Cfor 30 s, and 63°Cfor 1 min) with primers 5'-CTGGAGATGTGGCTGCAGAGCC-3' (forward primer) and 5'-TGCT- thelial cells (14), and cell lines derived from human small cell carci noma of the lung (15). Previously, we reported the expression of 3438 Downloaded from cancerres.aacrjournals.org on July 8, 2017. © 1995 American Association for Cancer Research. AUTOCRINE CELL GROWTH GGGAGCCAGTCCAGGAGTGA-3' (reverse primer); and (e) the 621-bp GM-CSF receptor «-chain fragment was detected by PCR (40 cycles at 94°C for 1 min, 60°Cfor 1 min, and 72°Cfor 1 min) with primers 5'-TGACCAGCACCATGCITCTCCT-3' (forward primer) and 5'-ACCACCCGAGAAATTGGCATCCAA-3' (reverse primer). To further confirm that the amplified products originated from the respective cDNA, they were subjected to appro priate restriction enzyme digestions. In addition, each RT-PCR was performed without the reverse transcriptase reaction as a negative control. Stimulation of cultured cancer cells by exogenous G-CSF administration and neutralization of its growth-promoting activity by anti-G-CSF antibody under serum-free conditions were studied. The proliferating activity of the cultured cancer cells was measured by the flow cytometric BrdUrd incorpo ration technique. The cells were incubated in 1 ml of a 1:1 mixture of RPMI 1640 and Eagle's MEM without serum supplementation in 12-well culture dishes (well diameter, 22 mm; Corning) at 37°Cin a humidified atmosphere of 5% CO2 with 95% air. Serial concentrations of recombinant mutant human G-CSF, kindly provided by Kyowa Hakko Kogyo Co., Ltd. (KW-2228; 3, 7), were added every 24 h for a total of three times. Twenty-four h after the final G-CSF treatment, BrdUrd was added to each culture well at a final concen tration of 5 /xg/ml, and incubation was continued for another hour. The cells were harvested with 0.25% trypsin and 1 mM EDTA and were then washed twice. The cells were subsequently stained with FITC-labeled anti-BrdUrd antibody and then poststained with 0.5% propidium iodide. The double-stained cells were analyzed with an Epics ELITE flow cytometer (Coulter, Hialeah, FL), and the LI, i.e., the number of cells stained with BrdUrd divided by the total estimated cell count, was calculated. For the neutralizing test, 0.5 /ig/ml concentrations of G-CSF were preincubated with or without serial concentrations of anti-human G-CSF antibody (IgG class; R&D Systems, Minneapolis, MN) before their addition to the cultured cells. The experiment was otherwise carried out in exactly the same way as the stimulation test. It was also demonstrated whether the presence of a specific anti-human G-CSF antibody would inhibit tumor cell proliferation. The antibody was added every 24 h for a total of three times to cell cultures with or without serial concentrations of anti-human G-CSF antibody (R&D Systems) under a scrum-free condition. The experiment otherwise was carried out in exactly the same way as the neutralizing test. KU-7 cells (19) derived WITH G-CSF from human bladder cancer and not exhibiting functional G-CSF receptors were used as control cells. Exactly the same experiments were carried out by the [%H]thymidine incor poration method. The bladder carcinoma cells (1 X 10J) were incubated in 0.1 ml of the culture medium without PCS in a 96-well microtitcr tray (Nunc, Roskilde, Denmark). Twenty-four h after the final G-CSF and/or anti-G-CSF antibody treatments, DNA synthesis in the cultures was determined by addi tional [methyl-3H]thymidine (Amersham, Amersham, UK) (0.6 fiCi/well; 1 Ci = 37 MBq) during a 4-h pulse. Cells were harvested onto glass fiber filters and counted with a liquid scintillation counter (I.S. 9800; Beckman Instru ments Inc., Fullerton, CA). G-CSF receptor binding experiments were conducted with the use of the following method. Na'25I (DuPont-NEN) and Enzymobead reagent (Bio-Rad) were used. Recombinant mutant G-CSF (KW-2228) served as the ligand. The KW-2228 was radioiodinated with 37 MBq of Na125I with the use of the solid-phase glucose oxidase-lactoperoxidase method, as described by Piao and Okabe (20). The specific activity of radioiodinated KW-2228 was 6 X IO6 cpm/fig protein. The cultured cells were incubated for 24 h at 4°Cin 24-well tissue culture plates in 0.5 ml of isotonic PBS containing 0.2% BSA and with or without 125I-labeled KW-2228. After incubation for 24 h, the medium was aspirated and the cells were washed with cold PBS. The cells were then solubilized in 0.25 ml of 2 M NaOH, and the radioactivities were measured. Nonspecific binding (binding of I25l-Iabeled KW-2228 to the cells in the presence of G-CSF at 1000 ng/0.5 ml), which ranged between 6-18%, was subtracted from the total binding to determine the specific binding. The specific binding of the labeled KW-2228 was expressed as the percentage of binding measured in the ab sence of unlabeled KW-2228. The Scatchard plot analysis of the specific binding of 125I-labeled KW-2228 to the cells was estimated. RESULTS The cancer cells used in this study were obtained from a 76-yearold man with metastatic transitional cell carcinoma of the bladder. The patient underwent radical cystectomy for invasive carcinoma of the bladder on June 28, 1993. Pathological analysis of the excised bladder Fig. 1. Immunohistochemical staining with the use of anti-G-CSF mAb. Sections of the 5% formalin-fixed and paraffin-embedded bladder tumor tissue specimen were studied hy the avidin-biotin-peroxidase method. The mAb that reacted with the tumor cells is shown as brown-colored granular staining, primarily involving the cytoplasm (A; X 400). The CHO cells transfected with human G-CSF cDNA and transplanted in SCID mice as a positive control were strongly positively stained (B; X 400). 0, negative control staining. 3439 Downloaded from cancerres.aacrjournals.org on July 8, 2017. © 1995 American Association for Cancer Research. AUTOCRINE CELL GROWTH =•6000 r Day 0 WITH G-CSF G-CSF and G-CSF receptor mRNA expression on the cultured cancer cells were studied with the use of RT signals for both G-CSF and G-CSF receptor and were detected, as shown in Fig. 3, B and C. The RT-PCR product exhibited a specific G-CSF transcription signal of 278 bp and a G-CSF receptor signal of 727 bp in samples from the cultured cells. The RT-PCR product demonstrated a specific GM-CSF transcription signal of 441 bp (Fig. 3D) but no definitive GM-CSF Day 2 Day5 Fig. 2. G-CSF concentrations in the culture media as measured The culture media, on which the cancer cells grew exclusively, amount of G-CSF, and the increase in the number of cancer paralleled that reached in 5560 pg/ml of medium after 7 days of receptor transcription signal of 621 bp (£). Stimulation of cultured cancer cells by exogenous G-CSF admin istration and neutralization of its growth-promoting activity by antiG-CSF antibody were studied by the flow cytometric BrdUrd incor poration technique. As shown in Fig. 4A, the BrdUrd Lis were 12.7, 14.0, and 16.7% for 0, 0.1, and 0.5 jug/ml G-CSF concentrations, Day? by the ELISA method. contained a significant cells during culturing culture. demonstrated transitional cell carcinoma, grade-3, pT3b, ly(-), respectively. Therefore, proliferation of the cultured cancer cells was stimulated by G-CSF. Meanwhile, when 0.5 /xg/ml G-CSF was preincubated with serial concentrations of anti-G-CSF antibody, BrdUrd v(+), pNO, MO. Six months after the procedure, he experienced urethral bleeding and was diagnosed as having urethral recurrence. He under went total urethrectomy on December 28, 1993. Subsequently, peri toneal tumor recurrence and multiple lung métastasesdeveloped, revealing marked leukocytosis; his peripheral blood leukocyte count was 94,000/mm3, and his serum G-CSF level was 103 pg/ml. Lis were 17.2,14.3, and 12.7% for 0,10, and 50 /¿g/mlconcentrations of anti-G-CSF antibody, respectively (Fig. 4B). Therefore, stimulation of cell proliferation by G-CSF was inhibited by anti-G-CSF antibody. The addition of 50 ¡¿g of anti-G-CSF antibody neutralized the cell growth stimulated by 0.5 jag/ml of G-CSF by 26.2%. Furthermore, when the cells were cultured with anti-G-CSF antibody, BrdUrd Lis were 11.7, 10.4, 9.5, and 8.9% at anti-G-CSF antibody concentrations Immunohistochemical study of the cancer tissue obtained by biopsy with the use of mAb against recombinant human G-CSF was per formed to identify the exact cell type responsible for G-CSF produc tion. The mAb that reacted with the tumor cells is shown as a brown-colored granular staining, primarily involving the cytoplasm. The positive staining was limited to the cancer cells and no other cell types, such as fibroblasts or infiltrating monocytes, were affected (Fig. L4). The CHO cells transfected with human G-CSF cDNA and transplanted in SCID mice as a positive control were strongly posi tively stained (Fig. IB). The culture medium, on which the cancer cells were grown exclusively, contained a significant amount of G-CSF, and the increase in the number of the cancer cells during culture paralleled that reached in the medium containing 5560 pg/ml after 7 days of culture (Fig. 2). of 0, 10, 50 /j,g, and 200 jug/ml, respectively (Fig. 5). In addition, [3H]thymidine uptake of the cells was illustrated in Table 1. The uptake at 24-h incubation after the final G-CSF admin istration with 0.1 and 0.5 /xg/ml was 5544.7 ± 680.1 and 6030.8 ±409.5 cpm, respectively. These were significantly higher than those of controls (4760.6 ±309.1 cpm; P < 0.05). In addition, 0.5 /n.g/ml G-CSF was preincubated with serial concentrations of anti-G-CSF antibody, and [3H]thymidine incorporations were 6180.8 ±285.3, 4849.8 ±216.5, and 4373.0 ±278.1 cpm in 0, 10, and 50 jug/ml concentrations of anti-G-CSF antibody, respectively. [3H]thymidine incorporations with anti-G-CSF antibody cultures were I I eoibp278bp- 0-Kt'm 441bp- G-CSF G-CSF receptor GM-CSF GM-CSF receptor ABODE Fig. 3. Detection of G-CSF mRNA and G-CSF receptor mRNA by the RT-PCR method. A. the ß-actin-specific fragment was detected by PCR (20 cycles at 94°Cfor 1 min, 65°C for 1 min, and 72°Cfor 3 min) with primers 5'-GATATCGCCGCGTCGTCGTCGAC-3' (forward primer) and 5'-CAGGAAGGAAGGCTGGAAGAGTGC-3' (reverse primer); B. the G-CSF-specific 278-bp fragment was detected by PCR (40 cycles at 94°Cfor 1 min, and 50°Cfor 1 min) with 5'-CTGTGTGCCACCTACAAG-3' (forward primer) and 5'-GCCATTCCCAGTTCTTCC-3' (reverse primer); C. the G-CSF receptor a-chain 727-bp fragment was detected by PCR (35 cycles at 94°Cfor 1 min, 65°Cfor 1 min, and 72°C for 1 min) with 5'-ACAGTCCTCACCCTGATGACCT-3' (forward primer) and 5'-TGCCTCTTAAAGGCCTGAGCTA-3' (reverse primer); D, the 441-bp GM-CSF-specific fragment was detected by the PCR (43 cycles at 94°Cfor 30 s, and 63°Cfor 1 min) with primers 5'-CTGGAGATCTGGCTGCACACCC-3' (forward primer) and 5'-TGCTGGGAGCCACTCCAGGAGTGA-3' (reverse primer); and £,the 621-bp GM-CSF receptor a-chain fragment was detected by PCR (40 cycles at 94°Cfor 1 min, 60°Cfor 1 min, and 72°Cfor 1 min) with primers 5'-TGACCACCACCATGCTTCTCCT-3' (forward) and 5'-ACCAGCCCAGAAATTCGCATCCAA-3' (reverse primer). To further confirm that the amplified products originated from the respective cDNA, they were subjected to appropriate restriction enzyme digestions. Size markers from lop, 4.3, 1.8, 1.1, 0.68, 0.38, 0.25, and 0.12 kb. RT-PCR exhibited a 278-bp band signal for G-CSF (B), a 727-bp band signal for the G-CSF receptor (C), and a 441-bp band of GM-CSF (D) in samples from the cultured cells. However, the 621-bp band of GM-CSF receptor was not identified in the sample from the cultured cells (£). 3440 Downloaded from cancerres.aacrjournals.org on July 8, 2017. © 1995 American Association for Cancer Research. AUTOCRINE CELL GROWTH WITH G-CSF .COto05rra8'Sso.nso o "u ir» 9-ED 'S eo g-«3 _jliÃ- O 10 20 30 40 50 60 O 10 20 PI-DNA Control LI 12.7% 30 40 PI-DNA GCSFO.Imcg/mi 50 O 60 IO 20 30 40 PI-DNA GCSFO. Smog/mi LI 14.0% 50 6 LI 16.7% B .S-° u S 5 EI8'OD E / : ÃŒBr:i^JL^i,,,,.0 CD CM "0 . 0 IO 20 30 40 PI-DNA GCSF 0.5mcg/m/ 50 fcg^ -:W;:•:;•;', 60 IO 20 Anti-GCSF LI 17.2% 30 40 PI-DNA lOmcg/nÃ- 60 50 O LI 14.3% IO 20 30 40 PI-DNA 50 Anti-GCSF SOmcg/nJ 60 U 12.7% Fig. 4. Study of growth stimulation by exogenous G-CSF administration and neutralization of growth-promoting activity by anli-G-CSF antibody. The proliferative activity of the cultured cancer cells was measured by the flow cytometric BrdUrd incorporation technique. The double-stained cells were analyzed with the use of an Epics ELITE flow cytometer, and the LI, i.e., the number of cells stained by BrdUrd divided by the total estimated cell count, was calculated. The Lis of the cells treated with 0.5, 0.1, and 0 |xg/ml (control) of G-CSF were 16.7, 14.0, and 12.7%, respectively (A). For the neutralizing test, 0.5-fig/ml concentrations of G-CSF were preincubated with or without serial concentrations of anti-human G-CSF antibody before their addition to the cultured cells. The experiment was otherwise carried out in exactly the same way as the stimulation test. As shown in B. the addition of 50 ng of anti-G-CSF antibody neutralized the cell growth stimulated by 0.5 (ig/ml of G-CSF, reducing growth by 26.2%. statistically significantly lower than were those without anti-G-CSF antibody cultures (P < 0.01). Furthermore, when anti-G-CSF antibody was added in the cultures every 24 h for three times, [3H]thymidine incorporations were 3750.8 ±178.8 cpm for 10 jig/ml, 3326.0 ±246.2 cpm for 50 fig/ml, and 3166.7 ±113.0 cpm for 200 fig/ml anti-G-CSF antibody con centrations. These were significantly lower than were those without anti-G-CSF antibody administration (4132.2 ± 231.4 cpm/well; P < 0.01). However, KU-7 cells did not demonstrate any inhibition of BrdUrd labeling or [3H]thymidine antibody was cocultured. Binding studies with the use of the radiolabeled recombinant GCSF demonstrated the presence of a high-affinity G-CSF binding receptor on the cultured cancer cells (Fig. 6). Nonspecific binding (binding of 125I-labeled KW-2228 to the cells in the presence of G-CSF at 1000 ng/0.5 ml), which ranged between 6 and 18%, was subtracted from the total binding to determine the specific binding. The specific binding of the labeled KW-2228 was expressed as the sV °E '-iif': : .'X §Sf^*'"'f«ÕÜi.-J) .;ri:VÕrifÃ-Ãœf"''0 10 20 Control incorporation when anti-G-CSF li- 30 40 PI-DNA LI 50 11.7% $0 0 10 Anti-GCSF .•9 ^^i 20 30 40 PI-DNA I0mcg/a/ SO LI 60 •' IO 10.4% 20 30 40 R-DNA Anti-GCGF Wmct/mt SO 60 LI 9.5» 10 Anti-GCSF 20 30 40 PI-DNA 200mcg/>J SO LI CO 8.9» Fig. 5. Flow cytometric BrdUrd incorporation study on the effect of anti-G-CSF antibody on cell growth proliferation. Anti-G-CSF antibody was added in the cultures every 24 h for three times under a serum-free condition. In vitro BrdUrd labeling was performed 24 h after the final administration of anti-G-CSF antibody. The LI was estimated as described previously. BrdUrd Lis were 11.7, 10.4, 9.5, and 8.9% in anti-G-CSF antibody concentrations of 0, 10, 50, and 200 fig/ml, respectively. 3441 Downloaded from cancerres.aacrjournals.org on July 8, 2017. © 1995 American Association for Cancer Research. AUTOCRINE CELL GROWTH percentage of binding measured in the absence of unlabeled KW-2228 (Fig. 6A). The Scatchard plot analysis of the specific binding of 125I-labeled KW-2228 to the cells shown in Fig. 6ßindicates that the cells harbor a single type of G-CSF receptor. The ßmax calculated from the intercept of the slope with the abscissa on the Scatchard plot was 458 molecules/cell, and the Kd was 103 pM. WITH G-CSF & 4 = 3 DO .E o â„¢1 î DISCUSSION by [' H]thymidine incorporation (cpm/well) G-CSF administration Control 0.1 Kg/ml G-CSF 0.5 u.g/ml G-CSF 4760.6 ±309.1 5544.7 ±680.1 6030.8 ±409.5 G-CSF neutralization Control (G-CSF 0.5 u,g/ml alone) 0.5 ng/ml G-CSF + 10 /ig/ml anti-G-CSF Ab 0.5 Mg/ml G-CSF + 50 /¿g/mlanti-G-CSF Ab 6180.8 ±285.3 4849.8 ±216.5 4373.0 ±278.1 Anti-G-CSF Ab administration Control 4132.2 ±231.4 10 ng/ml anti-G-CSF Ab 3750.8 ±178.8 50 u,g/ml anti-G-CSF Ab 3326.0 ±246.2 200 ng/ml anti-G-CSF Ah 3166.7 ±113.0 "The uptake at 24-h incubation after the final G-CSF administrations of 0.1 and 0.5 ¿ig/mlwere 5544.7 ±680.1 and 6030.8 ±409.5 cpm, respectively; these were significantly higher than those in the controls (4760.6 ±309.1 cpm; P < 0.05). When 0.5 ug/ml G-CSF was preincubated with serial concentrations of anti-G-CSF antibody, ["Hjthymidine incorporations were 6180.8 ±285.3,4849.8 ±216.5, and 4373.0 ±278.1 cpm at 0, 10, and 50 fig/ml of anti-G-CSF antibody, respectively. ["Hjthymidine incorporation in cultures with anti-G-CSF antibody was statistically significantly lower than was that in cultures without anti-G-CSF antibody (P < 0.01). Furthermore, when anti-G-CSF antibody was added in the cultures every 24 h for three times, ["Hjthymidine incorporation was 3750.8 ±178.8 cpm for 10 /xg/ml, 3326.0 ±246.2 cpm for 50 ug/ml, and 3166.7 ±113.0 cpm for 200 p.g/ml of anti-G-CSF antibody. These values were significantly lower than were those without anti-G-CSF antibody administration (4132.2 ±231.4 cpm/well; P < 0.01); Ab, antibody. 30 40 '"l-G-CSF(ng) B/F 0.3 CSF (2, 22), and various cytokines (22). Previously, we have reported the expression of functional receptors for G-CSF in transitional cell carcinoma of the bladder (16). In our previous report, G-CSF receptors were expressed on two bladder cancer cell lines, and administration of G-CSF provided increased cell proliferation, as estimated by the [3H]thymidine incorporation Table 1 Effects of G-CSF and anti-G-CSF antibody on [~H]thym\dine incorporation bladder cancer cells' 20 A Varieties of nonhematopoietic malignant tumors have been dem onstrated to secrete G-CSF (2-11). In addition, it has been reported that receptors for G-CSF have been confirmed on the cell surfaces of several nonhematopoietic cell types (13-15). Bladder cancer cells have been shown to secrete a variety of biological factors with no direct relation to urothelial cell origin including G-CSF (2-4), GM- method. These previous observations lead naturally to the tempting specu lation that the simultaneous acquisition of G-CSF production and expression of its receptor, by a malignant tumor, may enhance auto crine growth. However, Sato et al. (4) reported on G-CSF-producing bladder cancer, although they indicated that their study failed to demonstrate a crucial role for G-CSF in mediating a growth advantage for the tumor. Furthermore, Thacker et al. (23) demonstrated that the human osteosarcoma cell line MG63 responds to both G-CSF and GM-CSF in vitro. They indicated that retrovirally infected G-CSF or GM-CSF-producing MG63 cells exhibited autostimulatory growing features, as measured by [3H]thymidine incorporation. Stimulation of cultured cancer cells by exogenous G-CSF admin istration and neutralization of this growth-promoting activity by antiG-CSF antibody, as demonstrated by both the flow cytometric BrdUrd incorporation technique and [3H]thymidine incorporation assay indi- 10 0.2 0.1 10 B 20 30 40 (pico mole) Fig. 6. G-CSF receptor binding experiments. Nonspecific binding (binding of I25Ilabeled KW-2228 to the cells in the presence of G-CSF at 1000 ng/0.5 ml), which ranged between 6 and 18%, was subtracted from the total binding to determine the specific binding. The specific binding of the labeled KW-2228 was expressed as the percentage of binding measured in the absence of unlabeled KW-2228 (A). The Scatchard plot analysis of the specific binding of '25I-labeled KW-2228 to the cells shown in B indicates that the cells harbor a single type of G-CSF receptor. The ßmaxcalculated from the intercept of the slope with the abscissa on the Scatchard plot was 458 molecules/cell, and the Ka was 103 pM. cate that the proliferation of cultured cancer cells was stimulated by G-CSF, and that this stimulation was inhibited by anti-G-CSF anti body. In addition, binding studies performed with the use of radiolabeled recombinant G-CSF demonstrated the presence of a highaffinity G-CSF binding receptor on the cultured cancer cells. These results strongly suggest that G-CSF production by the blad der cancer cells produced an autocrine growth advantage. The leukemoid reaction is a well-known paraneoplastic syndrome that has been demonstrated to be initiated by G-CSF production by cancer cells (1). Furthermore, the leukemoid reaction has been widely observed clin ically to appear at an advanced stage of cancer in association with aggressive cell growth (4, 12). It is, therefore, deemed likely that the G-CSF production and G-CSF receptor expression exhibited by can cer cells play crucial roles in mediating the malignant progression of the nonhematopoietic cancer cells. The histogenesis of transitional cell carcinoma of the bladder re mains uncertain, although several theories have been proposed. Some authors have suggested that a metaplastic phenomenon presenting various degrees of differentiation may explain the malignant transi tional cell G-CSF production (24). In addition, this concept is supported further by the tremendous potential of the transitional epithelium and transitional cell carcinoma to differentiate along several lines (25). The frequent presence of both squamous and glandular differentiation has long been recognized in transitional cell carcinoma. More recently, the presence of neuroen docrine (small cell) differentiation has also been reported (26). 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Cancer (Phila.). 69: 527-536. 1992. 3443 Downloaded from cancerres.aacrjournals.org on July 8, 2017. © 1995 American Association for Cancer Research. Autocrine Growth of Transitional Cell Carcinoma of the Bladder Induced by Granulocyte-Colony Stimulating Factor Masaaki Tachibana, Ayako Miyakawa, Hiroshi Tazaki, et al. Cancer Res 1995;55:3438-3443. Updated version E-mail alerts Reprints and Subscriptions Permissions Access the most recent version of this article at: http://cancerres.aacrjournals.org/content/55/15/3438 Sign up to receive free email-alerts related to this article or journal. To order reprints of this article or to subscribe to the journal, contact the AACR Publications Department at [email protected]. To request permission to re-use all or part of this article, contact the AACR Publications Department at [email protected]. Downloaded from cancerres.aacrjournals.org on July 8, 2017. © 1995 American Association for Cancer Research.