15 Fakultätsübergreifend / Sonstige Einrichtung
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Item Open Access Chemosensitivity of testicular germ cell tumors is based on high constitutive Noxa protein levels and a functional p53 response(2013) Gutekunst, Matthias; Scheurich, Peter (Prof. Dr.)In contrast to the majority of tumors, testicular germ cell tumors (TGCTs) can be cured by chemotherapy even in advanced metastatic stages. Thus, these neoplasms are considered a paradigm of chemosensitive tumors. It is well accepted that their intrinsic susceptibility to apoptosis determines the unique responsiveness to Cisplatin-based chemotherapy. Although p53 has been implicated in the chemotherapeutic response of TGCTs, the role of this tumor suppressor remains controversial to date. In this study, RNAi-mediated silencing of p53 is shown to completely abrogate Cisplatin hypersensitivity of TGCTs. The central role of p53 is further demonstrated by the finding that the amount of p53 protein induced by Cisplatin treatment is tightly correlated with apoptosis induction. In this context, a reduced capacity to repair damaged DNA is rather unlikely to account for hypersensitivity, a conjecture that is strengthened by the finding that TGCT cells are capable of removing Cisplatin adducts from DNA if apoptosis induction is blocked by caspase inhibition. On the contrary, the hypersensitive phenotype is a result of the unique responsiveness of TGCTs to p53 activation in general, since treatment with the nongenotoxic p53 activators Nutlin-3 or Bortezomib leads to p53-dependent apoptosis to a similar extent as does Cisplatin treatment. Although functional p53 is a mandatory requirement for Cisplatin hypersensitivity in TGCTs, the proapoptotic character of the p53 response is dependent on the pluripotent cellular context of TGCTs mediated by Oct-4. Differentiation or silencing of Oct-4 expression abrogates Cisplatin sensitivity and reduces apoptosis induction by Nutlin-3 treatment. This is not due to differential activation of p53 since no substantial alterations in Cisplatin-induced target gene activation are observed. Furthermore, p53 accumulation is unaffected by differentiation or Oct-4 depletion. Rather, examination of the Bcl-2 family profile in pluripotent vs. differentiated or Oct-4-depleted cells revealed that high constitutive Noxa protein levels dictate an extremely low apoptotic threshold in TGCT cells. Oct-4 status and Noxa protein levels are correlated to Cisplatin sensitivity in a panel of TGCT cell lines as well as in TGCT patient samples. Importantly, this correlation is also seen with other genotoxic agents such as Etoposide or Doxorubicin and the non-genotoxic p53 activator Nutlin-3. Since Oct-4 depletion leads to a concomitant loss of Noxa protein and NOXA/PMAIP1 transcript, an Oct-4-dependent transcriptional mechanism might account for the high Noxa protein levels. RNAi experiments show that Puma is another important determinant of TGCT hypersensitivity. In contrast to Noxa, Puma is not present at high levels in TGCT cells but exerts its proapoptotic function upon activation by p53. In conclusion, this study demonstrates that pluripotent TGCTs are primed for apoptosis by Oct-4-mediated high constitutive Noxa protein levels. Thus, in response to genotoxic or other stresses p53 activation results in an efficient induction of apoptosis mediated by transcriptional target genes such as PUMA/BBC3.