Introduction
Angiogenesis, the formation of new blood vessels, is crucial for tumor growth, as tumor cells require oxygen and nutrients for proliferation and survival (
Folkman, 1995;
Carmeliet and Jain, 2000). Tumor angiogenesis is a complex process regulated by both pro‐ and antiangiogenic factors produced by the tumor cells as well as the stromal cells in the tumor microenvironment (
Hanahan and Folkman, 1996;
Jung et al, 2002). One of the most important angiogenic factors is VEGF, which regulates endothelial cell survival, proliferation and migration (
Carmeliet et al, 1996;
Ferrara, 1999). The critical role of VEGF in tumor angiogenesis has been well documented in animal studies using anti‐VEGF antibodies, or small molecules targeting VEGFR2 (
Kim et al, 1993;
Fong et al, 1999), and has recently been validated by the success of VEGF‐targeted cancer therapy in clinical trials (
Fernando and Hurwitz, 2003).
Expression of VEGF has been detected in both tumor and stromal compartments, raising the question of the relative importance of each compartment for VEGF‐mediated angiogenesis. Genetic inactivation of VEGF in tumor cells resulted in severe inhibition of tumor growth and angiogenesis in studies using wild‐type embryonic stem (ES) cells (
Ferrara et al, 1996), ras‐transformed ES cells (
Shi and Ferrara, 1999), embryonic fibroblasts (
Grunstein et al, 1999) or endocrine pancreatic cells (
Inoue et al, 2002). These gene‐targeting studies demonstrate that tumor‐derived VEGF is essential for tumor growth and neovascularization. Interestingly, appreciable VEGF expression was detected in tumor‐associated fibroblasts (TAFs) and immune cells in many tumor specimens (
Hlatky et al, 1994;
Lewis et al, 2000;
Pilch et al, 2001;
Barbera‐Guillem et al, 2002). In a human rhabdomyosarcoma xenograft model, it was shown that complete inhibition of tumor growth and angiogenesis required blockade of both tumor and host VEGF (
Gerber et al, 2000). However, two transgenic mouse lines expressing green fluorescent protein (GFP) driven by different human VEGF promoter regions generated conflicting results regarding the extent to which the stromal compartment could constitute a source of VEGF for angiogenesis (
Fukumura et al, 1998;
Kishimoto et al, 2000). In addition, a recent study using ras‐transformed VEGF‐deficient adult dermal fibroblasts concluded that VEGF production by tumor stroma had a modest role in tumor angiogenesis (
Viloria‐Petit et al, 2003). Thus, the contribution of stromal‐derived VEGF to tumor angiogenesis is unclear.
In the tumor stromal compartment, fibroblasts are the predominant cell type and potentially are a significant source of VEGF. These TAFs are phenotypically different from their normal counterparts and are active participants in tumor development (
Kunz‐Schughart and Knuechel, 2002a;
2002b). However, very little is known about the mechanisms of stromal cell recruitment. Efforts to purify fibroblast migratory factor(s) from human lung fibroblasts and from a mouse colon carcinoma cell line identified fibronectin (FN) as a potential stromal fibroblast recruitment factor (
Hu et al, 1997;
Morimoto and Irimura, 2001), although the role of this protein in tumor stroma recruitment has yet to be directly addressed. The platelet‐derived growth factor (PDGF) family members are the most extensively investigated regulators of mesenchymal cell proliferation and migration during development (
Hoch and Soriano, 2003); they are also highly expressed in tumors and could play important roles in stromal fibroblast recruitment. In fact, pathological studies with human tumor samples localized PDGFR β expression in the peripheral stroma and PDGF‐B expression in epithelial tumor cells (
Coltrera et al, 1995;
Bhardwaj et al, 1996;
Kawai et al, 1997;
Sundberg et al, 1997), suggesting that PDGF‐B may be implicated in stroma recruitment. Furthermore, overexpression of PDGF‐B stimulated development of vascular connective stroma in a human melanoma xenograft model and induced tumorigenic conversion of nontumorigenic human keratinocytes by stroma activation (
Forsberg et al, 1993;
Skobe and Fusenig, 1998), demonstrating that tumor cell‐produced PDGF‐B can facilitate tumor growth through its paracrine effects on stromal cells. In comparison, the role of PDGF‐A in tumorigenesis has been much less appreciated, in part due to its weaker mitogenic and chemotactic activities (
Beckmann et al, 1988;
Siegbahn et al, 1990). PDGF‐A has been documented to stimulate tumor growth in an autocrine fashion (
Betsholtz et al, 1989;
Harsh et al, 1990;
Sulzbacher et al, 2000), whereas direct evidence for a role of this factor in tumor stroma activation is still lacking. Likewise, the two newly identified PDGF members (
Heldin et al, 2002), PDGF‐C and PDGF‐D, have been implicated in autocrine stimulation of sarcoma and glioblastoma cells (
Lokker et al, 2002;
Zwerner and May, 2002), while any role as paracrine mediators remains to be established.
In this study, using fibrosarcomas generated from VEGF‐null ras‐transformed mouse embryonic fibroblasts (MEFs), we demonstrate that VEGF production in the stromal compartment plays a critical role in tumor angiogenesis. We further identified PDGF AA as the major factor produced by tumor cells to recruit tumor stromal fibroblasts and uncovered a key role for PDGFR α signaling in tumor angiogenesis and growth.
Discussion
The importance of VEGF produced by the tumor cells in tumor angiogenesis has been well documented in various studies, while the contribution of stromal‐derived VEGF is unclear (
Grunstein et al, 1999;
Shi and Ferrara, 1999;
Gerber et al, 2000;
Viloria‐Petit et al, 2003). Using ras‐transformed
VEGF−/− MEFs, we demonstrated that tumor stroma is an important source of VEGF for tumor angiogenesis. Furthermore, we identified PDGFR α signaling as a mechanism utilized by the VEGF‐null tumor cells to recruit VEGF‐producing stromal fibroblasts (
Figure 9). This role of PDGFR α signaling in stromal fibroblast recruitment and tumor angiogenesis is distinct from the specific role of PDGFR β signaling in pericyte recruitment. Since recruitment of host stromal fibroblasts is important for tumor angiogenesis and growth when tumor cells are deficient in VEGF production, the PDGFR α signaling pathway is likely to be an additional target for antiangiogenesis cancer therapy.
Our study demonstrated that stroma‐produced VEGF played a significant role in tumor growth and neovascularization since anti‐VEGF treatment significantly inhibited the growth of tumors grown from ras‐transformed VEGF‐null MEFs. This finding is at variance with a recent study using ras‐transformed VEGF‐null adult dermal fibroblasts (
Viloria‐Petit et al, 2003), which showed that even though appreciable levels of VEGF expression were detected in stromal cells, VEGF production appeared to have a modest role in oncogene‐driven tumor angiogenesis. It is noteworthy that we used a newly developed potent anti‐VEGF antibody (G6‐23) in our study, while an antibody (DC101) against VEGFR‐2/flk‐1 was used in the study employing adult dermal fibroblasts. DC101 might not be able to block VEGF activity completely, as increasing evidence indicates that VEGFR‐1/flt‐1 may be a positive regulator in tumor angiogenesis (
Hiratsuka et al, 2001;
2002;
Luttun et al, 2002), and has specific roles in the recruitment of endothelial progenitor cells and monocytes (
Hattori et al, 2002;
Pipp et al, 2003), both of which could promote vessel growth. Thus, the seemingly conflicting results regarding stromal VEGF contribution to tumor angiogenesis between the two studies could be due, at least in part, to the difference in the efficacy of the VEGF inhibitors employed. In addition, differences in genetic compositions in the two cell sources and in the expression levels of VEGF or ras in the derivative tumors could also render variations in sensitivity to VEGF inhibition. Nevertheless, our findings are in agreement with one significant conclusion of the study by
Viloria‐Petit et al (2003) that at least some of the angiogenesis associated with fibrosarcoma growth is VEGF‐independent. Although in the present study VEGF was found to be important for tumor angiogenesis in the fibrosarcomas originated from the ras‐transformed MEFs, neither the anti‐VEGF Mab G6‐23 nor mFlt(1‐3)‐IgG treatment was able to block tumor growth completely. That such escape from VEGF inhibition was not due to incomplete VEGF blockade is strongly suggested by the finding that, in parallel experiments, the same inhibitors could completely block the
in vivo growth of the A673 rhabdomyosarcoma cell line (data not shown). In the VEGF‐null adult dermal fibroblast tumor model, ras‐mediated downregulation of antiangiogenic factor thrombospondin‐1 (TSP‐1) was shown to be the driving force for tumor angiogenesis. In our system, TSP‐1 expression in ras‐transformed MEF cells was also found to be significantly lower compared to nontransformed cells, while there was little difference in TSP‐1 expression between
VEGF−/− and
VEGF+/+ ras‐transformed tumor cells. Therefore, downregulation of TSP‐1 by ras may have contributed to the partial tumor escape from VEGF dependence in our model as well. As oncogenic ras is known for both upregulating proangiogenic VEGF and downregulating antiangiogenic factor TSP‐1 (
Rak and Kerbel, 2001;
Watnick et al, 2003), it may be necessary to target both factors to disrupt more efficiently oncogene‐driven tumor angiogenesis.
Expression of PDGF gene family members has been shown in a number of solid tumors, ranging from gliomas to prostate cancers, and the role of PDGF signaling in these tumors can vary from autocrine stimulation of tumor cell growth to paracrine interaction between tumor cells and stromal cells (
George, 2003;
Pietras et al, 2003). In our fibrosarcoma model, PDGF autocrine signaling was not a significant factor in tumor growth because the tumor cells express little receptors and they were transformed with SV40 large T antigen and ras, both of which have been shown to downregulate PDGF signaling (
Zhan and Goldfarb, 1986;
Cook et al, 1993;
Paasinen‐Sohns and Holtta, 1997). Instead, we found that PDGFR α‐mediated paracrine signaling between tumor cells and stromal fibroblasts was a principal mechanism for stroma recruitment, and demonstrated that this pathway was critical for tumor growth. Our finding underlines the importance of paracrine PDGFR α signaling in tumorigenesis, which has received very little attention so far. Moreover, we found very little PDGF‐B expression in these ras‐transformed tumor cells, while PDGF‐B along with PDGFR β was detected mostly on stromal vessels within the tumor mass. The observation that soluble PDGFR β‐IgG inhibited tumor growth is consistent with previous reports that PDGFR β signaling is essential for pericyte recruitment and tumor vessel stabilization (
Abramsson et al, 2003;
Bergers et al, 2003). It is also possible that PDGFR β may play a minor role in stromal fibroblast recruitment by interacting with tumor cell‐produced PDGF‐C and endothelial‐derived PDGF‐B. Our study implicates that the two PDGF signaling pathways mediated by PDGFR α and PDGFR β play distinct and complementary roles in tumor angiogenesis. These two pathways are conceivably more important for the tumorigenic properties of the VEGF‐deficient tumor cells, as these cells rely on the recruitment of an angiogenic stroma for tumor angiogenesis.
Besides PDGF AA, other factors expressed by ras‐transformed MEF cells might also play a minor role in stromal fibroblast recruitment, as the fibroblast stimulatory activity in tumor cell CM was substantially but not completely inhibited by soluble PDGFR α‐IgG. We did detect some low level of transforming growth factor‐β1 (TGF‐β1) in our tumor cell CM, and it is possible that TGF‐β1 expressed by tumor cells could also contribute to tumor angiogenesis by increasing VEGF production in stromal cells (
Berking et al, 2001;
Tuxhorn et al, 2002). Recruited stromal cells can potentially produce other angiogenic factors in addition to VEGF; thus blocking stromal fibroblast recruitment could have impacts on tumor angiogenesis and growth beyond just inhibiting VEGF. Although the focus of this current study was on stromal fibroblasts, we expect that the inflammatory cells in the tumor stromal compartment could also be a significant player in tumor angiogenesis and are currently investigating this possibility.
We have shown here that VEGF‐mediated tumor angiogenesis is a complex process that both tumor cells and stromal cells contribute to, and that tumor cells can indirectly facilitate new blood vessel formation via their stimulatory effects on stromal cells. Furthermore, we have identified PDGFR α signaling pathway as an important mechanism for stromal fibroblast recruitment, which is an essential route for tumor angiogenesis when tumor cells are deficient in VEGF production. In agreement with others, we have also found that PDGFR β signaling localized on tumor vessels exerts an important function in tumor growth. The distinct roles of these signaling pathways in tumor angiogenesis warrant combination therapy targeting multiple pathways in order to reduce more efficiently the blood supply for tumors and thus to make better approaches for cancer therapy.
Materials and methods
Generation of VEGF‐null ras‐transformed mouse embryonic fibroblastic cell lines
MEFs were isolated from VEGF/
loxP(+/+) mice, in which exon 3 of the VEGF gene was flanked by
loxP sites (
Gerber et al, 1999). The transgenic MEFs were immortalized by stable transfection with SV40 large T antigen and then transformed with a vector expressing oncogenic mutant H‐Ras (Val‐12). Subsequently, the VEGF/
loxp(+/+) ras‐transformed MEFs were infected with an adenovirus expressing cre recombinase to delete exon 3 of the VEGF gene. Several
VEGF−/− subclones were isolated from the infected pool through limiting dilution. Cells were cultured in Dulbecco's modified Eagle's medium/nutrient mixture F‐12 HAM (DMEM/F12, 50:50 mixture), supplemented with 10% fetal bovine serum (FBS), 2 mM glutamine, 50 U/ml penicillin and 100 μg/ml streptomycin.
Real‐time quantitative RT–PCR analysis
RNA was isolated from culture cells or frozen tumor tissues using the Qiagen RNeasy kit, and RT–PCR reactions were run in a Model 7700 Sequence Detector (PE Applied Biosystems, Foster City, CA) and the results were normalized to GAPDH levels. The sequences of primers and probes are presented in
Supplementary material.
NIH 3T3 fibroblast migration
Migration assay was performed using 24 transwell FluoroBlok plates (BD Biosciences, Bedford, MA). A 500 μl portion of serum‐free assay medium containing testing samples, recombinant human PDGF AA (30 ng/ml) or PDGF BB (10 ng/ml) (R&D systems, Minneapolis, MN) was added to the bottom chamber, and then 2 × 104 3T3 cells (ATCC, Manassas, VA) in 100 μl assay medium were plated into the top reservoir of the transwell. The assay was conducted for approximately 15 h at 37°C. The transmigrated cells on the bottom side of the membrane were stained with 10 μM YoPro dye (Molecular Probes, Eugene, OR). Images were taken under a Nikon fluorescence microscope using OpenLab software (Improvision, Lexington, MA), and the relative fluorescence unit (RFU), indicative of the number of cells migrated, was quantified using ImagePro Plus software (Media Cybernetics, Silver Spring, MD).
NIH 3T3 fibroblast proliferation
Cells were seeded into 96‐well plates at a density of 3000 cells/well, and grown in complete culture medium (DMEM/F12 50:50, 10% FBS) for 1 day. Cells were then serum‐starved for another day before being treated with testing samples, recombinant human PDGF AA (30 ng/ml) or PDGF BB (10 ng/ml) for approximately 24 h. [3H]thymidine (1 μCi/well) was added to the culture for the last 6 h of treatment. Cells were harvested on Unifilter 96‐well white microplate (GF‐C) using a Packard Filtermate Harvester and were counted with a Packard luminescence counter (Packard, Meriden, CT).
Partial purification of stroma recruitment factors from CM
VEGF‐null G5 cells were incubated in serum‐free DMEM/F12 for 3 days. A 2 L volume of G5 CM was collected as initial starting material for purification. The CM was diluted in 25 mM sodium phosphate, pH 6.0, and then loaded to a 5 ml HiTrap S‐Sepharose cation exchange column (Amersham Pharmacia, Sweden). The bound proteins were eluted stepwise from the column with buffers containing 0.2 M and 1 M NaCl. The bioactive fractions were pooled and applied to a TSK size‐exclusion column (21.5 × 30 cm) (TOSOH Biosep LLC, Japan) equilibrated with 20 mM Tris buffer, pH 7.2, containing 2 M NaCl and 0.02% Tween 20. The subsequent bioactive fractions were pooled, adjusted to 0.1% trifluoroacetic acid and applied to a reversed‐phase C4 HPLC column (100 × 4.6 mm) (Eichrom Technologies, Darien, IL). Proteins were eluted with a linear gradient of 15–50% acetonitrile. Aliquots of each fraction were diluted and assayed for fibroblast migration and proliferation activity.
Adenovirus generation
Adenoviral vectors expressing chimeric human soluble PDGF receptors, PDGFR α‐IgG or PDGFR β‐IgG were generated using the AdEasy adenoviral vector system (BD Biosciences, Bedford, MA) according to the manufacturer's manuals. PDGFR α‐IgG and PDGFR β‐IgG consist of the extracellular domains of human PDGFR α and β respectively fused to the Fc region of human IgG1.
Fibrosarcoma formation and tumor growth inhibition studies
Five million cells in 0.1 ml of growth factor‐reduced Matrigel (BD Biosciences, Bedford, MA) were injected subcutaneously into the dorsal flank region of 6‐ to 8‐week‐old beige nude mice from Harlan Sprague Dawley. At 2 days after tumor cell inoculation, mice were injected intraperitoneally with anti‐VEGF G6‐23 or an isotype control antibody anti‐ragweed at 10 mg/kg body weight, twice weekly. There were 5–10 animals per treatment group. Tumor growth was monitored twice weekly by measurement of length (
L) and width (
W) with a vernier caliper and tumor volume was calculated using the formula
V=
LW2/2 (
Blaskovich et al, 2000). After 3 weeks, tumors were harvested, weighed and processed for histological analysis.
To assess the antitumor activity of the soluble PDGFR IgGs, adenoviruses expressing human chimeric PDGFR α‐IgG (Av‐PDGFR α‐IgG), PDGFR β‐IgG (Av‐PDGFR β‐IgG) or a control LacZ gene (Av‐LacZ) were injected directly into tumor mass. Different cell lines and treatment conditions were tested in groups of 5–8 mice. The tumor‐bearing mice were dosed at 1 × 109 PFU weekly, starting 1 day after tumor cell inoculation. After 3 weeks, tumors were weighed and harvested for pathology and histologic analyses.
Tumor cell proliferation
Cells were plated in 12‐well plates at 2 × 104 cells/well and infected with Av‐LacZ, Av‐PDGFR α‐IgG or Av‐PDGFR β‐IgG at 200 PFU/cell. Cells were cultured in growth medium containing 1% serum for 5 days and cell numbers were determined using a coulter counter.
In situ hybridization and immunohistochemistry
Tumors were fixed in 10% neutral buffered formalin for approximately 16 h prior to paraffin embedding. Sections 5 μm thick were processed for
in situ hybridization (
Ferrara et al, 2003a).
33P‐UTP‐labeled sense and antisense probes were PCR amplified using primers described in
Supplementary material. Immunohistochemical staining for VEGFR‐2/flk‐1 was performed as described (
Gerber et al, 1999). Vessel surface density was measured using Photoshop software and reported in units/μm.