Characterization of gene regulatory elements for selective gene expression in human melanoma cells

Since chemotherapy is not sufficiently effective, an alternative strategy for the treatment of advanced melanoma could be an in vivo gene therapy approach. For this purpose, a highly accurate delivery of the therapeutic gene and cell specific gene expression is essential. Since melanocytic cells are characterized by their pigmentation, and since tyrosinase is the key enzyme involved in melanogenesis, we studied the expression of a reporter gene which is under the control of the tyrosinase promoter or a combination of melanocyte-specific enhancer and tyrosinase promoter in ten human melanoma and four epithelial cell lines. Reporter gene expression was upregulated up to 21-fold using the tyrosinase promoter and up 154-fold using the enhancer/promoter construct compared to a control plasmid. Gene expression was strongly associated with capacity of cells for melanin synthesis. The results suggest that the use of tissue specific gene regulatory elements might provide a new opportunity for targeting therapeutic genes to melanoma cells.

Pharmacological modulation of IL-6 and IL-8 secretion by the H1-antagonist decarboethoxy-loratadine and dexamethasone by human mast and basophilic cell lines

Mast cells and basophils are central effector cells of allergic reactions and are involved in inflammatory diseases. These cell types produce an array of mediators including a broad spectrum of cytokines. In order to examine whether antiallergic drugs modulate the release of these mediators, we have investigated the influence of dexamethasone and decarboethoxy-loratadine (DEL), the active metabolite of the H1-blocking agent loratadine, on the release of IL-6 and IL-8 by the human mast cell line HMC-1 and the human basophilic cell line KU812 by ELISA. Dexamethasone (10(-6)-10(-11) M) or Del (10(-5)-10(-14) M) were added to the cells either 1 h prior to or simultaneously with PMA and Ca-ionophore A23187. When preincubated with the cells, DEL dose-dependently suppressed IL-6 release by up to 40% and IL-8 release by up to 50%. Dexamethasone potently suppressed secretion of both cytokines if simultaneously added to the cells with the stimuli by up to 60% and after preincubation by up to 80%. Since both antihistamines and glucocorticoids are used for treatment of allergic diseases, the findings reported here indicate that these drugs may modulate allergic reactions via inhibition of cytokine release from mast cells and basophils.

Mast cells in the cytokine network: the what, where from and what for

The basic understanding of mast cell ontogeny and function has been fundamentally changed in recent years with observations that the cells produce and respond to a broad range of cytokines. These rapidly accruing data and their potential significance were discussed at the recent symposium "Mast Cells in the Cytokine Network", and the overview lectures of most speakers are summarized in this special journal issue. In the present introductory manuscript, the organizers of the meeting discuss data fundamental to an understanding of the topic and highlight aspects of special interest. They consider mast cells to be defined most reliably by their unique ultrastructure since the cells are highly heterogeneous in dependence of the species studied, their tissue location, their stage of development and probably also in relation to cytokines. Most other characteristics of mast cells are shared with diverse other cell types. Murine mast cell development is induced by several cytokines. These factors are mostly ineffective in human cells except for stem cell factor which causes mast cell development from CD34+/c-kit+ progenitors. There is however recent evidence that fibroblasts and keratinocytes produce additional growth factors for human mast cells. Regarding cytokine secretion, most molecules known so far are produced by both murine and human mast cells. The cells furthermore bear receptors for several cytokines, enabling them to respond in an autocrine and paracrine fashion. Mast cells may thus function within a complex cytokine network, affecting physiological as well as immunological and inflammatory processes.

Expression of stem cell factor in cutaneous mastocytosis

Stem cell factor has recently been identified as a potent growth factor for bone marrow stem cells, melanocytes and mast cells. In order to evaluate its possible role in human mastocytosis, skin lesions from 13 patients with urticaria pigmentosa and five patients with mastocytomas, and normal skin specimens from five healthy donors were studied by immunohistochemistry, using polyclonal and monoclonal (hkl-12) antibodies against stem cell factor, and a monoclonal antibody (YB5.B8) against its receptor, the c-kit proto-oncogene product. Stem cell factor expression was noted in all sections studied, with an equal distribution pattern for both antibodies, but a weaker intensity with the hkl-12 reagent. Cytoplasmic staining was noted in keratinocytes, Langerhans cells, sweat gland ductal lining cells, mast cells, endothelial cells and spindle-shaped dermal stromal cells. An intense, diffusely granular reaction pattern was noted in all cells, except for a sparse, coarsely granular pattern in mast cells and stromal cells. In urticaria pigmentosa, staining was weaker in keratinocytes, but more prominent in Langerhans cells. In all sections, toluidine blue-positive mast cells and TA 99-positive basal epidermal melanocytes were the only cells to react with the c-kit antibody. Mastocytomas and urticaria pigmentosa lesions thus exhibit different patterns of stem cell factor expression. However, a possible pathogenetic role of this factor in mastocytosis remains to be determined.

Cytokine secretion by human mast cells

Mast cells have been traditionally viewed as effector cells of immediate-type hypersensitivity reactions. Besides this, mast cell activation and degranulation have been associated with various biologically and clinically important functions. Results of the past few years suggest that mast cells are involved in the development of late-phase reactions and influence other chronic inflammatory responses through the generation and secretion of various multipotential cytokines.

Mast cells as modulators of hair follicle cycling

While the central role of mast cells (MC) in allergy and inflammation is well-appreciated, much less is known about their physiological functions. The impressive battery of potent growth modulatory MC products, and increasing evidence of MC involvement in hyperproliferative and fibrotic disorders suggest that tissue remodelling may be one of those, namely in the skin. Here, we delineate why this may best be studied by analysing the potential role of MC in hair growth regulation. On the background of numerous, yet widely under-appreciated hints from the older literature, we summarize and discuss our recent observations from the C57BL/6 mouse model for hair research which support the concept that MC are functionally important modulators of hair follicle cycling, specifically during anagen development. This invites to exploit the murine hair cycle as a model for dissecting the physiological growth modulatory functions of MC and encourages the exploration of MC-targeting pharmaceutical strategies for the treatment of hair growth disorders.

Beta 2-integrins in different forms of urticaria

As urticarial lesions involve tissue invasion by inflammatory cells, and as beta 2-integrins play a central part in adhesion of leucocytes to endothelia, allowing their migration into the tissues, we have explored the distribution and sequential expression of these molecules in tissue sections from different forms of urticaria. Prick test weals (of 10 min duration) to common inhalant allergens showed only a minor increase of CD18, whereas in a case of cold urticaria CD11b and CD18 molecules were increasingly upregulated within the first 30 min after elicitation of the lesions. Skin test sites in delayed pressure urticaria, and urticarial lesions (> 6 h duration) of acute and chronic recurrent urticaria also showed marked upregulation of CD11b and CD18, and to a lesser extent of CD11a, but this did not strongly correlate with the intensity of the mixed cellular infiltrate. Non-lesional skin showed expression of beta 2-integrins in chronic urticaria, delayed pressure urticaria, and less so in acute urticaria, suggesting generalized leucocyte activation. This analysis of integrins thus suggests an early and extensive involvement of these molecules in the pathological events associated with the evolution of urticarial lesions.

Glutathione and related enzymes in tumor progression and metastases of human melanoma

We have shown previously that overexpression of p-170 glycoprotein-mediated multidrug resistance plays only a minor role in conferring chemoresistance to human melanoma cells. In addition to membrane transporters like p-170, metabolizing enzyme systems have been implicated in altered drug sensitivity. Recently, glutathione and associated enzymes have been associated with resistance to alkylating substances, particularly in gastrointestinal and gynecologic cancers. In this study, we investigated whether increased levels of glutathione and related enzymes may play a role in chemoresistance in melanoma. Levels of glutathione, glutathione S-transferase (GST), glutathione reductase, and gamma-glutamyl transpeptidase were analyzed in melanoma and non-melanoma cell lines. In addition, 18 melanoma metastases derived from skin and lymph nodes were examined. Levels of gamma-glutamyl transpeptidase were statistically different in cells derived from melanocytic tumors compared with non-melanoma cell lines and normal cells. In addition, GST levels in metastases derived from skin or lymph nodes were significantly lower than those in permanent cell lines. However, levels of glutathione and related enzymes in metastases and cell lines fluctuated over a wide range, up to 40-fold, regardless of treatment status or origin of metastases. In a second part of the study, the expression of GST isoenzymes alpha, mu, and pi was studied by immunohistology in 10 benign nevi, 29 primary melanomas, and 39 melanoma metastases before and during chemotherapy. Expression of GST isoenzymes was increased with tumor progression, and GST pi was the strongest isoform expressed. However, no correlation was found between GST levels by immunohistochemistry and the course of tumor progression, between GST levels in metastases obtained before or during chemotherapy, or between GST levels and clinical response. These data suggest that alterations in glutathione metabolism and the expression of GST do not play a major role in resistance to chemotherapeutic drugs in melanoma.

[Annular elastolytic giant cell granuloma with a spontaneous healing tendency]

Annular elastolytic giant cell granuloma is mostly found in middle aged women in skin areas exposed to sunlight. Our 17-year-old female patient had a widespread reddish-brown lesion on the abdomen that met the histological criteria for annular elastolytic giant cell granuloma. However, the clinical findings and the localization were uncommon. UV light was excluded as a trigger. Other, still unknown, factors that might change antigenicity of elastic fibres must be considered. Spontaneous resolution suggests a transient influence of such factors. Differential diagnosis includes skin disorders with elastolysis; discrimination especially from mid-dermal elastolysis is not well defined.

Nuclear proto-oncogene products transactivate the human papillomavirus type 16 promoter

Human papillomavirus (HPV) type 16 and 18 viral genomes are frequently detected in cervical and penile cancer biopsies. Although this strongly suggests a prominent role for HPV infection in the development of genital cancer, other genetic or environmental factors are also involved. Genital cancer is postulated to result from loss of cellular control functions, which leads to an unregulated expression of HPV oncogenic proteins. In our study, we determined the trans-activating properties of nuclear proto-oncogene proteins c-Fos, c-Jun and c-Myc on P97 enhancer/promoter activity of HPV16. Using a CAT-reporter construct containing the HPV16 enhancer/promoter element, we investigated the trans-activating effects of c-Fos, c-Jun, c-Myc, and E2 in cervical HT-3 cells. c-Fos and c-Jun overexpression resulted in a 3.3- and 3.1-fold up-regulation of CAT activity. Only 2-fold induction was determined by co-transfection with c-myc and the viral transcription factor E2. Based on these findings, we investigated the expression of HPV DNA (16 and 18) as well as nuclear proto-oncogenes (c-fos, c-jun and c-myc) in nine cervical cancers by in situ hybridisation. In six out of nine carcinomas, HPV16 and/or HPV18 DNA was detectable. All tumours showed an intense and homogeneous expression of c-fos and c-jun mRNA, while the signal for c-myc was detectable only in four specimens. These data suggest that deregulation of nuclear proto-oncogene expression may contribute to an overexpression of HPV-derived oncogenic proteins (E6 and E7), which is generally hypothesised to be an important step in the malignant transformation of HPV-associated tumours.

Mast cells in melanocytic tumours

The importance of mast cells in local homeostasis, inflammation and tumour surveillance is supported by many studies, and the association of mast cells with various neoplasms has been known for a long time. The functional significance of mast cells surrounding tumours is currently unclear. In the present histopathological study, 16 naevi and 44 primary malignant melanomas were analysed. The follow-up time after primary surgery of malignant melanoma patients was almost 10 years, during which time half of the tumours had metastasized. The numbers of mast cells surrounding pigmented lesions were determined. The mast cells were visualized using a modified toluidine blue staining (pH 0.5; 24 h). Significantly different numbers of mast cells were found in naevi compared to melanomas (P = 0.0013), but no significant correlation could be identified regarding prognostic parameters including tumour thickness and clinical outcome.

Human keratinocytes release mast cell differentiation factors other than stem cell factor

Besides stem cell factor (SCF), additional fibroblast-derived mast cell growth factors have previously been described. Since keratinocytes have also been shown to produce SCF, we have studied the ability of culture supernatants from the human HaCaT keratinocyte cell line to induce SCF-independent mast cell differentiation. The immature human mast cells of the HMC-1 line which express a mutant continuously activated SCF receptor were used as model target cells. Culture supernatants from differentiating keratinocytes (at day 11 of culture), and far less so those from proliferating keratinocytes (day 4 of culture), caused a marked, dose-dependent increase of histamine and tryptase in HMC-1 cells. This suggests that human HaCaT keratinocytes release mast cell differentiation factors other than SCF, to a degree related to their state of differentiation.

The differentiation-related upregulation of aryl hydrocarbon receptor transcript levels is suppressed by retinoic acid

The environmental contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) binds to a specific intracellular receptor protein -the Ah-receptor- which acts as a transcription factor. Herein we report on the relative levels of Ah-receptor-mRNA and TCDD-induced cytochrome P450 1A1 (Cyp1A1)-mRNA and their modulation by retinoic acid in the human keratinocyte cell line HaCaT. Ah-receptor-mRNA was already present in proliferating keratinocytes and increased 8-fold in the course of differentiation. Addition of 10 nM TCDD did not alter the level of Ah-receptor transcripts. In contrast, addition of 1 microM RA maintained the amount of Ah-receptor-mRNA at the basal level as observed only in proliferating keratinocytes. The transcription of Cyp1A1 was dependent on TCDD-treatment and increased fivefold in more differentiated cells as compared to proliferating cells. Simultaneous addition of retinoic acid revealed an only twofold increase. These results indicate that the expression of the AhR is dependent on the state of differentiation of keratinocytes and seems to be affected by retinoic acid.

P-glycoprotein expression in primary and metastatic malignant melanoma

Metastatic malignant melanoma is notoriously resistant to chemotherapeutic agents, but the exact mechanisms involved in this drug resistance are unknown. One recently defined major mechanism of multidrug resistance involves the overexpression of P-glycoprotein on cell membranes. In order to evaluate the significance of this putative drug efflux pump for chemoresistance of malignant melanoma, five different antibodies were employed to examine P-glycoprotein expression on tissue from 33 primary malignant melanomas and 35 metastases, before and after chemotherapy, using immunohistological techniques. The expression of P-glycoprotein was low on primary cutaneous melanomas (three of 33), and on metastases (one of 35). Normal tissue in and around the melanoma showed reactivity of endothelial cells, stromal cells and eccrine sweat glands with several antibodies tested. Chemotherapy with drugs commonly used in metastatic melanoma, including agents known to induce P-glycoprotein expression in other tumours (vindesine, cisplatin) had no effect on P-glycoprotein expression in human melanoma metastases. The high chemoresistance of human melanoma cells in vitro and in vivo is probably not mediated via P-glycoprotein, and other possible mechanisms involved will have to be explored in future studies.

Association with clinical outcome of expression of VLA-4 in primary cutaneous malignant melanoma as well as P-selectin and E-selectin on intratumoral vessels

BACKGROUND

The process of tumor growth and metastasis is a complex multistep cascade. The ability of tumor cells to adhere to and detach from extracellular matrix and endothelial cells may be crucial in the metastatic process and may dramatically alter the clinical prognosis and outcome for patients with certain cancers. A number of adhesion molecules have been detected on human melanoma cells and have been associated with various properties in vitro including invasiveness. Recent findings from our laboratory have indicated an ordered change in integrin expression during the process of tumor progression.

PURPOSE

This study was designed to identify molecular markers present on human melanoma cells and in intratumoral vessels that have prognostic significance regarding disease-free interval and survival time.

METHODS

Specimens of primary cutaneous malignant melanoma were obtained from 60 patients who had been followed for at least 36 months, with development of metastases in 29 patients during that period of time, and were analyzed for their expression of VLA-4, VLA-6, ICAM-1, ELAM-1 (E-selectin), CD62 (P-selectin), and CD44v6 molecules on tumor and endothelial cells by immunostaining. Light microscopy was used to evaluate and categorize the number of positively stained cells. Statistical analyses were done to determine the relationship of the expression of individual adhesion molecules with time to disease progression (i.e., disease-free interval) and overall survival time.

RESULTS

In each case, positive staining for ELAM-1 and CD62 on intratumoral vessels and for VLA-4 on human melanoma cells was negatively associated with disease-free interval (P < .01) and overall survival time (P < .01). The presence of VLA-6, CD44v6, and ICAM-1 on melanoma cells was not associated with clinical outcome.

CONCLUSIONS

Immunohistochemical screening and detection of ELAM-1, CD62, and VLA-4 may help to define a subgroup of melanoma patients at risk of developing metastases.

Efficacy of cetirizine in cholinergic urticaria

In order to examine the efficacy of cetirizine in cholinergic urticaria, we studied 24 patients in a double-blind crossover design during 3-week treatment periods, with either 10 or 20 mg/d cetirizine or placebo. The placebo period was always placed in between the two verum treatments to allow for a washout of the drug. Evaluation of the patients' daily symptom scores based on itching, erythema and whealing showed a highly significant improvement (p < 0.01). The percentage of days with mild or no symptoms was also increased significantly with the drug (p < 0.05). Except for whealing (p < 0.05), no significant differences between the two dosages of cetirizine could be determined. Since antihistamines have previously been shown to be frequently unsatisfactory in the treatment of cholinergic urticaria, the present data are encouraging regarding the control of symptoms in this condition.

[Rudolf Virchow (1821-1902) and his contributions to dermatology]

The contribution of Rudolf Virchow to dermatology seems to have been forgotten, or present-day dermatologists are not aware of it. The present historical review is intended to show that Virchow's thoughts and the terminology created by him are still alive. The report encompasses a short biography, including Virchow's nonmedical activities. It starts with early experimental publications, which laid to the foundation for his fame, and with dermatological studies of his early period. This is followed by a detailed description of his contributions pertaining to dermatology in his largest work, "Cellular-pathology". Special mention is made of Virchow's lasting contributions to medical, and particularly dermatological, terminology. Finally, his historical studies, his later small publications on topics in dermatology, his pupils and scientific friends, and the social-political and anthropological activities of later years are discussed. Thus, a multifaceted picture is painted of a still modern pathologist who has influenced dermatology in multiple ways.

Interleukin-6 expression in the skin of patients with lupus erythematosus

It has been proposed that interleukin-6 may play a role in the pathogenesis of autoimmune diseases like lupus erythematosus. We have therefore investigated the immunoreactivity of IL-6 in 32 skin biopsies of 23 patients suffering from chronic discoid lupus erythematosus (n = 16), subacute cutaneous lupus erythematosus (n = 5) and systemic lupus erythematosus (n = 5) as well as in uninvolved skin (n = 6) and in normal skin from healthy volunteers (n = 3). Increased immunohistochemical staining was detectable in 14 of 26 biopsies from lesional skin. The remaining biopsies from lesional, non-lesional and normal skin displayed only minimal or no reactivity, but 8 out of 12 lupus erythematosus patients had been pretreated with local or systemic antiinflammatory drugs. Irrespective of the LE subtype, immunolabelling was generally most intense in the basal layer of the epidermis, with additional intense suprabasal staining in sections from 2 of 5 SLE patients. Preferential production of IL-6 in the lower parts of the epidermis was confirmed by RNA in situ hybridization. No correlation was found between the deposition of immunoglobulins and complement at the dermo-epidermal junction and IL-6 expression in keratinocytes. These data suggest that IL-6 may be involved in LE although its exact role in the pathogenesis of the disease needs to be further elucidated.

Expression of the c-kit receptor in hypomelanosis: a comparative study between piebaldism, naevus depigmentosus and vitiligo

In order to investigate possible alterations in c-kit protein expression on epidermal melanocytes in different hypopigmentary disorders, we have examined skin specimens from one patient with piebaldism, one patient with naevus depigmentosus, and five patients with vitiligo. Cryosections were examined by immunohistochemistry using monoclonal antibodies against the c-kit protein (YB5.B8) and melanosomes (TA99). In piebaldism, hypomelanotic epidermis contained only a few TA99-positive epidermal melanocytes and no detectable c-kit protein, whereas in naevus depigmentosus the expression of c-kit protein was strong, and TA99 immunoreactivity was faint. In vitiligo lesions, no epidermal immunoreactivity for melanosomes or c-kit protein was found. Normally pigmented skin of all patients showed immunoreactivity of epidermal melanocytes for both c-kit protein and melanosomes. Different hypomelanotic lesions can thus be differentiated by absent melanocyte c-kit protein and low or no expression of melanosomal marker in piebaldism, normal c-kit but low melanosome expression in naevus depigmentosus, and the absence of all melanocyte markers in vitiligo.

Interferon-gamma downregulates epidermal growth factor receptors on human melanoma cells

Unregulated expression of epidermal growth factor receptor (EGF-R) is a common event in neoplastic transformation and has been shown to be associated with melanocytic tumor progression. Modulation of such a receptor by pharmacological agents could therefore be of clinical interest. We have studied EGF-R expression, its response to epidermal growth factor (EGF) and modulation effects by interferon gamma (IFN gamma) on human melanoma cells. Addition of EGF, anti-EGF and anti-EGF-R antibodies had no effect on proliferation of six melanoma cell lines tested. We report in this communication that EGF-R expression on human melanoma cells can be modulated by IFN-gamma. In the melanoma cell lines treated with IFN gamma, proliferative behavior was not affected; however, we demonstrate a downregulation of EGF-R expression on the protein level, by immunohistochemistry and flow cytometric analysis, and an accumulation of EGF-R mRNA by Northern blot analysis. The results suggest that IFN gamma downregulates EGF-R expression at a posttranscriptional level on human melanoma cells. This EGF/EGF-R interaction and its modulation by IFN gamma on human melanoma cells needs to be further clarified regarding its in vivo significance for the treatment and prognosis of malignant melanoma.