The influence of mesenchyme of neonatal seminal vesicle and embryonic urogenital sinus on the morphologic and functional cytodifferentiation of dunning prostatic adenocarcinoma: Roles of growth factors and proto-oncogenes

Role of the stromal microenvironment in carcinogenesis of the prostate

The topic of this review is the role of stromal-epithelial interactions in normal and malignant prostatic growth. Because cell-cell interactions and androgens play such key roles in the prostate, the goal of this review will be to apply endocrinologic and developmental concepts to the understanding of normal and malignant prostatic growth. Prostatic development is induced by androgens, which act via androgen receptors. Androgens elicit prostatic epithelial growth during fetal and prepubertal periods, and in adulthood androgens act via reciprocal homeostatic stromal-epithelial interactions to maintain functional differentiation and growth quiescence. During carcinogenesis, these reciprocal homeostatic stromal-epithelial interactions are disrupted. In this review, 2 models of prostatic carcinogenesis will be reviewed, both of which emphasize the role of the stromal microenvironment in the carcinogenic process. Hormonal carcinogenesis of the prostate can be elicited by treatment of rats and mice with testosterone plus estradiol (T+E2). Using an immortalized but nontumorigenic human prostatic epithelial cell line (BPH-1), tissue recombinant studies were employed to explore the cellular mechanisms of prostatic carcinogenesis. Accordingly, human BPH-1 prostatic epithelial cells were combined with rat UGM, and the resultant UGM+BPH-1 recombinants were grown in adult male nude mouse hosts. In untreated mouse hosts, UGM+BPH-1 recombinants produced solid branched epithelial cords and ductal structures exhibiting benign growth. In T+E2-treated hosts, UGM+BPH-1 recombinants formed invasive carcinomas. Since BPH-1 cells lack androgen and estrogen receptors, whereas rat UGM expresses both of these receptors, it is proposed that hormonal carcinogenesis is elicited by T+E2 via paracrine mechanisms mediated by the stromal microenvironment. During prostatic carcinogenesis in rats and humans, the periepithelial stroma undergoes progressive loss in smooth muscle with the appearance of carcinoma-associated fibroblasts (CAFs). This abnormal stroma was shown to promote carcinogenesis in genetically abnormal but nontumorigenic epithelial cells. CAF+BPH-1 tissue recombinants grown in male hosts formed carcinomas, whereas benign growth and orderly tissue architecture developed in recombinants composed of normal prostatic stroma+BPH-1. Malignant transformation triggered by CAF was associated with additional genetic alterations and changes in gene expression in the BPH-1 cells. Thus, the stromal microenvironment is a critical determinant of benign versus malignant growth.

Dedifferentiation of stromal smooth muscle as a factor in prostate carcinogenesis

We had earlier established an animal model of prostate carcinogenesis using a combination of testosterone (T) and 17beta-estradiol benzoate (E2) on Noble rats (Wang and Wong, 1998). In the present study we examined the changes in a number of smooth muscle differentiation markers including smooth muscle alpha-actin and myosin, vinculin, desmin, laminin and vimentin as well as changes in fine structure by electron microscopy. Our immunohistochemical (IHC) studies revealed that smooth muscle cells (SMCs) subjacent to dysplastic (precancerous) sites and carcinoma usually exhibited a preferential loss of myosin, desmin and laminin. However, the expression of alpha-actin and vinculin appeared to be more persistent in most dysplastic or neoplastic sites. The study reaffirmed our earlier observation that there was a concurrent dedifferentiation of surrounding SMCs during the development and progression of prostate carcinogenesis. The structural study revealed that SMC subjacent to epithelial dysplasia displayed a spectrum of derangements. These included the loosening of muscular layers with SMC characterized by their highly irregular external contours with numerous spine-like cytoplasmic projections. There was also a reduction in density of myofilaments and presence of many enlarged caveolae in muscle cells. Additionally, focal discontinuity or disruptions of muscular layer were often observed together with an increase in abundance of fibrous connective tissue. Moreover, the amount of smooth muscle appeared to be inversely correlated with the histologic grade of prostate tumors. In most instances, SMCs were totally absent in the moderately or poorly differentiated tumors and in metastatic tumors in the lung and the small intestine. Stromal muscular deformity was associated with concurrent changes in epithelial cells. Dysplastic epithelial cells were characterized by a reduction in abundance of secretory organelles such as reduction in size of Golgi apparatus, paucity of granular endoplasmic reticulum and secretory vesicles. The nuclei showed typical deformity characterized by deep nuclear membrane foldings. The basal lamina of dysplastic or tumor cells was present although focal structural abnormalities such as reduplication, disruption and smearing were sometimes observed. The present data indicate that derangements of epithelial cells during prostate carcinogenesis are associated with a reduction or dedifferentiation of stromal SMCs. Our results lend support to the hypothesis that transformed epithelium is incapable of maintaining normal differentiation of adjacent muscle. In turn, abnormal stromal, resulting from dedifferentiation or reduction of SMC, may lead to loss of stromal control over epithelial proliferation and differentiation. Consequently, a loss of differentiation in both epithelium and stromal SMCs may be critically involved in hormone-induced prostate carcinogenesis.

Growth factors and epithelial-stromal interactions in prostate cancer development

Epithelial-stromal interactions are important not only in growth, development, and functional cytodifferentiation of the prostate but also in derangements of prostate gland such as BPH and prostate carcinoma. This chapter explores the roles of epithelium and stroma during this delicate process and highlights the role and mutual influence of each on the other. It also examines the importance of ECM in mediating the effects of androgens and drawn attention to estrogen and genetic factors in the process. During this process of epithelial-stromal interaction, growth factors play a central role in mediating the interactions. This chapter focuses on the role of several growth factors including epidermal growth factor, fibroblast growth factor, transforming growth factor alpha, transforming growth factor beta, insulin-like growth factor-1, vascular endothelial growth factor, nerve growth factor, platelet-derived growth factor, and hepatocyte growth factor. This chapter emphasizes the importance of epithelial-stromal interactions in tumorigenesis and highlights the switch of paracrine to autocrine mode during the process of carcinogenesis.

Cultured stromal cells: an in vitro model of prostatic mesenchymal biology

BACKGROUND

Initial efforts to develop in vitro models to study prostatic biology focused on the culture and characterization of epithelial cells. Recently, attention has turned towards inclusion of stromal cells in experimental systems.

METHODS

Improved methods to isolate and culture stromal cells have been developed. An array of markers are employed to characterize subtypes of stromal cells, with particular interest in smooth muscle differentiation.

RESULTS

Defined, serum-free media are available for certain experimental applications. Conditions that promote smooth muscle differentiation have been identified. Investigators have characterized hormonal and peptide factors that regulate the growth of prostatic stromal cells, and have also described paracrine factors produced by stromal cells that influence epithelial biology.

CONCLUSIONS

Prostatic stromal-cell cultures are now widely employed by a large number of investigators for a diverse array of experimental purposes. While further refinement is required to obtain model systems that fully mimic in vivo processes, the availability of stromal- and epithelial-cell cultures provides a valuable resource for studying normal prostatic biology as well as benign prostatic hyperplasia (BPH) and cancer.