Bioinformatic Analysis and Clinical Case Studies Identify CD276 as a Promising Diagnostic Biomarker for Clear Cell Renal Cell Carcinoma

OBJECTIVE

This study aimed to explore the relationship between CD276 and clear cell renal carcinoma (ccRCC) and assess the diagnostic value of CD276 in ccRCC.

METHODS

Expression levels of CD276 in ccRCC and para-cancer tissues were compared and analyzed retrospectively using data obtained from TCGA and GEO databases. The clinical data was analyzed prospectively. Immunohistochemistry and RT-PCR analyses were used to analyze the expression of CD276 at the mRNA and protein levels. These analyses compared the expression between ccRCC tissues and para-cancer tissues obtained from 70 patients with ccRCC. Next, ELISA was used to analyze peripheral blood samples from 70 patients with ccRCC and 72 healthy individuals, facilitating the differentiation of ccRCC patients from normal controls. Finally, we utilized the Kaplan-Meier method to generate ROC curves for assessing the diagnostic value of CD276 for ccRCC.

RESULTS

Analysis of TCGA and GEO data revealed that the mRNA expression of CD276 was higher in ccRCC tissues than in para-cancer tissues (P < .05). Clinical validation using IHC and RT-PCR confirmed that the expression of CD276 was higher in ccRCC tissues than in para-cancer tissues, both at the mRNA and protein levels (P < .05). ELISA demonstrated that the expression of CD276 was higher in ccRCC patients than in normal individuals, and patients with a higher pathological grade showed higher expression of CD276 in the peripheral blood than those with a lower pathological grade (P < .05). ROC curves drawn from the above three datasets demonstrated that CD276 had a high diagnostic value for ccRCC (AUC = .894, .795, .938, respectively).

CONCLUSION

The expression of CD276 was higher in ccRCC tissues and positively associated with the pathological grade. Therefore, CD276 may serve as a molecular biomarker for ccRCC prediction.

Serum soluble B7-H3 is a prognostic marker for patients with non-muscle-invasive bladder cancer

Background

B7-H3 is a member of the B7 family of immune-regulatory ligands and is a costimulatory molecule promoting the T cell response in vitro. We herein investigated the clinical utility of serum soluble B7-H3 (sB7-H3) in patients with non-muscle invasive bladder cancer (NMIBC).

Methods

We analyzed 555 patients in whom NMIBC was diagnosed at Tokyo Metropolitan Tama Medical Center between 2008 and 2013. We measured the serum sB7-H3 (sB7-H3) level using the enzyme-linked immunosorbent assay (ELISA) and evaluated the utility of sB7-H3 as a prognostic biomarker for NMIBC. We used the Cox proportional hazards regression model to assess recurrence-free survival (RFS) and progression-free survival (PFS) with the sB7-H3 level.

Results

We detected high levels of sB7-H3 in the sera of 47% of patients with NMIBC versus only 8% in healthy donors. The increase of sB7-H3 was significantly associated with poor RFS and PFS. Multivariate analysis showed that elevated sB7-H3 was an independent prognostic factor of RFS and PFS. According to the European Organization for Research and Treatment of Cancer (EORTC), in intermediate-low and intermediate-high risk groups, the presence of sB7-H3 significantly determined the rate of recurrence and progression.

Conclusions

Our data suggested that evaluating serum sB7-H3 expression is a useful tool for predicting the prognosis of patients with NMIBC.

B7-H3 modulates endothelial cell angiogenesis through the VEGF cytokine

B7-H3 is a cell surface molecule in the immunoglobulin superfamily that has been shown to perform both immunological and non-immunological functions. It has also been found that vascular endothelial growth factor (VEGF) is an important molecule in the modulation of endothelial cell behavior. In this study, we analyzed the serum expression of B7-H3 in 113 rheumatoid arthritis and systemic lupus erythematous patients using the ELISA and found a positive correlation between B7-H3 and VEGF. Next, we investigated the involvement of B7-H3 in angiogenesis using human umbilical vein endothelial cells (HUVECs) with transient knockdown of B7-H3 and an in vivo Matrigel model. Data from the in vitro experiments showed that B7-H3 increased cell proliferation, migration, and tube formation, and correlated with the expression of VEGF. Furthermore, B7-H3 affected the formation of functional vascular networks in Matrigel plugs, which were dissected from mice injected with different HUVECs. Our data suggest that B7-H3 promotes angiogenesis through the enhancement of VEGF secretion. This is the first study proposing a significant role for B7-H3 in the promotion of angiogenesis and may provide further understanding of this gene's biological function.

Soluble B7-H3 (sB7-H3) is over-expressed in the serum of type 1 diabetes patients

Type 1 Diabetes (T1D) is an autoimmune disease resulting from insulin-secreting β-cells mediated by autoreactive T cells. We demonstrated increased level of sB7-H3 in T1D patients than in healthy control group. This result suggests that B7-H3 may be may be a promising biomarker associated with the pathogenesis of T1D.

[Serum levels of B7-H3 and IFN-γ in patients with hepatitis B and clinical implications]

OBJECTIVE

To detect the serum levels of soluble B7-H3 (sB7-H3) and interferon γ (IFN-γ) in patients with hepatitis B and related clinical implications.

METHODS

The levels of sB7-H3 and IFN-γ were detected by ELISA in 87 cases of hepatitis B including 16 cases of acute hepatitis, 25 cases of chronic moderate to severe hepatitis, 24 cases of liver cirrhosis, 22 cases of decompensated cirrhosis, and 24 healthy subjects. Their correlations with the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), α-fetoprotein (AFP), white blood cells (WBCs), hepatitis virus B (HBV) DNA were analyzed statistically.

RESULTS

The serum levels of sB7-H3 and IFN-γ in patients with hepatitis B were (202.17 ± 58.14) ng/mL and (3436.11 ± 1605.01) pg/mL, respectively, which were significantly higher than those in the healthy subjects. SB7-H3 was closely related to IFN-γ. AST, ALT, AFP, WBCs, and HBV DNA had no correlations with sB7-H3 and IFN-γ. SB7-H3 was the highest in the patients with acute hepatitis, while IFN-γ was the highest in the patients with chronic hepatitis B.

CONCLUSION

The levels of sB7-H3 and IFN-γ in the patients with hepatitis B are higher than those in the healthy subjects. Continuous monitoring of serum sB7-H3 and IFN-γ may helpful in predicting disease outcomes for patients with hepatitis B.

Differences in B7 and CD28 family gene expression in the peripheral blood between newly diagnosed young-onset and adult-onset type 1 diabetes patients

Type-1 diabetes (T1D) is a heterogeneous autoimmune disease, and there are pathogenetic differences between young- and adult-onset T1D patients. We hypothesized that the expressions of genes involved in costimulatory immune system pathways in peripheral blood are differently regulated in young- and adult-onset T1D. Study group I consisted of 80 children, adolescents, and young adults (age range 1.4-21.4 y; 31 controls and 49 T1D patients). Study group II consisted of 48 adults (age range 22.0-78.4 y; 30 controls and 18 T1D patients). The mRNA expression levels of CD86, CD28, CD25, CD226, CD40, BTLA, GITR, PDCD1, FoxP3, TGF-β, ICOS, sCTLA4, flCTLA4, and CD80 were measured in peripheral blood. Genetic polymorphisms (HLA haplotypes; rs231806, rs231775, and rs3087243 in CTLA4; rs763361 in CD226; and rs706778 in CD25) and T1D-associated autoantibodies were analyzed. In group I, there was significantly lower expression of CD226 in T1D patients than in the controls. In group II, there were significantly higher expression levels of CD86 and TGF-β in T1D patients than in the controls. In the T1D patients in group I, the upregulated CD80 expression correlated with the expression of both CTLA4 splice variants (sCTLA4 and flCTLA4). In contrast, in group II, upregulated CD86 correlated with TGF-β and CD25. In group I, the inhibitory CD80-CTLA4 pathway was activated, whereas, in group II, the activation CD86-CD28 pathway and TGF-β production were activated. These results emphasize the differences between young-onset and adult-onset T1D in the regulation of costimulatory pathways. These differences should be considered when developing novel treatments for T1D.

[Plasma sB7-H3 serves as an assistant diagnostic marker for hepatitis B virus-associated hepatocellular carcinoma]

OBJECTIVE

To investigate the relationship between the expression of soluble B7-H3 (sB7-H3) in the plasma and hepatitis virus B-associated hepatocellular carcinoma (HBV-HCC).

METHODS

Twenty-three patients with HBV-HCC and 15 healthy donors were enrolled in this study. The level of sB7-H3 in the plasma was detected by ELISA. The expression of sB7-H3 mRNA in peripheral blood monocytes (PBMCs), tumor tissues and peri-tumor normal tissues were determined by relative real-time quantitative PCR (qRT-PCR). The level of membrane B7-H3 (mB7-H3) expressed in tumor tissues and peri-tumor normal tissues were detected by immunohistochemical staining.

RESULTS

The level of plasma sB7-H3 in the HBV-HCC patients was significantly higher than that in the healthy donors (P<0.05). However, the level of sB7-H3 mRNA in PBMCs was not significantly different between the HBV-HCC patients and healthy donors (P>0.05). The level of plasma sB7-H3 dropped significantly after the resection of liver tumors (P<0.05). The qRT-PCR showed the expression of sB7-H3 mRNA in tumor tissues and peri-tumor normal tissues were about 60 and 1 800 times higher than those in PBMCs of the corresponding HBV-HCC patients, respectively, and the expression of sB7-H3 mRNA in peri-tumor normal tissues was about 30 times higher than that in tumor tissues. Immunohistochemical staining revealed that the expression of mB7-H3 in peri-tumor normal tissues was higher than that in tumor tissues.

CONCLUSION

sB7-H3 in the plasma of HBV-HCC patients is mainly generated from tumor and peri-tumor normal tissues, and it can serve as an assistant diagnostic marker for HBV-HCC.

Characterization of a soluble B7-H3 (sB7-H3) spliced from the intron and analysis of sB7-H3 in the sera of patients with hepatocellular carcinoma

B7-H3 is a recently discovered member of the B7 superfamily molecules and has been found to play a negative role in T cell responses. In this study, we identified a new B7-H3 isoform that is produced by alternative splicing from the forth intron of B7-H3 and encodes the sB7-H3 protein. Protein sequence analysis showed that sB7-H3 contains an additional four amino acids, encoded by the intron sequence, at the C-terminus compared to the ectodomain of 2Ig-B7-H3. We further found that this spliced sB7-H3 plays a negative regulatory role in T cell responses and serum sB7-H3 is higher in patients with hepatocellular carcinoma (HCC) than in healthy donors. Furthermore, we found that the expression of the spliced sb7-h3 gene is higher in carcinoma and peritumor tissues than in PBMCs of both healthy controls and patients, indicating that the high level of serum sB7-H3 in patients with HCC is caused by the increased expression of this newly discovered spliced sB7-H3 isoform in carcinoma and peritumor tissues.

[Expression and clinical significance of soluble B7-H3 in sera of patients with primary hepatocellular carcinoma]

OBJECTIVE

To detect the expression and clinical significance of co-stimulatory molecule B7-H3 in sera and tissues of patients with hepatocellular carcinoma (HCC).

METHODS

We collected 63 samples of sera and liver tissue from HCC patients, 5 adjacent normal tissues of hepatic hemangioma as controls, and the other 50 sera samples of healthy people in the same time. The expression of soluble B7-H3 (sB7-H3) in sera from HCC patients and healthy people was detected by ELISA. Immunohistochemistry was performed to analyze the expression of B7-H3 on normal liver and HCC tissues.

RESULTS

The level of sB7-H3 from HCC patients was significantly higher than that from healthy people [(4143.47±976.27) pg/mL vs (2076.18±605.42) pg/mL, P<0.05]; and sB7-H3 level was related to clinical stage, distant metastasis and the positive expression of B7-H3 in HCC tissues (P<0.05), while there was no significant difference between its expression and the other clinical pathological parameters, such as the patients' age, gender, histological type, lymphatic metastasis and size of tumor. Furthermore, a positive correlation was found between the level of sB7-H3 and CA19-9 in HCC patients (P<0.05), but it was not associated with AFP and CEA.

CONCLUSION

The level of sB7-H3 in HCC patients was significantly higher than that in healthy people, and B7-H3 expression was correlated with clinical pathological indexes, which implicated that detecting the expression of sB7- H3 might be helpful for the diagnosis of primary HCC.

[Expression of B7-H3 costimulatory molecule in peripheral blood of myasthenia gravis patients]

AIM

To reveal the clinical significance of B7-H3 costimulatory molecule in myasthenia gravis (MG) patients by analyzing membranous B7-H3 (mB7-H3) and soluble B7-H3 (sB7-H3) expressions.

METHODS

We collected peripheral blood samples of 35 MG patients and 44 health controls (HC) and detected the expression of mB7-H3 on peripheral blood mononuclear cells (PBMCs) using flow cytometry. ELISA was performed to analyze the levels of sB7-H3 in plasma samples from MG patients and HC.

RESULTS

There was no significant difference in the expressions of mB7-H3 on T lymphocytes, monocytes or B cells between MG patients and HC. However, the level of sB7-H3 from MG patients was (2.166±0.958) ng/mL, significantly lower than that from HC (3.379±0.768) ng/mL. The level of sB7-H3 in general MG (GMG) patients (1.664±0.699) ng/mL was lower than that in ocular MG (OMG) patients (2.396±0.985) ng/mL. In MG patients complicated with abnormal thymus, the level of sB7-H3 was (1.593±0.441) ng/mL, also lower than that in MG patients with normal thymus (2.364±1.014) ng/mL. In addition, a significant negative correlation was found between the levels of sB7-H3 and QMGS in MG patients (r=-0.4189, P=0.012), but sB7-H3 was not associated with mB7-H3 in MG patients.

CONCLUSION

In MG patients, down-regulation of sB7-H3 is finely correlated to the severity of the disease. Its different expression levels in various types of MG patients indicate that this costimulatory molecule may be involved in the immunopathogenesis of MG.

[Establishment of a sandwich ELISA for testing serum sB7-H3 and detection of sB7-H3 levels in liver disease]

AIM

To establish quantitative ELISA for soluble sB7-H3 and evaluate its clinical application.

METHODS

Two mAbs of mouse anti-human sB7-H3(4H7 and 2E6)established by our lab were used. The mAb 4H7 was used as coating antibody and the 2E6 as a sandwich antibody, which recognized a different epitope and was labeled by biotin. The serum sB7-H3 levels of healthy volunteers and patients were measured by this method.

RESULTS

Sandwich ELISA was established with the linear range covering from 8.192 ng/L to 2 000 ng/L. The outcomes of repeatability test, recovery test, stability test and specificity test were quite good. The increased levels of sB7-H3 were found in schistosomiasis cirrhosis, the reduced levels in severe hepatitis and the difference in both situations showed significance.

CONCLUSION

A specific and sensitive sandwich ELISA is developed, the detection in liver disease indicates that the ELISA kit provides a potential tool in the clinical application.