Elsevier

Journal of Thoracic Oncology

Volume 3, Issue 11, November 2008, Pages 1236-1244
Journal of Thoracic Oncology

Original Article
AZGP1 Autoantibody Predicts Survival and Histone Deacetylase Inhibitors Increase Expression in Lung Adenocarcinoma

https://doi.org/10.1097/JTO.0b013e318189f5ecGet rights and content
Under an Elsevier user license
open archive

Introduction

The importance of α-2-glycoprotein 1, zinc (AZGP1) in lung adenocarcinoma (AD) remains largely unknown. Analysis of serum autoantibodies to tumor antigens combined with gene expression profiling of primary tumors may provide insight into the mechanisms underlying lung carcinogenesis and identify new AD biomarkers.

Methods

T7 phage cDNA libraries were used to identify AZGP1 autoantibodies in the serum of 473 patients (192 ADs, 192 matched controls, and 89 additional ADs for confirmation of findings). AZGP1 mRNA expression was examined in 86 ADs and 10 control lung tissue samples using oligonucleotide microarrays. AZGP1 protein expression was studied in 230 tissue samples (222 ADs; 8 controls) with immunohistochemistry. Kaplan-Meier analyses were used to correlate circulating autoantibody and tissue mRNA production with survival. AD cell lines A549 and SKLU1 were treated with 5-aza-2′-deoxycytidine (5-AZA) and trichostatin A (TSA) to examine the role of promoter methylation and histone deacetylation in the expression of AZGP1. Real-time polymerase chain reaction was used to quantify the effects of treatment.

Results

In patients with AD, AZGP1 autoantibodies were observed in 40% of serum samples. Autoantibody production correlated with improved overall 5-year survival (p = 0.002) and improved survival in those with stage I to II disease (p = 0.008). A verification analysis was performed for the survival benefit and found similar results with p values of 0.02 and 0.036, respectively. Although abundant mRNA expression was found in a subset of tumors, mRNA expression did not correlate with prognosis. In normal lung, AZGP1 mRNA and protein expression were low or absent, whereas in AD they were highly expressed in 31.3% and 42.8% of samples, respectively. To determine whether AZGP1 expression in this subset of tumors might be affected by epigenetic mechanisms, low AZGP1-expressing A549 and SKLU1 AD cell lines were treated with TSA and 5-AZA. A 713-fold and 169-fold increase in mRNA expression were noted on treatment with TSA, respectively. Treatment with 5-AZA had minimal effect on AZGP1 mRNA expression.

Conclusions

The presence of AZGP1 serum autoantibody may be used as a prognostic marker in patients with AD. Furthermore, up-regulation of AZGP1 mRNA in AD may be affected by chromatin remodeling by means of histone acetylation.

Key Words

Lung adenocarcinoma
Autoantibody
AZGP1
Epigenetic regulation

Cited by (0)

Disclosure: The authors have no potential conflict of interest relevant to this article.

1

Daniel L. Albertus, Christopher W. Seder, Guoan Chen and Xiaoju Wang have contributed equally to this work.