JOURNAL OF MEDICAL RESEARCH<br />
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3D CULTURE AND ANALYSIS OF THE EXPRESSION<br />
OF CANCER STEM CELL MARKERS FROM GASTRIC<br />
CANCER CELL LINE MKN45<br />
Ngo Thu Ha¹, Le Thi Thanh Huong¹, La Thi Huyen², Nguyen Phu Hung¹,³<br />
¹Thai Nguyen University of Sciences<br />
²Institute of Biotechnology - Vietnam Academy of Science and Technology<br />
³French National Institute of Health and Medical Research U1235, Nantes, France<br />
Gastric cancer is the fourth leading cause of worldwide cancer mortality, Vietnam belongs to the<br />
specified high-risk group of developing gastric cancer. Gastric cancer stem cells (CSCs) are considered<br />
to be the origin of gastric adenocarcinoma. 3D cell culture is an important step of identification of stem<br />
cell as well as CSC. In this study, a non-adherent cell culture model (3D) was developed with a culture<br />
medium that had growth factors selective for the development of gastric CSCs from gastric cancer<br />
cell line MKN45. The result showed that only 6% single cancer cells developed into tumorspheres<br />
during culture process. Then, flow cytometry and immunofluorescence analysis was carried out<br />
to evaluate the expression of CSC markers CD44 and ALDH in samples taken from tumorspheres<br />
which arose from gastric CSCs. The results showed that gastric CSCs formed tumorspheres in 3D<br />
culture condition with a high expression of 92% and 40,1% for markers CD44 and ALDH, respectively.<br />
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Keywords: 3D culture, gastric cancer stem cell, CD44, ALDH, MKN45<br />
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I. INTRODUCTION<br />
Cancer is the leading cause of death<br />
globally. Gastric cancer has the fourth highest mortality, accounting for 723,000 deaths<br />
in 2012 according to World Health Organization [1]. Vietnamese are at high risk of<br />
developing gastric cancer. Important risk<br />
factors for development of gastric cancer include smoked foods, salted fish and meat,<br />
Corresponding author: Nguyen Phu Hung,<br />
Thai Nguyen University of Sciences<br />
Email: hungnguyenphu@gmail.com<br />
Received: 10 July 2017<br />
Accepted: 09 Octorber 2017<br />
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family history, chronic gastritis, smoking and<br />
Helicobacter pylori (H. pylori) infection [2].<br />
Epidemiological studies show the close relationship between chronic atrophic gastritis<br />
and H. pylori infection [3]. In atrophic gastritis, the reduction of parietal cells and chief<br />
cells lead to decrease HCl secretion which<br />
is a favorable environment for H. pylori development. H. pylori overgrowth increases<br />
genetic mutation in epithelial cells of stomach which can cause gastric cancer [4].<br />
Lauren's gastric cancer classification<br />
system subdivided gastric adenocarcinoma<br />
into two main types: intestinal type accounts<br />
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for 54% and diffuse type is about 32%. The<br />
remaining 14% belongs to indeterminate<br />
type (mixture of two main types above) [5;<br />
6]. While intestinal type tumors are typically<br />
found in the gastric antrum of older individuals, diffuse type tumors are more common<br />
in the gastric corpus of younger individuals<br />
[7; 8].<br />
Recent research indicated that although<br />
cancer stem cells (CSCs) frequency in tumors is low, CSCs are responsible for proliferation and differentiation of tumor cells.<br />
Gastric stem cells which are located in the<br />
isthmus or progenitor zone of gastric gland<br />
and differentiate into mucous, parietal, chief<br />
and endocrine cells can be considered the<br />
origin of gastric CSCs [9]. In in-vitro experiments, if one cell can form tumorsphere in<br />
non-adherent culture condition (3D) with<br />
medium containing growth factors, it can<br />
qualify as a CSCs.<br />
Cancer cells grown in 3D cell culture<br />
condition were more similar to cells in tumors when compared with cells that were<br />
cultured in adherent (2D) condition [10].<br />
CSC identification and culture are important<br />
parts of cancer research; single cell culture<br />
to form tumorspheres (3D culture) is a significant tool in CSCs culture.<br />
CD44 and ALDH are two popular markers used for evaluation and isolation of<br />
CSCs in many different types of cancers<br />
[11]. In gastric adenocarcinoma, these<br />
markers expression identifies gastric cancer stem cell markers and is related to drug<br />
tolerance of tumor [12]. There are many<br />
different methods to identify expression of<br />
CD44 and ALDH markers, but Flow cytometry and immunofluorescence are common<br />
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methods in CSC studies [13].<br />
CD44 (Cluster of differentiation 44), a<br />
receptor of hyaluronic acid, was used to<br />
identify gastric CSCs for the first time by<br />
Takaishi et al. in 2009 [14]. ALDH (aldehyde<br />
dehydrogenase) is an important marker of<br />
CSCs in solid tumors and gastric carcinoma<br />
in particular. It is involved in cell detoxification, regulation of cellular proliferation, and<br />
relates to drug tolerance in cancer [15].<br />
Studies on stem cells and CSCs have<br />
not been done previously in Vietnam, and<br />
3D cell culture is an emerging technique in<br />
cancer research in general and gastric cancer in particular. In this study, MKN45 gastric cancer cells were seeded in 3D culture<br />
condition. The existence of gastric CSCs<br />
was evaluated by measuring tumorsphere<br />
formation and the expression of CD44 and<br />
ALDH gastric cancer stem cell markers.<br />
CD44 and ALDH expression was measured<br />
using flow cytometry and immunofluorescence analysis.<br />
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II. MATERIALS AND METHODS<br />
1. Materials: Gastric cancer cell line<br />
MKN45<br />
Gastric cancer cell line MKN45 was a<br />
generous gift from Inserm U1053 Laboratory – French National Institute of Health and<br />
Medical Research in Bordeaux. Cells were<br />
maintained in RPMI media supplemented<br />
with 10% Fetal Bovine Serum (FBS), and<br />
1% ampicillin/streptomycin (P/S). The seeding density was 1 x 10⁵ cells/well in 3.8 cm²<br />
wells using adherent cell culture condition<br />
(2D). Cells were incubated at 37oC in the<br />
presence of 5% CO2. After 2 days, culture<br />
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medium was replaced. After 4 days, cells<br />
were passaged into a new culture well.<br />
2. Methods<br />
3D cell culture method<br />
To create non-adherent culture plates,<br />
12 well culture plate (area of 3,8 cm² for<br />
each well) from BD Bioscience were supplemented with 500 µM Poly-HEMA solution<br />
(Poly(2-hydroxy-ethyl methacrylate from<br />
Sigma) and 10 mg/ml of concentration. Culture plates were then dried surface in clean<br />
benches overnight. Plate were washed<br />
3 times using PBS 1X buffer before commencing cell culture.<br />
3D culture: Trypsinized cells were collected from 2D cell culture plate and diluted in PBS 1X buffer until reaching the<br />
concentration 1000 cell/µl. A 2 µl solution<br />
containing 2000 cells was resuspended in<br />
2 ml of specific stem cell culture medium in<br />
a non-adherent plate (treated by Poly-HEMA). This medium contains basic medium<br />
DMEMF12/Glutamax (from Invitrogen) supplemented with 1% P/S, Epithelial Growth<br />
Factor (EGF) 20 ng/ml, Fibroblast Growth<br />
Factor (FGF) 20 ng/ml, glucose 0.3%, and<br />
insulin 5 µg/ml (all components from Sigma). 1 ml of medium was replaced with new<br />
medium each 2 days. Cells were incubated<br />
at 37oC, 5% CO2. The formation of tumorspheres was evaluated for from the 5th day<br />
to 14th day of the culture process. Tumorspheres were collected for cell analysis.<br />
Immunofluorescence<br />
Collected tumorspheres were centrifuged at 1300 rpm for 3 min and washed<br />
2 times with PBS 1X buffer. Tumorsphere<br />
were stained with anti-human CD44-PE<br />
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monoclonal antibody 1:50 (from BD Biosciences) and with ALDH substrate 1:100<br />
in 500 µl ALDEFLUOR buffer (ALDEFLUOR kit from Stem cell Technology) at 37oC<br />
for 20 min. Tumorspheres were washed 2<br />
times with ALDEFLUOR buffer by centrifugation. The second wash used ALDEFLUOR buffer contains 10 µg/ml Hoechst 33342<br />
for nuclei staining (from Sigma).<br />
After tumorspheres were incubated with<br />
CD44 monoclonal antibody or stained with<br />
ALDH substrate in ALDEFLUOR kit, images<br />
were taken using NIKON fluorescence microscope at magnification of 200 and 400<br />
times with specialized software.<br />
Flow cytometry analysis<br />
Tumorspheres collected on the 10th day<br />
of culture were trypsinized and separated<br />
into single cells. Single cells were incubated with CD44-APC specific antibody (from<br />
BD Biosciences) and specific ALDH substrate in ALDEFLUOR kit (from Stem cell<br />
technology, Canada) according to manufactory instruction for 20 min at 37oC. Samples<br />
were washed 2 times by ALDEFLUOR buffer (500 µl for each) before being placed in<br />
specialized 4 ml glass tube (from BD Bioscience) and analysed by FACS Canto II flow<br />
cytometry system (BD - Biosciences) at the<br />
compatible wavelength of APC (Allophycocyanin) and FITC (Fluorescein isothiocyanate) for CD44 and ALDH, respectively.<br />
20,000 events recorded in flow cytometry<br />
were analyszed using DIVA 6.1 software.<br />
3. Ethics<br />
All MKN45 cells were provided by Inserm U1053 Laboratory – French National<br />
Institute of Health and Medical Research in<br />
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Bordeaux. There is no intervention to patients and animals.<br />
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III. RESULTS<br />
1. Formation of tumorsphere from<br />
MKN45 single cell in 3D cell culture<br />
condition<br />
Images of the tumorsphere formation<br />
<br />
and percentage of MKN45 single cell that<br />
formed tumorspheres is presented in Figure<br />
1. The result showed that only 6% ± 1,2%<br />
single cancer cells developed into tumorspheres by the 5th days of culture process.<br />
This means that for every 100 single cultured cells, only 6 of them have ability to<br />
form tumorsphere.<br />
<br />
Figure 1. Tumorsphere formation from a single cell of gastric cancer cell line MKN45<br />
A) Tumorsphere formation at the 1st, 5th and 12th day of observation<br />
B) Tumorsphere forming percentage (estimated in the 5th day of culture process)<br />
Scale bar (to estimate tumorsphere size): 50µm.<br />
2. The expression of CD44 and ALDH using immunofluorescence method<br />
As shown in Figure 2, the proportion of CD44 marker labeled with red fluorochrome was<br />
high at 90%. Similarly, the proportion of ALDH maker labeled with green fluorochrome was<br />
50%. The immunofluorescence image indicated that CD44 was expressed in the cell membrane, whereas ALDH was located in the cytosol.<br />
<br />
Figure 2. Tumorsphere immunofluorescence after 7 days of culture process<br />
CD44 (red), ALDH (green) and Hoechst (blue). Scale bar: 50µm.<br />
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3. The expression of CD44 and ALDH using Flow cytometry analysis<br />
To determine correctly the number of cells expressing CD44 or ALDH and to confirm the<br />
immunofluorescence result above, we used flow cytometry analysis. The result is shown in<br />
Figure 3. The dot blot data in P7 range shows that most MKN45 gastric cancer cell expressed<br />
CD44 at a proportion of 92,0% ± 2,7% (Figure 3A(b)). On the other hand, the expression of<br />
ALDH was 40,1% ± 2,5%, much lower than CD44 (Figure 3B(b)).<br />
<br />
Figure 3. Result of Flow cytometry analysis<br />
(A) for CD44 and (B) for ALDH marker. (a) Control (cells only)<br />
(b) Sample (CD44 antibody or ALDEFLUOR™ reagent added)<br />
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IV. DISCUSSION<br />
In the 2D cell culture, the connection between cells occurs on one side of the cell (on<br />
the surface of cultured plate). However, in 3D culture condition, cell attachments occur all<br />
around the surface of the cell. This influences the cell proliferation and differentiation [16].<br />
The roles of Epithelial Growth Factor (EGF) and Fibroblast Growth Factor (FGF) in stem cell<br />
self-renewal have been demonstrated [17; 18]. Therefore, the single cancer cells which were<br />
cultured in medium supplied with the above growth factors should have self-renewal capacity<br />
allowing cancer stem cells to form tumorspheres. Our result showed that only 6% ± 1,2%<br />
single cancer cells formed tumorspheres, this is compatible with the report of Jianming et al.<br />
in 2013 about tumorsphere formation of gastric cancer cell line MKN45 [19].<br />
Tumor is comprised of different cells which present distinct phenotypic and functional<br />
profiles. The heterogenous tumorsphere which arose from a single cell in 3D cell culture<br />
conditions indicate that different tumor cells can originate from a single unique stem cell.<br />
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