| This web only provides the extract of this article. If you want to read the figures and tables, please reference the PDF full text on Blackwell Synergy. Thank you. - Original Article - Change of the cell cycle after flutamide treatment in prostate cancer cells and its molecular mechanism Yong Wang1, Chen Shao2, Chang-Hong Shi3, Lei Zhang4, Hong-Hong Yue5, Peng-Fei Wang2, Bo Yang2, Yun-Tao Zhang2, Fan Liu1, Wei-Jun Qin2, He Wang2, Guo-Xing Shao2 1Department of Urology, Tangdu Hospital, 
2Department of Urology, 3Department of Microbiology,4Department of Epidemiology, 
5Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi, China
 Abstract Aim: To explore the effect of androgen receptor (AR) on the expression of the cell cycle-related genes, such as 
CDKN1A and BTG1, in prostate cancer cell line LNCaP.  
Methods: After AR antagonist flutamide treatment and 
confirmation of its effect by phase contrast microscope and flow cytometry, the differential expression of the cell 
cycle-related genes was analyzed by a cDNA microarray.  The flutamide treated cells were set as the experimental 
group and the LNCaP cells as the control. We labeled cDNA probes of the experimental group and control group with 
Cy5 and Cy3 dyes, respectively, through reverse transcription. Then we hybridized the cDNA probes with cDNA 
microarrays, which contained 8 126 unique human cDNA sequences and the chip was scanned to get the fluorescent 
values of Cy5 and Cy3 on each spot.  After primary analysis, reverse transcription polymerase chain reaction 
(RT-PCR) tests were carried out to confirm the results of the chips.  
Results:After AR antagonist flutamide treatment, 
three hundred and twenty-six genes 
(3.93%)  expressed differentially, 97 down-regulated and 219 up-regulated. 
Among them, eight up-regulated genes might be cell cycle-related, namely 
CDC10, NRAS, BTG1, 
Wee1, CLK3, DKFZP564A122, 
CDKN1A and BTG2. The CDKN1A and 
BTG1 gene mRNA expression was confirmed to be higher 
in the experimental group by RT-PCR, while 
p53 mRNA expression had no significant changes.  
Conclusion: Flutamide treatment might up-regulate 
CDKN1A and BTG1 expression in prostate cancer cells.  The protein expressions of 
CDKN1A and BTG1 play an important role in inhibiting the proliferation of cancer cells.  
CDKN1A has a great impact on the cell cycle of prostate cancer cells and may play a role in the cancer cells in a 
p53-independent pathway.  The prostate cancer cells might affect the cell cycle-related genes by activating AR and thus break the cell cycle control.  
(Asian J Androl 2005 Dec; 7: 375-380) Keywords: prostate cancer; LNCaP; p21; androgen receptor; CDKN1A; BTG1; cell cycle genes; flutamide Correspondence to: Dr Chen Shao, Department of Urology, Xijing 
  Hospital, Fourth Military Medical University, Xi'an 710032, 
  Shaanxi, China.
  Tel/Fax: +86-29-8337-5321
 E-mail: shaochen@fmmu.edu.cn
 Received 2004-06-30    Accepted 2005-01-11
 DOI: 10.1111/j.1745-7262.2005.00031.x
 
 1    Introduction  
 Prostate cancer is a worldwide disease. The  
incidence of prostate cancer in Europe was 103.5 cases per  
100 000 men in the year 2000 [1].  In USA, the  
incidence of this disease increased steadily between 1981  
and 1989, with a steep increase in the early 1990s.  In  
1996, 317 000 new cases of prostate cancer have been  
detected, while 41 400 patients died of this disease in the  
USA [2].  In China, some well-developed areas such as  
Shanghai also have seen a dramatic increase in the  
incidence of prostate cancer due to changes of lifestyles and  
dietary patterns [3]. 
 Clinical therapy of prostate cancer involves radical  
prostatectomy followed by adjuvant hormonotherapy or  
chemotherapy.  Administration of antiandrogens provides  
only partial remission because prostate cancer cells  
acquire a hormone-independent phenotype and the disease  
relapses within a few years.  Therefore, the  
development of androgen independency of prostate cancer is the main  
cause of therapeutic failure.  Nevertheless, the  
underlying molecular mechanisms involved in this situation were  
not clearly understood [4]. 
 In this study, we used the well-characterized,  
hormone-sensitive human prostate cancer cell line LNCaP  
to identify early mechanisms involved in the acquisition  
of hormone independence. 
  
 2    Materials and methods 
  
 2.1  Materials 
 LNCaP cells were cultured in RPMI-1640 medium  
sup-plemented with 10% fetal bovine serum  
(FBS) (Hyclone Inc., Savannah, USA)[5].  Stock solutions of the  
androgen receptor (AR) antagonist flutamide (Sigma Inc., St.  
Louis, USA) (10-4 mol/L) were made in absolute ethanol,  
while working solutions were further made in  
phosphate-buffered saline (PBS) (pH 7.2) [6].  Flutamide was  
routinely used at a final concentration of  
10-7 mol/L.  In the control (non-treated) group, an equal volume of pure  
ethanol, dissolved in PBS was used to eliminate any  
effect of the vehicle.  After 15 days of treatment, with a  
change of the medium every 2 days, when the experimental group cells reached  
90% confluence, we isolated mRNA and analyzed it after reverse transcription.   
Cy3-dCTP and Cy5-dCTP were purchased from Amersham Phamacia Biotech Inc. (Piscataway, NJ, USA)  
and Oligotex mRNA Midi Kit from Quigen Inc. (Valencia,  
CA, USA). ScanArray 4 000 laser scanner was from GSI  
Lomonics (Ottawa, Ontario, Canada).  GenePix Pro 3.0  
software from Axon Instruments Inc. (Sunnyvale, CA,       
USA). 
 2.2   Methods 
 2.2.1 Analysis of cell cycle changes  
 The control cells and cells that had been treated with  
flutamide for 15 days were analyzed by microscopy, using  
a microscope (Olympus, Tokyo, Japan) provided with a  
camera (Olympus, Tokyo, Japan).  Additionally, cells  
were collected and placed into 6-well plates at a density  
of 1 × 105/mL, washed with 0.01 mol/L PBS (pH 7.2),  
fixed in 70% ethanol for 18 h, resuspended in PBS  
and stained with propidium iodide (100 ìg/mL) for  
30 min.  Flow cytometer was explored by using blue light  
Argon-Ion laser (excitation wavelength, 488 nm; laser  
power, 200 mW; ELITE ESP, Beckman-Coulter,   
Fuller-ton, CA, USA)  and red fluorescence from the PI/DNA  
was recorded.  Cell cycle analysis was performed using  
a DNA-Prep Reagent System, with the following settings:  
one cycle analysis, no apoptosis. 
  
 2.2.2 Microarray assay 
 mRNA was extracted by Trizol and purified by  
Oli-gotex Midi Kit (Quigen Inc., Valencia, CA, USA)[7].   
Microarray analysis was performed by using the Human  
Gene Expression CHIP (version H80s, Biostar, Shanghai,  
China) containing 8 126 human genes.  A fluorescent  
probe was synthesized by reverse transcription of  
100 ìg of the above mRNA with 50 U AMV reverse transcriptase  
(Takara Shuzo, Kyoto, Japan) in the presence of Cy3- or  
Cy5-dCTP (Amersham, Arlington Heights, USA).  Then  
Cy3- and Cy5-labeled probes were prepared and incubated in the cDNA chip at 42 °C for 6 h, washed twice  
with 2 × Standard Saline  
Citrate(SSC)/0.2% SDS at 60 °C  for 30 min and then washed again with the same  
buffer for 5 min.  Finally, the chip was washed with  
0.05 × SSC at room temperature for 10 min and signals were  
quantified with the ScanArray 4000 (GSI Lomonics, Ottawa,  
Canada) and the Quant Array Software (GSI Lomonics,  
Ottawa, Canada).  All the Cy3 fluorescent units were  
normalized according to the normalized factor [6] and  
Cy5 fluorescent intensity was counted as 200 if it was  
below 200 fluorescent units.  The expression changes of  
genes were considered as up-regulated if the Cy5/Cy3  
signal ratio was higher than 2.0 and down-regulated if  
the ratio was lower than 0.5.  
  
 2.2.3 Semi-quantitative RT-PCR 
 Total RNA was extracted by the Qiagen RNA Isolation Kit (GIBCO Co., New York, USA).  For the  
first-strand cDNA synthesis, 5 mg/mL of RNA (Takara Co.,  
Dalian, China) were used.  In each reaction, a 100-mL  
solution containing 3 mmol random hexamers,  
25 mmol/L Tris-HCl, 37 mmol/LKCl, 1.5  
mmol/LMgCl2, 10 mmol/LDTT, 0.25 mmol/L dNTP, 40 units of RNasin, a RNase  
inhibitor, 50 U /mL Super Taq DNA polymerase, and 200  
units of reverse transcriptase were used.  The annealing  
mixture was incubated at room temperature for 15 min,  
and then incubated in a water bath at 41 °C for 60 min.   
The reverse transcriptase enzyme was inactivated by  
heating the solution to 95 °C for 5 min.  PCR was then  
carried out using PCR kit (Perkin-Elmer, Foster City,  
CA, USA) and primers.  The PCR was performed for 30  
cycles consisting of denaturation at 94 °C for 1 min,  
annealing at 57 °C for 1 min, and extension at  
72 °C for 2 min.  The PCR products were analyzed on  
1.5% agarose gel.  The primers used for PCR were as follow:  
CDKN1A sense (5¡¯-GAC ACC ACT GGA GGG TGA  
CT-3¡¯), CDKN1A antisense (5¡¯-TAC AGG TCC ACA TGG  
TCT TCC-3¡¯); b-actin sense (5¡¯-GAT TGC CTC AGG  
ACA TTT CTG-3¡¯), b-actin antisense (5¡¯-GAT TGC TCA  
GGA CAT TTC TG-3¡¯) [8].  And another experiment of  
KLK3 (its gene product is PSA) expression was also  
carried out, with the primers set as follow:  
KLK3 sense (5¡¯-AGC GTG ATC TTG CTG GGT CG-3¡¯),  
KLK3 antisense (5¡¯-CGT CAT TGG AAA TAA CAT GGA GG-3¡¯).  Gene  
primers were synthesized by Beijing Oake Company (Beijing, China).  
  
 3    Results 
  
 3.1 Morphological and cell cycle changes induced by  
flutamide 
 Flutamide treatment of LNCaP cells for 15 days  
resulted in dramatic changes of cell morphology (Figures 1,  
2).  Antiandrogen-treated cells became smaller, while less  
mitoses and cell contacts were found.  The density of  
cells also diminished.  The results of flow cytometer  
indicated that (71.47 ± 0.96)% of LNCaP cells sustained at  
G1 phase after the flutamide treatment while that of  
control cells was only (66.87 ± 1.50) % (Table 1). 
  
 3.2  The changes of gene expression after flutamide treatment 
 Detection of RNA purity was assayed by electrophoresis in agarose gels, and absorption spectrometry.   
As shown in Figure 3, 18S and 28S bands were clean  
and clear, while absorbance measurements revealed  
A260/A280 >2.0, indicating that the extracted mRNA was  
suitable for cDNA microarray assay.   
 According to the criteria offered by the chip  
manufacturer (Cy5/Cy3*>2.0, up-regulated;  
Cy5/Cy3*<0.5, down-regulated), there were 326 genes  
(3.93%) which were expressed differentially after the treatment with  
flutamide.  Ninety-seven genes were up-regulated and  
219 were down-regulated (Figure 4).  It was very  
interesting that there was an increased expression of eight  
genes related to cell cycle, namely CDC10,  
NRAS, BTG1, Wee1, CLK3,  
DKFZP564A122, CDKN1A and BTG2 (Table 2).  Especially  
CDKN1A and BTG1 who have relatively high Cy3 value. Meanwhile,  
p53 and its related genes did not change much after flutamide treatment  
(Table 3). 
 The induction of PSA mRNA may reflect the ability  
of AR to stimulate transcription, for the 5¡¯-regulatory  
region of the PSA gene contains multiple androgen  
responseelements [5].  PSA was  obviously down-regulated  
(Cy5/Cy3=0.202) in our chip assay, while AR did not change  
(Cy5/Cy3=0.65). 
 3.3 Semi-quantitative RT-PCR confirmation 
 In the control (non-treated) group, the  
CDKN1A expression in the LNCaP cells was merely faintly detected  
by RT-PCR.  In contrast, in flutamide-treated LNCaP  
cells, the expression of this gene product was  
significantly up-regulated (Figure 5).  In contrast,  
KLK3 (PSA) expression was down-regulated (as expected) after  
flutamide, indicating an effective blockage of AR by  
chronic flutamide treatment (Figure 6). 
  
 4    Discussion 
  
 AR plays a great role in regulating the proliferation of  
both normal and neoplastic prostate cells.  The activated  
DNA-bound AR homodimer complex recruits several kinds of co-regulatory proteins to stimulate or inhibit  
target gene transcription, thus promotes or represses cell  
proliferation, apoptosis or angiogenesis [9]. 
 In this study, we found that eight cell cycle-related  
genes, namely CDC10, NRAS,  
BTG1, Wee1, CLK3,  
DKFZP564A122, SLC31A1 and  
CDKN1A, were up-regulated in prostate cancer cells after flutamide treatment.   
In contrast, p53 and its downstream genes, such as  
tumor protein p53-binding protein TOPORS (Gene  
alias: TP53BPL),  TP53BP1,   
PA2, TP53BP2 and p53DINP1, remain unchanged.   
 CDKN1A is an important cell cycle regulator [10].   
Its gene product p21 (waf1/cip1) can inhibit the  
proliferation of cancer cells via both p53-dependent and  
p53-independent CDK inhibition.  In many tumors,  
CDKN1A could be activated through the  
p53-indpendent pathway[11, 12], in which mitogens as platelet-derived growth  
factor (PDGF), fibroblast growth factor (FGF), and  
epidermal growth factor (EGF) may function[13].  Choi et al. [12]reported that in prostate cancer cell line PC-3,  
the p53-independent pathway to activate  
CDKN1A may be related with over-expression of  
CDC2 and CDK2.  Our results showed that there was no significant change of  
p53 gene and its downstreamgenes after flutamide  
treatment; we assumed that the high expression of  
CDKN1A may occur through a p53-independent  
pathway in this experiment.  Kokontis et  
al.[14] found that androgen may inhibit androgen refractory prostate  
cancer cell line LNCaP-104R1 proliferation by a transient  
p21 (waf1/cip1) induction and following  
p27 (Kip1) induction as a result of a drop in  
c-myc expression.  However, in our research, we found neither  
p27 (Kip1) nor c-myc¡¯s expression changed (data not shown),  
suggesting a different pathway in androgen prolific cell line.   
Since there have been reports that CDKN1A  
expression was associated with tumor progression to  
androgen-independent prostate carcinoma [4], we supposed that  
p21 may play a key role in molecular events of the initiation  
of AIPC because of its anti-apoptotic effect.  
 Eder et al.[15] found in 2003 that after AR blockage  
by antisense oligonucleotide, the expression of  
IGFBP2,  PIP5KIA, PTOV1 and  
S100P changed.  However, in this study, we did not find the same kind of results. 
 The other genes we discovered in this experiment  
were also of interest.  BTG1, for example, may play a  
coordinate role in a general transduction pathway that  
was induced in response to DNA damage[16].  BTG1 expression was maximal in the  
G0/G1 phases of the cell cycle and  
was down-regulated when cells progress throughout  
G1[17].  It affected the proliferation by  
phosphorylating a putative p34cdc2 kinase site on BTG1,  
Ser-159, thus modulated CCR4 expression, and then induced  
the formation of hCAF-1/BTG1, which was of great consequence in the signaling events of cell division that lead  
to changes in cellular proliferation associated with  
cell-cell contact[18].  However, a shortage of correlated  
reports hinder further research of this gene on the prostate  
cancer cells¡¯ proliferation and cell contact. 
 In conclusion, we found that eight cell cycle-related  
genes may be involved in the process of  
flutamide-induced cell growth inhibition, especially  
CDKN1A and BTG1.  CDKN1A may function on the prostate cancer  
cells in a p53-independent mode.  The clarification of  
exact mechanism of flutamide¡¯s inhibitive effect on  
prostate cancer cells is of great importance in clinical  
hormone therapy.  Designing a new way with  
biotechnology to mimic and maximize flutamide¡¯s anti-cancer  
effect while avoiding its notorious hepatotoxicity may be  
an interesting idea to pursue in the future. 
  
 Acknowledgment 
  
 We owe our thanks to Professor Jian-Guang Zhou,  
the Academy of Military Medical Sciences (Beijing, China),  
for providing LNCaP cells.  This project was granted by  
the National Nature Science Foundation of China (No.   
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