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Aramini B, Masciale V, Grisendi G, Bertolini F, Maur M, Guaitoli G, Chrystel I, Morandi U, Stella F, Dominici M, Haider KH. Dissecting Tumor Growth: The Role of Cancer Stem Cells in Drug Resistance and Recurrence. Cancers (Basel) 2022; 14:cancers14040976. [PMID: 35205721 PMCID: PMC8869911 DOI: 10.3390/cancers14040976] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/12/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Cancer is one of the most debated problems all over the world. Cancer stem cells are considered responsible of tumor initiation, metastasis, drug resistance, and recurrence. This subpopulation of cells has been found into the tumor bulk and showed the capacity to self-renew, differentiate, up to generate a new tumor. In the last decades, several studies have been set on the molecular mechanisms behind their specific characteristics as the Wnt/β-catenin signaling, Notch signaling, Hedgehog signaling, transcription factors, etc. The most powerful part of CSCs is represented by the niches as “promoter” of their self-renewal and “protector” from the common oncological treatment as chemotherapy and radiotherapy. In our review article we highlighted the primary mechanisms involved in CSC tumorigenesis for the setting of further targets to control the metastatic process. Abstract Emerging evidence suggests that a small subpopulation of cancer stem cells (CSCs) is responsible for initiation, progression, and metastasis cascade in tumors. CSCs share characteristics with normal stem cells, i.e., self-renewal and differentiation potential, suggesting that they can drive cancer progression. Consequently, targeting CSCs to prevent tumor growth or regrowth might offer a chance to lead the fight against cancer. CSCs create their niche, a specific area within tissue with a unique microenvironment that sustains their vital functions. Interactions between CSCs and their niches play a critical role in regulating CSCs’ self-renewal and tumorigenesis. Differences observed in the frequency of CSCs, due to the phenotypic plasticity of many cancer cells, remain a challenge in cancer therapeutics, since CSCs can modulate their transcriptional activities into a more stem-like state to protect themselves from destruction. This plasticity represents an essential step for future therapeutic approaches. Regarding self-renewal, CSCs are modulated by the same molecular pathways found in normal stem cells, such as Wnt/β-catenin signaling, Notch signaling, and Hedgehog signaling. Another key characteristic of CSCs is their resistance to standard chemotherapy and radiotherapy treatments, due to their capacity to rest in a quiescent state. This review will analyze the primary mechanisms involved in CSC tumorigenesis, with particular attention to the roles of CSCs in tumor progression in benign and malignant diseases; and will examine future perspectives on the identification of new markers to better control tumorigenesis, as well as dissecting the metastasis process.
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Affiliation(s)
- Beatrice Aramini
- Division of Thoracic Surgery, Department of Experimental Diagnostic and Specialty Medicine–DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni-L. Pierantoni Hospital, 47121 Forlì, Italy;
- Thoracic Surgery Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy; (V.M.); (U.M.)
- Correspondence:
| | - Valentina Masciale
- Thoracic Surgery Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy; (V.M.); (U.M.)
| | - Giulia Grisendi
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.G.); (F.B.); (M.M.); (G.G.); (I.C.); (M.D.)
| | - Federica Bertolini
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.G.); (F.B.); (M.M.); (G.G.); (I.C.); (M.D.)
| | - Michela Maur
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.G.); (F.B.); (M.M.); (G.G.); (I.C.); (M.D.)
| | - Giorgia Guaitoli
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.G.); (F.B.); (M.M.); (G.G.); (I.C.); (M.D.)
| | - Isca Chrystel
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.G.); (F.B.); (M.M.); (G.G.); (I.C.); (M.D.)
| | - Uliano Morandi
- Thoracic Surgery Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy; (V.M.); (U.M.)
| | - Franco Stella
- Division of Thoracic Surgery, Department of Experimental Diagnostic and Specialty Medicine–DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni-L. Pierantoni Hospital, 47121 Forlì, Italy;
| | - Massimo Dominici
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.G.); (F.B.); (M.M.); (G.G.); (I.C.); (M.D.)
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Ma R, Mandell J, Lu F, Heim T, Schoedel K, Duensing A, Watters RJ, Weiss KR. Do Patient-derived Spheroid Culture Models Have Relevance in Chondrosarcoma Research? Clin Orthop Relat Res 2021; 479:477-490. [PMID: 32469486 PMCID: PMC7899730 DOI: 10.1097/corr.0000000000001317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/27/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND In high-grade chondrosarcoma, 5-year survival is lower than 50%. Therefore, it is important that preclinical models that mimic the disease with the greatest possible fidelity are used to potentially develop new treatments. Accumulating evidence suggests that two-dimensional (2-D) cell culture may not accurately represent the tumor's biology. It has been demonstrated in other cancers that three-dimensional (3-D) cancer cell spheroids may recapitulate tumor biology and response to treatment with greater fidelity than traditional 2-D techniques. To our knowledge, the formation of patient-derived chondrosarcoma spheroids has not been described. QUESTIONS/PURPOSES (1) Can patient-derived chondrosarcoma spheroids be produced? (2) Do spheroids recapitulate human chondrosarcoma better than 2-D cultures, both morphologically and molecularly? (3) Can chondrosarcoma spheroids provide an accurate model to test novel treatments? METHODS Experiments to test the feasibility of spheroid formation of chondrosarcoma cells were performed using HT-1080, an established chondrosarcoma cell line, and two patient-derived populations, TP19-S26 and TP19-S115. Cells were cultured in flasks, trypsinized, and seeded into 96-well ultra-low attachment plates with culture media. After spheroids formed, they were monitored daily by bright-field microscopy. Spheroids were fixed using paraformaldehyde and embedded in agarose. After dehydration with isopropanol, paraffin-embedded spheroids were sectioned, and slides were stained with hematoxylin and eosin. To compare differences and similarities in gene expression between 2-D and 3-D chondrosarcoma cultures and primary tumors, and to determine whether these spheroids recapitulated the biology of chondrosarcoma, RNA was extracted from 2-D cultures, spheroids, and tumors. Quantitative polymerase chain reaction was performed to detect chondrosarcoma markers of interest, including vascular endothelial growth factor alpha, hypoxia-inducible factor 1α, COL2A1, and COL10A1. To determine whether 2-D and 3-D cultures responded differently to novel chondrosarcoma treatments, we compared their sensitivities to disulfiram and copper chloride treatment. To test their sensitivity to disulfiram and copper chloride treatment, 10,000 cells were seeded into 96-well plates for 2-D culturing and 3000 cells in each well for 3-D culturing. After treating the cells with disulfiram and copper for 48 hours, we detected cell viability using quantitative presto-blue staining and measured via plate reader. RESULTS Cell-line and patient-derived spheroids were cultured and monitored over 12 days. Qualitatively, we observed that HT-1080 demonstrated unlimited growth, while TP19-S26 and TP19-S115 contracted during culturing relative to their initial size. Hematoxylin and eosin staining of HT-1080 spheroids revealed that cell-cell attachments were more pronounced at the periphery of the spheroid structure than at the core, while the core was less dense. Spheroids derived from the intermediate-grade chondrosarcoma TP19-S26 were abundant in extracellular matrix, and spheroids derived from the dedifferentiated chondrosarcoma TP19-S115 had a higher cellularity and heterogeneity with spindle cells at the periphery. In the HT-1080 cells, differences in gene expression were appreciated with spheroids demonstrating greater expressions of VEGF-α (1.01 ± 0.16 versus 6.48 ± 0.55; p = 0.003), COL2A1 (1.00 ± 0.10 versus 7.46 ± 2.52; p < 0.001), and COL10A1 (1.01 ± 0.19 versus 22.53 ± 4.91; p < 0.001). Differences in gene expressions were also noted between primary tumors, spheroids, and 2-D cultures in the patient-derived samples TP19-S26 and TP19-S115. TP19-S26 is an intermediate-grade chondrosarcoma. With the numbers we had, we could not detect a difference in VEGF-α and HIF1α gene expression compared with the primary tumor. COL2A1 (1.00 ± 0.14 versus 1.76 ± 0.10 versus 335.66 ± 31.13) and COL10A1 (1.06 ± 0.378 versus 5.98 ± 0.45 versus 138.82 ± 23.4) expressions were both greater in the tumor (p (COL2A1) < 0.001; p (COL10A1) < 0.0001) and 3-D cultures (p (COL2A1) = 0.004; p (COL10A1) < 0.0001) compared with 2-D cultures. We could not demonstrate a difference in VEGF-α and HIF1α expressions in TP19-S115, a dedifferentiated chondrosarcoma, in the tumor compared with 2-D and 3-D cultures. COL2A1 (1.00 ± 0.02 versus 1.86 ± 0.18 versus 2.95 ± 0.56) and COL10A1 (1.00 ± 0.03 versus 5.52 ± 0.66 versus 3.79 ± 0.36) expressions were both greater in spheroids (p (COL2A1) = 0.003; p (COL10A1) < 0.0001) and tumors (p (COL2A1) < 0.001; p (COL10A1) < 0.0001) compared with 2-D cultures. Disulfiram-copper chloride treatment demonstrated high cytotoxicity in HT-1080 and SW-1353 chondrosarcoma cells grown in the 2-D monolayer, but 3-D spheroids were highly resistant to this treatment. CONCLUSION We provide preliminary findings that it is possible to generate 3-D spheroids from chondrosarcoma cell lines and two human chondrosarcomas (one dedifferentiated chondrosarcoma and one intermediate-grade chondrosarcoma). Chondrosarcoma spheroids derived from human tumors demonstrated morphology more reminiscent of primary tumors than cells grown in 2-D culture. Spheroids displayed similar expressions of cartilage markers as the primary tumor, and we observed a higher expression of collagen markers in the spheroids compared with cells grown in monolayer. Spheroids also demonstrated greater chemotherapy resistance than monolayer cells, but more patient-derived spheroids are needed to further conclude that 3-D cultures may mimic the chemoresistance that chondrosarcomas demonstrate clinically. Additional studies on patient-derived chondrosarcoma spheroids are warranted. CLINICAL RELEVANCE Chondrosarcomas demonstrate resistance to chemotherapy and radiation, and we believe that if they can be replicated, models such as 3-D spheroids may provide a method to test novel treatments for human chondrosarcoma. Additional comprehensive genomic studies are required to compare 2-D and 3-D models with the primary tumor to determine the most effective way to study this disease in vitro.
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Affiliation(s)
- Ruichen Ma
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Jonathan Mandell
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Feiqi Lu
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Tanya Heim
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Karen Schoedel
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Anette Duensing
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Rebecca J Watters
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Kurt R Weiss
- R. Ma, J. Mandell, F. Lu, T. Heim, R. Watters, K. R. Weiss, Musculoskeletal Oncology Laboratory, University of Pittsburgh School of Medicine Department of Orthopaedic Surgery, Pittsburgh, PA, USA
- R. Ma, F. Lu, School of Medicine, Tsinghua University, Beijing, China
- J. Mandell, Department of Infectious Diseases and Microbiology, University of Pittsburgh, PA, USA
- K. Schoedel, A. Duensing, K. R. Weiss, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
- A. Duensing, R. Watters, K. R. Weiss, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
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