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<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Molecular Medicine Reports</journal-id>
<journal-title-group>
<journal-title>Molecular Medicine Reports</journal-title></journal-title-group>
<issn pub-type="ppub">1791-2997</issn>
<issn pub-type="epub">1791-3004</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/mmr.2014.2904</article-id>
<article-id pub-id-type="publisher-id">mmr-11-03-2255</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Twist-related protein 1 enhances oral tongue squamous cell carcinoma cell invasion through &#x003B2;-catenin signaling</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>ZHENG</surname><given-names>LIAN</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>LI</surname><given-names>NING</given-names></name><xref ref-type="corresp" rid="c1-mmr-11-03-2255"/></contrib>
<contrib contrib-type="author">
<name><surname>GUO</surname><given-names>FENG</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>JIAN</surname><given-names>XIN-CHUN</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>JIANG</surname><given-names>CAN-HUA</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>YIN</surname><given-names>PING</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>MIN</surname><given-names>AN-JIE</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>HUANG</surname><given-names>LONG</given-names></name></contrib>
<aff id="af1-mmr-11-03-2255">Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China</aff></contrib-group>
<author-notes>
<corresp id="c1-mmr-11-03-2255">Correspondence to: Dr Ning Li, Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008 P.R. China, E-mail: <email>liningbeta@hotmail.com</email>; <email>lining463@yahoo.com</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>3</month>
<year>2015</year></pub-date>
<pub-date pub-type="epub">
<day>07</day>
<month>11</month>
<year>2014</year></pub-date>
<volume>11</volume>
<issue>3</issue>
<fpage>2255</fpage>
<lpage>2261</lpage>
<history>
<date date-type="received">
<day>20</day>
<month>01</month>
<year>2014</year></date>
<date date-type="accepted">
<day>07</day>
<month>08</month>
<year>2014</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2015, Spandidos Publications</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0">
<license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p></license></permissions>
<abstract>
<p>Accumulating evidence suggests that &#x003B2;-catenin signaling may be involved in oral tongue squamous cell carcinoma (OTSCC) cell invasion. Abnormal activation of twist-related protein 1 (TWIST1 or TWIST) has been identified in several types of human cancer. A recent study showed that overexpression of TWIST is associated with a poor prognosis in patients with OTSCC and may enhance OTSCC cell invasion. This study investigated the effect of TWIST on &#x003B2;-catenin signaling in OTSCC cells and its impact on OSTCC cell invasion. Stable overexpression of TWIST, with or without knockdown of &#x003B2;-catenin, and stable knockdown of TWIST were performed in SCC-4 and TCA8113 human OTSCC cells. Overexpression of TWIST in SCC-4 and TCA8113 cells increased &#x003B2;-catenin signaling luciferase reporter activity, mRNA levels of the &#x003B2;-catenin signaling target genes, c-Myc and c-Jun levels, soluble &#x003B2;-catenin level, the phosphorylation status of glycogen synthase kinase-3&#x003B2; (GSK-3&#x003B2;) at serine 9, matrix metalloproteinase-2 (MMP-2) expression and cell invasion. Knockdown of TWIST had the opposite effect. All of these changes, with the exception of phosphorylation of GSK-3&#x003B2;, were eliminated by stable knockdown of &#x003B2;-catenin. In addition, the phosphatidylinositol 3-kinase (PI3K) inhibitor, LY294002 abrogated the enhancing effects of TWIST on mRNA levels of c-Myc and c-Jun, soluble &#x003B2;-catenin levels, MMP-2 expression, cell invasion and GSK-3&#x003B2; phosphorylation. In conclusion, the present study demonstrated that TWIST enhances cell invasion and MMP-2 expression in OTSCC cells through &#x003B2;-catenin signaling, probably via a PI3K-dependent mechanism. This study provides novel insights into the molecular mechanisms underlying OTSCC progression.</p></abstract>
<kwd-group>
<kwd>twist-related protein 1</kwd>
<kwd>&#x003B2;-catenin</kwd>
<kwd>oral tongue squamous cell carcinoma</kwd>
<kwd>cell invasion</kwd>
<kwd>matrix metalloproteinase</kwd>
<kwd>phosphatidylinositol 3-kinase</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Oral squamous cell carcinoma is the most common form of head and neck cancer. It accounts for &gt;90&#x00025; of all such cancers and has a poor prognosis that may be attributable to the high frequency of lymph node metastasis and local invasion (<xref rid="b1-mmr-11-03-2255" ref-type="bibr">1</xref>). Tongue cancer is the most common form of intraoral cancer. Its incidence is rising in comparison with that of cancer in other head and neck sites (<xref rid="b2-mmr-11-03-2255" ref-type="bibr">2</xref>). Metastatic tongue carcinoma is associated with poorer survival and a lower rate of local tumor control than other sites of head and neck cancer and has a five-year survival rate of just 50&#x00025; (<xref rid="b2-mmr-11-03-2255" ref-type="bibr">2</xref>). The development of oral tongue squamous cell carcinoma (OTSCC) metastasis currently poses significant clinical challenges due to the limited therapeutic options that are available (<xref rid="b3-mmr-11-03-2255" ref-type="bibr">3</xref>).</p>
<p>Twist-related protein 1 (TWIST), also known as TWIST1, is a member of the basic helix-loop-helix transcription factor family. During embryonic development, TWIST is essential in the development of the mesoderm and differentiation of mesoderm-derived tissues (<xref rid="b4-mmr-11-03-2255" ref-type="bibr">4</xref>). A high level of expression of TWIST has been detected in several forms of cancer and has been associated with the initial phase of metastatic progression (<xref rid="b5-mmr-11-03-2255" ref-type="bibr">5</xref>). A recent study has shown that overexpression of TWIST is associated with a poor prognosis in patients with OTSCC and that knockdown of TWIST inhibits OTSCC cell invasion (<xref rid="b6-mmr-11-03-2255" ref-type="bibr">6</xref>).</p>
<p>&#x003B2;-catenin, originally identified as an essential regulator of E-cadherin-mediated cell-cell interaction, is a key component of the Wnt signaling pathway (<xref rid="b7-mmr-11-03-2255" ref-type="bibr">7</xref>). In the majority of cells, &#x003B2;-catenin is predominantly located at the plasma membrane in a complex with cadherins and &#x003B1;-catenin. This forms the insoluble pool of &#x003B2;-catenin. Under normal conditions, a small quantity of soluble &#x003B2;-catenin, which is free from cadherin, is present in the cytoplasm (<xref rid="b8-mmr-11-03-2255" ref-type="bibr">8</xref>). Wnt signals are transduced via specific cell surface receptors and activate a series of biochemical reactions, involving a large protein complex consisting of &#x003B2;-catenin and glycogen synthase kinase-3&#x003B2; (GSK-3&#x003B2;). This results in stabilization of soluble &#x003B2;-catenin and therefore an increase in the soluble pool of this molecule (<xref rid="b9-mmr-11-03-2255" ref-type="bibr">9</xref>). Soluble &#x003B2;-catenin interacts with T cell factor (Tcf) family transcription factors to activate a number of downstream target genes, such as c-Myc and c-Jun, which are important in the initiation and progression of carcinogenesis (<xref rid="b8-mmr-11-03-2255" ref-type="bibr">8</xref>,<xref rid="b10-mmr-11-03-2255" ref-type="bibr">10</xref>,<xref rid="b11-mmr-11-03-2255" ref-type="bibr">11</xref>). Recent studies have provided <italic>in vitro</italic> evidence that &#x003B2;-catenin signaling is pivotal in facilitating OTSCC cell invasion (<xref rid="b12-mmr-11-03-2255" ref-type="bibr">12</xref>,<xref rid="b13-mmr-11-03-2255" ref-type="bibr">13</xref>).</p>
<p>A pilot study conducted by our group suggested that TWIST may regulate &#x003B2;-catenin signaling in OTSCC cells. The current study investigated the effect of TWIST on &#x003B2;-catenin signaling in OTSCC cells and its impact on OSTCC cell invasion.</p></sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title>Cells lines, plasmids and reagents</title>
<p>Human SCC-4 and TCA8113 OTSCC cell lines were obtained from the American Type Culture Collection (Manassas, VA, USA) and Wuhan Boster Bio-Engineering Inc. (Wuhan, China), respectively. Human Twist cDNA was subcloned into a pcDNA 3.1 expression vector (<xref rid="b14-mmr-11-03-2255" ref-type="bibr">14</xref>). TOPflash and FOPflash plasmids were obtained from Millipore (Billerica, MA, USA). Twist (sc-38604-V) and &#x003B2;-catenin (sc-29209-V) short hairpin (sh) RNA lentiviral particles, control shRNA lentiviral particles-A (sc-108080), anti-TWIST (sc-81417) mouse monoclonal antibodies, anti-&#x003B2;-catenin (sc-7963) mouse monoclonal antibodies and anti-matrix metalloproteinase-2 (MMP-2, sc-53630) mouse monoclonal antibodies were obtained from Santa Cruz Biotechnology Inc. (Santa Cruz, CA, USA). Anti-GSK-3&#x003B2; and Anti-phospho-GSK-3&#x003B2; (serine 9) rabbit monoclonal antibodies were obtained from Cell Signaling Technology, Inc. (Beverly, MA, USA). Superfect&#x02122; transfection reagent was purchased from Qiagen (Valencia, CA, USA). A dual-luciferase reporter assay system was obtained from Promega Corporation (Madison, WI, USA). G418, puromycin, LY294002 and all chemicals of reagent grade were obtained from Sigma (St. Louis, MO, USA).</p></sec>
<sec>
<title>Transfection and lentiviral transduction</title>
<p>The TWIST expression construct was transfected into cells using Superfect&#x02122; transfection reagent (Qiagen) according to the manufacturer&#x02019;s instructions. Pools of stable transfectants were generated via selection with G418 (800 &#x003BC;g/ml) according to the manufacturer&#x02019;s instructions. Lentiviral transduction was performed as previously described (<xref rid="b15-mmr-11-03-2255" ref-type="bibr">15</xref>), and pools of stable transductants were generated via selection with puromycin (5 &#x003BC;g/ml).</p></sec>
<sec>
<title>Western blot analysis</title>
<p>Immunoblotting was performed with the appropriate antibodies. Soluble cell lysate fractions were prepared as previously described (<xref rid="b15-mmr-11-03-2255" ref-type="bibr">15</xref>). Briefly, cells were lysed in 0.1&#x00025; Nonidet P-40 lysis buffer (0.1&#x00025; Nonidet P-40; 10 mM HEPES, pH 7.5; 142.5 mM KCl; 5 mM MgCl<sub>2</sub>; and 1 mM ethylene glycol tetra acetic acid). The lysates were centrifuged at 14,000 &#x000D7; g for 10 min and the supernatants were saved as soluble cell lysate. To prepare the whole cell lysate, cells were dissolved in 250 &#x003BC;l of 2X SDS loading buffer (62.5 mm TrisHCl, pH 6.8; 2&#x00025; SDS; 25&#x00025; glycerol; 0.01&#x00025; bromphenol blue; and 5&#x00025; 2-mercaptoethanol), and incubated at 95&#x000B0;C for 10 min. Equal quantities of proteins for each sample were separated by 10&#x00025; SDS-polyacrylamide gel and blotted onto polyvinylidene difluoride microporous membranes (Millipore). Membranes were incubated for 1 h with a 1/1,000 dilution of primary antibody, and then washed and revealed using secondary antibodies conjugated to horseradish peroxidase (1/5,000, 1 h). Peroxidase was visualized with a GE Healthcare enhanced chemiluminescence kit (Beijing, China).</p></sec>
<sec>
<title>Reverse transcription-quantitative polymerase chain reaction (RT-qPCR)</title>
<p>RNA was prepared from cells using TRIzol reagent (Life Technologies, Carlsbad, CA, USA) followed by purification with a TURBO DNA-free system (Ambion, Austin, TX, USA). A total of 200 ng cDNA was synthesized using SuperScript II reverse transcriptase (Invitrogen, Carlsbad, CA, USA). RT-qPCR was performed on the LightCycler thermal cycler system (Roche Diagnostics, Indianapolis, IN, USA) using SYBR Green I kit (Roche Diagnostics) according to the manufacturer&#x02019;s instructions. The PCR amplification conditions were as follows: 20 sec at 95&#x000B0;C followed by 40 cycles of 3 sec at 95&#x000B0;C and 30 sec at 60&#x000B0;C. The results were normalized against those of the reference gene, glyceraldehyde-3-phosphate dehydrogenase (GAPDH). The following primers were used: Forward: 5&#x02032;-AGGGATTTTCTCAGTCCTTC-3&#x02032; and reverse: 5&#x02032;-CATGCCCTCATCTAATGTCT-3&#x02032; for &#x003B2;-catenin; forward: 5&#x02032;-GGACGACGAGACCTTCATCAA-3&#x02032; and reverse: 5&#x02032;-CCAGCTTCTCTGAGACGAGCTT-3&#x02032; for human c-Myc; forward: 5&#x02032;-CAAAGTTTGGATTGCATCAAGTG-3&#x02032; and reverse: 5&#x02032;-TAACATTATAAATGGTCACAGCACATG-3&#x02032; for human c-Jun; and forward: 5&#x02032;-GACTCATGACCA CAGTCCATGC-3&#x02032; and reverse: 5&#x02032;-AGAGGCAGGGATG ATGTTCTG-3&#x02032; for human GAPDH. Each experiment was repeated twice in triplicate.</p></sec>
<sec>
<title>Luciferase assay</title>
<p>SCC-4 and TCA8113 cells were transfected with TOPflash or FOPflash plasmids using Superfect transfection reagent (Qiagen). PRL-CMV plasmid encoding <italic>Renilla reniformis</italic> luciferase (at a concentration of one fifth molar ratio relative to the test plasmids) was co-transfected as an internal control. The luciferase assays were performed following 24 h transfection with a dual-luciferase reporter assay system (Promega Corporation) according to the manufacturer&#x02019;s instructions. Each experiment was repeated three times in duplicate.</p></sec>
<sec>
<title>In vitro cell invasion assay</title>
<p>Transwell<sup>&#x000AE;</sup> cell-culture chambers with 8-&#x003BC;m pores (BD Biosciences, Bedford, MA, USA) and 24 wells per plate were coated with 50 &#x003BC;l Matrigel (10 mg/ml; BD Biosciences; diluted 1:3). SCC-4 and TCA8113 cells were seeded in the upper chamber at 5&#x000D7;10<sup>5</sup> cells per well, in Dulbecco&#x02019;s modified Eagle&#x02019;s medium and RPMI-1640 serum-free medium, respectively. Complete medium (600 &#x003BC;l) with 10&#x00025; fetal bovine serum was added to the lower chamber. After 24 h of incubation, cells were fixed and stained with crystal violet. Invading cells were counted in five random fields per chamber under an inverted microscope (IX83; Olympus, Bejing, China). Each experiment was repeated three times in duplicate.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Statistical analyses were performed using SPSS for Windows 10.0 (SPSS Inc., Chicago, IL, USA). Data are expressed as the mean &#x000B1; standard deviation. Comparisons of means between groups were performed with one-way analysis of variance followed by post hoc pairwise comparisons using Tukey&#x02019;s tests. P&lt;0.05 was considered to indicate a statistically significant difference.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>TWIST expression is increased by transfection with a TWIST expression vector and decreased by transduction of TWIST shRNA</title>
<p>To investigate the function of TWIST in OTSCC cells, SCC-4 and TCA8113 human OTSCC cells were stably transfected with a TWIST expression vector to induce overexpression of TWIST. In addition, a separate group of cells was stably transduced with TWIST-shRNA in order to knock down the expression of this gene. As shown in <xref rid="f1-mmr-11-03-2255" ref-type="fig">Fig. 1</xref>, TWIST is constitutively expressed in SCC-4 and TCA8113 cells. Its expression was reduced by ~80&#x00025; by stable transduction of TWIST-shRNA. Compared with controls, TWIST expression was increased three-fold in SCC-4 and TCA8113 cells that had been stably transfected with TWIST. These results were not altered by transduction of &#x003B2;-catenin-shRNA (<xref rid="f1-mmr-11-03-2255" ref-type="fig">Fig. 1</xref>).</p></sec>
<sec>
<title>SCC-4 and TCA8113 cells overexpressing TWIST show an increase in &#x003B2;-catenin transcriptional activity</title>
<p>As shown in <xref rid="f2-mmr-11-03-2255" ref-type="fig">Fig. 2</xref>, the transcriptional activity of &#x003B2;-catenin signaling in SCC-4 and TCA8113 cells was measured with TOPflash, a synthetic &#x003B2;-catenin/Tcf-dependent luciferase reporter (<xref rid="b11-mmr-11-03-2255" ref-type="bibr">11</xref>). Compared with controls, the luciferase activity of TOPflash was increased seven-fold in SCC-4 and TCA8113 cells overexpressing TWIST. This effect was eliminated in cells stably transduced with &#x003B2;-catenin-shRNA. By contrast, knockdown of TWIST decreased the luciferase activity of TOPflash by ~70&#x00025; (<xref rid="f2-mmr-11-03-2255" ref-type="fig">Fig. 2</xref>). However, little change was observed with FOPflash, a negative control reporter with a mutation in the Tcf binding elements (<xref rid="b11-mmr-11-03-2255" ref-type="bibr">11</xref>) (<xref rid="f2-mmr-11-03-2255" ref-type="fig">Fig. 2</xref>). These results suggest that TWIST may regulate &#x003B2;-catenin signaling in OTSCC cells.</p></sec>
<sec>
<title>TWIST increases mRNA levels of target genes of &#x003B2;-catenin signaling</title>
<p>As shown in <xref rid="f3-mmr-11-03-2255" ref-type="fig">Fig. 3</xref>, RT-qPCR demonstrated that overexpression or knockdown of TWIST had no significant effect on &#x003B2;-catenin mRNA levels in SCC-4 and TCA8113 cells. However, the mRNA levels of target genes (c-Myc and c-Jun) of &#x003B2;-catenin signaling were increased 4.5-fold in cells overexpressing TWIST. Again, this effect was abrogated by transduction of &#x003B2;-catenin-shRNA and by the phosphatidylinositol 3-kinase (PI3K) inhibitor, LY294002. Knockdown of TWIST decreased the mRNA levels of c-Myc and c-Jun by ~60&#x00025;, compared with the control (<xref rid="f3-mmr-11-03-2255" ref-type="fig">Fig. 3</xref>).</p></sec>
<sec>
<title>TWIST increases levels of soluble, but not of total, &#x003B2;-catenin protein levels</title>
<p>As shown in <xref rid="f4-mmr-11-03-2255" ref-type="fig">Fig. 4</xref>, total &#x003B2;-catenin protein levels in SCC-4 and TCA8113 cells were not altered by overexpression or knockdown of TWIST. By contrast, overexpression of TWIST increased the levels of soluble &#x003B2;-catenin by 5.5-fold. This effect was eliminated by transduction of &#x003B2;-catenin-shRNA and by administration of LY294002. Knockdown of TWIST decreased the soluble &#x003B2;-catenin level by over 60&#x00025; (<xref rid="f4-mmr-11-03-2255" ref-type="fig">Fig. 4</xref>).</p></sec>
<sec>
<title>TWIST increases levels of soluble &#x003B2;-catenin by increasing the phosphorylation of GSK-3&#x003B2;</title>
<p>GSK-3&#x003B2; is a major downstream target of the PI3K/Akt pathway. It is inactivated by phosphorylation at serine 9 by PI3K/Akt. This results in the stabilization and accumulation of soluble &#x003B2;-catenin (<xref rid="b16-mmr-11-03-2255" ref-type="bibr">16</xref>). As shown in <xref rid="f5-mmr-11-03-2255" ref-type="fig">Fig. 5</xref>, the total GSK-3&#x003B2; protein level in SCC-4 and TCA8113 cells was not altered by overexpression or knockdown of TWIST. Overexpression of TWIST increased phosphorylation of GSK-3&#x003B2; at serine 9 by 3.5-fold. This effect was eradicated by administration of LY294002, although not by transduction of &#x003B2;-catenin-shRNA. Knockdown of TWIST decreased serine 9 phosphorylation by ~70&#x00025; (<xref rid="f5-mmr-11-03-2255" ref-type="fig">Fig. 5</xref>). These results indicate that TWIST is able to regulate levels of soluble &#x003B2;-catenin via induction of phosphorylation of GSK-3&#x003B2; by PI3K/Akt in OTSCC cells.</p></sec>
<sec>
<title>TWIST overexpression increases OTSCC cell invasion and the expression of MMP-2</title>
<p>TWIST and &#x003B2;-catenin are important for OTSCC cell invasion (<xref rid="b6-mmr-11-03-2255" ref-type="bibr">6</xref>,<xref rid="b12-mmr-11-03-2255" ref-type="bibr">12</xref>,<xref rid="b13-mmr-11-03-2255" ref-type="bibr">13</xref>). MMPs are also known to be involved in cancer cell invasion (<xref rid="b17-mmr-11-03-2255" ref-type="bibr">17</xref>,<xref rid="b18-mmr-11-03-2255" ref-type="bibr">18</xref>). The effect of TWIST and &#x003B2;-catenin on OTSCC cell invasion and MMP expression was investigated. As shown in <xref rid="f6-mmr-11-03-2255" ref-type="fig">Fig. 6</xref>, overexpression of TWIST markedly increased SCC-4 and TCA8113 cell invasiveness. This effect was abrogated by transduction with &#x003B2;-catenin-shRNA and by administration of LY294002. By contrast, knockdown of TWIST markedly decreased cell invasion (<xref rid="f6-mmr-11-03-2255" ref-type="fig">Fig. 6</xref>). In accordance with these findings, overexpression of TWIST led to an increase in MMP-2 expression, whilst knockdown of TWIST led to a reduction in MMP-2 expression compared with controls (<xref rid="f7-mmr-11-03-2255" ref-type="fig">Fig. 7</xref>).</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Accumulating <italic>in vitro</italic> evidence suggests that &#x003B2;-catenin signaling is important in OTSCC cell invasion (<xref rid="b12-mmr-11-03-2255" ref-type="bibr">12</xref>,<xref rid="b13-mmr-11-03-2255" ref-type="bibr">13</xref>). Abnormal activation of TWIST has been implicated in several types of human cancer (<xref rid="b19-mmr-11-03-2255" ref-type="bibr">19</xref>). A recent study has reported that overexpression of TWIST is associated with a poor prognosis in patients with OTSCC, and may enhance OTSCC cell invasion (<xref rid="b6-mmr-11-03-2255" ref-type="bibr">6</xref>). To the best of our knowledge, this study provides the first evidence that TWIST enhances OTSCC cell invasion through regulation of &#x003B2;-catenin signaling. The data were highly consistent in the two OTSCC cell lines.</p>
<p>In this study, overexpression and knockdown of TWIST in OTSCC cells increased and decreased the levels of soluble &#x003B2;-catenin, respectively. &#x003B2;-catenin interacts with Tcf transcription factors to activate a number of downstream target genes, including c-Myc and c-Jun (<xref rid="b8-mmr-11-03-2255" ref-type="bibr">8</xref>,<xref rid="b10-mmr-11-03-2255" ref-type="bibr">10</xref>,<xref rid="b11-mmr-11-03-2255" ref-type="bibr">11</xref>). Overexpression and knockdown of TWIST increased and decreased, respectively, the TOPflash &#x003B2;-catenin signaling reporter activity, as well as the mRNA levels of c-Myc and c-Jun. Notably, TWIST did not alter the total levels of the &#x003B2;-catenin protein, indicating that TWIST may regulate the level of soluble &#x003B2;-catenin via a post-transcriptional mechanism. This is in accordance with the observed increase in serine-9 phosphorylation of GSK-3&#x003B2;, which ultimately results in stabilization and accumulation of soluble &#x003B2;-catenin (<xref rid="b16-mmr-11-03-2255" ref-type="bibr">16</xref>). GSK-3&#x003B2; is a major downstream target of the PI3K/Akt pathway (<xref rid="b16-mmr-11-03-2255" ref-type="bibr">16</xref>). Since the PI3K inhibitor, LY294002, eliminated the increase in serine 9 phosphorylation of GSK-3&#x003B2; and the increase in soluble &#x003B2;-catenin induced by overexpression of TWIST, it is likely that TWIST regulates the soluble &#x003B2;-catenin level in OTSCC cells through the PI3K/Akt/GSK-3&#x003B2; pathway.</p>
<p>Overexpression of TWIST markedly enhanced cell invasion and MMP-2 expression in OTSCC cells. This result was corroborated by a significant reduction in cell invasion and MMP-2 expression in OTSCC cells with the knockdown of TWIST. The enhancing effect of TWIST on OTSCC cell invasion and MMP-2 expression was almost completely eradicated by knocking down &#x003B2;-catenin with shRNA, suggesting that &#x003B2;-catenin signaling is an essential mediator of the effect of TWIST on OSTCC cell invasion.</p>
<p>Abnormal activation of &#x003B2;-catenin signaling is critical in the progression of a variety of cancers, including OTSCC (<xref rid="b11-mmr-11-03-2255" ref-type="bibr">11</xref>&#x02013;<xref rid="b13-mmr-11-03-2255" ref-type="bibr">13</xref>). Yin <italic>et al</italic> (<xref rid="b15-mmr-11-03-2255" ref-type="bibr">15</xref>) showed that TWIST negatively regulated &#x003B2;-catenin signaling via a PI3K-dependent mechanism in osteosarcoma cells. Their findings are in accordance with the fact that in a homogeneous cohort of osteosarcoma patients, the TWIST gene is frequently found to be deleted in the tumors at diagnosis, and haploinsufficiency of this gene is significantly correlated with a poorer patient outcome (<xref rid="b15-mmr-11-03-2255" ref-type="bibr">15</xref>). The present study, however, found that TWIST was a positive regulator of &#x003B2;-catenin signaling by a PI3K-dependent mechanism. This finding is in agreement with a recent study demonstrating that overexpression of TWIST is associated with a poor prognosis in patients with OTSCC (<xref rid="b6-mmr-11-03-2255" ref-type="bibr">6</xref>). This discrepancy suggests that the regulatory effect of TWIST on &#x003B2;-catenin signaling may be dependent on the type of tissue or cancer involved.</p>
<p>MMPs are critical for cancer cell invasion (<xref rid="b17-mmr-11-03-2255" ref-type="bibr">17</xref>,<xref rid="b18-mmr-11-03-2255" ref-type="bibr">18</xref>). Recent studies have suggested that MMP-2 is important for OTSCC lymph node metastasis <italic>in vivo</italic> and OTSCC cell invasion <italic>in vitro</italic> (<xref rid="b6-mmr-11-03-2255" ref-type="bibr">6</xref>,<xref rid="b20-mmr-11-03-2255" ref-type="bibr">20</xref>). This study found that TWIST markedly increased MMP-2 expression through &#x003B2;-catenin signaling, suggesting that the TWIST/&#x003B2;-catenin signaling axis is important for OTSCC progression. In addition, as TWIST and &#x003B2;-catenin signaling are abnormally activated in a variety of cancers, the TWIST/&#x003B2;-catenin signaling axis may be important in cancers other than OTSCC. This hypothesis requires further investigation in future studies.</p>
<p>In conclusion, the current study demonstrated that TWIST enhances cell invasion and MMP-2 expression in OTSCC cells through its effects on &#x003B2;-catenin signaling, which are likely to be mediated via a PI3K-dependent mechanism. This study provides novel insights into the molecular mechanisms underlying OTSCC progression.</p></sec></body>
<back>
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<floats-group>
<fig id="f1-mmr-11-03-2255" position="float">
<label>Figure 1</label>
<caption>
<p>TWIST expression in OTSCC cells with overexpression and knockdown of TWIST. (A) SCC-4 and (B) TCA8113 human OTSCC cells. Lane 1, NC; lane 2, VC; lane 3, T; lane 4, T+B-shRNA; lane 5, SC; lane 6, T-shRNA. Expression was analyzed with western blot analysis. &#x003B2;-actin was used as a loading control. The density of the TWIST blots were normalized against that of &#x003B2;-actin blots to obtain a relative blot density. This was expressed as a fold change of the relative TWIST blot density compared with the NC group (designated as 1). <sup>a</sup>P&lt;0.05, compared with NC or VC, <sup>b</sup>P&lt;0.05, compared with T, <sup>c</sup>P&lt;0.05, compared with T+B-shRNA and <sup>d</sup>P&lt;0.05, compared with SC. OTSCC, oral tongue squamous cell carcinoma; NC, normal control; VC, cells transfected with empty pcDNA3 vector; T, cells transfected with pcDNA3-TWIST expression vector; T+B-shRNA, cells transfected with pcDNA-TWIST expression vector and &#x003B2;-catenin short hairpin RNA; SC, cells transfected with scrambled control shRNA; T-shRNA, cells transfected with TWIST shRNA; TWIST, twist-related protein 1.</p></caption>
<graphic xlink:href="MMR-11-03-2255-g00.gif"/></fig>
<fig id="f2-mmr-11-03-2255" position="float">
<label>Figure 2</label>
<caption>
<p>Effect of TWIST on &#x003B2;-catenin luciferase reporter activity in OTSCC cells. (A) SCC-4 and (B) TCA8113 human OTSCC cells were transfected with TOPflash, a synthetic &#x003B2;-catenin luciferase reporter, or FOPflash, a negative control reporter for TOPflash. After 24 h, the luciferase activity in each group was analyzed. The luciferase activity was expressed as a fold change relative to that of the NC group (designated as 1). <sup>a</sup>P&lt;0.05, compared with NC or VC, <sup>b</sup>P&lt;0.05, compared with T, <sup>c</sup>P&lt;0.05, compared with B-shRNA, <sup>d</sup>P&lt;0.05, compared with T+B-shRNA and <sup>e</sup>P&lt;0.05, compared with SC. OTSCC, oral tongue squamous cell carcinoma; NC, normal control; VC, cells transfected with empty pcDNA3 vector; T, cells transfected with pcDNA3-TWIST expression vector; T+B-shRNA, cells transfected with pcDNAs-TWIST expression vector and &#x003B2;-catenin short hairpin RNA; SC, cells transfected with scrambled control shRNA; T-shRNA, cells transfected with TWIST shRNA; TWIST, twist-related protein 1.</p></caption>
<graphic xlink:href="MMR-11-03-2255-g01.gif"/></fig>
<fig id="f3-mmr-11-03-2255" position="float">
<label>Figure 3</label>
<caption>
<p>Effect of TWIST on mRNA levels of &#x003B2;-catenin, C-Myc and C-Jun in OTSCC cells. (A) SCC-4 and (B) TCA8113 human OTSCC. Reverse transcription-qunatitative polymerase chain reaction was performed in each group. The mRNA levels were expressed as a fold change relative to that of the NC group (designated as 1). <sup>a</sup>P&lt;0.05, compared with NC or VC. OTSCC, oral tongue squamous cell carcinoma; NC, normal control; VC, cells transfected with empty pcDNA3 vector; T, cells transfected with pcDNA3-TWIST expression vector; T+B-shRNA, cells transfected with pcDNAs-TWIST expression vector and &#x003B2;-catenin short hairpin RNA; T+Ly, cells transfected with pcDNAs-WIST expression vector and treated with 50 &#x003BC;m LY294002; SC, cells transfected with scrambled control shRNA; T-shRNA, cells transfected with TWIST shRNA; TWIST, twist-related protein 1.</p></caption>
<graphic xlink:href="MMR-11-03-2255-g02.gif"/></fig>
<fig id="f4-mmr-11-03-2255" position="float">
<label>Figure 4</label>
<caption>
<p>Effect of TWIST on levels of &#x003B2;-catenin protein in OTSCC cells. (A) SCC-4 and (B) TCA8113 human OTSCC cells. Lane 1, NC; lane 2, VC; lane 3, T; lane 4, B-shRNA; lane 5, T+B-shRNA; lane 6, T+LY; lane 7, SC; lane 8, T-shRNA. The soluble and total &#x003B2;-catenin protein levels were analyzed with western blot analysis. &#x003B2;-actin was used as a loading control. The density of the &#x003B2;-catenin blot was normalized against that of &#x003B2;-actin to obtain a relative blot density, which was expressed as a fold change to the relative &#x003B2;-catenin blot density in the NC group (designated as 1). <sup>a</sup>P&lt;0.05, compared with NC or VC, <sup>b</sup>P&lt;0.05, compared with T, <sup>c</sup>P&lt;0.05, compared with B-shRNA, <sup>d</sup>P&lt;0.05, compared with T+B-shRNA, <sup>e</sup>P&lt;0.05, compared with T+LY and <sup>f</sup>P&lt;0.05, compared with SC. OTSCC, oral tongue squamous cell carcinoma; NC, normal control; VC, cells transfected with empty pcDNA3 vector; T, cells transfected with pcDNA3-TWIST expression vector; T+B-shRNA, cells transfected with pcDNAs-TWIST expression vector and &#x003B2;-catenin short hairpin RNA; T+Ly, cells transfected with pcDNAs-WIST expression vector and treated with 50 &#x003BC;m LY294002; SC, cells transfected with scrambled control shRNA; T-shRNA, cells transfected with TWIST shRNA; TWIST, twist-related protein 1.</p></caption>
<graphic xlink:href="MMR-11-03-2255-g03.gif"/></fig>
<fig id="f5-mmr-11-03-2255" position="float">
<label>Figure 5</label>
<caption>
<p>Effect of TWIST on phosphorylated GSK-3&#x003B2; levels in OTSCC cells. (A) SCC-4 and (B) TCA8113 human OTSCC cells. Lane 1, NC; lane 2, VC; lane 3, T; lane 4, B-shRNA; lane 5, T+B-shRNA; lane 6, T+LY; lane 7, SC; lane 8, T-shRNA. Phosphorylation of GSK-3&#x003B2; at serine 9 in each group was analyzed with western blotting. &#x003B2;-actin was used as a loading control. The density of the P-GSK-3&#x003B2; blot was normalized against that of total GSK-3&#x003B2; and &#x003B2;-actin to obtain a relative blot density, which was expressed as a fold change of the relative P-GSK-3&#x003B2; blot density in the NC group (designated as 1). <sup>a</sup>P&lt;0.05, compared with NC or VC, <sup>b</sup>P&lt;0.05, compared with T, <sup>c</sup>P&lt;0.05, compared with B-shRNA, <sup>d</sup>P&lt;0.05, compared with T+B-shRNA, <sup>e</sup>P&lt;0.05, compared with T+LY and <sup>f</sup>P&lt;0.05, compared with SC. P-GSK-3&#x003B2;, phosphorylated glycogen synthase-3&#x003B2;; OTSCC, oral tongue squamous cell carcinoma; NC, normal control; VC, cells transfected with empty pcDNA3 vector; T, cells transfected with pcDNA3-TWIST expression vector; T+B-shRNA, cells transfected with pcDNAs-TWIST expression vector and &#x003B2;-catenin short hairpin RNA; T+Ly, cells transfected with pcDNAs-WIST expression vector and treated with 50 &#x003BC;m LY294002; SC, cells transfected with scrambled control shRNA; T-shRNA, cells transfected with TWIST shRNA; TWIST, twist-related protein 1.</p></caption>
<graphic xlink:href="MMR-11-03-2255-g04.gif"/></fig>
<fig id="f6-mmr-11-03-2255" position="float">
<label>Figure 6</label>
<caption>
<p>Effect of TWIST on OTSCC cells. (A) SCC-4 and (B) TCA8113 human OTSCC cells. Transwell invasion assays were performed in each group and the number of cells that had invaded were counted. <sup>a</sup>P&lt;0.05, cpmpared with NC or VC, <sup>b</sup>P&lt;0.05, compared with T, <sup>c</sup>P&lt;0.05, compared with B-shRNA, <sup>d</sup>P&lt;0.05, compared with T+B-shRNA, <sup>e</sup>P&lt;0.05, compared with T+LY and <sup>f</sup>P&lt;0.05, compared with SC. OTSCC, oral tongue squamous cell carcinoma; NC, normal control; VC, cells transfected with empty pcDNA3 vector; T, cells transfected with pcDNA3-TWIST expression vector; T+B-shRNA, cells transfected with pcDNAs-TWIST expression vector and &#x003B2;-catenin short hairpin RNA; T+Ly, cells transfected with pcDNAs-WIST expression vector and treated with 50 &#x003BC;m LY294002; SC, cells transfected with scrambled control shRNA; T-shRNA, cells transfected with TWIST shRNA; TWIST, twist-related protein 1.</p></caption>
<graphic xlink:href="MMR-11-03-2255-g05.gif"/></fig>
<fig id="f7-mmr-11-03-2255" position="float">
<label>Figure 7</label>
<caption>
<p>Effect of TWIST on expression of MMP-2 in OTSCC cells. (A) SCC-4 and (B) TCA8113 human OTSCC cells. Lane 1, NC; lane 2, VC; lane 3, T; lane 4, B-shRNA; lane 5, T+B-shRNA; lane 6, T+LY; lane 7, SC; lane 8, T-shRNA. The expression of MMP-2 in each group was measured using western blot analysis. &#x003B2;-actin was used as a loading control. The density of the MMP-2 blot was normalized against that of &#x003B2;-actin to obtain a relative blot density, which was expressed as a fold change of the relative MMP-2 blot density in the NC group (designated as 1). <sup>a</sup>P&lt;0.05, compared with NC or VC, <sup>b</sup>P&lt;0.05, compared with T, <sup>c</sup>P&lt;0.05, compared with B-shRNA, <sup>d</sup>P&lt;0.05, compared with T+B-shRNA, <sup>e</sup>P&lt;0.05, compared with T+LY and <sup>f</sup>P&lt;0.05, compared with SC. MMP-2, matrix metalloproteinase-2, OTSCC, oral tongue squamous cell carcinoma; NC, normal control; VC, cells transfected with empty pcDNA3 vector; T, cells transfected with pcDNA3-TWIST expression vector; T+B-shRNA, cells transfected with pcDNAs-TWIST expression vector and &#x003B2;-catenin short hairpin RNA; T+Ly, cells transfected with pcDNAs-WIST expression vector and treated with 50 &#x003BC;m LY294002; SC, cells transfected with scrambled control shRNA; T-shRNA, cells transfected with TWIST shRNA; TWIST, twist-related protein 1.</p></caption>
<graphic xlink:href="MMR-11-03-2255-g06.gif"/></fig></floats-group></article>
