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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.2013.1361</article-id>
<article-id pub-id-type="publisher-id">mmr-07-05-1651</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>RNA interference-mediated inhibition of survivin and VEGF in pancreatic cancer cells <italic>in vitro</italic></article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>SONG</surname><given-names>JIANLIN</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>CAO</surname><given-names>LIPIN</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>LI</surname><given-names>YIXIONG</given-names></name><xref ref-type="corresp" rid="c1-mmr-07-05-1651"/></contrib>
<aff id="af1-mmr-07-05-1651">Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China</aff></contrib-group>
<author-notes>
<corresp id="c1-mmr-07-05-1651">Correspondence to: Professor Yixiong Li, Department of General Surgery, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, Hunan 410008, P.R. China, E-mail: <email>liyixiong2011@hotmail.com</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>5</month>
<year>2013</year></pub-date>
<pub-date pub-type="epub">
<day>06</day>
<month>03</month>
<year>2013</year></pub-date>
<volume>7</volume>
<issue>5</issue>
<fpage>1651</fpage>
<lpage>1655</lpage>
<history>
<date date-type="received">
<day>01</day>
<month>11</month>
<year>2012</year></date>
<date date-type="accepted">
<day>18</day>
<month>02</month>
<year>2013</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2013, Spandidos Publications</copyright-statement>
<copyright-year>2013</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>The aim of the present study was to investigate the effects of simultaneous short hairpin RNA (shRNA)-targeted survivin and vascular endothelial growth factor (VEGF) inhibition on the proliferation, apoptosis and angiogenesis of human pancreatic cancer cells (Panc-1). Targeted small interfering RNA (siRNA) expression vectors of survivin and VEGF were constructed and transfected into Panc-1 cells. The downregulation of survivin and VEGF expression was evaluated by real-time PCR and western blot analysis. The effects of targeted shRNA on the proliferation and apoptosis of Panc-1 cells were analyzed by MTT assay and flow cytometry (FCM). The culture medium from Panc-1 cells transfected with siRNA was collected and human umbilical vein endothelial cells (HUVECs) were seeded in this media. The proliferation and apoptosis of the HUVECs were also investigated by MTT assay and FCM. A transfected cell line (Panc-1/survivin-shRNA and Panc-1/VEGF-shRNA) was established in which the expression of survivin and VEGF was downregulated. The cell viabilities of Panc-1 cells and HUVECs in the combined inhibition groups were markedly decreased compared with the controls. The cell apoptosis rates of Panc-1 cells and HUVECs in the combined inhibition groups were observed to be significantly increased compared with the controls. The simultaneous RNA interference-mediated downregulation of survivin and VEGF expression inhibited proliferation and induced the apoptosis of Panc-1 cells and HUVECs, indicating that combined therapy with survivin and VEGF inhibition may serve as a potential strategy for the treatment of pancreatic cancer.</p></abstract>
<kwd-group>
<kwd>survivin</kwd>
<kwd>vascular endothelial growth factor</kwd>
<kwd>RNA interference</kwd>
<kwd>Panc-1</kwd>
<kwd>human umbilical vein endothelial cells</kwd>
<kwd>pancreatic cancer</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Pancreatic cancer is one of the most common types of cancer with 300,000 mortalities every year worldwide. Morbidity and mortality are gradually increasing (<xref rid="b1-mmr-07-05-1651" ref-type="bibr">1</xref>). At present, the success of tumor resection and the efficacy of chemotherapy and radiotherapy are extremely low (<xref rid="b2-mmr-07-05-1651" ref-type="bibr">2</xref>). In addition to conventional cancer therapies, several alternative approaches for limiting tumor progression are currently under investigation. These strategies aim to reduce the expression of tumor-related genes, for example, by the use of small interfering RNAs (siRNAs). The main targets of these strategies are central regulatory genes which control cell proliferation, cell death and angiogenesis, including the apoptosis inhibitor survivin and vascular endothelial growth factor (VEGF). Survivin, a member of the inhibitor of apoptosis protein (IAP) family, has been demonstrated to be involved in the regulation of apoptosis, cellular proliferation and angiogenesis in cancer and has attracted growing attention as a potential target for cancer therapy (<xref rid="b3-mmr-07-05-1651" ref-type="bibr">3</xref>). VEGF is the most effective and specific factor for the promotion of tumor angiogenesis and is vital for tumor growth and metastasis (<xref rid="b4-mmr-07-05-1651" ref-type="bibr">4</xref>). VEGF and survivin are overexpressed in the majority of cancer types, including human pancreatic cancer (<xref rid="b5-mmr-07-05-1651" ref-type="bibr">5</xref>&#x02013;<xref rid="b8-mmr-07-05-1651" ref-type="bibr">8</xref>). It has been reported that antisense oligodeoxynucleotides (AS-ODNs) or siRNAs, specifically directed at survivin or VEGF, induced apoptosis and inhibited the proliferation of tumor cells (<xref rid="b9-mmr-07-05-1651" ref-type="bibr">9</xref>,<xref rid="b10-mmr-07-05-1651" ref-type="bibr">10</xref>). However, the effects of combined target gene silencing of survivin and VEGF on the proliferation, apoptosis and angiogenesis of human pancreatic cancer cells have not yet been reported.</p>
<p>The aim of the present study was to investigate the effects of simultaneously targeting survivin and VEGF with short hairpin RNA (shRNA) on the proliferation, apoptosis and angiogenesis of human pancreatic cancer cells (Panc-1). Gene therapy simultaneously targeting survivin and VEGF may be a potent and attractive strategy for the treatment of pancreatic cancer.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>shRNA design and plasmid construction</title>
<p>siRNA target design tools from oligo designer 3.0 were used to design survivin-, VEGF- and non-specific-shRNA sequences. Four vectors were designed, which included 4 survivin- and VEGF-specific siRNAs designated as S1, S2, S3 and S4 and V1, V2, V3 and V4, respectively. The vectors including nonsense sequences were designated Snc and Vnc. Sequences of siRNAs targeted at survivin and VEGF and the nonsense control constructs are presented in <xref rid="tI-mmr-07-05-1651" ref-type="table">Table I</xref>. The oligonucleotides were annealed and inserted into the pGPU6/GFP/Neo expression vector according to the manufacturer&#x02019;s instructions (Genepharma, Shanghai, China). The recombinant vectors were confirmed by digestion analysis using restriction endonucleases and all inserted sequences were verified by DNA sequencing.</p></sec>
<sec>
<title>Cell culture and transfection</title>
<p>The human pancreatic cancer cell line, Panc-1 (American Type Culture Collection, Manassas, VA, USA), was cultured in Dulbecco&#x02019;s modified Eagle&#x02019;s medium (DMEM; Invitrogen Life Technologies, Carlsbad, CA, USA) containing 10&#x00025; fetal calf serum in a 37&#x000B0;C incubator with a 5&#x00025; CO<sub>2</sub>-humidified atmosphere. Panc-1 cells were seeded in 6-well plates at 4-5&#x000D7;10<sup>4</sup> cells/well and cultured overnight to 70&#x00025; confluence prior to transfection. Transfection was performed using Lipofectamine&#x02122; 2000 and the cells were transfected with the vectors according to the manufacturer&#x02019;s instructions (Invitrogen Life Technologies, Carlsbad, CA, USA). Following this, assays were performed using transfectants.</p></sec>
<sec>
<title>Real-time PCR analysis of mRNA expression</title>
<p>Total cellular RNA was isolated using TRIzol reagent according to the manufacturer&#x02019;s instructions (Invitrogen Life Technologies). Real-time PCR was performed using total RNA (2 mg) using oligo(dT)<sub>18</sub> primers at 42&#x000B0;C for 60 min and 70&#x000B0;C for 10 min. The primer sequences used were as follows: survivin (136 bp), 5&#x02032;-accgcatctctacattcaag-3&#x02032; (forward) and 5&#x02032;-ttgaagcagaagaaacactg-3&#x02032; (reverse); VEGF (136 bp), 5&#x02032;-actgaggagtccaacatcac-3&#x02032; (forward) and 5&#x02032;-gtctgcattcacatttgttg-3&#x02032; (reverse); &#x003B2;-actin (208 bp), 5&#x02032;-cattaaggagaagctgtgct-3&#x02032; (forward) and 5&#x02032;-gttgaaggtagtttcgtgga-3&#x02032; (reverse). The relative quantification of the target gene expression was performed using the 2<sup>&#x02212;&#x00394;&#x00394;Ct</sup> method. Each experiment was performed at least three times.</p></sec>
<sec>
<title>Western blot analysis of target protein expression</title>
<p>Untransfected or stably transfected Panc-1 cells were lysed in lysis buffer and the lysates were cleared by centrifuging. Proteins were separated by 10&#x00025; sodium dodecyl sulfate-polyacrylamide gele electrophoresis (SDS-PAGE), electroblotted onto a nitrocellulose membrane, blocked by 5&#x00025; skimmed milk and probed with anti-survivin, -VEGF and -GAPDH antibodies (Sigma-Aldrich, St. Louis, MO, USA). Following incubation with secondary antibody, immunoblots were visualized by chemiluminescence using a chemiluminescence kit and the specific bands were recorded on X-ray film. GAPDH protein levels were used as a control to verify equal protein loading.</p></sec>
<sec>
<title>Cell proliferation assay</title>
<p>Panc-1 cells and HUVECs (American Type Culture Collection) were seeded in the collected culture medium of each group and cell viability was measured by 3-(4,5-dimethylthazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay (Sigma-Aldrich). Panc-1 cells or HUVECs (1&#x000D7;10<sup>4</sup> cells/well) were seeded into seven 96-well culture plates and each group consisted of 3 parallel wells. MTT was added to each well and the cells were incubated at 37&#x000B0;C. The reaction was then stopped by lysing the cells with 150 ml DMSO for 5 min. Optical densities were determined using a Versamax microplate reader (Molecular Devices, Sunnyvale, CA, USA) at 570 nm.</p></sec>
<sec>
<title>Apoptosis detection</title>
<p>The apoptosis of Panc-1 cells and HUVECs seeded in the collected culture medium of each group was assessed 72 h following transfection by staining cells with Annexin V/propidium iodide (PI) and analyzed using flow cytometry (FCM).</p></sec>
<sec>
<title>Statistical analysis</title>
<p>All statistical analyses were performed using SPSS 13.0 (SPSS, Inc., Chicago, IL, USA). Comparisons among all groups were performed using the one-way analysis of variance (ANOVA) test and Student Newman Keuls method. P&lt;0.05 was considered to indicate a statistically significant difference.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Inhibitive effect of specific shRNA vectors on survivin and VEGF expression in Panc-1 cells and selection of the most effective specific shRNA vector</title>
<p>mRNA and protein expression levels of survivin and VEGF, inhibited by specific-shRNAs in the Panc-1 cells, were analyzed by real-time PCR and western blot analysis. As demonstrated in <xref rid="f1-mmr-07-05-1651" ref-type="fig">Fig. 1</xref>, real-time PCR revealed that the expression of survivin was inhibited in the S1, S2, S3 and S4 groups (13.63, 13.14, 13.27 and 7.81&#x00025;, respectively, compared with the normal and positive controls; P&lt;0.05) and the expression of VEGF was inhibited in the V1, V2, V3 and V4 groups (22.51, 28.27, 12.69 and 15.46&#x00025; respectively, compared with the normal and positive controls; P&lt;0.05). No significant difference was identified between survivin and the VEGF positive and normal controls (P&gt;0.05). Western blot analysis revealed that survivin and VEGF protein expression was significantly inhibited, consistent with the real-time PCR results. S4 and V3, directed at survivin and VEGF, respectively, were selected as the most effective inhibitors for investigation in the latter experiments.</p></sec>
<sec>
<title>Individual and combined inhibitive effect of siRNA on survivin and VEGF expression in Panc-1 cells</title>
<p>Real-time PCR and western blot analysis (<xref rid="f2-mmr-07-05-1651" ref-type="fig">Fig. 2</xref>) demonstrated that the expression of survivin and VEGF by Panc-1 cells was inhibited in the S4 and V3 groups, respectively, at the mRNA and protein levels, and the expression levels of survivin and VEGF mRNA and protein were significantly reduced simultaneously in the S4&#x0002B;V3 group compared with the control (P&lt;0.05).</p></sec>
<sec>
<title>Proliferation assay</title>
<p>Cell growth curves of Panc-1 cells and HUVECs determined by MTT for 48 h are presented in <xref rid="f3-mmr-07-05-1651" ref-type="fig">Fig. 3</xref> and revealed that the viability of the Panc-1 cells and HUVECs was inhibited in a time-dependent manner and the highest inhibitory rates were 81.2 &#x000B1;0.95 and 78.7&#x000B1;1.06&#x00025;, respectively, at 48 h. Compared with control cells, the viability of Panc-1 cells and HUVECs in the S4 or V3 groups was reduced and the reduction was greater in the S4&#x0002B;V3 group (P&lt;0.05).</p></sec>
<sec>
<title>Apoptosis of Panc-1 cells and HUVECs detected by Annexin V-FITC and PI staining</title>
<p>Apoptosis was assessed following transfection by staining cells with Annexin V/PI and analyzed using FCM (<xref rid="f4-mmr-07-05-1651" ref-type="fig">Fig. 4</xref>). The strongest apoptotic signals were identified in the Panc-1 cells and HUVECs of the S4&#x0002B;V3 group and the percentages of apoptotic cells were 19.17&#x000B1;0.09 and 23.45&#x000B1;0.49&#x00025;, respectively. The results indicate that the apoptosis rates of Panc-1 cells and HUVECs in the S4 and V3 groups were higher than those in the control. This increase was higher in the S4&#x0002B;V3 group (P&lt;0.05).</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Abnormal proliferation and angiogenesis and resistance to apoptosis are hallmarks of various forms of cancer and commonly lead to the failure of cancer therapy. Survivin is a novel human IAP family member containing a single baculoviral IAP repeat domain. Survivin inhibits caspases and blocks the apoptotic pathway and its &#x003B1;-helix structure interacts with microtubules and interfers with mitosis (<xref rid="b11-mmr-07-05-1651" ref-type="bibr">11</xref>). In addition, survivin is involved in tumor angiogenesis by inhibition of vascular endothelial cell apoptosis (<xref rid="b12-mmr-07-05-1651" ref-type="bibr">12</xref>). VEGF, a vascular permeability factor, is a highly specific endothelial cell mitogen which inhibits apoptosis and promotes the survival of vascular endothelial cells (<xref rid="b13-mmr-07-05-1651" ref-type="bibr">13</xref>,<xref rid="b14-mmr-07-05-1651" ref-type="bibr">14</xref>). VEGF is secreted by malignant tumor cells and plays a critical role in angiogenesis by binding receptors on vascular endothelial cells (<xref rid="b15-mmr-07-05-1651" ref-type="bibr">15</xref>,<xref rid="b16-mmr-07-05-1651" ref-type="bibr">16</xref>). Therefore, simultaneous inhibition of expression of survivin and VEGF in pancreatic cancer cells may inhibit proliferation and angiogenesis and induce apoptosis more effectively than individual inhibition.</p>
<p>Survivin and VEGF are upregulated in various malignancies, including pancreatic cancer, and are associated with aggressive tumor behavior and recurrence (<xref rid="b5-mmr-07-05-1651" ref-type="bibr">5</xref>&#x02013;<xref rid="b8-mmr-07-05-1651" ref-type="bibr">8</xref>). Previous studies have reported that inhibition of survivin in pancreatic cancer cells by AS-ODNs or siRNA reduces tumor cell growth and induces apoptosis (<xref rid="b17-mmr-07-05-1651" ref-type="bibr">17</xref>). It has also been reported that inhibition of survivin in the endothelial cells may induce the apoptosis of endothelial cells and reduce tumor-associated angiogenesis (<xref rid="b18-mmr-07-05-1651" ref-type="bibr">18</xref>,<xref rid="b19-mmr-07-05-1651" ref-type="bibr">19</xref>). In addition, inhibition of VEGF in tumor cells by AS-ODNs or siRNA has been identified to reduce tumor cell growth, induce apoptosis and affect tumor angiogenesis (<xref rid="b20-mmr-07-05-1651" ref-type="bibr">20</xref>,<xref rid="b21-mmr-07-05-1651" ref-type="bibr">21</xref>). However, studies concerning the effect of simultaneous targeting of survivin and VEGF on the proliferation, apoptosis and angiogenesis of human pancreatic cancer cells have not been performed to date.</p>
<p>RNA interference (RNAi) is a powerful post-transcriptional gene silencing technique and is characterized by high efficiency and specificity and low toxicity. At present, the technique is widely utilized in gene therapy and has became a powerful tool for studies on gene function (<xref rid="b22-mmr-07-05-1651" ref-type="bibr">22</xref>). To explore the potential of survivin and VEGF as effective therapeutic targets, RNAi was performed to silence endogenous survivin and VEGF expression in Panc-1 cells.</p>
<p>In the present study, mRNA and protein expression levels of survivin and VEGF in Panc-1 cells were markedly downregulated. Consistent with this downregulation, MTT assay and FCM revealed increased levels of cell apoptosis and inhibition of cell growth. This effect on proliferation and apoptosis was higher in the combined survivin and VEGF inhibition group. In addition, due to the downregulation of survivin and VEGF in the culture medium of the Panc-1 cells transfected by siRNA, cell apoptosis rate was also observed to be increased and cell growth was inhibited in HUVECs. Again, this effect was more apparent in the combined survivin and VEGF inhibition group. However, the molecular mechanism by which these effects are mediated in HUVECs remain unknown. Further studies are required to validate survivin and VEGF as pharmaceutical targets for anti-tumorigenesis in pancreatic cancer <italic>in vivo</italic>.</p>
<p>In summary, the results of the current study indicate that survivin and VEGF are associated with the development of pancreatic cancer and the anti-tumorigenic effects of simultaneous shRNA-targeted survivin and VEGF are considerably greater than those of a single inhibitor. Through investigation of the anti-tumorigenic mechanisms of simultaneous inhibition of survivin and VEGF in Panc-1 cells and HUVECs, we hypothesize that combined therapy with survivin and VEGF inhibition should be analyzed further as a potential therapeutic strategy for human pancreatic cancer.</p></sec></body>
<back>
<ack>
<title>Acknowledgements</title>
<p>The authors thank members of the Department of Clinical Laboratory (Xiangya Hospital, Central South University) for their assistance and technical support.</p></ack>
<ref-list>
<title>References</title>
<ref id="b1-mmr-07-05-1651"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Saif</surname><given-names>MW</given-names></name><name><surname>Sviglin</surname><given-names>H</given-names></name><name><surname>Carpenter</surname><given-names>M</given-names></name></person-group><article-title>Impact of ethnicity on outcome in pancreatic carcinoma</article-title><source>JOP</source><volume>6</volume><fpage>246</fpage><lpage>254</lpage><year>2005</year></element-citation></ref>
<ref id="b2-mmr-07-05-1651"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rodriguez</surname><given-names>JA</given-names></name><name><surname>Li</surname><given-names>M</given-names></name><name><surname>Yao</surname><given-names>Q</given-names></name><name><surname>Chen</surname><given-names>C</given-names></name><name><surname>Fisher</surname><given-names>WE</given-names></name></person-group><article-title>Gene overexpression in pancreatic adenocarcinoma: diagnostic and therapeutic implications</article-title><source>World J Surg</source><volume>29</volume><fpage>297</fpage><lpage>305</lpage><year>2005</year></element-citation></ref>
<ref id="b3-mmr-07-05-1651"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kawasaki</surname><given-names>H</given-names></name><name><surname>Toyoda</surname><given-names>M</given-names></name><name><surname>Shinohara</surname><given-names>H</given-names></name><etal/></person-group><article-title>Expression of survivin correlates with apoptosis, proliferation and angiogenesis during human colorectal tumorigenesis</article-title><source>Cancer</source><volume>91</volume><fpage>2026</fpage><lpage>2032</lpage><year>2001</year></element-citation></ref>
<ref id="b4-mmr-07-05-1651"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ikeda</surname><given-names>N</given-names></name><name><surname>Nakajima</surname><given-names>Y</given-names></name><name><surname>Sho</surname><given-names>M</given-names></name><etal/></person-group><article-title>The association of K-ras gene mutation and vascular endothelial growth factor gene expression in pancreatic carcinoma</article-title><source>Cancer</source><volume>92</volume><fpage>488</fpage><lpage>499</lpage><year>2001</year></element-citation></ref>
<ref id="b5-mmr-07-05-1651"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Satoh</surname><given-names>K</given-names></name><name><surname>Kaneko</surname><given-names>K</given-names></name><name><surname>Hirota</surname><given-names>M</given-names></name><name><surname>Masamune</surname><given-names>A</given-names></name><name><surname>Satoh</surname><given-names>A</given-names></name><name><surname>Shimosegawa</surname><given-names>T</given-names></name></person-group><article-title>Expression of survivin is correlated with cancer cell apoptosis and is involved in the development of human pancreatic duct cell tumors</article-title><source>Cancer</source><volume>92</volume><fpage>271</fpage><lpage>278</lpage><year>2001</year></element-citation></ref>
<ref id="b6-mmr-07-05-1651"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>MA</given-names></name><name><surname>Park</surname><given-names>GS</given-names></name><name><surname>Lee</surname><given-names>HJ</given-names></name><etal/></person-group><article-title>Survivin expression and its clinical significance in pancreatic cancer</article-title><source>BMC Cancer</source><volume>5</volume><fpage>127</fpage><year>2005</year></element-citation></ref>
<ref id="b7-mmr-07-05-1651"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Itakura</surname><given-names>J</given-names></name><name><surname>Ishiwata</surname><given-names>T</given-names></name><name><surname>Friess</surname><given-names>H</given-names></name><etal/></person-group><article-title>Enhanced expression of vascular endothelial growth factor in human pancreatic cancer correlates with local disease progression</article-title><source>Clin Cancer Res</source><volume>3</volume><fpage>1309</fpage><lpage>1316</lpage><year>1997</year></element-citation></ref>
<ref id="b8-mmr-07-05-1651"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ikeda</surname><given-names>N</given-names></name><name><surname>Adachi</surname><given-names>M</given-names></name><name><surname>Taki</surname><given-names>T</given-names></name><etal/></person-group><article-title>Prognostic significance of angiogenesis in human pancreatic cancer</article-title><source>Br J Cancer</source><volume>79</volume><fpage>1553</fpage><lpage>1563</lpage><year>1999</year></element-citation></ref>
<ref id="b9-mmr-07-05-1651"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Olie</surname><given-names>RA</given-names></name><name><surname>Simoes-Wust</surname><given-names>AP</given-names></name><name><surname>Baumann</surname><given-names>B</given-names></name><etal/></person-group><article-title>A novel antisense oligonucleotide targeting survivin expression induces apoptosis and sensitizes lung cancer cells to chemotherapy</article-title><source>Cancer Res</source><volume>60</volume><fpage>2805</fpage><lpage>2809</lpage><year>2000</year></element-citation></ref>
<ref id="b10-mmr-07-05-1651"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ciardiello</surname><given-names>F</given-names></name><name><surname>Bianco</surname><given-names>R</given-names></name><name><surname>Damiano</surname><given-names>V</given-names></name><etal/></person-group><article-title>Antiangiogenic and antitumor activity of anti-epidermal growth factor receptor C225 monoclonal antibody in combination with vascular endothelial growth factor antisense oligonucleotide in human GEO colon cancer cells</article-title><source>Clin Cancer Res</source><volume>6</volume><fpage>3739</fpage><lpage>3747</lpage><year>2000</year></element-citation></ref>
<ref id="b11-mmr-07-05-1651"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yonesaka</surname><given-names>K</given-names></name><name><surname>Tamura</surname><given-names>K</given-names></name><name><surname>Kurata</surname><given-names>T</given-names></name><etal/></person-group><article-title>Small interfering RNA targeting survivin sensitizes lung cancer cell with mutant p53 to adriamycin</article-title><source>Int J Cancer</source><volume>118</volume><fpage>812</fpage><lpage>820</lpage><year>2006</year></element-citation></ref>
<ref id="b12-mmr-07-05-1651"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mita</surname><given-names>AC</given-names></name><name><surname>Mita</surname><given-names>MM</given-names></name><name><surname>Nawrocki</surname><given-names>ST</given-names></name><name><surname>Giles</surname><given-names>FJ</given-names></name></person-group><article-title>Survivin: key regulator of mitosis and apoptosis and novel target for cancer therapeutics</article-title><source>Clin Cancer Res</source><volume>14</volume><fpage>5000</fpage><lpage>5005</lpage><year>2008</year></element-citation></ref>
<ref id="b13-mmr-07-05-1651"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dvorak</surname><given-names>HF</given-names></name><name><surname>Nagy</surname><given-names>JA</given-names></name><name><surname>Feng</surname><given-names>D</given-names></name><name><surname>Brown</surname><given-names>LF</given-names></name><name><surname>Dvorak</surname><given-names>AM</given-names></name></person-group><article-title>Vascular permeability factor/vascular endothelial growth factor and the significance of microvascular hyperpermeability in angiogenesis</article-title><source>Curr Top Microbiol Immunol</source><volume>237</volume><fpage>97</fpage><lpage>132</lpage><year>1999</year></element-citation></ref>
<ref id="b14-mmr-07-05-1651"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jones</surname><given-names>A</given-names></name><name><surname>Fujiyama</surname><given-names>C</given-names></name></person-group><article-title>Angiogenesis in urological malignancy: prognostic indicator and therapeutic target</article-title><source>BJU Int</source><volume>83</volume><fpage>535</fpage><lpage>555</lpage><year>1999</year></element-citation></ref>
<ref id="b15-mmr-07-05-1651"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hayashibara</surname><given-names>T</given-names></name><name><surname>Yamada</surname><given-names>Y</given-names></name><name><surname>Miyanishi</surname><given-names>T</given-names></name><etal/></person-group><article-title>Vascular endothelial growth factor and cellular chemotaxis: a possible autocrine pathway in adult T-cell leukemia cell invasion</article-title><source>Clin Cancer Res</source><volume>7</volume><fpage>2719</fpage><lpage>2726</lpage><year>2001</year></element-citation></ref>
<ref id="b16-mmr-07-05-1651"><label>16</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Xie</surname><given-names>K</given-names></name><name><surname>Wei</surname><given-names>D</given-names></name><name><surname>Huang</surname><given-names>S</given-names></name></person-group><article-title>Transcriptional anti-angiogenesis therapy of human pancreatic cancer</article-title><source>Cytokine Growth Factor Rev</source><volume>17</volume><fpage>147</fpage><lpage>156</lpage><year>2006</year></element-citation></ref>
<ref id="b17-mmr-07-05-1651"><label>17</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jiang</surname><given-names>C</given-names></name><name><surname>Tan</surname><given-names>T</given-names></name><name><surname>Yi</surname><given-names>XP</given-names></name><name><surname>Shen</surname><given-names>H</given-names></name><name><surname>Li</surname><given-names>YX</given-names></name></person-group><article-title>Lentivirus-mediated shRNA targeting XIAP and survivin inhibit SW1990 pancreatic cancer cell proliferation in vitro and in vivo</article-title><source>Mol Med Rep</source><volume>4</volume><fpage>667</fpage><lpage>674</lpage><year>2011</year></element-citation></ref>
<ref id="b18-mmr-07-05-1651"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>O&#x02019;Connor</surname><given-names>DS</given-names></name><name><surname>Schechner</surname><given-names>JS</given-names></name><name><surname>Adida</surname><given-names>C</given-names></name><etal/></person-group><article-title>Control of apoptosis during angiogenesis by survivin expression in endothelial cells</article-title><source>Am J Pathol</source><volume>156</volume><fpage>393</fpage><lpage>398</lpage><year>2000</year></element-citation></ref>
<ref id="b19-mmr-07-05-1651"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mesri</surname><given-names>M</given-names></name><name><surname>Morales-Ruiz</surname><given-names>M</given-names></name><name><surname>Ackermann</surname><given-names>EJ</given-names></name><etal/></person-group><article-title>Suppression of vascular endothelial growth factor-mediated endothelial cell protection by survivin targeting</article-title><source>Am J Pathol</source><volume>158</volume><fpage>1757</fpage><lpage>1765</lpage><year>2001</year></element-citation></ref>
<ref id="b20-mmr-07-05-1651"><label>20</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Takei</surname><given-names>Y</given-names></name><name><surname>Kadomatsu</surname><given-names>K</given-names></name><name><surname>Yuzawa</surname><given-names>Y</given-names></name><name><surname>Matsuo</surname><given-names>S</given-names></name><name><surname>Muramatsu</surname><given-names>T</given-names></name></person-group><article-title>A small interfering RNA targeting vascular endothelial growth factor as cancer therapeutics</article-title><source>Cancer Res</source><volume>64</volume><fpage>3365</fpage><lpage>3370</lpage><year>2004</year></element-citation></ref>
<ref id="b21-mmr-07-05-1651"><label>21</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Forster</surname><given-names>Y</given-names></name><name><surname>Meye</surname><given-names>A</given-names></name><name><surname>Krause</surname><given-names>S</given-names></name><name><surname>Schwenzer</surname><given-names>B</given-names></name></person-group><article-title>Antisense-mediated VEGF suppression in bladder and breast cancer cells</article-title><source>Cancer Lett</source><volume>212</volume><fpage>95</fpage><lpage>103</lpage><year>2004</year></element-citation></ref>
<ref id="b22-mmr-07-05-1651"><label>22</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Meister</surname><given-names>G</given-names></name><name><surname>Landthaler</surname><given-names>M</given-names></name><name><surname>Dorsett</surname><given-names>Y</given-names></name><name><surname>Tuschl</surname><given-names>T</given-names></name></person-group><article-title>Sequence-specific inhibition of microRNA- and siRNA-induced RNA silencing</article-title><source>RNA</source><volume>10</volume><fpage>544</fpage><lpage>550</lpage><year>2004</year></element-citation></ref></ref-list></back>
<floats-group>
<fig id="f1-mmr-07-05-1651" position="float">
<label>Figure 1</label>
<caption>
<p>Relative expression of survivin and VEGF (A) mRNA and (B) protein following transfection with shRNA. <sup>&#x0002A;</sup>P&lt;0.05, vs. control. VEGF, vascular endothelial growth factor; shRNA, short hairpin RNA.</p></caption>
<graphic xlink:href="MMR-07-05-1651-g00.gif"/></fig>
<fig id="f2-mmr-07-05-1651" position="float">
<label>Figure 2</label>
<caption>
<p>Individual and simultaneous suppression of survivin and VEGF in Panc-1 cells by shRNA (S4 and V3). Relative expression of survivin and VEGF (A) mRNA and (B) protein levels determined by real-time PCR and western blot analysis, respectively. <sup>&#x0002A;</sup>P&lt;0.05, vs. control. VEGF, vascular endothelial growth factor; shRNA, short hairpin RNA.</p></caption>
<graphic xlink:href="MMR-07-05-1651-g01.gif"/></fig>
<fig id="f3-mmr-07-05-1651" position="float">
<label>Figure 3</label>
<caption>
<p>Survivin and VEGF gene knockdown inhibited cell growth. Cell growth curves of (A) Panc-1 cells and (B) HUVECs. Cell viability was analyzed by MTT for 48 h and the highest inhibitory rate of Panc-1 cells and HUVECs in the S4&#x0002B;V3 group was 81.2 &#x000B1;0.95 and 78.7&#x000B1;1.06&#x00025;, respectively, at 48 h. Viability of Panc-1 cells and HUVECs in the S4 or V3 group was decreased. This decrease was higher in the S4&#x0002B;V3 group. <sup>&#x0002A;</sup>P&lt;0.05, vs. control. VEGF, vascular endothelial growth factor; HUVECs, human umbilical vein endothelial cells.</p></caption>
<graphic xlink:href="MMR-07-05-1651-g02.gif"/></fig>
<fig id="f4-mmr-07-05-1651" position="float">
<label>Figure 4</label>
<caption>
<p>Survivin and VEGF gene knockdown induced cell apoptosis. Cell apoptosis rate of (A) Panc-1 cells and (B) HUVECs. The strongest apoptotic signals appeared in Panc-1 cells and HUVECs of the S4&#x0002B;V3 group and the percentage of apoptotic cells was 19.17&#x000B1;0.09 and 23.45 &#x000B1;0.49&#x00025;, respectively. The apoptosis rate of Panc-1 cells and HUVECs in the S4 or V3 group was higher than the control and this decrease was higher in the S4&#x0002B;V3 group. <sup>&#x0002A;</sup>P&lt;0.05, vs. control. VEGF, vascular endothelial growth factor; HUVECS, human umbilical vein endothelial cells.</p></caption>
<graphic xlink:href="MMR-07-05-1651-g03.gif"/></fig>
<table-wrap id="tI-mmr-07-05-1651" position="float">
<label>Table I</label>
<caption>
<p>Sequences of shRNA against human survivin and VEGF.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Vector</th>
<th align="center" valign="bottom">Target sequences</th>
<th align="center" valign="bottom">Sequences cloned into the vector (5&#x02032;-3&#x02032;)</th></tr></thead>
<tbody>
<tr>
<td align="left" valign="top">S1</td>
<td align="left" valign="top">GCGCTTTCCTTTCTGTCAAGA</td>
<td align="left" valign="top">S:CACCGCGCTTTCCTTTCTGTCAAGATTCAAGAGATCTTGACAGAAAGGAAAGCGCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGCGCTTTCCTTTCTGTCAAGATCTCTTGAATCTTGACAGAAAGGAAAGCGC</td></tr>
<tr>
<td align="left" valign="top">S2</td>
<td align="left" valign="top">GACAGAGAAAGAGCCAAGAAC</td>
<td align="left" valign="top">S: CACCGACAGAGAAAGAGCCAAGAACTTCAAGAGAGTTCTTGGCTCTTTCTCTGTCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGACAGAGAAAGAGCCAAGAACTCTCTTGAAGTTCTTGGCTCTTTCTCTGTC</td></tr>
<tr>
<td align="left" valign="top">S3</td>
<td align="left" valign="top">GCACCACTTCCAGGGTTTATT</td>
<td align="left" valign="top">S: CACCGCACCACTTCCAGGGTTTATTTCAAGAGAATAAACCCTGGAAGTGGTGCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGCACCACTTCCAGGGTTTATTCTCTTGAAATAAACCCTGGAAGTGGTGC</td></tr>
<tr>
<td align="left" valign="top">S4</td>
<td align="left" valign="top">GCACTTCAGACCCACTTATTT</td>
<td align="left" valign="top">S: CACCGCACTTCAGACCCACTTATTTCAAGAGAATAAGTGGGTCTGAAGTGCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGCACTTCAGACCCACTTATTCTCTTGAAATAAGTGGGTCTGAAGTGC</td></tr>
<tr>
<td align="left" valign="top">Snc</td>
<td align="left" valign="top">GTTCTCCGAACGTGTCACGTC</td>
<td align="left" valign="top">S: CACCGTTCTCCGAACGTGTCACGTCAAGAGATTACGTGACACGTTCGGAGAATTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAATTCTCCGAACGTGTCACGTAATCTCTTGACGTGACACGTTCGGAGAAC</td></tr>
<tr>
<td align="left" valign="top">V1</td>
<td align="left" valign="top">GCAGATTATGCGGATCAAACC</td>
<td align="left" valign="top">S: CACCGCAGATTATGCGGATCAAACCTTCAAGAGAGGTTTGATCCGCATAATCTGCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGCAGATTATGCGGATCAAACCTCTCTTGAAGGTTTGATCCGCATAATCTGC</td></tr>
<tr>
<td align="left" valign="top">V2</td>
<td align="left" valign="top">GCGCAAGAAATCCCGGTATAA</td>
<td align="left" valign="top">S: CACCGCGCAAGAAATCCCGGTATAATTCAAGAGATTATACCGGGATTTCTTGCGCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGCGCAAGAAATCCCGGTATAATCTCTTGAATTATACCGGGATTTCTTGCGC</td></tr>
<tr>
<td align="left" valign="top">V3</td>
<td align="left" valign="top">GCGAGGCAGCTTGAGTTAAAC</td>
<td align="left" valign="top">S: CACCGCGAGGCAGCTTGAGTTAAACTTCAAGAGAGTTTAACTCAAGCTGCCTCGCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGCGAGGCAGCTTGAGTTAAACTCTCTTGAAGTTTAACTCAAGCTGCCTCGC</td></tr>
<tr>
<td align="left" valign="top">V4</td>
<td align="left" valign="top">GCCAGCACATAGGAGAGATGA</td>
<td align="left" valign="top">S: CACCGCCAGCACATAGGAGAGATGATTCAAGAGATCATCTCTCCTATGTGCTGGCTTTTTTG</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAAGCCAGCACATAGGAGAGATGATCTCTTGAATCATCTCTCCTATGTGCTGGC</td></tr>
<tr>
<td align="left" valign="top">Vnc</td>
<td align="left" valign="top">GTTCTCCGAACGTGTCACGTC</td>
<td align="left" valign="top">S: CACCGTTCTCCGAACGTGTCACGTCAAGAGATTACGTGACACGTTCGGAGAATTTTTT G</td></tr>
<tr>
<td align="left" valign="top"/>
<td align="left" valign="top"/>
<td align="left" valign="top">A: GATCCAAAAAATTCTCCGAACGTGTCACGTAATCTCTTGACGTGACACGTTCGGAGAAC</td></tr></tbody></table>
<table-wrap-foot><fn id="tfn1-mmr-07-05-1651">
<p>shRNA, short hairpin RNA; VEGF, vascular endothelial growth factor; S, sense strand; A, antisense strand.</p></fn></table-wrap-foot></table-wrap></floats-group></article>
