<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "journalpublishing3.dtd">
<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<?release-delay 0|0?>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">OR</journal-id>
<journal-title-group>
<journal-title>Oncology Reports</journal-title></journal-title-group>
<issn pub-type="ppub">1021-335X</issn>
<issn pub-type="epub">1791-2431</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/or.2014.3533</article-id>
<article-id pub-id-type="publisher-id">or-32-06-2343</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Knockdown of glucose-regulated protein 78 enhances poly(ADP-ribose) polymerase cleavage in human pancreatic cancer cells exposed to endoplasmic reticulum stress</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>JIANG</surname><given-names>XIA</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>KANDA</surname><given-names>TATSUO</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-or-32-06-2343"/></contrib>
<contrib contrib-type="author">
<name><surname>NAKAMOTO</surname><given-names>SHINGO</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref><xref rid="af2-or-32-06-2343" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>HAGA</surname><given-names>YUKI</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>SASAKI</surname><given-names>REINA</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>NAKAMURA</surname><given-names>MASATO</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>WU</surname><given-names>SHUANG</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>MIKATA</surname><given-names>RINTARO</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>YOKOSUKA</surname><given-names>OSAMU</given-names></name><xref rid="af1-or-32-06-2343" ref-type="aff">1</xref></contrib></contrib-group>
<aff id="af1-or-32-06-2343">
<label>1</label>Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chuo-ku, Chiba 260-8677, Japan</aff>
<aff id="af2-or-32-06-2343">
<label>2</label>Department of Molecular Virology, Chiba University, Graduate School of Medicine, Chuo-ku, Chiba 260-8677, Japan</aff>
<author-notes>
<corresp id="c1-or-32-06-2343">Correspondence to: Dr Tatsuo Kanda, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan, E-mail: <email>kandat-cib@umin.ac.jp</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>12</month>
<year>2014</year></pub-date>
<pub-date pub-type="epub">
<day>06</day>
<month>10</month>
<year>2014</year></pub-date>
<volume>32</volume>
<issue>6</issue>
<fpage>2343</fpage>
<lpage>2348</lpage>
<history>
<date date-type="received">
<day>07</day>
<month>08</month>
<year>2014</year></date>
<date date-type="accepted">
<day>25</day>
<month>09</month>
<year>2014</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2014, Spandidos Publications</copyright-statement>
<copyright-year>2014</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 present study examined the expression of glucose-regulated protein 78 (GRP78/Bip) in human pancreatic cancer cell lines and the effect of knockdown of GRP78 on the cleavage of poly(ADP-ribose) polymerase (PARP). Human pancreatic cancer cell lines (KP-2, MIAPaCa-2, Panc-1 and SUIT-2), constitutively expressed GRP78. We also demonstrated that ER stress induced by thapsigargin upregulated protein levels of GRP78. In the presence of thapsigargin, knockdown of GRP78 enhanced the PARP cleavage in the human pancreatic cancer cells. These results provide evidence that GRP78 is a potential therapeutic target for &#x02018;difficult-to-treat&#x02019; pancreatic cancer, in which ER stress signaling in part falls into disorder.</p></abstract>
<kwd-group>
<kwd>apoptosis</kwd>
<kwd>ER stress</kwd>
<kwd>GRP78/Bip</kwd>
<kwd>pancreatic cancer</kwd>
<kwd>resistance</kwd>
<kwd>UPR</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Pancreatic cancer is almost the deadliest of all malignancies (<xref rid="b1-or-32-06-2343" ref-type="bibr">1</xref>). In Japan, pancreatic cancer is currently the fifth leading cause of cancer-related death among individuals of both genders (<xref rid="b2-or-32-06-2343" ref-type="bibr">2</xref>,<xref rid="b3-or-32-06-2343" ref-type="bibr">3</xref>). Resection surgery is still the only potentially curative treatment for pancreatic cancer, and recent improvements in operative technique have been reported (<xref rid="b4-or-32-06-2343" ref-type="bibr">4</xref>). Although advances in adjuvant treatment have been observed (<xref rid="b5-or-32-06-2343" ref-type="bibr">5</xref>), in general, the prognosis of patients with pancreatic cancer is still poor. Further studies of the mechanisms of pancreatic carcinogenesis and cancer development are needed, and new therapeutic options are highly desirable.</p>
<p>Endoplasmic reticulum (ER) stress response in tumor cells is critical for tumor cell growth and cancer progression (<xref rid="b6-or-32-06-2343" ref-type="bibr">6</xref>). The ER stress response is mediated by at least three sensor molecules: inositol-requiring enzyme 1&#x003B1; (IRE1&#x003B1;), PKR-like ER kinase (PERK), and activating transcription factor 6 (ATF6), which are usually associated with glucose-regulated protein 78 (GRP78/Bip) (<xref rid="b7-or-32-06-2343" ref-type="bibr">7</xref>). ER stress, which is associated with the accumulation of unfolded proteins, induces unfolded protein response (UPR), yet if ER stress is overloaded, cells could face death such as by apoptosis and autophagy. Downstream of IRE1&#x003B1; and PERK, the effector molecules, X-box-binding protein 1 (XBP1) and C/EBP homologous protein (CHOP), and growth arrest and DNA damage gene 34 (GADD34) all exist, and they are activated by ER stress. ER stress also leads to the phosphorylation of eukaryotic translation initiation factor 2&#x003B1; (eIF2&#x003B1;) (<xref rid="b8-or-32-06-2343" ref-type="bibr">8</xref>). For example, p90ATF6 is converted to the activated form p50ATF6, and p50ATF6 translocates to the nucleus (<xref rid="b9-or-32-06-2343" ref-type="bibr">9</xref>). Basic leucine-zipper family factors p50ATF6 and XBP1 could induce expression of a subset of UPR-related genes, which include ER stress elements, and are involved in efficient protein folding, maturation and degradation in the ER (<xref rid="b6-or-32-06-2343" ref-type="bibr">6</xref>).</p>
<p>The association between ER stress response and tumor growth and progression has been reported (<xref rid="b10-or-32-06-2343" ref-type="bibr">10</xref>). We and others have reported that GRP78 is involved in cancer development and innate immune response in the liver (<xref rid="b11-or-32-06-2343" ref-type="bibr">11</xref>&#x02013;<xref rid="b14-or-32-06-2343" ref-type="bibr">14</xref>). Liver and pancreas progenitors commonly develop from endoderm cells in the embryonic foregut (<xref rid="b15-or-32-06-2343" ref-type="bibr">15</xref>). Pancreatic epithelial cells have a highly developed ER due to a strong engagement in digestive enzyme secretion (<xref rid="b16-or-32-06-2343" ref-type="bibr">16</xref>). GRP78 is the main target of UPR signaling that promotes pancreatic cancer cell survival (<xref rid="b17-or-32-06-2343" ref-type="bibr">17</xref>). GRP78 is involved in cancer progression as well as drug resistance (<xref rid="b18-or-32-06-2343" ref-type="bibr">18</xref>,<xref rid="b19-or-32-06-2343" ref-type="bibr">19</xref>). Hence, to decrease the ability of pancreatic cancer cells to survive and proliferate, it may be necessary to block GRP78 expression (<xref rid="b17-or-32-06-2343" ref-type="bibr">17</xref>).</p>
<p>We previously demonstrated that blocking of the induction of UPR, as well as inhibition of GRP78 expression is associated with the cleavage of poly(ADP-ribose) polymerase (PARP) (<xref rid="b13-or-32-06-2343" ref-type="bibr">13</xref>). In the present study, we examined the expression of ER stress-related molecules in human pancreatic cancer cell lines in the presence or absence of thapsigargin, one of the ER stress-inducers. We also investigated whether knockdown of GRP78 by small interfering RNA (siRNA) enhances the PARP cleavage in human pancreatic cancer cell lines exposed to ER stress.</p></sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title>Cell culture</title>
<p>Human pancreatic cancer cell lines (KP-2, MIAPaCa-2, Panc-1 and SUIT-2) were grown in RPMI-1640 medium (Sigma, St. Louis, MO, USA) supplemented with 10&#x00025; fetal bovine serum, 100 U/ml penicillin and 100 &#x003BC;g/ml streptomycin at 37&#x000B0;C in a humidified atmosphere with 5&#x00025; CO<sub>2</sub>. Inhibitor of sarcoplasmic/endoplasmic reticulum (ER) Ca<sup>2+</sup> ATPases (SERCA), thapsigargin, control siRNA (si-control) and siRNA for GRP78 (si-GRP78) were purchased from BioVision (Milpitas, CA, USA) and Santa Cruz Biotechnology (Santa Cruz, CA, USA), respectively.</p></sec>
<sec>
<title>Western blotting</title>
<p>Twenty-four hours after thapsigargin (1 &#x003BC;M) treatment, cells were lysed in sodium dodecyl sulfate sample buffer, and after sonication, lysates were processed for western blot analysis (<xref rid="b11-or-32-06-2343" ref-type="bibr">11</xref>). Briefly, protein samples were subjected to electrophoresis on 5&#x02013;20&#x00025; polyacrylamide gels and transferred onto polyvinylidene difluoride membranes (ATTO, Tokyo, Japan). Membranes were probed with antibodies specific for ATF4, ATF6 and tubulin (Abcam, Cambridge, UK); GADD34, gyceraldehyde-3-phosphate dehydrogenase (GAPDH) and XBP1 (Santa Cruz); eIF2&#x003B1;, phospho-eIF2&#x003B1; (Ser51), GRP78/Bip and PARP (Cell Signaling Technology, Tokyo, Japan). After washing with PBS-T, the membranes were incubated with secondary horseradish peroxidase-conjugated antibodies. Signals were detected by means of enhanced chemiluminescence (GE Healthcare, Tokyo, Japan) and scanned by image analyzer LAS-4000 and Image Gauge (version 3.1) (Fuji Film, Tokyo, Japan) and ImageJ software (NIH, Bethesda, MD, USA).</p></sec>
<sec>
<title>Transfection of siRNA</title>
<p>To confirm the effects of GRP78 knockdown on apoptosis, we examined GRP78 knockdown by small-interfering RNA (siRNA). Cells were transfected with 50 nM si-GRP78 or si-control, using Effectene transfection reagent (Qiagen, Hilden, Germany) according to the manufacturer&#x02019;s protocol (<xref rid="b20-or-32-06-2343" ref-type="bibr">20</xref>). After 24 h of transfection, cells were treated with 1 &#x003BC;M thapsigargin for 24 h.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Results are expressed as means &#x000B1; standard deviation (SD). Statistical analysis was performed using the Student&#x02019;s t-test. A P-value &lt;0.05 was considered to indicate a statistically significant result.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Human pancreatic cancer cell lines express GRP78</title>
<p>First, we examined the GRP78 expression in the human pancreatic cancer cell lines SUIT-2, MIAPaCa-2, Panc-1 and KP-2 (<xref rid="b3-or-32-06-2343" ref-type="bibr">3</xref>). Protein samples were collected from the four pancreatic cancer cell lines, and protein levels of GRP78 were investigated by western blotting with a specific antibody for GRP78 (<xref rid="f1-or-32-06-2343" ref-type="fig">Fig. 1</xref>). We confirmed that all four pancreatic cancer cell lines variably expressed GRP78.</p></sec>
<sec>
<title>Thapsigargin upregulates the protein levels of GRP78 in the human pancreatic cancer cell lines</title>
<p>Next, we examined the effect of thapsigargin, one of the ER stress-inducers, on GRP78 expression in the human pancreatic cancer cell lines (<xref rid="f2-or-32-06-2343" ref-type="fig">Fig. 2</xref>). Treatment of 1 &#x003BC;M thapsigargin for 24 h led to the upregulation of GRP78 expression at the protein level &#x0005B;21.5&#x000B1;0.7 vs. 1&#x000B1;0.1 (in untreated control), n=3, p=0.00015; 111.5&#x000B1;1.0 vs. 1&#x000B1;0.12, n=3, p=0.000010; 5.2&#x000B1;0.57 vs. 1&#x000B1;0.1, n=3, p=0.0023; and 5.9&#x000B1;0.2 vs. 1&#x000B1;0.1, n=3, p=0.00013, respectively, in the SUIT-2, MIAPaCa-2, Panc-1 and KP-2 cells&#x0005D;. In the MIAPaCa-2, cells GRP78 expression was more strongly induced than in the other three cell lines.</p></sec>
<sec>
<title>Effects of thapsigargin on GADD34, ATF4, ATF6 and XBP1 protein expression levels in the human pancreatic cancer cell lines</title>
<p>We examined the protein expression of ER stress signaling-associated molecules in the human pancreatic cell lines treated with or without thapsigargin. The results for the Panc-1 and KP-2 cells are shown in <xref rid="f3-or-32-06-2343" ref-type="fig">Fig. 3</xref>. In the Panc-1 cells, ATF4 and ATF6 expression was upregulated in the presence of 1 &#x003BC;M thapsigargin &#x0005B;1.4&#x000B1;0.010 vs. 1&#x000B1;0.023 (in untreated control), n=3, p=0.000089; and 1.2&#x000B1;0.0027 vs. 1&#x000B1;0.010, n=3, p=0.00019, respectively&#x0005D; (<xref rid="f3-or-32-06-2343" ref-type="fig">Fig. 3A, C and D</xref>. In the Panc-1 cells, GADD34 and XBP1 expression at the protein level was down-regulated in the presence of 1 &#x003BC;M thapsigargin &#x0005B;0.82&#x000B1;0.012 vs. 1&#x000B1;0.0076 (in untreated control), n=3, p=0.0000414; and 0.87&#x000B1;0.024 vs. 1&#x000B1;0.019, n=3, p=0.0012, respectively&#x0005D; (<xref rid="f3-or-32-06-2343" ref-type="fig">Fig. 3A, B and E</xref>).</p>
<p>On the other hand, in KP-2 cells, the protein expression levels of GADD34, ATF4, ATF6 and XBP1 were upregulated in the presence of 1 &#x003BC;M thapsigargin &#x0005B;2.1&#x000B1;0.22 vs. 1&#x000B1;0.012 (in untreated control), n=3, p=0.0063; 1.3&#x000B1;0.073 vs. 1&#x000B1;0.0062, n=3, p=0.0088; 2.1&#x000B1;0.022 vs. 1&#x000B1;0.014, n=3, p=0.0000008; and 1.2&#x000B1;0.019 vs. 1&#x000B1;0.0063, n=3, p=0.00043, respectively&#x0005D; (<xref rid="f3-or-32-06-2343" ref-type="fig">Fig. 3A and F&#x02013;I</xref>).</p>
<p>XBP1 was also upregulated in the presence of 1 &#x003BC;M thapsigargin in both SUIT-2 and MIAPaCa-2 cells, yet we did not observe any enhancement of GADD34, ATF4 or ATF6 by thapsigargin (data not shown).</p></sec>
<sec>
<title>Effects of thapsigargin on the phosphorylation of eIF2&#x003B1; in the human pancreatic cancer cell lines</title>
<p>We also examined the phosphorylation status of eIF2&#x003B1; to understand how thapsigargin affects ER stress signaling in Panc-1 and KP-2 cells (<xref rid="f4-or-32-06-2343" ref-type="fig">Fig. 4A</xref>). In Panc-1 cells, phosphorylation of Ser51-eIF2&#x003B1; in the presence of thapsigargin tended to increase, compared with that in the absence of thapsigargin (<xref rid="f4-or-32-06-2343" ref-type="fig">Fig. 4B</xref>; 1.1&#x000B1;0.059 vs. 1&#x000B1;0.064, n=3, p=0.17). In the KP-2 cells, significant phosphorylation of Ser51-eIF2&#x003B1; in the presence of thapsigargin was observed when compared with that in the absence of thapsigargin (<xref rid="f4-or-32-06-2343" ref-type="fig">Fig. 4C</xref>; 2.1&#x000B1;0.14 vs. 1&#x000B1;0.075, n=3, p=0.00050).</p></sec>
<sec>
<title>Knockdown of endogenous GRP78 enhances PARP cleavage in the pancreatic cancer cells</title>
<p>We confirmed that the expression of GRP78 at the protein level was upregulated in all four human pancreatic cancer cell lines tested, yet other molecules downstream of GRP78 reported to be involved in ER stress were expressed at variable levels depending on the individual cell line. Thus, we focused our examination on GRP78. Our previous study (<xref rid="b13-or-32-06-2343" ref-type="bibr">13</xref>) demonstrated that blocking of GRP78 induction led to PARP cleavage in hepatocyte apoptosis. We investigated the effect of knockdown of GRP78 by siRNA on PARP cleavage in pancreatic cancer cells treated with thapsigargin (<xref rid="f5-or-32-06-2343" ref-type="fig">Fig. 5A and B</xref>).</p>
<p>GRP78 expression was significantly inhibited by transfection with si-GRP78 in the presence of thapsigargin, compared with that with si-control &#x0005B;1.4&#x000B1;0.040 vs. 1.8&#x000B1;0.040, n=3, p=0.00014; and 7.1&#x000B1;0.24 vs. 18.3&#x000B1;0.37, n=3, p=0.0000038, respectively, in Panc-1 (<xref rid="f5-or-32-06-2343" ref-type="fig">Fig. 5A</xref>) and MIAPaCa-2 cells (<xref rid="f5-or-32-06-2343" ref-type="fig">Fig. 5B</xref>)&#x0005D;.</p>
<p>PARP cleavage was significantly enhanced by transfection with si-GRP78 in the presence of thapsigargin, compared with that with si-control &#x0005B;4.5&#x000B1;0.045 vs. 1.6&#x000B1;0.085, n=3, p=0.00000080; and 2.6&#x000B1;0.13 vs. 1.5&#x000B1;0.047, n=3, p=0.00016, respectively, in Panc-1 (<xref rid="f5-or-32-06-2343" ref-type="fig">Fig. 5A</xref>) and MIAPaCa-2 cells (<xref rid="f5-or-32-06-2343" ref-type="fig">Fig. 5B</xref>)&#x0005D;.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>In the present study, we demonstrated that i) human pancreatic cancer cell lines expressed GRP78; ii) ER stress induced by thapsigargin upregulated protein levels of GRP78 in human pancreatic cancer cell lines; iii) ER stress-related molecules downstream of GRP78 were expressed at various levels according to the respective human pancreatic cancer cell lines; and iv) finally, knockdown of GRP78 by siRNA enhanced PARP cleavage in the human pancreatic cancer cell lines. To our knowledge, this is the first report to show the association between GRP78 and PARP cleavage in pancreatic cancer cell lines treated with thapsigargin.</p>
<p>Our results that human pancreatic cancer cell lines express GRP78 supported a previous study (<xref rid="b21-or-32-06-2343" ref-type="bibr">21</xref>) showing that the heat shock proteins HSP90 and GRP78 are constitutively expressed in gastrointestinal cancers including human pancreatic cancer. We also observed that ER stress induced by thapsigargin upregulated protein levels of GRP78 in human pancreatic cancer cell lines. However, ER stress-related molecules downstream of GRP78, such as GADD34, ATF4, ATF6, XBP1 and phospho-eIF2&#x003B1; were not constitutively increased by thapsigargin, but rather were dependent on individual cell lines (<xref rid="f2-or-32-06-2343" ref-type="fig">Figs. 2</xref>&#x02013;<xref rid="f4-or-32-06-2343" ref-type="fig">4</xref>). These results suggest that GRP78 may have an impact on many different cellular processes and survival of pancreatic cancer and that ER stress signaling downstream of GRP78 can be expected to be disturbed in pancreatic cancer.</p>
<p>It was reported that an increase in GRP78 expression in pancreatic cancer cells may enhance and account for the altered sensitivity of pancreatic cancer to chemotherapeutic agents (<xref rid="b21-or-32-06-2343" ref-type="bibr">21</xref>). UPR regulator GRP78 is an anti-apoptotic protein that is usually upregulated in cancer and plays a critical role in chemoresistance in various types of cancers (<xref rid="b22-or-32-06-2343" ref-type="bibr">22</xref>). Recently it was also reported that UPR induction in tumor endothelial cells under an acidic pH condition is related to chemoresistance and may contribute to therapeutic failure in response to chemotherapy (<xref rid="b23-or-32-06-2343" ref-type="bibr">23</xref>). It was also reported that GRP78 is overexpressed in malignant cells resistant to therapy (<xref rid="b24-or-32-06-2343" ref-type="bibr">24</xref>).</p>
<p>PARP is one of the proteins processed by post-translational modification and plays a crucial role in many processes, including DNA repair and cell death (<xref rid="b25-or-32-06-2343" ref-type="bibr">25</xref>). During apoptosis, caspases cause PARP cleavage and inactivation, in which PARP proteolysis produces an 89-kDa C-terminal fragment and a 24-kDa N-terminal (<xref rid="b25-or-32-06-2343" ref-type="bibr">25</xref>). We observed that in the presence of thapsigargin, knockdown of GRP78 enhanced PARP cleavage in human pancreatic cancer cells Panc-1 as well as MIAPaCa-2. Wang <italic>et al</italic> reported that suppression of GRP78 by taxol and vinblastine potentiated the activation of JNK phosphorylation, caspase-7 and PARP cleavage in the human breast cancer cell line MCF-7 (<xref rid="b26-or-32-06-2343" ref-type="bibr">26</xref>). The Hsp90 inhibitor SNX-2112 also induced PARP cleavage as well as the reduction in GRP78 expression in the multidrug-resistant human chronic myeloid leukemia K562/ADR cell line (<xref rid="b27-or-32-06-2343" ref-type="bibr">27</xref>).</p>
<p>Collectively, our results suggest that both GRP78 and PARP may have key roles in the chemoresistance of pancreatic cancer (<xref rid="b28-or-32-06-2343" ref-type="bibr">28</xref>) and that GRP78 may be one of the valid targets against chemoresistance (<xref rid="b24-or-32-06-2343" ref-type="bibr">24</xref>). In conclusion, GRP78 is a potential therapeutic target for &#x02018;difficult-to-treat&#x02019; pancreatic cancer, in which ER stress signaling in part falls into disorder.</p></sec></body>
<back>
<ack>
<title>Acknowledgements</title>
<p>The present study was supported by Grants for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan (24590955 to T.K.).</p></ack>
<ref-list>
<title>References</title>
<ref id="b1-or-32-06-2343"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lennon</surname><given-names>AM</given-names></name><name><surname>Wolfgang</surname><given-names>CL</given-names></name><name><surname>Canto</surname><given-names>MI</given-names></name><etal/></person-group><article-title>TThe early detection of pancreatic cancer: what will it take to diagnose and treat curable pancreatic neoplasia?</article-title><source>Cancer Res</source><volume>74</volume><fpage>3381</fpage><lpage>3389</lpage><year>2014</year></element-citation></ref>
<ref id="b2-or-32-06-2343"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kuroda</surname><given-names>T</given-names></name><name><surname>Kumagi</surname><given-names>T</given-names></name><name><surname>Yokota</surname><given-names>T</given-names></name><etal/></person-group><article-title>Improvement of long-term outcomes in pancreatic cancer and its associated factors within the gemcitabine era: a collaborative retrospective multicenter clinical review of 1,082 patients</article-title><source>BMC Gastroenterol</source><volume>13</volume><fpage>134</fpage><year>2013</year></element-citation></ref>
<ref id="b3-or-32-06-2343"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Okitsu</surname><given-names>K</given-names></name><name><surname>Kanda</surname><given-names>T</given-names></name><name><surname>Imazeki</surname><given-names>F</given-names></name><name><surname>Yonemitsu</surname><given-names>Y</given-names></name><name><surname>Ray</surname><given-names>RB</given-names></name><name><surname>Chang</surname><given-names>C</given-names></name><name><surname>Yokosuka</surname><given-names>O</given-names></name></person-group><article-title>Involvement of interleukin-6 and androgen receptor signaling in pancreatic cancer</article-title><source>Genes Cancer</source><volume>1</volume><fpage>859</fpage><lpage>867</lpage><year>2010</year></element-citation></ref>
<ref id="b4-or-32-06-2343"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Miyazaki</surname><given-names>M</given-names></name><name><surname>Yoshitomi</surname><given-names>H</given-names></name><name><surname>Shimizu</surname><given-names>H</given-names></name><etal/></person-group><article-title>Repeat pancreatectomy for pancreatic ductal cancer recurrence in the remnant pancreas after initial pancreatectomy: is it worthwhile?</article-title><source>Surgery</source><volume>155</volume><fpage>58</fpage><lpage>66</lpage><year>2014</year></element-citation></ref>
<ref id="b5-or-32-06-2343"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sudo</surname><given-names>K</given-names></name><name><surname>Ishihara</surname><given-names>T</given-names></name><name><surname>Hirata</surname><given-names>N</given-names></name><etal/></person-group><article-title>Randomized controlled study of gemcitabine plus S-1 combination chemotherapy versus gemcitabine for unresectable pancreatic cancer</article-title><source>Cancer Chemother Pharmacol</source><volume>73</volume><fpage>389</fpage><lpage>396</lpage><year>2014</year></element-citation></ref>
<ref id="b6-or-32-06-2343"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mahadevan</surname><given-names>NR</given-names></name><name><surname>Rodvold</surname><given-names>J</given-names></name><name><surname>Sepulveda</surname><given-names>H</given-names></name><name><surname>Rossi</surname><given-names>S</given-names></name><name><surname>Drew</surname><given-names>AF</given-names></name><name><surname>Zanetti</surname><given-names>M</given-names></name></person-group><article-title>Transmission of endoplasmic reticulum stress and pro-inflammation from tumor cells to myeloid cells</article-title><source>Proc Natl Acad Sci USA</source><volume>108</volume><fpage>6561</fpage><lpage>6566</lpage><year>2011</year></element-citation></ref>
<ref id="b7-or-32-06-2343"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schroder</surname><given-names>M</given-names></name><name><surname>Kaufman</surname><given-names>RJ</given-names></name></person-group><article-title>ER stress and the unfolded protein response</article-title><source>Mutat Res</source><volume>569</volume><fpage>29</fpage><lpage>63</lpage><year>2005</year></element-citation></ref>
<ref id="b8-or-32-06-2343"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hamanaka</surname><given-names>RB</given-names></name><name><surname>Bennett</surname><given-names>BS</given-names></name><name><surname>Cullinan</surname><given-names>SB</given-names></name><name><surname>Diehl</surname><given-names>JA</given-names></name></person-group><article-title>PERK and GCN2 contribute to eIF2&#x003B1; phosphorylation and cell cycle arrest after activation of the unfolded protein response pathway</article-title><source>Mol Biol Cell</source><volume>16</volume><fpage>5493</fpage><lpage>5501</lpage><year>2005</year></element-citation></ref>
<ref id="b9-or-32-06-2343"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Xu</surname><given-names>W</given-names></name><name><surname>Liu</surname><given-names>L</given-names></name><name><surname>Charles</surname><given-names>IG</given-names></name><name><surname>Moncada</surname><given-names>S</given-names></name></person-group><article-title>Nitric oxide induces coupling of mitochondrial signalling with the endoplasmic reticulum stress response</article-title><source>Nat Cell Biol</source><volume>6</volume><fpage>1129</fpage><lpage>1134</lpage><year>2004</year></element-citation></ref>
<ref id="b10-or-32-06-2343"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ma</surname><given-names>Y</given-names></name><name><surname>Hendershot</surname><given-names>LM</given-names></name></person-group><article-title>The role of the unfolded protein response in tumour development: friend or foe?</article-title><source>Nat Rev Cancer</source><volume>4</volume><fpage>966</fpage><lpage>977</lpage><year>2004</year></element-citation></ref>
<ref id="b11-or-32-06-2343"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jiang</surname><given-names>X</given-names></name><name><surname>Kanda</surname><given-names>T</given-names></name><name><surname>Nakamoto</surname><given-names>S</given-names></name><name><surname>Miyamura</surname><given-names>T</given-names></name><name><surname>Wu</surname><given-names>S</given-names></name><name><surname>Yokosuka</surname><given-names>O</given-names></name></person-group><article-title>Involvement of androgen receptor and glucose-regulated protein 78 kDa in human hepatocarcinogenesis</article-title><source>Exp Cell Res</source><volume>323</volume><fpage>326</fpage><lpage>336</lpage><year>2014</year></element-citation></ref>
<ref id="b12-or-32-06-2343"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Shuda</surname><given-names>M</given-names></name><name><surname>Kondoh</surname><given-names>N</given-names></name><name><surname>Imazeki</surname><given-names>N</given-names></name><etal/></person-group><article-title>Activation of the ATF6, XBP1 and grp78 genes in human hepatocellular carcinoma: a possible involvement of the ER stress pathway in hepatocarcinogenesis</article-title><source>J Hepatol</source><volume>38</volume><fpage>605</fpage><lpage>614</lpage><year>2003</year></element-citation></ref>
<ref id="b13-or-32-06-2343"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jiang</surname><given-names>X</given-names></name><name><surname>Kanda</surname><given-names>T</given-names></name><name><surname>Tanaka</surname><given-names>T</given-names></name><name><surname>Wu</surname><given-names>S</given-names></name><name><surname>Nakamoto</surname><given-names>S</given-names></name><name><surname>Imazeki</surname><given-names>F</given-names></name><name><surname>Yokosuka</surname><given-names>O</given-names></name></person-group><article-title>Lipopolysaccharide blocks induction of unfolded protein response in human hepatoma cell lines</article-title><source>Immunol Lett</source><volume>152</volume><fpage>8</fpage><lpage>15</lpage><year>2013</year></element-citation></ref>
<ref id="b14-or-32-06-2343"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Martinon</surname><given-names>F</given-names></name><name><surname>Glimcher</surname><given-names>LH</given-names></name></person-group><article-title>Regulation of innate immunity by signaling pathways emerging from the endoplasmic reticulum</article-title><source>Curr Opin Immunol</source><volume>23</volume><fpage>35</fpage><lpage>40</lpage><year>2011</year></element-citation></ref>
<ref id="b15-or-32-06-2343"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kanda</surname><given-names>T</given-names></name><name><surname>Jiang</surname><given-names>X</given-names></name><name><surname>Yokosuka</surname><given-names>O</given-names></name></person-group><article-title>Androgen receptor signaling in hepatocellular carcinoma and pancreatic cancers</article-title><source>World J Gastroenterol</source><volume>20</volume><fpage>9229</fpage><lpage>9236</lpage><year>2014</year></element-citation></ref>
<ref id="b16-or-32-06-2343"><label>16</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Nawrocki</surname><given-names>ST</given-names></name><name><surname>Carew</surname><given-names>JS</given-names></name><name><surname>Dunner</surname><given-names>K</given-names><suffix>Jr</suffix></name><etal/></person-group><article-title>Bortezomib inhibits PKR-like endoplasmic reticulum (ER) kinase and induces apoptosis via ER stress in human pancreatic cancer cells</article-title><source>Cancer Res</source><volume>65</volume><fpage>11510</fpage><lpage>11519</lpage><year>2005</year></element-citation></ref>
<ref id="b17-or-32-06-2343"><label>17</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mujumdar</surname><given-names>N</given-names></name><name><surname>Banerjee</surname><given-names>S</given-names></name><name><surname>Chen</surname><given-names>Z</given-names></name><etal/></person-group><article-title>Triptolide activates unfolded protein response leading to chronic ER stress in pancreatic cancer cells</article-title><source>Am J Physiol Gastrointest Liver Physiol</source><volume>306</volume><fpage>G1011</fpage><lpage>G1020</lpage><year>2014</year></element-citation></ref>
<ref id="b18-or-32-06-2343"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fu</surname><given-names>Y</given-names></name><name><surname>Lee</surname><given-names>AS</given-names></name></person-group><article-title>Glucose regulated proteins in cancer progression, drug resistance and immunotherapy</article-title><source>Cancer Biol Ther</source><volume>5</volume><fpage>741</fpage><lpage>744</lpage><year>2006</year></element-citation></ref>
<ref id="b19-or-32-06-2343"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>E</given-names></name><name><surname>Nichols</surname><given-names>P</given-names></name><name><surname>Spicer</surname><given-names>D</given-names></name><name><surname>Groshen</surname><given-names>S</given-names></name><name><surname>Yu</surname><given-names>MC</given-names></name><name><surname>Lee</surname><given-names>AS</given-names></name></person-group><article-title>GRP78 as a novel predictor of responsiveness to chemotherapy in breast cancer</article-title><source>Cancer Res</source><volume>66</volume><fpage>7849</fpage><lpage>7853</lpage><year>2006</year></element-citation></ref>
<ref id="b20-or-32-06-2343"><label>20</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kanda</surname><given-names>T</given-names></name><name><surname>Yokosuka</surname><given-names>O</given-names></name><name><surname>Imazeki</surname><given-names>F</given-names></name><name><surname>Arai</surname><given-names>M</given-names></name><name><surname>Saisho</surname><given-names>H</given-names></name></person-group><article-title>Enhanced sensitivity of human hepatoma cells to 5-fluorouracil by small interfering RNA targeting <italic>Bcl-2</italic></article-title><source>DNA Cell Biol</source><volume>24</volume><fpage>805</fpage><lpage>809</lpage><year>2005</year></element-citation></ref>
<ref id="b21-or-32-06-2343"><label>21</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ehrenfried</surname><given-names>JA</given-names></name><name><surname>Herron</surname><given-names>BE</given-names></name><name><surname>Townsend</surname><given-names>CM</given-names><suffix>Jr</suffix></name><name><surname>Evers</surname><given-names>BM</given-names></name></person-group><article-title>Heat shock proteins are differentially expressed in human gastrointestinal cancers</article-title><source>Surg Oncol</source><volume>4</volume><fpage>197</fpage><lpage>203</lpage><year>1995</year></element-citation></ref>
<ref id="b22-or-32-06-2343"><label>22</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tsai</surname><given-names>HY</given-names></name><name><surname>Yang</surname><given-names>YF</given-names></name><name><surname>Wu</surname><given-names>AT</given-names></name><etal/></person-group><article-title>Endoplasmic reticulum ribosome-binding protein 1 (RRBP1) overexpression is frequently found in lung cancer patients and alleviates intracellular stress-induced apoptosis through the enhancement of GRP78</article-title><source>Oncogene</source><volume>32</volume><fpage>4921</fpage><lpage>4931</lpage><year>2013</year></element-citation></ref>
<ref id="b23-or-32-06-2343"><label>23</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Visioli</surname><given-names>F</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Alam</surname><given-names>GN</given-names></name><name><surname>Ning</surname><given-names>Y</given-names></name><name><surname>Rados</surname><given-names>PV</given-names></name><name><surname>N&#x000F6;r</surname><given-names>JE</given-names></name><name><surname>Polverini</surname><given-names>PJ</given-names></name></person-group><article-title>Glucose-regulated protein 78 (Grp78) confers chemoresistance to tumor endothelial cells under acidic stress</article-title><source>PLoS One</source><volume>9</volume><fpage>e101053</fpage><year>2014</year></element-citation></ref>
<ref id="b24-or-32-06-2343"><label>24</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Roller</surname><given-names>C</given-names></name><name><surname>Maddalo</surname><given-names>D</given-names></name></person-group><article-title>The molecular chaperone GRP78/BiP in the development of chemoresistance: mechanism and possible treatment</article-title><source>Front Pharmacol</source><volume>4</volume><fpage>10</fpage><year>2013</year></element-citation></ref>
<ref id="b25-or-32-06-2343"><label>25</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Soldani</surname><given-names>C</given-names></name><name><surname>Scovassi</surname><given-names>AI</given-names></name></person-group><article-title>Poly(ADP-ribose) polymerase-1 cleavage during apoptosis: an update</article-title><source>Apoptosis</source><volume>7</volume><fpage>321</fpage><lpage>328</lpage><year>2002</year></element-citation></ref>
<ref id="b26-or-32-06-2343"><label>26</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>J</given-names></name><name><surname>Yin</surname><given-names>Y</given-names></name><name><surname>Hua</surname><given-names>H</given-names></name><etal/></person-group><article-title>Blockade of GRP78 sensitizes breast cancer cells to microtubules-interfering agents that induce the unfolded protein response</article-title><source>J Cell Mol Med</source><volume>13</volume><fpage>3888</fpage><lpage>3897</lpage><year>2009</year></element-citation></ref>
<ref id="b27-or-32-06-2343"><label>27</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>R</given-names></name><name><surname>Shao</surname><given-names>F</given-names></name><name><surname>Liu</surname><given-names>Z</given-names></name><etal/></person-group><article-title>The Hsp90 inhibitor SNX-2112, induces apoptosis in multidrug resistant K562/ADR cells through suppression of Akt/NF-&#x003BA;B and disruption of mitochondria-dependent pathways</article-title><source>Chem Biol Interact</source><volume>205</volume><fpage>1</fpage><lpage>10</lpage><year>2013</year></element-citation></ref>
<ref id="b28-or-32-06-2343"><label>28</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lei</surname><given-names>Y</given-names></name><name><surname>Henderson</surname><given-names>BR</given-names></name><name><surname>Emmanuel</surname><given-names>C</given-names></name><name><surname>Harnett</surname><given-names>PR</given-names></name><name><surname>Defazio</surname><given-names>A</given-names></name></person-group><article-title>Inhibition of ANKRD1 sensitizes human ovarian cancer cells to endoplasmic reticulum stress-induced apoptosis</article-title><source>Oncogene</source><month>Feb</month><day>17</day><year>2014</year><comment>(Epub ahead of print)</comment></element-citation></ref></ref-list></back>
<floats-group>
<fig id="f1-or-32-06-2343" position="float">
<label>Figure 1</label>
<caption>
<p>Glucose-regulated protein 78 (GRP78/Bip) is expressed at various levels in the human pancreatic cancer cell lines. Western blot analyses of GRP78 and glyceraldehydes 3-phosphate dehydrogenase (GAPDH) in SUIT-2, MIAPaCa-2, Panc-1 and KP-2 cells.</p></caption>
<graphic xlink:href="OR-32-06-2343-g00.gif"/></fig>
<fig id="f2-or-32-06-2343" position="float">
<label>Figure 2</label>
<caption>
<p>Effects of thapsigargin on glucose-regulated protein 78 (GRP78/Bip) expression in human pancreatic cancer cell lines. (A) Western blot analyses of GRP78 and GAPDH in SUIT-2, MIAPaCa-2, Panc-1 and KP-2 cells treated with or without 1 &#x003BC;M thapsigargin for 24 h. GRP78/glyceraldehyde 3-phosphate dehydrogenase (GAPDH) ratios from 3 independent experiments were measured using ImageJ software in (B) SUIT-2, (C) MIAPaCa-2, (D) Panc-1 and (E) KP-2 cells, respectively.</p></caption>
<graphic xlink:href="OR-32-06-2343-g01.gif"/></fig>
<fig id="f3-or-32-06-2343" position="float">
<label>Figure 3</label>
<caption>
<p>Effects of thapsigargin on growth arrest and DNA damage gene 34 (GADD34), activating transcription factor 4 (ATF4), ATF6 and X-box-binding protein 1 (XBP1) expression in human pancreatic cancer cell lines Panc-1 and KP-2. (A) Western blot analyses of GADD34, ATF4, ATF6, XBP1 and tubulin in Panc-1 and KP-2 cells treated with or without 1 &#x003BC;M thapsigargin for 24 h. (B) The ratios of GADD34 over tubulin, (C) ATF4 over tubulin, (D) ATF6 over tubulin and (E) XBP1 over tubulin in Panc-1 cells were measured using ImageJ software. (F) The ratios of GADD34 over tubulin, (G) ATF4 over tubulin, (H) ATF6 over tubulin and (I) XBP1 over tubulin in KP-2 cells were also measured using ImageJ software.</p></caption>
<graphic xlink:href="OR-32-06-2343-g02.gif"/></fig>
<fig id="f4-or-32-06-2343" position="float">
<label>Figure 4</label>
<caption>
<p>Effects of thapsigargin on the phosphorylation of Ser51-eIF2&#x003B1; (p-eIF2&#x003B1;) in human pancreatic cancer cell lines Panc-1 and KP-2. (A) Western blot analyses of p-eIF2&#x003B1; and total eIF2&#x003B1; in Panc-1 and KP-2 cells treated with or without 1 &#x003BC;M thapsigargin for 24 h. The ratios of p-eIF2&#x003B1; over total eIF2&#x003B1; were measured using ImageJ software in (B) Panc-1 and (C) KP-2 cells.</p></caption>
<graphic xlink:href="OR-32-06-2343-g03.gif"/></fig>
<fig id="f5-or-32-06-2343" position="float">
<label>Figure 5</label>
<caption>
<p>Knockdown of endogenous glucose-regulated protein 78 (GRP78/Bip) by siRNA enhances poly(ADP-ribose) polymerase (PARP) cleavage in pancreatic cancer cells. Western blot analyses of GRP78 and tubulin in (A) Panc-1 and (B) MIAPaCa-2 cells treated with or without 1 &#x003BC;M thapsigargin for 24 h. Cell lysates were analyzed for GRP78, PARP and tubulin expression using specific antibodies. Bands were analyzed using ImageJ software. (C) Schematic presentation of endoplasmic reticulum stress (ER) pathways in human pancreatic cancer cell lines.</p></caption>
<graphic xlink:href="OR-32-06-2343-g04.gif"/></fig></floats-group></article>
