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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">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.2016.4615</article-id>
<article-id pub-id-type="publisher-id">or-35-04-2373</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Decreased expression of the type III TGF-&#x003B2; receptor enhances metastasis and invasion in hepatocellullar carcinoma progression</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>ZHANG</surname><given-names>SEN</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>SUN</surname><given-names>WU-YI</given-names></name><xref ref-type="corresp" rid="c1-or-35-04-2373"/></contrib>
<contrib contrib-type="author">
<name><surname>WU</surname><given-names>JING-JING</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>GU</surname><given-names>YUAN-JING</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>WEI</surname><given-names>WEI</given-names></name><xref ref-type="corresp" rid="c1-or-35-04-2373"/></contrib>
<aff id="af1-or-35-04-2373">Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine of the Chinese Education Ministry, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, Anhui 230032, P.R. China</aff></contrib-group>
<author-notes>
<corresp id="c1-or-35-04-2373">Correspondence to: Dr Wu-Yi Sun or Professor Wei Wei, Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine of the Chinese Education Ministry, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, Anhui 230032, P.R. China, E-mail: <email>sunwuyi51@126.com</email>, E-mail: <email>wwei@ahmu.edu.cn</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>04</month>
<year>2016</year></pub-date>
<pub-date pub-type="epub">
<day>08</day>
<month>02</month>
<year>2016</year></pub-date>
<volume>35</volume>
<issue>4</issue>
<fpage>2373</fpage>
<lpage>2381</lpage>
<history>
<date date-type="received">
<day>18</day>
<month>11</month>
<year>2015</year></date>
<date date-type="accepted">
<day>23</day>
<month>12</month>
<year>2015</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2016, Spandidos Publications</copyright-statement>
<copyright-year>2016</copyright-year></permissions>
<abstract>
<p>The transforming growth factor &#x003B2; (TGF-&#x003B2;) superfamily of cytokines is multifunctional and involved in the regulation of cell growth and differentiation. TGF-&#x003B2; can induce an epithelial-mesenchymal transition (EMT) of both epithelial and endothelial cells. This has consequences for cancer progression in regards to both migration and invasion abilities. The type III TGF-&#x003B2; receptor (T&#x003B2;RIII) is a ubiquitously expressed TGF-&#x003B2; co-receptor which regulates TGF-&#x003B2; signaling and the progression of various types of cancer. Previous studies have shown that T&#x003B2;RIII exhibits abnormal expression and plays an essential role in regulating cancer invasion and metastasis, while little is known in regards to its role in hepatocellular carcinoma (HCC) progression. In the present study, we designed the present research to study the role of T&#x003B2;RIII in the invasion and metastasis of HCC and the possible mechanisms involved. The results demonstrated decreased expression of T&#x003B2;RIII in HCC patient tissues and human HCC cell lines. TGF-&#x003B2;1 stimulation led to the increased migratory ability and reduced expression of T&#x003B2;RIII in HCC cells. In addition, knockdown of T&#x003B2;RIII by small interfering RNA (siRNA) promoted the migration and invasion of HCC cells and induced activation of the Smad2 and Akt pathways. All the results suggest that T&#x003B2;RIII is a novel suppressor of HCC progression.</p></abstract>
<kwd-group>
<kwd>hepatocellular carcinoma</kwd>
<kwd>TGF-&#x003B2;1</kwd>
<kwd>type III TGF-&#x003B2; receptor</kwd>
<kwd>metastasis</kwd>
<kwd>invasion</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Hepatocellular carcinoma (HCC) represents the most common type of primary liver cancer (<xref rid="b1-or-35-04-2373" ref-type="bibr">1</xref>). HCC is a highly prevalent and lethal neoplasia, and the management of HCC has significantly improved during the last few years (<xref rid="b2-or-35-04-2373" ref-type="bibr">2</xref>). A better understanding of the pathogenesis and the molecular mechanisms facilitate a better prediction of prognosis and the most appropriate treatment approach. At present, curative therapies including resection and transplantation have increased the survival rate of HCC patients at an early stage, while those diagnosed at intermediate and advanced stages still suffered from a high risk of side-effects (<xref rid="b3-or-35-04-2373" ref-type="bibr">3</xref>&#x02013;<xref rid="b5-or-35-04-2373" ref-type="bibr">5</xref>). Investigation of the cellular origins and the early molecular events resulting in HCC are urgently necessary for further understanding HCC disease progression.</p>
<p>The transforming growth factor &#x003B2; (TGF-&#x003B2;) superfamily of cytokines is composed of TGF-&#x003B2;s, activins, inhibins, bone morphogenetic proteins (BMPs) and anti-M&#x000FC;llerian hormone (AMH) and are expressed in all multicellular organisms (<xref rid="b6-or-35-04-2373" ref-type="bibr">6</xref>). In mammals, the TGF-&#x003B2; family exerts regulatory functions on cell growth, differentiation, apoptosis, immunity, extracellular matrix (ECM) production, adhesion and even embryonic development. Alterations of the components of the TGF-&#x003B2; signaling pathway and abnormal production of TGF-&#x003B2;s are often observed in disease progression despite the involvement in the maintenance of tissue homeostasis under both normal and dynamic conditions (<xref rid="b7-or-35-04-2373" ref-type="bibr">7</xref>,<xref rid="b8-or-35-04-2373" ref-type="bibr">8</xref>). The TGF-&#x003B2; isoforms (TGF-&#x003B2;1-3) exert their biological effects by binding to three receptors: type I (T&#x003B2;RI), type II (T&#x003B2;RII) and type II (T&#x003B2;RIII). Once bound to TGF-&#x003B2;, the constitutively active T&#x003B2;RII recruits, binds and activates T&#x003B2;RI, thereby stimulating its protein kinase activity. The downstream substrates for T&#x003B2;RI are members of the receptor-activated Smads (R-Smads), namely Smad2 and Smad3. After inducing phosphorylation by receptors, R-Smads form complexes with common mediated Smad4 (Co-Smad), and then translocate to the nucleus where regulation of the transcription of certain genes occurs in cooperation with other transcription factors (<xref rid="b9-or-35-04-2373" ref-type="bibr">9</xref>).</p>
<p>T&#x003B2;RIII is the most abundantly expressed and characterized TGF-&#x003B2; receptor, and is a proteoglycan comprised of 851 amino acids (<xref rid="b10-or-35-04-2373" ref-type="bibr">10</xref>,<xref rid="b11-or-35-04-2373" ref-type="bibr">11</xref>). As a TGF-&#x003B2; superfamily co-receptor, the role of T&#x003B2;RIII in regulating TGF-&#x003B2; signaling is context-dependent and complex (<xref rid="b12-or-35-04-2373" ref-type="bibr">12</xref>,<xref rid="b13-or-35-04-2373" ref-type="bibr">13</xref>). The significant and indispensable role of T&#x003B2;RIII in mediating signaling is exerted dependently through T&#x003B2;RII and T&#x003B2;RI as well as potential signaling independently through T&#x003B2;RII and T&#x003B2;I. Overexpression of T&#x003B2;RIII was found to restore TGF-&#x003B2;1 sensitivity in CAL-27 human oral squamous cells (<xref rid="b14-or-35-04-2373" ref-type="bibr">14</xref>). In MDA-MB-231 human breast cancer cells, T&#x003B2;RIII expression inhibited Smad2/3 signaling dependent on the T&#x003B2;RIII cytoplasmic domain, and the independent binding of T&#x003B2;I/T&#x003B2;RII to T&#x003B2;RIII competed with T&#x003B2;I/T&#x003B2;RII signaling complex formation, thus inhibiting TGF-&#x003B2;-mediated Smad signaling (<xref rid="b15-or-35-04-2373" ref-type="bibr">15</xref>). Importantly, the alteration of T&#x003B2;RIII expression level and the mediating roles have been observed in the progression of several types of cancers including breast, prostate, lung and ovarian cancer (<xref rid="b16-or-35-04-2373" ref-type="bibr">16</xref>&#x02013;<xref rid="b19-or-35-04-2373" ref-type="bibr">19</xref>). Furthermore, the anchorage-independent growth of human MCF-7 breast cancer cells was inhibited when T&#x003B2;RIII expression was recovered <italic>in vitro</italic> (<xref rid="b20-or-35-04-2373" ref-type="bibr">20</xref>), and suppression of tumorigenicity occurred in MDA-MB231 breast cancer cells after increased T&#x003B2;RIII expression in athymic nude mice (<xref rid="b21-or-35-04-2373" ref-type="bibr">21</xref>). The expression level of T&#x003B2;RIII and its regulatory role in HCC progression remain to be clarified.</p>
<p>Therefore, in the present study, we investigated the expression of T&#x003B2;RIII at both the mRNA and protein levels in HCC patient tissues and cell lines. <italic>In vitro</italic>, we also studied the regulatory roles of T&#x003B2;RIII in metastasis and invasion of HCC and the related mechanisms.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>HCC patient tissues</title>
<p>Quantitative real-time PCR (qRT-PCR) and western blotting were utilized to examine the expression of T&#x003B2;RIII at the mRNA and protein level, respectively, in 10 HCC tissue specimens, which were collected at the First Affiliated Hospital of Anhui Medical University. All of the tissue specimens were pathologically confirmed as primary hepatic carcinoma and were promptly placed into sterile vials, and stored at &#x02212;80&#x000B0;C until required. Tissue collection was approved by the Ethics Committee of Anhui Medical University. All procedures involving specimens obtained from human subjects were performed following informed consent from the patients.</p></sec>
<sec>
<title>Cell culture</title>
<p>Human HCC cell lines with stepwise metastatic potential (HepG2, SMMC-7721, MHCC97H, HCCLM3) and the normal immortalized liver cell line L02 were cultured in Dulbecco's modified Eagle's medium (DMEM), supplemented with 10% (v/v) fetal bovine serum (FBS) (both from Gibco, Life Technologies, USA) and 100 U/ml of penicillin and 100 <italic>&#x000B5;</italic>g/ml of streptomycin. Human normal liver L02 cells, and human HCC cell lines HepG2 and SMMC-7721 were purchased from Shanghai Cell Bank, Chinese Academy of Sciences (Shanghai, China). MHCC97H and HCCLM3 cells were purchased from Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Science (Shanghai, China). All of the cell lines were maintained at 37&#x000B0;C in a 5% CO<sub>2</sub> atmosphere.</p></sec>
<sec>
<title>Quantitative real-time PCR (qRT-PCR)</title>
<p>qRT-PCR was carried out to examine the mRNA expression of T&#x003B2;RIII. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) served as an internal control. Total RNA was extracted using TRIzol reagent (Invitrogen, Life Technologies, USA). Total RNA (2 <italic>&#x000B5;</italic>g) was reverse transcribed using the RevertAid First Strand cDNA Synthesis kit (Fermentas, Lithuania) according to the manufacturer's instructions. The detection was carried out in a real-time PCR detection system (ABI 7500) using the SYBR-GreenER qPCR SuperMix Universal kit (Invitrogen, Life Technologies) according to the manufacturer's instructions. The primer sequences for each gene were: GAPDH forward primer, 5&#x02032;-AGGTCGGAGTCAACGGATTTG-3&#x02032; and reverse primer, 5&#x02032;-CCTGGAAGATGGTGATGGGAT-3&#x02032;; T&#x003B2;RIII forward primer, 5&#x02032;-ACCCCCAACTCTAACCC CTACA-3&#x02032; and reverse primer, 5&#x02032;-GCCAATACTGTTAGGACAATAATTTTC-3&#x02032;. The cycle threshold value was defined as the PCR cycle number at which the reporter fluorescence crosses the threshold. The cycle threshold value of each product was determined and normalized against that of the internal control, GAPDH.</p></sec>
<sec>
<title>T&#x003B2;RIII small interfering RNA (siRNA) transfection</title>
<p>According to the T&#x003B2;RIII gene sequences, three siRNA duplexes targeting the T&#x003B2;RIII gene were designed (GenePharma, China): T&#x003B2;RIII-homo-2729 sense, 5&#x02032;-GGGCCAUGAUGCAGAAUAATT-3&#x02032; and antisense, 5&#x02032;-UUAUUCUGCAUCAUGGCCCTT-3&#x02032;; T&#x003B2;RIII-homo-2059 sense, 5&#x02032;-GGUGUGGUCUACUAUAACUTT-3&#x02032; and antisense, 5&#x02032;-AGUUAUAGUAGACCACACCTT-3&#x02032;; T&#x003B2;RIII-homo-759 sense, 5&#x02032;-GGUCACACUUCACCUGAAUTT-3&#x02032; and antisense, 5&#x02032;-AUUCAGGUGAAGUGUGACCTT-3&#x02032;. The transfection operation was performed under guidance of the Lipofectamine 3000 protocol (Invitrogen, Life Technologies). The transfection efficiency was confirmed by western blotting.</p></sec>
<sec>
<title>Western blotting</title>
<p>Liver samples and human HCC cell lines were collected and cultured respectively, according to the methods described above. Liver tissue was homogenized in RIPA lysis buffer and phenylmethylsulfonyl fluoride (PMSF) at a ratio of 99:1 (v/v). The cells were washed twice with ice-cold phosphate-buffered saline (PBS) after the corresponding treatment and lysed in cell lysis buffer. The protein concentration was determined with the BCA protein assay kit (Thermo Fisher Scientific, USA). A protein sample was mixed with 5x sample buffer (4:1) (Bio-Rad, Hercules, CA, USA) and heated in boiling water for 10 min. The proteins were separated by 10% sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), transferred to polyvinylidene fluoride (PVDF) membranes (Millipore, Bedford, MA, USA), and incubated with blocking buffer (0.05% Tween-20 PBS with 5% non-fat milk) for 2 h. Immunoblots were incubated with the indicated primary antibodies overnight at 4&#x000B0;C, followed by the appropriate horseradish peroxidase-conjugated secondary antibody for 2 h at room temperature, and immunodetection was visualized by enhanced chemiluminescence (Pierce, Rockford, IL, USA) using hydrogen peroxide and luminol as substrates. Autoradiographs were scanned using ImageQuant LAS 4000 mini (GE Healthcare Bio-Sciences AB, Uppsala, Sweden). The density of the specific bands was quantified using ImageJ software (National Institutes of Health, Bethesda, MD, USA).</p></sec>
<sec>
<title>Wound healing assay</title>
<p>SMMC-7721 cells were seeded in a 6-well plate at 70&#x02013;90% confluency and the cell monolayer was scraped in a straight line to create a 'scratch' with a P200 pipette tip. The debris was removed and the edge of the scratch was smoothed by washing the cells twice with 1 ml PBS. Then, 2 ml serum-free DMEM was added with different concentrations of TGF-&#x003B2;1 (0.2, 1, 5 and 25 ng/ml) and images were captured using a computer-based microscopic imaging system at the 0 h time point at a magnification of &#x000D7;200. After 24 h, images of the wound were captured again under magnification of &#x000D7;200.</p>
<p>Changes in the migratory ability of the human SMMC-7721 cells after transfection with T&#x003B2;RIII siRNA were also assessed by wound healing assay. SMMC-7721 cells were seeded to 70&#x02013;90% confluency and starved for 12 h. T&#x003B2;RIII siRNA was transfected into the SMMC-7721 cells under the guidance of the Lipofectamine 3000 protocol. After 12 h, the wound was created using the same method as described above. Images at 0 and 24 h were captured by a computer-based microscopy imaging system under a magnification of &#x000D7;200, respectively. Cell motility was evaluated according to the following formula: Cell motility ratio = (distance 24 h -distance 0 h)/distance 0 h.</p></sec>
<sec>
<title>Transwell assay</title>
<p>SMMC-7721 cells plated in 6-well plates previously transfected with the T&#x003B2;RIII siRNA for 12 h were harvested by trypsinization. The cells were washed once with PBS to remove the influence of FBS and then the cell pellet was resuspended in serum-free DMEM at 1&#x000D7;10<sup>6</sup> cells/ml. The cells (25,000&#x02013;50,000) were seeded in the upper chamber of a Transwell filter, coated with Matrigel (BD Biosciences) in order to determine the cell invasive ability. The cells were cultured for 48 h at 37&#x000B0;C in a 5% CO<sub>2</sub> incubator through Matrigel toward the lower chamber, containing medium with 10% FBS as the chemoattractant. After incubation, the medium in the upper chamber was discarded and then the upper chamber was removed gently from the 24-well plates. The filter was fixed in 90% alcohol for 30 min and hexamethyl pararosaniline staining for 5 min. Images were captured of representative fields of each filter, and the number of cells was quantified.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>All data are expressed as means &#x000B1; SD. Statistical analysis was performed using one-way ANOVA. Statistical calculations were conducted using SPSS 10.0 soft ware. The results were considered statistically significant for P-value &lt;0.05.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Decreased expression of T&#x003B2;RIII in HCC patient tissues</title>
<p>To investigate whether T&#x003B2;RIII expression is altered in HCC patient specimens, we initially analyzed the mRNA expression level in 10 human HCC tissue samples and compared the level with the matched non-tumor tissue samples as normal controls by qRT-PCR. From all the specimens, we observed a significant decrease in T&#x003B2;RIII mRNA expression in tumor tissues compared with the matched non-tumor tissue samples (<xref rid="f1-or-35-04-2373" ref-type="fig">Fig. 1A</xref>). To confirm decreased expression of T&#x003B2;RIII in HCC patient tissues, we examined T&#x003B2;RIII expression at the protein level by western blot analysis. The result showed that the protein expression of T&#x003B2;RIII was significantly decreased in the HCC tumor tissues compared with the level in the matched non-tumor tissue samples (<xref rid="f1-or-35-04-2373" ref-type="fig">Fig. 1B</xref>). The results revealed the impaired expression of T&#x003B2;RIII at both the mRNA and protein level.</p></sec>
<sec>
<title>Decreased expression of T&#x003B2;RIII in human HCC cell lines along with increased metastatic potential</title>
<p>To further confirm the alteration in the expression in T&#x003B2;RIII in HCC progression, human liver L02 cells and four HCC cell lines with stepwise metastatic potential (HepG2, SMMC-7721, MHCC97H and HCCLM3) were selected to observe the expression change of T&#x003B2;RIII <italic>in vitro</italic> by western blotting. Western blot results demonstrated the highest expression level in human liver L02 cells, while the expression of T&#x003B2;RIII was gradually decreased with increasing metastatic potential in the HCC cell lines. Moreover, the expression of T&#x003B2;RIII in the HCC cell lines MHCC97H and HCCLM3 which possess high metastatic potential was markedly lower than that in the HepG2 cells, an HCC cell line with low metastatic potential (<xref rid="f2-or-35-04-2373" ref-type="fig">Fig. 2</xref>). These results showed that a reduction in the expression of T&#x003B2;RIII occurred simultaneously with the increasing metastatic potential of the HCC cells.</p></sec>
<sec>
<title>TGF-&#x003B2;1 treatment enhances the migratory ability of human HCC cell lines</title>
<p>TGF-&#x003B2;1 is overexpressed and involved in the regulation of the progression of various types of cancer, and we investigated the effect of TGF-&#x003B2;1 on the migratory ability of human HCC cells. Human SMMC-7721 cells were seeded in a 6-well plate (5&#x000D7;10<sup>5</sup> cells/well) and starved for 12 h on the following day. Then, SMMC-7721 cells were exposed to TGF-&#x003B2;1 for 24 h at concentrations of 0.2, 1, 5 and 25 ng/ml. The wound healing assay showed that TGF-&#x003B2;1 significantly elevated the migratory ability of the SMMC-7721 cells in a concentration-dependent manner, particularly in the 5 and 25 ng/ml treatment groups (<xref rid="f3-or-35-04-2373" ref-type="fig">Fig. 3</xref>). The results indicated that TGF-&#x003B2;1 promoted the metastasis of the HCC cells.</p></sec>
<sec>
<title>TGF-&#x003B2;1 stimulation reduces the expression of T&#x003B2;RIII in human HCC cells</title>
<p>To further characterize the effect of TGF-&#x003B2;1 on the expression of T&#x003B2;RIII, we treated human SMMC-7721 cells with TGF-&#x003B2;1 at stepwise concentrations (0.2, 1, 5 and 25 ng/ml) and assessed the protein level of T&#x003B2;RIII using western blotting. Treatment with TGF-&#x003B2;1 (5 and 25 ng/ml) resulted in a significantly decreased expression level of the T&#x003B2;RIII protein (<xref rid="f4-or-35-04-2373" ref-type="fig">Fig. 4</xref>). To assess whether the effects of TGF-&#x003B2;1 on T&#x003B2;RIII were specific, we analyzed the effect of TGF-&#x003B2;1 on T&#x003B2;RII expression. Western blot results showed no significant changes in the level of T&#x003B2;RII expression upon TGF-&#x003B2;1 treatment at various concentrations (<xref rid="f4-or-35-04-2373" ref-type="fig">Fig. 4</xref>). The results above indicated that it was T&#x003B2;RIII instead of T&#x003B2;RII that was down-regulated by TGF-&#x003B2;1 in the human SMMC-7721 cells.</p></sec>
<sec>
<title>Decreased expression of T&#x003B2;RIII elevates the migratory and invasive abilities of human HCC cells</title>
<p>We detected the gradually decreased expression of T&#x003B2;RIII in human HCC cell lines along with increasing metastatic potential. To investigate the roles of T&#x003B2;RIII in regulating the migratory and invasive abilities of the HCC cells, we silenced the expression of T&#x003B2;RIII by transfection of siRNA targeting the T&#x003B2;RIII gene. The wound healing and Transwell assays were performed to detect the migratory and invasive abilities of the SMMC-7721 cells transfected with the siRNA targeting T&#x003B2;RIII, respectively. The wound healing assay results revealed that the migratory ability of the SMMC-7721 cells in the siRNA transfection groups was significantly increased compared with the corresponding control groups (<xref rid="f5-or-35-04-2373" ref-type="fig">Fig. 5</xref>). The Transwell assay showed a significantly increased invasive ability of the SMMC-7721 cells in the siRNA transfection groups compared with the corresponding control groups (<xref rid="f6-or-35-04-2373" ref-type="fig">Fig. 6</xref>). Collectively, these results confirmed that the downregulation of T&#x003B2;RIII expression promoted HCC cell migration and invasion <italic>in vitro</italic>.</p></sec>
<sec>
<title>Silencing of T&#x003B2;RIII expression by siRNA activates the Smad2 and Akt pathways in the SMMC-7721 cells</title>
<p>TGF-&#x003B2;1 was found to promote the migration of HCC cells and reduced the expression of T&#x003B2;RIII, and furthermore, silencing of the expression of T&#x003B2;RIII elevated the migration and invasion abilities of the HCC cells. Thus, we hypothesized that the inhibitory effects of T&#x003B2;RIII on migration and invasion of HCC cells may be through regulation of the TGF-&#x003B2; downstream signaling pathway. Therefore, to further confirm this hypothesis, we examined Smad2 and Akt activation by western blotting after transfection of T&#x003B2;RIII siRNA. The results revealed that silenced expression of T&#x003B2;RIII in the siRNA transfection groups increased the expression levels of p-Smad2 and p-Akt compared with the corresponding control groups (<xref rid="f7-or-35-04-2373" ref-type="fig">Fig. 7</xref>).</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>The three highly homologous isoforms of TGF-&#x003B2; in humans (TGF-&#x003B2;1, TGF-&#x003B2;2 and TGF-&#x003B2;3) share a receptor complex and signal in similar ways while their expression levels vary depending on the tissue (<xref rid="b22-or-35-04-2373" ref-type="bibr">22</xref>). TGF-&#x003B2; can induce an epithelial-mesenchymal transition (EMT) of both epithelial and endothelial cells, which contributes to disease progression in both cancer and fibrosis (<xref rid="b23-or-35-04-2373" ref-type="bibr">23</xref>). EMT promotes cellular migratory and invasion properties, as cellular migration requires the loss of cell-cell contacts and acquisition of fibroblastic characteristics. Several studies have demonstrated the increased expression of TGF-&#x003B2;1 in various types of cancers and the close association with tumor metastasis, invasion and the poor prognosis of patients (<xref rid="b24-or-35-04-2373" ref-type="bibr">24</xref>,<xref rid="b25-or-35-04-2373" ref-type="bibr">25</xref>). Although the increased expression of TGF-&#x003B2;1 has been reported to be closely associated with a poor prognosis and tumor angiogenesis in HCC (<xref rid="b26-or-35-04-2373" ref-type="bibr">26</xref>&#x02013;<xref rid="b28-or-35-04-2373" ref-type="bibr">28</xref>), the mechanism concerning the role of the promotion of tumorigenesis remains unclear. The research based on the MDA-MB-231 breast cancer and Ovca420 ovarian cancer cells <italic>in vitro</italic> revealed that TGF-&#x003B2;1 reduced the expression of T&#x003B2;RIII at the mRNA and protein levels in a dose- and time-dependent manner (<xref rid="b29-or-35-04-2373" ref-type="bibr">29</xref>). In our previous study, we established an HCC animal model by intraperitoneally injecting diethylinitrosamine (DEN) in 14-day-old C57BL/6J mice. The results revealed significantly increased expression of TGF-&#x003B2;1 and induced activation of Smad2 signaling in a time-dependent manner after the injection (<xref rid="b30-or-35-04-2373" ref-type="bibr">30</xref>). In the present study, we observed that TGF-&#x003B2;1 promoted the migratory ability and induced decreased expression of T&#x003B2;RIII in HCC cells. These results suggest that the TGF-&#x003B2;1 expression level may be a diagnostic predictor of HCC progression, and its promotive effect on the migration of HCC cells may be associated with the low expression of T&#x003B2;RIII.</p>
<p>The negative regulation of T&#x003B2;RIII expression by TGF-&#x003B2;1 may provide insight into the tumor-promoting effects of elevated TGF-&#x003B2;1 and the role of decreased T&#x003B2;RIII expression in HCC as well. The expression level of TGF-&#x003B2;1 was found to be elevated and correlated with the migration and invasion in a spectrum of human cancers (<xref rid="b24-or-35-04-2373" ref-type="bibr">24</xref>,<xref rid="b25-or-35-04-2373" ref-type="bibr">25</xref>). Nevertheless, the mechanism by which the high level of TGF-&#x003B2;1 exerts tumor-promoting effects remains unclear. A recent study found that T&#x003B2;RIII inhibited TGF-&#x003B2;-mediated signaling through the independent binding to T&#x003B2;RI and T&#x003B2;RII and competition with T&#x003B2;RI/T&#x003B2;RII complex formation (<xref rid="b15-or-35-04-2373" ref-type="bibr">15</xref>). We found decreased expression of T&#x003B2;RIII concomitant with the elevated level of TGF-&#x003B2;1, as well as the role of TGF-&#x003B2;1 in promoting metastasis in the HCC cell lines. Thus, the present study confirmed decreased T&#x003B2;RIII expression as a possible mechanism for the tumor-promoting role of TGF-&#x003B2;1.</p>
<p>TGF-&#x003B2; binds to the constitutively active type II TGF-&#x003B2; receptor (T&#x003B2;RII) along with the consequent activation of the type I TGF-&#x003B2; receptor (T&#x003B2;RI), subsequently forming heteromeric complexes to induce downstream signaling transduction (<xref rid="b9-or-35-04-2373" ref-type="bibr">9</xref>,<xref rid="b12-or-35-04-2373" ref-type="bibr">12</xref>). Although lacking intrinsic enzymatic activity, T&#x003B2;RIII is the most abundantly expressed TGF-&#x003B2; superfamily receptor and has a complex- and context-dependent role in regulating TGF-&#x003B2; superfamily signaling and cancer progression with mechanisms yet to be defined. Recently, the decreased and even lost expression of T&#x003B2;RIII have been reported in several types of cancers including breast, prostate, lung and ovarian cancer (<xref rid="b16-or-35-04-2373" ref-type="bibr">16</xref>&#x02013;<xref rid="b19-or-35-04-2373" ref-type="bibr">19</xref>). Several studies have also demonstrated the aberrant expression of T&#x003B2;RIII in HCC (<xref rid="b27-or-35-04-2373" ref-type="bibr">27</xref>,<xref rid="b31-or-35-04-2373" ref-type="bibr">31</xref>). However, the specific expression condition and roles of T&#x003B2;RIII in HCC development and progression require further research. The results of the present study showed that the expression of T&#x003B2;RIII in human HCC tissues was significantly decreased compared with the level in the matched normal liver tissues, at the mRNA and protein levels. In our previous study of an animal model, we also found that the expression of T&#x003B2;RIII was decreased in DEN-induced HCC mice compared with normal control mice along with increasing time after DEN injection (<xref rid="b30-or-35-04-2373" ref-type="bibr">30</xref>). These results suggest that the decreased expression of T&#x003B2;RIII has a negative regulatory role in HCC progression.</p>
<p>Notably, the regulatory roles of T&#x003B2;RIII in inhibiting tumor invasion, angiogenesis, and metastasis have also been defined. The restoration of T&#x003B2;RIII expression in murine mammary cancer cells and prostate cancer cells inhibited tumor invasion, angiogenesis, and metastasis both basally and in response to TGF-&#x003B2; treatment <italic>in vivo</italic> and <italic>in vitro</italic>, respectively (<xref rid="b16-or-35-04-2373" ref-type="bibr">16</xref>,<xref rid="b17-or-35-04-2373" ref-type="bibr">17</xref>,<xref rid="b21-or-35-04-2373" ref-type="bibr">21</xref>,<xref rid="b32-or-35-04-2373" ref-type="bibr">32</xref>), and expression of T&#x003B2;RIII inhibited the motility and invasion of NSCLC cells and knockdown of T&#x003B2;RIII expression increased its invasion (<xref rid="b18-or-35-04-2373" ref-type="bibr">18</xref>). To further investigate the roles of T&#x003B2;RIII in the regulation of HCC migration and invasion, we performed research using human HCC cell lines <italic>in vitro</italic>. Consistently, the results showed that gradually decreased expression of T&#x003B2;RIII was observed in HCC cell lines along with increasing metastatic potential. Human normal liver L02 cells showed the highest expression level of T&#x003B2;RIII protein, while the MHCC97H and HCCLM3 cell lines with high metastatic potential exhibited a markedly lower expression level than that in HepG2, an HCC cell line with low metastatic potential. Based on the findings of decreased T&#x003B2;RIII expression in HCC cell lines with increasing metastatic potential, we hypothesized that T&#x003B2;RIII may be a negative regulator of the migration and invasion of HCC. In addition, the results of siRNA targeting of the T&#x003B2;RIII gene revealed that knockdown of T&#x003B2;RIII led to the enhanced motility and invasiveness of human SMC-7721 cells both basically and under TGF-&#x003B2;1 stimulation. Collectively, based on the results in HCC patient tissues and in a previous HCC mouse model (<xref rid="b30-or-35-04-2373" ref-type="bibr">30</xref>), we propose that low expression of T&#x003B2;RIII is involved in the malignant progression of HCC, and T&#x003B2;RIII plays a suppressive role in regulating the metastasis and invasion of HCC.</p>
<p>T&#x003B2;RIII has been previously found to exert inhibitory effects on the migration and invasion of HCC and on various types of cancers; however, the related mechanisms remain to be defined. T&#x003B2;RIII has been shown to have effects on both the Smad and non-Smad signaling pathways in a ligand-dependent or -independent manner, including the Smad, NF-&#x003BA;B and p38 signaling pathways (<xref rid="b33-or-35-04-2373" ref-type="bibr">33</xref>&#x02013;<xref rid="b35-or-35-04-2373" ref-type="bibr">35</xref>). In mouse lung fibroblasts, the expression of T&#x003B2;RIII was found to reduce the phosphorylation of Smad2, Smad3 and Akt (<xref rid="b36-or-35-04-2373" ref-type="bibr">36</xref>). Moreover, it has been reported that restoration of T&#x003B2;RIII in breast cancer inhibited the expression level of Smad2 or Smad3 <italic>in vivo</italic> and <italic>in vitro</italic> (<xref rid="b16-or-35-04-2373" ref-type="bibr">16</xref>). In our previous study in an HCC mouse model, we detected that the expression of p-Smad2 was elevated in a time-dependent manner, meanwhile the TGF-&#x003B2;1 level was increased (<xref rid="b30-or-35-04-2373" ref-type="bibr">30</xref>). In the present study, we detected the expression of p-Smad2 and p-Akt in SMMC-7721 cells after transfection with T&#x003B2;RIII siRNA. The results revealed that the expression levels of p-Smad2 and p-Akt were elevated in the siRNA groups compared with the corresponding control groups. These results suggest that T&#x003B2;RIII suppressed the progression of HCC by inhibiting the activation of Smad2 and Akt pathways, and subsequently decreasing the migration and invasion of HCC.</p>
<p>In conclusion, T&#x003B2;RIII displayed decreased expression with HCC progression <italic>in vivo</italic> and <italic>in vitro</italic>, which may be associated with the higher level of TGF-&#x003B2;1. An elevated level of TGF-&#x003B2;1 and decreased expression of T&#x003B2;RIII may lead to the activation of Smad2, and the mechanism between them is yet to be defined. Furthermore, T&#x003B2;RIII acts as a suppressive factor in regulating the migration and invasion of HCC, by inhibiting the Smad2 and Akt pathways. The present study confimed that T&#x003B2;RIII may be a candidate molecular target in HCC diagnosis and treatment.</p></sec></body>
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<title>Acknowledgments</title>
<p>The present study was financially supported by the National Natural Science Foundation of China (nos. 81300332 and 81330081), the Specialized Research Fund for the Doctoral Program of Higher Education of China (no. 20113420120002), and the Natural Science Foundation of the Higher Education Institutions of Anhui Province (no. KJ2012A153). The authors acknowledge the assistance of the staff members of the Institute of Clinical Pharmacology, Anhui Medical University, in conducting the present study.</p></ack>
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<floats-group>
<fig id="f1-or-35-04-2373" position="float">
<label>Figure 1</label>
<caption>
<p>Expression of T&#x003B2;RIII in tumor and non-tumor tissues of HCC patients. (A) The T&#x003B2;RIII mRNA levels in tumor and non-tumor tissues were assayed by qRT-PCR. (B) The protein expression of T&#x003B2;RIII in tumor and non-tumor tissues was assayed by western blotting. The quantitative analysis results shown in the histograms were calculated as fold-change relative to the non-tumor group that was assigned a value of 1. The data are shown as means &#x000B1; SD. <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01 compared with the non-tumor group.</p></caption>
<graphic xlink:href="OR-35-04-2373-g00.tif"/></fig>
<fig id="f2-or-35-04-2373" position="float">
<label>Figure 2</label>
<caption>
<p>Expression of T&#x003B2;RIII in HCC cell lines with different metastatic potential. (A) The expression level of T&#x003B2;RIII in HCC cell lines by western blotting. (B) The quantitative analysis of T&#x003B2;RIII expression is shown. The histogram results were calculated as fold-change relative to the L02 group that was assigned a value of 1. The data are shown as means &#x000B1; SD and the results shown are representative of at least three independent experiments. <sup>&#x0002A;</sup>P&lt;0.05, <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01 compared with the L02 group, <sup>##</sup>P&lt;0.01 compared with the HepG2 group.</p></caption>
<graphic xlink:href="OR-35-04-2373-g01.tif"/></fig>
<fig id="f3-or-35-04-2373" position="float">
<label>Figure 3</label>
<caption>
<p>Effects of TGF-&#x003B2;1 on the migration of SMMC-7721 cells. (A) Representative images of the wound healing assay results. (B) Histogram representing changes in the migratory ability of SMMC-7721 cells following stimulation with TGF-&#x003B2;1 (0.2, 1, 5 and 25 ng/ml). The cell motility ratio of the control group was assigned as a value of 1. Cell motility was evaluated according to the following formula: Cell motility ratio = (distance 24 h &#x02212; distance 0 h)/distance 0 h. The data are shown as means &#x000B1; SD. <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01 compared with the control group.</p></caption>
<graphic xlink:href="OR-35-04-2373-g02.tif"/></fig>
<fig id="f4-or-35-04-2373" position="float">
<label>Figure 4</label>
<caption>
<p>Expression levels of T&#x003B2;RII and T&#x003B2;RIII in TGF-&#x003B2;1-stimulated SMMC-7721 cells. (A) SMMC-7721 cells were incubated for 24 h with TGF-&#x003B2;1 and total cell lysates were prepared for analysis by western blotting to detect T&#x003B2;RII and T&#x003B2;RIII expression levels. (B) Quantitative analysis is shown as fold-change compared with the control group that was assigned a value of 1. The data are shown as means &#x000B1; SD. The results shown are representative of at least three independent experiments. <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01 compared with the control group.</p></caption>
<graphic xlink:href="OR-35-04-2373-g03.tif"/></fig>
<fig id="f5-or-35-04-2373" position="float">
<label>Figure 5</label>
<caption>
<p>Effects of T&#x003B2;RIII siRNA on the migration of SMMC-7721 cells. (A) The migratory ability was assessed by wound healing assay. (B) Histogram shows the effects of transfection on migratory ability. Cell motility was evaluated according to the following formula: Cell migration ratio = (distance 24 h &#x02212; distance 0 h)/distance 0 h. The data from three independent experiments are shown as the mean &#x000B1; SD. NC, negative control; siT&#x003B2;RIII, T&#x003B2;RIII siRNA. <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01 compared with the control group; <sup>##</sup>P&lt;0.01 compared with the TGF-&#x003B2;1 group.</p></caption>
<graphic xlink:href="OR-35-04-2373-g04.tif"/></fig>
<fig id="f6-or-35-04-2373" position="float">
<label>Figure 6</label>
<caption>
<p>Effects of T&#x003B2;RIII siRNA on the invasive ability of SMMC-7721 cells. (A) The invasive ability was assessed by Transwell invasion assay. (B) Histogram shows the effects of transfection on invasion ability. The data from three independent experiments are shown as the mean &#x000B1; SD. NC, negative control; siT&#x003B2;RIII, T&#x003B2;RIII siRNA. <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01 compared with the control group; <sup>##</sup>P&lt;0.01 compared with the TGF-&#x003B2;1 group.</p></caption>
<graphic xlink:href="OR-35-04-2373-g05.tif"/></fig>
<fig id="f7-or-35-04-2373" position="float">
<label>Figure 7</label>
<caption>
<p>Effects of T&#x003B2;RIII siRNA transfection on activation of the Smad2 and Akt pathways in SMMC-7721 cells. Low expression of T&#x003B2;RIII resulted in the increased activation levels of Smad2 (A) and Akt (B). The semi-quantitative analysis is shown as a histogram. The results were calculated as fold-change relative to the control group, which was assigned as a value of 1. siT&#x003B2;RIII, T&#x003B2;RIII siRNA. <sup>&#x0002A;&#x0002A;</sup>P&lt;0.01, compared with the control group; <sup>#</sup>P&lt;0.05, <sup>##</sup>P&lt;0.01 compared with the TGF-&#x003B2;1 group.</p></caption>
<graphic xlink:href="OR-35-04-2373-g06.tif"/></fig></floats-group></article>
