doi:10.1369/jhc.5A6912.2006
Volume 54 (9): 1051-1059, 2006 Copyright ©The Histochemical Society, Inc. Breast Cancer Resistance Protein (BCRP/ABCG2) Is Expressed by Progenitor Cells/Reactive Ductules and Hepatocytes and Its Expression Pattern Is Influenced by Disease Etiology and Species Type: Possible Functional Consequences
Laboratory of Morphology and Molecular Pathology (SVB,LL,AVL,TAR), Laboratory of Hepatology (AK,JvP,DC,FN,JF), University Hospitals Leuven, Leuven, Belgium; Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida (BEP); and Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands (PLJ) Correspondence to: Sara Vander Borght, Minderbroederstraat 12, 3000 Leuven, Belgium. E-mail: Sara.vanderborght{at}uz.kuleuven.ac.be
Breast cancer resistance protein (BCRP/ABCG2) is an ATP-binding cassette transport protein that is expressed in several organs including the liver. Previous studies have shown that ABC transport proteins play an important pathophysiological role in several liver diseases. However, to date, expression pattern and possible role of BCRP in human liver diseases and animal models have not been studied in detail. Here we investigated the expression pattern of BCRP in normal liver, chronic parenchymal and biliary human liver diseases, and parallel in different rat models of liver diseases. Expression was studied by immunohistochemistry and additionally by RT-PCR analysis in Thy-1-positive rat oval cells. Bile ducts, hepatic progenitor cells, reactive bile ductules, and blood vessel endothelium were immunoreactive for BCRP in normal liver and all types of human liver diseases and in rat models. BCRP was expressed by the canalicular membrane of hepatocytes in normal and diseased human liver, but never in rat liver. Remarkably, there was also expression of BCRP at the basolateral pole of human hepatocytes, and this was most pronounced in chronic biliary diseases. In conclusion, BCRP positivity in the progenitor cells/reactive ductules could contribute to the resistance of these cells to cytotoxic agents and xenotoxins. Basolateral hepatocytic expression in chronic biliary diseases may be an adaptive mechanism to pump bile constituents back into the sinusoidal blood. Strong differences between human and rat liver must be taken into account in future studies with animal models. (J Histochem Cytochem 54:10511059, 2006)
Key Words: breast cancer resistance protein immunohistochemistry basolateral expression hepatic progenitor cells multidrug resistance phenotype human and rat liver
THE BREAST CANCER RESISTANCE PROTEIN, which will be referred to as BCRP in human and Bcrp in rat in this study, belongs to the ATP-binding cassette transporter G (ABCG) family and is also known as ABCG2, ABCP, and MXR (Doyle et al. 1998
In normal human tissues, BCRP is expressed on the apical membrane of trophoblast cells in the placenta; on the epithelium of the small intestine, colon, brain, prostate, and testis; ducts and lobules of the breast; and in the endothelium of veins and capillaries (Doyle et al. 1998
In normal human liver, BCRP is expressed by bile canaliculi, and this has led to the suggestion that BCRP most likely plays a role in the secretion of bile constituents from the hepatocytes into the bile canaliculus (Maliepaard et al. 2001
According to Tanaka et al. (2005)
It is well known that ABC transporters such as the multidrug resistance transporter 1 (MDR1), the multidrug resistance-associated transporter 1 (MRP1), and MRP3 play an important role in uptake and secretion of bile constituents and in protection of hepatocytes and progenitor cells/reactive ductules against toxic substances (Borst and Elferink 2002 To the best of our knowledge, there are no studies on the protein expression of BCRP in human liver diseases and animal models. This prompted us to study BCRP expression in a wide variety of liver diseases by immunohistochemistry (IHC).
Human Liver Specimens Human liver specimens taken from liver explants or needle liver biopsies taken for diagnostic purposes were used for this study as follows: normal liver (n=5), chronic viral hepatitis (n=15), chronic biliary liver diseases [primary biliary cirrhosis (PBS), n=12, primary sclerosing cholangitis (PSC), n=2], (non)-alcoholic steatohepatitis [(N)-ASH], (n=13), and acute necrotizing hepatitis (viral, drug induced, auto-immune) (n=7). From each specimen a part was snap frozen in liquid nitrogen-cooled isopentane and stored at 80C, and another part was fixed in 6% formalin or in B5 fixative and embedded in paraffin for routine diagnosis.
For assessment of histopathology and fibrosis, sections were stained with hematoxylineosin, PAS diastase, Hall's bilirubin, and Sirius Red (Bancroft and Cook 1984
As control, we used five liver biopsies that showed no morphological abnormalities. Two biopsies were taken from normal-appearing liver at a distance from focal nodular hyperplasia and three were morphologically completely normal needle biopsies taken to exclude auto-immune hepatitis, storage disease, and congenital hepatic fibrosis. Serum bilirubin, alkaline phosphatase, gamma glutamyl transferase, alanine aminotransferase, and aspartate aminotransferase were measured in the blood of all patients. In 16/49 patients, blood levels were measured at the day of biopsy and in 32/49 patients, the number of days between measuring blood levels and biopsy was 17 ± 7.6. No serological data were available from six patients. Use of these tissues for the study of hepatic transport protein expression was approved by the Local Commission for Medical Ethics and Clinical Studies of the University of Leuven.
Rat Models
Carbon Tetrachloride (CCl4) Model (Hepatitis Model)
Bile Duct Ligation Model (Biliary Model)
Formalin Injection Rat Model (Biliary Model)
Choline-deficientAcetylaminofluorene (CD-AAF) Model (Oval Cell Activation Model)
Liver specimens were snap frozen in liquid nitrogen-cooled isopentane and stored at 80C. Three blocks were fixed in Bouin's solution, B5-fixative, and 6% formalin, respectively, and embedded in paraffin. RNA from Thy-1-positive rat oval cells was used for reverse transcriptase-PCR. These cells were isolated from rats 12 days after 2-acetylaminofluorene (2-AAF)/PHx-treatment as described previously (Petersen et al. 1998
Western Blotting
IHC Five-µm-thick sections were made from the human paraffin-embedded biopsies, subsequently deparaffinized in xylene, and rehydrated. Endogenous peroxidase activity was blocked using 0.3% H2O2 in methanol for 20 min. Before staining, paraffin sections were pretreated in citrate buffer (pH 6.0) for 30 min in a hot water bath at 98.5C.
To detect BCRP expression, we used two recently developed monoclonal antibodies: BXP-21 and BXP-34. Development of these antibodies has been described previously (Scheffer et al. 2000 Five-µm-thick serial sections were made from the paraffin-embedded tissue of four patients. On these sections, IHC was performed with monoclonal antibodies against CK7 (dilution 1:50), CK19 (dilution 1:20), and BCRP (BXP-21; dilution 1:5). The same two-step EnVision method (Dako) as above was applied. Four-µm-thick frozen sections of rat liver were cut, dried overnight at room temperature, fixed in acetone for 10 min, and finally washed in PBS immediately before use. Frozen rat sections were blocked with normal goat serum (dilution 1:5 in PBS) for 7 min and subsequently incubated with a 1:10 dilution of the rabbit polyclonal anti-Bcrp, M-70 antibody followed by incubation with anti-rabbit peroxidase-conjugated EnVision (Dako). Serial sections were stained with a 1:300 dilution of a mouse monoclonal anti-OV-6 antibody (Dr. S. Sell; Albany Medical College, Albany, NY) followed by incubation with a peroxidase-labeled goat anti-mouse IgG and with a peroxidase-labeled rabbit anti-goat-conjugated IgG. Secondary and tertiary antibodies were obtained from Sigma and diluted (1:100) in PBS containing rat liver powder. Negative controls consisted of omission of the primary antibody.
Semi-quantitative Scoring and Statistical Evaluation
Double-fluorescence Immunostaining Polyclonal carcinoembryonic antigen antibody, dilution 1:300, was incubated at room temperature for 45 min followed by tetramethylrhodamine isothiocyanate (TRITC) or fluorescein isothiocyanate (FITC)-labeled swine anti-rabbit antibodies (Dako). Subsequently, the monoclonal BXP-21 antibody, dilution 1:5, was incubated for 45 min at room temperature followed by FITC- or TRITC-labeled rabbit anti-mouse antibodies (Dako). Antibodies were diluted in PBS. All incubation steps were followed by a wash in three changes of PBS. Sections were mounted with para-phenylene-diamine. Controls consisted of omission of the first step and were consistently negative. No nonspecific labeling could be detected. Double staining was detected using confocal laser scanning microscopy (410 inverted laser scan microscope; Carl Zeiss Inc., Göttingen, Germany).
RT-PCR
Human Specimens On paraffin-embedded biopsies of normal human liver tissue, we observed BXP-21 positivity on the canalicular surface of hepatocytes, the endothelium of small veins and capillaries, and in nerve bundles. Arteries showed a varying and weak reactivity of BXP-21. The canalicular and blood vessel expression is in agreement with Maliepaard et al. (2001) In all human liver diseases, the same structures as seen in normal liver were BXP-21 positive. In addition, we observed positivity in hepatic progenitor cells/reactive bile ductules on paraffin-embedded biopsies and on frozen sections fixed with 4% paraformaldehyde for 10 min. Progenitor cells/reactive ductules were negative on acetone-fixed frozen biopsies. To confirm BXP-21 positivity of progenitor cells/reactive ductules, we performed stainings for BXP-21 and the progenitor cell/ductular markers CK7 and CK19 (Figure 1 ).
In several cases we also observed expression of BXP-21 at the basolateral pole of hepatocytes. Extent of this basolateral pattern was scored as absent, focal periseptal, or as diffusely present in the parenchyma (Figure 2 ; Table 2 ). Basolateral BXP-21 expression was more frequently seen in chronic biliary than in parenchymal (i.e., viral hepatitis, (N)-ASH, and acute necrotizing hepatitis) liver diseases and was neither correlated with fibrosis stage nor with inflammatory activity within the group of chronic viral hepatitis (Table 2). Extent of basolateral BXP-21 expression was not correlated with serological markers.
Basolateral expression of BXP-21 was confirmed by double-fluorescence immunostainings for BXP-21 and pCEA, which is an established canalicular marker (Figure 3 ) (Lau et al. 2002
Rat Specimens To confirm specificity of the polyclonal antibody M-70, we tested it on Western blot of rat placenta, liver, and kidney. The M-70 antibody reacted with a protein band with an apparent molecular mass of 72 kDa in all three samples, confirming the specificity of this antibody (Figure 4 ). Equal protein loading was demonstrated by ß-actin detection on the same blot.
Using this antibody for IHC staining of normal rat liver, we observed positivity of the interlobular bile ducts and the endothelial layer of small veins, arterioles, and capillaries in normal rat liver. In sharp contrast with human liver, rat hepatocytes were consistently negative.
As shown previously (Roskams et al. 1998
This was further supported by the observation that Thy-1-positive oval cells contain Bcrp mRNA (Figure 6 ).
One of the important findings of the current study is that progenitor cells/reactive ductules in human liver strongly express BCRP. Because BCRP is known to export a variety of exogenous and endogenous toxic compounds from the cell (Staud and Pavek 2005
Remarkably, expression of BCRP by progenitor cells/reactive ductules could only be demonstrated on biopsies fixed with formalin-containing solutions and was not detectable on acetone-fixed frozen sections. Volk et al. (2005)
Expression of Bcrp mRNA in Thy-1-positive rat oval cells isolated from 2-AAF/PHx-treated rats is in line with the recent finding of Shimano et al. (2003)
As in normal human liver, diseased human liver was characterized by BCRP expression at the canalicular pole of hepatocytes, which has previously led to the suggestion that BCRP most likely plays a role in the secretion of bile constituents from the hepatocytes into the bile canaliculus (Maliepaard et al. 2001
The phenomenon of basolateral expression of a hepatic transporter that is normally only present at the apical pole has also been described previously for MRP2 in a case report of antidepressant-induced toxic liver disease and in human HepG2 cells treated with phorbol 12-myristate 13-acetate (PMA) and for MDR3 in PBC (Kubitz et al. 2001
Although rat models and human diseased livers showed a strong expression of BCRP in bile ducts, ductules, and endothelia, hepatocytic expression observed in human normal and diseased liver was completely absent in all rat models and normal rat liver. This suggests that the hepatocytic expression of BCRP is much lower in the rat that in human liver. In agreement with these findings, Shimano et al. (2003) In conclusion, BCRP positivity in the progenitor cells/reactive ductules could contribute to the resistance of these cells to cytotoxic agents. Basolateral hepatocytic expression in chronic biliary diseases may be an adaptive mechanism to pump bile constituents back into the sinusoidal blood. Strong differences between human and rat liver must be taken into account in future studies with animal models.
The authors thank Paula Aertsen, Martine Verhoeven, and Petra Windmolders for their excellent technical skills. T.R. is a basic researcher for the Fonds voor Wetenschappelijk Onderzoek (FWO)Vlaanderen. L.L. and D.C. are postdoctoral researchers for the Fonds voor Wetenschappelijk Onderzoek (FWO)Vlaanderen.
Received for publication December 23, 2005; accepted April 29, 2006
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