Abstract
Objectives
Increasing evidence showed that microRNAs (miRNAs) were implicated in the chemical resistance of human cancers. We intended to investigate the role of miR-218 in cisplatin sensitivity of esophageal cancer cells.
Methods
Quantitative real-time polymerase chain reaction (qRT-PCR) was carried out to analyze miR-218 expression in human esophageal cancer cell line Eca9706 and a cisplatin-resistant subline (ECa9706-CisR cells). The effects of miR-218 transfection on ECa9706 and ECa9706-CisR cell viability, including cell viability and apoptosis rate were confirmed using MTT assay, or flow cytometry, respectively. qRT-PCR was used to validate survivin as a direct target gene of miR-218 in our system.
Results
We found that miR-218 was significantly decreased in ECa9706-CisR cells compared with parent Eca9706 cells. Overexpression of miR-218 by mimics transfection would enhance cisplatin sensitivity evaluated by cell viability inhibition and apoptosis promotion. We validated here survivin as a direct target of miR-218 in ECa9706 cells, which might contribute to the chemoresistance of esophageal cancer cells to cisplatin.
Conclusions
In summary, our data suggest that miR-218 might represent as a promising sensitizer of cisplatin therapy in clinical esophageal cancer patients.
1 Introduction
Esophageal cancer (EC) is now one of the most aggressive and lethal type of malignant digestive tract tumor [1]. Currently, esophagectomy resection remains as the common and regular treatment strategy for EC patients at the early stage of this disease [2]. However, after resections, approximately half of patients develop systemic or local recurrences gradually along with the progression of EC, which would give bad outcomes [3-4]. Therefore, to improve prognosis, chemotherapy combined with surgery are widely used in the clinic. The results come out that effect of chemotherapy is not satisfying and the chemosensitivity differs between patients [5]. Low sensitivity or even chemoresistance give poor prognosis and also increase economic burden to patients. Cisplatin is a widely used chemotherapeutic agent. Resistance to cisplatin is frequently reported in EC patients [6-8]. Thus, efforts to understand the mechanisms of cisplatin resistance and elevate its sensitivity are of great importance in EC treatment.
MicroRNAs (miRNAs), typically 18-25 nucleotides in length, constitute a class of endogenous, small non-coding RNAs that are highly conserved across species [9]. Recent reports revealed that some miRNAs in cancers are associated with the response of chemotherapy [10-13]. For miR-218, a growing body of evidence supports that miR-218 acts as a potent tumor suppressor and participates in tumor progression, development and metastasis and also confers sensitivity to certain chemotherapeutic drugs in several types of human cancers [14]. For instance, in cervical cancer, miR-218 could impair cell growth, induce cell apoptosis and increase chemosensitivity to cisplatin in vitro [15]. It acts similarly in gastric cancer cells [16]. In EC cells, it was recently proved that miR-218 could inhibit cell proliferation and metastasis by targeting BMI1 [17]. Actually, it was also demonstrated by another group and they considered that miR-218 could both suppress tumor growth and enhance the chemosensitivity of EC cells to cisplatin, via regulating the expression of phosphorylated PI3K, AKT and mTOR [18]. However, the involvement of miR-218 in cisplatin sensitivity still lacks sufficient clues. In addition, the mechanisms that govern its activity in chemosensitivity remain to be more discussed.
2 Materials and methods
2.1 Cell Lines
Human esophageal squamous cell carcinoma cell line ECa9706 was purchased from Shanghai Institutes for Biological Sciences. ECa9706 cells were maintained in 1640 medium supplemented with 10% FBS at 37°C in the 5% CO2. According to Wang’s methods [19], a cisplatin-resistant subline named ECa9706-CisR cell line was obtained from parental ECa9706 cells.
2.2 Reagents and Transfections
Cisplatin was purchased from Sigma. MiR-218 mimic duplexes were synthesized by Gene Pharma. RNAimax was purchased from Life Science. Transfections were performed using RNAimax as per the manufacturer’s instructions. 48 hours post-transfection cells were harvested for further experiments.
2.3 Cell Viability MTT Assay
MTT assay using tetrazolium 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide dye was employed to determine cell viability. Briefly, approximately 5×103 cells per well were seeded into a 96-well plate overnight. At certain time, 20ml of MTT solution was added into each well, and the plate was subsequently incubated for 4h in the incubator. Then, the liquid was removed from the plate, and 150ml of DMSO was added to each well. All plates were read at 490nm.
2.4 qRT-PCR
Total RNA was extracted by using TRIzol. Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) was performed from 2μ;g of total RNA transcribed with random primers. Amplification of cDNA was performed according to the manufacturer’s protocol using Takara SYBR Premix Ex Taq II kit. U6 was used as an internal control for microRNAs, and GAPDH was used as the internal control for genes. The relative expression level was calculated using the comparative 2-∆∆Ct method.
2.5 Apoptosis Analysis
For apoptosis analysis, ECa9706 and ECa9706-CisR cells were collected and Annexin V-FITC assay kit was used according to the manufacturer’s protocol after treated with 5mM cisplatin for 24h.
2.6 Statistical Analysis
Data in the present study were represented as means ± sd of at least three independent experiments. Student’s t-test was used for comparison between two groups. A P value < 0.05 was considered significantly different.
3 Results
3.1 Expression of miR-218 is lower in cisplatin-resistant EC cell lines
To determine whether miR-218 is implicated in cisplatin resistance in EC cells, ECa9706 cell line and its cisplatin-resistant subline named ECa9706-CisR was firstly established through a continuous exposure to increasing doses of cisplatin (from 1.5 to 12μ;M) over 12 months, according to Wang’s method [19]. The resistance to cisplatin of ECa9706-CisR cells was proven in Figure 1A. The expression level of miR-218 was then evaluated in this ECa9706-CisR cells and its parental line. qRT-PCR analysis showed significantly lower expression of miR-218 in cisplatin-resistant ECa9706-CisR cells (Figure 1B). These results suggest an association between miR-218 downregulation and cisplatin resistance in EC cells.

Expression of miR-218 is lower in cisplatin-resistant esophageal cancer cell lines. (A)Cell viability inhibition effect of 5mM cisplatin on ECa9706 cells and ECa9706-CisR cells.**: P<0.01. (B)Relative miR-218 expression level in ECa9706 cells and ECa9706-CisR cells. *: P<0.05.
3.2 miR-218 transfection enhances cisplatin sensitivity
To explore whether miR-218 could increase cisplatin sensitivity of ECa9706 and established ECa9706-CisR cells, we transfected mimics of miR-218 or control duplexes into the indicated cells. As expected, following transfection of miR-218 mimics, the sensitivity of both ECa9706 and ECa9706-CisR cells to cisplatin was increased compared with negative control cells or miR-C cells, as demonstrated by MTT assay (Figure 2A). In addition, as shown in Figure 2B, flow cytometry demonstrated that miR-218 overexpression elevated the apoptosis rate in both cell lines upon treatment with 5μ;M of cisplatin. These results indicated that miR-218 expression is closely related to the sensitivity of EC cells to cisplatin.

miR-218 enhances cisplatin sensitivity in both Eca9706 and ECa9706-CisR cells. (A)Cells were transfected with either control miRNA or miR-218 mimics. Then cells were treated with increasing doses of cisplatin (0, 1, 2, 5, 10 and 20mM). 48h later, MTT assay was performed. (B)Overexpression of miR-218 increased apoptosis rate when treated with 5mM cisplatin in both Eca9706 and ECa9706-CisR cells. *: P<0.05, **: P<0.01.
3.3 miR-218 targets survivin to increase cisplatin sensitivity
To investigate whether miR-218-induced cisplatin sensitivity was mediated by its downstream targets, we first examined in silico predicted targets using miRDB (http://mirdb. org/miRDB/). Besides, a study from breast cancer cells had pointed out that survivin, encoded by BIRC5, was significantly reduced after miR-218 transfection and this targeting regulated resistance to chemotherapeutics in breast cancer cells [20]. Thus, we also speculated that in our EC cells, the miR-218/survivin pathway contributed to the increase of cisplatin sensitivity. To confirm this hypothesis, we carried out qRT-PCR experiments, and found that miR-218 significantly downregulated survivin expression in both ECa9706 and ECa9706-CisR cells (Figure 3A). Notably, we found that in the miR-C transfected cells, survivin expression was a bit increased in ECa9706-CisR than the parent ECa9706 cells. To further test whether the targeting of survivin might contribute a lot for miR-218-induced cisplatin resistance, we overexpressed survivin in ECa9706 cells and monitored the chemoresistance effect of this overexpression. As shown in Figure 3B, we proved that survivin could enhance cisplatin resistance in this cell line.

miR-218 downregulates survivin to increase cisplatin sensitivity in both Eca9706 and Eca9706-CisR cells. (A)Either control microRNA or miR-218 mimics were transfected into both ECa9706 and ECa9706-CisR cells. 48h later, cells were harvested for qRT-PCR test. **: P<0.01. (B)Survivin was overexpressed in Eca9706 cells by plasmid transfection. Then cells were treated with increasing doses of cisplatin (0, 2, 5, 10 and 20mM). 24h later, MTT assay was performed. *: P<0.05, **: P<0.01, ***: P<0.001.
4 Discussion
Our current study showed that miR-218 was significantly decreased in cisplatin-resistant EC cell line, which in turn, was associated with cisplatin resistance in these cells. Specifically, we demonstrated that miR-218 transfection by its mimics could increase chemosensitivity of both ECa9706 cells and ECa9706-CisR cells to cisplatin in vitro, probably via targeting survivin expression. Our findings might provide an important layer of genetic regulation in EC progression, especially in its chemoresistance to cisplatin, and ultimately would benefit developing valuable therapeutic tools for EC therapy.
The roles of miRNAs in the chemoresistance of EC cells have recently attracted attention. For example, miR-141 was found to be the most highly expressed miRNA in the cisplatin-resistant EC cell lines, and it confers resistance to cisplatin-induced apoptosis by targeting YAP121. A report from another group also showed that, miR-96 serves as an oncogene role in EC cells through downregulating RECK, which also promotes chemo- or radioresistance in these cells [22]. As regards miR-218, its downregulation has been reported in several types of human cancers. In EC cells, it has been proved that miR-218 could inhibit cell proliferation and metastasis [17]. Additionally, it was also reported by another group that miR-218 could both suppress tumor growth and enhance the chemosensitivity of EC cells to cisplatin, through downregulating the levels of phosphorylated PI3K, AKT and mTOR [17]. Consistent with this, in the present study, we observed that miR-218 was downregulated in cisplatin-resistant EC cells, and its forced expression sensitized cells to cisplatin treatment. We further validated here survivin was targeted by miR-218. However, a complete understanding of survivin-mediated chemoresistance remains still unclear. Future work will be required to further explore the detailed mechanisms by which survivin affects chemoresistance.
In conclusion, this study confirmed that miR-218 could enhance cisplatin sensitivity of EC cells via targeting survivin. Based on these results, we suggested that the miR-218/survivin axis is a potential therapeutic target for EC treatment. And anti-survivin drugs might be developed with a focus on enhanced sensitivity of EC patients to chemotherapy.
Conflict of interest statement:Authors state no conflict of interest
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© 2016 Lin Jingjing et al.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
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- Clinical value of self-assessment risk of osteoporosis in Chinese
- Research Article
- Correlation analysis of VHL and Jade-1 gene expression in human renal cell carcinoma
- Research Article
- Is acute appendicitis still misdiagnosed?
- Retraction
- Retraction of: application of food-specific IgG antibody detection in allergy dermatosis
- Review Article
- Platelet Rich Plasma: a short overview of certain bioactive components
- Research Article
- Correlation between CTLA-4 gene rs221775A>G single nucleotide polymorphism and multiple sclerosis susceptibility. A meta-analysis
- Review Article
- Standards of anesthesiology practice during neuroradiological interventions
- Research Article
- Expression and clinical significance of LXRα and SREBP-1c in placentas of preeclampsia
- Letter to the Editor
- ARDS diagnosed by SpO2/FiO2 ratio compared with PaO2/FiO2 ratio: the role as a diagnostic tool for early enrolment into clinical trials
- Research Article
- Impact of sensory integration training on balance among stroke patients: sensory integration training on balance among stroke patients
- Review Article
- MicroRNAs as regulatory elements in psoriasis
- Review Article
- Influenza A(H1N1)pdm09 and postpandemic influenza in Lithuania
- Review Article
- Garengeot’s hernia: two case reports with CT diagnosis and literature review
- Research Article
- Concept of experimental preparation for treating dentin hypersensitivity
- Research Article
- Hydrogen water reduces NSE, IL-6, and TNF-α levels in hypoxic-ischemic encephalopathy
- Research Article
- Xanthogranuloma of the sellar region diagnosed by frozen section
- Case Report
- Laparoscopic antegrade cholecystectomy: a standard procedure?
- Case Report
- Maxillary fibrous dysplasia associated with McCune-Albright syndrome. A case study
- Regular Article
- Sialoendoscopy, sialography, and ultrasound: a comparison of diagnostic methods
- Research Article
- Antibody Response to Live Attenuated Vaccines in Adults in Japan
- Conference article
- Excellence and safety in surgery require excellent and safe tutoring
- Conference article
- Suggestions on how to make suboptimal kidney transplantation an ethically viable option
- Regular Article
- Ectopic pregnancy treatment by combination therapy
- Conference article
- Use of a simplified consent form to facilitate patient understanding of informed consent for laparoscopic cholecystectomy
- Regular Article
- Cusum analysis for learning curve of videothoracoscopic lobectomy
- Regular Article
- A meta-analysis of association between glutathione S-transferase M1 gene polymorphism and Parkinson’s disease susceptibility
- Conference article
- Plastination: ethical and medico-legal considerations
- Regular Article
- Investigation and control of a suspected nosocomial outbreak of pan-drug resistant Acinetobacter baumannii in an intensive care unit
- Regular Article
- Multifactorial analysis of fatigue scale among nurses in Poland
- Regular Article
- Smoking cessation for free: outcomes of a study of three Romanian clinics
- Regular Article
- Clinical efficacy and safety of tripterygium glycosides in treatment of stage IV diabetic nephropathy: A meta-analysis
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Prevention and treatment of peritoneal adhesions in patients affected by vascular diseases following surgery: a review of the literature
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Surgical treatment of recidivist lymphedema
- Special Issue on Italian Society for the Study of Vascular Anomalies
- CT and MR imaging of the thoracic aorta
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Role of FDG-PET scan in staging of pulmonary epithelioid hemangioendothelioma
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Sternal reconstruction by extracellular matrix: a rare case of phaces syndrome
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Prenatal diagnosis, 3-D virtual rendering and lung sparing surgery by ligasure device in a baby with “CCAM and intralobar pulmonary sequestration”
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Serum levels of inhibin B in adolescents after varicocelelectomy: A long term follow up
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Our experience in the treatment of Malignant Fibrous Hystiocytoma of the larynx: clinical diagnosis, therapeutic approach and review of literature
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Integrated therapeutic approach to giant solitary fibrous tumor of the pleura: report of a case and review of the literature
- Special Issue on Italian Society for the Study of Vascular Anomalies
- Celiac axis compression syndrome: laparoscopic approach in a strange case of chronic abdominal pain in 71 years old man
- Special Issue on Italian Society for the Study of Vascular Anomalies
- A rare case of persistent hypoglossal artery associated with contralateral proximal subclavian stenosis
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Contralateral risk reducing mastectomy in Non-BRCA-Mutated patients
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Professional dental and oral surgery liability in Italy: a comparative analysis of the insurance products offered to health workers
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Informed consent in robotic surgery: quality of information and patient perception
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Malfunctions of robotic system in surgery: role and responsibility of surgeon in legal point of view
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Iatrogenic splenic injury: review of the literature and medico-legal issues
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Donation of the body for scientific purposes in Italy: ethical and medico-legal considerations
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Cosmetic surgery: medicolegal considerations
- Focus on Medico-Legal and Ethical Topics in Surgery in Italy
- Voluntary termination of pregnancy (medical or surgical abortion): forensic medicine issues
- Review Article
- Role of Laparoscopic Splenectomy in Elderly Immune Thrombocytopenia
- Review Article
- Endoscopic diagnosis and treatment of neuroendocrine tumors of the digestive system
- Review Article
- Efficacy and safety of splenectomy in adult autoimmune hemolytic anemia
- Research Article
- Relationship between gastroesophageal reflux disease and Ph nose and salivary: proposal of a simple method outpatient in patients adults
- Case Report
- Idiopathic pleural panniculitis with recurrent pleural effusion not associated with Weber-Christian disease
- Research Article
- Morbid Obesity: treatment with Bioenterics Intragastric Balloon (BIB), psychological and nursing care: our experience
- Research Article
- Learning curve for endorectal ultrasound in young and elderly: lights and shades
- Case Report
- Uncommon primary hydatid cyst occupying the adrenal gland space, treated with laparoscopic surgical approach in an old patient
- Research Article
- Distraction techniques for face and smile aesthetic preventing ageing decay
- Research Article
- Preoperative high-intensity training in frail old patients undergoing pulmonary resection for NSCLC
- Review Article
- Descending necrotizing mediastinitis in the elderly patients
- Research Article
- Prophylactic GSV surgery in elderly candidates for hip or knee arthroplasty
- Research Article
- Diagnostic yield and safety of C-TBNA in elderly patients with lung cancer
- Research Article
- The learning curve of laparoscopic holecystectomy in general surgery resident training: old age of the patient may be a risk factor?
- Research Article
- Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients
- Research Article
- Anal sphincter dysfunction in multiple sclerosis: an observation manometric study