Abstract
Objective
The aim of this study was to investigate the correlation of von Hippel-Lindau tumor suppressor (VHL) mRNA expression and jade family PHD finger 1 (Jade-1) gene expression in patients with renal cell carcinoma (RCC). Another aim of this study was to analyze the relationship of these two genes with clinicalpathological features of the RCC patients. Methods: A total of 75 RCC patients who received surgically therapy in our hospital were included. All patients had complete pathological data. The expression of VHL/Jade-1 was determined by real-time polymerase chain reaction (RT-PCR). Results: VHL and Jade-1 were both obviously downregulated in RCC tissues than that of the matched normal tissues, and both negatively correlated with tumor size as well as tumor grade. And we found a fine association of VHL gene expression with Jade-1. Conclusion: VHL/Jade-1 exhibited significantly decreased expression in RCC tissues and was closely related to the clinical prognosis of patients. The finding of VHL expression positively correlated with Jade-1 expression shed light and provided crucial evidence on the connection of VHL protein with Wnt/b-catenin pathway.
1 Introduction
Renal cell carcinoma (RCC) ranks as the most frequent type of all kidney cancers, which represents more than 85% incidence among kidney cancers [1,2]. It is also the ninth most common cancer in developed countries [3]. In recent years, the incidence of RCC shows a rising trend. Recent progress in antiangiogenic therapy has increased the median survival of RCC patients at advance stages from 10 months to more than 40 months [4]. However, because of the highly expression of drug-resistant genes, general chemotherapy method has limited or absolutely no significant effect [5,6]. Therefore, deeper understanding of the pathogenesis and progression of RCC is of highly importance for developing more therapy targets and improving prognosis of RCC patients.
Von Hippel–Lindau (VHL) disease is a hereditary cancer syndrome caused by inherited mutations that inactivate the VHL tumour suppressor gene [7]. Patients with VHL disease are with relative higher risk for a variety of cancers, including RCC of the clear cell histology and other kinds of cancers [8]. The best-characterized function of VHL refers to targeting of the hypoxia-inducible factor (HIF) transcription factor for proteolytic degradation [9,10]. However, VHL inactivation mediates both HIF–dependent and –independent pathways [11-14]. Notably, the majority of the HIF-independent functions were discovered through biochemical interactions, among which, VHL had been reported to interact with and stabilize Jade-1.
Jade-1, a short-lived protein most highly expressed in renal proximal tubules, is a candidate renal tumor sup-pressor. It was initially identified by yeast two-hybrid analysis as a VHL-interacting protein [15]. Jade-1 could suppress renal cancer cell growth in part by increasing apoptosis [16]. It functions as: 1) a ubiquitin ligase to inhibit canonical Wnt/b-catenin signaling [17]; 2) a transcription factor associated with histone acetyltransferase activity [18]; 3) with increased abundance of cyclin-dependent kinase inhibitor p21 [19]. The relationship between Jade-1 and VHL has not yet to be elucidated fully, and may have important implications for RCC development [16]. Recent findings of ubiquitylation followed by degradation of b-catenin by Jade-1 provided evidence that loss of VHL could lead to tumor formation through b-catenin de-repression [20].
However, the connection of VHL expression with Jade-1 expression, and their clinical significance in RCC remain unclear. Here we sought to give direct evidence to demonstrate their correlations and characterize their clinical value in RCC patients.
2 Materials and methods
2.1 Patients and tissues
A total of 75 RCC tissues, as well as adjacent normal tissues from patients with RCC pathologically confirmed were collected from 2012 to 2015. Characteristic data for sex, age, tumor size, lymph node (LN) metastasis and tumor grade of patients were obtained from patients’ medical records. The study protocol was complied with the ethical guidelines of The Central Hospital of Lishui City.
Informed consent: Informed consent has been obtained from all individuals included in this study.
2.2 RNA extraction, Reverse transcription and Real-Time PCR
Total RNA of tissues was extracted with TRIzol reagent (Invitrogen, Carlsbad, CA). The quantitation and quality of RNA was determined using Nanodrop 2000c spectrophotometer. Reverse transcription of RNA was done. Real-Time PCR analysis was performed with SYBR Green qPCR mix (TOYOBO). Samples were normalized to β-actin. Relative VHL or Jade-1 expression was calculated using the power formula: 2-∆Ct (∆Ct = CtGene – Ctβ-actin).
2.3 Statistical analysis
All statistical analyses were performed using SAS software v8. The significance of differences between cancer and normal tissues was estimated by Paired Student’s t-test. κ 2 test was performed to test the relationship between gene expression and clinical parameters. Correlation between expression levels of VHL and Jade-1 genes in RCC tissues was analyzed using Spearman’s linear correlation. Two-sided P-values were calculated, and a probability level of 0.05 was chosen for statistical significance.
3 Results
3.1 VHL and Jade-1 expressions were decreased in RCC and negatively correlated with advanced clinical stage
Real-time PCR was performed to detect the expression of VHL and Jade-1 in 75 pairs of human RCC tissues. We found that 62.7% (47/75) of VHL expression was downregulated in RCC tissues when compared with adjacent normal tissues (Figure 1A, t-test, P<0.01). Also, 60% (45/75) of Jade-1 expression in RCC tissues was significantly down-regulated (Figure 1B, t-test, P<0.01).

The status and expression levels of VHL and Jade-1 in RCC and adjacent normal tissues. Comparison of relative VHL (A)and Jade-1 (B)expression levels as assessed by real-Time PCR between 75 RCCs and adjacent normal tissues. The relative mRNA expression levels in kidney tumors are presented as fold change = 2∆CtN-∆CtT of tumors versus matched normal tissues.
Then, patients with RCC were classified into two groups based on the DDCt of relative VHL expression or Jade-1 expression (positive or negative expression). As showed in Table 1, VHL expression was significantly associated with tumor size and tumor grade (Table 1, k2 test, P<0.01), but no significant association with patients’ sex, age or LN metastasis (Table 1, k2 test, P>0.05). However, Jade-1 expression was not only significantly associated with tumor size and tumor grade (Table 1, k2 test, P<0.01), but also associated with LN metastasis (Table 1, k2 test, P<0.01). Taken together, these results indicated that VHL and Jade-1 were downregulated in RCC, and reduced expression of them may play tumor suppressive roles in the progression of RCC.
Relationship between mRNA expression of both VHL and Jade-1, and age, sex, tumor size, lymph node metastasis and tumor grade in RCC.
| Variables | Total number of cases | VHL positive n (%) | VHL negative n (%) | P | Jade-1 positive n(%) | Jade-1 negative n(%) | P |
|---|---|---|---|---|---|---|---|
| 28 (37.3%) | 47 (62.7%) | 30 (40.0%) | 45 (60.0%) | ||||
| Age | |||||||
| <=50 | 29 | 13 | 16 | 12 | 17 | ||
| >50 | 46 | 15 | 31 | 0.3324 | 18 | 28 | 1.0000 |
| Sex | |||||||
| Male | 44 | 16 | 28 | 19 | 25 | ||
| Female | 31 | 12 | 19 | 1.0000 | 11 | 20 | 0.6331 |
| Tumor Size | |||||||
| <=4cm | 33 | 19 | 14 | 19 | 14 | ||
| >4cm | 42 | 9 | 33 | 0.0018 | 11 | 31 | 0.0088 |
| LN metastasis | |||||||
| Yes | 35 | 15 | 20 | 8 | 27 | ||
| No | 40 | 13 | 27 | 0.4734 | 22 | 18 | 0.0053 |
| Tumor Grade | |||||||
| I | 15 | 12 | 3 | 13 | 2 | ||
| II | 25 | 8 | 17 | 9 | 16 | ||
| III+IV | 35 | 8 | 27 | 0.0005 | 8 | 27 | 0.0001 |
3.2 VHL was positively correlated with Jade-1 expression in RCC
To further explore the relationship between VHL and Jade-1, Spearman’s correlation analysis was performed by SAS software. The results indicated that there was a positively correlation between VHL and Jade-1 expression (Figure 2, P<0.0001). Our data demonstrated that Jade-1 might be positively regulated by VHL, or they might be involved in one pathway.

The positive correlation between VHL and Jade-1 expression in 75 RCC samples was determined using Spearman’s correlation analysis (P<0.0001).
4 Discussion
The familial cancer syndrome, VHL disease, occurs as a consequence of inheriting a mutation in the VHL tumour-suppressor gene located on chromosome locus 3p257. VHL is frequently inactivated in sporadic cases of clear-cell RCC. Its genetic alterations, including gene mutations, hypermethylation of the promoter region, and loss of heterozygosity at the VHL locus are common genetic events in sporadic cases of clear-cell RCC. Clear-cell RCC is the major subtype of RCC. The findings in clear-cell RCC might be applied into the total satiation of RCC.
In our study, we determined the mRNA expression of VHL as well as its partner Jade-1 in RCC tissues, matched with paired normal tissues as controls. We found that both of them exhibited decreased expression in RCC tissues. And the expression level of VHL positively correlated with that of Jade-1, indicating a positive regulation of Jade-1 by VHL in RCC cells. This phenomenon was ideally and in line with our expectation, since it was already known that VHL could interact with and stabilize Jade-1 [15]. As the upstream regulator, VHL to some extent would decide at least protein levels of Jade-1. However, why VHL could also regulate the mRNA expression of Jade-1 remains unclear. Some other mechanisms should be involved in this process. Nevertheless, we do believe that, VHL might function as a tumor suppressor in RCC through Jade-1 to regulate the Wnt/b-catenin signaling. Actually, only one previous report has discussed the interplay between VHL/ HIF-1alpha and Wnt/b-catenin pathways during colorectal tumorigenesis [21]. Therefore, our results provide another possibility to interpret the crosstalk of VHL with Wnt/b-catenin pathway in RCC.
We also analyzed the relationships of VHL and Jade-1 with clinical parameters of the collected RCC patients. We surprisingly found that both VHL and Jade-1 significantly correlated with tumor size and tumor grade, which further confirmed their tumor suppressor roles in RCC. Additionally, we found that only Jade-1 was correlated with lymph node metastasis parameters, indicating that besides promoting apoptosis, Jade-1 might also participate in metastasis processes in RCC cells.
The limited aspect of our study is that, we merely detect the mRNA expression of the two molecules. Indeed, it is more important to address the gene mutation, DNA methylation or protein expression of VHL in RCC tissues. Considering the huge workload, we just measured the mRNA levels of VHL. Hence, for the follow-up studies, we will focus more on genetic and epigenetic levels of VHL regulation. It is the same for Jade-1 studies.
In summary, our results reported the correlation of VHL with Jade-1 in RCC tissues, both of which were decreased, and accessed their clinical values by analyzing the relationship between mRNA expression of VHL and/or Jade-1 and clinical parameters of RCC patients. Our findings provide another clue to connect VHL and Wnt/b-catenin pathway in RCC.
Conflict of interest statement
Authors state no conflict of interest
References
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© 2016 Wu Xiao-fen et al.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
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- Effect of hesperetin on chaperone activity in selenite-induced cataract
- Research Article
- 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