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Expression and role of adrenomedullin in renal tumors and value of its mRNA levels as prognostic factor in clear-cell renal carcinoma
International Journal of Cancer, 07/29/09
Deville JL et al. - In a trial to determine expression and role of adrenomedullin (AM) in renal tumors and value of its mRNA levels as prognostic factor in clear-cell renal carcinoma (cRCC), these findings highlight the implication of the AM pathway in the metastatic process and the prognostic relevance of AM in cRCC and point to a potential new therapeutic target.
Methods- AM is highly expressed in several tumors and plays an important role in angiogenesis and tumor growth through its receptors: calcitonin receptor-like receptor/receptor activity-modifying protein 2 and 3 (CLR/RAMP2 and CLR/RAMP3).
- Real-time quantitative reverse-transcription-PCR showed AM mRNA levels were higher in cRCC and in chromophobe renal carcinomas (chRCC) than in normal renal tissue.
- AM mRNA expression in cRCC correlated strongly with VEGF-A mRNA expression.
- Immunohistochemically, AM, CLR and RAMP2 were localized in the carcinomatous epithelial compartment of cRCC.
- RAMP3 immunostaining was found only in the inflammatory cells that infiltrated tumors, suggesting a cross talk between tumor cells and the microenvironment.
- cRCC cells BIZ and 786-O expressed and secreted AM into the culture medium.
- In vitro, exogenous AM treatment stimulated cell proliferation, migration and invasion, indicating the cell can respond to AM.
- The action of AM was specific and was mediated by the CLR/RAMP2 and CLR/RAMP3 receptors.
- Clinical data showed the prognostic value of AM.
- High AM mRNA levels were associated with an increased risk of relapse after curative nephrectomy for cRCC.
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