Year of Publication

2013

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Medicine

Department

Toxicology

First Advisor

Dr. Daret St. Clair

Abstract

Although the prostate specific antigen (PSA) test is widely used in clinical settings for prostate cancer (PCa) diagnosis and post-treatment follow-up monitoring, false positive PSA test results, which contribute to over-diagnosis of PCa, and false negative results, which miss some patients with aggressive PCa, remain problems of clinical importance.

Our study demonstrates that radiation therapy, which is widely used for treatment of localized PCa, generates TNF-α in tumor cells and stromal fibroblasts, redox dependently. Interestingly, TNF-α rapidly and transiently triggers the RelA-mediated NF-κB canonical pathway, but its effect on RelB expression is more robust and long lasting, which leads to sustainable suppression of PSA expression. TNF-α further amplifies endogenous reactive oxygen species (ROS) partially through NADPH oxidase activation and mediates redox-dependent downstream signaling pathways. Addition of the NADPH oxidase inhibitor or ROS scavengers such as superoxide dismutase (SOD) mimetic can abrogate TNF-α-mediated suppression of PSA expression by inhibiting the RelB-AR axis. Treatment with TNF-α suppresses PSA expression and it confers minor yet statistically significant protection to LNCap cells against irradiation, indicating that radiation-induced TNF-α may not only interfere with the PSA-based PCa diagnosis and post-treatment monitoring but may also diminish the efficacy of radiotherapy.

In addition, we uncover a role for RelB in suppressing PSA expression at the advanced stage of PCa, which could be a mechanism for the low PSA level in some patients bearing aggressive PCa. Experiments with both RelB overexpression and siRNA knockdown indicate that RelB negatively regulates androgen receptor (AR) and PSA levels in human prostate cancer, LNCap, cells. RelB directly interacts with AR to form a complex on the enhancer elements of the PSA promoter. Thus, the RelB-AR axis is an important contributor to PSA suppression at the advanced stage of PCa.

Overall, this study is the first to reveal a redox-mediated association among radiation-generated TNF-α, activation of the RelB-mediated alternative NF-kappaB pathway and PSA suppression. This mechanistic information provides new insights with practical and clinical implications for PSA-based PCa diagnosis and post-treatment monitoring as well as redox intervention in radiation therapy.

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