EIF4E Is an Adverse Prognostic Marker of Melanoma Patient Survival by Increasing Melanoma Cell Invasion Shahram Khosravi, Kevin J. Tam, Gholamreza S.

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eIF4E Is an Adverse Prognostic Marker of Melanoma Patient Survival by Increasing Melanoma Cell Invasion Shahram Khosravi, Kevin J. Tam, Gholamreza S. Ardekani, Magdalena Martinka, Kevin J. McElwee, Christopher J. Ong Journal of Investigative Dermatology Volume 135, Issue 5, Pages 1358-1367 (May 2015) DOI: 10.1038/jid.2014.552 Copyright © 2015 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 1 Eukaryotic translation initiation factor 4E (eIF4E) protein expression in different melanoma stages and in melanoma cell lines compared with normal human melanocytes. Representative images of eIF4E immunohistochemical staining in melanocytic lesions. (a–d) Bar = 100 μm. (e–h) Bar = 10 μm. (a and e) Negative eIF4E staining. (b and f) Weak eIF4E staining. (c and g) Moderate eIF4E staining. (d and h) Strong eIF4E staining. (i) eIF4E expression is increased in MM compared with CAN (P<0.001, χ2 test), DN (P<0.001, χ2 test), and PM (P=0.008, χ2 test). eIF4E expression is also increased in PM compared with CAN and DN (P<0.001, χ2 test). (j) Western blot analysis of eIF4E in whole-cell extracts from melanoma cell lines and melanocytes. CAN, common acquired nevi; DN, dysplastic nevi; MC, melanocyte; MM, metastatic melanoma; PM, primary melanoma. Journal of Investigative Dermatology 2015 135, 1358-1367DOI: (10.1038/jid.2014.552) Copyright © 2015 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 2 Kaplan–Meier curves representing the correlation between eukaryotic translation initiation factor 4E (eIF4E) expression and 5-year survival of melanoma patients. (a and b) Increased eIF4E expression is associated with poor overall and disease-specific 5-year survival in all melanoma patients (P<0.001, log rank test). (c and d) Increased eIF4E expression is associated with poor overall and disease-specific 5-year survival in primary melanoma patients (P=0.027 and 0.022, respectively, log rank test). (e and f) Increased eIF4E expression is associated with poor overall and disease-specific 5-year survival in primary melanoma patients with tumors ≥1 mm thick (P=0.021 and 0.024, respectively, log rank test). Cum., cumulative. Journal of Investigative Dermatology 2015 135, 1358-1367DOI: (10.1038/jid.2014.552) Copyright © 2015 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 3 Eukaryotic translation initiation factor 4E (eIF4E) knockdown inhibits melanoma cell invasion by reducing matrix metalloproteinase 2 (MMP-2) expression and activity. MMRU (left column) and MMLH (right column) melanoma cell lines were transfected with eIF4E-specific siRNA (sieIF4E) or control small interfering RNA (siRNA) for two consecutive times, with the second time being 48 hours after the first. (a and c) For Boyden chamber assay, 72 hours after the first transfection, cells were suspended in a serum-free medium, seeded on matrigel, incubated at 37 °C for 24 hours, stained, and quantified. Top, representative images of invaded cells in the insets of Transwell chambers. Bottom, quantification of cell invasion. *P<0.05, Student’s t-test. (b and d) Protein extracts were prepared 96 hours after the first transfection and analyzed by western blotting. Matrix metalloproteinase 2 (MMP-2) activity was determined by zymography 96 hours after the first transfection. Journal of Investigative Dermatology 2015 135, 1358-1367DOI: (10.1038/jid.2014.552) Copyright © 2015 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 4 There is a direct correlation between high eukaryotic translation initiation factor 4E (eIF4E) expression and strong matrix metalloproteinase 2 (MMP-2) expression. Simultaneous high eIF4E expression and strong MMP-2 expression correlate with a poorer 5-year survival. (a) High eIF4E expression directly correlates with strong MMP-2 expression in human melanomas (n=372; P<0.001, χ2 test). (b and c) Simultaneous low eIF4E expression and negative-moderate MMP-2 expression (category 1) was significantly associated with a better overall and disease-specific 5-year survival outcome compared with low eIF4E and strong MMP-2 expression or high eIF4E and negative-moderate MMP-2 expression (category 2), or high eIF4E and strong MMP-2 expression (category 3) in all melanoma patients, and in (d and e) primary melanoma patients (P<0.001 for both overall and disease-specific 5-year survival of all and primary melanoma patients, log rank test). Journal of Investigative Dermatology 2015 135, 1358-1367DOI: (10.1038/jid.2014.552) Copyright © 2015 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 5 Eukaryotic translation initiation factor 4E (eIF4E) knockdown promotes apoptosis and inhibits cell proliferation in melanoma cells. MMRU (left column) and MMLH (right column) melanoma cells were transfected with eIF4E-specific siRNA (sieIF4E) or control small interfering RNA (siRNA) for two consecutive times, with the second time being 48 hours after the first. (a and d) Ninety-six hours after the first transfection, protein extracts were analyzed by western blotting. (b and e) Fourty-eight, 72, and 96 hours after the first transfection, cell proliferation was analyzed by sulforhodamine B assay. *P<0.05 and **P<0.01, Student’s t-test. (c and f) Ninety-six hours after the first transfection, cells were stained with propidium iodide and the percentage of apoptotic (sub-G1) cells was measured by flow cytometry. Top, quantification of apoptotic cells. Bottom, representative FACS images. **P<0.01 and ***P<0.001, Student’s t-test. Journal of Investigative Dermatology 2015 135, 1358-1367DOI: (10.1038/jid.2014.552) Copyright © 2015 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 6 Doxorubicin-induced apoptosis is enhanced in melanoma cells after eukaryotic translation initiation factor 4E (eIF4E) knockdown. (a and c) MMRU and (b and d) MMLH cells were transiently transfected with sieIF4E or control small interfering RNA (siRNA) for two consecutive times, with the second time being 48 hours after the first time. Seventy-two hours after the first transfection, cells were treated with 0.25 μg/ml doxorubicin for 24 hours. In addition, cells treated with non-silencing control siRNA (siC) alone or doxorubicin alone were included as controls. (a and b) The cells were fixed with 10% trichloroacetic acid for 1 hour, and cell proliferation was quantitated by sulforhodamine B staining or (c and d) cells were stained with propidium iodide and the percentage of apoptotic (sub-G1) cells was determined by flow cytometry. *P<0.05, Student’s t-test. dox, doxorubicin. Journal of Investigative Dermatology 2015 135, 1358-1367DOI: (10.1038/jid.2014.552) Copyright © 2015 The Society for Investigative Dermatology, Inc Terms and Conditions