Cyclooxygenase 2 plays a critical role in the development of gastrointestinal cancers in both human and animal models. About 80% of the gastric cancer showed a high level of expression of cyclooxygenase 2, but a subset of cases do not express without unknown reason. Aberrant methylation of CpG island of COX-2 was examined by using a series of gastric cancer cell lines and primary gastric cancers. Two out of 8 cell lines (25%) and 11 out of 93 (12%) primary cancers showed aberrant methylation of the 5 region of COX-2. Methylation of COX-2 was closely associated with loss of expression and treatment of methylation inhibitor, 5-deoxy-2 -azacytidine restored the expression of COX-2. A combined treatment of 5-deoxy-2 -azacytidine and a histone deacetylese inhibitor, trichostatin A, restored re-expression of the gene synergistically and chromatin immunoprecipitation analysis revealed that histone of methylated COX-2 promoter is deacetylated, indicating the role of cytosine methylation and histone deacetylation in the silencing of the gene. These results indicate that a subset of gastric cancer with COX-2 methylation evolves through the pathway that is independent of COX-2 expression and that COX-2 inhibitor may not be useful to induce apoptosis in these cases. © 2002 Wiley-Liss, Inc.
Key words: NSAID; chromatin, histone acetylation; methylator phenotypeCyclooxygenases are rate-limiting enzymes in the synthesis of prostaglandins. Two isoforms, cyclooxygenase 1 (COX-1) and cyclooxyganese 2 (COX-2), are involved in this process, 1 and COX-1 is the constitutive isoform expressed in various types of tissues, whereas COX-2 is an inducible enzyme. Overexpression of COX-2 has been reported in multiple types of gastrointestinal malignancies including colorectal, gastric, esophageal and pancreatic cancers. [2][3][4][5][6] Studies that used animal models indicate that COX-2 plays important roles in cell adhesion, apoptosis and angiogenesis. 7,8 Numerous epidemiological studies suggest that the use of nonsteroidal anti-inframatory drugs (NSAIDs) decreases the incidence of gastrointestinal cancers and COX-2 is recognized as a major target of NSAIDs. 9 Inhibition of COX-2 by NSAIDS or COX-2-specific inhibitors causes cell death in cancer cells, 10,11 indicating that COX-2 is an important molecular target for prevention and therapy in gastrointestinal cancers.The precise mechanism of how COX-2 expression is controlled remains unclear. Recent studies indicate that both positive and negative regulators are involve in the regulation of COX-2 expression. Among these, a signal pathway related to RAS/MAP kinase is demonstrated to up-regulate COX-2. 12 In addition, this pathway up-regulates COX-2 by increasing the stability of the transcript. 13 On the other hand, p53 has been demonstrated to down-regulate COX-2. 14 Therefore, activation of COX-2 can be partly explained by the alteration of several known oncogenes and tumor suppressor genes. Several lines of evidence suggest that COX-2 expression is not exclusive in all the tumors analyzed...