The role of interleukin-6 in the induction of hypercalcemia in renal cell carcinoma transplanted into nude mice Weissglas, M.G.; Schamhart, D.H.J.; Lowik, C; Papapoulos, S.; Theuns, H.; Kurth, K-H. Published in: Endocrinology DOI:10.1210/en.138.5.1879 Link to publication Citation for published version (APA):Weissglas, M. G., Schamhart, D. H. J., Lowik, C., Papapoulos, S., Theuns, H., & Kurth, K-H. (1997). The role of interleukin-6 in the induction of hypercalcemia in renal cell carcinoma transplanted into nude mice. Endocrinology, 138, 1879-1885. DOI: 10.1210/en.138.5.1879 General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. ABSTRACTHypercalcemia is a well known complication of renal cell carcinoma (RCC). As RCCs can produce IL-6, and IL-6 may stimulate bone resorption and cause mild hypercalcemia, we examined whether IL-6 is involved in renal cancer-associated hypercalcemia in vivo. Three human renal cell carcinoma tumor lines (RC-8, RC-9, and NC-65) growing in nude mice were studied. Tumors were implanted sc, and parameters of bone metabolism and serum human IL-6 levels were determined in relation to tumor volume (TV). All three tumor lines secreted human IL-6, although in different quantities. The maximum level of IL-6 in RC-8 was 434 pg/ml (TV, 200 mm 3 ), that in RC-9 was 81 pg/ml (TV, 1800 mm 3 ), and that in NC-65 was 2368 pg/ml (TV, 1800 mm 3 ). Hypercalcemia developed in RC-8 and RC-9 tumor-bearing animals, but not in NC-65-bearing animals. The hypercalcemia in both RC-8 and RC-9 tumor lines was associated with elevated levels of PTH-related peptide (PTHrP) and loss of trabecular bone volume.Serum calcium and phosphate concentrations showed an almost linear relationship with plasma PTHrP independently of the tumor line and serum IL-6 levels. No hypercalcemia occurred in the NC-65 animals, which had the highest levels of IL-6, but no detectable plasma PTHrP and PTHrP messenger RNA expression in the tumor. Administration of neutralizing antibodies to IL-6 to RC-8 animals normalized serum calcium concentrations and PTHrP values and induced a significant inhibition of tumor growth. No such effect on tumor growth of anti-IL-6 was seen in the other two tumor lines. The normalization of serum calcium in RC-8 mice is most likely attributed to the growthinhibit...
Hypercalcemia is a well known complication of renal cell carcinoma (RCC). As RCCs can produce IL-6, and IL-6 may stimulate bone resorption and cause mild hypercalcemia, we examined whether IL-6 is involved in renal cancer-associated hypercalcemia in vivo. Three human renal cell carcinoma tumor lines (RC-8, RC-9, and NC-65) growing in nude mice were studied. Tumors were implanted s.c., and parameters of bone metabolism and serum human IL-6 levels were determined in relation to tumor volume (TV). All three tumor lines secreted human IL-6, although in different quantities. The maximum level of IL-6 in RC-8 was 434 pg/ml (TV, 200 mm3), that in RC-9 was 81 pg/ml (TV, 1800 mm3), and that in NC-65 was 2368 pg/ml (TV, 1800 mm3). Hypercalcemia developed in RC-8 and RC-9 tumor-bearing animals, but not in NC-65-bearing animals. The hypercalcemia in both RC-8 and RC-9 tumor lines was associated with elevated levels of PTH-related peptide (PTHrP) and loss of trabecular bone volume. Serum calcium and phosphate concentrations showed an almost linear relationship with plasma PTHrP independently of the tumor line and serum IL-6 levels. No hypercalcemia occurred in the NC-65 animals, which had the highest levels of IL-6, but no detectable plasma PTHrP and PTHrP messenger RNA expression in the tumor. Administration of neutralizing antibodies to IL-6 to RC-8 animals normalized serum calcium concentrations and PTHrP values and induced a significant inhibition of tumor growth. No such effect on tumor growth of anti-IL-6 was seen in the other two tumor lines. The normalization of serum calcium in RC-8 mice is most likely attributed to the growth-inhibiting effect of anti-IL-6 on RC-8 tumor. We conclude that IL-6 secreted by RCC does not contribute directly to hypercalcemia, but may enhance hypercalcemia by stimulating the tumor growth of a subpopulation of PTHrP-secreting carcinomas.
Aims-To determine the expression of parathyroid hormone related protein (PTHrP) and interleukin-6 (IL-6) mRNAs and their possible relation in malignant tumours, derived from patients with and without hypercalcaemia, commonly associated with humoral hypercalcaemia of malignancy. Methods-PTHrP and IL-6 mRNA expression was studied by northern blot analysis in tumour specimens from 13 consecutive patients. Six patients (two with hypercalcaemia) had squamous cell carcinomas of the larynx and seven (one with hypercalcaemia) had renal cell carcinomas. Results-There was no relation between the histological features of the tumours and the expression of either PTHrP or IL-6 mRNAs. PTHrP mRNA was detected in all squamous cell carcinomas, expression being highest in the two patients with hypercalcaemia. In the renal cell carcinomas PTHrP mRNA was expressed only in the patient with hypercalcaemia. IL-6 mRNA was detected in nearly all tumours studied but there was no apparent relation between its expression and that of PTHrP mRNA or serum calcium con- These findings raise questions about the modulation of PTHrP gene expression in patients with hypercalcaemia and suggest that other factors may also be involved in the development of this condition.3 Previous studies in our laboratory have shown that the production and expression of PTHrP mRNA by squamous cell carcinoma cell lines could be enhanced by co-culturing these cells with fibroblasts.' 0" It may be that local soluble factors produced during the interaction between the epithelial and mesenchymal cells are responsible for the increased production of PTHrP. Such factors include cytokines and we recently showed that interleukin-6 (IL-6) production by fibroblasts is greatly enhanced during co-culture with keratinocytes by IL-1, which is secreted by most epithelial cells including squamous cell carcinomas.'2 Interleukin-6, which stimulates osteoclast formation," '4 is also a hypercalcaemic factor'5 and recently co-secretion of PTHrP and IL-6 has been reported in hypercalcaemic nude mice bearing a human renal cell carcinoma 6 and in a patient with phaeochromocytoma and HHM.'7To examine the possible relation between PTHrP and IL-6 in malignant tumours, we studied the expression of the two peptides by northern blot analysis in two types of tumours commonly associated with HHM. These were squamous cell carcinomas (larynx) and adenocarcinomas (renal cell) derived from patients with and without hypercalcaemia. MethodsIn this prospective study 13 patients (nine men (mean age 59 + 4 years) and four women (mean age 70 + 6 years)) were investigated. Six patients had histologically confirmed laryngeal squam-
Humoral hypercalcemia of malignancy is a paraneoplastic syndrome believed to be due to production by the tumor of substances that stimulate osteoclastic bone resorption primarily. The human renal cell carcinoma cell line RC-8, grown in nude mice, was investigated for factors involved in renal cancer-induced hypercalcemia. At a tumor load of 200 to 400 mm.3 the mice developed hypercalcemia and hypophosphatemia associated with a rise in serum 1,25-dihydroxyvitamin D concentration and cachexia. The tumor released 1) significant amounts of human interleukin-6 (IL-6) and 2) parathyroid hormone-related peptide (PTHrP) into the circulation. Cancer cells further expressed mRNA for both human IL-6 and PTHrP. No secretion of human tumor necrosis factor-alpha or interleukin-1 beta could be demonstrated in the circulation of the host. Antibodies to IL-6 caused a significant (p = 0.043) inhibition of tumor growth and decreased serum calcium concentrations compared with control animals. Our data suggest that IL-6 is involved, either directly or indirectly, in the development of hypercalcemia in renal cell carcinoma.
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