Purpose: The V600E BRAF mutant plays an important role in the pathogenesis of papillary thyroid cancer (PTC) and is associated with loss of expression of thyroid iodide-metabolizing genes. This study was done to investigate the restorability of expression of these genes by suppressing the BRAF/extracellular signal-regulated kinase kinase (MEK)/mitogen-activated protein (MAP) kinase pathway in V600E BRAF^harboring thyroid cells and to explore the mechanisms involved. Experimental Design: We used inducible expression of V600E BRAF, small interfering RNA transfection, and MEK-specific inhibitor to alter the MAP kinase pathway activities and subsequently examined the changes in expression, promoter activities, and methylation status of thyroid genes. Results: MEK inhibitor U0126 or cessation of V600E BRAF expression in PCCL3 cells restored expression of thyroid genes silenced by induced expression ofV600E BRAF. U0126 also restored the expression of these genes inV600E BRAF^harboring PTC-derived NPA cells. Knockdown of BRAF by specific small interfering RNA restored expression of some of these genes in NPA cells. Luciferase reporter assay using thyroid-stimulating hormone receptor gene as a model showed that the promoter activity was modulated by the MAP kinase pathway. Promoter methylation in association with DNA methyltransferase expression played a role in gene silencing by MAP kinase pathway in NPA cells.
Conclusions:We showed the restorability of expression of thyroid iodide-metabolizing genes silenced by V600E BRAF, and linked this process to gene methylation in PTC cells. The results provide clinical implications that therapeutic targeting at the BRAF/MEK/MAP kinase pathway may be a good approach in restoring thyroid gene expression for effective radioiodine therapy for BRAF mutation-harboring PTC.Papillary thyroid cancer (PTC) accounts for 80% of all thyroid cancers and is the most common endocrine malignancy, with a currently rapidly increasing incidence (1, 2). Following thyroidectomy, radioiodine ablation is the mainstay of medical treatment for PTC, but patients may fail it when the cancer has lost radioiodine avidity, a primary cause for thyroid cancerrelated morbidity and mortality (3,4). This radioiodine treatment takes advantage of the unique function of thyroid cells to uptake, concentrate, and organify iodide, a substrate normally used for synthesis of thyroid hormones. Several thyroid-specific protein molecules play a key role in this iodide-metabolizing process, including thyroid stimulating hormone receptor (TSHR), sodium iodide symporter (NIS), thyroglobulin (Tg), thyroperoxidase (TPO), and the thyroid gene transcription factors TTF-1 and Pax-8 (5). Loss of expression of the genes for these molecules is common in thyroid cancer and is a sufficient cause for the loss of radioiodine avidity and failure of radioiodine therapy in this cancer (6 -10). Thus, a novel approach leading to restoration of expression of these thyroid iodide-metabolizing genes would provide great hope for those pati...