Epidermal Growth Factor Receptor Tyrosine Kinase Inhibition Up-regulates Interleukin-6 in Cancer Cells and Induces Subsequent Development of Interstitial Pneumonia
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Yukari Ishiguro1,3,*, Hitoshi Ishiguro2,3,*, and Hiroshi Miyamoto3
1 Department of Biology and Function in the Head and Neck, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
2 Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
3 Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York
* Y. I. and H. I. contributed equally to this work.
Yukari Ishiguro, email:
Keywords: fibrosis, EGFR-TKI, IL-6, cytokine, side-effect
Received: March 15, 2013 Accepted: March 29, 2013 Published: March 31, 2013
Acute interstitial pneumonia is one of serious side effects of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment, while it often has significant clinical benefit in cancer patients. Therefore, it is necessary to clarify underlying mechanisms for the development of the adverse effects by EGFR-TKI. In the present study, we attempted to determine how EGFR-TKI treatment in cancer cells induced interstitial pneumonia. The growth of tongue cancer HSC-3 and lung cancer A549 cell lines treated with EGFR-TKI was assessed by MTT assay. Cytokines and growth factors in conditioned medium obtained from EGFR-TKI-treated cancer cells were analyzed using cytokine membrane array and ELISA. Interleukin-6 (IL-6) promoter activity was measured by luciferase assay. We found that EGFR-TKI treatment significantly decreased the cell viability yet increased expression levels of IL-6 protein and mRNA, IL-6 secretion, and IL-6 transcriptional activity in these lines. In addition, using the co-culture model and IL-6 treatment was found to increase the expression of collagen and α-actin, which were markers for fibrosis, in lung fibroblast cells. These results suggest that up-regulated IL-6 plays an important role in the development of EGFR-TKI-induced interstitial fibroblastic proliferation. Therefore, blocking of IL-6 signaling could be beneficial to cancer patients undergoing EGFR-TKI treatment for reducing the risk of its unfavorable effects.
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