Homozygous mutations in the Fhit gene results in resistance to ionizing radiation and inhibition of apoptosis

Abstract Purpose: The Fhit gene was identified because it represents the most active constitutive chromosome fragile site and has functions often associated with a tumor suppressor gene. Mutations in the Fhit locus have been identified in many cancer-derived cell lines, primary human tumors including lung, head and neck, colon, breast, and esophagus, and are associated with tobacco-induced lung cancers. In this study, we examined the cellular response of mouse epithelial cells with complete loss of Fhit to therapeutic doses of ionizing radiation and the prognostic importance of Fhit protein in early stage breast cancer patients treated with breast conserving therapy. Materials and Methods: Mouse epithelial cell lines containing either homozygous mutant Fhit−/− or wild-type Fhit+/+ were derived from mice (C57BL/6J X 129/SvJ) with either wild-type or inactivated Fhit gene. Clonogenic cell survival assays were carried out on subconfluent cells in logarithmic growth using a 137Cs irradiator and survival curves were plotted as the log of the surviving cells versus dose and corrected for cloning efficiency. Apoptosis following ionizing radiation was determined by flow cytometry using the Annexin-V FITC kit and DAPI staining. Paraffin-embedded breast tumor blocks were obtained from 42 women with local breast tumor recurrence and 42 matched breast cancer patients without local cancer relapse treated with breast conserving therapy and stained with a 1:4000 dilution of polyclonal antibody to the Fhit protein and scored based on both intensity and distribution of Fhit staining within the invasive breast cancer component. Results: Treatment of Fhit−/− mouse epithelial cells with single fraction doses of ionizing radiation including 2, 4, 6, and 10 Gy result in 4-6 fold increase in cellular survival compared with isogenic parental cells from Fhit+/+ mice. Fhit−/− epithelial cells displayed 3-5 fold lower levels of apoptosis in response to both low and high doses of ionizing radiation compared to parental mammalian cells expressing wild-type Fhit protein. Finally, we demonstrated that breast tumors from breast cancer patients with local breast tumor recurrences following breast conserving therapy more often lacked immunhistochemical detection of Fhit protein compared to tumors from breast cancer patients without local breast cancer recurrence (p=0.02). Interestingly, the adjacent benign regions of these sections contained similar levels of Fhit protein expression suggesting that a somatic alteration is critical in the clinical resistance to ionizing radiation observed in these patients. Apoptotic pathways regulating the aberrant response to DNA damage-induced apoptosis in Fhit knock-out cells are currently being studied. Conclusion: Mouse epithelial cells containing homozygous Fhit mutations are resistant to single fraction low and high dose ionizing radiation with decreased levels of radiation-induced apoptotic cell death. Breast tumors from women with local breast cancer recurrence following breast conserving therapy have low levels of Fhit protein. These findings may have important biologic and treatment implications including those for cancer patients with tumors having mutations in Fhit and suggest that treatment with ionizing radiation in these patients may not result in optimal responses.