ProNGF Correlates with Gleason Score and Is a Potential Driver of Nerve Infiltration in Prostate Cancer Jay Pundavela, Yohann Demont, Phillip Jobling,

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ProNGF Correlates with Gleason Score and Is a Potential Driver of Nerve Infiltration in Prostate Cancer Jay Pundavela, Yohann Demont, Phillip Jobling, Lisa F. Lincz, Severine Roselli, Rick F. Thorne, Danielle Bond, Ralph A. Bradshaw, Marjorie M. Walker, Hubert Hondermarck The American Journal of Pathology Volume 184, Issue 12, Pages 3156-3162 (December 2014) DOI: 10.1016/j.ajpath.2014.08.009 Copyright © 2014 American Society for Investigative Pathology Terms and Conditions

Figure 1 Immunohistochemical detection of precursor of nerve growth factor (proNGF). ProNGF was immunodetected in a series of 120 prostate cancers and benign prostate hyperplasia. Representative images are shown. A and B: Benign prostate hyperplasia (no staining in epithelial cells, 0). C: Gleason score 3+3 cancer (low intensity staining, 1). D: Gleason score 4+4 cancer (high intensity staining, 3). E: Gleason score 4+5 cancer (high intensity staining, 3). F: Gleason score 4+4 cancer (medium intensity staining, 2). Boxed areas show higher magnification of proNGF cellular staining. Quantitative image analyses of the tumors presented here are shown in Supplemental Figure S2. Prostate cancers and benign prostate hyperplasia (n = 120) were analyzed. Original magnification: ×100 (A–F); ×400 (boxed areas, A–F). The American Journal of Pathology 2014 184, 3156-3162DOI: (10.1016/j.ajpath.2014.08.009) Copyright © 2014 American Society for Investigative Pathology Terms and Conditions

Figure 2 Frequency distribution of precursor of nerve growth factor (proNGF) level according to Gleason score. ProNGF levels [0, no staining (white); 1, low intensity staining (light gray); 2, intermediate intensity staining (dark gray); and 3, high intensity staining (black)] were measured in epithelial cells of benign prostatic hyperplasia (BPH) and prostate cancers. A: Distribution according to Gleason score. Tumors with high Gleason scores of 7 and ≥8 (3+4, 4+3, 4+5, 5+4, 5+5) were more likely to have high proNGF expression than tumors with low Gleason scores (Gleason grades 3+3) and BPH. The calculated coefficient of correlation between proNGF staining intensity and Gleason score was τB = 0.51. B: Distribution according to Gleason grade. The proportion of tissue areas expressing high levels of ProNGF increased in Gleason grade 4 and 5 areas compared with Gleason grade 3 areas. ∗∗∗P < 0.001, Fisher's exact test; ∗∗∗∗P < 0.0005, χ2 test. The American Journal of Pathology 2014 184, 3156-3162DOI: (10.1016/j.ajpath.2014.08.009) Copyright © 2014 American Society for Investigative Pathology Terms and Conditions

Figure 3 Precursor of nerve growth factor (proNGF) production in prostate cancer cell lines. A: Western blot detects proNGF in normal prostate epithelial cells (PrECs), transformed nontumorigenic prostate epithelial cells (RWPE-1), benign prostate hyperplasia cells (BPH-1), and prostate cancer cells (LNCaP, DU415, PC-3). A major band is observed at 60 kDa and two other minor bands at 50 and 85 kDa. B: Densitometric quantification of proNGF. Normalization was performed relative to β-actin. The American Journal of Pathology 2014 184, 3156-3162DOI: (10.1016/j.ajpath.2014.08.009) Copyright © 2014 American Society for Investigative Pathology Terms and Conditions

Figure 4 Axonogenesis is induced by prostate cancer cells. A: Co-culture experiments were performed in Transwell Boyden chambers with PC-3 prostate cancer cells in the upper chamber and neuronal cells (PC12 or 50B11) in the lower chamber. Neurite outgrowth started after 3 days. B and C: After 4 days of co-culture, PC12 and 50B11 cells remain undifferentiated in the absence of PC-3 cells (control), and neurite outgrowth is observed in co-culture with PC-3 (+PC-3). This neurotrophic effect is diminished in the presence of anti-proNGF blocking antibodies (+PC-3 + anti-proNGF antibody), whereas the isotype control antibodies (+PC-3 + isotype antibody) do not inhibit axonogenesis. Arrows indicate neurites. D and E: Quantification of neurite outgrowth in PC12 and 50B11 cells. Experiments were performed in triplicate and data represent means ± SD. Analysis of variance test was used. ∗P < 0.05, ∗∗P < 0.01. The American Journal of Pathology 2014 184, 3156-3162DOI: (10.1016/j.ajpath.2014.08.009) Copyright © 2014 American Society for Investigative Pathology Terms and Conditions