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ABSTRACT. We used a proteomic approach to compare the differentially regulated protein expression profiles of cisplatin-naïve and cisplatin-resistant bladder ...
Biomedical Research (Tokyo) 36 (4) 253-261, 2015

Protein expression profile related to cisplatin resistance in bladder cancer cell lines detected by two-dimensional gel electrophoresis Yoshinori TAOKA1, Kazumasa MATSUMOTO1, Kazuya OHASHI2, Satoru MINAMIDA1, Masahiro HAGIWARA1, Shoji NAGI1, Tatsuya SAITO2, Yoshio KODERA2, and Masatsugu IWAMURA1 1

Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan and 2 Department of Physics, Kitasato University School of Science, Sagamihara, Kanagawa 252-0373, Japan (Received 9 June 2015; and accepted 17 June 2015)

ABSTRACT We used a proteomic approach to compare the differentially regulated protein expression profiles of cisplatin-naïve and cisplatin-resistant bladder cancer cell lines to screen candidate molecules related to cisplatin resistance. The cisplatin-resistant cell line T24 was established by the stepwise exposure of T24 cells to up to 40 μM of cisplatin. We performed a comprehensive study of protein expression in bladder cancer cell lines that included cisplatin-naïve (T24) and cisplatin-resistant cells (T24CDDPR) by means of agarose two-dimensional gel electrophoresis followed by analysis of liquid chromatography tandem mass spectroscopy. We identified 25 obviously different spots for T24 and T24 CDDPR. Seven spots had increased expression and 18 spots had decreased expression in T24CDDPR compared to those in T24. Cytoskeletal proteins and enzyme modulators were prominent among differential proteins. Of the 25 proteins, we selected HNRNPA3, PCK2, PPL, PGK1, TKT, SERPINB2, GOT2, and EIF3A for further validation by Western blot. HNRNPA3, PGK1, TKT, and SERPINB2 had more than 1.5-times incremental expression in T24CDDPR compared to that in T24. PCK2 and PPL expressions were decreased less than 20% in T24CDDPR compared to that in T24. The results of 25 new proteins in this study could be valuable and could lead to the development of a new molecular marker.

Bladder cancer is the second most common malignant tumor in the urologic field. Patients with locally advanced bladder cancer at diagnosis will subsequently have development of local progression or distant metastases. In patients with advanced cancer, chemotherapy is the treatment of choice. Since cisdiamminedichloroplatinum, known as cisplatin, for the treatment of testicular and bladder cancers was approved by the Food and Drug Administration in 1978, platinum-based drugs have been the main treatment administered against a variety of cancers (3). Address correspondence to: Kazumasa Matsumoto, M.D. Department of Urology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan Tel: +81-42-778-9091, Fax: +81-42-778-9374 E-mail: [email protected]

Cisplatin-based chemotherapy, including methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) or gemcitabine and cisplatin (GC), is an effective and frequently used modality for advanced and metastatic bladder cancer (21).  However, resistance to chemotherapeutic agents is a major clinical problem in the effective management of cancer. Long-term follow-up has been reported in patients with advanced bladder cancer, but progression-free survival and overall survival have not been satisfactory (16). To overcome drug resistance, alteration of chemotherapy has been performed, including increased dose, shortened intervals, or a variety of combination strategies. Unfortunately, in terms of bladder cancer, there are no established therapeutic modalities for patients with progression or recurrence after cisplatin-based treatment (5, 8).  Proteomics using cancer specimens is promising

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for detecting clinically available biomarkers, which eventually provide the information for an appropriate clinical choice and development of innovative therapy. Such a proteomic approach has been used not only for a host of tumor tissue biopsy specimens but also for cultured tumor cells. To identify appropriate proteins for biomarkers, we utilized a unique two-dimensional gel electrophoresis (2-DE) method that uses an agarose gel for isoelectric focusing on the first dimension. Agarose 2-DE can analyze much larger quantities of proteins (up to 1.5 mg) and a wider dynamic range than conventional 2-DE (14). In our previous studies, proteomic analyses were continuously investigated in urothelial carcinoma to identify the candidates for biomarkers, including proteins, sera, and autoantibodies (11, 14, 19, 20).  In this present study, we used a proteomic approach to compare the differentially regulated protein expression profiles of cisplatin-naïve and cisplatinresistant bladder cancer cell lines to screen candidate molecules related to cisplatin resistance. MATERIALS AND METHODS Cell line and cell culture. Human bladder cancer cell lines T24, RT4, 5637, and TCCSUP were purchased from American Type Culture Collection. EJ was kindly gifted from the Kitasato Institution Hospital (Dr. Akira Irie). The cisplatin-resistant cell line T24 (T24CDDPR) was established by the stepwise exposure of T24 cells to 13.3 μM, 26.6 μM, and 40 μM of cisplatin (12). RT4ρ0, which was deleted in mitochondrial DNA, was established from RT4 using continuous exposure of ethidium bromide in conditional medium additionally supplemented with 50 μg/mL uridine and 100 μg/mL sodium pyruvate (1). These cells were maintained in RPMI 1640 medium supplemented with 10% fetal bovine serum (GIBCO BRL), penicillin (100 U/mL), and streptomycin (100 μg/mL) at 37°C in a 5% CO2 humidified incubator. Sample preparation. Bladder cancer cell lines approximately 20 mg in weight were homogenized using a Teflon glass homogenizer in an extracting solution with 30-fold volume. The extraction solution contained 7 M urea, 2 M thiourea, 0.1 M DTT, 2.5% w/v Pharmalyte (pH 3–10), 2% w/v CHAPS, and Complete Mini EDTA-free protease inhibitor (Roche Diagnostics, Mannheim, Germany), one tablet of which was dissolved in 10 mL of the solution. After homogenization, each homogenate was subjected to rapid agitation in the presence of 0.35-mm

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to 0.50-mm glass beads (As One Corporation, Osaka, Japan) and centrifuged at 112,000×g for 20 min. The supernatants were subjected to agarose 2-DE. Agarose 2-DE and MS/MS analysis. Protein extracts were separated by agarose 2-DE. The isoelectric focusing of the first dimension used an agarose gel, and that of the second dimension used an SDS-PAGE gel. We used 12% SDS-PAGE gel for the proteins weighing between 30 kDa and 100 kDa, and we used a linear gradient of 6% to 10% SDS-PAGE gel for the proteins weighing more than 50 kDa. Agarose 2-DE was performed on three sets of T24 and T24CDDPR bladder cancer cell lines. The slab gel was stained with CBB R-350 (PhastGel Blue R; GE Healthcare, Little Chalfont, UK). We calculated the molecular weight of the protein spot using CS analyzer 2.0 (Atto, Tokyo, Japan) computer software. We subjected each spot to protein digestion and tandem mass spectroscopy (MS/MS) analysis using a liquid chromatography tandem mass spectroscopy (LC-MS/MS) system, which consisted of a Nanospace SI-2 HPLC system (Shiseido Fine Chemicals, Tokyo, Japan) and an ion-trap mass spectrometer (LCQ Deca; Thermo Fisher Scientific, San Jose, CA, USA).  We used the SEQUEST search program to identify each protein. SEQUEST referenced the nr.Z and Swiss-Prot.Z protein sequence databases downloaded from ftp://ftp.ncbi.nih.gov/blast/db/. The two criteria used to judge whether our identification was successful were as follows: 1) the SEQUEST score was more than 50; and 2) at least two peptide fragments were reliably detected. If the SEQUEST score was less than 50, then we confirmed that there were more than two high-quality and reliable MS/MS spectra available. If there were several names for a single protein, then the most popular one was applied for analysis. Theoretical molecular weight was calculated from the amino acid sequence. Accession numbers were obtained from the protein database on the UniProt Web page (http://www.uniprot.org/). Sequence coverage shows the accordance rate of peptides confirmed by MS/MS analyses in amino-acid sequences of candidate proteins. Peptide-spectrum matches were obtained from the total number of identified peptide sequences for the protein, including those redundantly identified. Select proteins. To select proteins, we first excluded myosin or cytokeratin, which were broadly investigated in the field of protein analysis. Then, proteins with expression that obviously increased or de-

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Fig. 1 Two-dimensional electrophoresis gels (2-DE) shows 30 proteins with differential expression of cisplatin-naïve T24 (a, c) and cisplatin-resistant T24 (b, d). The 2-DE gels show 20 spots in 12% gels (a, b) and 10 spots in a linear gradient of 6% to 10% gels (c, d). Red arrow shows increased cisplatin-resistant T24 and blue arrow shows decreased cisplatin-resistant T24.

creased in 2-DE were selected. Finally, we searched PubMed for relevant articles published up until February 2015. The following search terms and their combinations were used: each protein name and “bladder cancer”; “urothelial carcinoma”; or “cisplatin.” Inclusion criteria for further immunoblotting were as follow: less than 10 articles matched protein names with “bladder cancer” or “urothelial carcinoma” and less than five articles matched protein names with “cisplatin.” From these searches, we selected eight proteins for immunoblotting. Immunoblotting. Cell line samples were homogenized with a Teflon glass homogenizer in sample buffer (50 mM Tris-HCl, pH 6.8, 0.1 M DTT, 10% glycerol, 2% SDS, and 0.1% bromophenol blue). Protein extracts were separated under denaturing conditions in 10% to 20% polyacrylamide slab gel (DRC, Tokyo, Japan). The SDS-PAGE gel was run with a constant voltage of 300 V. After completion of electrophoresis, proteins were transferred onto HybondP PVDF membranes (GE Healthcare) and detected with mouse monoclonal antibodies against phosphoenolpyruvate carboxykinase (PCK2) (1 : 100; Abgent, San Diego, CA, USA), heterogeneous nuclear

ribonucleoprotein A3 (HNRNPA3) (1 : 200; Abcam, Cambridge, UK), glutamate oxaloacetate transaminase 2 (GOT2) (1 : 1000; Abnova, Taipei City, Taiwan), phospoglycerate kinase 1 (PGK1) (1 : 200; Abgent, San Diego, CA, USA), transketolase (TKT) (1 : 100; Abcam), plasminogen activator inhibitor 2 (SERPINB2) (1 : 1000; Novusn Biologicals, Littleton, CO, USA), eukaryotic translation initiation factor 3 subunit A (EIF3A) (1 : 5000; Santa Cruz Biotech, Dallas, TX, USA), or periplakin (PPL) (1 : 1000; Novusn Biologicals). Horseradish peroxidase–conjugated secondary antibodies (Dako, Glostrup, Denmark) were diluted 1 : 10,000 (2% normal swine serum/TBS). For the calibration of each lane, we obtained rabbit anti-β actin monoclonal antibody (Cell Signaling Technology, Danvers, MA, USA). Antigens on the membrane were detected with Immobilon Western detection reagents (Millipore, Billerica, MA, USA). RESULTS Identification of cisplatin-related protein in cisplatinnaïve and cisplatin-resistant bladder cancer cell lines Protein expressions were quite different for T24 and

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T24CDDPR on 2-DE gels (Fig. 1). We compared 2-DE gels of both cell lines and selected 20 spots in 12% gels and 10 spots in a linear gradient of 6% to 10% gels. There were 30 obviously different spots for T24 and T24CDDPR. Eight spots had increased expression and 22 spots had decreased expression in T24CDDPR compared to that in T24. Characteristics of these spots are shown in Table 1. Because five of these spots were duplicated, 25 spots were finally selected.  The 25 proteins, which were differentiated protein expressions of T24 and T24CDDPR, were categorized as 10 functions. The categories were as follows: seven cytoskeletal proteins (Spot No. 8(24), 9(25), 10(28), 12, 13, 26, 27); five enzyme modulators (Spot No. 16, 17, 18, 22, 23); four transferases (Spot No. 3, 4, 11(29), 15); two nucleic acid–binding proteins (Spot No. 2, 14); two transporter proteins (Spot No. 7, 20); one oxidoreductase (Spot No. 1); one protein synthesis (Spot No. 5); one lyase (Spot No. 6); one coagulation factor (Spot No. 19(30)); and one translation factor (Spot No. 21). Of the 25 proteins, we selected HNRNPA3, PCK2, PPL, PGK1, TKT, SERPINB2, GOT2, and EIF3A for further validation by Western blot. Validation of differentiated protein expression To further verify the identified proteins, Western blotting analysis was performed to determine the existence of these eight proteins in T24 or T24CDDPR. Representative results are shown in Fig. 2. The results showed that HNRNPA3, PGK1, TK, and SERPINB2 had more than 1.5-times the incremental expression in T24CDDPR compared to that in T24. PCK2 and PPL had less than 20% decreased expressions in T24CDDPR compared to that in T24. GOT2 and EIF3A had comparable expressions in the two cell lines.  Western blot analysis was also performed to determine six protein expression patterns in various bladder cancer cell lines (Fig. 3). HNRNPA3, TKT, SERPINB2, and PPL were expressed in all bladder cancer cell lines. PCK2 was expressed in two other cell lines. In terms of PGK1, there was slight expression or loss of expression in bladder cancer cell lines (except for T24).  Expression levels of four proteins in T24CDDPR in three different concentrations of cisplatin were investigated (Fig. 4). HNRNPA3 and PGK1 showed increased expression irrespective of the exposure of cisplatin concentration. PCK2 and PPL demonstrated gradually decreased expression, which correlated with the exposure of cisplatin concentration.

DISCUSSION Proteomics research is a new biological modality that contributes greatly to our understanding of gene functions in the post-genomic era and that focuses on protein expression and post-translational modification. There is an increasing interest in proteomic techniques because the cells could express the function of proteins in various ways, but DNA sequence information provides a static frame. The detection of proteins was based on the consideration that cells could produce specific proteins to exert specific functions. When cells encounter unusual situations, they try to adjust by expressing proteins that may help to deal with the new situation. Such proteins, specifically synthesized on demand, may indicate characteristic disease states and thus may serve as diagnostic markers.  Identifying anti-cancer drug resistance proteins using proteomic techniques in bladder cancer has been performed in recent reports. Miura et al. (13) identified 36 differentially expressed proteins; 21 proteins were upregulated and 15 were downregulated in HT1376 cisplatin-resistant bladder cancer cell lines exposed to 5 μM cisplatin. They reported that adseverin (SCIN), which is a calcium-dependent actin-binding protein, was upregulated four-fold in cisplatin-resistant cells compared to cisplatin-naïve cells. The mitochondrial fraction was more increased than the cytoskeletal fraction among the differentiated proteins. Meng et al. (10) identified 30 proteins (19 upregulated and 11 downregulated proteins) in pumc91 bladder cancer cell lines exposed to 1.0 mg/L adriamycin. They demonstrated that annexin A2 (ANXA2), a calcium-dependent phospholipid-binding protein, and nucleophosmin (NPM1), a nonribosomal nucleolar phosphoprotein, were upregulated in adriamycin-resistant cells compared to adriamycin-naïve cells. Transferase and oxidoreductase were prominent fractions among differential proteins. These proteins, described in previous reports (10, 13), play important roles in apoptosis and cell proliferation. Once cancer cells acquire a resistance to anti-cancer drugs because of a changing protein profile, they show unregulated and aggressive behavior, resulting in patients suffering from bulky tumors after local progression and distant metastasis.  In this study, we performed a proteomics analysis to identify differential protein expressions of cisplatin-naïve and cisplatin-resistant bladder cancer cell lines. We successfully identified 25 proteins with significantly altered expression levels. Based on their functions, these proteins are mainly involved

80,000

42,000

30

46,567

77,209

48,029

204,526

226,392

51,304

30,760

47,140

57,901

166,469

71,413

46,567

37,074

67,835

44,587

47,446

39,595

32,658

44,066

51,304

30,760

44,840

70,592

95,278

40,397

55,955

44,939

Plasminogen activator inhibitor 2

Protein-glutamine gamma-glutamyltransferase 2

Keratin, type I cytoskeletal 18

Periplakin

Myosin-9

Keratin, type II cytoskeletal 7

Keratin, type II cytoskeletal 8

Alpha-enolase

Pyruvate kinase PKM

Eukaryotic translation initiation factor 3 subunit A

Cytoplasmic dynein 1 intermediate chain 2

Plasminogen activator inhibitor 2

Aldo-keto reductase family 1 member C4

Transketolase

Phosphoglycerate kinase 1

Aspartate aminotransferase, mitochondrial

Heterogeneous nuclear ribonucleoprotein A3

Tropomyosin alpha-1 chain

Keratin, type I cytoskeletal 19

Protein-glutamine gamma-glutamyltransferase 2

Keratin, type I cytoskeletal 18

Keratin, type II cytoskeletal 7

Keratin, type II cytoskeletal 8

DnaJ homolog subfamily A member 1

Phosphoenolpyruvate carboxykinase

Elongation factor 2

Phosphoserine aminotransferase

Serine hydroxymethyltransferase

Plasminogen activator inhibitor 1 RNA-binding protein

Sulfide:quinone oxidoreductase

Protein Name

SERPINB2

TGM2

KRT18

PPL

MYH9

KRT7

KRT8

ENO1

PKM

EIF3A

DYNC1I2

SERPINB2

AKR1C4

TKT

PGK1

GOT2

HNRNPA3

TPM1

KRT19

TGM2

KRT18

KRT7

KRT8

DNAJA1

PCK2

EEF2

PSAT1

SHMT2

SERBP1

SQRDL

G.N.

108.2

208.26

266.27

72.20

268.26

222.22

272.28

178.23

202.22

220.27

110.2

108.2

60.2

186.21

190.25

110.23

142.3

58.3

204.3

168.3

160.2

154.2

206.2

168.3

104.2

268.28

190.2

200.3

182.24

146.2

Score

P05120

P21980

P05783

O60437

P35579

P08729

P05787

P06733

P14618

Q14152

Q13409

P05120

P17516

P29401

P00558

P00505

P51991

Q9Y427

P08727

P21980

P05783

P08729

P05787

P31689

Q16822

P13639

Q9Y617

P34897

Q8NC51

Q9Y6N5

Accession No.

29.74

25.32

58.57

5.81

5.81

37.87

52.39

16.3

44.03

16.3

23.23

29.74

9.49

25.68

38.25

26.82

31.78

12.45

53.65

25.25

42.57

30.65

52.83

41.15

16.93

27.42

37.38

32.09

35.71

27.58

Seq. Cov. (%)

11

21

27

 8

27

23

28

18

21

24

11

11

 6

19

19

11

15

 6

21

18

16

16

21

17

11

27

20

21

20

16

PSMs

Increase

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Increase

Increase

Increase

Increase

Increase

Increase

Increase

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Decrease

Status

Spot No., spot number; M.W. (Obs.), observed molecular weight; M.W. (Theo.), theoretical molecular weight; G.N., gene name; Score, SEQUEST score; Accession No., accession number; Seq. Cov. (%), sequence coverage; PSMs, peptide-spectrum matches; Status, change in the expression levels of the protein in cisplatin-resistant T24 compared to that in T24.

45,000

29

42,000

19

28

40,000

18

210,000

70,000

17

220,000

45,000

16

27

45,000

15

26

43,000

14

49,000

41,000

13

40,000

42,000

25

80,000

11

12

24

45,000

10

45,000

49,000

09

55,000

40,000

08

23

45,000

07

22

70,000

06

70,000

95,000

05

150,000

41,000

04

21

77,209

47,000

03

20

48,029

45,000

02

49,929

43,000

01

M.W. (Theo.)

M.W. (Obs.)

Spot No.

Table 1 Protein expression profile in cisplatin-resistant T24 compared to that in T24

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Fig. 2 Differentially expressed representative proteins, PCK2 (A) and HNRNPA3 (B). (a) Two-dimensional electrophoresis gel. (b) Gel images, enlarged in triplicate, of the area containing protein spots. Red arrow shows increased expression and blue arrow shows decreased expression. (c) Western blot. (d) Protein expression levels calculated from Western blot.

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Fig. 3 (a) Protein expression in various bladder cancer cell lines using Western blot. Protein was applied to each column (20 μg). Lane 1: cisplatin-naïve T24, Lane 2: cisplatin-resistant T24, Lane 3: RT4, Lane 4: RT4ρ0, Lane 5: 5637, Lane 6: EJ, Lane 7: TCCSUP. (b) Table shows protein expression levels. Each protein level is calculated from Western blot and compared to the level of T24.

in cytoskeletal proteins and enzyme modulators. Some of these proteins have been reported to be associated with chemotherapy resistance in previous proteomic studies (10, 13). Our study also found several novel candidate resistance-associated proteins. Using PubMed, HNRNPA3 and PCK2 showed no match with “bladder cancer” or “urothelial carcinoma” and only showed one match with “cisplatin”; there was one study of HNRNPA3 with cisplatin, reporting that the expression of HNRNPA3 was upregurated in cisplatin-resistant breast cancer cells (18). These proteins need to validate whether proteins would contribute to responding to anti-cancer therapy. The analysis of protein changes after treatment may aid in clinical decisions and may possibly facilitate optimized personalized treatments.  More than 20 distinct HNRNPs have been identified in human cells, designated HNRNPA1 to HNRNPU in increasing molecular size from 32 to 110 kDa. HNRNPs are RNA-binding proteins (RBP) that are essential players in mRNA metabolism, acting as coordinators of post-transcriptional events by participating in an extensive network of RNA–RBP inter-

action. Individual HNRNPs also function in several other cellular processes, like transcription, DNA repair, telomere biogenesis, and cell signaling (2, 4, 6). As a consequence of their multiple roles in the regulation of gene expression, expression levels of HNRNP are tightly linked to cell proliferation (4). Our findings showed HNRNPA3 overexpression, which may acquire biological aggressiveness after exposure to cisplatin in bladder cancer cells.  PCK activity, which catalyzes the conversion of oxaloacetate to phosphoenolpyruvate, is distributed in cytosol and mitochondria as a result of two enzymatically indistinct isozymes, PCK1 and PCK2 (9). PCK2 is important for maintaining cell progression and survival, especially under stress conditions. Our results showed downregulation of PCK2 using cisplatin-resistant bladder cancer cell lines. Park et al. (15) investigated the association of PCK2 expression with chemoradiation response using 5-fluouracyl (5-FU). They reported that downregulation of PCK2 may be linked to induced 5-FU resistance, but not to intrinsic 5-FU susceptibility, in colon cancer cells. Because low energy metabolism and slow

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Fig. 4 (a) Protein expression in various resistance levels of bladder cancer cell lines using Western blot. Protein was applied (20 μg) in each column. Lane 1: cisplatin-naïve T24, Lane 2: cisplatin-resistant T24 using 13.3 μM of cisplatin, Lane 3: cisplatin-resistant T24 using 26.6 μM of cisplatin, Lane 4: cisplatin-resistant T24 using 40.0 μM of cisplatin. (b) Table shows protein expression levels. Each protein level is calculated from Western blot and compared to the level of T24.

proliferation can decrease the susceptibility to chemotherapy (17, 22), PCK2 downregulation could lead to slow energy metabolism and may subsequently reduce the susceptibility to anti-cancer drugs.  Cisplatin resistance is most often multifactor, multistep, and multipathway (3). In our study, we found proteins possibly correlated with cisplatin resistance and showed that each protein demonstrated each behavior in various concentrations of cisplatin. For example, periplakin, which is involved in cellular movement and attachment (7), showed gradually decreased expression correlated with the concentration of cisplatin and, on the contrary, HNRNPA3 showed incremental expressions. This finding suggests that each protein would be preferentially expressed at the time of exposure level of cisplatin, and that it might be difficult to completely inhibit a single mechanism regulating cisplatin resistance to restore the susceptibility.  The results could lead to the development of a new molecular marker. This would be an important step in establishing a treatment strategy for patients with advanced cancer. However, it is unlikely that

all the detected proteins would be related to cisplatin resistance. We observed that cancer cells chemically changed the protein profile, and we think of this as “cisplatin resistance.” In addition, our results demonstrated that a variety of protein characteristics contributed to resistance, including high molecular weight and complex protein profile (10, 13). Finally, the observed proteins were not noted to be fully shared by other cancer models because of the heterogeneity of cancerous cells. Further studies are warranted to determine the potential application of altered proteins that are possibly connected to cisplatin resistance. Acknowledgment This study was supported in part by a Grant-in-Aid for Scientific Research C (15K10607) from The Japan Society for the Promotion of Science (to K. Matsumoto).

Cisplatin-related proteins

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