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Vol. 11, Issue 8, 2543-2551, August 2000

§
*Department of Radiation Oncology, Division of Cancer Biology,
University of Michigan Comprehensive Cancer Center, and
Program in Cellular and Molecular Biology, University of
Michigan Medical School, Ann Arbor, Michigan 48109-0936
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ABSTRACT |
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We have previously shown that the tumor suppressor p53 can play a protective role against UV-induced apoptosis in human fibroblasts. In the present study, we investigated whether the protective function of p53 expression is established before or after UV irradiation. Using a stable human cell line expressing a murine temperature-sensitive p53 in which p53 function could be tightly and reversibly regulated, we found that functional p53 stimulated the induction of apoptosis when expressed for as little as 4-12 h after UV irradiation and that this induction was not dependent on de novo protein synthesis. In contrast, expression of p53 for 12 h or more before UV irradiation reduced the extent of apoptosis even when functional p53 expression was maintained after irradiation. The protection conferred by p53 required ongoing protein synthesis and correlated with enhanced recovery of mRNA synthesis. Together, these results suggest that p53 induces distinct proapoptotic and antiapoptotic signals and that these opposing activities can be separated both temporally and by their requirement for de novo protein synthesis. These findings may have important implications for the refinement of gene therapy approaches combining p53 with pharmacological agents that target transcription or translation.
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INTRODUCTION |
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The p53 tumor-suppressor gene is the most commonly altered gene in
malignancy (Hollstein et al., 1996
). The tumor-suppressive function of p53 can be attributed in part to its participation in the
cellular response to DNA damage. In response to DNA strand breaks or
transcription blocking DNA damage, such as UV light-induced photoproducts, p53 accumulates through a posttranscriptional mechanism (Levine, 1997
; Ljungman, 2000
). The p53 protein can act as both an
activator and a repressor of transcription (Levine, 1997
). The
transactivation function of p53 has been suggested to play a role in
the regulation of the G1 and
G2 cell cycle checkpoints (Levine, 1997
; Bunz
et al., 1998
), the induction of apoptosis (Miyashita
et al., 1994
; Owen-Schaub et al., 1995
; Sheikh
et al., 1998b
), and the stimulation of nucleotide excision
repair (NER) (Hwang et al., 1999
).
In addition to its role as a stress-inducible regulator of
transcription, p53 may also be able to participate directly in NER and
other cellular processes independent of its ability to act as a
transcription factor (Caelles et al., 1994
; Wang et
al., 1995
, 1996
; Chen et al., 1996
; McKay et
al., 1999
). Furthermore, p53 can regulate the basal level of
expression of p53-responsive genes such as
p21WAF1 and p48XPE in
unstressed cells (Tang et al., 1998
; Hwang et
al., 1999
). This implies that p53 may regulate cellular processes
without being activated by DNA damage and thus may be biologically
important even before sustaining DNA damage.
To further study the role of p53 in the regulation of apoptosis after
exposure to UV light, a stable HT29 colon carcinoma subline expressing
a temperature-sensitive allele of murine p53 (Merchant et
al., 1996
) was used. This temperature-sensitive p53 is fully
active and nuclear at the permissive temperature of 32°C, whereas it
is inactive and localized in the cytoplasm at the nonpermissive temperature of 38°C (Gannon and Lane, 1991
; Ginsberg et
al., 1991
; Martinez et al., 1991
). This system
permitted the rapid switching from mutant to wild-type p53 conformation
at the permissive temperature without inducing apoptosis and further
permitted the rapid loss of p53 function at the restrictive
temperature. Using this model system, we show that p53 expression
before UV irradiation protected cells against UV irradiation, whereas
p53 expression exclusively after UV irradiation stimulated UV-induced
apoptosis. These results suggest that wild-type p53 expression in
unstressed cells has an impact on the UV-induced p53 response.
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MATERIALS AND METHODS |
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Cell Culture
The two cell lines used in this study, HT29-neo and HT29-tsp53
(formerly referred to as ts29-G cells), were derived from the human
colon cancer cell line HT29 (Merchant et al., 1996
). Both cell lines were maintained at 38°C (nonpermissive temperature) in
RPMI-1640 supplemented with 10% FBS and antibiotics
(penicillin/streptomycin).
UV Irradiation
Subconfluent cells, seeded 2 d before UV irradiation, were
irradiated without medium at room temperature with a germicidal UV
light (Philips, New York, NY) emitting at 254 nm at a rate of
0.6 J·m
2·s
1 (UVX
radiometer, UVP, San Gabriel, CA).
Western Blots
Thirty micrograms of total cellular protein was loaded per well
in 15% polyacrylamide gels. Proteins were transferred to Immobilon-P membrane (Millipore, Bedford, MA) overnight at 4°C. Detection of
proteins was performed as described previously (Ljungman et al., 1999
). The antibodies used were raised against p53 (p53 AB-2; Oncogene Research Products, Cambridge, MA),
p21WAF1 (WAF1 AB-1; Oncogene Science), Bax (Bax
N20; Santa Cruz Biotechnology, Santa Cruz, CA), and
-actin (clone
AC-74; Sigma Chemical, St. Louis, MO).
Measurements of Apoptosis
Apoptosis was scored 48 h after UV irradiation either by
assessing the fraction of cells with a sub-G1 DNA
content by flow cytometry or by estimating the extent of DNA
fragmentation with the use of agarose gel electrophoresis (Chung
et al., 1998
).
Bromodeoxyuridine Labeling and Flow Cytometry
Cells were incubated for either 15 min or 12 h with 30 µM
bromodeoxyuridine (BrdU; Sigma) at 37°C to label nascent DNA
synthesis, fixed, and analyzed by flow cytometry, as described
previously (Chang et al., 1999
). The antibodies used were
anti-BrdU (diluted 1:100; PharMingen, San Diego, CA) and an
FITC-conjugated anti-mouse immunoglobulin G (diluted 1:15; Sigma). The
samples were assessed by two-parameter flow cytometry for FITC (DNA
synthesis) and propidium iodide (DNA content) signals with the
use of a Coulter Epics Elite Cell Sorter and the Multicycle Software
package (Phoenix Flow Systems, San Diego, CA).
Measurements of mRNA Synthesis
Cells, incubated with 185 Bq/ml
[14C]thymidine (Amersham Pharmacia Biotech,
Uppsala, Sweden) for 2 d to label cellular DNA, were
sham-irradiated (control) or irradiated with 20 J/m2 UV light. Nascent mRNA was labeled for 30 min with [3H]uridine (Amersham Pharmacia
Biotech) and was subsequently isolated from cell lysates with the use
of the Straight A's mRNA isolation system (Novagen, Madison, WI).
[3H]Uridine incorporation into poly(A) RNA was
quantified with a scintillation counter as described previously
(Ljungman et al., 1999
).
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RESULTS |
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Role for p53 in UV-induced Apoptosis
First, we examined whether the timing of functional p53 expression
could be tightly regulated in the HT29-tsp53 cell system used in this
study. At the nonpermissive temperature of 38°C, the p53-regulated
protein p21WAF1 was not detected, but expression
of this protein was induced within 2 h at the permissive
temperature of 32°C. No measurable induction of
p21WAF1 was observed in HT29-neo control cells
(Figure 1A). p53 function, as assessed by
the induction of p21WAF1, was found to be
reversible at 38°C in HT29-tsp53 cells (Figure 1B). Examining the
cell cycle distribution of these cells revealed the expected decrease
in the percentage of cells entering S phase when incubated at 32°C
(Figure 1C). Switching the temperature back to 38°C (Figure 1C)
reversed the G1 arrest induced by functional p53
expression. Thus, transactivation and cell cycle arrest mediated by p53
can be tightly regulated and are reversible in this cell system.
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Although this allele of p53 induces apoptosis at the permissive
temperature in many other cell lines (Caelles et al., 1994
; Wagner et al., 1994
), very little apoptosis was induced in
HT29-tsp53 cells at the permissive temperature in the absence of DNA
damage (Figure 2A) (Merchant et
al., 1996
). Whereas 20 J/m2 UV light only
weakly induced apoptosis in HT29-tsp53 cells at the restrictive
temperature of 38°C, expression of functional p53 exclusively after
UV irradiation led to a significant increase in the induction of
apoptosis (Figure 2, A and B). Because functional p53 expression was
found to be readily reversible (Figure 1, B and C), this model system
permitted us to investigate the minimal period of functional p53
expression that was required for the induction of apoptosis after UV
irradiation. It was found that a 12-h incubation at 32°C immediately
after UV irradiation was sufficient for p53 to contribute to UV-induced
apoptosis (Figure 2C). Conversely, there was a significant decrease in
the induction of apoptosis when the shift to 32°C was delayed by as
little as 4 h (Figure 2D). Together, these results suggest that
functional p53 contributes to UV-induced apoptosis when expressed
within the first 4-12 h after UV irradiation.
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p53 Can Protect against UV-induced Apoptosis
The results presented above could be perceived to contradict
recent reports that suggest that p53 is protective against UV-induced apoptosis (McKay and Ljungman, 1999
; Wani et al., 1999
). It
is important to note that in those studies, wild-type p53 was present both before and after UV irradiation, whereas we found that p53 contributed to apoptosis when p53 was in mutant conformation before UV
irradiation but was functional after UV irradiation. Therefore, we
performed a series of temperature-shift experiments (Table 1) to test the effect of previous p53
expression on UV-induced apoptosis. Whereas these temperature shifts
had very little effect on UV-induced apoptosis in HT29-neo control
cells (Figure 3A), profound differences
were observed in HT29-tsp53 cells (Figure 3B). p53 expression
exclusively before UV irradiation failed to sensitize cells to
subsequent UV exposure (compare protocols 1 and 3). In fact, previous
expression of functional p53 inhibited UV-induced apoptosis mediated by
functional p53 expressed during the post-UV incubation period (compare
protocols 2 and 4). This effect of previous p53 expression was observed
over a broad range of UV doses (Figure 3C). Interestingly, very little
protection against the subsequent UV exposure was conferred by
incubation of HT29-tsp53 cells for 3-6 h at 32°C (Figure 3D), even
though p21WAF1 was induced within 2 h
(Figure 1A). Therefore, expression of neither functional p53 nor
p21WAF1 appeared to be sufficient for protection
against UV-induced apoptosis. We conclude that p53 expression can
stimulate UV-induced apoptosis when expressed exclusively after UV
irradiation, whereas p53 can protect against UV-induced apoptosis when
expressed before UV irradiation.
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The Protective Function of p53 Does Not Appear to Involve a Sustained G1 Arrest
It is thought that p53 may protect cells exposed to DNA-damaging
agents by arresting them in the G1 phase of the
cell cycle, allowing cells more time for repair before DNA replication
(Lane, 1992
; Bissonnette and Hunting, 1998
; McKay et al.,
1998
). To address whether the protective function of p53 was related to
the induction of a sustained cell cycle arrest, we assessed the cell
cycle distribution of HT29-tsp53 cells with the use of two-parameter
flow cytometry. UV irradiation of HT29-tsp53 cells maintained at the
restrictive temperature led to a significant increase in the S-phase
population of cells 24 h after UV irradiation (Figure
4). Irradiation of cells subjected to
temperature-shift protocols 2 and 4 did not alter the proportion of
cells in the G1, S, or G2/M
phase of the cell cycle (Figure 4D). Furthermore, there were no
significant differences in cell cycle distribution of HT29-tsp53 cells
subjected to protocols 2 and 4 despite the fact that these protocols
greatly affected sensitivity to UV-induced apoptosis (Figure 3). We
also performed similar experiments in which BrdU was maintained in the
medium during the entire post-UV incubation period. No significant difference was detected in the proportion of cells entering S phase
during the 12-h period in which cells were committed to p53-dependent
apoptosis (Figure 4E). Therefore, the results suggest that the
protective effect of previous p53 expression against UV-induced
apoptosis does not appear to involve the establishment of a sustained
G1 cell cycle arrest.
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To determine whether differences in the cell cycle distribution of
HT29-tsp53 cells at the time of irradiation could account for
differences in the apoptotic response, a detailed time course for the
establishment of cell cycle arrest in HT29-tsp53 cells was obtained
(Figure 5). A clear time-dependent
decrease in the proportion of cells entering S phase was observed in
HT29-tsp53 cells when incubated at 32°C. This
G1 arrest was first evident within 6 h at
32°C, which correlated with maximal induction of p21WAF1 (Figure 1). Importantly, even though
G1 arrest was detected within 6 h at 32°C,
significant protection against UV-induced apoptosis required 12 or more
hours of functional p53 expression (Figure 3D). Thus, we find no
clear correlation between the establishment of G1
arrest and resistance to UV-induced apoptosis in these cells.
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p53 and the Recovery of Transcription
The ability of cells to recover mRNA synthesis after UV
irradiation has been found to be inversely correlated with the severity of the apoptotic response after exposure of cells to UV light (Ljungman
and Zhang, 1996
; McKay et al., 1998
; McKay and Ljungman, 1999
). Furthermore, Li-Fraumeni syndrome cells lacking normal p53
function have been shown to be defective in the recovery of mRNA
synthesis after UV irradiation and are hypersensitive to UV-induced
apoptosis (McKay and Ljungman, 1999
). Therefore, we hypothesized that
the antiapoptotic function of p53 may be related to an enhanced
recovery of mRNA synthesis after UV irradiation. Consistent with this
hypothesis, we show that the recovery of mRNA synthesis was more
efficient in HT29-tsp53 cells maintained at 32°C than in cells
maintained at 38°C (Figure 6A). This is rather striking given the fact that NER is extremely sensitive to
decreases in temperature (Hjertvik et al., 1998
).
Importantly, previous expression of functional p53 stimulated the
recovery of mRNA synthesis, whereas switching cells to the permissive
temperature at the time of UV irradiation failed to stimulate this
recovery process (Figure 6A). Furthermore, previous expression of
functional p53 resulted in a modest stimulation of the recovery of
transcription when p53 was in mutant conformation during the post-UV
recovery period. These results suggest that functional p53 participates in the recovery of mRNA synthesis after UV irradiation but that this
participation is indirect and is established before UV irradiation, perhaps through the regulation of one or more rate-limiting steps involved in this recovery process.
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To investigate whether UV exposure impaired the expression of
p53-responsive genes, the expression of p21WAF1
and Bax was assessed 6 h after UV irradiation of HT29-tsp53 cells subjected to each of the temperature-shift protocols described in Table
1. UV irradiation was found to block the p53-mediated induction of
p21WAF1 (Figure 6B, lane 4). As reported
previously, UV irradiation led to a loss of
p21WAF1 proteins that had been accumulated by
previous p53 expression (Figure 6B, lane 8) (McKay et al.,
1998
; Wang et al., 1999
). Interestingly, Bax protein levels
were not altered by p53 expression or UV irradiation (Figure 6B, lanes
1, 3, and 7). These results, together with previous reports (Lu
et al., 1996
; McKay et al., 1998
), suggest that
transactivation of p53-responsive genes such as
p21WAF1 is attenuated soon after exposure to 20 J/m2 UV light.
Protein Synthesis and p53-mediated Apoptosis
Overexpression of functional p53 did not in itself lead to the
induction of apoptosis in HT29-tsp53 cells, but apoptosis was stimulated by functional p53 expression after UV irradiation under conditions in which transcription was impaired. We hypothesized that
p53-mediated apoptosis could be transactivation-independent and could
result from the inefficient expression of proteins that normally
protect against the proapoptotic function of p53. Therefore, we sought
to determine whether apoptosis was induced by UV irradiation in the
presence of the protein synthesis inhibitor cycloheximide (CHX). CHX
alone induced apoptosis in HT29-tsp53 but not HT29-neo cells, and
previous expression of functional p53 protected against CHX-stimulated
apoptosis (Figure 7A). Like UV light, CHX
inhibited the p53-mediated induction of p21WAF1
(Figure 7B). We suggest that p53 contributes to both proapoptotic and
antiapoptotic pathways in these cells. The antiapoptotic function of
p53 appears to involve gene and protein expression and needs to be
established before cell treatment, whereas the proapoptotic activity of
p53 is transactivation- and translation-independent.
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DISCUSSION |
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The Timing of p53 Expression Affects UV-induced Apoptosis
Using an HT29 colon carcinoma-derived cell line
expressing a temperature-sensitive allele of p53, we found that the
timing of p53 expression affected whether p53 contributed to or
inhibited UV-induced apoptosis. As reported previously (Merchant
et al., 1996
), apoptosis was not induced at the permissive
temperature in HT29-tsp53 cells. However, p53 significantly enhanced
UV-induced apoptosis when expressed exclusively after UV irradiation.
We demonstrated that this proapoptotic effect required p53 expression during the first 4-12 h after UV irradiation. In distinct contrast, functional p53 expression for 12 h or more before UV irradiation protected cells against UV-induced apoptosis even when p53 expression was maintained after irradiation (Figure 3). This is the first demonstration that previous expression of p53 can have an impact on the
response to subsequent cellular stresses. We conclude that p53
participates in UV-induced apoptosis soon after UV irradiation in these
cells but that the proapoptotic effect of p53 can be overcome by
previous expression of functional p53.
Overexpression of p53 is thought to transactivate hundreds of genes
(Farmer et al., 1992
; Zambetti et al., 1992
;
Smith and Fornace, 1997
). Although expression of the proapoptotic
protein Bax is regulated by p53 (Miyashita et al., 1994
), we
did not observe significant changes in Bax expression in the HT29-tsp53
cells at the permissive temperature. Wild-type p53 has also been
reported to regulate the level of expression of the death receptors Fas and TRAIL (Owen-Schaub et al., 1995
; Sheikh et
al., 1998b
). UV light has been suggested to promote apoptosis
through the stimulation of death receptor signaling (Rehemtulla
et al., 1997
; Aragane et al., 1998
; Sheikh
et al., 1998a
; Hill et al., 1999
), and thus, one
might expect that enhanced expression of these receptors by expression
of functional p53 would sensitize cells to subsequent UV exposure. In
contrast to this prediction, we found that previous expression of
functional p53 conferred protection against UV-induced apoptosis.
Therefore, it is unlikely that p53-enhanced expression of Bax, Fas, or
TRAIL contributed to UV-induced apoptosis in these cells.
Several previous studies have shown that p53 can induce apoptosis
without a requirement for the transactivation of target genes (Caelles
et al., 1994
; Wagner et al., 1994
; Haupt et
al., 1995
; Chen et al., 1996
; Wang et al.,
1996
). Our study shows that p53 expression induced apoptosis under
conditions in which transcription (Figure 5), translation (Figure 6),
or both were impaired, supporting a transactivation- and
translation-independent mechanism of p53-mediated apoptosis. In fact,
not only did p53-mediated apoptosis occur in the absence of de novo
protein synthesis, but inhibition of protein synthesis in HT29-tsp53
cells was found to stimulate p53-mediated apoptosis. Thus, our results
support a model (McKay et al., 1998
) in which a sustained
high cellular level of wild-type p53 under conditions in which it is
unable to enhance the expression of p53-regulated proteins triggers apoptosis.
The p53 protein can exert both protective and apoptosis-enhancing
functions after exposure to DNA-damaging agents. The protective roles
of p53 in inducing cell cycle arrest and stimulating NER are thought to
be dependent on the p53-mediated transactivation of genes such as
p21WAF1 and p48 (Tang et al., 1998
;
Hwang et al., 1999
). However, some DNA-damaging agents
induce DNA lesions that interfere with the elongation of RNA polymerase
II, and thus, the induction of protective gene products by p53 may not
occur efficiently (Figures 5 and 6) (McKay et al., 1998
). In
fact, we found that 20 J/m2 UV light severely
attenuated the p53-mediated induction of p21WAF1
in HT29-tsp53 cells (Figure 5). The protective effect of the expression
of functional p53 before, but not after, UV irradiation (Figure 3) most
likely resulted from the ability of p53 to transactivate genes before
sustaining DNA damage.
Although p21WAF1 can be protective against
p53-mediated apoptosis under certain circumstances (Polyak et
al., 1996
; Gorospe et al., 1997
) and the expression of
p21WAF1 was induced within 2 h at the
permissive temperature, the protection conferred by p53 required 12 or
more hours of functional p53 expression. Therefore, it is unlikely that
either p53 or p21WAF1 per se was directly
involved in the protection exerted by the pre-UV expression of
functional p53. These results suggest that the expression of one or
more alternative p53-regulated proteins is involved in this protective
function of p53.
The Enhanced Recovery of Transcription is a Pre-UV Function of p53
The recovery of mRNA synthesis after the induction of RNA
polymerase II-blocking lesions by UV light (Sauerbier and Hercules, 1978
; Protic-Sabljic and Kraemer, 1985
; Donahue et al.,
1994
) is greatly affected by the transcription-coupled repair
capacity of cells (Ljungman and Zhang, 1996
; McKay and Ljungman, 1999
). Although it remains somewhat controversial, the wild-type p53 status of
a cell may be important for the efficient execution of preincision
steps in both the transcription-coupled repair (Wang et al.,
1995
; Mirzayans et al., 1996
; McKay et al., 1997
; Barley et al., 1998
; McKay and Ljungman, 1999
; Rey et
al., 1999
; Therrien et al., 1999
) and global genomic
repair (Ford and Hanawalt, 1995
, 1997
; Smith et al.,
1995
; McKay et al., 1999
; Therrien et al., 1999
;
Wani et al., 1999
) pathways of NER. In addition, it has been
reported that DNA is more relaxed (less supercoiled) after UV
irradiation in p53-deficient cells (Aranda-Anzaldo et al.,
1999
), suggesting that DNA repair-induced strand breaks persist longer
in p53-deficient cells. Thus, both preexcision and postexcision events
in the NER pathway may be enhanced in wild-type p53-expressing cells,
resulting in a more rapid recovery of transcription and a reduced rate
of apoptosis after exposure to UV light. In addition, it is possible
that postrepair processes required for the efficient recovery of
transcription are stimulated by p53 (McKay and Ljungman, 1999
).
It has been reported previously that the recovery of transcription
after UV irradiation is defective in p53-compromised cells (Ford and
Hanawalt, 1995
; Mirzayans et al., 1996
; McKay et
al., 1997
; Barley et al., 1998
; McKay and Ljungman,
1999
) and that these cells are hypersensitive to UV-induced apoptosis
(McKay and Ljungman, 1999
; Wani et al., 1999
). In these
previous studies, the model system used did not permit the issue of the
timing of p53 expression to be addressed. Defects in NER and the
recovery of transcription have been detected in cells with compromised p53 function very soon after UV irradiation (Wang et al.,
1995
; McKay and Ljungman, 1999
; Therrien et al., 1999
).
However, the induction of p53 and its downstream gene products is
delayed by several hours after UV irradiation (Lu and Lane, 1993
;
Ljungman and Zhang, 1996
; Dumaz et al., 1997
; McKay et
al., 1998
). Furthermore, p53 and its target genes are not strongly
induced by UV light at doses used to assess NER and the recovery of
transcription (Ljungman and Zhang, 1996
; Dumaz et al., 1997
;
McKay et al., 1998
). Therefore, the "induction" of p53
and its downstream gene products after UV irradiation does not appear
to be essential for these recovery processes. Importantly, recent
reports suggest that p53 can regulate the level of expression of
p53-responsive gene products under nonstressed conditions (Tang
et al., 1998
; Hwang et al., 1999
). Thus, it is
plausible that p53 stimulates the recovery of transcription by
regulating the basal level of expression of one or more gene product(s)
that is (are) rate limiting for this recovery process. In support of
this model, we found that functional p53 expression was required before
UV irradiation to facilitate the recovery of transcription in
HT29-tsp53 cells. This pre-UV function of p53 would be expected to
permit more efficient recovery of gene expression after UV irradiation
(Figure 8).
|
In conclusion, we have demonstrated that p53 strongly promotes
apoptosis in HT29-tsp53 cells when gene expression is blocked by
UV-induced DNA damage or CHX treatment but that this induction of
apoptosis is strongly attenuated by the previous expression of
functional p53. Therefore, the timing of p53 expression affects whether
p53 contributes to or inhibits apoptosis induced by UV light or CHX
treatment in these cells. Although the exogenous p53 expression in this
cell system is very high and there may be some cell type specificity in
the p53 response, together with our earlier work (McKay and Ljungman,
1999
) these results suggest that previous p53 expression confers
protection against UV-induced apoptosis. This protection is most likely
due to the regulation of one or more gene products that inhibit
UV-induced apoptosis, and this arises at least in part through the
stimulation of protective processes such as DNA repair and the recovery
of transcription. We suggest that p53 induction in the context of
either blocked transcription or translation would promote apoptosis
(Figure 8). Importantly, these results suggest that the timing of p53
expression may have significant clinical implications for combining p53
gene therapy with therapeutic agents that target transcription or
translation of tumor cells.
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ACKNOWLEDGMENTS |
|---|
We thank Dr. Jonathan Maybaum for the cell lines used in this study. We are also grateful for the excellent technical assistance of the staff at the Flow Cytometry Core Unit (University of Michigan). This work was supported by funds from the Department of Radiation Oncology (University of Michigan), by funds from the University of Michigan Comprehensive Cancer Center's institutional grant from the American Cancer Society, and by a grant from the National Institutes of Health (CA82376-01).
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FOOTNOTES |
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Present address: Ottawa Regional Cancer
Centre, Ottawa, ON, Canada, K1H 8L6.
§ Corresponding author. E-mail address: ljungman{at}umich.edu.
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