TITLE: Uncarboxylated Osteocalcin and Gprc6a Axis Produce Intratumoral Androgens in Castration-Resistant Prostate Cancer

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AWARD NUMBER: W81XWH-14-1-0037 TITLE: Uncarboxylated Osteocalcin and Gprc6a Axis Produce Intratumoral Androgens in Castration-Resistant Prostate Cancer PRINCIPAL INVESTIGATOR: Sreenivasa R. Chinni, Ph.D CONTRACTING ORGANIZATION: Wayne State University Detroit, MI 48202 REPORT DATE: May 2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT: Approved for Public Release; Distribution Unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation.

REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE 2. REPORT TYPE 3. DATES COVERED May 2016 Final 1 Mar 2014-28 Feb 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Uncarboxylated Osteocalcin and Gprc6a Axis Produce Intratumoral Androgens in Castration-Resistant Prostate Cancer 5b. GRANT NUMBER W81XWH-14-1-0037 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Sreenivasa R. Chinni, Ph.D 5e. TASK NUMBER 5f. WORK UNIT NUMBER E-Mail:schinni@med.wayne.edu 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Wayne State University 540 E. Canfield Avenue, Detroit, MI 40201 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR S REPORT NUMBER(S) 12. DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Castrate resistant prostate cancer (CRPC) represents the final and lethal disease state in the progression of prostate cancer. CRPC patients often develop bone metastasis resulting in bone fractures and morbidity. Recently, tumor cells have been shown to activate androgen receptor signaling via multiple pathways, despite castrate levels of testosterone. One such adaptive mechanism is the intracrine production of androgens in the primary tumor and/or at metastatic sites by the activity of androgen biosynthetic enzymes. Recent study shows that Gprc6a/Osteocalcin axis regulates physiological androgen biosynthesis in testis. Since Osteocalcin is overexpressed in patients with bone metastasis and existence of intratumoral androgen synthesis in bone metastasis, we hypothesized that bone tumor expressed Osteocalcin can induce intratumoral androgen synthesis in bone metastasis. We show that in VCaP model system Gprc6a is expressed and overexpression of its ligand Osteocalcin in these cells leads to expression of androgen biosynthetic enzymes. This data suggest that prostate cancer bone tumors hijack Osteocalcin/Gprc6a axis for the production of intratumoral androgens via overexpression of certain androgen biosynthetic enzyme expression. Bone tumor expressed androgens promote disease progression via tumoral androgen production and androgen receptor activation. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT a. REPORT b. ABSTRACT c. THIS PAGE 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18

Table of Contents Page Introduction..... 1 Key Words 1 Overall Project Summary.. 1 Key Research Accomplishments... 6 Conclusion 6 Publications, Abstracts, and Presentations 6 Inventions, Patents and Licenses 6 Reportable Outcome. 6 Other Achievements 7 References 7 Appendices 7

1. INTRODUCTION: Castrate resistant prostate cancer (CRPC) represents the final and lethal disease state in the progression of prostate cancer. Recently, tumor cells have been shown to activate androgen receptor signaling via multiple pathways, despite castrate levels of testosterone. One such adaptive mechanism is the intracrine production of androgens in the primary tumor and/or at metastatic sites by the activity of androgen biosynthetic enzymes(1). CRPC is often characterized by disease progression in bone, and osteoblasts are known to express osteocalcin. Osteocalcin undergoes carboxylation at multiple glutamic acids, the resultant gama carboxylated Osteocalcin interacts with bone extracellular matrix associated calcium and hydroxyapatite and deposited in the bone matrix. Some Osteocalcin is released into circulation without undergoing decarboxylation and recently Karsenty`s group showed that circulating uncarboxylated Osteocalcin is a potent factor inducing androgen production in Leydig cells in testes (2). Osteocalcin binds and activates a novel cell surface receptor Gprc6a in Leydig cells to induce androgen biosynthetic enzyme expression and androgen production. However, osteocalcin is dysregulated in CRPC, with higher levels of the uncarboxylated form found in patients with bone metastasis (3). We thus hypothesize that uncarboxylated osteocalcin, expressed by osteoblasts or tumor cells, leads to local biosynthesis of androgens, thereby contributing to expansion of the metastatic deposit in bone, despite castrate levels of serum testosterone. Thus, just as the skeleton regulates fertility in an endocrine fashion, and it may also promote bone metastasis via an intracrine mechanism. 2. KEYWORDS: CRPC: PC: Gprc6a AKR1C3: 17BHSD RTPCR SCID VCaP DHT RFP Castrate resistant prostate cancer Prostate Cancer A seven transmemberane G-protein coupled receptor Aldo Keto Reductase 1C3 17 beta Hydroxysteroid Dehydrogenase Real time Polymerase Chain Reaction Severe combined immuno deficient Vertebral metastasis prostate cancer cell line Dihydroxy testosterone. Red fluorescence protein 3. OVERALL PROJECT SUMMARY: Major Goals: Goal 1: Demonstrate the functional Gprc6a expression in prostate cancer cells Goal 2: Determine the clinical significance of osteocalcin, Gprc6a, and androgen biosynthetic enzymes during CRPC progression. Major activities: 1. We generated stable VCaP cell lines expressing RFP (red fluorescence protein as control) Osteocalcin and mutant Osteocalcin using lentivirus mediated stable infections. 2. Determined the gene expression of Gprc61 and androgen biosynthetic gene expression in Osteocalcin and mutant Osteocalcin infected cells. 3. We performed intratibial implantation experiment with osteocalcin and mutant osteocalcin expressing cells 4. Determined the T and DHT levels in bone tumors Specific objectives:

Expression of Osteocalcin forms in VCaP cells: We used a lentiviral system for expressing Osteocalcin and mutated Osteocalcin. Osteocalcin is mutated at three positions where glutamic acid residue at 17, 18 and 24 were mutated to glutamine to prevent carboxylation. Both native and mutated osteocalin was cloned into lentiviral expression plasmids. Viral stocks were infected with VCaP cells to express RFP, Osteocalcin and mutated Osteocalcin. Osteocalcin gene expression was determined using RT-PCR method. Osteocalcin and mutated Osteocalcin was expressed in VCaP cells (Figure 1). Conditioned media was collected from RFP, osteocalin and mutated Osteocalcin expressing cells. ELISA quatitiation show that Osteocalcin is secreted Figure 1. RT-PCR analysis of Osteocalcin in lentivirus infected VCaP cells. RNA extracted from RFP and Osteocalcin expressing cells were analyzed for Osteocalcin for indicated number of PCR amplifications. Amplified Osteocalcin and GAPDH gene products were run on the gel. from the VCaP-osteocalcin cells (Figure 2). ELISA does not detect mutated Osteocalcin in mutated osteocacin expressing cells. Figure 2. ELISA of Osteocalcin: Conditioned media from VCaP cells expressing RFP, wild type Osteocalcin and 3E/Q mutant Osteocalcin were analyzed for secreted Osteocalcin. Figure 3. Westernblot analysis of VCaP cell infectants with androgen biosynthetic enzymes and Gprc6a and b-tubulin. Determine the decarboxylated osteocalcin induced expression of androgen biosynthetic enzymes. To determine the functional Gprc6a expression in VCaP cells, androgen biosynthetic enzyme expression was determined in VCaP RFP, wild type Osteocalcin and 3E/Q mutant Osteocalcin infected cells. VCaP and VCaP transfectants express Gprc6a. HSD3B2 and HSD17B6 expression was increased in both wild type and 3E/Q mutant Osteocalcin infected cells (Figure 3). Determine Testosterone and DHT levels in VCaP cells upon decarboxylated osteocalcin /Gprc6a activation: VCaP cells transfectants expressing RFP, Osteocalcin and 3E/Q osteocalcin cells were injected into tibae of mice. Mass spectrometric quantitation of Testosterone and DHT was performed in bone tumors. Bone tumors expressing 3E/Q osteocalcin have high production of testosterone (Figure 4), where DHT levels are higher in both osteocalcin and 3E/Q osteocalcin expressing tumors. Figure 4. Testosterone and DHT levels in bone tumors

In vivo studies of Gprc6a mediated androgen biosynthetic enzyme expression: VCaP cells transfectants expressing RFP, Osteocalcin and 3E/Q osteocalcin cells were injected into tibae of mice. Bone tumors were imaged with luciferin after 14 weeks. Data show that osteocalcin tranfected cells grew slower, whereas mutant 3E/Q osteocalcin transfected cells grew larger, suggesting mutant osteocalcin promote bone tumor growth (Figure 5). Figure 5. Bone tumor growth of VCaP osteocalcin transfectants. A. Whole body mice luciferase imaging for bone tumors. B. Quantitation of tumor growth. 4. KEY RESEARCH ACCOMPLISHMENTS: Osteocalin/Gprc6a axis promotes intratumoral androgen synthesis by over expressing androgen biosynthetic enzyme expression. Decarboxylated osteocalcin (3E/Q mutant osteocalcin) is an inducer of bone tumor growth through activation of Gprc6a receptor. 5. CONCLUSIONS: Our data show that Osteocalcin/Gprc6a axis is functional in VCaP prostate cancer cells. This pathway can induce intra turmoral androgen synthesis through overexpression of androgen biosynthetic enzyme expression. Together this pathway promotes prostate cancer bone metastasis and drive androgen receptor mediated bone tumor growth. 6. PUBLICATIONS, ABSRACTS, AND PRESENTATIONS: 7. INVENTIONS, PATENTS AND LICENCES: 8. REPORTABLE OUTCOMES:

9. OTHER ACHIEVEMENT: We developed three stable cells lines through lentivirus mediated expression of RFP, Osteocalcin and 3E/Q mutated Osteocalcin in VCaP cells. 10. REFRENCES: 1. Mohler JL, Titus MA, Bai S, Kennerley BJ, Lih FB, Tomer KB, et al. Activation of the androgen receptor by intratumoral bioconversion of androstanediol to dihydrotestosterone in prostate cancer. Cancer Res.71(4):1486-96. 2. Oury F, Sumara G, Sumara O, Ferron M, Chang H, Smith CE, et al. Endocrine regulation of male fertility by the skeleton. Cell.144(5):796-809. 3. Gardner TA, Lee SJ, Lee SD, Li X, Shirakawa T, Kwon DD, et al. Differential expression of osteocalcin during the metastatic progression of prostate cancer. Oncol Rep. 2009;21(4):903-8. 11. APPENDICES: