We and others have shown that the
cystatin E/M gene is inactivated in primary human
tumors, pointing to its role as a tumor suppressor gene. However, the molecular mechanism of
tumor suppression is not yet understood. Using plasmid-directed
cystatin E/M gene overexpression, a lentivirus-mediated
tetracycline-inducible vector system, and human papillomavirus 16 (HPV 16) E6 and E7 gene-immortalized normal human epidermal keratinocytes, we demonstrated intracellular and non-cell-autonomous apoptotic growth inhibition of tumor cell lines and that growth inhibition is associated with cytoplasmic retention of NF-κB. We further demonstrated decreased phosphorylation of IκB
kinase (IKKβ) and IκBα in the presence of
tumor necrosis factor alpha (TNF-α), confirming the role of
cystatin E/M in the regulation of the NF-κB signaling pathway. Growth suppression of nude mouse xenograft
tumors carrying a
tetracycline-inducible vector system was observed with the addition of
doxycycline in
drinking water, confirming that the
cystatin E/M gene is a tumor suppressor gene. Finally, immunohistochemical analyses of cervical
carcinoma in situ and primary
tumors have shown a statistically significant inverse relationship between the expression of
cystatin E/M and
cathepsin L and a direct relationship between the loss of
cystatin E/M expression and nuclear expression of NF-κB. We therefore propose that the
cystatin E/M suppressor gene plays an important role in the regulation of NF-κB.