Carcinogenesis vol.35 no.5 pp.1121–1131, 2014 doi:10.1093/carcin/bgt491 Advance Access publication January 7, 2014 Inhibition of the nuclear transporter, Kpnβ1, results in prolonged mitotic arrest and activation of the intrinsic apoptotic pathway in cervical cancer cells Liselotte Angus†, Pauline J.van der Watt† and Virna D.Leaner* Division of Medical Biochemistry, Faculty of Health Sciences, University of Cape Town, Institute of Infectious Disease and Molecular Medicine, Cape Town 7925, South Africa *To whom correspondence should be addressed. Division of Medical Biochemistry, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa. Tel: +27 21 406 6250; Fax: +27 21 406 6061; Email: [email protected] The karyopherin β proteins are involved in nuclear-cytoplasmic trafficking and are crucial for protein and RNA subcellular localization. We previously showed that Kpnβ1, a nuclear importin protein, is overexpressed in cervical cancer and is critical for cervical cancer cell survival and proliferation, whereas non-cancer cells are less dependent on its expression. This study aimed to identify the mechanisms by which inhibition of Kpnβ1 results in cervical cancer cell death. We show that the inhibition of Kpnβ1 results in the induction of apoptosis and a prolonged mitotic arrest, accompanied by distinct mitotic defects in cervical cancer cells but not non-cancer cells. In cervical cancer cells, Kpnβ1 downregulation results in sustained degradation of the antiapoptotic protein, Mcl1, and elevated Noxa expression, as well as mitochondrial membrane permeabilization resulting in the release of cytochrome C and activation of associated caspases. Although p53 becomes stabilized in Kpnβ1 knockdown cervical cancer cells, apoptosis occurs in a p53-independent manner. These results demonstrate that blocking Kpnβ1 has potential as an anticancer therapeutic approach. Introduction Karyopherin β1 (Kpnβ1, also known as importin β or p97) is a member of the karyopherin β superfamily of nuclear transport proteins. Karyopherin β proteins are soluble nuclear transport receptor proteins that function in transporting cargo proteins into and out of the cell nucleus, via the nuclear pore complex (1). Karyopherin β proteins may act as importins or exportins depending on the direction of transport. Nuclear import via the importin protein, Kpnβ1, can occur by Kpnβ1 acting as an autonomous nuclear transport receptor. Alternatively, Kpnβ1 can function in combination with up to 11 different partners to ferry distinct cargoes (2). These include Kpnα (importin α) family members, snurportin (3), importin 7 (4) and XRIPα (5). Kpnβ1 acts mainly in association with Kpnα family members, which recognize protein cargoes bearing nuclear localization signals and bind these proteins in the cytoplasm (6). Kpnβ1 then translocates the import complex (cargo:Kpnα:Kpnβ1) into the nucleus, at which point it dissociates on the binding of RanGTP, and the cargo proteins can then act on their downstream targets. In addition to the nuclear import function of Kpnβ1, it is also reported to play a key role in the transition of the cell cycle, mitosis and replication (2,7). Kpnβ1 protein localization is spatially and temporarily regulated during mitosis, and it has been shown to interact with mitotic microtubules after nuclear envelope breakdown Abbreviations: FACS, fluorescence-activated cell sorting; HPV, human papillomavirus; Kpnβ1, karyopherin β 1; mRNA, messenger RNA; MTT, 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide; PBS, phosphate-buffered saline; SAF, spindle assembly factor; siRNA, short interfering RNA. † These authors contributed equally to this work. and accumulate at spindle poles (8). Roscioli et al. (9) have recently shown that Kpnβ1 regulates multiple aspects of mitosis, whereby overexpression of Kpnβ1 resulted in dynamic mitotic defects in HeLa cells, including multipolar division, abnormal chromosome alignment, mitotic delay and spindle axis reorientation. As Kpnβ1 and its family members are required for multiple cellular processes, this protein family has received interest as potential targets for cancer therapy (10–12). Kpnβ1, in particular, has recently been identified as a potential anticancer target (reviewed in ref. 13). In previous studies, we showed that Kpnβ1 messenger RNA (mRNA) and protein expression is elevated in cervical cancer cells compared with normal epithelial cells, as well as in transformed fibroblast cells compared with untransformed fibroblasts, suggesting that Kpnβ1 overexpression might be a feature of the transformed phenotype (14). Furthermore, we showed that elevated Kpnβ1 expression in cervical cancer/transformed cells derives from deregulated E2F activity (15). In cervical cancer cells infected with the human papillomavirus (HPV), E6 and E7 oncoproteins are expressed, which function in the degradation of p53 and inactivation of Rb, respectively (16,17). As Rb negatively regulates the expression of E2F and E2F functions in the activation of the Kpnβ1 promoter, E7-mediated inactivation of Rb accounts for, at least in part, the increased Kpnβ1 expression observed in these cells (15). Smith et al. (18) observed increased Kpnβ1 mRNA expression in ovarian cancer cell lines and transformed ovarian cells compared with normal epithelial cells, suggesting that Kpnβ1 overexpression is not specific to cervical cancer, and Kuusisto et al. (19) observed increased Kpnβ1 protein expression in transformed fibroblast and epithelial cell lines compared with their untransformed counterparts. These authors showed that increased expression of Kpnβ1 (and its adaptor Kpnα2, also known as Impα1) enables enhanced import efficiencies in transformed cells (19). We previously showed that the elevated expression of Kpnβ1 is necessary for cancer cell survival as its inhibition in cervical cancer and transformed cells results in cell death (14). The inhibition of Kpnβ1 in normal cells, on the other hand, does not result in cell death (14). These results show that normal and cancer cells respond differently to the inhibition of Kpnβ1 and suggest that cancer cells become functionally dependent on Kpnβ1 overexpression, highlighting the importance of Kpnβ1 upregulation in maintaining cancer cell biology. The mechanism by which cancer cell death is activated when Kpnβ1 is inhibited remains unknown. In this study, we examined the mechanism of cervical cancer cell death induced by Kpnβ1 inhibition. We show that the inhibition of Kpnβ1 in cervical cancer cells results in distinct mitotic defects, a prolonged mitotic arrest, sustained degradation of Mcl-1 and elevated Noxa expression. In addition, Kpnβ1 downregulation affects mitochondrial membrane permeabilization resulting in the release of cytochrome C, activation of associated caspases-3/7 and cell death via apoptosis. Although p53 becomes stabilized in Kpnβ1 knockdown cells, apoptosis occurs in a p53-independent manner. Materials and methods Cell culture and RNA interference HeLa, CaSki and WI38 were obtained from the American Type Culture Collection. FG0 cells were obtained from the Department of Medicine, University of Cape Town (Cape Town, South Africa) (20). Cells were maintained in Dulbecco’s modified Eagle’s medium supplemented with penicillin (100 U/ml), streptomycin (100 μg/ml) and 10% fetal calf serum (Gibco, Paisley, Scotland). All cells were cultured in 5% CO2 at 37°C. For the inhibition of Kpnβ1 gene expression, short interfering RNA (siRNA) was used (sc-35736, Santa Cruz, Santa Cruz, CA). siRNA consisting of a scrambled sequence (sc-37007, Santa Cruz) was used as a non-silencing control. Cells were transiently transfected with 20 nM of siRNA using transfectin (Bio-Rad, Richmond, CA). All cell lines were authenticated by DNA profiling using the Cell ID System (Promega, Madison, WI). © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected] 1121 L.Angus, P.J.van der Watt and V.D.Leaner Cell cycle synchronization Cells were transfected with either 20 nM control siRNA or Kpnβ1 siRNA. After 48 h of post-transfection, cells were treated with 2 mM thymidine (Sigma– Aldrich, St Louis, MO) for 24 h. Cells were released from the thymidine block for 3 h, after which the cells were incubated with 100 ng/ml nocodazole (Sigma) for 12 h. The nocodazole-containing medium was removed and cells were washed with phosphate-buffered saline (PBS) before fresh growth medium was added. After various time points, total protein and cells were harvested for western blot and fluorescence-activated cell sorting (FACS) analysis, respectively. Cell cycle analysis About 0.5 × 106 cells were fixed in 80% ethanol and incubated overnight at 4°C. Fixed cells were resuspended in PBS containing 3 μM propidium iodide and 500 U ribonuclease A. Cells cycle profiles were analyzed using the Beckman FACSverse Flow Cytometer at 615 nm. Quantification of the cell cycle profiles was performed using ModFit LT software. Western blot analysis Cells were treated as desired and lysed in radioimmunoprecipitation assay buffer [10 mM Tris–HCl (pH 7.4), 150 mM NaCl, 1% sodium deoxycholate, 0.1% sodium dodecyl sulphate, 1% Triton X-100, 1× complete protease inhibitor cocktail (Roche, Mannheim, Germany)]. Protein concentrations were quantified using a BCA Assay Kit (Pierce, Rockford, IL) and separated on a polyacrylamide gel and transferred to a HyBond™-ECL™ nitrocellulose membrane (Amersham, Buckinghamshire, UK). Western blot analysis were performed using rabbit anti-Karyopherin β1 (H-300; sc-11367), mouse anti-p53 (M7001, DakoCytomation, Glostrup, Denmark), rabbit anti-p21 (H-164; sc-756), rabbit anti-Mcl-1 (H-260; sc-20679), rabbit anti-PARP (H-250; sc-7150), rabbit anti-psHis3 (ser-10; sc-8656), rabbit anti-β-tubulin (H235; sc-9104), rabbit anti-TATA-box binding protein (N-12; sc-204), mouse anti-cytochrome C (BD Pharmingen, San Diego, CA), mouse anti-Bax (BD Pharmingen), rabbit anti-p38 (M0800, Sigma), rabbit anti-pereroxiredoxin-3 (P1247, Sigma), mouse Rb (4H1; #9309, Cell Signaling, Danvers, MA) and rabbit phospho-Rb (ser780; #9307S, Cell Signaling) antibodies. All antibodies were obtained from Santa Cruz Biotechnology unless otherwise stated. 3-(4,5-Dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide assays Cells were plated at 2000 cells per well in 96-well plates and the following day transfected with 20 nM control or Kpnβ1 siRNA. After 120 h of post-transfection, viable cells were measured using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) reagent (Cell Proliferation Kit I, Roche) and absorbance at 595 nm was measured on a microplate spectrophotometer. To assay for MTT absorbance after simultaneous Kpnβ1 and p53 knockdown, cells were plated as described previously and the following day transfected with 20 nM control or Kpnβ1 siRNA, in addition to 20 nM control or p53 siRNA. Forty-eight hours after transfection, cells were re-transfected with 10 nM control or p53 siRNA to maintain p53 downregulation. Ninety-six hours after post-transfection, viable cells were measured using the MTT reagent. Trypan blue assay HeLa cells were plated at 25 000 cells per well in 24-well plates and the following day transfected with 20 nM control or Kpnβ1 siRNA. Every day posttransfection cells were trypsinized, incubated with 0.4% Trypan blue and the number of stained (dead) and unstained (live) cells counted using a haemocytometer. The number of dead/live cells was expressed relative to the total number of cells for each time point. Fluorescent microscopy Cells grown on coverslips were transfected with 20 nM control or Kpnβ1 siRNA. To obtain images of kinetochore-associated proteins, cells were pre-incubated in calcium extraction buffer (100 mM 1,4-piperazinediethane-sulphonic acid, 1 mM MgCl2, 1 mM CaCl2, 0.5% Triton X-100, pH 6.8) at 37°C for 3 min before fixation in 4% paraformaldehyde. Cells were blocked in PBS-T containing 1% bovine serum albumin and 0.3 M glycine for 30 min. Coverslips were subsequently incubated with anti-β-tubulin (1:100; Santa Cruz) for 45 min. After three washes with PBS, Cy3-conjugated goat anti-rabbit secondary antibody (1:400; Jackson ImmunoResearch) was applied for 45 min. Nuclear DNA was stained using 100 ng/ml 4′,6-diamidino-2-phenylindole and coverslips were mounted with Mowiol. Cells were examined under a Zeiss Axiovert 200 fluorescence microscope (Carl Zeiss International, Jena, Germany). Subcellular fractionation For mitochondria and cytoplasmic protein extraction. Cells were grown in 10 cm plates and treated with combinations of control siRNA, Kpnβ1 siRNA and p53 siRNA. Cells were lysed in subcellular fractionation buffer (250 mM sucrose, 20 mM N-2-hydroxyethylpiperazine-N′-2-ethanesulphonic acid, 10 mM KCl, 1.5 mM MgCl2, 1 mM ethylenediaminetetraacetic acid, 1 mM 1122 ethyleneglycol-bis(aminoethylether)-tetraacetic acid, 1 mM dithiothreitol and 1× complete protease inhibitor cocktail [Roche]), passed through a 25 G needle and incubated on ice for 20 min. The nuclear pellet was centrifuged out at 720g for 5 min. The supernatant was further centrifuged at 10 000g and the supernatant was used as the cytoplasmic fraction. The pellet containing the mitochondria fraction was washed in subcellular fractionation buffer and passed through a 25 G needle. The mitochondria fraction was pelleted at 10 000g and resuspended in RIPA buffer. Anti-β-tubulin and anti-pereroxiredoxin-3 antibodies were used as protein loading controls for cytoplasmic and mitochondrial fractions, respectively. For nuclear and cytoplasmic protein extraction. Nuclear and cytoplasmic protein fractionation was performed using the NE-PER Nuclear Protein Extraction Kit (ThermoScientific, Rockford, IL), according to manufacturer’s instructions. Anti-β-tubulin and anti-TATA-box binding protein antibodies were used as protein loading controls for cytoplasmic and nuclear fractions, respectively. Cycloheximide half-life experiments For p53 half-life experiments, cells were transfected with control or Kpnβ1 siRNA and incubated for 72 h before treatment with 50 µg/ml cycloheximide. Protein was harvested at various time points after cycloheximide treatment and subjected to western blot analysis using an anti-p53 antibody. An anti-p38 MAP kinase antibody was used to control for protein loading. Bands were quantitated by densitometric scanning and analyzed using Image J. To determine the protein half-life, the band intensities were plotted in log scale relative to time and a linear trend-line drawn. The half-life equated to log2/slope. Caspase-3/7 assays For the analysis of caspase-3/7 activity following Kpnβ1 inhibition in HeLa, CaSki, FG0 and WI38 cells, cells were plated at 2000 cells per well in 96-well plates and 24 h later transfected with 20 nM Kpnβ1 siRNA or control siRNA. After 72 h of post-transfection, the caspase-3/7 assay was performed using the Caspase-Glo® 3/7 Assay Kit (Promega), according to the manufacturers’ instructions. For the analysis of caspase-3/7 activity following Kpnβ1 and concomitant p53 inhibition, cells were plated at 2000 cells per well in 96-well plates and 24 h later transfected with 20 nM control or Kpnβ1 siRNA, together with 20 nM control or p53 siRNA. After 48 h of siRNA transfection, cells were re-transfected with 10 nM control or p53 siRNA, and the following day, the caspase-3/7 assay was performed using the Caspase-Glo® 3/7 Assay Kit. An MTT assay was performed concurrently to normalize for cell number, and caspase-3/7 activity was expressed relative to cell number. RNA isolation and real-time reverse transcription–PCR analysis Cells were transfected with 20 nM siRNA and RNA harvested 72 or 96 h post-siRNA transfection, using Qiazol (Qiagen, Hilden, Germany), according to the manufacturer’s instructions. Complementary DNA was synthesized using 2 µg RNA and used in real-time reverse transcription (RT)–PCR analysis. The CT method was used for the calculation of expression fold change between samples. CT values were standardized to the levels of glyceraldehyde 3-phosphate dehydrogenase. Experiments were performed in triplicate and the average mRNA expression levels determined after normalization to glyceraldehyde 3-phosphate dehydrogenase. The average normalized value for control siRNA treated samples was converted to 1.0, and the fold increase/decrease in the Kpnβ1 siRNA treated samples determined, with the standard error of the mean representative of the repeated measurements. The sequence of quantitative PCR primers are as follows: Noxa F: 5ʹ TGGAAGTCGAGTGTGCT ACTCAA 3ʹ and R: 5ʹ AGATTCAGAAGTTTC TGCCGGAA 3ʹ; Puma F: 5ʹ CCTGGAGGGTCCTGTACAATCT 3ʹ and R: 5ʹ GCACCTAATTGGGCTCCATCT 3ʹ; HPV16 E6 F: 5ʹ ATGTTTCAGGAC CCACAGG 3ʹ and R: 5ʹ TAAATCCCGAAAAGCAAAGTC 3ʹ; HPV16 E7 F: 5ʹ AAGTGTGACTCTACGCTTCGGTT 3ʹ and R: 5ʹ GCCCATTAACAGGTC TTCCAAA 3ʹ; p73 F: 5ʹ CTCTGGAACCAGACAGC ACC 3ʹ and R: 5ʹ TGCT CAGCAGATTGAACTGG 3ʹ; p63 F: ATGTCCCAG AGCACACAGAC and R: CACGTCGAAACTGTGCGGGC; glyceraldehyde 3-phosphate dehydrogenase F: 5ʹ GGCTCTCCAGAACATCATCC 3ʹ and R: 5ʹ GCCTGCTTC ACCACCTTC 3ʹ. Statistical analysis For all data analysis comparisons, the Student’s t-test was performed. A Pvalue of <0.05 was considered statistically significant. Results Kpnβ1 inhibition results in prolonged mitotic arrest and apoptosis in cervical cancer cells In previous studies, we have shown that Kpnβ1 mRNA and protein expression is elevated in cervical cancer and transformed cells, Kpnβ1 inhibition results in mitotic arrest and apoptosis through deregulation of E2F activity, and that the inhibition of Kpnβ1 results in cell death (14,15). Interestingly, the inhibition of Kpnβ1 did not affect normal cell survival (14). To further support these findings, we investigated the effect of Kpnβ1 siRNA on representative cervical cancer and non-cancer cells over a period of 5 days using the MTT assay. Kpnβ1 inhibition in HeLa and CaSki cervical cancer cells resulted in a significant decrease in MTT absorbance, indicative of decreased cell proliferation and/or the induction of cell death (Figure 1A, a and b). The non-cancer cells (FG0 and WI38), on the other hand, were unaffected (Figure 1Ac and d). Western blot analysis confirmed >60% Kpnβ1 knockdown in each cell line (Figure 1B and C) and also revealed elevated Kpnβ1 levels in the cervical cancer cells compared with the non-cancer fibroblasts (Figure 1B). As Kpnβ1 inhibition in cervical cancer cells resulted in decreased MTT absorbance, we next investigated whether there was an induction of cell death, using the trypan blue assay. Results showed a significant increase in the percentage of dead cells after Kpnβ1 inhibition, and a concomitant decrease in the percentage of live cells, confirming the induction of cancer cell death after Kpnβ1 knockdown (Figure 1D and E). We further investigated whether apoptosis was induced as the mechanism of cell death. Caspase-3/7 activity was measured after Kpnβ1 inhibition in HeLa and CaSki cervical cancer cell lines and compared with that in the two non-cancer cell lines (FG0 and WI38). Kpnβ1 inhibition resulted in significant activation of caspase-3/7 in HeLa and CaSki cells but not in non-cancer FG0 and WI38 cells (Figure 1F). These results highlight how normal and cancer cells respond differently to the inhibition of Kpnβ1. As Kpnβ1 inhibition in cervical cancer cells resulted in apoptotic cell death, we further investigated its effect on cell cycle progression due to the reported role of karyopherin proteins in the transition of the cell cycle, mitosis and replication (2,7). Cervical cancer cells were treated with either control or Kpnβ1 siRNA and cell cycle analysis performed 96 h post-transfection. Interestingly, Kpnβ1 inhibition resulted in a significant decrease in the percentage of cells in G1 and an associated significant increase in the percentage of cells in the G2/M phase of the cell cycle (Figure 2A). As expected, there was a significant increase in the percentage of sub-G1 cells, indicative of cell death (Figure 2A). The G2/M arrest was investigated further by blocking the cells in the G2/M stage of the cell cycle using a thymidine–nocodazole block. Cells were released from the mitotic block and harvested for protein for immunoblot or fixed for FACS analysis, respectively. The cell cycle profiles obtained by FACS analysis showed that Kpnβ1 inhibition resulted in a prolonged G2/M arrest compared with cells transfected with control siRNA (Figure 2B, Table I). In control siRNA treated cells, the number of cells in the G2/M phase of the cell cycle decreased within 4 h after the release of the G2/M block (Figure 2B). In contrast, Kpnβ1 knockdown cells remained in the G2/M phase of the cell cycle 12 h after the release of the G2/M block (Figure 2B). Western blot analysis confirmed that Kpnβ1 inhibition resulted in a prolonged mitotic arrest. After the release of the G2/M block, pS10Histone-3, a marker for cells in mitosis, remained elevated for longer in cells treated with Kpnβ1 siRNA compared with controls (Figure 2C). The prolonged G2/M arrest in Kpnβ1 inhibited cells associated with decreased levels of Mcl-1. Mcl-1, an antiapoptotic member of the Bcl-2 family, has previously been shown to be degraded during prolonged G2/M arrest (21). Cells treated with Kpnβ1 siRNA resulted in Mcl-1 degradation within 6 h after the release of the nocodazole block. In contrast, Mcl-1 was expressed at all of the time points tested (0–12 h) in control siRNA treated cells (Figure 2C). p53 and p21 levels were elevated in Kpnβ1 treated cells compared with cells treated with control siRNA (Figure 2C), supporting previously reported data by van der Watt et al. (14) showing that p53 and p21 levels become elevated when Kpnβ1 expression is inhibited in cervical cancer cells. PARP cleavage, a hallmark of DNA damage and apoptosis, was also observed in cells treated with Kpnβ1 siRNA (Figure 2C). Interestingly, no prolonged mitotic arrest was observed when Kpnβ1 was inhibited in the non-cancer cell line WI38 (Supplementary Figure 1A, available at Carcinogenesis Online). Furthermore, pS10His3 and Mcl-1 levels were unchanged between control and Kpnβ1 siRNA-transfected WI38 cells, confirming that no prolonged mitotic arrest was induced (Supplementary Figure 1B, available at Carcinogenesis Online). These results further demonstrate that normal and cancer cells respond differently to the inhibition of Kpnβ1 and suggest that while cervical cancer cells become functionally dependent on high Kpnβ1 expression, relying on it for mitotic progression, normal cells can function in the presence of low levels of Kpnβ1. Kpnβ1 inhibition results in distinct mitotic defects Previous studies have shown that Kpnβ1 operates in physical association with the mitotic spindle in human cells (8). To investigate whether loss of endogenous Kpnβ1 resulted in mitotic defects, cervical cancer cells were treated with either control or Kpnβ1 siRNA and mitotic cells analyzed by immunofluorescence. Figure 2Da–d shows representative fluorescent microscopy images of the mitotic abnormalities induced by the inhibition of Kpnβ1 in asynchronous CaSki cells. Multipolar spindles (i), chromosome misalignment (ii) and lagging chromosomes in anaphase/telophase (iii) and metaphase (iv) were observed in CaSki cells treated with Kpnβ1 siRNA for 96 h (Figure 2D, Supplementary Figure 2A, available at Carcinogenesis Online). Quantification of the mitotic defects observed in CaSki cells treated with Kpnβ1 siRNA showed a significant increase in mitotic abnormalities (53%) compared with control (16%) siRNA treated cells (Figure 2E). The quantification of mitotic defects in HeLa cells similarly revealed a significant increase in mitotic abnormalities in Kpnβ1 knockdown cells compared with control cells (Figure 2E, Supplementary Figure 2B and C, available at Carcinogenesis Online). Non-cancer cells (FG0 and WI38), however, did not display any increase in mitotic defects after Kpnβ1 inhibition (Figure 2E). Kpnβ1 knockdown results in mitochondrial membrane permeablization and cell death via the intrinsic apoptotic pathway, accompanied by an increase in p53 levels As we observed the induction of caspase-3/7 activity, mitotic defects and a prolonged mitotic arrest associated with Mcl-1 degradation, we hypothesized that the intrinsic mitochondrial pathway might be activated and responsible for cell death after Kpnβ1 inhibition. Cytochrome C subcellular localization was thus investigated, as its release into the cytoplasm is a characteristic feature of the intrinsic mitochondrial pathway. Western blot analysis confirmed that Kpnβ1 protein expression was downregulated when cervical cancer cells were treated with Kpnβ1 siRNA (Figure 3A). Mitochondrial and cytoplasmic fractions were extracted from these cells and cytochrome C subcellular localization investigated by immunoblot analysis. Results showed that cytochrome C was released from the mitochondria into the cytoplasm in cells with Kpnβ1 knockdown, whereas cytochrome C was absent in the cytoplasm in cells treated with control siRNA (Figure 3B). This suggests that Kpnβ1 knockdown results in apoptosis through mitochondrial cytochrome C release. Recent studies have shown that Bax is translocated to the mitochondrial membrane, to induce cytochrome C release into the cytoplasm (23). As cytochrome C was released in cells treated with Kpnβ1 siRNA, Bax translocation was investigated. Western blot analysis revealed that there was Bax translocation from the cytoplasm to the mitochondria in cervical cancer cells treated with Kpnβ1 siRNA (Figure 3B). No cytoplasmic to mitochondria Bax translocation was observed in control siRNA treated cells (Figure 3B). Degradation of Mcl-1 has previously been shown to be induced in both the cytoplasm and mitochondria under stress-induced conditions (23). As Mcl-1 was shown to be degraded in synchronized cells, due to a prolonged mitotic arrest as a result of Kpnβ1 inhibition (Figure 2C), the levels of Mcl-1 protein in both the cytoplasm and mitochondria were further investigated in asynchronous cells. Subcellular fractionation showed that Mcl-1 levels were decreased in both the cytoplasmic and mitochondria fractions when Kpnβ1 expression was inhibited compared with control (Figure 3B). Bax translocation to the mitochondria and Mcl-1 degradation in the cytoplasmic as 1123 L.Angus, P.J.van der Watt and V.D.Leaner Fig. 1. Kpnβ1 inhibition results in cell death and caspase-3/7 activation in cervical cancer but not in non-cancer cells. (A) Representative cervical cancer (HeLa and CaSki) and non-cancer (FG0 and WI38) cell lines were transfected with control (ctl) or Kpnβ1 siRNA and cell number measured over a period of 5 days using the MTT assay. Kpnβ1 inhibition in cervical cancer cells significantly reduced cell number (*P < 0.05, N = 3), whereas non-cancer cells were unaffected. Error bars represent the mean ± SD. (B) Western blot showing Kpnβ1 knockdown in HeLa, CaSki, FG0 and WI38 cells. β-Tubulin was used to control for cell loading. (C) Densitometric quantification of the western blot in B, showing >60% Kpnβ1 knockdown in each cell line. (D and E) Trypan blue assay showing a decrease in the percentage of live cells and associated increase in the percentage of dead cells after Kpnβ1 inhibition (*P < 0.05, N = 3). (F) Caspase-3/7 activity was measured in cervical cancer (HeLa and CaSki) and fibroblast (FG0 and WI38) cells 72 h post-transfection with control or Kpnβ1 siRNA. Kpnβ1 inhibition resulted in a significant induction of caspase-3/7 activity in cervical cancer but not in non-cancer cells. Error bars represent the mean ± SEM (*P < 0.05, N = 3). 1124 Kpnβ1 inhibition results in mitotic arrest and apoptosis Fig. 2. Kpnβ1 inhibition results in a prolonged mitotic arrest and distinct mitotic defects in cervical cancer cells. (A) CaSki cells were transfected with 20 nM control or Kpnβ1 siRNA and cell cycle analysis performed 96 h post-transfection. An increase in the percentage of cells in the G2/M phase of the cell cycle was observed, together with an increase in the percentage of sub-G1 cells and a decrease in the percentage of cells in the G1 phase (*P < 0.05, N = 3). (B) CaSki cells were synchronized at the G2/M boundary by a thymidine–nocodazole block and then released to progress through the cell cycle. Samples were collected at various time points after the release of the G2/M block and examined by FACS analysis. The sub-G1 cells were gated out of the analysis. (C) Samples were similarly collected at various time points after release of the G2/M block for western blot analyses. p38 was used as a loading control. (D, a–d) Representative pictures are shown for mitotic abnormalities induced by the inhibition of Kpnβ1 in asynchronous CaSki cells. Cell nuclei were stained with 4′,6-diamidino2-phenylindole (panels 1 and 2) and β-tubulin (panel 3) and merged images are shown in panel 4. Multipolar spindles (a), chromosome misalignment (b) and lagging chromosomes in anaphase/telophase (c) and metaphase (d) were observed when CaSki cells were treated with Kpnβ1 siRNA for 96 h (E) The frequency of mitotic abnormalities was counted, in triplicate, in >70 cells, in cervical cancer cell lines HeLa and CaSki and non-cancer cell lines FG0 and WI38, treated with control or Kpnβ1 siRNA for 72 h (*P < 0.05). 1125 L.Angus, P.J.van der Watt and V.D.Leaner Table I. Percentage of cells in each stage of the cell cycle after release from a G2/M block Time after G2/M block (h) Control siRNA 0 2 4 6 8 10 12 24 Kpnβ1 siRNA 0 2 4 6 8 10 12 24 Percentage of cells (%) G1 S G2/M 4.26 4.39 48.41 54.74 62.42 68.95 65.93 25.66 27.73 15.89 14.07 13.88 11.67 10.9 10.41 45.9 68.01 79.72 37.52 31.38 25.91 20.14 23.67 28.44 17.09 15.74 27.43 31.72 32.96 38.32 36.98 33.24 35.55 35.43 29.71 24.76 27.23 22.34 21.36 28.15 47.36 48.83 47.16 43.52 39.81 39.34 41.66 38.61 well as the mitochondria fractions in Kpnβ1 inhibited cells was not restricted to the CaSki cell line, as similar changes were observed in HeLa cells (Supplementary Figure 3A, available at Carcinogenesis Online). Noxa is a pro-apoptotic BH3-only member of the Bcl-2 protein family that has been shown to be involved in the intrinsic mitochondrial apoptotic pathway. Noxa mRNA expression was measured by real-time quantitative RT–PCR and was found to be significantly elevated in HeLa and CaSki cells when Kpnβ1 expression was inhibited (Figure 3C). Puma, another pro-apoptotic member of the Bcl-2 protein family closely related to its family member, Noxa, has also been reported to be involved in the intrinsic mitochondrial pathway. In contrast to Noxa expression, Puma mRNA expression was found at low levels and remained unchanged when cells were treated with Kpnβ1 or control siRNA (Figure 3D). As Noxa is commonly activated by p53 (24) and because we observed an increase in p53 expression after Kpnβ1 knockdown (Figure 2C), we next investigated the p53 response further. To determine whether Kpnβ1 inhibition had an impact on p53 stability, cervical cancer cells were transfected with control or Kpnβ1 siRNA and treated with cycloheximide to inhibit de novo protein synthesis. Protein lysates were harvested at various time intervals after cycloheximide treatment and western blot analysis performed to analyze p53 stability (Figure 3E). Control siRNA-transfected cells exhibited a p53 half-life of ~10.71 min, whereas the half-life of p53 in Kpnβ1 siRNA-transfected cells was increased ~5-fold to 51.02 min. The halflife of 10 min measured in the control cells correlates well with that described in published literature for p53 in cells containing the HPV E6 protein (25,26). These results indicate that p53 is protected from degradation when Kpnβ1 is inhibited, explaining the increase in p53 protein levels following Kpnβ1 knockdown. To determine whether p53 was protected from degradation due to it being excluded from the nucleus after Kpnβ1 inhibition, nuclear and cytoplasmic protein fractions were harvested from control and Kpnβ1 siRNA-transfected cells, and western blot analysis performed. Interestingly, p53 protein accumulated in both the nucleus and cytoplasm of Kpnβ1 knockdown HeLa and CaSki cells (Figure 3F, Supplementary Figure 3B, available at Carcinogenesis Online), suggesting that the increase in p53 levels was not due to p53 being prevented from entering the nucleus. The minor band above p53 in the lanes with nuclear protein is likely phosphorylated p53, which is reported to localize in the nucleus of HPV E6-expressing cells (27). As HPV-positive cervical cancer cells express HPV E6 and E7 oncoproteins, which function in the degradation of p53 and Rb 1126 proteins, respectively, it was possible that the increase in p53 protein levels might be due to the inhibition of HPV E6 expression after Kpnβ1 knockdown. HPV E6 expression was analyzed in cells after siRNA transfection yet no decrease in E6 expression was observed (Figure 3G). Similarly, E7 levels were unchanged after Kpnβ1 inhibition (Figure 3H), as were levels of its target protein, Rb (both unphosphorylated and phosphorylated forms, Figure 3I). These results suggest that the increase in p53 observed after Kpnβ1 knockdown does not occur due to a decrease in E6 expression. Kpnβ1 inhibition results in p53-independent cell death To determine whether the increase in p53 levels was a contributor to the induction of cell death observed when Kpnβ1 was knockeddown, p53 siRNA was co-transfected with Kpnβ1 siRNA. Kpnβ1 and p53 knockdown was confirmed by western blot analysis (Figure 4A). p21 expression was reliant on p53, as knockdown of p53 resulted in a decrease in p21 protein levels (Figure 4A). MTT analysis showed that the inhibition of p53 in Kpnβ1 knockdown cervical cancer cells did not rescue the cells from Kpnβ1 siRNA-induced cell death (Figure 4B). To corroborate this finding, cytochrome C release was measured in cells in which Kpnβ1 and p53 were both silenced. As observed in earlier experiments, Kpnβ1 knockdown resulted in cytochrome C release into the cytoplasm. In double knockdown cells, treated with Kpnβ1 and p53 siRNA, the results remained unchanged compared with Kpnβ1 only inhibited cells (Figure 4C). Similarly, caspase-3/7 assays confirmed no change in caspase-3/7 activity after simultaneous knockdown of Kpnβ1 and p53, compared with Kpnβ1 knockdown alone (Figure 4D). The elevated levels of Noxa mRNA expression when Kpnβ1 expression was inhibited, as shown in Figure 3C, also occurred in a p53-independent manner, as Noxa mRNA expression was unaltered when cells were treated with Kpnβ1 siRNA alone or together with p53 siRNA (Figure 4E). Finally, because p53 is known to regulate the G2/M checkpoint, it was investigated whether the G2/M block still occurred after concomitant Kpnβ1 and p53 knockdown. A significant increase in the percentage of cells in the G2/M phase of the cell cycle was observed after Kpnβ1/p53 double knockdown (Figure 2F), similar to that observed after Kpnβ1 knockdown alone (Figure 2A), confirming that the G2/M arrest was a p53-independent event. To investigate whether p63 and p73 could compensate for the loss of p53 after p53 knockdown, mRNA expression levels of the pro-apoptotic isoforms of p63 and p73 were measured in the double knockdown cells, treated with Kpnβ1 and p53 siRNA, compared with cells treated with Kpnβ1 siRNA only. p63 and p73 levels remained unchanged when cells were either treated with Kpnβ1 siRNA alone or together with p53 siRNA, suggesting that p73 and p63 levels do not increase to compensate for the loss of p53 (Supplementary Figure 4, available at Carcinogenesis Online). The p53-independent cell death induced by Kpnβ1 inhibition was not restricted to HeLa cells as the same experiments were performed using CaSki cells and similar results obtained, further confirming that Kpnβ1 inhibition results in a p53-independent cell death (Supplementary Figure 5, available at Carcinogenesis Online). Taken together, these results suggest that apoptosis induced in Kpnβ1 knockdown cells is due to a p53-independent mechanism, involving a prolonged G2/M arrest, the degradation of Mcl-1, induction of pro-apoptotic Noxa and translocation of Bax that together mediate the intrinsic mitochondrial-dependent apoptotic pathway, leading to cytochrome C release, caspase-3/7 activation and cell death (Figure 5). Discussion Ectopic overexpression of Kpnβ1 has previously been shown to yield mitotic spindles with abnormal fragmented poles in HeLa cervical cancer cells, as well as MRC5 human fibroblast cells and NIH-3T3 murine fibroblasts (8). Interestingly, mitotic entry and spindle Kpnβ1 inhibition results in mitotic arrest and apoptosis Fig. 3. Kpnβ1 knockdown results in mitochondrial membrane permeabilization, elevated Noxa expression and the stabilization of p53. (A) CaSki cells were treated with 20 nM control or Kpnβ1 siRNA for 96 h and western blot analysis confirmed that Kpnβ1 protein expression was downregulated. (B) Biochemical subfractionation was performed after control or Kpnβ1 siRNA transfection and cytochrome C, Bax and Mcl-1 protein levels analyzed in the mitochondria (mito) and cytoplasmic (cyto) fractions. The different size Mcl-1 proteins in the cytoplasmic and mitochondrial fractions are likely the untruncated (42 kDa) and N-terminal truncated (40 kDa) forms of the protein, respectively (22). Anti-β-tubulin and anti-pereroxiredoxin-3 antibodies were used as loading controls for cytoplasmic and mitochondrial fractions, respectively. (C and D) Real-time RT–PCR was performed using control or Kpnβ1 siRNA-transfected cells and a significant increase in Noxa mRNA expression in Kpnβ1 knockdown cells was observed (*P < 0.05, N = 3). No change in Puma mRNA expression levels was observed. Results shown are the mean ± SEM of experiments performed in triplicate and repeated at least two independent times. (E) HeLa cells were transfected with 20 nM control or Kpnβ1 siRNA and treated with 50 µg/ml cycloheximide 72 h after siRNA transfection. Western blot analysis showed an increased stabilization of p53 protein in cells transfected with Kpnβ1 siRNA compared with control siRNA-transfected cells. p38 was used as a protein loading control. (F) Biochemical fractionation, 72 h post-transfection, showed that p53 accumulated in both the cytoplasmic and nuclear fraction when HeLa cells were treated with Kpnβ1 siRNA compared with control siRNA. (G and H) Real-time RT–PCR analysis was performed using RNA harvested 72 h post-transfection, and no change in HPV16 E6 or HPV16 E7 mRNA expression was observed after Kpnβ1 knockdown (N = 3). (I) Western blot analysis was performed using protein harvested 96 h post-transfection, and no change in Rb or phospho-Rb levels was observed. 1127 L.Angus, P.J.van der Watt and V.D.Leaner Fig. 4. Cell death as a result of Kpnβ1 knockdown occurs in a p53-independent manner. HeLa cells were transfected with control or Kpnβ1 siRNA, with or without p53 siRNA treatment. (A) Western blot analysis confirmed knockdown of Kpnβ1 and p53 after 72 h of post-transfection. p21 protein expression was decreased in cells treated with p53 siRNA. (B) Relative cell viability, measured using an MTT assay, showed that the loss of cell viability as a result of Kpnβ1 siRNA knockdown was not reversed by p53 siRNA treatment (*P < 0.01, N = 3). (C) Subcellular fractionation of the mitochondrial (mito) and cytoplasmic (cyto) fractions showed that cytochrome C release by Kpnβ1 siRNA knockdown occurred in a p53-independent manner. (D) Increased caspase-3/7 activity as a result of Kpnβ1 inhibition was p53-independent (*P < 0.05, N = 3). (E) Elevated Noxa mRNA expression, as measured by qualitative real-time PCR, as a result of Kpnβ1 siRNA was not reversed by p53 siRNA treatment (*P < 0.05, N = 3). (F) Cell cycle analysis shows a significant increase in the percentage of cells in the G2/M phase of the cell cycle after concomitant Kpnβ1 and p53 knockdown, together with a significant increase in the percentage of sub-G1 cells (*P < 0.05, N = 3). 1128 Kpnβ1 inhibition results in mitotic arrest and apoptosis Fig. 5. Proposed model for the apoptotic pathway associated with inhibition of Kpnβ1. In this report, we propose that inhibition of nuclear import via Kpnβ1 in cancer cells results in a prolonged M phase arrest, sustained degradation of Mcl-1 and elevated Noxa expression. The imbalance between anti- and pro-apoptotic proteins results in Bax cytoplasmic-mitochondrial translocation, which results in permeabilization of the outer mitochondrial membrane, leading to cytochrome C release and activation of associated caspases and cell death via apoptosis. Although p53 becomes stabilized in Kpnβ1 knockdown cells, apoptosis occurs in a p53-independent manner. assembly were inhibited when high doses of Kpnβ1 were transfected (8,28). Here, we report that the transient inhibition of endogenous Kpnβ1 results in a prolonged mitotic arrest and distinct mitotic defects in cervical cancer cells. A tightly regulated expression of Kpnβ1 is, therefore, required for successful mitotic cell division, as upregulation or downregulation of Kpnβ1 protein levels result in defects in mitosis and cell cycle progression. As the nuclear envelope and nuclear pore complexes break down at the start of mitosis (29), it is unlikely that the mitotic defects/prolonged mitotic arrest occur due to alterations in the nuclear import pathway but rather due to the integral roles played by Kpnβ1 in the mitotic process. In our study, downregulation of Kpnβ1 expression levels resulted in a significant increase in cells presented with both pole defects and misaligned or lagging chromosomes (Figure 2D, Supplementary Figure 2, available at Carcinogenesis Online), suggestive of defective kinetochore-microtubule attachment. Recent work has shown that Kpnβ and Kpnα proteins can regulate spindle assembly by binding to key spindle assembly factors (SAFs) such as TPX2, NuMA and the kinesin XCTK2, inhibiting them except in areas where RanGTP is present (8,28,30–32). RanGTP is present in mitotic chromosomes, as RanGEF RCC1 remains chromosome bound at mitosis. Kpnβ and Kpnα act as negative regulators of spindle formation by sequestering SAFs, whereas RanGTP acts as a positive regulator by counteracting Kpnβ and Kpnα binding to SAF. The inhibition of Kpnβ1 is, therefore, likely to affect spindle formation as the inhibition on SAFs is released and SAFs are activated. Overexpression of SAF, such as TPX2, results in a significant increase in mitotic abnormalities, which include multipolar spindle formation in HeLa cells (8). The inhibition of endogenous Kpnβ1 may, therefore, result in the mitotic defects due to deregulated and activated SAFs. These observed mitotic defects may explain the prolonged mitotic arrest observed after a G2/M block. In addition, Kpnβ1 has been shown to be required for nuclear pore complex and nuclear envelope reassembly in postmitotic cells, hence its inhibition like also impacts this process, contributing to the prolonged mitotic arrest observed (33). Schmitz et al. (34) show that Kpnβ1 inhibition leads to a delay of both early and late mitotic events, likely due to its roles in spindle assembly and nuclear envelope reassembly, respectively. Although Kpnβ1 inhibition resulted in a prolonged mitotic arrest, it is interesting to note that the mitotic block itself appeared less efficient in Kpnβ1 knockdown cells compared with control cells (Figure 2B). As the nocodazole treatment was preceded by treatment with thymidine to arrest the cells in G1/S, it is possible that some of the Kpnβ1 knockdown cells were unable to progress out of the thymidine-induced G1/S block, due to the inhibition of nuclear import resulting in aberrations in cellular processes required for S phase progression. This might explain why fewer cells were able to become arrested in G2/M. This, however, requires further investigation. Associated with the observed mitotic arrest was the induction of apoptosis after Kpnβ1 knockdown. Apoptosis is regulated by the tight balance between antiapoptotic Bcl family proteins and their pro-apoptotic counterparts. Mcl-1 protects mitochondrial integrity, whereas pro-apoptotic members of the family, such as Bax, promote the release of cytochrome C. Studies have shown that Bax, which ordinarily resides in the cytoplasm, translocates to the mitochondrial membrane, where it undergoes a conformational change, oligomerizes and is inserted into the membrane to facilitate the release of cytochrome C (35–38). Nijhawan et al. (23) have shown that the elimination of Mcl-1, which is rapidly degraded by the proteosome upon cell death signals, is required for Bax translocation from the cytosol to the mitochondria to induce cytochrome C release and caspase activation. Only prolonged mitotic arrest allows for sufficient Mcl-1 phosphorylation and degradation to trigger apoptosis (21,39,40). As we observed Mcl-1 degradation after Kpnβ1 inhibition, we propose that the cells arrested in mitosis after Kpnβ1 knockdown undergo apoptosis, via Bax translocation from the cytoplasm to the mitochondria, ultimately resulting in cytochrome C release and caspase activation (Figure 5). It is interesting that although Kpnβ1 inhibition in the cervical cancer cell lines results in a prolonged mitotic arrest and the induction of apoptosis, its inhibition in normal cells does not 1129 L.Angus, P.J.van der Watt and V.D.Leaner (Figure 1, Supplementary Figure 1, available at Carcinogenesis Online). During tumourigenesis, cancer cells are known to become ‘addicted’ to certain proteins that enable them to enhance cellular processes and sustain their increased proliferative and metabolic abilities. It could be along similar lines that cancer cells upregulate Kpnβ1 expression and become functionally dependent on high levels of this protein. Hence, its inhibition in cancer cells is detrimental to the cell, in this case resulting in cell death via a mitotic arrest and the induction of intrinsic mitochondrial apoptosis. It has also been proposed that cancer cells are inherently more sensitive to apoptosis, due to their oncogenic lesions (41). The lack of phenotype observed after Kpnβ1 inhibition in normal cells could be due to a reliance on other karyopherin β family members in normal cells. Alternatively, it could result from the fact that the siRNA does not deplete all of the Kpnβ1 present in the cell (due to the nature of a transient transfection) and thus the low levels of Kpnβ1 still present are sufficient to support mitosis and nuclear import. This would imply that normal cells and cancer cells vary greatly with regards to the amount of Kpnβ1 they require, making Kpnβ1 an attractive target for cancer therapy. Finally, although Kpnβ1 inhibition resulted in the stabilization and accumulation of p53, p53 did not contribute to the apoptosis observed when Kpnβ1 was inhibited (Figures 3 and 4). This is of particular interest as we observed an increase in Noxa mRNA expression in Kpnβ1 knockdown cells; a characteristically p53-dependent response (24). However, recent evidence, as well as data obtained in this study, has shown that Noxa expression can be induced in a p53-independent manner (42,43). Interestingly, cell death induced by Kpnβ1 inhibition does not involve enhanced Puma mRNA levels, a close relative of Noxa, suggesting that Noxa and Puma levels may be activated under different stresses. In addition to cell death induced by Kpnβ1 inhibition being p53-independent, it was also not dependent on p21, as p21 protein levels declined after p53 siRNA treatment and the same extent of apoptotic cell death was observed (Figure 4). Our finding that Kpnβ1 inhibition results in the accumulation of p53 protein in the nucleus and cytoplasm (Figure 3F) is in contrast with data published by Marchenko et al. (44). Marchenko et al. (44) showed that after the inhibition of Kpnβ1 using siRNA in H1299 cells, p53 levels decreased in the nucleus but increased in the cytoplasm, suggesting that p53 becomes retained in the cytoplasm due to its inability to enter the nucleus following the inhibition of its nuclear importer (44). These authors, however, used ectopically expressed p53 in a p53 null cell line, whereas we examined endogenous p53 protein in p53 wild-type expressing cell lines (HeLa and CaSki). It may be that in our scenario, p53 is unable to enter the nucleus; however, the p53 that is already in the nucleus becomes stabilized, whereas in control siRNA treated cells, p53 is constantly being degraded. In HPVpositive cells, p53 degradation occurs via E6-mediated ubiquitination in the nucleus by the ubiquitin E3 ligase, E6-AP (45), after which E6 and p53 are co-exported to the cytoplasm, where p53 is degraded by the 26 S proteasome (46). Although we show that HPV E6 mRNA levels were unchanged after Kpnβ1 knockdown (Figure 3G and H), thus not accounting for the increased stabilization of p53, it is possible that E6 is prevented from entering the nucleus upon Kpnβ1 knockdown, thereby preventing p53 from being degraded. E6 has been shown to utilize Kpnβ1 for its nuclear import (47), although it can also interact with the import receptor Kpnβ2 (47). Hence, inhibition of Kpnβ1 might, in part, prevent E6 nuclear import, leading to p53 stabilization in the nucleus and cytoplasm. Although our study was performed using HPV-positive cervical cancer cells, it is important to note that the cell killing effect after Kpnβ1 inhibition is not specific to HPVpositive cervical cancer, as Kpnβ1 inhibition in HPV-negative cervical cancer cells also results in cell death, as published by us previously (14). In conclusion, the inhibition of endogenous Kpnβ1 in cervical cancer cells results in a significant increase in mitotic abnormalities and a prolonged mitotic arrest. We propose that the prolonged mitotic arrest results in degradation of Mcl-1, which results in an imbalance between pro-apoptotic and antiapoptotic Bcl-2 members. Bax 1130 is translocated to the mitochondria where it induces cytochrome C release to activate the associate caspases and result in apoptotic cell death. Even though p53 levels are stabilized in Kpnβ1 knockdown cells, the associated cell death is p53 independent. We propose that Kpnβ1 may be a potential anticancer therapeutic target for both p53 wild-type and mutant tumors. Supplementary material Supplementary Figures 1–5 can be found at http://carcin.oxfordjournals.org/ Funding University of Cape Town; the Carnegie Corporation of New York; the Cancer Association of South Africa (CANSA); Medical Research Council of South Africa. 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