O‐glycosylated clusterin as a sensitive marker for diagnosing early stages of prostate cancer

AbstractBackgroundProstate‐specific antigen (PSA) has been the most popular diagnostic marker for prostate cancer. The frequent occurrence of low PSA values (<10 ng/ml) in patients with highly suspicious prostate cancer, however, has undermined the accuracy of clinical examinations. The aim of this study was to develop a better resolution for diagnosing prostate cancer to overcome the disadvantage of PSA.MethodsWe focused on the glycosylation status of patients' serum proteins and conducted comprehensive lectin microarray analyses to characterize N‐ and O‐glycans using sera from prostate cancer and benign prostatic diseases. Next, we retrieved candidate serum proteins with characteristic glycan structures using lectin‐immobilized beads and identified them by quantitative mass spectrometry using a technique referred to as isobaric tag for relative and absolute quantitation (iTRAQ) labeling. Finally, we constructed a new assay to quantify a candidate glycoprotein with the newly identified glycans.ResultsLectin microarray analyses revealed that sera from patients with prostate cancer had a higher affinity for Jacalin, Amaranthus caudatus (ACA) lectin, and Maclura pomifera (MPA) lectin, compared with that from patients with benign prostatic diseases and normal subjects, suggesting that O‐glycosylated proteins are more abundant in sera from patients with prostate cancer. Then, serum glycoproteins preferentially adsorbed onto Jacalin‐Agarose as well as biotin‐ACA/and biotin‐MPA/streptavidin‐immobilized magnetic beads were isolated, labeled with iTRAQ, and identified using quantitative mass spectrometry. It was found that the ACA‐ and MPA‐recognizable clusterin was more enriched in patients' sera from prostate cancer compared with those from benign prostatic diseases. Following this discovery, we constructed a Luminex‐based assay to quantify O‐glycosylated clusterin, in which total serum clusterin was first captured on anti‐clusterin antibody‐immobilized beads, and then clusterin‐associated O‐glycans were determined by the pair of biotin‐MPA and streptavidin‐phycoerythrin. When PSA values registered less than 10 ng/ml, the corresponding serum level of MPA‐recognized clusterin determined by this assay was beneficial for distinguishing the patients with prostate cancer from the patients with benign prostatic disease.ConclusionFor PSA values that measure less than 10 ng/ml, the serum O‐glycosylated clusterin level can be a complementary indicator for the malignancy of prostate cancer.