Consistent with the maintenance of a stable ratio between melanocytes and keratinocytes in the normal skin, few melanocytes, as identified by Melan-A staining, were found in normal areas of the skin. Rad6 expression was undetectable in these normal regions (Figure 5A, panels a-a” and b-b”). Rad6 expression became noticeable in the neighboring areas of skin that showed increased numbers of (Melan-A positive) melanocytes ( Figure 5A, panels c-c” and d-d”), and Rad6 was overexpressed

and colocalized with Melan-A stained cells in tumor regions ( Figure 5A, panels e-e”, f-f”). Similar Ibrutinib analysis of Rad6 and β-catenin showed an inverse relationship between Rad6 and β-catenin in the normal areas of SSMM samples with strong β-catenin staining and negligible Rad6 ( Figure 5B, panels a-a”), whereas both Rad6 and β-catenin staining were detected in the adjacent tumor areas ( Figure 5B, panels b-b”). These data suggest that unlike β-catenin, Rad6 may contribute to the development of cutaneous melanoma. A major finding of this study is the discovery of Rad6 as an early marker for cutaneous melanoma development. We show that Rad6, an ubiquitin conjugating enzyme, and activator of canonical Wnt/β-catenin signaling

via β-catenin stabilizing modifications, plays an important role in melanoma development. Analysis of clinical melanoma and nevi cores in melanoma tissue microarray showed up-regulation of Rad6 expression in primary melanoma cases compared to nevi. The present data are supported by a detailed immunohistochemical Alpelisib study of Rad6 and β-catenin in archived nevi, primary, and metastatic melanoma samples from Rutecarpine 90 patients that showed Rad6 expression is associated with primary and metastatic melanoma but not nevi, and that Rad6 that is overexpressed in > 95% of metastatic melanomas co-occurs with β-catenin

in about half of metastatic melanomas [42]. In support of the clinical data, western blot and immunofluorescence analysis showed an inverse relationship between Rad6 and β-catenin in normal melanocytes, whereas primary and metastatic melanoma cell lines showed a direct correlation between levels of Rad6, high molecular weight β-catenin, β-catenin-mediated TOP/Flash reporter activity, and migratory potential. These data are consistent with the positive feedback loop between Rad6B gene expression and β-catenin stabilization/activation reported in breast cancer, wherein Rad6B, a transcriptional target of β-catenin, is induced by T-Cell factor/β-catenin [25], and Rad6B in turn stabilizes β-catenin by inducing K63-linked polyubiquitin modifications (high molecular weight β-catenin forms) that bestow β-catenin with elevated transcriptional activity and resistance to 26S proteasomal degradation [24].