Ma Bo, Wheeler Sarah E, Clark Amanda M, Whaley Diana L, Yang Min, Wells Alan
Department of Pathology, University of Pittsburgh, Pittsburgh, PA.
Pittsburgh VA Healthcare System, Pittsburgh, PA.
Hepatology. 2016 Nov;64(5):1725-1742. doi: 10.1002/hep.28755. Epub 2016 Sep 23.
Liver is one of the most common sites of cancer metastasis. Once disseminated, the prognosis is poor as these tumors often display generalized chemoresistance, particularly for carcinomas that derive not from the aerodigestive tract. When these cancers seed the liver, the aggressive cells usually undergo a mesenchymal to epithelial reverting transition that both aids colonization and renders the tumor cells chemoresistant. In vitro studies demonstrate that hepatocytes drive this phenotypic shift. However, the in vivo evidence and the molecular signals that protect these cells from induced death are yet to be defined. Herein, we report that membrane surface E-cadherin-expressing prostate cancer cells were resistant to cell death by chemotherapeutic drugs but E-cadherin null cells or those expressing E-cadherin only in the cytoplasm were sensitive to death signals and chemotherapies both in vitro and in vivo. While cell-cell E-cadherin ligandation reduced mitogenesis, this chemoprotection was proliferation-independent as killing of both 5-ethynyl-2'-deoxyuridine-positive (or Ki67 ) and 5-ethynyl-2'-deoxyuridine-negative (Ki67 ) cells was inversely related to membrane-bound E-cadherin. Inhibiting the canonical survival kinases extracellular signal-regulated protein kinases, protein kinase B, and Janus kinase, which are activated by chemotherapeutics in epithelial cell-transitioned prostate cancer, abrogated the chemoresistance both in cell culture and in animal models of metastatic cancer. For disseminated tumors, protein kinase B disruption in itself had no effect on tumor survival but was synergistic with chemotherapy, leading to increased killing.
Liver microenvironment-driven phenotypic switching of carcinoma cells and subsequent survival signaling results in activation of canonical survival pathways that protect the disseminated prostate cancer liver micrometastases in a proliferation-independent manner, and these pathways can be targeted as an adjuvant treatment to improve the efficacy of traditional chemotherapeutics (Hepatology 2016;64:1725-1742).
肝脏是癌症转移最常见的部位之一。一旦发生转移,预后很差,因为这些肿瘤通常表现出普遍的化疗耐药性,特别是对于非源自气消化道的 carcinomas。当这些癌症转移至肝脏时,侵袭性细胞通常会经历间充质到上皮的逆转转变,这既有助于定植,又使肿瘤细胞具有化疗耐药性。体外研究表明,肝细胞驱动这种表型转变。然而,体内证据以及保护这些细胞免于诱导死亡的分子信号尚未明确。在此,我们报告表达膜表面 E-钙黏蛋白的前列腺癌细胞对化疗药物诱导的细胞死亡具有抗性,但 E-钙黏蛋白缺失细胞或仅在细胞质中表达 E-钙黏蛋白的细胞在体外和体内对死亡信号和化疗均敏感。虽然细胞间 E-钙黏蛋白配体结合减少了有丝分裂,但这种化学保护与增殖无关,因为对 5-乙炔基-2'-脱氧尿苷阳性(或 Ki67)和 5-乙炔基-2'-脱氧尿苷阴性(Ki67)细胞的杀伤均与膜结合 E-钙黏蛋白呈负相关。抑制在上皮细胞转化的前列腺癌中被化疗激活的经典存活激酶细胞外信号调节蛋白激酶、蛋白激酶 B 和 Janus 激酶,在细胞培养和转移性癌症动物模型中均消除了化疗耐药性。对于播散性肿瘤,蛋白激酶 B 的破坏本身对肿瘤存活没有影响,但与化疗具有协同作用,导致杀伤增加。
肝脏微环境驱动的癌细胞表型转换及随后的存活信号传导导致经典存活途径的激活,以增殖无关的方式保护播散性前列腺癌肝微转移灶,并且这些途径可作为辅助治疗的靶点,以提高传统化疗的疗效(《肝脏病学》2016 年;64:1725 - 1742)