Department of Biomedical Sciences, University of Minnesota Medical School, Duluth, MN 55812, United States.
World J Gastroenterol. 2019 Oct 14;25(38):5732-5772. doi: 10.3748/wjg.v25.i38.5732.
In their seminal papers Hanahan and Weinberg described oncogenic processes a normal cell undergoes to be transformed into a cancer cell. The functions of ion channels in the gastrointestinal (GI) tract influence a variety of cellular processes, many of which overlap with these hallmarks of cancer. In this review we focus on the roles of the calcium (Ca), sodium (Na), potassium (K), chloride (Cl) and zinc (Zn) transporters in GI cancer, with a special emphasis on the roles of the KCNQ1 K channel and CFTR Cl channel in colorectal cancer (CRC). Ca is a ubiquitous second messenger, serving as a signaling molecule for a variety of cellular processes such as control of the cell cycle, apoptosis, and migration. Various members of the TRP superfamily, including TRPM8, TRPM7, TRPM6 and TRPM2, have been implicated in GI cancers, especially through overexpression in pancreatic adenocarcinomas and down-regulation in colon cancer. Voltage-gated sodium channels (VGSCs) are classically associated with the initiation and conduction of action potentials in electrically excitable cells such as neurons and muscle cells. The VGSC Na1.5 is abundantly expressed in human colorectal CRC cell lines as well as being highly expressed in primary CRC samples. Studies have demonstrated that conductance through Na1.5 contributes significantly to CRC cell invasiveness and cancer progression. Zn transporters of the ZIP/SLC39A and ZnT/SLC30A families are dysregulated in all major GI organ cancers, in particular, ZIP4 up-regulation in pancreatic cancer (PC). More than 70 K channel genes, clustered in four families, are found expressed in the GI tract, where they regulate a range of cellular processes, including gastrin secretion in the stomach and anion secretion and fluid balance in the intestinal tract. Several distinct types of K channels are found dysregulated in the GI tract. Notable are hERG1 upregulation in PC, gastric cancer (GC) and CRC, leading to enhanced cancer angiogenesis and invasion, and KCNQ1 down-regulation in CRC, where KCNQ1 expression is associated with enhanced disease-free survival in stage II, III, and IV disease. Cl channels are critical for a range of cellular and tissue processes in the GI tract, especially fluid balance in the colon. Most notable is CFTR, whose deficiency leads to mucus blockage, microbial dysbiosis and inflammation in the intestinal tract. CFTR is a tumor suppressor in several GI cancers. Cystic fibrosis patients are at a significant risk for CRC and low levels of CFTR expression are associated with poor overall disease-free survival in sporadic CRC. Two other classes of chloride channels that are dysregulated in GI cancers are the chloride intracellular channels (CLIC1, 3 & 4) and the chloride channel accessory proteins (CLCA1,2,4). CLIC1 & 4 are upregulated in PC, GC, gallbladder cancer, and CRC, while the CLCA proteins have been reported to be down-regulated in CRC. In summary, it is clear, from the diverse influences of ion channels, that their aberrant expression and/or activity can contribute to malignant transformation and tumor progression. Further, because ion channels are often localized to the plasma membrane and subject to multiple layers of regulation, they represent promising clinical targets for therapeutic intervention including the repurposing of current drugs.
在他们的开创性论文中,Hanahan 和 Weinberg 描述了正常细胞经历的致癌过程,使其转化为癌细胞。离子通道在胃肠道 (GI) 中的功能影响多种细胞过程,其中许多与癌症的这些特征重叠。在这篇综述中,我们专注于钙 (Ca)、钠 (Na)、钾 (K)、氯 (Cl) 和锌 (Zn) 转运体在胃肠道癌症中的作用,特别强调 KCNQ1 K 通道和 CFTR Cl 通道在结直肠癌 (CRC) 中的作用。Ca 是一种普遍存在的第二信使,作为多种细胞过程的信号分子,如细胞周期的控制、细胞凋亡和迁移。TRP 超家族的各种成员,包括 TRPM8、TRPM7、TRPM6 和 TRPM2,已被牵连到胃肠道癌症中,特别是在胰腺腺癌中过度表达和结肠癌中下调。电压门控钠通道 (VGSC) 经典地与神经元和肌肉细胞等电兴奋细胞的动作电位的起始和传导有关。VGSC Na1.5 在人类结直肠 CRC 细胞系中大量表达,在原发性 CRC 样本中也高度表达。研究表明,Na1.5 的电导率对 CRC 细胞的侵袭性和癌症进展有显著贡献。ZIP/SLC39A 和 ZnT/SLC30A 家族的 Zn 转运体在所有主要的胃肠道器官癌症中失调,特别是在胰腺癌 (PC) 中 ZIP4 的上调。在胃肠道中发现超过 70 种 K 通道基因,分为四个家族,它们调节多种细胞过程,包括胃中的胃泌素分泌和肠道中的阴离子分泌和液体平衡。几种不同类型的 K 通道在胃肠道中失调。值得注意的是,PC、胃癌 (GC) 和 CRC 中 hERG1 的上调导致癌症血管生成和侵袭增强,而 CRC 中 KCNQ1 的下调与 II 期、III 期和 IV 期疾病中疾病无进展生存率的提高有关。Cl 通道对胃肠道中的多种细胞和组织过程至关重要,特别是在结肠中的液体平衡。最值得注意的是 CFTR,其缺乏会导致肠道中的粘液阻塞、微生物失调和炎症。CFTR 是几种胃肠道癌症的肿瘤抑制因子。囊性纤维化患者患 CRC 的风险显著增加,散发性 CRC 中 CFTR 表达水平低与总体疾病无进展生存率差相关。在胃肠道癌症中失调的另外两类氯离子通道是氯离子细胞内通道 (CLIC1、3 和 4) 和氯离子通道辅助蛋白 (CLCA1、2 和 4)。CLIC1 和 4 在 PC、GC、胆囊癌和 CRC 中上调,而 CLCA 蛋白在 CRC 中下调。总之,离子通道的多种影响清楚地表明,它们的异常表达和/或活性可以促进恶性转化和肿瘤进展。此外,由于离子通道通常位于质膜上,并受到多层次的调节,因此它们代表了有前途的临床治疗靶点,包括重新利用现有药物。