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Zhuang Y, Yang H. The Prognostic Significance of Adjuvant Chemotherapy in Adult Ovarian Granulosa Cell Tumors: A Systematic Review and Meta-analysis. Cancer Control 2023; 30:10732748231215165. [PMID: 37957122 PMCID: PMC10644757 DOI: 10.1177/10732748231215165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/01/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate the oncological and prognostic significance of adjuvant chemotherapy (CT) in patients with adult granulosa cell tumors of the ovary (AOGCT). METHODS We searched the Chinese National Knowledge Infrastructure, Clinical Trials, Wanfang Database, Web of Science, Cochrane Library, and MEDLINE electronic databases for articles published up to May 2023. Reference lists of the enrolled studies, Google Scholar, and scientific meeting reports were also manually searched. RESULTS We enrolled 5641 patients with AOGCT from 33 eligible studies, including 1674 (29.7%) and 3967 (70.3%) patients in the CT and non-CT groups, respectively. Based on the cumulative results, adjuvant CT did not affect the risk of recurrence or progression (R/P) (odds ratio [OR]: 1.67, 95% confidence interval [CI]: 1.01-2.78, I2 = 63%, P = .05) and 5-year overall survival (OR: .86, 95% CI: .70-1.04, I2 = 0%, P = .12) of patients with AOGCT. However, adjuvant CT might reduce the 5-year disease-free survival (OR: 2.90, 95% CI: 1.19-7.08, I2 = 55%, P = .02). Sub-group analysis revealed that adjuvant CT did not affect the risk of R/P in patients with early-stage AOGCT (OR: .78, 95% CI: .43-1.43, I2 = 2%, P = .43) and advanced or recurrent AOGCT (OR: .78, 95% CI: .43-1.43, I2 = 2%, P = .43). CONCLUSION This meta-analysis suggests that patients with AOGCT might not benefit from adjuvant CT, even those with advanced or recurrent disease. The results should be interpreted with caution because of the inherent limitations of retrospective studies.
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Affiliation(s)
- Yuan Zhuang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Hua Yang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
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Roze J, Sendino Garví E, Stelloo E, Stangl C, Sereno F, Duran K, Groeneweg J, Paijens S, Nijman H, van Meurs H, van Lonkhuijzen L, Piek J, Lok C, Jonges G, Witteveen P, Verheijen R, van Haaften G, Zweemer R, Monroe G. In Vitro Systematic Drug Testing Reveals Carboplatin, Paclitaxel, and Alpelisib as a Potential Novel Combination Treatment for Adult Granulosa Cell Tumors. Cancers (Basel) 2021; 13:368. [PMID: 33498451 PMCID: PMC7864192 DOI: 10.3390/cancers13030368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 12/11/2022] Open
Abstract
Adult granulosa cell tumors (AGCTs) arise from the estrogen-producing granulosa cells. Treatment of recurrence remains a clinical challenge, as systemic anti-hormonal treatment or chemotherapy is only effective in selected patients. We established a method to rapidly screen for drug responses in vitro using direct patient-derived cell lines in order to optimize treatment selection. The response to 11 monotherapies and 12 combination therapies, including chemotherapeutic, anti-hormonal, and targeted agents, were tested in 12 AGCT-patient-derived cell lines and an AGCT cell line (KGN). Drug screens were performed within 3 weeks after tissue collection by measurement of cell viability 72 h after drug application. The potential synergy of drug combinations was assessed. The human maximum drug plasma concentration (Cmax) and steady state (Css) thresholds obtained from available phase I/II clinical trials were used to predict potential toxicity in patients. Patient-derived AGCT cell lines demonstrated resistance to all monotherapies. All cell lines showed synergistic growth inhibition by combination treatment with carboplatin, paclitaxel, and alpelisib at a concentration needed to obtain 50% cell death (IC50) that are below the maximum achievable concentration in patients (IC50 < Cmax). We show that AGCT cell lines can be rapidly established and used for patient-specific in vitro drug testing, which may guide treatment decisions. Combination treatment with carboplatin, paclitaxel, and alpelisib was consistently effective in AGCT cell lines and should be further studied as a potential effective combination for AGCT treatment in patients.
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Affiliation(s)
- Joline Roze
- Department of Gynaecological Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands; (J.R.); (J.G.); (R.V.); (G.M.)
| | - Elena Sendino Garví
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Oncode Institute, Utrecht University, 3584 CX Utrecht, The Netherlands; (E.S.G.); (E.S.); (C.S.); (F.S.); (K.D.); (G.v.H.)
| | - Ellen Stelloo
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Oncode Institute, Utrecht University, 3584 CX Utrecht, The Netherlands; (E.S.G.); (E.S.); (C.S.); (F.S.); (K.D.); (G.v.H.)
| | - Christina Stangl
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Oncode Institute, Utrecht University, 3584 CX Utrecht, The Netherlands; (E.S.G.); (E.S.); (C.S.); (F.S.); (K.D.); (G.v.H.)
| | - Ferdinando Sereno
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Oncode Institute, Utrecht University, 3584 CX Utrecht, The Netherlands; (E.S.G.); (E.S.); (C.S.); (F.S.); (K.D.); (G.v.H.)
| | - Karen Duran
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Oncode Institute, Utrecht University, 3584 CX Utrecht, The Netherlands; (E.S.G.); (E.S.); (C.S.); (F.S.); (K.D.); (G.v.H.)
| | - Jolijn Groeneweg
- Department of Gynaecological Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands; (J.R.); (J.G.); (R.V.); (G.M.)
| | - Sterre Paijens
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (S.P.); (H.N.)
| | - Hans Nijman
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (S.P.); (H.N.)
| | - Hannah van Meurs
- Department of Gynecological Oncology, Centre for Gynaecological Oncology Amsterdam, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands; (H.v.M.); (L.v.L.)
| | - Luc van Lonkhuijzen
- Department of Gynecological Oncology, Centre for Gynaecological Oncology Amsterdam, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands; (H.v.M.); (L.v.L.)
| | - Jurgen Piek
- Department of Obstetrics and Gynaecology, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands;
| | - Christianne Lok
- Department of Gynaecological Oncology, Centre for Gynaecological Oncology Amsterdam, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands;
| | - Geertruida Jonges
- Department of Pathology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands;
| | - Petronella Witteveen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands;
| | - René Verheijen
- Department of Gynaecological Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands; (J.R.); (J.G.); (R.V.); (G.M.)
| | - Gijs van Haaften
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Oncode Institute, Utrecht University, 3584 CX Utrecht, The Netherlands; (E.S.G.); (E.S.); (C.S.); (F.S.); (K.D.); (G.v.H.)
| | - Ronald Zweemer
- Department of Gynaecological Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands; (J.R.); (J.G.); (R.V.); (G.M.)
| | - Glen Monroe
- Department of Gynaecological Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands; (J.R.); (J.G.); (R.V.); (G.M.)
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Liu X, Zhang P, Li Y, Zhao N, Han H. The AMPK-mTOR axis requires increased MALAT1 expression for promoting granulosa cell proliferation in endometriosis. Exp Ther Med 2021; 21:21. [PMID: 33235630 PMCID: PMC7678598 DOI: 10.3892/etm.2020.9453] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 08/12/2020] [Indexed: 02/07/2023] Open
Abstract
Endometriosis is a common reproductive disorder in women, with a global prevalence of 10-15%. Long noncoding RNAs (lncRNAs) are critical to gene transcription, cell cycle modulation and immune response. The lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) reportedly mediates autophagy of endometrial stromal cells in endometriosis. The present study aimed to evaluate the role and mechanism of MALAT1 in granulosa cells (GCs) in endometriosis. Consequently, MALAT1 expression was upregulated in GCs obtained from patients with endometriosis and in the steroidogenic human granulosa-like tumor cell line KGN. However, MALAT1 knockdown consequently decreased the proliferation and viability of these cells, as determined by MTT and 5-ethynyl-2'-deoxyuridine staining assays. Both Annexin V-fluorescein isothiocyanate/propidium iodide flow cytometry and western blotting performed to detect proapoptotic factors indicated that MALAT1 depletion might promote KGN cell apoptosis. Furthermore, MALAT1 knockdown increased GC autophagy, as evidenced by microtubule-associated protein 1A/1B-light chain 3 (LC3) cleavage upregulation and p62 degradation. In addition, although 5'-AMP-activated protein kinase (AMPK) mRNA expression and protein levels decreased in GCs obtained from patients with endometriosis and KGN cells, MALAT1 knockdown restored AMPK levels. However, addition of BML-275 (MALAT1 inhibitor) to MALAT1-knockdown KGN cells recovered their viability and proliferative capacity and simultaneously reduced their apoptotic and autophagic capacity. Therefore, MALAT1 may regulate GC proliferation via AMPK-mTOR-mediated cell apoptosis and autophagy.
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Affiliation(s)
- Xuejie Liu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261000, P.R. China
| | - Ping Zhang
- Department of Obstetrics, Zhucheng People's Hospital, Zhucheng, Shandong 262200, P.R. China
| | - Yanmin Li
- Department of Obstetrics and Gynecology, Liaocheng Second People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Na Zhao
- Department of Obstetrics and Gynecology, Dezhou People's Hospital, Dezhou, Shandong 253000, P.R. China
| | - Haiyan Han
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261000, P.R. China
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Ekizceli G, Inan S, Oktem G, Onur E, Ozbilgin K. Immunohistochemical determination of mTOR pathway molecules in ovaries and uterus in rat estrous cycle stages. Histol Histopathol 2020; 35:1337-1351. [PMID: 32940340 DOI: 10.14670/hh-18-258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
mTOR is a member of the PI3K/Akt/mTOR signaling pathway that participates in cell growth, proliferation, protein synthesis, transcription, angiogenesis, apoptosis and autophagy. mTOR and MAPK pahways are two important key signal pathways which are related to each other. We investigated the role of mTOR and other signaling molecules in rat ovaries and uteruses in stages of the estrous cycle. Young adult female rats were divided into four groups as proestrous, estrous, metestrous and diestrous according to vaginal smears. Immunohistochemical staining of mTORC1, IGF1, PI3K, pAKT1/2/3, ERK1 and pERK1/2 was performed and pAKT1/2/3 and ERK1 were also analyzed using western blotting on ovarian and uterine tissue samples. According to our results, PI3K/Akt/mTOR and ERK/pERK showed an increase in the rat ovulation period. When all the groups were evaluated the immunoreactivities for all of the antibodies were detected in the oocytes, granulosa and theca cells, corpus luteum and stroma of ovary and lamina propria, surface and glandular epithelium of uterus with the strongest observed with anti-ERK1 antibody and then with a decreasing trend with anti-mTORC1, anti-pAkt1/2/3, anti-IGF1, anti-PI3K and anti-pERK1/2 antibodies in the proestrus and estrus stages. Differently from other parts of the ovary, highest antibody expression in the corpus luteum was observed in the metestrous stage. Moreover, the existence of pAKT1/2/3 and ERK1 proteins was confirmed with the Western blotting technique. We suggest that mTOR and mTOR-related ERK signaling molecules may participate in the rat ovulation process.
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Affiliation(s)
- Gulcin Ekizceli
- Department of Histology and Embryology, Faculty of Medicine, Istanbul Health and Technology University, Istanbul, Turkey.
| | - Sevinc Inan
- Department of Histology and Embryology, Izmir Economy University, School of Medicine, Izmir, Turkey
| | - Gulperi Oktem
- Department of Histology and Embryology, Ege University School of Medicine, Izmir, Turkey
| | - Ece Onur
- Department of Medical Biochemistry, Manisa Celal Bayar University, School of Medicine, Manisa, Turkey
| | - Kemal Ozbilgin
- Department of Histology and Embryology, Manisa Celal Bayar University, School of Medicine, Manisa, Turkey
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Fan L, Li H, Wang W. Long non-coding RNA PRRT3-AS1 silencing inhibits prostate cancer cell proliferation and promotes apoptosis and autophagy. Exp Physiol 2020; 105:793-808. [PMID: 32086850 DOI: 10.1113/ep088011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 02/20/2020] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS What is the central question of this study? What is the role of lncRNA PRRT3-AS1 in the regulation of peroxisome proliferator-activated receptor γ (PPARγ) gene-mediated mechanistic target of rapamycin (mTOR) signalling pathway in proliferation, apoptosis and autophagy of prostate cancer cells? What is the main finding and its importance? The targeting relation between lncRNA PRRT3-AS1 and PPARγ was verified, and it was demonstrated that silencing of lncRNA PRRT3-AS1 can upregulate apoptosis and autophagy yet downregulate proliferation, migration and invasion of prostate cancer cells through the mTOR signalling pathway. Further work is needed to consolidate the therapeutic value of lncRNA PRRT3-AS1 in clinical trials and treatment of prostate cancer. ABSTRACT Although long non-coding RNAs (lncRNAs) are correlated with multiple cancers, their molecular mechanisms in prostate cancer (PC) remain inadequately understood. This study investigated the effects of lncRNA PRRT3-AS1 on the progression of prostate cancer (PC) with involvement of peroxisome proliferator-activated receptor γ (PPARγ). Microarray analysis was used to identify the differentially expressed genes and lncRNAs associated with PC. RT-qPCR and western blot analysis were employed to test the expression of lncRNA PRRT3-AS1, mammalian target of rapamycin (mTOR) signalling pathway-, apoptosis- and autophagy-related genes. A scratch test, Transwell assay, CCK-8 assay, colony formation assay, flow cytometry and monodansylcadaverine staining were employed to identify the migration, invasion, proliferation activity, cell cycle and apoptosis and autophagy of PC3 cells, respectively. Tumorigenicity assays in nude mice were used to detect the tumorigenic ability. GSE55945 and GSE46602 datasets indicated that lncRNA PRRT3-AS1 was highly expressed in PC. PPARγ was predicted as a target gene of lncRNA PRRT3-AS1. Ectopic overexpression of PPARγ or lncRNA PRRT3-AS1 silencing led to inhibited cell viability, migration and invasion, and accelerated apoptosis. Furthermore, the delivery of si-PRRT3-AS1 or PPARγ vector to PC3 cells resulted in the regression of xenografts in nude mice. Based on the in vitro and in vivo experiments, silencing of lncRNA PRRT3-AS1 was observed to activate the PPARγ gene, which in turn could inhibit PC cell proliferation and promote apoptosis and autophagy by blocking the mTOR signalling pathway.
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Affiliation(s)
- Li Fan
- Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, 130033, P.R. China
| | - Hai Li
- Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, 130033, P.R. China
| | - Weihua Wang
- Department of Urology, China and Japan Union Hospital of Jilin University, Changchun, 130033, P.R. China
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Güralp O, Bese T, Bildik G, Demikiran F, İnce Ü, Malik E, Arvas M, Öktem Ö. The mammalian target of rapamycin protein expression in human granulosa cell tumors. J Turk Ger Gynecol Assoc 2019; 20:247-254. [PMID: 30592193 PMCID: PMC6883760 DOI: 10.4274/jtgga.galenos.2018.2018.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To investigate the role of mammalian target of rapamycin (mTOR) in human granulosa cell ovarian tumors and the therapeutic effect of rapamycin in COV434 mitotic granulosa cell lines. Material and Methods: A retrospective evaluation of the medical records and pathologic sections of patients with granulosa cell ovarian carcinoma was performed. mTOR and p-mTOR expression was immunohistochemically investigated. A COV434 cell culture were treated with 0.5, 1, 2, and 5 μM rapamycin. Real-time growth curve analysis via xCELLigence system and apoptotic cell analysis via YO-PRO™-1 Iodide were performed to assess the therapeutic effect of rapamycin on cancer cells. Results: A total of twenty patients were evaluated. mTOR staining was detected in 18 (90%) patients. Mild, moderate, intense, and very intense staining was observed in three (15%), eight (40%), six (30%), and one (5%) sample, respectively. The mean mTOR staining ratio was 59±41%. P-mTOR staining was observed in two (10%) patients. One (5%) patient had 5% staining, and one (5%) patient had 100% staining for p-mTOR. Both of the latter patients had very intense staining. Rapamycin caused a dose-dependent growth arrest and induced apoptosis in COV434 mitotic granulosa cells. The real-time growth curves of the cells treated with these drugs were distinguished by a marked reduced slope after exposure for several hours, indicating a rapid onset of apoptosis. Live/dead cell analysis with YO-PRO-1 staining showed that rapamycin induced apoptosis in 24% of the cells when used at 1 μM concentration, whereas the rate increased to 61% and 72% when the cells were treated with 2 μM and 5 μM rapamycin, respectively. Conclusion: mTOR expression is observed in various degrees in 90%, and p-mTOR expression is observed in only 10% of patients with granulosa cell ovarian carcinoma. Rapamycin caused a dose-dependent growth arrest and apoptosis in COV434 mitotic granulosa cells.
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Affiliation(s)
- Onur Güralp
- Department of Obstetrics and Gynecology, Carl von Ossietszky Oldenburg University, Klinikum AöR, Oldenburg, Germany
| | - Tugan Bese
- Department of Obstetrics and Gynecology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Gamze Bildik
- Koç University Graduate School of Health Sciences and School of Medicine, İstanbul, Turkey
| | - Fuat Demikiran
- Department of Obstetrics and Gynecology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ümit İnce
- Department of Pathology, Acıbadem University Faculty of Medicine, İstanbul, Turkey
| | - Eduard Malik
- Department of Obstetrics and Gynecology, Carl von Ossietszky Oldenburg University, Klinikum AöR, Oldenburg, Germany
| | - Macit Arvas
- Department of Obstetrics and Gynecology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Özgür Öktem
- Koç University Graduate School of Health Sciences and School of Medicine, İstanbul, Turkey
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Sirotkin AV, Adamcova E, Rotili D, Mai A, Mlyncek M, Mansour L, Alwasel S, Harrath AH. Comparison of the effects of synthetic and plant-derived mTOR regulators on healthy human ovarian cells. Eur J Pharmacol 2019; 854:70-78. [PMID: 30959047 DOI: 10.1016/j.ejphar.2019.03.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/10/2023]
Abstract
The aim of the present in vitro study was to compare the effects of synthetic and plant-derived mTOR regulators on healthy human ovarian cells. We compared the effect of two synthetic mammalian mTOR blockers MC2141 and MC2183 with that of natural/plant-derived mTOR blocker rapamycin and mTOR activator resveratrol on cultured human ovarian granulosa cells. We evaluated the accumulation of markers for the mTOR system (sirtuin 1; SIRT 1), proliferation (PCNA), and apoptosis (caspase 3) along with the expression of the transcription factor p53 by quantitative immunocytochemistry. It was observed that MC2183 but not MC2141 or rapamycin reduced SIRT 1 accumulation. MC2141, MC2183, and rapamycin inhibited the accumulation of PCNA, caspase 3, and p53. On the contrary, resveratrol promoted the accumulation of SIRT-1, PCNA, caspase 3, and p53. We have demonstrated the involvement of the mTOR system in the regulation of healthy human ovarian cell proliferation and apoptosis for the first time and indicated that the action of mTOR regulators on ovarian cell apoptosis can be mediated by p53. We have further shown that mTOR regulators can affect ovarian functions without any changes in SIRT-1 accumulation and that the stimulatory effects of resveratrol on analyzed ovarian cell functions are opposite to the inhibitory effects of rapamycin and synthetic mTOR blockers.
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Affiliation(s)
- Alexander V Sirotkin
- Constantine the Philosopher University in Nitra, 949 74, Nitra, Slovakia; Research Institute of Animal Production Nitra, 949 59, Lužianky, Slovakia; King Saud University, Department of Zoology, College of Science, Riyadh, 11451, Saudi Arabia.
| | - Erika Adamcova
- Constantine the Philosopher University in Nitra, 949 74, Nitra, Slovakia
| | - Dante Rotili
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185, Rome, Italy
| | - Antonello Mai
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185, Rome, Italy; Pasteur Institute, Cenci-Bolognetti Foundation, Sapienza University of Rome, 00185, Rome, Italy
| | - Milos Mlyncek
- Constantine the Philosopher University in Nitra, 949 74, Nitra, Slovakia; Faculty Hospital in Nitra, 949 01, Nitra, Slovakia
| | - Lamjed Mansour
- King Saud University, Department of Zoology, College of Science, Riyadh, 11451, Saudi Arabia
| | - Saleh Alwasel
- King Saud University, Department of Zoology, College of Science, Riyadh, 11451, Saudi Arabia
| | - Abdel Halim Harrath
- King Saud University, Department of Zoology, College of Science, Riyadh, 11451, Saudi Arabia
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Bildik G, Akin N, Senbabaoglu F, Esmalian Y, Sahin GN, Urman D, Karahuseyinoglu S, Ince U, Palaoglu E, Taskiran C, Arvas M, Guzel Y, Yakin K, Oktem O. Endogenous c-Jun N-terminal kinase (JNK) activity marks the boundary between normal and malignant granulosa cells. Cell Death Dis 2018; 9:421. [PMID: 29549247 PMCID: PMC5856777 DOI: 10.1038/s41419-018-0459-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 12/21/2022]
Abstract
Granulosa cell tumor of the ovary (GCT) is a very rare tumor, accounting for only 2% of all ovarian tumors. It originates from sex cords in the ovary and can be divided into adult (95%) and juvenile (5%) types based on histologic findings. To date, no clear etiologic process has been identified other than a missense point mutation in the FOXL2 gene. Our previous works showed that c-Jun N-terminal kinase (JNK) pathway plays critical role in cell cycle progression and mitosis of normal and immortalized granulosa cells and follicle growth in rodent ovaries. These findings led us to investigate the role of JNK pathway in the granulosa cell tumor of the ovary. We used two different GCT cell lines (COV434 and KGN) and fresh GCT samples of adult and juvenile types obtained from the patients during surgery. We have discovered that endogenous kinase activity of JNK is markedly enhanced in the GCT samples and cell lines, whereas it was almost undetectable in mitotic non-malignant human granulosa cells. The inhibition of JNK pathway in GCT cell lines with two different pharmacologic inhibitors (SP600125 and AS601245) or siRNA resulted in a dose-dependent reduction in in vitro cell growth, increased apoptosis and diminished estradiol and AMH productions. JNK inhibition was also associated with a decrease in the number of cells positive for mitosis marker phospho-histone H3Ser 10 in the asynchronous cells; and diminished EdU uptake during S phase and cell cycle arrest at G2/M-phase transition in the synchronized cells. Ex vivo treatment of patient-derived GCT samples with JNK inhibitors for 24 h significantly decreased their in vitro growth and estradiol and AMH productions. Furthermore, in human GCT xenograft model, in vivo tumor growth was significantly reduced and plasma AMH levels were significantly decreased in SCID mice after administration of JNK inhibitors and siRNA. These findings suggest that targeting JNK pathway may provide therapeutic benefit in the treatment of granulosa cell tumors for which currently no curative therapy exists beyond surgery.
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Affiliation(s)
- Gamze Bildik
- Graduate School of Health Sciences and School of Medicines, Koc University, Istanbul, Turkey
| | - Nazli Akin
- Graduate School of Health Sciences and School of Medicines, Koc University, Istanbul, Turkey
| | - Filiz Senbabaoglu
- Graduate School of Health Sciences and School of Medicines, Koc University, Istanbul, Turkey
| | - Yashar Esmalian
- Graduate School of Health Sciences and School of Medicines, Koc University, Istanbul, Turkey
| | - Gizem Nur Sahin
- Graduate School of Health Sciences and School of Medicines, Koc University, Istanbul, Turkey
| | - Defne Urman
- Graduate School of Health Sciences and School of Medicines, Koc University, Istanbul, Turkey
| | - Sercin Karahuseyinoglu
- Department of Histology and Embryology, School of Medicine, Koc University, Istanbul, Turkey
| | - Umit Ince
- Department of Pathology, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Erhan Palaoglu
- American Hospital Clinical Biochemistry Laboratories, Istanbul, Turkey
| | - Cagatay Taskiran
- Department of Obstetrics and Gynecology, Gynecologic Oncology Division, School of Medicine, Koc University, Istanbul, Turkey
| | - Macit Arvas
- Women's Health Center, American Hospital, Istanbul, Turkey
| | - Yilmaz Guzel
- Women's Health Center, American Hospital, Istanbul, Turkey
| | - Kayhan Yakin
- Department of Obstetrics and Gynecology, The Division of Reproductive Endocrinology and Infertility, Translational Research Laboratories, School of Medicine, Koc University, Istanbul, Turkey
| | - Ozgur Oktem
- Department of Obstetrics and Gynecology, The Division of Reproductive Endocrinology and Infertility, Translational Research Laboratories, School of Medicine, Koc University, Istanbul, Turkey.
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Abstract
The "ovarian cycle" is an exquisite and dynamic endocrine system that includes ovarian events, hypothalamic-pituitary interactions, uterine endometrial and myometrial changes during implantation and pregnancy, cervical alterations in structure, and breast development. The ovarian cycle and the steroid hormones produced by the ovary also impact epithelial cancer development in the ovary, uterus, cervix, and breast. This chapter provides a personal view of recent developments that occur in this complex endocrine environment.
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Affiliation(s)
- JoAnne S Richards
- Baylor College of Medicine, Houston, TX, United States; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, United States.
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Response of an ovarian granulosa cell tumor with everolimus and exemestane after initial response to letrozole. Anticancer Drugs 2017; 28:931-933. [PMID: 28817387 DOI: 10.1097/cad.0000000000000534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Granulosa cell tumors of the ovaries (GCTO), the most common sex cord tumors of the female genitalia, are characterized by a remarkably favorable prognosis but tend to recur even after several years of follow-up. Standard approach to manage these relapsing tumors is almost inexistent and physicians' choice is most commonly based on his/her personal expertise. Recently, the use of hormone therapy in GCTO has induced prolonged response and survival. In this case report, we report the first successful use of everolimus in the combination of exemestane to reverse the resistance to hormonal therapy with letrozole in a 53-year-old woman with GCTO.
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Ali MU, Ur Rahman MS, Jia Z, Jiang C. Eukaryotic translation initiation factors and cancer. Tumour Biol 2017; 39:1010428317709805. [PMID: 28653885 DOI: 10.1177/1010428317709805] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Recent technological advancements have shown tremendous mechanistic accomplishments in our understanding of the mechanism of messenger RNA translation in eukaryotic cells. Eukaryotic messenger RNA translation is very complex process that includes four phases (initiation, elongation, termination, and ribosome recycling) and diverse mechanisms involving protein and non-protein molecules. Translation regulation is principally achieved during initiation step of translation, which is organized by multiple eukaryotic translation initiation factors. Eukaryotic translation initiation factor proteins help in stabilizing the formation of the functional ribosome around the start codon and provide regulatory mechanisms in translation initiation. Dysregulated messenger RNA translation is a common feature of tumorigenesis. Various oncogenic and tumor suppressive genes affect/are affected by the translation machinery, making the components of the translation apparatus promising therapeutic targets for the novel anticancer drug. This review provides details on the role of eukaryotic translation initiation factors in messenger RNA translation initiation, their contribution to onset and progression of tumor, and how dysregulated eukaryotic translation initiation factors can be used as a target to treat carcinogenesis.
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Affiliation(s)
- Muhammad Umar Ali
- 1 Clinical Research Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Muhammad Saif Ur Rahman
- 1 Clinical Research Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenyu Jia
- 2 Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Cao Jiang
- 1 Clinical Research Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Guzel Y, Oktem O. Understanding follicle growth in vitro: Are we getting closer to obtaining mature oocytes from in vitro-grown follicles in human? Mol Reprod Dev 2017; 84:544-559. [PMID: 28452156 DOI: 10.1002/mrd.22822] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/06/2017] [Accepted: 04/06/2017] [Indexed: 12/17/2022]
Abstract
Obtaining and fertilizing mature oocytes from immature follicles that were grown outside the body has conceptually attracted scientists for centuries, with initial attempts first documented in the 19th century. Significant progress has been made since then, due in part to a better understanding of folliculogenesis and improved techniques of in vitro follicle growth. Indeed, in vitro growth is now considered a reasonable approach to preserve or restore fertility when immature follicles and their oocytes need to be grown and matured outside the body. Certain patients would benefit from in vitro follicle growth, particularly those who carry a risk of cancer re-seeding after grafting of frozen-thawed ovarian tissue or who are at the risk of premature ovarian failure due to several intrinsic ovarian defects and genetic mutations that lead to accelerated follicle atresia and early exhaustion of the ovarian reserve. This review provides an update on the current status of in vitro growth of preantral human follicles, from initial efforts to the most recent achievements.
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Affiliation(s)
- Yilmaz Guzel
- Department of Obstetrics and Gynecology, Istanbul Aydin University School of Medicine, Istanbul, Turkey
| | - Ozgur Oktem
- Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul, Turkey.,Women's Health Center, Assisted Reproduction Unit, American Hospital, Istanbul, Turkey
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Haltia UM, Andersson N, Yadav B, Färkkilä A, Kulesskiy E, Kankainen M, Tang J, Bützow R, Riska A, Leminen A, Heikinheimo M, Kallioniemi O, Unkila-Kallio L, Wennerberg K, Aittokallio T, Anttonen M. Systematic drug sensitivity testing reveals synergistic growth inhibition by dasatinib or mTOR inhibitors with paclitaxel in ovarian granulosa cell tumor cells. Gynecol Oncol 2017; 144:621-630. [PMID: 28104295 DOI: 10.1016/j.ygyno.2016.12.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/18/2016] [Accepted: 12/19/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Resistance to standard chemotherapy poses a major clinical problem in the treatment of ovarian cancer patients. Adult-type granulosa cell tumor (AGCT) is a unique ovarian cancer subtype for which efficient treatment options are lacking in advanced disease. To this end, systematic drug response and transcriptomics profiling were performed to uncover new therapy options for AGCTs. METHODS The responses of three primary and four recurrent AGCTs to 230 anticancer compounds were screened in vitro using a systematic drug sensitivity and resistance testing (DSRT) platform, coupled with mRNA sequencing. The responses of the AGCTs were compared with those of human granulosa luteal cells and bone marrow mononuclear cells. RESULTS Patient-derived AGCT cells showed selective sensitivity to the Src family tyrosine kinase inhibitor dasatinib. A combination of either dasatinib or an mTOR-inhibitor everolimus with paclitaxel resulted in synergistic inhibition of AGCT cell viability. The key kinase targets of dasatinib and members of the mTOR pathway were constantly expressed at mRNA and protein levels, indicating multikinase signal addictions in the AGCT cells. Transcriptomic characterization of the tumors revealed no known oncogenic mutations, suggesting that the drug sensitivity of AGCTs was rather conveyed by selective target expression. CONCLUSIONS We used a systematic functional approach to reveal novel treatment options for a unique gynecological cancer. The selective synergy found between taxanes and dasatinib or mTOR inhibitors warrants further clinical investigations of these combinations in relapsed or aggressive AGCTs and demonstrate that high-throughput drug screening and molecular profiling can provide an effective approach to uncover new therapy options.
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Affiliation(s)
- Ulla-Maija Haltia
- Children's Hospital, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014 University of Helsinki, Finland; Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00290 Helsinki, Finland
| | - Noora Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014 University of Helsinki, Finland
| | - Bhagwan Yadav
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO Box 20, 00014 Helsinki, Finland
| | - Anniina Färkkilä
- Children's Hospital, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014 University of Helsinki, Finland; Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00290 Helsinki, Finland.
| | - Evgeny Kulesskiy
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO Box 20, 00014 Helsinki, Finland
| | - Matti Kankainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO Box 20, 00014 Helsinki, Finland
| | - Jing Tang
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO Box 20, 00014 Helsinki, Finland
| | - Ralf Bützow
- Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, PO Box 400, 00290 Helsinki, Finland
| | - Annika Riska
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00290 Helsinki, Finland
| | - Arto Leminen
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00290 Helsinki, Finland
| | - Markku Heikinheimo
- Children's Hospital, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014 University of Helsinki, Finland; Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO 63110, USA
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO Box 20, 00014 Helsinki, Finland
| | - Leila Unkila-Kallio
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00290 Helsinki, Finland
| | - Krister Wennerberg
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO Box 20, 00014 Helsinki, Finland
| | - Tero Aittokallio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO Box 20, 00014 Helsinki, Finland; Department of Mathematics and Statistics, University of Turku, 20014 Turku, Finland
| | - Mikko Anttonen
- Clinical Chemistry and Hematology, University of Helsinki and HUSLAB, Helsinki University Hospital, PO Box 400, 00290 Helsinki, Finland
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Sirotkin AV. The Role and Application of Sirtuins and mTOR Signaling in the Control of Ovarian Functions. Cells 2016; 5:cells5040042. [PMID: 27886120 PMCID: PMC5187526 DOI: 10.3390/cells5040042] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 11/03/2016] [Accepted: 11/04/2016] [Indexed: 12/11/2022] Open
Abstract
The present short review demonstrates the involvement of sirtuins (SIRTs) in the control of ovarian functions at various regulatory levels. External and endocrine factors can affect female reproduction via SIRTs-mammalian target of rapamycin (mTOR) system, which, via hormones and growth factors, can in turn regulate basic ovarian functions (proliferation, apoptosis, secretory activity of ovarian cells, their response to upstream hormonal regulators, ovarian folliculo- and oogenesis, and fecundity). SIRTs and SIRTs-related signaling molecules and drugs regulating mTOR can be used for characterization, prediction, and regulation of ovarian functions, as well as for diagnostics and treatment of ovarian disorders.
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Affiliation(s)
- Alexander V Sirotkin
- Department of Zoology and Anthropology, Constantine the Philosopher University, 94974 Nitra, Slovakia.
- Research Institute of Animal Production, 941 51 Lužianky, Slovakia.
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Trisdale SK, Schwab NM, Hou X, Davis JS, Townson DH. Molecular manipulation of keratin 8/18 intermediate filaments: modulators of FAS-mediated death signaling in human ovarian granulosa tumor cells. J Ovarian Res 2016; 9:8. [PMID: 26911253 PMCID: PMC4765146 DOI: 10.1186/s13048-016-0217-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/04/2016] [Indexed: 12/28/2022] Open
Abstract
Background Granulosa cell tumors (GCT) are a rare ovarian neoplasm but prognosis is poor following recurrence. Keratin intermediate filaments expressed in these tumors are a diagnostic marker, yet paradoxically, may also constitute a target for therapeutic intervention. In the current study, we evaluated keratin 8/18 (K8/18) filament expression as a mechanism of resistance to apoptosis in GCT, specifically focusing on regulation of the cell surface death receptor, Fas (FAS). Methods The GCT cell line, KGN, was transiently transfected with siRNA to KRT8 and KRT18 to reduce K8/18 filament expression. Expression of K8/18, FAS, and apoptotic proteins (PARP, cleaved PARP) were evaluated by fluorescence microscopy, flow cytometric analysis, and immunoblotting, respectively. The incidence of FAS-mediated apoptosis in KGN cells was measured by caspase 3/7 activity. All experiments were performed independently three to six times, using a fresh aliquot of KGN cells for each experiment. Quantitative data were analyzed by one- or two-way analysis of variance (ANOVA), followed by a Tukey’s post-test for multiple comparisons; differences among means were considered statistically significant at P < 0.05. Results Control cultures of KGN cells exhibited abundant K8/18 filament expression (~90 % of cells), and minimal expression of FAS (<25 % of cells). These cells were resistant to FAS-activating antibody (FasAb)-induced apoptosis, as determined by detection of cleaved PARP and measurement of caspase 3/7 activity. Conversely, siRNA-mediated knock-down of K8/18 filament expression enhanced FAS expression (> 70 % of cells) and facilitated FasAb-induced apoptosis, evident by increased caspase 3/7 activity (P < 0.05). Additional experiments revealed that inhibition of protein synthesis, but not MEK1/2 or PI3K signaling, also prompted FasAb-induced apoptosis. Conclusions The results demonstrated that K8/18 filaments provide resistance to apoptosis in GCT by impairing FAS expression. The abundance of keratin filaments in these cells and their role in apoptotic resistance provides a greater mechanistic understanding of ovarian tumorgenicity, specifically GCT, as well as a clinically-relevant target for potential therapeutic intervention.
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Affiliation(s)
| | - Nicolette M Schwab
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, NH, 03824, USA.
| | - Xiaoying Hou
- Veterans Affairs Medical Center and Olson Center for Women's Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - John S Davis
- Veterans Affairs Medical Center and Olson Center for Women's Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - David H Townson
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, NH, 03824, USA. .,Current address: Department of Animal & Veterinary Sciences, University of Vermont, Burlington, VT, 05405, USA.
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Sirotkin AV, Alexa R, Dekanova P, Kadasi A, Stochmalov A, Grossmann R, Alwasel SH, Harrath AH. The mTOR System Can Affect Basic Ovarian Cell Functions and Mediate the Effect of Ovarian Hormonal Regulators. INT J PHARMACOL 2015. [DOI: 10.3923/ijp.2015.570.578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Liu Z, Ren YA, Pangas SA, Adams J, Zhou W, Castrillon DH, Wilhelm D, Richards JS. FOXO1/3 and PTEN Depletion in Granulosa Cells Promotes Ovarian Granulosa Cell Tumor Development. Mol Endocrinol 2015; 29:1006-24. [PMID: 26061565 DOI: 10.1210/me.2015-1103] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The forkhead box (FOX), FOXO1 and FOXO3, transcription factors regulate multiple functions in mammalian cells. Selective inactivation of the Foxo1 and Foxo3 genes in murine ovarian granulosa cells severely impairs follicular development and apoptosis causing infertility, and as shown here, granulosa cell tumor (GCT) formation. Coordinate depletion of the tumor suppressor Pten gene in the Foxo1/3 strain enhanced the penetrance and onset of GCT formation. Immunostaining and Western blot analyses confirmed FOXO1 and phosphatase and tensin homolog (PTEN) depletion, maintenance of globin transcription factor (GATA) 4 and nuclear localization of FOXL2 and phosphorylated small mothers against decapentaplegic (SMAD) 2/3 in the tumor cells, recapitulating results we observed in human adult GCTs. Microarray and quantitative PCR analyses of mouse GCTs further confirmed expression of specific genes (Foxl2, Gata4, and Wnt4) controlling granulosa cell fate specification and proliferation, whereas others (Emx2, Nr0b1, Rspo1, and Wt1) were suppressed. Key genes (Amh, Bmp2, and Fshr) controlling follicle growth, apoptosis, and differentiation were also suppressed. Inhbb and Grem1 were selectively elevated, whereas reduction of Inha provided additional evidence that activin signaling and small mothers against decapentaplegic (SMAD) 2/3 phosphorylation impact GCT formation. Unexpectedly, markers of Sertoli/epithelial cells (SRY [sex determining region Y]-box 9/keratin 8) and alternatively activated macrophages (chitinase 3-like 3) were elevated in discrete subpopulations within the mouse GCTs, indicating that Foxo1/3/Pten depletion not only leads to GCTs but also to altered granulosa cell fate decisions and immune responses. Thus, analyses of the Foxo1/3/Pten mouse GCTs and human adult GCTs provide strong evidence that impaired functions of the FOXO1/3/PTEN pathways lead to dramatic changes in the molecular program within granulosa cells, chronic activin signaling in the presence of FOXL2 and GATA4, and tumor formation.
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Affiliation(s)
- Zhilin Liu
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
| | - Yi A Ren
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
| | - Stephanie A Pangas
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
| | - Jaye Adams
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
| | - Wei Zhou
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
| | - Diego H Castrillon
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
| | - Dagmar Wilhelm
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
| | - JoAnne S Richards
- Departments of Molecular and Cellular Biology (Z.L., Y.A.R., S.A.P., J.A., J.S.R.), Pathology and Immunology (S.A.P.), and Obstetrics and Gynecology (J.A.), Baylor College of Medicine, and Department of Experimental Radiation Oncology (W.Z.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030; Department of Pathology (D.H.C.), The University of Texas Southwestern Medical School, Dallas, Texas 75390; and Department of Anatomy and Developmental Biology (D.W.), Monash University, Clayton VIC 3800, Australia
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Wilson MK, Fong P, Mesnage S, Chrystal K, Shelling A, Payne K, Mackay H, Wang L, Laframboise S, Rouzbahman M, Levin W, Oza AM. Stage I granulosa cell tumours: A management conundrum? Results of long-term follow up. Gynecol Oncol 2015; 138:285-91. [PMID: 26003143 DOI: 10.1016/j.ygyno.2015.05.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/14/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED Optimal management of women with early stage granulosa cell tumours (GCT) presents a management conundrum - they have excellent prognosis but a third will relapse. Advances uncovering the molecular characteristics of GCT have not been matched by improvements in our understanding and treatment. METHODS Stage I GCT patients referred to Auckland City Hospital (1955-2012) and Princess Margaret Cancer Centre (1992-2012) were identified. Baseline characteristics, histopathology and outcomes were recorded retrospectively. RESULTS One hundred and sixty stage I GCT patients were identified with a median age of 49 years. Median follow-up was 7.0 years (range 0.1-44.2 years). Fifty-one patients (32%) relapsed with a median time to relapse (TTR) of 12.0 years (1.3-17.7 years) - 20 initial relapses occurred 10 years post-diagnosis. Higher relapse rates (43% vs. 24% p=0.02) and shorter TTR (10.2 vs. 16.2 years p=0.007) were seen with stage Ic versus stage Ia disease. Cyst rupture was associated with increased relapse (p=0.03). Surgery was the main therapeutic modality at relapse. Eighty six percent of patients received non-surgical management at least once post-relapse. Clinical benefit rate was 43% with chemotherapy, 61% with hormonal therapy and 86% with radiation. Five- and 10-year overall survival (OS) were 98.5 and 91.6%, respectively. Median OS was similar in patients with (24.3 years) and without relapse (22.3 years). CONCLUSION Surgery remains fundamental at diagnosis and relapse. Caution should be exercised in recommending adjuvant chemotherapy at initial diagnosis given median OS was greater than 20 years even with relapse. Hormonal therapy at relapse appears encouraging but needs further assessment. Novel treatment strategies need exploration with international collaboration essential for this.
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Affiliation(s)
- Michelle K Wilson
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Canada; Department of Medical Oncology, Auckland City Hospital, New Zealand
| | - Peter Fong
- Department of Medical Oncology, Auckland City Hospital, New Zealand
| | - Soizick Mesnage
- Department of Medical Oncology, Auckland City Hospital, New Zealand
| | - Kathryn Chrystal
- Department of Medical Oncology, Auckland City Hospital, New Zealand
| | - Andrew Shelling
- Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Kathryn Payne
- Department of Pathology, Auckland City Hospital, New Zealand
| | - Helen Mackay
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Canada
| | - Lisa Wang
- Department of Statistics, Princess Margaret Cancer Centre, Canada
| | | | | | - Wilfred Levin
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Canada
| | - Amit M Oza
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Canada.
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Lamm W, Schiefer A, Nöbauer IM, Horvat R, Speiser P, Köstler WJ. Aromatase Inhibitor Therapy As Effective Rescue in a Patient With Tamoxifen-Refractory Metastatic Granulosa Cell Tumor of the Ovary. J Clin Oncol 2014; 34:e31-3. [PMID: 24934781 DOI: 10.1200/jco.2013.49.5952] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Genetically engineered mouse models for epithelial ovarian cancer: are we there yet? Semin Cell Dev Biol 2014; 27:106-17. [PMID: 24685617 DOI: 10.1016/j.semcdb.2014.03.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 03/18/2014] [Indexed: 12/12/2022]
Abstract
The development of preclinical spontaneous genetically engineered mouse models (GEMMs) requires an understanding of the genetic basis of the human disease. Such robust models have proven invaluable for increasing understanding of human malignancies as well as identifying new biomarkers and testing new therapies for these diseases. While GEMMs have been reported for ovarian cancer, the majority have proven disappointing overall in their recapitulation of paired genetic and histological features especially for serous ovarian epithelial cancer. This review describes GEMMs for ovarian cancer, in particular, high grade serous ovarian cancer and assesses these in light of recent changes in our understanding of the human malignancy.
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A Comprehensive Review of Diagnostic and Treatment Options for Granulosa Cell Tumors of the Ovary. Obstet Gynecol Surv 2014; 69:29-38. [DOI: 10.1097/ogx.0000000000000010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Sekkate S, Kairouani M, Serji B, Tazi A, Mrabti H, Boutayeb S, Errihani H. Ovarian granulosa cell tumors: a retrospective study of 27 cases and a review of the literature. World J Surg Oncol 2013; 11:142. [PMID: 23777285 PMCID: PMC3691822 DOI: 10.1186/1477-7819-11-142] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 06/02/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Granulosa tumors were described for the first time in 1855 by Rokitansky. These tumors are malignancies with a relatively favorable prognosis. They are characterized by a prolonged natural history and a tendency to late recurrences. The aim of this study is to investigate the epidemiological and pathological characteristics of granulosa cell tumors and to investigate the prognosis factor for recurrences. METHODS The clinical data of patients who were treated in the period from January 2003 to December 2010 at the National Institute of Oncology in Rabat, Morocco for adult granulosa cell tumors of the ovary were investigated retrospectively. Data for age, clinical manifestation, imaging, diagnosis and treatment of the patients were reviewed and analyzed. Post-operative histology was obtained for all patients. RESULTS Twenty-seven cases were retrieved. The median patient age was 53 years. The most common clinical manifestations at diagnosis were abdominal pain and vaginal bleeding. Mean tumor size was 14 cm. The majority of patients had stage I (63%, n = 17), while (18,5%, n = 5) had stage III, (7.4%, n = 2) had stage IV, and (11%, n = 3) of patients had an unknown stage. In the follow-up period (median = 63.44 months), five (18.51%) patients relapsed. The median time to relapse was 41.8 months, (range: 18 to 62 months). CONCLUSIONS Granulosa cell tumor of the ovary is an uncommon neoplasm. The adult form progresses slowly and often is diagnosed in an early stage of disease. Surgery is indicated. A prolonged post-therapeutic follow-up is necessary because of the risk of recurrences, late and exceptional for the adult form.
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Affiliation(s)
- Sakina Sekkate
- Department of Clinical Oncology, National Institute of Oncology, Rabat, Morocco.
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Francis JC, Kolomeyevskaya N, Mach CM, Dietrich JE, Anderson ML. MicroRNAs and Recent Insights into Pediatric Ovarian Cancers. Front Oncol 2013; 3:95. [PMID: 23641362 PMCID: PMC3639433 DOI: 10.3389/fonc.2013.00095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 04/07/2013] [Indexed: 12/22/2022] Open
Abstract
Ovarian cancer is the most common pediatric gynecologic malignancy. When diagnosed in children, ovarian cancers present unique challenges that differ dramatically from those faced by adults. Here, we review the spectrum of ovarian cancers found in young women and girls and discuss the biology of these diseases. A number of advances have recently shed significant new understanding on the potential causes of ovarian cancer in this unique population. Particular emphasis is placed on understanding how altered expression of non-coding RNA transcripts known as microRNAs play a key role in the etiology of ovarian germ cell and sex cord-stromal tumors. Emerging transgenic models for these diseases are also reviewed. Lastly, future challenges and opportunities for understanding pediatric ovarian cancers, delineating clinically useful biomarkers, and developing targeted therapies are discussed.
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Affiliation(s)
- Jessica C Francis
- Department of Obstetrics and Gynecology, Baylor College of Medicine Houston, TX, USA
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