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MacKintosh ML, Derbyshire AE, McVey RJ, Bolton J, Nickkho‐Amiry M, Higgins CL, Kamieniorz M, Pemberton PW, Kirmani BH, Ahmed B, Syed AA, Ammori BJ, Renehan AG, Kitchener HC, Crosbie EJ. The impact of obesity and bariatric surgery on circulating and tissue biomarkers of endometrial cancer risk. Int J Cancer 2019; 144:641-650. [PMID: 30289975 PMCID: PMC6519061 DOI: 10.1002/ijc.31913] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/21/2018] [Accepted: 09/19/2018] [Indexed: 02/03/2023]
Abstract
Obesity is the strongest risk factor for endometrial cancer (EC). To inform targeted screening and prevention strategies, we assessed the impact of obesity and subsequent bariatric surgery-induced weight loss on endometrial morphology and molecular pathways implicated in endometrial carcinogenesis. Blood and endometrial tissue were obtained from women with class III-IV obesity (body mass index ≥40 and ≥50 kg/m2 , respectively) immediately prior to gastric bypass or sleeve gastrectomy, and at two and 12 months' follow up. The endometrium underwent pathological examination and immunohistochemistry was used to quantify proliferation (Ki-67), oncogenic signaling (PTEN, pAKT, pERK) and hormone receptor (ER, PR) expression status. Circulating biomarkers of insulin resistance, reproductive function and inflammation were also measured at each time point. Seventy-two women underwent bariatric surgery. At 12 months, the mean change in total and excess body weight was -32.7 and -62.8%, respectively. Baseline endometrial biopsies revealed neoplastic change in 10 women (14%): four had EC, six had atypical hyperplasia (AH). After bariatric surgery, most cases of AH resolved (5/6) without intervention (3/6) or with intrauterine progestin (2/6). Biomarkers of endometrial proliferation (Ki-67), oncogenic signaling (pAKT) and hormone receptor status (ER, PR) were significantly reduced, with restoration of glandular PTEN expression, at 2 and 12 months. There were reductions in circulating biomarkers of insulin resistance (HbA1c, HOMA-IR) and inflammation (hsCRP, IL-6), and increases in reproductive biomarkers (LH, FSH, SHBG). We found an unexpectedly high prevalence of occult neoplastic changes in the endometrium of women undergoing bariatric surgery. Their spontaneous reversal and accompanying down-regulation of PI3K-AKT-mTOR signaling with weight loss may have implications for screening, prevention and treatment of this disease.
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Affiliation(s)
- Michelle L. MacKintosh
- Department of Obstetrics and GynaecologySt Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Abigail E. Derbyshire
- Department of Obstetrics and GynaecologySt Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Rhona J. McVey
- Department of HistopathologyManchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - James Bolton
- Department of HistopathologyManchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Mahshid Nickkho‐Amiry
- Department of Obstetrics and GynaecologySt Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Catherine L. Higgins
- Department of HistopathologyManchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Martyna Kamieniorz
- Department of HistopathologyManchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Philip W. Pemberton
- Department of Clinical BiochemistryManchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
| | - Bilal H. Kirmani
- Department of Cardiothoracic SurgeryLiverpool Heart and Chest HospitalLiverpoolUnited Kingdom
| | - Babur Ahmed
- Department of Obesity Medicine, Diabetes & EndocrinologySalford Royal NHS Foundation Trust, Manchester Academic Health Science CentreSalfordUnited Kingdom
| | - Akheel A. Syed
- Department of Obesity Medicine, Diabetes & EndocrinologySalford Royal NHS Foundation Trust, Manchester Academic Health Science CentreSalfordUnited Kingdom
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine & HealthUniversity of ManchesterManchesterUnited Kingdom
| | - Basil J. Ammori
- Department of Obesity Medicine, Diabetes & EndocrinologySalford Royal NHS Foundation Trust, Manchester Academic Health Science CentreSalfordUnited Kingdom
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine & HealthUniversity of ManchesterManchesterUnited Kingdom
| | - Andrew G. Renehan
- Obesity and Cancer Research Group, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and HealthManchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre, University of ManchesterManchesterUnited Kingdom
| | - Henry C. Kitchener
- Gynaecological Oncology Research Group, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUnited Kingdom
| | - Emma J. Crosbie
- Department of Obstetrics and GynaecologySt Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUnited Kingdom
- Gynaecological Oncology Research Group, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUnited Kingdom
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Yu L, Shang ZF, Wang J, Wang H, Huang F, Zhang Z, Wang Y, Zhou J, Li S. PC-1/PrLZ confers resistance to rapamycin in prostate cancer cells through increased 4E-BP1 stability. Oncotarget 2016; 6:20356-69. [PMID: 26011939 PMCID: PMC4653010 DOI: 10.18632/oncotarget.3931] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/29/2015] [Indexed: 01/12/2023] Open
Abstract
An important strategy for improving advanced PCa treatment is targeted therapies combined with chemotherapy. PC-1, a prostate Leucine Zipper gene (PrLZ), is specifically expressed in prostate tissue as an androgen-induced gene and is up-regulated in advanced PCa. Recent work confirmed that PC-1 expression promotes PCa growth and androgen-independent progression. However, how this occurs and whether this can be used as a biomarker is uncertain. Here, we report that PC-1 overexpression confers PCa cells resistance to rapamycin treatment by antagonizing rapamycin-induced cytostasis and autophagy (rapamycin-sensitivity was observed in PC-1-deficient (shPC-1) C4-2 cells). Analysis of the mTOR pathway in PCa cells with PC-1 overexpressed and depressed revealed that eukaryotic initiation factor 4E-binding protein 1(4E-BP1) was highly regulated by PC-1. Immunohistochemistry assays indicated that 4E-BP1 up-regulation correlates with increased PC-1 expression in human prostate tumors and in PCa cells. Furthermore, PC-1 interacts directly with 4E-BP1 and stabilizes 4E-BP1 protein via inhibition of its ubiquitination and proteasomal degradation. Thus, PC-1 is a novel regulator of 4E-BP1 and our work suggests a potential mechanism through which PC-1 enhances PCa cell survival and malignant progression and increases chemoresistance. Thus, the PC-1-4E-BP1 interaction may represent a therapeutic target for treating advanced PCa.
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Affiliation(s)
- Lan Yu
- Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing 100850, PR China
| | - Zeng-Fu Shang
- School of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, Jiangsu 215123, PR China
| | - Jian Wang
- Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing 100850, PR China
| | - Hongtao Wang
- State Key Laboratory of Experimental Hematology Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300200, PR China
| | - Fang Huang
- Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing 100850, PR China
| | - Zhe Zhang
- Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing 100850, PR China
| | - Ying Wang
- Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing 100850, PR China
| | - Jianguang Zhou
- Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing 100850, PR China
| | - Shanhu Li
- Laboratory of Medical Molecular Biology, Beijing Institute of Biotechnology, Beijing 100850, PR China
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