Abstract

Colorectal cancers (CRCs) invariably become hypoxic as they enlarge, and this places unique metabolic demands upon the tumor cells. Hypoxic stress can enhance the invasiveness of cancer cells and induce chemoresistance. c-Myc, an oncogene regulated by hypoxia inducible factors (HIFs), plays a critical role in cell proliferation and metabolism. However, the interplay between c-Myc and HIFs and its clinical significance in hypoxic adaptation in CRCs are unknown. We demonstrate that c-Myc mRNA and protein levels in colon cancer cells are induced within 2 h of hypoxic stress (1% O2) but are then significantly downregulated when exposed to prolonged hypoxia. In chronic hypoxia (over 8 h at 1% O2), HIF-2α but not HIF-1α gradually accumulated in colon cancer cells. Knockdown of HIF-2α increased levels of c-Myc and its downstream target cyclinD1 in chronic hypoxia, indicating that HIF-2α may function to downregulate c-Myc. Chronic hypoxia suppressed the expression of cyclinD1, CDK4, and CDK6, inducing G1 phase block and 5-flurouracil (5-FU) chemoresistance. Overexpression of c-Myc reversed the inhibition of cyclinD1, CDK4, and CDK6, which accelerated the G1/S phase transition under hypoxia and enhanced sensitivity to 5-FU. In contrast, knockdown of c-Myc impaired 5-FU chemosensitivity in colon cancer cells. In summary, HIF-2α plays an important role in regulating the expression of c-Myc in chronic hypoxia, and consequently controls the sensitivity of colon cancer cells to 5-FU treatment in this environment.

Highlights

  • Colorectal cancers (CRCs) are one of the most common cancers worldwide [1]

  • Hypoxic stress can enhance the invasiveness of cancer cells and induce chemoresistance. c-Myc, an oncogene regulated by hypoxia inducible factors (HIFs), plays a critical role in cell proliferation and metabolism

  • We identify the regulation of c-Myc by Hypoxia inducible factors (HIFs)-2α under chronic hypoxic stress and demonstrate the impact on 5-FU chemosensitivity in colon cancer cells

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Summary

INTRODUCTION

Colorectal cancers (CRCs) are one of the most common cancers worldwide [1]. Chemotherapy is an integral component of the management of advanced disease, but there can be treatment failures due to drug resistance [2]. When solid tumors grow at a faster rate than neovascularization can sustain, regions of low oxygenation develop [2] Molecular adaptation to this hypoxic environment results in metastasis, cell cycle retardation, resistance to chemotherapy, and a poor prognosis [3]. Two clinical studies demonstrated that preoperative neoadjuvant chemotherapy with 5-flurouracil (5-FU) in breast cancer patients or postoperative adjuvant chemotherapy in CRC patients with c-Myc amplification were associated with better therapeutic responses than www.impactjournals.com/oncotarget in those with no amplification. This was accompanied by longer postoperative relapse-free survival [11, 12], suggesting a correlation between c-Myc expression and chemosensitivity. We identify the regulation of c-Myc by HIF-2α under chronic hypoxic stress and demonstrate the impact on 5-FU chemosensitivity in colon cancer cells

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