Abstract

Mechanisms underlying the pathogenesis of high-grade serous epithelial ovarian cancers (HGSOC) are not yet well defined although key precursor cells have been identified (including fimbriated fallopian tube epithelium, FTSECs). Since iron is elevated in endometriotic cysts and the pelvic cavity, it is suggested that this source of redox-active iron may contribute to ovarian cancer pathogenesis. Specifically, sources of nontransferrin-bound iron (NTBI) within the pelvic cavity could arise from ovulation, retrograde menstruation, follicular fluid, or iron overload conditions (i.e., hemochromatosis). Herein, we investigated the cellular response of p53-inactivated and telomerase-expressing (immortalized) FTSECs (Pax8+/FoxJ1−) to NTBI (presented as ferric ammonium citrate (FAC), supplemented in media for >2 months) in order to assess its ability to promote the transition to a tumor-like phenotype; this cellular response was compared with immortalized FTSECs transformed with H-RasV12A and c-MycT58A. Both approaches resulted in increased cell numbers and expression of the oncogenic transcriptional regulator, ecotropic virus integration site 1 (EVI1, a gene most frequently amplified at 3q26.2 in HGSOC, represented by multiple variants), along with other oncogenic gene products. In contrast to the transformed cells, FAC-exposed FTSECs elicited elevated migratory capacity (and epithelial–mesenchymal transition mRNA profile) along with increased expression of DNA damage response proteins (i.e., FANCD2) and hTERT mRNA relative to controls. Interestingly, in FAC-exposed FTSECs, EVI1 siRNA attenuated hTERT mRNA expression, whereas siRNAs targeting β-catenin and BMI1 (both elevated with chronic iron exposure) reduced Myc and Cyclin D1 proteins. Collectively, our novel findings provide strong foundational evidence for potential iron-induced initiation events, including EVI1 alterations, in the pathogenesis of HGSOC, warranting further in depth investigations. Thus, these findings will substantially advance our understanding of the contribution of iron enriched within the pelvic cavity, which may identify patients at risk of developing this deadly disease.

Highlights

  • Ovarian cancer (OVCA) is the 5th deadliest cancer, and the most lethal cancer in women in the United States[1]

  • Evidence exists that links elevated free iron (NTBI) to OVCA pathogenesis[16,17,21,24,27], the mechanisms underlying its contribution have yet to be defined experimentally

  • Since it is theorized that the cell of origin for high-grade serous epithelial ovarian cancers (HGSOC) may derive from either the ovarian surface epithelium (OSE) or the FTE5,6, we utilized immortalized human ovarian surface epithelial cells (T80, which stably express SV40 Large T Antigen and human telomerase reverse transcriptase (hTERT)) as well as immortalized FT194 to investigate the long-term effects of nontransferrin-bound iron (NTBI) exposure

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Summary

Introduction

Ovarian cancer (OVCA) is the 5th deadliest cancer, and the most lethal cancer in women in the United States[1]. The etiology of this disease remains unclear, which has made it difficult to improve early detection and therapeutic strategies for these patients[2,3,4]. Well-defined characteristics of HGSOC include inactivated p53, mutant. Rockfield et al Oncogenesis (2019)8:46 amongst other genes including the RNA component of telomerase (TERC)) and 8q24 (harboring the protooncogene c-Myc)[5,7,8,9,10,11,12,13]. The early events that mediate the transition from precursors such as fallopian tube secretory epithelial cells (FTSECs) to HGSOC have yet to be determined

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