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.

Highlights

  • Granulosa cell tumor of the ovary (GCT) is a very rare tumor characterized by its tendency to recur years afterC134W) in the FOXL2 gene that is positive in 97% of adult-type granulosa cell tumor and absent in its juvenile form[3]

  • In human GCT xenograft model, in vivo tumor growth was significantly reduced and plasma Anti-mullerian hormone (AMH) levels were significantly decreased in SCID mice after administration of Jun N-terminal kinase (JNK) inhibitors and small interfering RNA (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

  • We found that JNK inhibition in spontaneously immortalized rat granulosa cells (SIGC) resulted in cell cycle arrest at G2/M transition[17,18]

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Summary

Introduction

C134W) in the FOXL2 gene that is positive in 97% of adult-type granulosa cell tumor and absent in its juvenile form[3]. Juvenile-type GCT (JGCT) is much rarer, does not harbor FOXL2 mutations and affects pre-pubertal girls and young women with a mean age of onset of around 8 years[7,8]. Pre-ovulatory growth of the somatic cells of the ovary is induced by the follicle-stimulating hormone (FSH), and alterations in its signaling pathway have been suggested to play a role in tumorigenesis. The majority of patients diagnosed with adult or juvenile GCT present with an early-stage disease, with a tumor limited to the ovary and have a good prognosis with a survival rate of >90% with surgery alone. There are no other curative treatment forms other than surgery[9,12,13]

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