Abstract

BackgroundSquamous cell carcinoma of the head and neck (SCCHN) is the seventh most common cancer worldwide. Unfortunately, the survival of patients with SCCHN has not improved in the last 40 years, and thus new targets for therapy are needed. Recently, elevations in serum level of interleukin 6 (IL-6) and expression of Twist in tumor samples were found to be associated with poor clinical outcomes in multiple types of cancer, including SCCHN. Although Twist has been proposed as a master regulator of epithelial-mesenchymal transition and metastasis in cancers, the mechanisms by which Twist levels are regulated post-translationally are not completely understood. Tumor progression is characterized by the involvement of cytokines and growth factors and Twist induction has been connected with a number of these signaling pathways including IL-6. Since many of the effects of IL-6 are mediated through activation of protein phosphorylation cascades, this implies that Twist expression must be under a tight control at the post-translational level in order to respond in a timely manner to external stimuli.Methodology/Principal FindingsOur data show that IL-6 increases Twist expression via a transcription-independent mechanism in many SCCHN cell lines. Further investigation revealed that IL-6 stabilizes Twist in SCCHN cell lines through casein kinase 2 (CK2) phosphorylation of Twist residues S18 and S20, and that this phosphorylation inhibits degradation of Twist. Twist phosphorylation not only increases its stability but also enhances cell motility. Thus, post-translational modulation of Twist contributes to its tumor-promoting properties.Conclusions/SignificanceOur study shows Twist expression can be regulated at the post-translational level through phosphorylation by CK2, which increases Twist stability in response to IL-6 stimulation. Our findings not only provide novel mechanistic insights into post-translational regulation of Twist but also suggest that CK2 may be a viable therapeutic target in SCCHN.

Highlights

  • Squamous cell carcinoma of the head and neck (SCCHN) is the seventh most common cancer worldwide [1]

  • Conclusions/Significance: Our study shows Twist expression can be regulated at the post-translational level through phosphorylation by casein kinase 2 (CK2), which increases Twist stability in response to interleukin 6 (IL-6) stimulation

  • Published reports have implicated both Twist and IL-6 in the development/progression of cancer, as their expressions are detectable in many epithelial tumors or patients’ serum and are associated with unfavorable clinical outcomes [4,16,18]

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Summary

Introduction

Squamous cell carcinoma of the head and neck (SCCHN) is the seventh most common cancer worldwide [1]. Overexpression of Twist in clinical tumor specimens was found to be correlated with metastasis and poor prognosis in patients with SCCHN as well as other cancers [4,5,6,7]. Twist is regarded as an oncogene, as its elevated expression promotes disease progression and metastasis by inducing the epithelial-mesenchymal transition (EMT) [8]. The survival of patients with SCCHN has not improved in the last 40 years, and new targets for therapy are needed. Elevations in serum level of interleukin 6 (IL-6) and expression of Twist in tumor samples were found to be associated with poor clinical outcomes in multiple types of cancer, including SCCHN. Since many of the effects of IL-6 are mediated through activation of protein phosphorylation cascades, this implies that Twist expression must be under a tight control at the post-translational level in order to respond in a timely manner to external stimuli

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