Abstract
Tamoxifen resistance is emerging as a big challenge in endocrine therapy of luminal A breast cancer patients. In this study, we aimed to determine the molecular changes of PI3K/AKT/PTEN signaling pathway during tamoxifen-resistance development using gradually increased doses of tamoxifen in one model, while fixing tamoxifen treatment dose at 35 μM for several times in the second model. An upregulation of AKT/PI3K genes was noticed at 30 μM tamoxifen concentration in cells treated with a gradual increase of tamoxifen doses. In the second model, significant upregulation of AKT1 was seen in cells treated with 35 μM tamoxifen for three times. All genes studied showed a significant increase in expression in resistant cells treated with 50 µM and 35 µM six times tamoxifen. These genes’ upregulation was accompanied by PTEN and GSK3 ß genes’ down-regulation, and it was in correlation to the changes in the metabolic rate of glucose in tamoxifen-resistant models. A significant increase in glucose consumption rate from culture media was observed in tamoxifen resistant cells with the highest consumption rate reported in the first day of culturing. Increased glucose consumption rates were also correlated with GLUL significant gene expression and non-significant change in c-MYC gene expression that may lead to increased endogenous glutamine synthesis. As a result, several molecular and metabolic changes precede acquired tamoxifen resistance could be used as resistance biomarkers or targets to reverse tamoxifen resistance.
Highlights
Breast cancer patients with luminal A molecular subtype are given endocrine therapy as the first-line treatment[1]
Glucose and glutamine metabolic changes are critical in cancer cells growth as they are utilized by the cells through distinct pathways[13]
There was a remarkable increase in total necrosis in MCF-7 cells treated with 50 μM and 35(6) μM produced from the first and second approaches as compared to untreated cells; this might be due to the aggressive behavior of these resistant cells through forming multilayers and having higher rates of growth which lead to overgrowth of cells and necrosis
Summary
Breast cancer patients with luminal A molecular subtype are given endocrine therapy as the first-line treatment[1]. Many studies have proposed several mechanisms of TAM-R Among these mechanisms, loss or change in the expression of ERα6 and variations in signaling pathways such as growth factor receptor and PI3K/AKT pathway have been reported[3,6,7] while other mechanisms remain unknown[8]. Glucose and glutamine metabolic changes are critical in cancer cells growth as they are utilized by the cells through distinct pathways[13]. Their interactive activity is usually mediated by Faculty of Pharmacy, AL-Zaytoonah University of Jordan, Amman 11733, Jordan. Their interactive activity is usually mediated by Faculty of Pharmacy, AL-Zaytoonah University of Jordan, Amman 11733, Jordan. *email: lama.hamadneh@zuj. edu.jo
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