The major epithelial mucin, which is expressed by more than 90% of breast carcinomas and epithelial breast cancer cell lines, is MUC1. The MUC1 membrane mucin has a relatively simple structure, where a tandem repeat (TR) region carrying multiple O‐glycans forms the major part of the extracellular domain. The gene shows a size polymorphism, due to variation in the number of tandem repeats, each of which has five potential glycosylation sites. MUC1 has been found to be a good model for studying mucin‐type O‐glycosylation both in vitro and in vivo.Changes in the pattern of glycosylation of MUC1 have been observed in breast cancer (Burchell et al. 2001) and have led to an interest in MUC1 as a possible target antigen for immunotherapeutic intervention (Taylor‐Papadimitriou et al. 2000). The mucin expressed at high levels in the normal lactating mammary gland carries mainly core 2‐based O‐glycans (2–3 per tandem repeat). In breast cancers, the level of the ST3 Gal 1 enzyme is elevated (Burchell et al. 1999) and this is associated with increased numbers of Sialyl T O‐glycans being added, as predicted from in vitro studies, showing competition for the core 1 substrate between this sialyl transferase and the relevant core 2 enzyme (Dalziel et al. 2001). Moreover, the TR domain is more densely glycosylated. While the Sialyl T O‐glycan is commonly found on normal cells (e.g. resting T cells), it is cancer associated in the mammary gland. However, several lines of evidence indicate that this MUC1 glycoform, as expressed on breast cancers, can be immunosuppressive, maybe reflecting an inhibitory interaction with a lectin, possibly a siglec (Nath et al. 1999), on immune effector cells. In 25–30% of breast cancers, O‐glycosylation is terminated very early so that GalNAc (Tn) or NeuAc α2,6 GalNAc (Sialyl Tn) glycans appear. Sialyl Tn is highly tumour‐specific and is detected immunohistochemically only when the enzyme ST6GalNAcI is expressed. The Tn and Sialyl Tn will bind to different lectins, including MGL and could stimulate the immune response. Preliminary studies in mouse models suggest that an immunization protocol which includes MUC1‐carrying Sialyl Tn O‐glycans can protect against tumour growth, while clinical studies in breast cancer patients using immunogens based on the Sialyl Tn glycan are underway.
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