Breast Cancer Clinical Trial
Official title:
Role of Sorcin and Annexin A3 in Breast Cancer Patients
Breast cancer (BC) is the most common female malignancy worldwide and the second leading
cause of cancer death in women. One in eight women in the United States will develop the
illness in their lifetimes. In Egypt, 37.7% of total cancer cases among women is breast
cancer. A locally advanced disease is very common and total mastectomy is the most commonly
performed surgery. Screening methods and adjuvant therapy following surgery led to a
remarkable decrease in mortality.
Reliable prognostic and predictive markers are needed to guide the selection of the most
appropriate adjuvant therapies for individual patients with breast cancer. In fact, a shift
from defining the cancer patients who should receive chemotherapy on the basis of their
prognostic characteristics to defining the patients who are likely to benefit most from this
modality of adjuvant treatment is currently taking place. Understanding the molecular
mechanisms underlying the spread of cancer cells to distant organs, therefore, is a
prerequisite for the development of novel cancer therapies.
Breast cancer is the most common female malignancy worldwide. Despite advances in cancer
diagnosis and treatment in recent years, traditional treatments (radiotherapy, chemotherapy,
and hormone therapy) are always limited by the resistance of some tumor cells, thus forcing
researchers to continue to look for new therapeutic approaches and targets. Soluble
resistance-related Calcium-binding protein (Sorcin) is a penta-EF hand calcium binding
protein, which participates in the regulation of calcium homeostasis in cells and has
molecular mass of 22 kDa. The EF-hand is a common helix-loop-helix structural motif used by
proteins to bind calcium. Most proteins are endowed with an even number of EF-hands, which
are usually structurally and functionally paired. The penta-EF hand (PEF) family includes
sorcin, calpains, programmed cell death protein 6 (PDCD6), peflin and grancalcin.
High sorcin regulates the calcium channels and exchangers located at the plasma membrane and
at the endo/sarcoplasmic reticulum (ER/SR) and allows high levels of calcium in the ER to be
maintained, preventing ER stress and the unfolded protein response, and increases escape from
apoptosis. The 18-kDa variant of sorcin is regulated by Tumor necrosis factor
receptor-associated protein 1 (TRAP1), a mitochondrial anti-apoptotic protein upregulated in
several human tumors which controls sorcin folding and expression. Conversely, sorcin
silencing activates apoptotic proteases as caspase-3 and caspase-12 results in major defects
in mitosis and cytokinesis, blocks cell cycle progression in mitosis, increases the number of
rounded polynucleated cells and induces apoptosis and cell death shifting the equilibrium
between cell life and cell death towards proliferation in MDR cancer cells overexpressing
sorcin.
Sorcin is highly expressed in the heart, brain and breast and overexpressed in many cancer
cells. The gene for sorcin (SRI) spans about 21.9 kb of human genomic DNA. The gene is
located in chromosome 7q21. Sorcin gene is in the same amplicon as other genes involved in
the resistance to chemotherapeutics in cancer cells (multi-drug resistance, MDR) such as the
ATP-binding cassette (ABC) transporters ABCB4 and ABCB1 (Mdr1, or P-glycoprotein 1).
Annexins are a family of intracellular proteins that bind membrane phospholipids in a Calcium
concentration-dependent manner. The human genome encodes for 12 different annexins varying in
expression and distribution within the tissues. Some of these are ubiquitously expressed (A1,
A2, A5, A6, and A7), while some are selective (A3, A8, A9, A10, and A13). Several annexins
play important roles during tumor progression. However, little is known about the clinical
implications and biological functions of Annexin A3 (ANXA3) in breast cancer. ANXA3 has a
role in cell differentiation, cell migration, immune regulation.
The ANXA3 gene is located on human chromosome 4q13-q22 and encodes a protein of 323 amino
acid residues. Annexin A3 participates in various tumor-associated biological processes,
including tumor initiation, progression, metastasis and is associated with chemotherapy
resistance.
ANXA3 is expressed and secreted by neoplastic mammary cells, and its inhibition halts
migration in breast cancer cells. The expression of Annexin A3 in human breast carcinoma
closely correlated with tumor size and axillary lymph node metastasis. Elevated serum levels
of ANXA3 protein were due to its increased secretion from neoplastic breast cells into the
systemic circulation. There is inverse correlation between Annexin A3 expression and overall
breast cancer patient survival. Moreover, Annexin A3 might be a novel and potential
prognostic marker for patients with breast cancer and is involved in regulating apoptosis by
affecting the Bcl-2/Bax balance. It promote the transcription of the anti-apoptotic gene
Bcl-2 and downregulate the proapoptotic gene BAX.
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