The expression and significance of insulin-like growth factor-1 receptor and its pathway on breast cancer stem/progenitors

IntroductionDysregulation of the insulin-like growth factor-1 receptor (IGF-1R)/ PI3K/Akt pathway was shown to correlate with breast cancer disease progression. Cancer stem cells (CSCs) are a subpopulation within cancer cells which participate in tumor initiation, radio/chemoresistance and metastasis. In breast cancer, breast CSCs (BCSCs) were identified as CD24-CD44+ cells or cells with high intracellular aldehyde dehydrogenase activity (ALDH+). Elucidation of the role of IGF-1R in breast cancer stem cells (BCSCs) is crucial to the design of breast cancer therapies targeting BCSCs. Methods: IGF-1R expression in BCSCs and non-CSCs sorted from xenografts of human primary breast cancers was examined by FACS, western blot analysis and immunoprecipitation (IP). The role of IGF-1R in BCSCs was assessed by IGF-1R blockade with chemical inhibitor and gene silencing. The involvement of PI3K/Akt/mTOR as downstream pathway was studied by their phosphorylation status upon IGF-1R inhibition and the effects of chemical inhibitors of these signaling molecules on BCSCs. We also studied 16 clinical specimens of breast cancer for the expression of phosphor-Akt in the BCSCs by FACS. Results: Expression of phosphorylated IGF-1R was greater in BCSCs than in non-BCSCs from xenografts of human breast cancer which were supported by western blot and IP experiments. The sorted IGF-1R expressing cells displayed features of cancer stem/progenitors such as mammosphere formation in vitro and tumorigenicity in vivo, both of which were suppressed by knockdown of IGF-1R. A specific inhibitor of the IGF-1R, PPP, suppressed the phospho-AktSer473 and preferentially decreased ALDH+ BCSC populations of human breast cancer cells. Furthermore, PPP inhibited the capacity of CD24-CD44+ BCSCs to undergo epithelial-mesenchymal transition process with downregulation of mesenchymal markers. Inhibitors of signal molecules downstream of IGR-1R including PI3K/Akt/mTOR also reduced the ALDH + population of breast cancer cells. Furthermore, the mTOR inhibitor, rapamycin, suppressed BCSCs in vitro and in vivo. Conclusions: Our data support the notion that IGF-1R is a marker of stemness, and IGF-1R and its downstream PI3K/Akt/mTOR pathway are attractive targets for therapy directed against breast cancer stem/progenitors.



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