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Hypoxia-inducing factors as master regulators of stemness properties and altered metabolism of cancer- and metastasis-initiating cells

Journal

JOURNAL OF CELLULAR AND MOLECULAR MEDICINE
Volume 17, Issue 1, Pages 30-54

Publisher

WILEY
DOI: 10.1111/jcmm.12004

Keywords

Hypoxia; Hypoxia-inducible factors; Metabolic pathways; Cancer progression; Metastases; Cancer stem; progenitor cells; Cancer-initiating cells; Metastasis-initiating cells; Targeted therapies

Funding

  1. National Institutes of Health [R01CA138791, TMEN U54 CA163120, SPORE P50 CA127297, EDRN UO1 CA111294]
  2. Department of Defense [PC074289, BC074639]
  3. NATIONAL CANCER INSTITUTE [P50CA127297, R01CA138791, U54CA163120, U01CA111294] Funding Source: NIH RePORTER

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Accumulating lines of experimental evidence have revealed that hypoxia-inducible factors, HIF-1 and HIF-2, are key regulators of the adaptation of cancer- and metastasis-initiating cells and their differentiated progenies to oxygen and nutrient deprivation during cancer progression under normoxic and hypoxic conditions. Particularly, the sustained stimulation of epidermal growth factor receptor (EGFR), insulin-like growth factor-1 receptor (IGF-1R), stem cell factor (SCF) receptor KIT, transforming growth factor- receptors (TGF-Rs) and Notch and their downstream signalling elements such as phosphatidylinositol 3-kinase (PI3K)/Akt/molecular target of rapamycin (mTOR) may lead to an enhanced activity of HIFs. Moreover, the up-regulation of HIFs in cancer cells may also occur in the hypoxic intratumoral regions formed within primary and secondary neoplasms as well as in leukaemic cells and metastatic prostate and breast cancer cells homing in the hypoxic endosteal niche of bone marrow. The activated HIFs may induce the expression of numerous gene products such as induced pluripotency-associated transcription factors (Oct-3/4, Nanog and Sox-2), glycolysis- and epithelial-mesenchymal transition (EMT) programme-associated molecules, including CXC chemokine receptor 4 (CXCR4), snail and twist, microRNAs and angiogenic factors such as vascular endothelial growth factor (VEGF). These gene products in turn can play critical roles for high self-renewal ability, survival, altered energy metabolism, invasion and metastases of cancer cells, angiogenic switch and treatment resistance. Consequently, the targeting of HIF signalling network and altered metabolic pathways represents new promising strategies to eradicate the total mass of cancer cells and improve the efficacy of current therapies against aggressive and metastatic cancers and prevent disease relapse.

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