Hyperglycemia Promotes Liver Metastasis of Colorectal Cancer via Upregulation of Integrin αvβ6

Background: Diabetes is related to higher risk of multiple cancers. This study aimed to explore the effect and mechanism of diabetes on liver metastasis of CRC. Material/Methods: Overall and liver metastasis-free survival in diabetic and non-diabetic CRC patients were compared by Kaplan Meier analysis. Expression of av136 was detected by immunohistochemistry in clinical specimens. Effects of hyperglycemia on av136 expression in colon cancer cells were assessed by western blot, real-time PCR, and flowcytometry. Effects of hyperglycemia on migration and invasion were demonstrated by Transwell assay. Expression and activity of MMP-9 and MMP-2 were determined by real-time PCR and gelatin zymography. Liver metastatic nodules were counted and 136 expression was detected by western blot in a liver metastasis mouse model. Results: CRC patients with diabetes had poorer overall and liver metastasis-free survival, and diabetes was associated with higher av136 expression in CRC specimens. Hyperglycemia promoted the invasion and migration of colon cancer cells, and upregulated the expression and activity of MMP-9, which were attenuated by inhibition of av136. Hyperglycemia upregulated the expression of 136 and cell surface expression of av136, which was reduced by ERK inhibitor. The in vitro results were confirmed in vivo in the mouse model. Conclusions: Our study demonstrated the enhancing effect of hyperglycemia on liver metastasis of CRC, and showed that av136 was involved in this process, suggesting that control of glucose levels and inhibition of av136 can reduce the risk of liver metastasis in diabetic CRC patients.

Automated summary

This study revealed that diabetic colorectal cancer patients had worse overall and liver metastasis-free survival, with higher expression of av136 in tumor specimens. Hyperglycemia promoted invasion and migration of colon cancer cells, upregulating MMP-9 expression and activity, which was attenuated by av136 inhibition. The findings suggest that controlling glucose levels and inhibiting av136 can reduce the risk of liver metastasis in diabetic colorectal cancer patients.