Journal
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
Volume 115, Issue 26, Pages E5990-E5999Publisher
NATL ACAD SCIENCES
DOI: 10.1073/pnas.1801348115
Keywords
HIF; GLI2; TGF-beta; tumor microenvironment; chemoresistance
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Funding
- core budget of the Agency for Science, Technology, and Research of Singapore, Singapore-China Collaborative Research Grant [13-711102]
- International S&T Cooperation Program of China Grant [2013DFG32990]
- National High Technology Research and Development Program (863) of China [2012AA02A520]
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Colorectal cancer patients often relapse after chemotherapy, owing to the survival of stem or progenitor cells referred to as cancer stem cells (CSCs). Although tumor stromal factors are known to contribute to chemoresistance, it remains not fully understood how CSCs in the hypoxic tumor microenvironment escape the chemotherapy. Here, we report that hypoxia-inducible factor (HIF-1 alpha) and cancer-associated fibroblasts (CAFs)-secreted TGF-beta 2 converge to activate the expression of hedgehog transcription factor GLI2 in CSCs, resulting in increased stemness/dedifferentiation and intrinsic resistance to chemotherapy. Genetic or small-molecule inhibitor-based ablation of HIF-1 alpha/TGF-beta 2-mediated GLI2 signaling effectively reversed the chemoresistance caused by the tumor microenvironment. Importantly, high expression levels of HIF1 alpha/TGF-beta 2/GLI2 correlated robustly with the patient relapse following chemotherapy, highlighting a potential biomarker and therapeutic target for chemoresistance in colorectal cancer. Our study thus uncovers a molecular mechanism by which hypoxic colorectal tumor microenvironment promotes cancer cell sternness and resistance to chemotherapy and suggests a potentially targeted treatment approach to mitigating chemoresistance.
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