Review Article

Molecular Regulation of Bone Marrow Metastasis in Prostate and Breast Cancer

Table 1

Tumor cell-derived factors that may affect BM metastasis through interaction with BM microenvironment.

FactorsFunction Expression stimulator References

(i) Breast cancer cells
CXCR4CXCR4 binds to CXCL12 on BM endothelial cell, invades into bone, and causes Akt activation, for which activated Src is required.ErBb2 signaling increases CXCR4 translation through activation of PI3K/Akt/mTOR pathway.[11, 21, 22]
VCAM-IVCAM-1 binds α4β7 and α4β1 (VLA-4) integrins on OCL progenitors, causing OCL differentiation and osteoclastogenesis.VCAM-1 is increased by expressed NF-κB, α4, or VCAM-1 blocking antibodies effectively inhibiting bone metastasis.[23, 24]
CD44CD44 binding to its receptor (hyaluronan) and its activation lead to IL-8 production in the tumor cell, which stimulates osteolysis.High levels of CD44 expression on breast cancer cells promote their invasion and adhesion to BM endothelial cells.[26]
Jagged-1Jagged-1 by activation Notch signaling stimulates the IL-6 expression in OB; also Jagged-1 expression activates OCL differentiation, and bone resorption occurs.Jagged-1 expression is again activated by bone-derived TGF-β through Smad pathway during osteolytic bone metastasis.
[22, 2729]
Runx2/CBFβMediates inhibition of OB differentiation by inducing antagonist of Wnt, sclerostin.IL-11 and GM-CSF are target genes of Runx2/CBFβ as OCL activators.[30]
DKK1Inhibits OB differentiation, the expression of OPG, and RANKL reduction.By stimulation of DKK-1 expression in tumor cells, IL-6 inhibits Wnt-mediated osteogenesis, causing an imbalance in bone homeostasis and increased bone degradation.[17, 31]
CSF-1The surface form by itself induces the differentiation and survival of OCL, protecting OCL against the inhibitory effect of TGF-β.[32]
PPT-1It is related to homing, integration, dysfunction in BM microenvironment, and eventual metastasis.[33]

(ii) Prostate cancer cells
Endothelin-1Increases the activity of OB by inhibiting DKK-1 expression by marrow stromal cells; it increases osteoblast expression type 1 collagen.It is increased in the serum of patients with PCa metastasized to bone.[15, 34, 35]
CXCR4Causes tumor cell homing to BM by CXCL12/CXCR4 signaling.The absence of PTEN and the subsequent activation of PI3K/Akt pathway lead to an increase in CXCR4 expression, regulating the growth and metastasis of bone through CXCL12/CXCR4 pathway.[20, 36]
Osteonectin MMP activity, especially MMP2 that is associated with invasion and metastatic potential in cancer cells, is induced by osteonectin. S-ErbB3 stimulates the bone to secrete osteonectin, which subsequently enhances the invasion of PC-3 PCa cells by interacting with αvβ3 and αvβ5 cell surface receptors.[3739]
Shh signalingPCa cells expressing Shh can directly and specifically induce differentiation in preosteoblasts through a Gli1-dependent mechanism.Ascorbic acid upregulates paracrine Shh signaling in MC3T3 preosteoblasts. Matrix collagen is formed by OB in presence of AA, potentiating Shh signaling between PCa cells and OBs, inducing OB differentiation.[29, 40, 41]
TBK1TBK1 inhibits mTOR signaling pathway, and this inhibition induces dormancy and drug resistance in PCa cells. TBK1 enhances PCa stem-like cells and drug resistance in PCa.Binding of PCa cell to OB in hematopoietic stem cell niche induces the expression of TBK1.[42]
u-PA and uPARTheir expression is associated with aggressive disease phenotype, progression, and metastasis to bone.Can be used as a factor in prognosis and progression of PCa.[43, 44]

Abbreviations: CXCR4: C-X-C chemokine receptor 4; CXCL12: C-X-C motif chemokine 12; BM: bone marrow; CXCR4: C-X-C motif receptor type 4; PI3K: phosphoinositide 3-kinase; mTOR: mammalian target of rapamycin; VCAM-1: vascular-endothelial molecule-1; OCL: osteoclast; OB: osteoblast; TGF-β: transforming growth factor β; Runx2: runt-related transcription factor 2; CBFβ: core-binding factor subunit beta; GM-CSF: granulocyte macrophage colony stimulating factor; OPG: osteoprotegerin; RANKL: receptor activator of nuclear factor-kβ ligand; DKK-1: Dickkopf homolog 1; CSF-1: colony stimulating factor-1; PPT-1: preprotachykinin-1; Pca: prostate cancer; PTEN: phosphatase and tensin homolog; MMP: matrix metalloprotease; Shh: Sonic hedgehog; TBK1: TANK binding kinase 1; u-PA: urokinase-type plasminogen activator.