published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Obstetrics and Gynaecology / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / Clinical Oncology / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / Biological Sciences / Doctoral / Doctor of Philosophy

Ovarian cancer is a highly metastatic disease having a poor prognosis (<25%). The factors and underlying mechanisms that regulate ovarian cancer metastasis, however, are still incompletely understood. p70 S6 kinase (p70S6K), a serine/threonine kinase, is frequently activated in high-grade malignant human ovarian cancer. The aim of this study is to investigate the molecular mechanisms by which p70S6K may promote ovarian cancer metastasis. The results show that p70S6K is a critical regulator of the actin cytoskeleton, peritoneal adhesion and dissemination, and multicellular aggregates/spheroids formation in the acquisition of the metastatic phenotype. The regulation of p70S6K on the actin cytoskeleton is through two important functions: as an actin cross-linking protein and as a Rho family GTPase-activating protein. Ectopic expression of constitutively active p70S6K induced a marked reorganization of the actin cytoskeleton and directional migration of ovarian cancer cells. Actin binding and immunofluorescence studies showed that p70S6K had a direct interaction with the actin filaments with no other proteins involved. This interaction did not affect actin polymerization kinetics but cross-linked the actin filaments to inhibit cofilin-induced actin depolymerization. In addition, p70S6K mediated the activation of Rac1 and Cdc42 GTPases and their downstream effector p21-activated kinase 1, but not RhoA. Peritoneal adhesion and dissemination is regulated by p70S6K through integrin expression. Expression of p70S6K siRNA efficiently inhibited ovarian cancer cell adhesion to fibronectin and laminin among different peritoneal extracellular matrix components, as well as to human primary peritoneal mesothelial cells. These effects were associated with the expression of alpha5 and beta1 integrin. Studies into the mechanisms suggest that p70S6K may upregulate alpha5 integrin by a transcriptional mechanism whereas beta1 integrin is regulated at a post-transcriptional level. Enhanced expression of alpha5 and beta1 integrin by active p70S6K mediated the subsequent peritoneal adhesion. In ovarian cancer xenografts, p70S6K and beta1 integrin interference significantly inhibited peritoneal dissemination through reduction in the number and weight of tumors. Multicellular spheroids are present in the malignant ascites of ovarian cancer patients. Using a 3-dimensional culture system, expression of p70S6K siRNA resulted in inhibition of multicellular spheroid formation, which was mediated by N-cadherin but not E- or P-cadherin. In addition to spheroid formation, inhibition of p70S6K was associated with reduced growth of spheroids and disaggregation capabilities on different extracellular matrix components. Taken together, these findings indicate that p70S6K plays an important role in the biology of ovarian cancer metastasis through regulation of several critical steps in dissemination and migration, suggesting that p70S6K could be explored as a potential therapeutic target in ovarian cancer. / published_or_final_version / Biological Sciences / Doctoral / Doctor of Philosophy

published_or_final_version / Pathology / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Ovarian cancer is the most lethal gynecological cancer. This is mainly due to widespread peritoneal dissemination and malignant ascites, in which angiogenesis, the formation of new blood vessels, is critical to both ascites development and its metastasis. Loss of E-cadherin is a well-established marker that characterizes the progression of metastatic tumors, including ovarian cancer. The release of a soluble form of E-cadherin (sE-cad) has been frequently associated with a rapid reduction of functional E-cadherin at the cell surface. Importantly, sE-cad is significantly present in ascites from women with stage III/IV ovarian cancer when compared to women with benign ovarian cysts. However, despite the clinical significance, most studies have focused on its role in weakening cell-cell adhesion, whether sE-cad itself has any biological function is not fully understood. Here it is shown for the first time a potent angiogenic role for sE-cad released from ovarian carcinoma. Soluble form of E-cadherin promoted the migration, permeability, and tubulogenesis of endothelial cells. These activities were also observed with a sE-cad/Fc chimera, and targeted inhibition using E-cadherin blocking antibodies completely prevented the sE-cad mediated effects. In addition, it was further revealed that sE-cad could be released from ovarian cancer cells in form of exosomes, a form of extracellular vesicles that play an important role in distant intercellular communication. sE-cad-positive exosomes were able to stimulate the angiogenic phenotype in vitro and functional neovascularization in a Matrigel implant model in vivo. The use of E-cadherin blocking antibodies resulted in diminished angiogenesis, confirming that the effect was sE-cad-positive exosomes specific. In search of the underlying mechanism by which sE-cad-positive exosomes promoted angiogenesis in endothelial cells which lacked E-cadherin, sE-cad was found to heterodimerize with VE-cadherin. This effect was associated with constitutive activation of phosphatidylinositol 3-kinase (PI3K)/Akt and its effector β-catenin, but not p120 catenin. Similarly, the angiogenic phenotype could be reversed by inhibition of VE-cadherin, PI3K/Akt and β-catenin. A mass spectrometric proteomic analysis of the isolated exosomes revealed distinct membrane-bound proteases, especially disintegrin and metalloproteinase 10 (ADAM10) and matrix metalloproteinase 25 (MMP25) commonly associated with ovarian cancer progression, are implicated in sE-cad production. Small interfering RNA-mediated down-regulation of ADAM10 and MMP25 significantly inhibited sE-cad production. Moreover, hepatocyte growth factor, a multifaceted cytokine which is frequently elevated in ovarian cancer ascites, was shown to increase the expression of ADAM10 and MMP25 concomitant with an elevated level of sE-cad. Together, these results uncover a novel angiogenic role of sE-cad and a new mechanism of the action of sE-cad in tumor progression. / published_or_final_version / Biological Sciences / Doctoral / Doctor of Philosophy

Epithelial ovarian cancer is a common female malignancy with a relatively high mortality rate worldwide. This may due to a lack of efficient diagnostic methods at early stage and worsen by complications caused by metastasis at advanced stage. For successful metastasis, cancer cells detached from the original growing sites have to survive in the body circulation before conquering a distant location within the body. Resistance to anoikis (apoptosis induced without appropriate extracellular matrix) is therefore utmost important during metastatic spreading. In addition, a pre-metastatic niche remodeled by cancer cells is also a pre-requisite for metastatic colonization. Emerging evidence has suggested the dysregulation of miRNAs is associated with different aspects of tumorigenesis. However, the specific roles of miRNAs in anoikis resistance and in remodeling of distant niche remain unknown thus far. This study attempted to investigate the functional roles of miR-141, in particularly anoikis resistance of ovarian cancer cells and the reprogramming of stromal cells. The miR-200 family is frequently upregulated and associated with human cancer metastasis. In this study, by cDNA array profiling together with biochemical and functional studies, miR-141, a member of miR-200 family, was identified as an oncomiR enhancing cell viability in low serum medium and anoikis resistance. Moreover, enforced expression of miR-141 led to bigger tumor sizes and promoted metastatic colonization in mouse models. Further studies demonstrated miR-141 directly targets tumor suppressive KLF12 in ovarian cancer cells, depletion of KLF12 could mimic function of miR-141. Clinical study revealed the upregulated miR-141 was significantly correlated with the downregulated KLF12, serous subtype, advanced and distant metastatic ovarian cancer. Furthermore, Genechip profiling, Human Apoptosis Array and Luciferase reporter assay revealed the upregulated miR-141 and downregulated KLF12 enhanced anoikis resistance via elevation of survivin which protect cells against intrinsic apoptotic activity. On the other aspect, miR-141 was found to be a secretary miRNA and commonly detected in the serum of ovarian cancer patients. The upregulated miR-141 expression was also correlated to levels of common cancer biomarker CA125. Importantly, the serum miR-141 level was significantly correlated with the tumor burden of patients during treatments, indicating it could be used as a non-invasive biomarker for ovarian cancers. Finally, based on miR-141 as tumor-secreted and circulated miRNA, a series of functional studies demonstrated that miR-141 could be transferred to hFF-1 fibroblast cells. Intriguingly, ovarian cancer cells cultured in miR-141-fibroblast culturing medium showed a remarkable increase of cell migration, suggesting that the remodeled-miR-141 fibroblast cells can secrete stimulating factors and promote ovarian cancer cells aggressiveness. This is the first study showing miR-141 could reprogram fibroblast cells to be a niche for ovarian cancer cell dissemination and metastatic progression. However, further investigations for verifying such functions are warranted. In conclusion, this study provides strong evidence that miR-141 is oncoMir enhancing ovarian cancer cell plasticity in metastasis e.g. anoikis resistance. Moreover, the finding of secretary form miR-141 not only gives the feasibility to be a potential biomarker for detecting ovarian cancer but also shows a possible mechanism of how miRNAs reprogram the distant niche for metastatic colonization. / published_or_final_version / Obstetrics and Gynaecology / Doctoral / Doctor of Philosophy

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences