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      Antrodia cinnamomea extract inhibits the proliferation of tamoxifen-resistant breast cancer cells through apoptosis and skp2/microRNAs pathway

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          Abstract

          Background

          Breast cancer is the most common cancer in women and affects 1.38 million women worldwide per year. Antiestrogens such as tamoxifen, a selective estrogen receptor (ER) modulator, are widely used in clinics to treat ER-positive breast tumors. However, remissions of breast cancer are often followed by resistance to tamoxifen and disease relapse. Despite the increasing understanding of the resistance mechanisms, effective regimens for treating tamoxifen-resistant breast cancer are limited. Antrodia cinnamomea is a traditional medicinal mushroom native only to Taiwan. In this study, we aimed to examine in vitro effect of antrodia cinnamomea in the tamoxifen-resistant cancer.

          Methods

          Antrodia cinnamomea was studied for its biological activity against proliferation of tamoxifen-resistant breast cancer by XTT assay. Next, the underlying mechanism was studied by flow cytometry, qPCR and Western’s blotting assay.

          Results

          Our results revealed that the ethanol extract of antrodia cinnamomea (AC) can inhibit the growth of breast cancer cells, including MCF-7 cell and tamoxifen-resistant MCF-7 cell lines. Combination treatment with AC and 10 − 6 M tamoxifen have the better inhibitory effect on the proliferation of tamoxifen-resistant MCF-7 cells than only AC did. AC can induce apoptosis in these breast cancer cells. Moreover, it can suppress the mRNA expression of skp2 (S-phase kinase-associated protein 2) by increasing the expressions of miR-21-5p, miR-26-5p, and miR-30-5p in MCF-7 and tamoxifen-resistant MCF-7 cells.

          Conclusions

          These results suggest that the ethanol extract of antrodia cinnamomea could be a novel anticancer agent in the armamentarium of tamoxifen-resistant breast cancer management. Moreover, we hope to identify additional pure compounds that could serve as promising anti-breast cancer candidates for further clinical trials.

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          Most cited references39

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          Deciphering the transcriptional complex critical for RhoA gene expression and cancer metastasis.

          The RhoA GTPase is crucial in numerous biological functions and is linked to cancer metastasis. However, the understanding of the molecular mechanism responsible for RhoA transcription is still very limited. Here we show that RhoA transcription is orchestrated by the Myc-Skp2-Miz1-p300 transcriptional complex. Skp2 cooperates with Myc to induce RhoA transcription by recruiting Miz1 and p300 to the RhoA promoter independently of Skp1-Cullin-F-box protein containing complex (SCF)-Skp2 E3 ligase activity. Deficiency of this complex results in impairment in RhoA expression, cell migration, invasion, and breast cancer metastasis, recapitulating the phenotypes observed in RhoA knockdown, and RhoA restoration rescues the defect in cell invasion. Overexpression of the Myc-Skp2-Miz1 complex is found in metastatic human cancers and is correlated with RhoA expression. Our study provides insight into how oncogenic Skp2 and Myc coordinate to induce RhoA transcription and establishes a novel SCF-Skp2 E3-ligase-independent function for oncogenic Skp2 in transcription and cancer metastasis.
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            MicroRNA-30c expression level is an independent predictor of clinical benefit of endocrine therapy in advanced estrogen receptor positive breast cancer.

            MicroRNAs (miRNAs) are small RNA molecules that modulate gene expression and which have been implicated in cancer. We evaluated whether five candidate predictive miRNAs, derived from a pilot study in which 249 miRNAs were assayed, were associated with clinical benefit of tamoxifen therapy in advanced breast cancer. These five miRNAs were measured in an independent series of 246 estrogen receptor (ER)-positive primary breast tumors of patients who received tamoxifen for advanced disease by quantitative Real Time PCR. Univariate analysis showed that higher expression levels of hsa-miR-30a-3p, hsa-miR-30c, and hsa-miR-182 were significantly associated with benefit of tamoxifen treatment and with longer PFS (all P-values <0.01). In multivariate analysis, corrected for the traditional predictive factors, only hsa-miRNA-30c was an independent predictor (P-value <0.01). Finally, in an attempt to understand the biology connected to this miRNA, Global testing pathway analysis showed an association of hsa-miRNA-30c expression with HER and RAC1 signaling pathways. We identified hsa-miRNA-30c as an independent predictor for clinical benefit of tamoxifen therapy in patients with advanced breast cancer. Assessment of tumor levels and connected pathways could be helpful to improve treatment strategies.
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              Mechanisms associated with resistance to tamoxifen in estrogen receptor-positive breast cancer (review).

              Anti-estrogens such as tamoxifen are widely used in the clinic to treat estrogen receptor-positive breast tumors. Patients with estrogen receptor-positive breast cancer initially respond to treatment with anti-hormonal agents such as tamoxifen, but remissions are often followed by the acquisition of resistance and, ultimately, disease relapse. The development of a rationale for the effective treatment of tamoxifen-resistant breast cancer requires an understanding of the complex signal transduction mechanisms. In the present study, we explored some mechanisms associated with resistance to tamoxifen, such as pharmacologic mechanisms, loss or modification in estrogen receptor expression, alterations in co-regulatory proteins and the regulation of the different signaling pathways that participate in different cellular processes such as survival, proliferation, stress, cell cycle, inhibition of apoptosis regulated by the Bcl-2 family, autophagy, altered expression of microRNA, and signaling pathways that regulate the epithelial-mesenchymal transition in the tumor microenvironment. Delineation of the molecular mechanisms underlying the development of resistance may aid in the development of treatment strategies to enhance response and compromise resistance.
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                Author and article information

                Contributors
                +886 5 272-0411 , biodcc@ccu.edu.tw
                +886 5 362-1000 , smbepigwu77@gmail.com
                Journal
                BMC Complement Altern Med
                BMC Complement Altern Med
                BMC Complementary and Alternative Medicine
                BioMed Central (London )
                1472-6882
                9 May 2018
                9 May 2018
                2018
                : 18
                : 152
                Affiliations
                [1 ]ISNI 0000 0004 1756 1410, GRID grid.454212.4, Department of Pharmacy, , Chiayi Chang Gung Memorial Hospital, ; Chiayi, Taiwan
                [2 ]ISNI 0000 0004 1756 1410, GRID grid.454212.4, Department of Chinese Medicine, , Chiayi Chang Gung Memorial Hospital, ; Chiayi, Taiwan
                [3 ]GRID grid.145695.a, School of Chinese medicine, College of Medicine, , Chang Gung University, ; Tao-Yuan, Taiwan
                [4 ]ISNI 0000 0004 1756 1410, GRID grid.454212.4, Departments of Nephrology, , Chiayi Chang Gung Memorial Hospital, ; Chiayi, Taiwan
                [5 ]ISNI 0000 0004 1756 1410, GRID grid.454212.4, Kidney and Diabetic Complications Research Team (KDCRT), , Chiayi Chang Gung Memorial Hospital, ; Chiayi, Taiwan
                [6 ]ISNI 0000 0004 1756 1410, GRID grid.454212.4, Department of Hematology and oncology, , Chiayi Chang Gung Memorial Hospital, ; Chiayi, Taiwan
                [7 ]ISNI 0000 0004 0639 0994, GRID grid.412897.1, Division of Hematology and Oncology, Department of Internal Medicine, , Taipei Medical University Hospital, ; Taipei, Taiwan
                [8 ]ISNI 0000 0004 0532 3650, GRID grid.412047.4, Institute of Molecular Biology, , National Chung Cheng University, ; No.168, Sec. 1, University Rd., Minhsiung Chiayi County, 62102 Taiwan, Republic of China
                [9 ]GRID grid.145695.a, Division of Acupuncture and Chinese Traumatology, Department of TCM, , Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, ; Kaohsiung, Taiwan
                [10 ]ISNI 0000 0004 1756 1410, GRID grid.454212.4, Department of Otolaryngology, , Chang Gung Memorial Hospital, ; Chiayi, Taiwan
                [11 ]ISNI 0000 0004 1756 1410, GRID grid.454212.4, Center of Excellence for Chang Gung Research Datalink, , Chang Gung Memorial Hospital, ; Chiayi, Taiwan
                Article
                2204
                10.1186/s12906-018-2204-y
                5944021
                29743060
                86bdf020-7fe8-4218-b61a-40fea7c14beb
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 8 November 2017
                : 16 April 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004663, Ministry of Science and Technology, Taiwan;
                Award ID: MOST105-2320-B-182-006-MY3
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Complementary & Alternative medicine
                breast cancer,tamoxifen-resistant,skp2,microrna,antrodia cinnamomea

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