Proteoglycan–collagen associations in the non-lactating human breast connective tissue during the menstrual cycle

Proteoglycans in the Pathogenesis of Hormone-Dependent Cancers: Mediators and Effectors

Hormone-dependent cancers exhibit high morbidity and mortality. In spite of advances in therapy, the treatment of hormone-dependent cancers remains an unmet health need. The tumor microenvironment (TME) exhibits unique characteristics that differ among various tumor types. It is composed of cancerous, non-cancerous, stromal, and immune cells that are surrounded and supported by components of the extracellular matrix (ECM). Therefore, the interactions among cancer cells, stromal cells, and components of the ECM determine cancer progression and response to therapy. Proteoglycans (PGs), hybrid molecules consisting of a protein core to which sulfated glycosaminoglycan chains are bound, are significant components of the ECM that are implicated in all phases of tumorigenesis. These molecules, secreted by both the stroma and cancer cells, are crucial signaling mediators that modulate the vital cellular pathways implicated in gene expression, phenotypic versatility, and response to therapy in specific tumor types. A plethora of deregulated signaling pathways contributes to the growth, dissemination, and angiogenesis of hormone-dependent cancers. Specific inputs from the endocrine and immune systems are some of the characteristics of hormone-dependent cancer pathogenesis. Importantly, the mechanisms involved in various aspects of cancer progression are executed in the ECM niche of the TME, and the PG components crucially mediate these processes. Here, we comprehensively discuss the mechanisms through which PGs affect the multifaceted aspects of hormone-dependent cancer development and progression, including cancer metastasis, angiogenesis, immunobiology, autophagy, and response to therapy.

Quantification of breast tissue density: Correlation between single-sided portable NMR and micro-CT measurements

Mammographic density (MD) is a strong independent risk factor for breast cancer. Traditional screening for MD using X-ray mammography involves ionising radiation, which is not suitable for young women, those with previous radiation exposure, or those having undergone a partial mastectomy. Therefore, alternative approaches for MD screening that do not involve ionising radiation will be important as the clinical use of MD increases, and as more frequent MD testing becomes desirable for research purposes. We have previously demonstrated the potential utility of spin relaxation-based, single-sided portable-NMR measurements for the purpose of MD quantification. We present here a more refined analysis by quantifying breast tissue density in excised samples on a continuous scale (0% to 100% fibroglandular tissue content) using micro-CT (μCT), and comparing the results to spin-relaxation and diffusion portable-NMR measurements of the same samples. μCT analysis of mammary tissues containing high- and low-MD (HMD and LMD, respectively) regions had Hounsfield Unit (HU) histograms with a bimodal pattern, with HMD regions exhibiting significantly higher HU values than LMD regions. Quantitative MD (%HMD) values obtained using μCT exhibited an excellent correlation with portable-NMR results, namely longitudinal spin-relaxation time constants (T₁) and the relative tissue water content obtained from portable-NMR diffusion measurements (R² = 0.92, p < 0.0001 and R² = 0.96, p < 0.0001, respectively). These findings are consistent with our previous results demonstrating relatively high water content in HMD breast tissue, consistent with the high proportion of fibroglandular tissue, FGT, which in turn contains more abundant water-carrying HSPG proteins. We observed an excellent correlation between the T₁ values and diffusion NMR-measured relative tissue water content (R² = 0.94, p < 0.0001). These findings demonstrate, for the first time, the ability of single-sided portable NMR to accurately quantify MD in vitro on a continuous scale. The results also indicate that portable-NMR analysis can assist in the identification of features underpinning MD, namely FGT and adipose tissue content. Future work will involve application of portable NMR to quantifying MD in vivo.

Proteoglycans: Potential Agents in Mammographic Density and the Associated Breast Cancer Risk

Although increased mammographic density (MD) has been well established as a marker for increased breast cancer (BC) risk, its pathobiology is far from understood. Altered proteoglycan (PG) composition may underpin the physical properties of MD, and may contribute to the associated increase in BC risk. Numerous studies have investigated PGs, which are a major stromal matrix component, in relation to MD and BC and reported results that are sometimes discordant. Our review summarises these results and highlights discrepancies between PG associations with BC and MD, thus serving as a guide for identifying PGs that warrant further research towards developing chemo-preventive or therapeutic agents targeting preinvasive or invasive breast lesions, respectively.

Pathological postpartum breast engorgement: prediction, prevention, and resolution

BACKGROUND

Severe breast engorgement can cause substantial discomfort for mothers and interfere with an infant's ability to feed at the breast. This study explored the possibility of prediction of pathological postpartum breast engorgement in lactating women in relation to intense breast engorgement at the end of the luteal phase of the menstrual cycle and the possibility of prevention and resolution of postpartum breast engorgement with expression with a breast pump of colostrum before the appearance of transitional milk.

SUBJECTS AND METHODS

The first group included 70 women with pathological postpartum breast engorgement. The second group included 52 postpartum women, with 24 women having colostrum extracted by the breast pump from each breast once or twice for a duration of 20-25 minutes sequentially in the first 2-3 days after delivery in addition to the removal of colostrum by the baby, before engorgement developed. Twenty-eight women had colostrum removed only by the baby. The degree of breast engorgement was assessed using the previously published Robson four-level scale.

RESULTS

Of the 70 patients with severe postpartum engorgement studied in the first group, 90% showed intense breast engorgement in the late luteal phase of the menstrual cycle. Expression of colostrum milk in the first experimental group from each breast eliminated excessive breast engorgement in breastfeeding mothers.

CONCLUSIONS

Presence of intense breast engorgement at the end of the luteal phase of the menstrual cycle may be one of the most important indicators useful for predicting severe postpartum breast engorgement. Extraction of colostrum before the appearance of transitional milk lowers the risk of excessive engorgement in breastfeeding women.

Progesterone--promoter or inhibitor of breast cancer

Based on the results of a French cohort of postmenopausal women, it has been claimed that micronized progesterone does not enhance breast cancer risk. The impact of reproductive factors on breast cancer risk and a high prevalence of occult breast carcinomas at the time of menopause suggest an involvement of endogenous progesterone in the development of breast cancer. High mammographic density in the luteal phase and during treatment with estrogen/progestogen combinations reflect a change in the composition of mammary stroma and an increased water accumulation in the extracellular matrix which is caused by hygroscopic hyaluronan-proteoglycan aggregates. Proteoglycans are also involved in the regulation of proliferation, migration, and differentiation of epithelial cells and angiogenesis, and may influence malignant transformation of breast cells and progression of tumors. Reports on a lack of effect of estrogen/progesterone therapy on breast cancer risk may be rooted in a selective prescription to overweight women and/or to the very low progesterone serum levels after oral administration owing to a strong inactivation rate. The contradictory results concerning the proliferative effect of progesterone may be associated with a different local metabolism in normal compared to malignant breast tissue. Similar to other progestogens, hormone replacement therapy with progesterone seems to promote the development of breast cancer, provided that the progesterone serum levels have reached the threshold for endometrial protection.

Depletion of nuclear actin is a key mediator of quiescence in epithelial cells

Functional differentiation is orchestrated by precise growth-regulatory controls conveyed by the tissue microenvironment. Cues from laminin 111 (LN1) lower transcription and suppress mammary epithelial cell growth in culture, but how LN1 induces quiescence is unknown. Recent literature points to involvement of nuclear β-actin in transcriptional regulation. Here, we show that quiescence induced by growth factor withdrawal, or LN1 addition, rapidly decreases nuclear β-actin. LN1, but not other extracellular matrix (ECM) molecules, decreases the levels of nuclear β-actin and destabilizes RNA polymerase (RNA Pol) II and III binding to transcription sites, leading to a dramatic drop in transcription and DNA synthesis. Constitutive overexpression of globular β-actin in the nucleus reverses the effect of LN1 on transcription and RNA Pol II association and prevents the cells from becoming quiescent in the presence of LN1. The physiological relevance of our findings was verified by identifying a clear spatial separation of LN1 and β-actin in developing mammary end buds. These data indicate a novel role for nuclear β-actin in growth arrest of epithelial cells and underscore the importance of the integrity of the basement membrane in homeostasis.

Varying assay geometry to emulate connective tissue planes in an in vitro model of acupuncture needling

During traditional acupuncture, fine needles are inserted subcutaneously and rotated, which causes loose fascial tissue to wind around the needle. This coupling is stronger at acupuncture points, which tend to fall above intermuscular fascial planes, than control points, which lay above skeletal muscle. These different anatomical constraints may affect the mechanical coupling. Fascia at acupuncture points is bounded on two sides by skeletal muscle, but at control points is essentially unbounded. These differences were approximated in simple in vitro models. To emulate the narrower boundary within the intermuscular plane, type I collagen was cast in circular gels of different radii. To model the channel-like nature of these planes, collagen was cast in elliptical gels with major and minor axes matching the large and small circular gels, respectively, and in planar gels constrained on two sides. Acupuncture needles were inserted into the gels and rotated via a computer-controlled motor while capturing the evolution of fiber alignment under cross-polarization. Small circular gels aligned faster, but failed earlier than large circular gels. Rotation in elliptical and planar gels generated more alignment-per-revolution than circular gels. Planar gels were particularly resistant to failure. Fiber alignment in circular gels was isotropic, but was stronger in the direction of the minor axis in elliptical and planar gels. In fibroblast-populated gels, cells followed the alignment of the collagen fibers, and also became denser in regions of stronger alignment. These results suggest that the anatomy at acupuncture points provides unique boundaries that accentuate the mechanical response to needle manipulation.

The expression of syndecan-1, syndecan-4 and decorin in healthy human breast tissue during the menstrual cycle

BACKGROUND

In order to unravel the interactions between the epithelium and the extra cellular matrix (ECM) in breast tissue progressing to cancer, it is necessary to understand the relevant interactions in healthy tissue under normal physiologic settings. Proteoglycans in the ECM play an important role in the signaling between the different tissue compartments. The proteoglycan decorin is abundant in the breast stroma. Decreased expression in breast cancer tissue is a sign of a poor tumor prognosis. The heparane sulphate proteoglycans syndecan-1 and syndecan-4 promote the integration of cellular adhesion and proliferation. The aim of this study was to investigate the gene expression and location of decorin, syndecan-1 and syndecan-4 in the healthy breast during the menstrual cycle.

METHODS

Tissue from healthy women undergoing breast reduction plastic surgery was examined using immunohistochemistry (n = 38) and Real-Time RT-PCR (n = 20). Both parous and nulliparous women were eligible and the mean age of the women was 34(+/- 10 years) with regular menstrual cycles (28 +/- 7 days). None of the women had used hormonal treatment the last three months. The women were randomized to needle biopsy two months before the operation in the follicular or luteal menstrual phase and for another biopsy at the operation in the opposite phase. Serum samples were obtained to characterize the menstrual phase. The Wilcoxon signed rank test and Mann Whitney test were used for statistical analyses.

RESULTS

By real time-RT-PCR the gene signal for all three proteoglycans; decorin (p = 0.02) and syndecan-1 (p = 0.03) and syndecan-4 (p = 0.02) was significantly lower among parous women in the luteal phase than in the follicular phase. Immunohistochemistry confirmed the identification of the proteins but no significant difference between menstrual phases was observed. Serum samples verified the menstrual phase.

CONCLUSIONS

Our study shows, for the first time in the healthy breast, a significantly lower expression of the genes for the three proteoglycans, decorin, syndecan-1 and syndecan-4 in the luteal phase during the menstrual cycle. These changes were registered under normal physiologic conditions. Since ECM molecules appear to be involved in tumor progression, these findings in the normal breast could constitute a base for further studies in women receiving hormonal therapy or those with breast cancer.

Gene expression in the third dimension: the ECM-nucleus connection

Decades ago, we and others proposed that the dynamic interplay between a cell and its surrounding environment dictates cell phenotype and tissue structure. Whereas much has been discovered about the effects of extracellular matrix molecules on cell growth and tissue-specific gene expression, the nuclear mechanisms through which these molecules promote these physiological events remain unknown. Using mammary epithelial cells as a model, the purpose of this review is to discuss how the extracellular matrix influences nuclear structure and function in a three-dimensional context to promote epithelial morphogenesis and function in the mammary gland.

pH-induced contrast in viscoelasticity imaging of biopolymers

Understanding contrast mechanisms and identifying discriminating features is at the heart of diagnostic imaging development. This paper focuses on how pH influences the viscoelastic properties of biopolymers to better understand the effects of extracellular pH on breast tumour elasticity imaging. Extracellular pH is known to decrease as much as 1 pH unit in breast tumours, thus creating a dangerous environment that increases cellular mutation rates and therapeutic resistance. We used a gelatin hydrogel phantom to isolate the effects of pH on a polymer network with similarities to the extracellular matrix in breast stroma. Using compressive unconfined creep and stress relaxation measurements, we systematically measured the viscoelastic features sensitive to pH by way of time-domain models and complex modulus analysis. These results are used to determine the sensitivity of quasi-static ultrasonic elasticity imaging to pH. We found a strong elastic response of the polymer network to pH, such that the matrix stiffness decreases as pH was reduced; however, the viscous response of the medium to pH was negligible. While physiological features of breast stroma such as proteoglycans and vascular networks are not included in our hydrogel model, observations in this study provide insight into viscoelastic features specific to pH changes in the collagenous stromal network. These observations suggest that the large contrast common in breast tumours with desmoplasia may be reduced under acidic conditions, and that viscoelastic features are unlikely to improve discriminability.

Ultrasonic measurements of breast viscoelasticity

In vivo measurements of the viscoelastic properties of breast tissue are described. Ultrasonic echo frames were recorded from volunteers at 5 fps while applying a uniaxial compressive force (1-20 N) within a 1 s ramp time and holding the force constant for up to 200 s. A time series of strain images was formed from the echo data, spatially averaged viscous creep curves were computed, and viscoelastic strain parameters were estimated by fitting creep curves to a second-order Voigt model. The useful strain bandwidth from this quasi-static ramp stimulus was 10(-2) < or = omega < or = 10(0) rad/s (0.0016-0.16 Hz). The stress-strain curves for normal glandular tissues are linear when the surface force applied is between 2 and 5 N. In this range, the creep response was characteristic of biphasic viscoelastic polymers, settling to a constant strain (arrheodictic) after 100 s. The average model-based retardance time constants for the viscoelastic response were 3.2 +/- 0.8 and 42.0 +/- 28 s. Also, the viscoelastic strain amplitude was approximately equal to that of the elastic strain. Above 5 N of applied force, however, the response of glandular tissue became increasingly nonlinear and rheodictic, i.e., tissue creep never reached a plateau. Contrasting in vivo breast measurements with those in gelatin hydrogels, preliminary ideas regarding the mechanisms for viscoelastic contrast are emerging.

Elasticity imaging of polymeric media

Viscoelastic properties of soft tissues and hydropolymers depend on the strength of molecular bonding forces connecting the polymer matrix and surrounding fluids. The basis for diagnostic imaging is that disease processes alter molecular-scale bonding in ways that vary the measurable stiffness and viscosity of the tissues. This paper reviews linear viscoelastic theory as applied to gelatin hydrogels for the purpose of formulating approaches to molecular-scale interpretation of elasticity imaging in soft biological tissues. Comparing measurements acquired under different geometries, we investigate the limitations of viscoelastic parameters acquired under various imaging conditions. Quasi-static (step-and-hold and low-frequency harmonic) stimuli applied to gels during creep and stress relaxation experiments in confined and unconfined geometries reveal continuous, bimodal distributions of respondance times. Within the linear range of responses, gelatin will behave more like a solid or fluid depending on the stimulus magnitude. Gelatin can be described statistically from a few parameters of low-order rheological models that form the basis of viscoelastic imaging. Unbiased estimates of imaging parameters are obtained only if creep data are acquired for greater than twice the highest retardance time constant and any steady-state viscous response has been eliminated. Elastic strain and retardance time images are found to provide the best combination of contrast and signal strength in gelatin. Retardance times indicate average behavior of fast (1-10 s) fluid flows and slow (50-400 s) matrix restructuring in response to the mechanical stimulus. Insofar as gelatin mimics other polymers, such as soft biological tissues, elasticity imaging can provide unique insights into complex structural and biochemical features of connectives tissues affected by disease.

Secretory phenomena in the non-lactating human mammary gland

The normal non-lactating premenopausal human mammary gland has been shown by immunohistochemistry and transmission electron microscopy to secrete a number of antimicrobial peptides such as beta-defensins, the cathelicidin LL37, lactoferrin and adrenomedullin. In addition, the non-lactating gland elaborates a prominent glycocalyx at the apical membrane of the glandular epithelial cells, parts of which are shed into the lumen of endpieces and ducts. This glycocalyx includes the mucins MUC 1 and MUC 4, a strongly Alcian Blue positive palyanionic component and sulfated material stained with Aldehyde Fuchsin. MUC 1 and the Alcian Blue positive material are considered to play an antimicrobial role, too. Lactalbumin and lipid droplets also occur in the non-lactating gland. At the EM-level secretory phenomena operating by exocytosis and by means of the apocrine mechanism have been observed. Cytoskeletal components presumably play a role in apocrine secretion. Apart from secretion at the cellular apex, secretion at the cellular basis also occurs regularly, which may represent the production of para- or endocrine factors.

Viscoelasticity imaging using ultrasound: parameters and error analysis

Techniques are being developed to image viscoelastic features of soft tissues from time-varying strain. A compress-hold-release stress stimulus commonly used in creep-recovery measurements is applied to samples to form images of elastic strain and strain retardance times. While the intended application is diagnostic breast imaging, results in gelatin hydrogels are presented to demonstrate the techniques. The spatiotemporal behaviour of gelatin is described by linear viscoelastic theory formulated for polymeric solids. Measured creep responses of polymers are frequently modelled as sums of exponentials whose time constants describe the delay or retardation of the full strain response. We found the spectrum of retardation times tau to be continuous and bimodal, where the amplitude at each tau represents the relative number of molecular bonds with a given strength and conformation. Such spectra indicate that the molecular weight of the polymer fibres between bonding points is large. Imaging parameters are found by summarizing these complex spectral distributions at each location in the medium with a second-order Voigt rheological model. This simplification reduces the dimensionality of the data for selecting imaging parameters while preserving essential information on how the creeping deformation describes fluid flow and collagen matrix restructuring in the medium. The focus of this paper is on imaging parameter estimation from ultrasonic echo data, and how jitter from hand-held force applicators used for clinical applications propagate through the imaging chain to generate image noise.

RGD-dependent binding of procathepsin X to integrin alphavbeta3 mediates cell-adhesive properties

Secreted lysosomal cysteine proteases (cathepsins) are involved in degradation and remodeling of the extracellular matrix, thus contributing to cell adhesion and migration. Among the eleven human lysosomal cysteine proteases, only procathepsin X contains an RGD motif located in a highly exposed region of the propeptide, which may allow binding of the proenzyme to RGD-recognizing integrins. Here, we have tested procathepsin X for cell-adhesive properties and found that it supports integrin alpha(v)beta(3)-dependent attachment and spreading of human umbilical vein endothelial cells. Using site-directed mutants of procathepsin X, we proved that this effect is mediated by the RGD sequence within the proregion of the protease. Endogenous procathepsin X is transported to the plasma membrane, accumulates in vesicles at lamellipodia of the human umbilical vein endothelial cell, and is partly associated with the cell surface, as shown by immunofluorescence. In addition, procathepsin X is partly co-localized with integrin beta(3), as detected by immunogold electron microscopy. A direct interaction between endogenous procathepsin X and alpha(v)beta(3) was demonstrated by co-immunoprecipitation. Moreover, surface plasmon resonance analysis revealed significant and RGD-dependent binding of procathepsin X to integrin alpha(v)beta(3). Our results provide for the first time evidence that the extracellular function of cathepsin X may include binding to integrins thereby modulating the attachment of migrating cells to ECM components.

Ultrastructural analysis of mouse embryonic stem cell-derived chondrocytes

Pluripotent embryonic stem (ES) cells cultivated as cellular aggregates, so called embryoid bodies (EBs), differentiate spontaneously into different cell types of all three germ layers in vitro resembling processes of cellular differentiation during embryonic development. Regarding chondrogenic differentiation, murine ES cells differentiate into progenitor cells, which form pre-cartilaginous condensations in the EB-outgrowths and express marker molecules characteristic for mesenchymal cell types such as Sox5 and Sox6. Later, mature chondrocytes appear which express collagen type II, and the collagen fibers show a typical morphology as demonstrated by electron-microscopical analysis. These mature chondrogenic cells are organized in cartilage nodules and produce large amounts of extracellular proteoglycans as revealed by staining with cupromeronic blue. Finally, cells organized in nodules express collagen type X, indicating the hypertrophic stage. In conclusion, differentiation of murine ES cells into chondrocytes proceeds from the undifferentiated stem cell via progenitor cells up to mature chondrogenic cells, which then undergo hypertrophy. Furthermore, because the ES-cell-derived chondrocytes did not express elastin, a marker for elastic cartilage tissue, we suggest the cartilage nodules to resemble hyaline cartilage tissue.

Proteoglycans and collagen in the intervertebral disc of the rhesus monkey (Macaca mulatta)

The different varieties of supportive tissues in the intervertebral discs of the rhesus monkeys (Macaca mulatta) were investigated with regard to morphology of the collagen fibrils and distribution and localization of proteoglycans (PG). The annulus fibrosus and the nucleus pulposus of the intervertebral disc were structurally closely integrated into the cartilaginous endplates of the vertebral bodies. The collagen fibrils in the intervertebral disc fell into two categories; i.e. thick (70-110 nm) and thin (40-50 nm) ones. In the outer zone of the annulus fibrosus only thick fibrils occurred, while in the regions of the inner part of the annulus fibrosus, in the periphery of the nucleus pulposus and in the cartilaginous endplates both types of fibrils were found. PG were found free in the matrix and in great numbers in association with collagen fibrils in all regions of the intervertebral disc. They interconnected neighbouring fibrils and decorated the surface of the collagen fibrils in irregular orientation. Only the thick fibrils of the annulus fibrosus contained small regularly arranged intrafibrillar PG precipitates. The free precipitates were usually longer and thicker than the collagen-associated PG, in addition they could be branched. Since rhesus monkeys are closely related to humans, they can serve as model organisms and the findings presented may be of relevance to the understanding of the human intervertebral discs.

Progress in focus: recent advances in histochemistry and cell biology

Advances in histochemical and cell biological techniques enable increasingly refined investigations into the cellular and subcellular distribution of specific molecules and into their role in dynamic processes; thus progress in these fields complements the growing knowledge in genomics and proteomics. The present review summarizes recent technical progress and novel applications.