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Zhao S, Zhao Y, Zhao Y, Wang G. Pathogenesis and signaling pathways related to iodine-refractory differentiated thyroid cancer. Front Endocrinol (Lausanne) 2024; 14:1320044. [PMID: 38313845 PMCID: PMC10836590 DOI: 10.3389/fendo.2023.1320044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024] Open
Abstract
Thyroid cancer is the most common malignant neoplasm within the endocrine system and the field of head and neck surgery. Although the majority of thyroid cancers, more than 90%, are well-differentiated thyroid carcinomas with a favourable prognosis, the escalating incidence of this disease has contributed to an increasing number of patients with a propensity for recurrent disease, rapid disease progression, and poor or no response to conventional treatments. These clinical challenges are commonly attributed to alterations in key thyroid oncogenes or signaling pathways, thereby initiating tumour cell dedifferentiation events, accompanied by reduced or virtually absent expression of the sodium/iodine symporter (NIS). As a result, the disease evolves into iodine-refractory differentiated thyroid cancer (RAIR-DTC), an entity that is insensitive to conventional radioiodine therapy. Despite being classified as a differentiated thyroid cancer, RAIR-DTC has an extremely poor clinical prognosis, with a 10-year survival rate of less than 10%. Therefore, it is of paramount importance to comprehensively elucidate the underlying pathogenesis of RAIR-DTC and provide specific targeted interventions. As the pathogenic mechanisms of RAIR-DTC remain elusive, here we aim to review recent advances in understanding the pathogenesis of RAIR-DTC and provide valuable insights for the development of future molecularly targeted therapeutic approaches.
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Affiliation(s)
- Simeng Zhao
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, China
| | - Yuejia Zhao
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, China
| | - Yongfu Zhao
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, China
| | - Guangzhi Wang
- Department of Thyroid Surgery, The Second Hospital of Dalian Medical University, Dalian, China
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Clinical Implications of mTOR Expression in Papillary Thyroid Cancer—A Systematic Review. Cancers (Basel) 2023; 15:cancers15061665. [PMID: 36980552 PMCID: PMC10046096 DOI: 10.3390/cancers15061665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Papillary thyroid cancer (PTC) comprises approximately 80% of all thyroid malignancies. Although several etiological factors, such as age, gender, and irradiation, are already known to be involved in the development of PTC, the genetics of cancerogenesis remain undetermined. The mTOR pathway regulates several cellular processes that are critical for tumorigenesis. Activated mTOR is involved in the development and progression of PTC. Therefore, we performed a systematic review of papers studying the expression of the mTOR gene and protein and its relationship with PTC risk and clinical outcome. A systematic literature search was performed using PubMed, Embase, and Scopus databases (the search date was 2012–2022). Studies investigating the expression of mTOR in the peripheral blood or tissue of patients with PTC were deemed eligible for inclusion. Seven of the 286 screened studies met the inclusion criteria for mTOR gene expression and four for mTOR protein expression. We also analyzed the data on mTOR protein expression in PTC. We analyzed the association of mTOR expression with papillary thyroid cancer clinicopathological features, such as the TNM stage, BRAF V600E mutation, sex distribution, lymph node and distant metastases, and survival prognosis. Understanding specific factors involved in PTC tumorigenesis provides opportunities for targeted therapies. We also reviewed the possible new targeted therapies and the use of mTOR inhibitors in PTC. This topic requires further research with novel techniques to translate the achieved results to clinical application.
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Oh JM, Ahn BC. Molecular mechanisms of radioactive iodine refractoriness in differentiated thyroid cancer: Impaired sodium iodide symporter (NIS) expression owing to altered signaling pathway activity and intracellular localization of NIS. Theranostics 2021; 11:6251-6277. [PMID: 33995657 PMCID: PMC8120202 DOI: 10.7150/thno.57689] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/22/2021] [Indexed: 12/16/2022] Open
Abstract
The advanced, metastatic differentiated thyroid cancers (DTCs) have a poor prognosis mainly owing to radioactive iodine (RAI) refractoriness caused by decreased expression of sodium iodide symporter (NIS), diminished targeting of NIS to the cell membrane, or both, thereby decreasing the efficacy of RAI therapy. Genetic aberrations (such as BRAF, RAS, and RET/PTC rearrangements) have been reported to be prominently responsible for the onset, progression, and dedifferentiation of DTCs, mainly through the activation of mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/AKT signaling pathways. Eventually, these alterations result in a lack of NIS and disabling of RAI uptake, leading to the development of resistance to RAI therapy. Over the past decade, promising approaches with various targets have been reported to restore NIS expression and RAI uptake in preclinical studies. In this review, we summarized comprehensive molecular mechanisms underlying the dedifferentiation in RAI-refractory DTCs and reviews strategies for restoring RAI avidity by tackling the mechanisms.
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mTOR Pathway in Papillary Thyroid Carcinoma: Different Contributions of mTORC1 and mTORC2 Complexes for Tumor Behavior and SLC5A5 mRNA Expression. Int J Mol Sci 2018; 19:ijms19051448. [PMID: 29757257 PMCID: PMC5983778 DOI: 10.3390/ijms19051448] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/07/2018] [Accepted: 05/07/2018] [Indexed: 12/18/2022] Open
Abstract
The mammalian target of rapamycin (mTOR) pathway is overactivated in thyroid cancer (TC). We previously demonstrated that phospho-mTOR expression is associated with tumor aggressiveness, therapy resistance, and lower mRNA expression of SLC5A5 in papillary thyroid carcinoma (PTC), while phospho-S6 (mTORC1 effector) expression was associated with less aggressive clinicopathological features. The distinct behavior of the two markers led us to hypothesize that mTOR activation may be contributing to a preferential activation of the mTORC2 complex. To approach this question, we performed immunohistochemistry for phospho-AKT Ser473 (mTORC2 effector) in a series of 182 PTCs previously characterized for phospho-mTOR and phospho-S6 expression. We evaluated the impact of each mTOR complex on SLC5A5 mRNA expression by treating cell lines with RAD001 (mTORC1 blocker) and Torin2 (mTORC1 and mTORC2 blocker). Phospho-AKT Ser473 expression was positively correlated with phospho-mTOR expression. Nuclear expression of phospho-AKT Ser473 was significantly associated with the presence of distant metastases. Treatment of cell lines with RAD001 did not increase SLC5A5 mRNA levels, whereas Torin2 caused a ~6 fold increase in SLC5A5 mRNA expression in the TPC1 cell line. In PTC, phospho-mTOR activation may lead to the activation of the mTORC2 complex. Its downstream effector, phospho-AKT Ser473, may be implicated in distant metastization, therapy resistance, and downregulation of SLC5A5 mRNA expression.
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Guan H, Guo Y, Liu L, Ye R, Liang W, Li H, Xiao H, Li Y. INAVA promotes aggressiveness of papillary thyroid cancer by upregulating MMP9 expression. Cell Biosci 2018; 8:26. [PMID: 29632659 PMCID: PMC5887255 DOI: 10.1186/s13578-018-0224-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/30/2018] [Indexed: 11/22/2022] Open
Abstract
Background Innate immunity activator (INAVA) has been shown to be elevated in lung adenocarcinoma. However, its expression pattern and function in papillary thyroid cancer (PTC) are unknown. This study aimed to identify the clinical, biological, and mechanistic impacts of INAVA on PTC. Methods Using The Cancer Genome Atlas dataset, real time PCR, and immunohistochemistry, the expression of INAVA in PTC was analyzed. Gain- and loss-of-function assays were performed to investigate the role of INAVA in PTC cell invasion, migration, and metastasis. We explored the molecular mechanisms underlying the roles of INAVA in PTC cells using transcriptome resequencing, real time PCR, western blotting and immunohistochemistry. Results We found that INAVA expression was significantly upregulated in PTC and was significantly associated with lymph node metastasis. Loss- and gain-of-function experiments demonstrated that INAVA promoted the aggressive phenotype of PTC cells in vitro and in vivo. Mechanistic study suggested that upregulation of INAVA resulted in elevated fibroblast growth factor 1 (FGF1), which in turn increased the expression level of matrix metalloproteinases 9 (MMP9). We further identified that the level of INAVA was positively correlated with the levels of FGF1 and MMP9 in clinical PTC specimens. Conclusion These data establish a novel role for INAVA in promoting PTC progression and suggest that INAVA may represent a therapeutic target for the disease. Electronic supplementary material The online version of this article (10.1186/s13578-018-0224-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hongyu Guan
- 1Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080 Guangdong China
| | - Yan Guo
- 1Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080 Guangdong China
| | - Liehua Liu
- 1Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080 Guangdong China
| | - Runyi Ye
- 2Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weiwei Liang
- 1Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080 Guangdong China
| | - Hai Li
- 1Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080 Guangdong China
| | - Haipeng Xiao
- 1Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080 Guangdong China
| | - Yanbing Li
- 1Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080 Guangdong China
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Tavares C, Coelho MJ, Eloy C, Melo M, da Rocha AG, Pestana A, Batista R, Ferreira LB, Rios E, Selmi-Ruby S, Cavadas B, Pereira L, Sobrinho Simões M, Soares P. NIS expression in thyroid tumors, relation with prognosis clinicopathological and molecular features. Endocr Connect 2018; 7:78-90. [PMID: 29298843 PMCID: PMC5754505 DOI: 10.1530/ec-17-0302] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 11/09/2017] [Indexed: 02/05/2023]
Abstract
Thyroid cancer therapy is based on surgery followed by radioiodine treatment. The incorporation of radioiodine by cancer cells is mediated by sodium iodide symporter (NIS) (codified by the SLC5A5 gene), that is functional only when targeted to the cell membrane. We aimed to evaluate if NIS expression in thyroid primary tumors would be helpful in predicting tumor behavior, response to therapy and prognosis. NIS expression was addressed by qPCR and immunohistochemistry. In order to validate our data, we also studied SLC5A5 expression on 378 primary papillary thyroid carcinomas from The Cancer Genome Atlas (TCGA) database. In our series, SLC5A5 expression was lower in carcinomas with vascular invasion and with extrathyroidal extension and in those harboring BRAFV600E mutation. Analysis of SLC5A5 expression from TCGA database confirmed our results. Furthermore, it showed that larger tumors, with locoregional recurrences and/or distant metastases or harboring RAS, BRAF and/or TERT promoter (TERTp) mutations presented significantly less SLC5A5 expression. Regarding immunohistochemistry, 12/211 of the cases demonstrated NIS in the membrane of tumor cells, those cases showed variable outcomes concerning therapy success, prognosis and all but one were wild type for BRAF, NRAS and TERTp mutations. SLC5A5 mRNA lower expression is associated with features of aggressiveness and with key genetic alterations involving BRAF, RAS and TERTp. Mutations in these genes seem to decrease protein expression and its targeting to the cell membrane. SLC5A5 mRNA expression is more informative than NIS immunohistochemical expression regarding tumor aggressiveness and prognostic features.
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Affiliation(s)
- Catarina Tavares
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Maria João Coelho
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Institute of Biomedical Sciences of Abel Salazar (ICBAS)Porto, Portugal
| | - Catarina Eloy
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Miguel Melo
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Department of EndocrinologyDiabetes and Metabolism, University and Hospital Center of Coimbra, Coimbra, Portugal
- Medical FacultyUniversity of Coimbra, Coimbra, Portugal
| | - Adriana Gaspar da Rocha
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Public Health UnitACeS Baixo Mondego, Coimbra, Portugal
| | - Ana Pestana
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Rui Batista
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Luciana Bueno Ferreira
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Elisabete Rios
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
- Department of PathologyMedical Faculty of the University of Porto, Porto, Portugal
- Department of PathologyHospital de S. João, Porto, Portugal
| | - Samia Selmi-Ruby
- Inserm UMR-S1052CNRS UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Bruno Cavadas
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Institute of Biomedical Sciences of Abel Salazar (ICBAS)Porto, Portugal
| | - Luísa Pereira
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Manuel Sobrinho Simões
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
- Department of PathologyMedical Faculty of the University of Porto, Porto, Portugal
- Department of PathologyHospital de S. João, Porto, Portugal
| | - Paula Soares
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
- Department of PathologyMedical Faculty of the University of Porto, Porto, Portugal
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