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Lutz F, Han SY, Büyücek S, Möller K, Viehweger F, Schlichter R, Menz A, Luebke AM, Bawahab AA, Reiswich V, Kluth M, Hube-Magg C, Hinsch A, Weidemann S, Lennartz M, Dum D, Bernreuther C, Lebok P, Sauter G, Marx AH, Simon R, Krech T, Fraune C, Gorbokon N, Burandt E, Minner S, Steurer S, Clauditz TS, Jacobsen F. Expression of Trefoil Factor 1 (TFF1) in Cancer: A Tissue Microarray Study Involving 18,878 Tumors. Diagnostics (Basel) 2024; 14:2157. [PMID: 39410561 PMCID: PMC11475926 DOI: 10.3390/diagnostics14192157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 09/12/2024] [Accepted: 09/21/2024] [Indexed: 10/20/2024] Open
Abstract
Background/Objectives: Trefoil factor 1 (TFF1) plays a role in the mucus barrier. Methods: To evaluate the prevalence of TFF1 expression in cancer, a tissue microarray containing 18,878 samples from 149 tumor types and 608 samples of 76 normal tissue types was analyzed through immunohistochemistry (IHC). Results: TFF1 staining was detectable in 65 of 149 tumor categories. The highest rates of TFF1 positivity were found in mucinous ovarian carcinomas (76.2%), colorectal adenomas and adenocarcinomas (47.1-75%), breast neoplasms (up to 72.9%), bilio-pancreatic adenocarcinomas (42.1-62.5%), gastro-esophageal adenocarcinomas (40.4-50.0%), neuroendocrine neoplasms (up to 45.5%), cervical adenocarcinomas (39.1%), and urothelial neoplasms (up to 24.3%). High TFF1 expression was related to a low grade of malignancy in non-invasive urothelial carcinomas of the bladder (p = 0.0225), low grade of malignancy (p = 0.0003), estrogen and progesterone receptor expression (p < 0.0001), non-triple negativity (p = 0.0005) in invasive breast cancer of no special type, and right-sided tumor location (p = 0.0021) in colorectal adenocarcinomas. Conclusions: TFF1 IHC has only limited utility for the discrimination of different tumor entities given its expression in many tumor entities. The link between TFF1 expression and parameters of malignancy argues for a relevant biological role of TFF1 in cancer. TFF1 may represent a suitable therapeutic target due to its expression in only a few normal cell types.
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Affiliation(s)
- Florian Lutz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Soo-Young Han
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Seyma Büyücek
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Katharina Möller
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Florian Viehweger
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Ria Schlichter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Andreas M. Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Ahmed Abdulwahab Bawahab
- Department of Basic Medical Sciences, College of Medicine, University of Jeddah, Jeddah 21589, Saudi Arabia;
| | - Viktor Reiswich
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
- Institute of Pathology, Clinical Center Osnabrueck, 49078 Osnabrueck, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Andreas H. Marx
- Department of Pathology, Academic Hospital Fuerth, 90766 Fuerth, Germany;
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
- Institute of Pathology, Clinical Center Osnabrueck, 49078 Osnabrueck, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
- Institute of Pathology, Clinical Center Osnabrueck, 49078 Osnabrueck, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Till S. Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (F.L.); (S.-Y.H.); (S.B.); (K.M.); (F.V.); (R.S.); (A.M.); (A.M.L.); (V.R.); (M.K.); (C.H.-M.); (A.H.); (S.W.); (M.L.); (D.D.); (C.B.); (P.L.); (G.S.); (T.K.); (C.F.); (N.G.); (E.B.); (S.M.); (S.S.); (T.S.C.); (F.J.)
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Jeong H, Park J, Kang JH, Sabaté del Río J, Kong S, Park T. Organoid-Based Human Stomach Micro-Physiological System to Recapitulate the Dynamic Mucosal Defense Mechanism. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2300164. [PMID: 37525340 PMCID: PMC10520631 DOI: 10.1002/advs.202300164] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 07/11/2023] [Indexed: 08/02/2023]
Abstract
Several stomach diseases are attributed to the dysregulation of physiological function of gastric mucosal barrier by pathogens. Gastric organoids are a promising tool to develop treatment strategies for gastric infections. However, their functional features of in vivo gastric mucosal barrier and host-microbe interactions are limited due to the lack of physiological stimuli. Herein, a human stomach micro-physiological system (hsMPS) with physiologically relevant gastric mucosal defense system is described based on the combination of organoid and MPS technology. A fluid flow enhanced epithelial-mesenchymal interaction in the hsMPS enables functional maturation of gastric epithelial cells, which allows for the recreation of mesh-like mucus layer containing high level of mucus protective peptides and well-developed epithelial junctional complexes. Furthermore, gastroprotection mechanisms against Helicobacter pylori (H. pylori) are successfully demonstrated in this system. Therefore, hsMPS represents a new in vitro tool for research where gastric mucosal defense mechanism is pivotal for developing therapeutic strategies.
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Affiliation(s)
- Hye‐Jin Jeong
- Department of Biomedical EngineeringUlsan National Institute of Science and TechnologyUlsan44919Republic of Korea
| | - Ji‐Hyeon Park
- Department of SurgerySeoul National University HospitalSeoul National University College of MedicineSeoul03080Republic of Korea
- Department of SurgeryGachon University Gil Medical CenterIncheon21565Republic of Korea
| | - Joo H. Kang
- Department of Biomedical EngineeringUlsan National Institute of Science and TechnologyUlsan44919Republic of Korea
| | - Jonathan Sabaté del Río
- Center for Soft and Living MatterInstitute for Basic Science (IBS)Ulsan44919Republic of Korea
| | - Seong‐Ho Kong
- Department of SurgerySeoul National University HospitalSeoul National University College of MedicineSeoul03080Republic of Korea
| | - Tae‐Eun Park
- Department of Biomedical EngineeringUlsan National Institute of Science and TechnologyUlsan44919Republic of Korea
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Benson KK, Sheel A, Rahman S, Esnakula A, Manne A. Understanding the Clinical Significance of MUC5AC in Biliary Tract Cancers. Cancers (Basel) 2023; 15:cancers15020433. [PMID: 36672382 PMCID: PMC9856870 DOI: 10.3390/cancers15020433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Biliary tract cancers (BTC) arise from biliary epithelium and include cholangiocarcinomas or CCA (including intrahepatic (ICC) and extrahepatic (ECC)) and gallbladder cancers (GBC). They often have poor outcomes owing to limited treatment options, advanced presentations, frequent recurrence, and poor response to available systemic therapy. Mucin 5AC (MUC5AC) is rarely expressed in normal biliary epithelium, but can be upregulated in tissues of benign biliary disease, premalignant conditions (e.g., biliary intraepithelial neoplasia), and BTCs. This mucin's numerous glycoforms can be divided into less-glycosylated immature and heavily-glycosylated mature forms. Reported MUC5AC tissue expression in BTC varies widely, with some associations based on cancer location (e.g., perihilar vs. peripheral ICC). Study methods were variable regarding cancer subtypes, expression positivity thresholds, and MUC5AC glycoforms. MUC5AC can be detected in serum of BTC patients at high concentrations. The hesitancy in developing MUC5AC into a clinically useful biomarker in BTC management is due to variable evidence on the diagnostic and prognostic value. Concrete conclusions on tissue MUC5AC are difficult, but serum detection might be relevant for diagnosis and is associated with poor prognosis. Future studies are needed to further the understanding of the potential clinical value of MUC5AC in BTC, especially regarding predictive and therapeutic value.
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Affiliation(s)
- Katherine K. Benson
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Ankur Sheel
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Shafia Rahman
- Department of Internal Medicine, Division of Medical Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Ashwini Esnakula
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Ashish Manne
- Department of Internal Medicine, Division of Medical Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
- Correspondence: ; Tel.: +1-614-366-2982
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Yi J, Ren L, Li D, Wu J, Li W, Du G, Wang J. Trefoil factor 1 (TFF1) is a potential prognostic biomarker with functional significance in breast cancers. Biomed Pharmacother 2020; 124:109827. [PMID: 31986408 DOI: 10.1016/j.biopha.2020.109827] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/07/2019] [Accepted: 12/13/2019] [Indexed: 01/25/2023] Open
Abstract
Breast cancer (BC) is the most common cancer in women and the second leading cause of their cancer death. Establishing an accurate BC prognosis is very difficult because of its heterogeneity. Elevated TFF1 levels in serum were associated with development of BC, TFF1 expression was upregulated in BC compared to the healthy breast tissue. The aim of this study was to investigate the function of TFF1 in BCs, and to assess whether serum TFF1 could be used in formulating a prognosis for BC patients. In silico analyses were carried out to determine the expression of TFF1 mRNA in different types of BC and the association between TFF1 expression and survival of BC patients. Expression of TFF1 protein was checked in 52 paraffin-embedded tissues of BCs by immunochemistry, and serum concentration of TFF1 in 70 BC patients and 32 healthy controls was measured by ELISA. Functional activities of TFF1 in BC cells were determined by CCK-8 assay, colony formation, BrdU-DNA synthesis, and assays for migration and invasion. Results showed that expression of TFF1 mRNA was correlated with expression of biomarkers of luminal cancers including ESR1, GATA3, FOXA1, MYB and XBP1. In addition, patients with ER+BC had higher expression of TFF1 than those with ER- (p < 0.05). There was also lower expression of TFF1 in triple-negative breast cancer (TNBC) than in non-TNBC (p < 0.05), which corresponds with the level of serum TFF1 in TNBC patients, compared with non-TNBC patients (p < 0.001). Furthermore, expression of TFF1 was associated with tumor size (p = 0.002), nodal status (p < 0.001), histological grade (p < 0.001), ER status (p = 0.012), PR status (p < 0.001) and HER2 (p < 0.001), while serum TFF1 was only statistically different among BC with ER+, PR + and HER2+ (p = 0.04139, 0.0018, 0.0004). Elevated TFF1 expression correlated with increased overall survival of BC patients (p = 0.00068). Finally, TFF1 was found to inhibit the cell growth, colony formation, migration and invasion of BC cells in vitro. All these results suggest that expression of TFF1 was related to ER status of BC and that expression of TFF1 was lower in TNBC than in non-TNBC. TFF1 was found to inhibit proliferation, migration and invasion of BC cells in vitro. Expression of TFF1 was associated with clinical characters of patients with BC. Serum TFF1 could be used to predict prognosis of patients with BC, especially non-TNBC.
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Affiliation(s)
- Jie Yi
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Liwen Ren
- The State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Beijing Key Laboratory of Drug Target Research and Drug Screen, Institute of Materia Medica, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Dandan Li
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Jie Wu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Wan Li
- The State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Beijing Key Laboratory of Drug Target Research and Drug Screen, Institute of Materia Medica, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Guanhua Du
- The State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Beijing Key Laboratory of Drug Target Research and Drug Screen, Institute of Materia Medica, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Jinhua Wang
- The State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Beijing Key Laboratory of Drug Target Research and Drug Screen, Institute of Materia Medica, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
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The Importance of CYP19A1 in Estrogen Receptor-Positive Cholangiocarcinoma. Discov Oncol 2018; 9:408-419. [DOI: 10.1007/s12672-018-0349-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/19/2018] [Indexed: 12/18/2022] Open
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6
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Research progress of cholangiocarcinoma induced by liver fluke infection. INFECTION INTERNATIONAL 2018. [DOI: 10.2478/ii-2018-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractA liver fluke is a digenetic trematode parasitizing in the hepatic ducts of human beings or animals. Patients with liver fluke infection suffer from a series of hepatobiliary diseases. The prevalence of cholangiocarcinoma is significantly high in areas with a high incidence of clonorchiasis. A liver fluke is an important biocarcinogenic factor in the occurrence of cholangiocarcinoma. The secretory products of the body of this parasite and long-term mechanical stimulation induce continuous inflammation of the bile duct. Gene expression of the bile duct cells is imbalanced, leading to carcinogenesis of the bile duct. This article provides a summary of recent studies on the epidemiology, clinicopathology, and molecular biology of cholangiocarcinoma induced by liver fluke infection.
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7
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Armartmuntree N, Murata M, Techasen A, Yongvanit P, Loilome W, Namwat N, Pairojkul C, Sakonsinsiri C, Pinlaor S, Thanan R. Prolonged oxidative stress down-regulates Early B cell factor 1 with inhibition of its tumor suppressive function against cholangiocarcinoma genesis. Redox Biol 2017; 14:637-644. [PMID: 29169115 PMCID: PMC5701798 DOI: 10.1016/j.redox.2017.11.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/31/2017] [Accepted: 11/12/2017] [Indexed: 02/07/2023] Open
Abstract
Early B cell factor 1 (EBF1) is a transcription factor involved in the differentiation of several stem cell lineages and it is a negative regulator of estrogen receptors. EBF1 is down-regulated in many tumors, and is believed to play suppressive roles in cancer promotion and progression. However, the functional roles of EBF1 in carcinogenesis are unclear. Liver fluke-infection-associated cholangiocarcinoma (CCA) is an oxidative stress-driven cancer of bile duct epithelium. In this study, we investigated EBF1 expression in tissues from CCA patients, CCA cell lines (KKU-213, KKU-214 and KKU-156), cholangiocyte (MMNK1) and its oxidative stress-resistant (ox-MMNK1-L) cell lines. The formation of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) was used as an oxidative stress marker. Our results revealed that EBF1 expression was suppressed in cancer cells compared with the individual normal bile duct cells at tumor adjacent areas of CCA tissues. CCA patients with low EBF1 expression and high formation of 8-oxodG were shown to correlate with poor survival. Moreover, EBF1 was suppressed in the oxidative stress-resistant cell line and all of CCA cell lines compared to the cholangiocyte cell line. This suggests that prolonged oxidative stress suppressed EBF1 expression and the reduced EBF1 level may facilitate CCA genesis. To elucidate the significance of EBF1 suppression in CCA genesis, EBF1 expression of the MMNK1 cell line was down-regulated by siRNA technique, and its effects on stem cell properties (CD133 and Oct3/4 expressions), tumorigenic properties (cell proliferation, wound healing and cell migration), estrogen responsive gene (TFF1), estrogen-stimulated wound healing, and cell migration were examined. The results showed that CD133, Oct3/4 and TFF1 expression levels, wound healing, and cell migration of EBF1 knockdown-MMNK1 cells were significantly increased. Also, cell migration of EBF1-knockdown cells was significantly enhanced after 17β-estradiol treatment. Our findings suggest that EBF1 down-regulation via oxidative stress induces stem cell properties, tumorigenic properties and estrogen responses of cholangiocytes leading to CCA genesis with aggressive clinical outcomes.
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Affiliation(s)
- Napat Armartmuntree
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Mariko Murata
- Department of Environmental and Molecular Medicine, Mie University Graduate School of Medicine, Mie 514-8507, Japan
| | - Anchalee Techasen
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Faculty of Associated Medical Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Puangrat Yongvanit
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Watcharin Loilome
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Nisana Namwat
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Chawalit Pairojkul
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Chadamas Sakonsinsiri
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Somchai Pinlaor
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Raynoo Thanan
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand.
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8
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Saensa-ard S, Leuangwattanawanit S, Senggunprai L, Namwat N, Kongpetch S, Chamgramol Y, Loilome W, Khansaard W, Jusakul A, Prawan A, Pairojkul C, Khantikeo N, Yongvanit P, Kukongviriyapan V. Establishment of cholangiocarcinoma cell lines from patients in the endemic area of liver fluke infection in Thailand. Tumour Biol 2017; 39:1010428317725925. [DOI: 10.1177/1010428317725925] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cholangiocarcinoma is a rare type of cancer which is an increasingly discernible health threat. The disease is usually very difficult in diagnosis and various treatment modalities are typically not effective. Cholangiocarcinoma is a complex and very heterogeneous malignancy characterized by tumor location, different risk factors, molecular profiling, and prognosis. Cancer cell lines represent an important tool for investigation in various aspects of tumor biology and molecular therapeutics. We established two cell lines, KKU-452 and KKU-023, which were derived from patients residing in the endemic area of liver fluke infection in Thailand. Both of tumor tissues have gross pathology of perihilar and intrahepatic mass-forming cholangiocarcinoma. Two cell lines were characterized for their biological, molecular and genetic properties. KKU-452 and KKU-023 cells are both adherent cells with epithelium morphology, but have some differences in their growth pattern (a doubling time of 17.9 vs 34.8 h, respectively) and the expression of epithelial bile duct markers, CK7 and CK19. Cytogenetic analysis of KKU-452 and KKU-023 cells revealed their highly complex karyotypes; hypertriploid and hypotetraploid, respectively, with multiple chromosomal aberrations. Both cell lines showed mutations in p53 but not in KRAS. KKU-452 showed a very rapid migration and invasion properties in concert with low expression of E-cadherin and high expression of N-cadherin, whereas KKU-023 showed opposite characters. KKU-023, but not KKU-452, showed in vivo tumorigenicity in xenografted nude mice. Those two established cholangiocarcinoma cell lines with unique characters may be valuable for better understanding the process of carcinogenesis and developing new therapeutics for the patients
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Affiliation(s)
- Sunitta Saensa-ard
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | | | - Laddawan Senggunprai
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nisana Namwat
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sarinya Kongpetch
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Yaovalux Chamgramol
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Watcharin Loilome
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Walaiporn Khansaard
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Apinya Jusakul
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Auemduan Prawan
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chawalit Pairojkul
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Narong Khantikeo
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Puangrat Yongvanit
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Veerapol Kukongviriyapan
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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9
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PELDEN SONAM, INSAWANG TONKLA, THUWAJIT CHANITRA, THUWAJIT PETI. The trefoil factor 1 (TFF1) protein involved in doxorubicin-induced apoptosis resistance is upregulated by estrogen in breast cancer cells. Oncol Rep 2013; 30:1518-26. [DOI: 10.3892/or.2013.2593] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/26/2013] [Indexed: 11/05/2022] Open
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10
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Bougen NM, Amiry N, Yuan Y, Kong XJ, Pandey V, Vidal LJP, Perry JK, Zhu T, Lobie PE. Trefoil factor 1 suppression of E-CADHERIN enhances prostate carcinoma cell invasiveness and metastasis. Cancer Lett 2012; 332:19-29. [PMID: 23266572 DOI: 10.1016/j.canlet.2012.12.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 11/22/2012] [Accepted: 12/16/2012] [Indexed: 11/17/2022]
Abstract
Metastasis is the primary mediator of prostate cancer (PCA) lethality and poses a significant clinical obstacle. The identification of factors involved in the metastasis of PCA is imperative. We demonstrate herein that trefoil factor 1 (TFF1) promotes PCA cell migration and invasion in vitro and metastasis in vivo. The capacity of TFF1 to enhance cell migration/invasion is mediated by transcriptional repression of E-CADHERIN. Consideration of targeted inhibition of TFF1 to prevent metastasis of prostate carcinoma is warranted.
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Affiliation(s)
- N M Bougen
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
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11
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Estrogen is increased in male cholangiocarcinoma patients' serum and stimulates invasion in cholangiocarcinoma cell lines in vitro. J Cancer Res Clin Oncol 2012; 138:1311-20. [PMID: 22476540 DOI: 10.1007/s00432-012-1207-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 03/19/2012] [Indexed: 02/07/2023]
Abstract
PURPOSE Cholangiocarcinoma is defined as a chronic liver disease with altered estrogen metabolism and could result in estrogen retention. Estrogenic response was known as a promoting factor in progression of some cancer. In this study, we determined the significant increase of estrogen level in cholangiocarcinoma patients' sera. METHODS The estrogen levels in cholangiocarcinoma patients' sera were measured and correlated with clinical presentations. Estrogen receptor-α expressions in cholangiocarcinoma tissues were detected by immunohistochemistry method. KKU-100 and KKU-M213 cholangiocarcinoma cell lines were treated with 17β-estradiol and tested the proliferative and invasive effects. RESULTS The estrogen levels showed positive correlations with serum bilirubin and alkaline phosphatase and a negative correlation with albumin. This study also showed an association with shorter survival times when patients with low and high serum estrogen levels were compared. In vitro studies demonstrated the effect of estrogen on cell proliferation and invasion in dose-dependent manners, which could be inhibited by tamoxifen, a clinical used estrogen antagonist. Invasion showed an association with the TFF1 gene expression and could be inhibited by small interfering RNA against TFF1 gene. Estrogen receptor-α was the main estrogen receptor that response to 17β-estradiol stimulation. CONCLUSIONS TFF1 trefoil protein could be one of the effectors for estrogen-induced invasion in cholangiocarcinoma via the estrogen receptor-α. These findings could lead to an understanding of the mechanism of cholangiocarcinoma progression.
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12
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Deficiency in trefoil factor 1 (TFF1) increases tumorigenicity of human breast cancer cells and mammary tumor development in TFF1-knockout mice. Oncogene 2011; 30:3261-73. [PMID: 21358676 PMCID: PMC3141110 DOI: 10.1038/onc.2011.41] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Although trefoil factor 1 (TFF1; previously named pS2) is abnormally expressed in about 50% of human breast tumors, its physiopathological role in this disease has been poorly studied. Moreover, controversial data have been reported. TFF1 function in the mammary gland therefore needs to be clarified. In this study, using retroviral vectors, we performed TFF1 gain- or loss-of-function experiments in four human mammary epithelial cell lines: normal immortalized TFF1-negative MCF10A, malignant TFF1-negative MDA-MB-231 and malignant TFF1-positive MCF7 and ZR75.1. The expression of TFF1 stimulated the migration and invasion in the four cell lines. Forced TFF1 expression in MCF10A, MDA-MB-231 and MCF7 cells did not modify anchorage-dependent or -independent cell proliferation. By contrast, TFF1 knockdown in MCF7 enhanced soft-agar colony formation. This increased oncogenic potential of MCF7 cells in the absence of TFF1 was confirmed in vivo in nude mice. Moreover, chemically induced tumorigenesis in TFF1-deficient (TFF1-KO) mice led to higher tumor incidence in the mammary gland and larger tumor size compared with wild-type mice. Similarly, tumor development was increased in the TFF1-KO ovary and lung. Collectively, our results clearly show that TFF1 does not exhibit oncogenic properties, but rather reduces tumor development. This beneficial function of TFF1 is in agreement with many clinical studies reporting a better outcome for patients with TFF1-positive breast primary tumors.
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13
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Tosco A, Monti MC, Fontanella B, Montefusco S, D’Andrea L, Ziaco B, Baldantoni D, Rio MC, Marzullo L. Copper binds the carboxy-terminus of trefoil protein 1 (TFF1), favoring its homodimerization and motogenic activity. Cell Mol Life Sci 2010; 67:1943-55. [PMID: 20213275 PMCID: PMC11115634 DOI: 10.1007/s00018-010-0309-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 01/29/2010] [Accepted: 02/09/2010] [Indexed: 12/20/2022]
Abstract
Trefoil protein 1 (TFF1) is a small secreted protein belonging to the trefoil factor family of proteins, that are present mainly in the gastrointestinal (GI) tract and play pivotal roles as motogenic factors in epithelial restitution, cell motility, and other incompletely characterized biological processes. We previously reported the up-regulation of TFF1 gene in copper deficient rats and the unexpected property of the peptide to selectively bind copper. Following the previous evidence, here we report the characterization of the copper binding site by fluorescence quenching spectroscopy and mass spectrometric analyses. We demonstrate that Cys58 and at least three Glu surrounding residues surrounding it, are essential to efficiently bind copper. Moreover, copper binding promotes the TFF1 homodimerization, thus increasing its motogenic activity in in vitro wound healing assays. Copper levels could then modulate the TFF1 functions in the GI tract, as well as its postulated role in cancer progression and invasion.
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Affiliation(s)
- Alessandra Tosco
- Division of Biomedicine “Arturo Leone”, Department of Pharmaceutical Sciences, University of Salerno, Via Ponte don Melillo, 84084 Fisciano (SA), Italy
| | - Maria Chiara Monti
- Division of Chemistry and Chemical Technologies “Luigi Gomez-Paloma”, Department of Pharmaceutical Sciences, University of Salerno, Via Ponte don Melillo, 84084 Fisciano (SA), Italy
| | - Bianca Fontanella
- Division of Biomedicine “Arturo Leone”, Department of Pharmaceutical Sciences, University of Salerno, Via Ponte don Melillo, 84084 Fisciano (SA), Italy
| | - Sandro Montefusco
- Division of Biomedicine “Arturo Leone”, Department of Pharmaceutical Sciences, University of Salerno, Via Ponte don Melillo, 84084 Fisciano (SA), Italy
| | - Luca D’Andrea
- Institute of Biostructures and Bioimaging, CNR, Naples, Italy
| | - Barbara Ziaco
- Institute of Biostructures and Bioimaging, CNR, Naples, Italy
| | | | - Marie-Christine Rio
- Department of Cancer Biology, Institute of Genetics and Molecular and Cellular Biology, CNRS UMR 7104, INSERM U964, Université de Strasbourg, Strasbourg, France
| | - Liberato Marzullo
- Division of Biomedicine “Arturo Leone”, Department of Pharmaceutical Sciences, University of Salerno, Via Ponte don Melillo, 84084 Fisciano (SA), Italy
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14
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[Trefoil factor: from laboratory to clinic]. DONG WU XUE YAN JIU = ZOOLOGICAL RESEARCH 2010; 31:17-26. [PMID: 20446449 DOI: 10.3724/sp.j.1141.2010.01017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Trefoil factor (TFF) family is a group of peptides with one or several trefoil factor domains in their structure, which are highly conserved in evolution, and are characterized by heat and enzymatic digestion resistance. The mammalian TFFs have three members (TFF1-3), and the gastrointestinal tract and the airway system are major organs of their expression and secretion. At certain physiological conditions, with a tissue-specific distribution, TFF plays an important role in mucosal protection and wound healing. But in the malignant tissues, TFF is widely expressed, correlated strongly with the genesis, metastasis and invasion of tumor cells. These phenomena indicated that TFF may be a possible common mediator of oncogenic responses to different stimuli. The biological functions of TFF involve complex regulatory processes. Single chain TFF may activate cell membrane receptors and induce specific signaling transduction. On the other hand, TFF can form a complex with other proteins to exert its biological effects. In clinical medicine, TFF is primarily applied as drugs in the mucosal protection, in the prevention and the treatment of mucosal damage-related diseases and as pathological biomarkers of tumors. At present the first hand actions and the molecular mechanisms related to TFFs are still the major challenges in TFF research. Furthermore, the discovery of the naturally occurring complex of TFF and crystallins is highly valuable to the understanding of the biological functions and action mechanisms of TFF.
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