The importance of the circadian/melatonin signal in suppressing the metastatic progression of breast and other cancers has been reported by numerous laboratories including our own. Currently, the mechanisms underlying the anti-metastatic actions of melatonin have not been well established. In the present study, the anti-metastatic actions of melatonin were evaluated and compared on the ERα-negative, Her2-positive SKBR-3 breast tumor cell line and ERα-positive MCF-7 cells overexpressing a constitutively active HER2.1 construct (MCF-7Her2.1 cells). Activation of Her2 is reported to induce the expression and/or phosphorylation-dependent activation of numerous kinases and transcription factors that drive drug resistance and metastasis in breast cancer. A key signaling node activated by the Her2/Mapk/Erk pathway is Rsk2, which has been shown to induce numerous signaling pathways associated with the development of epithelial-to-mesenchymal transition (EMT) and metastasis including: Creb, Stat3, cSrc, Fak, Pax, Fascin, and actin polymerization. The data demonstrate that melatonin (both endogenous and exogenous) significantly represses this invasive/metastatic phenotype through a mechanism that involves the suppression of EMT, either by promoting mesenchymal-to-epithelial transition (MET), and/or by inhibiting key signaling pathways involved in later stages of metastasis. These data, combined with our earlier in vitro studies, support the concept that maintenance of elevated and extended duration of nocturnal melatonin levels plays a critical role in repressing the metastatic progression of breast cancer.
Liver cancer is the second leading cause of cancer death worldwide. Metabolic pathways within the liver and liver cancers are highly regulated by the central circadian clock in the suprachiasmatic nuclei (SCN). Daily light and dark cycles regulate the SCN-driven pineal production of the circadian anticancer hormone melatonin and temporally coordinate circadian rhythms of metabolism and physiology in mammals. In previous studies, we demonstrated that melatonin suppresses linoleic acid metabolism and the Warburg effect (aerobic glycolysis)in human breast cancer xenografts and that blue-enriched light (465-485 nm) from light-emitting diode lighting at daytime (bLAD) amplifies nighttime circadian melatonin levels in rats by 7-fold over cool white fluorescent (CWF) lighting. Here we tested the hypothesis that daytime exposure of tissue-isolated Morris hepatoma 7288CTC-bearing male rats to bLAD amplifies the nighttime melatonin signal to enhance the inhibition of tumor growth. Compared with rats housed under a 12:12-h light:dark cycle in CWF light, rats in bLAD light evinced a 7-fold higher peak plasma melatonin level at the mid-dark phase; in addition, high melatonin levels were prolonged until 4 h into the light phase. After implantation of tissue-isolated hepatoma 7288CTC xenografts, tumor growth rates were markedly delayed, and tumor cAMP levels, LA metabolism, the Warburg effect, and growth signaling activities were decreased in rats in bLAD compared with CWF daytime lighting. These data show that the increased nighttime circadian melatonin levels due to bLAD exposure decreases hepatoma metabolic, signaling, and proliferative activities beyond what occurs after normal melatonin signaling under CWF light.
Cancer patients with disrupted 24-hour (circadian) rhythms are reported to have poorer survival as compared to those with normal rhythms. Severe alterations in circadian rhythms predict an increased risk of death in patients with colorectal and breast cancer, suggesting that circadian disruption may impact tumor progression and metastasis. We recently reported that circadian/melatonin (MLT) disruption by exposure to dim light at night (dLAN) resulted in constitutive phospho-activation of ERK1/2, CREB, NF-kB, and STAT3 in breast tumor xenografts promoting resistance to Tamoxifen and Doxorubicin therapy. Given that chemoresistant breast cancer is frequently metastatic, this study examined if dLAN-induced circadian/MLT disruption can promote epithelial-to- mesenchymal transition (EMT) of epithelial MCF-7 breast tumor xenografts leading to the development of metastatic foci in the lungs, livers, and brains of circadian complete (MLT-producing) athymic nude female rats and mice. Female nude rats with ERα+ MCF-7 or T47D human epithelial breast cancer xenografts were housed in LD,12:12 and LD,12:12dLAN (dLAN) photoperiods or in dLAN supplemented with nighttime MLT (0.05 µg/ml) in the drinking water, with lights on at 0600 hrs and off at 1800 hrs. Blood samples collected during the mid-dark phase (2400 hrs) showed elevated nocturnal melatonin (118.4 pg/ml) in the LD,12:12 group, but significantly suppressed melatonin (10.0 pg/ml) in the dLAN group. Tumor xenografts from rats housed in dLAN showed a ~3-fold decrease in latency-to-onset and a ~2.8-fold increase in growth rates vs. those from rats in dLAN + MLT. Tumor cAMP levels, as well as numerous signaling pathways involved in promoting EMT (Vimentin, β-catenin, and SNAIL) and metastasis (HER2/HER3, pCREB, pERK1/2, pRSK2, and pSTAT3), showed increased expression/phospho-activation at 2400 hrs in response to dLAN but repressed expression in tumors from rats in dLAN + MLT. Follow-up studies with Foxn1nude female mice implanted with non-metastatic luciferase expressing MCF-7 breast cancer cells showed that exposure to dLAN suppressed the nighttime serum levels of MLT by 93% in these mice compared to those in a LD,12:12 photoperiod. Exposure of mice to dLAN induced the rapid growth of MCF-7luc tumor xenografts and, after 5 weeks, induced the metastatic outgrowth of MCF-7 xenografts to form luciferase identifiable metastatic foci in the lungs, livers, and brains of all mice, as measured by IVIS small animal imaging system. Conversely, MCF-7luc tumor xenografts from mice exposed to dLAN and supplemented with nighttime MLT showed a reduced tumor development, 3-fold slower tumor growth, and a small metastatic lesion in one lung of a single mouse. This study is the first to show that circadian/MLT disruption by host exposure to dLAN is able to drive EMT in human epithelial breast cancer xenografts to generate metastatic foci in lung, liver, and brain of mice. Citation Format: Steven M. Hill, Shulin Xiang, Robert T. Dauchy, Melissa Wren-Dail, Murali Anbalagan, Brian Rowan, Tripp Frasch, David E. Blask. Circadian/melatonin disruption by dim light at night drives human epithelial breast cancer to a metastatic phenotype [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4897. doi:10.1158/1538-7445.AM2017-4897
Resistance to chemotherapy is a significant impediment to the treatment of breast cancer. More than 30% of breast cancer patients present with intrinsic resistance to chemotherapy; almost all who initially respond will develop acquired resistance. Resistant tumors frequently exhibit constitutive activation of numerous survival signaling pathways, including ERK, AKT, NF-kB, and STAT3. We have reported that the circadian hormone melatonin inhibits the growth of both ERá+/ERá- breast cancers and, as well as the daytime induced phospho-activation of ERK1/2, AKT and NF-kB in breast tumor xenografts. We also demonstrated that dim light at night (dLAN), by decreasing nocturnal melatonin, resulted in constitutive phospho-activation of ERK1/2, CREB, NF-kB, and STAT3, promoting resistance to tamoxifen and doxorubicin therapy. Here we tested the hypothesis that dLAN, via phospho-activation of ERK1/2 and STAT3, promotes resistance to paclitaxel (Pax). Female nude rats with “tissue-isolated” MCF-7 breast cancer xenografts were housed in photoperiodic conditions of either LD 12:12, 12:12dLAN (0.2 lux), or 12:12dLAN supplemented with nighttime melatonin (0.05 õg/ml) in the drinking water, with lights on at 0600 hrs and off at 1800 hrs. When estimated tumor weights reached 2.5 g, animals were treated daily with either diluent or Pax i.p. (4õã/kg) 2 h prior to onset of dLAN or dLAN with nighttime melatonin supplementation. Blood samples collected during the mid-dark phase (2400 hrs) showed elevated nocturnal melatonin in the LD 12:12 group, but significantly suppressed melatonin in the dLAN group. Tumor xenografts from rats housed in dLAN showed a 3-fold decrease in latency-to-onset and a 2.8-fold increased growth rates vs. those from rats receiving melatonin supplementation. Tumor cAMP levels, linoleic acid, and tumor metabolism (Warburg effect) were significantly elevated in dLAN tumors. Numerous signaling pathways including ERK1/2, RSK2, and STAT3, were phospho-activated and others including AKT and HER2/3 were elevated at 2400 hrs by dLAN but repressed in dLAN melatonin supplemented tumors. Tumors from dLAN rats showed intrinsic resistance to Pax, whereas those in LD 12:12 or dLAN and supplemented with nighttime melatonin rapidly regressed. These findings show that temporally coordinated and integrated metabolic and signal transduction mechanisms, particularly the STAT3 pathway, underlying human breast cancer growth, can be activated by the host's exposure to LAN with profound effects culminating in rapid tumor progression and the development of resistance to chemotherapy. Citation Format: Steven M. Hill, Shulin Xiang, Robert T. Dauchy, Lulu mao, Lin Yuan, Adam Hauch, Victoria P. Belancio, Melissa A. Wren-Dail, David Pointer, Peter W. Lundberg, Whitney M. Summers, David E. Blask. Circadian/melatonin disruption by dim light at night drives paclitaxel resistance in breast cancer via activation of stat3. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 874.
Over 36,000 people in the United States will be diagnosed with hepatocellular carcinoma (HCC) in 2016, the second leading cause of cancer death worldwide. Metabolic pathways within the liver and in HCC are highly regulated by the central circadian clock in the suprachiastmatic nucleus (SCN). The SCN drives nighttime production of the circadian anti-cancer hormone melatonin by the pineal gland in rats and humans. We have shown that the nighttime circadian melatonin signal suppresses the Warburg effect (aerobic glycolysis) in human breast cancer xenografts and that blue-enriched light (460-480 nm) from LEDs at daytime (bLAD), amplifies the nighttime circadian melatonin signal by 7-fold in rats over cool white fluorescent (CWF) lighting. Here we tested whether daytime exposure of tissue-isolated HepG2 xenograft-bearing male nude rats to bLAD amplifies the nighttime melatonin signal to increase tumor sensitivity to nighttime administered sorafenib (FDA-approved multi-kinase inhibitor) treatment via enhancing suppression of the Warburg effect. Animals were randomized to 6 subgroups (n = 4): CWF Groups I, 12 h light:12 h dark (LD,12:12) (CWF + vehicle) and II (CWF + sorafenib); bLAD Groups III (LD,12bLAD:12) (bLAD + vehicle), IV (bLAD + sorafenib), V (bLAD + S20928 MT1/MT2 receptor blocker), and VI (bLAD + S20928 + sorafenib). Drug treatments began when tumors were 2.5 g estimated weight. Plasma nighttime melatonin levels were 7-fold higher in Groups III-VI, compared to Groups I and II. Tumor latency-to-onset of growth and growth rates were markedly delayed and decreased, respectively, in Group III compared to Group I. Sorafenib induced tumor regression at a rate that was 2-fold higher in the bLAD- vs CWF-exposed rats. Tumor glucose uptake and lactate production (Warburg effect) at the mid-dark phase were significantly reduced in CWF-exposed rats receiving sorafenib vs vehicle. In vehicle-treated bLAD-exposed rats, the Warburg effect was significantly decreased vs CWF-exposed rats receiving vehicle. In bLAD + sorafenib-treated rats, the Warburg effect was reduced by an additional 51% (glucose uptake) and 89% (lactate production), respectively, vs CWF + sorafenib-treated rats. Melatonin receptor blocker S20928 completely prevented the effects of bLAD and bLAD + sorafenib on the Warburg effect and made these tumors completely resistant to sorafenib-induced tumor regression. These findings are the first to show in vivo that: 1) nighttime circadian sorafenib therapy inhibited the Warburg effect and induced HepG2 tumor regression under CWF lighting conditions, and 2) the bLAD-amplified nocturnal circadian melatonin signal increased tumor sensitivity to sorafenib-induced regression by enhancing a melatonin receptor-mediated suppression of the Warburg effect. Citation Format: Robert T. Dauchy, David T. Pointer, Aaron E. Hoffman, Melissa A. Wren-Dail, Shulin Xiang, Lin Yuan, David E. Blask, Victoria P. Belancio, Steven M. Hill. Daytime blue-enriched LED light-induced circadian amplification of the nighttime melatonin signal increases sorafenib sensitivity in human hepatocellular carcinoma via enhanced suppression of the Warburg effect [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3191. doi:10.1158/1538-7445.AM2017-3191
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