• Myeloma cell-derived Runx2 promotes myeloma progression.• High levels of Runx2 expression are associated with a high-risk myeloma population.The progression of multiple myeloma (MM) is governed by a network of molecular signals, the majority of which remain to be identified. Recent studies suggest that Runt-related transcription factor 2 (Runx2), a well-known bone-specific transcription factor, is also expressed in solid tumors, where expression promotes both bone metastasis and osteolysis. However, the function of Runx2 in MM remains unknown. The current study demonstrated that (1) Runx2 expression in primary human MM cells is significantly greater than in plasma cells from healthy donors and patients with monoclonal gammopathy of undetermined significance; (2) high levels of Runx2 expression in MM cells are associated with a high-risk population of MM patients; and (3) overexpression of Runx2 in MM cells enhanced tumor growth and disease progression in vivo. Additional studies demonstrated that MM cell-derived Runx2 promotes tumor progression through a mechanism involving the upregulation of Akt/b-catenin/Survivin signaling and enhanced expression of multiple metastatic genes/proteins, as well as the induction of a bone-resident cell-like phenotype in MM cells. Thus, Runx2 expression supports the aggressive phenotype of MM and is correlated with poor prognosis. These data implicate Runx2 expression as a major regulator of MM progression in bone and myeloma bone disease. (Blood. 2015;125(23):3598-3608)
IntroductionMultiple myeloma (MM) is a largely incurable B-cell malignancy characterized by the clonal expansion of malignant plasma cells in the bone marrow.1-3 A hallmark of MM is the predominant localization in the bone marrow and the propensity for progression from primary bone sites to new bone sites in both local and distant bones. 2,4 Bone disease occurs in ;90% of patients with MM 5 and is the main cause of patient mortality, however, the cellular mechanisms driving MM progression in bone remain largely undefined.Runt-related transcription factor 2 (Runx2), a member of the runtrelated gene family, is a bone-specific transcription factor 6,7 considered to be the master regulator of osteoblastogenesis and bone formation. [6][7][8][9] Accumulating evidence has demonstrated that various solid tumors, such as breast and prostate cancers, also express Runx2 [10][11][12][13][14][15][16][17] and that Runx2 expression is significantly correlated with the development of bone metastasis and subsequent osteolysis. [10][11][12][13][14][15][16][17][18][19] Despite the evidence in solid tumors, the role of Runx2 in MM remains unclear. In this study, the regulatory roles and mechanisms of Runx2 in the promotion of MM growth, survival, and progression in bone were elucidated.
Materials and methods
Cell lines and cell cultureMouse myeloma 5TGM1 cells were a gift from Dr Claire M. Edwards (University of Oxford, Oxford, United Kingdom). Human myeloma MM.1R cells were purchased from American Type Culture Collection. All...