2001, 142: 5050-5055. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. 2022 Aug 23;14:2519-2531. doi: 10.2147/CMAR.S369910. PGs produced from this arachidonic acid conversion are both autocrine and paracrine factors that help to govern physiologic homeostasis. Mundy GR: Mechanisms of bone metastasis. At least three major growth factors sequestered in the matrix are activated by MMPs. 2006, 6: 181-10.1186/1471-2407-6-181. PubMed Central The ratio of RANKL to OPG determines the extent of the osteoclast activity and bone degradation. -, Science. Article Skeletal metastases in breast carcinoma: classic patterns of treatment response Hemonc Today | This case focuses on a 51-year-old woman with a history of right breast cancer initially. Cathepsin K is the major mediator of bone resorption, controlling the osteoclast portion of the vicious cycle. 2006, 21: 1350-1358. 10.1158/0008-5472.CAN-08-4437. 2009, 15: 5829-5839. 2000, 2: 737-744. The presence of metastatic lesions in bone disrupts the normal bone microenvironment and upsets the fine balance between the key components. Identification of a stimulator or protector of osteoblasts would be a major improvement in treatment for osteolytic breast cancer as well as other diseases of bone loss. Studies with MMP9-null mice indicate its importance in tumor progression in ovarian cancer, prostate cancer and bone metastasis [56]. PubMed Central Commonly used modalities include local therapies such as surgery, radiation therapy and radiofrequency ablation (RFA) together with systemic therapies such as endocrine therapy, chemotherapy, monoclonal antibody-based therapy, bone-enhancing therapy and radioisotope therapy. When a patient has a metastasis and no site of origin can be found (a metastasis of unknown origin) the most likely site is the lung or kidney. Even in adults it is estimated that about 10% of the bone is renewed each year [7]. 2. Troen BR: Molecular mechanisms underlying osteoclast formation and activation. 1984, 235: 561-564. J Dent Res. PDGF can function as a mitogen for cells of mesenchymal origin and possesses chemoattractant properties, making it an important factor in cell proliferation and migration. Cite this article. 2010, 3: 572-599. It is estimated that 85% of individuals with advanced disease harbor bone metastases [1]. Their multifunctionality demonstrates their importance. Bone. Radiol Clin North Am. Bone metastases in breast cancer may be osteolytic, osteoblastic, or mixed blastic and lytic. Blood. In addition, pre-clinical trials with agents that target cathepsin K, certain matrix metalloproteinases (MMPs), and transforming growth factor (TGF)- are underway. There is also evidence that molecules in conditioned medium from PC-3 cells alone [34], or from both PC-3 cells and MC3T3-E1 osteoblasts [35], promote osteoclastogenesis. The blastic bone lesions are caused when the cancer cells release the fluids. Article Exp Oncol. More than 2 out of 3 breast and prostate cancers that . osteolytic bone metastases are characterized by destruction and loss of normal bone or bone matrix 1,2 in which parathyroid hormone-related peptide (pthrp) features a significant part in the evolution of osteolytic lesions by stimulating the differentiation and activating osteoclasts via the rankl pathway, which primarily mediate the degradation 2000, 373: 104-114. By knowing the typical behavior of the metastatic lesion - lytic or blastic - you can help sort between the types to make the mnemonic even more useful. 10.1196/annals.1365.035. J Bone Oncol. Google Scholar. Bisphosphonates such as zoledronic acid (Zoledronate) bind to hydroxyapatite of the bone matrix and are ingested by osteoclasts, which then undergo apoptosis. Mol Cancer Ther. Clezardin P, Teti A: Bone metastasis: pathogenesis and therapeutic implications. Balkwill F, Mantovani A: Cancer and inflammation: implications for pharmacology and therapeutics. 2010, 9: 122-10.1186/1476-4598-9-122. PGE2 is associated with inflammation, cell growth, tumor development and metastasis [42]. Before Ganapathy V, Ge R, Grazioli A, Xie W, Banach-Petrosky W, Kang Y, Lonning S, McPherson J, Yingling JM, Biswas S, Mundy GR, Reiss M: Targeting the transforming growth factor-beta pathway inhibits human basal-like breast cancer metastasis. Osteoclasts derive from hematopoietic stem cells. An official website of the United States government. 10.2353/ajpath.2009.080906. Request PDF | Mechanoregulation may drive osteolysis during bone metastasis: A finite element analysis of the mechanical environment within bone tissue during bone metastasis and osteolytic . -, Cancer Metastasis Rev. It is common to find increased PTHrP serum levels in breast cancer patients. As seen in the images here, multiple, confluent sclerotic, blastic bony lesions are typical of metastatic breast cancer. Clin Orthop Relat Res. 1999, London: Martin Dunitz Ltd. Raisz LG, Mundy GR, Luben RA: Skeletal reactions to neoplasms. Estrogen profoundly affects bone remodeling by suppressing production of RANKL while increasing production of OPG. Breast cancer metastasis to the bone: mechanisms of bone loss. eCollection 2022 Dec. Edwards CM, Clements ME, Vecchi LA 3rd, Johnson JA, Johnson RW. Google Scholar. Ooi LL, Zhou H, Kalak R, Zheng Y, Conigrave AD, Seibel MJ, Dunstan CR: Vitamin D deficiency promotes human breast cancer growth in a murine model of bone metastasis. Those leading to excess bone deposition are considered osteoblastic. 2008, 473: 98-105. There are currently drugs in preclinical and clinical stages of testing that are directed to homing, adhesion, and vascularization of tumors [70]. Proteolytic cleavage of SPARC releases biologically active cleavage products that affect angiogenesis factors such as VEGF, platelet-derived growth factor (PDGF) and FGF-2. The presence of tumor cells in the bone microenvironment perturbs the balance between osteoblasts and osteoclasts, leading to excess bone loss or formation. 10.1158/1535-7163.MCT-08-0153. Clin Cancer Res. Clohisy DR, Perkins SL, Ramnaraine ML: Review of cellular mechanisms of tumor osteolysis. Continuing research into the mechanisms of cancer cell dormancy could result in a treatment that would prevent cancer cell proliferation in the bone and the chain of events that leads to osteolysis. In addition, other cells not specific for bone but likely to be found in the bone (macrophages, neutrophils and T lymphocytes) produce MMPs. 2010, 363: 2458-2459. Biochem Biophys Res Commun. Thus, in the course of the osteolytic process, the osteoblasts are unable to fulfill their role as bone building cells. Larkins TL, Nowell M, Singh S, Sanford GL: Inhibition of cyclooxygenase-2 decreases breast cancer cell motility, invasion and matrix metalloproteinase expression. Lefley D, Howard F, Arshad F, Bradbury S, Brown H, Tulotta C, Eyre R, Alfrez D, Wilkinson JM, Holen I, Clarke RB, Ottewell P. Breast Cancer Res. Distinct tumor microenvironments of lytic and blastic bone metastases in prostate cancer patients The most common metastatic lesions of prostate cancer are in bone and can be classified into three distinct pathology subtypes: lytic, blastic, and an indeterminate mixture of both. Bone metastases may cause pain, may make the bones more susceptible to fractures, and may cause increased levels of calcium in the blood. 2022 Nov 30;10:1088823. doi: 10.3389/fchem.2022.1088823. Juarez P, Guise TA: TGF-beta in cancer and bone: Implications for treatment of bone metastases. Accessibility It improves the quality of life by preventing fractures but does not prolong life [73]. Br J Cancer. 2006, 12: 1431-1440. Cholesterol Synthesis Is Important for Breast Cancer Cell Tumor Sphere Formation and Invasion. Symptoms when breast cancer has spread to the bones . Both RANKL and VEGF can induce osteoclast formation [48], and MMPs play a role in bone matrix degradation. Department of Biochemistry and Molecular Cell Biology, The Pennsylvania State University, University Park, PA, 16802, USA, Yu-Chi Chen,Donna M Sosnoski&Andrea M Mastro, You can also search for this author in Clin Exp Metastasis. The cancer cells affect osteoblast morphology and extracellular matrix. Many metastatic breast cancer cell lines have been found to also secrete PDGF, which has a strong impact on osteoblast development. McHayleh W, Ellerman J, Roodman D: Hematologic malignancies and bone. AMM, the senior investigator and corresponding author, has worked in the area of breast cancer metastasis to bone for over 12 years. Recently, Roy and colleagues [69] investigated this association in a mouse model of autoimmune arthritis and found that arthritic mice had an increase in both lung and bone metastasis compared to the non-arthritic mice. Springer Nature. Cathepsin K is believed to be the major protease in this capacity. At the tissue level, PDGF is involved in bone formation, wound healing, erythropoiesis and angiogenesis as well as tumor growth and lesion development [57]. Ooi LL, Zheng Y, Stalgis-Bilinski K, Dunstan CR: The bone remodeling environment is a factor in breast cancer bone metastasis. Edited by: Rosen CL. 2023;2582:343-353. doi: 10.1007/978-1-0716-2744-0_24. Part of Proff P, Romer P: The molecular mechanism behind bone remodelling: a review. Google Scholar. Unable to load your collection due to an error, Unable to load your delegates due to an error. However, because TGF- plays a more global role in cell proliferation and differentiation, its utility as a therapeutic may be limited. 2000 Jun 15;88(12 Suppl):2979-88. doi: 10.1002/1097-0142(20000615)88:12+<2979::aid-cncr13>3.0.co;2-u. spinal cord compression) palpable mass deformity pathological fracture hypercalcemia bone marrow aplasia Of the many prostaglandins, PGE2 is known to play a critical role in cancer progression. eCollection 2022. Current therapeutic targets are indicated in green. It is now known that PGE2 signaling through its receptor EP4 plays a crucial role in osteolysis by inducing monocytes to form mature osteoclasts. A large-scale 2017 study of the 10 most common cancers with bone metastasis found: Lung cancer had the lowest 1-year survival rate after bone metastasis (10 percent). Google Scholar. The MMP family, composed of more than 20 members, can collectively degrade all components of the extracelluar matrix. Coleman RE, Lipton A, Roodman GD, Guise TA, Boyce BF, Brufsky AM, Clzardin P, Croucher PI, Gralow JR, Hadji P, Holen I, Mundy GR, Smith MR, Suva LJ: Metastasis and bone loss: Advancing treatment and prevention. Once osteoclasts are activated, they degrade bone matrix through several proteolytic enzymes, including MMPs and cathepsin K. Although cathepsin K is the major bone resorbing protease, MMPs, which are secreted by many cells, may be the 'master regulator' of the entire mechanism. In addition, its expression is enhanced in the presence of TGF- [20]. Hadjidakis DJ, Androulakis II: Bone remodeling. 2003, 3: 537-549. These results signify an important role for cancer cell-derived Runx2 in the osteolytic process. These molecules cause osteoblasts not only to form new bone but also to release RANKL and other osteoclastic mediators. 2007, 24: 599-608. Because osteoblasts secrete both RANKL and OPG, they are major mediators of osteoclastogenesis [25]. Disclaimer, National Library of Medicine 10.1158/0008-5472.CAN-09-2758. Raica M, Anca M: Platelet-derived growth factor (PDGF)/PDGF receptors (PDGFR) axis as target for antitumor and antiangiogenic therapy. Purpose: This is a study in adult patients with different types of cancer. 1970, 86: 1436-1440. FOIA These types of tumors are called osteolytic, or simply lytic. Edited by: Rosen CL. Breast cancer metastasis to the bone: mechanisms of bone loss, http://breast-cancer-research.com/series/metastasis_pathway. However, the presence of metastatic breast cancer cells or other bone metastatic cancers, such as prostate, lung, renal, and myeloma, accelerates the remodeling process and disturbs the balance between bone depositing cells, osteoblasts, and bone degrading cells, osteoclasts. 8600 Rockville Pike We also discuss known risk factors as well as detection and assessment of bone metastases. Aldridge SE, Lennard TW, Williams JR, Birch MA: Vascular endothelial growth factor acts as an osteolytic factor in breast cancer metastases to bone. 10.1177/154405910608500704. Recent research has revealed how cancer cell Runx2 affects other cells in the bone microenvironment and promotes osteolysis. Of course, the best cure for bone metastasis is prevention. As pointed out by Lynch, the spatial and temporal expression of these molecules is of utmost importance. Annu Rev Pathol. J Biomol Tech. In summary, all of these factors contribute to propagating the vicious cycle and increasing osteolysis (Figure 1B). government site. Article Neutralization of TGF- in conditioned medium from human metastatic MDA-MB-231 breast cancer cells permitted the differentiation of osteoblasts in culture, suggesting that TGF- negatively affects osteoblasts while promoting growth of the metastatic cells [33]. Cancer Res. 2008, Washington, DC: American Society for Bone and Mineral Research, 374-378. full_text. 2005, 208: 194-206. Cancer Treat Rev. Evidence from an intratibial bone metastasis model indicates that when highly aggressive metastatic MDA-MB-231 cells express dysfunctional Runx2 or small hair-pin RNA for Runx2, both osteoclastogenesis and osteolytic lesions decrease [40]. Chemotherapy may bring about ovarian failure and premature menopause [1]. The results of an in vivo study showed that OPN-deficient mice showed significantly reduced bone metastasis [38]. It was recently reported that mice deficient in vitamin D or calcium showed increased metastatic tumor growth and accelerated rates of bone resorption [66, 67]. In middle aged and elderly women, calcium and/or vitamin D deficiencies are quite common, as is the incidence of breast cancer [65]. Akech and colleagues [34] recently reported that Runx2 (Runt-related transcription factor 2) is produced by the highly metastatic prostate cancer cell PC-3, and positively correlates to the severity of osteolytic disease. Khosla S: Minireview: the OPG/RANKL/RANK system. It was also noted that tumor cells caused other cells in the bone (for example, lymphocytes) to produce molecules such as prostaglandins (PGs) that can affect bone [4]. In this process, the older bone doesn't break down while the new bone forms. Clements ME, Holtslander L, Edwards C, Todd V, Dooyema SDR, Bullock K, Bergdorf K, Zahnow CA, Connolly RM, Johnson RW. For post-menopausal women, high bone turnover may be caused by estrogen deficiency. 2008, 3: e3537-10.1371/journal.pone.0003537. Grey A: Teriparatide for bone loss in the jaw. Osteocytes may act as mechanosensing cells and initiate the process when microfractures and loading are involved. 2010, [Epub ahead of print]. Curr Opin Support Palliat Care. blastic (bone formation), or mixed lesions (Fig 2). 2022 Aug 6;10(8):1908. doi: 10.3390/biomedicines10081908. These functional molecules complete the cycle and osteolysis continues. 10.1097/00003086-200004000-00013. 10.1056/NEJMoa030847. All in all, PTHrP is an important mediator between breast cancer cells and cells of the bone microenvironment and, as such, is a major contributor to the bone degradation process. Cancer Cell. Bone metastasis significantly affects both quality of life and survival of the breast cancer patient. The dynamics of this system are interrupted when metastatic breast cancer cells are introduced, adding another layer of active molecules to the bone environment. While the outcome is predominantly osteoblastic, it is known that prostate cancer lesions display both blastic and lytic characteristics early in the process. While drugs that inhibit osteoclast differentiation or activity are vital to treating osteolysis, therapies designed to restore osteoblast number and function will be required to fully resolve osteolytic lesions. FOIA This approach will allow testing of components and drugs in a model less complex than an animal but more relevant than standard tissue culture. (A) The bone remodeling unit consists of osteoblasts, which produce osteoid, bone matrix, and osteoclasts, which degrade mineralized bone. Evolving cancer-niche interactions and therapeutic targets during bone metastasis. The resorption phase of the process begins with recruitment of pre-osteoclasts that differentiate into activated osteoclasts under the direction of osteoblasts (Figure 1A). 1973, 28: 316-321. In normal bone remodeling, osteoclasts secrete PDGF, which acts as a chemoattractant to recruit pre-osteoblasts to the site of bone repair [58]. Feng X, McDonald JM: Disorders of bone remodeling. In the early 1970 s it was reported that prostaglandins could resorb fetal bone in culture [43], and that aspirin, a COX-1 inhibitor, and indomethacin, a COX-2 inhibitor, could prevent osteolysis in tissue culture [44]. 2010, 70: 412-424. Terms and Conditions, Other drugs on the horizon target TGF-, and cathepsin K. Various approaches, including kinase inhibitors, ligand-neutralizing antibodies and anti-sense molecules, are being investigated [33]. 2022 Feb;22(2):85-101. doi: 10.1038/s41568-021-00406-5. It is interesting that cancer cells often remain dormant in bone for many years before they begin to grow. 10.1038/onc.2009.389. This is a disease of clonal malignancy of terminally differentiated plasma cells that accumulate in the bone marrow. 10.1177/154405910608500703. Cancer Treat Rev. Metastatic breast cancer cells tend to spread to the bones more often than they do to other parts of the body. Other articles in the series can be found online at http://breast-cancer-research.com/series/metastasis_pathway, extracellular matrix metalloproteinase inducer, secreted protein acidic and rich in cysteine: osteonectin/BM-40, Lipton A, Uzzo R, Amato RJ, Ellis GK, Hakimian B, Roodman GD, Smith MR: The science and practice of bone health in oncology: managing bone loss and metastasis in patients with solid tumors. Provided by the Springer Nature SharedIt content-sharing initiative. What initiates remodeling in the non-tumor-containing bone? Recently we have begun developing an in vitro bioreactor [78]. 2010, 36: 615-620. These factors can stimulate the tumor cells to proliferate and produce more growth factors and more PTHrP, further perpetuating the vicious cycle of bone metastasis. Where do the MMPs come from? With rare exceptions, cancer that has spread to the bones can't be cured. Its common for people to have lytic and blastic lesions at the same time. However, PTHrP does not directly stimulate osteoclast differentiation, but rather stimulates other cells to increase RANKL and decrease OPG production. 2005, 5 (Suppl): S46-53. Metastases leading to overall bone loss are classified as osteolytic. Halpern J, Lynch CC, Fleming J, Hamming D, Martin MD, Schwartz HS, Matrisian LM, Holt GE: The application of a murine bone bioreactor as a model of tumor: bone interaction. 10.1007/s10585-007-9112-8. J Dent Res. Phadke PA, Mercer RR, Harms JF, Jia Y, Frost AR, Jewell JL, Bussard KM, Nelson S, Moore C, Kappes JC, Gay CV, Mastro AM, Welch DR: Kinetics of metastatic breast cancer cell trafficking in bone. Doctors use imaging tests, such as x-rays, to figure out the types of . However, more accessible and defined [76] models are needed. Evidence to support the concept that there is an intimate relationship between breast cancer cells and osteoclasts is described using an in vivo bone metastasis model in which human breast cancer cells are inoculated into the left ventricle of nude mice. There are many suspected factors, such as microfractures, loss of mechanical loading, hormones, cytokines, calcium levels and inflammation. When the bone loss is extensive, the osteoblasts are absent from the lesion [32]. 10.1056/NEJMe1010459. Kang and colleagues [20] found that expression of two MMP genes, MMP1 and ADAMTS1, discriminated between a subline of osteotropic metastatic MDA-MB-231 cells and the parental line. 2007, 57: 43-66. Although the mechanisms of osteoteoblastic and osteolytic responses are not fully understood, it is clear that many factors involved in osteolytic breast cancer bone metastasis also regulate the osteolytic aspects of prostate cancer. This review summarizes the current understanding of the osteolytic mechanisms of bone metastases, including a discussion of current therapies. Verbruggen ASK, McCarthy EC, Dwyer RM, McNamara LM. However, cathepsin K is also produced by other cells in the bone microenvironment, such as macrophages and bone marrow stromal cells. [Management of bone metastases from breast cancer]. 2010, 70: 6150-6160. Oncogene. However, both bone degradation and deposition likely occur early in the metastatic process. The majority of breast cancer metastases ultimately cause bone loss. MeSH Metastastic human breast cancer cells (MDA-MB-231) added to this culture attach, penetrate the tissue and form single cell files characteristic of metastases seen in pathologic tissues. CAS Denosumab (Prolia), the latest drug to enter the field, is a monoclonal antibody to RANKL. IGF binding proteins keep this molecule latent. Methods Mol Biol. A newly discovered molecule downstream of RANKL is extracellular matrix metalloproteinase inducer (EMMPRIN)/CD147, a cell surface glycoprotein that is known to induce MMPs and VEGF [48]. Clipboard, Search History, and several other advanced features are temporarily unavailable. 10.1158/1078-0432.CCR-05-1806. Endocr Rev. In a series of in vitro, ex vivo and in vivo experiments, Ohshiba and colleagues [45] demonstrated that direct cell-cell contact between breast cancer cells and osteoblasts caused an increase in COX-2 expression in the osteoblasts due to activation of the NFB/mitogen-activated protein (MAP) kinase pathway. Kozlow W, Guise TA: Breast cancer metastasis to bone: mechanisms of osteolysis and implications for therapy. In addition, factors such as TGF- and IGFs that are released from the bone matrix during degradation serve to increase PTHrP expression in breast cancer cells. Cancer Res. Metastasis of breast cancer cells to bone consists of multiple sequential steps. 2009, 3: 213-218. CAS Clin Exp Metastasis. Exp Cell Res. Trabecular bone is the major site of bone turnover under normal conditions and in diseases of bone loss or formation. 10.1097/SPC.0b013e32832f4149. Bethesda, MD 20894, Web Policies In addition, production of inflammatory cytokines (that is, IL-6, TNF-, M-CSF, IL-1) is suppressed by estrogen [64]. HHS Vulnerability Disclosure, Help Shimo T, Okui T, Horie N, Yokozeki K, Takigawa M, Sasaki A. Until recently they were the only FDA approved drugs for metastatic bone disease [71]. Clinically, complications secondary to bone metastasis include pain, pathologic fractures, spinal cord compression, and hypercalcemia of malignancy. Metastatic cancer cells tend to colonize the heavily vascularized areas of the skeleton, such as the red marrow of the long bones, sternum, pelvis, ribs and vertebrae, where they disrupt not only bone physiology but also hematopoiesis and the immune system [3].
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