Peritoneal metastasis of epithelial ovarian carcinoma is the primary means of metastatic spread, although a small minority of tumors disseminate via hematogenous or lymphatic routes. At the time of diagnosis, about 70% of patients will have peritoneal spread of the disease, indicative of advanced stage (III-IV), which confers a worse prognosis than if the disease were discovered at an earlier stage. Though the process of peritoneal seeding is poorly understood, the most widely accepted hypothesis is that cells detach from the primary tumor, and are transported via peritoneal fluid throughout the abdomen, eventually attaching themselves to the peritoneal surface. Phenotypically, the tumor cells with the best chance of metastasizing are cells with the ability to escape apoptosis following detachment, while exhibiting increased capacity to adhere to, and invade through the peritoneum, which is exactly the cellular phenotype routinely seen in advanced stage ovarian carcinoma [
22]. In the present study, we show that forced expression of ST6Gal-I in ovarian epithelial cells, resulting in α2–6 sialylation of β
1 integrins, induces increased adhesion and migration on collagen I and invasion through Matrigel. These results suggest that upregulation of ST6Gal-I in ovarian carcinoma may confer a more metastatic phenotype, which mirrors the findings of others' work with colon and breast cancers [
13,
12].
The regulation of ST6Gal-I expression is multifactorial. Its expression is increased by oncogenic ras [
9-
11], though a ras mutation is only present in approximately 6% of epithelial ovarian cancers [
23]. However, even in the absence of a ras mutation, perturbations in the ras signaling pathway can lead to physiologically activated H-ras, which can be present in as much as 60% of ovarian tumors [
24]. Cytokines, such as TNF-α, IL-1, and IL-6, can also induce expression of ST6Gal-I [
25,
26], and interestingly, IL-1 and IL-6 have been shown to increase ovarian carcinoma cell motility and metastasis, as well as being able to up-regulate TNF-α production [
27,
28]. Finally, there are data to suggest that steroidal regulation of ST6Gal-I may be of importance in ovarian cancer. Corticosteroids up-regulate α2–6 sialyltransferase activity
in vivo [
29,
30], and increase ST6Gal-I mRNA expression
in vitro [
31]. Further, cortisol has been shown to increase invasiveness in the SKOV3 cell line
in vitro [
32]. Estradiol (E
2) decreases ST6Gal-I expression in a dose dependent fashion in the human breast cancer cell line, MCF-7, an effect reversed with Tamoxifen [
33]. A lack of responsiveness to E
2 in ovarian cancers has been demonstrated in SKOV3 to be due to a mutation in estrogen receptor-α [
34], and thus is a plausible explanation for the hypersialylated phenotype despite an estrogenic microenvironment. Based on our findings in the present study, α2–6-hypersialylation may contribute to the invasive phenotype induced by these various modalities by altering the function of the β
1 integrin receptor.
We have previously shown that ST6Gal-I-mediated sialylation of β
1 integrins expressed by colon tumor cells increases cell adhesion to, and migration on collagen I [
12]. Likewise, α2–6 sialylation of purified integrin receptors enhances receptor binding to collagen I, confirming a critical role for sialylation in regulating integrin function. Collagen I has been shown to be secreted
in vitro by LP9 mesothelial cells, along with fibronectin, laminin, vitronectin, and collagen types III and IV.
In vivo, these molecules would contribute to the make up of the extracellular matrix (ECM) that free floating ovarian carcinoma cells would encounter, adhere to, and subsequently invade [
35]. β
1 integrin's importance in the metastasis of ovarian cancer has been repeatedly demonstrated. β
1 integrin is integral to multicellular spheroid formation [
36], adhesion to peritoneal mesothelium [
35,
37], migration toward a variety of ECM molecules [
38], and spheroid disaggregation and invasion [
39]. Most studies of altered β
1 function have focused on either changes in integrin expression or regulation of activity through "inside-out" signaling mechanisms (e.g., conformational changes elicited by the binding of cytosolic molecules to integrin cytoplasmic tails). However, there is growing appreciation for the role of variant sialylation in modulating β
1 activity.
Given the extensive evidence of hypersialylation in tumor progression, sialyltransferases have been investigated as potential targets for drug therapy [
40]. ST6Gal-I acts to catalyze the transfer of the activated sialyl residue from a sugar nucleotide donor to a glycoconjugate acceptor. Strategies designed to halt this process can be aimed at competitively inhibiting the donor with a sugar nucleotide analog, or with an analog of the transition state which binds with many order higher affinity to sialyltransferases than do ground state analogs [
41], or by inhibiting the acceptor with a glucoconjugate analog. Another promising avenue of sialyltransferase inhibition is with antisense-oligodeoxynucleotides, which reduce cell surface sialylation without affecting overall cell viability or growth [
42]. Challenges remain in developing a sialyltransferase inhibitor that is readily bioavailable, but several strategies to circumvent these problems are under investigation.