While genetic mutations of certain intracellular components of the Wnt/β-catenin pathway, such as
APC and
CTNNB1, are significant contributing factors for colorectal cancers, they are typically not the predominate mechanism associated with other cancer types such as breast cancer. Instead, it appears that dysregulation of cell surface Wnt/β-catenin signaling components leads to aberrant activation of this pathway in breast cancer (
Turashvili et al., 2006;
Lindvall et al., 2007). We found that expression of the Wnt signaling co-receptor LRP6 is up-regulated in a subset of human breast cancer tissues and cell lines (unpublished data). In the present study, we demonstrated that transgenic mice over-expressing LRP6 in mammary epithelial cells driven by the MMTV promoter is sufficient to induce mammary gland hyperplasia, a precursor to breast cancer. During the revision process of the manuscript, Lindvall et al. reported that canonical Wnt signaling through LRP6 is required for normal mouse mammary gland development, and that LRP6 expression is increased in basal-like human breast cancer, a triple-negative phenotype associated with high grade, poor prognosis, and younger patient age (
Lindvall et al., 2009). Altogether, these findings indicate that mammary tumorigenesis can be initiated at the cell surface receptor level in mammary epithelium, and that LRP6 is a potential target for breast cancer therapy.
Cyclin D1 and c-Myc are two important cell cycle regulators. Clinically, the
Cyclin D1 gene is amplified in up to 20% of human breast cancers and Cyclin D1 protein is overexpressed in >50% of human mammary carcinomas (
Bartkova et al., 1994;
Gillett et al., 1994;
McIntosh et al., 1995). For c-Myc, a comprehensive meta-analysis suggests that at least 15% of breast cancers present with significant amplification of
c-Myc, and that
c-Myc amplification is significantly associated with a poor prognosis in breast cancer (Deming et al., 2000). In animal studies, transgenic mice over-expressing Cyclin D1 in mammary epithelium (MMTV-Cyclin D1) develop mammary hyperplasia and mammary carcinomas (
Wang et al., 1994). Similarly, constitutive c-Myc expression under the control of MMTV or the whey acidic protein promoters is oncogenic in transgenic mice (reviewed in
Amundadottir et al., 1996;
Nass and Dickson, 1997). Amplification of
c-Myc or
Cyclin D1 has been identified as a downstream step at the end of Wnt/β-catenin pathway activation (
He et al., 1998;
Shtutman et al., 1999;
Tetsu and McCormick, 1999). Therefore, it is expected that LRP6 overexpression would cause the activation of Wnt/β-catenin signaling, up-regulation of Cyclin D1 and c-Myc expression levels, and increases the expression of the cell proliferation marker Ki67, all of which we observed experimentally in MMTV-LRP6 mice. As such, these events could account for mammary hyperplasia in MMTV-LRP6 mice.
MMPs are multifunctional enzymes capable of targeting the extracellular matrix, growth factors, cytokines and cell surface-associated adhesion and signaling receptors. Clinically, MMPs have been associated with advanced-stage cancer and contribute to tumor progression, invasion, and metastasis. In ductal breast carcinomas, it has been demonstrated that MMP-2, -3, -9, -11, -13 and -14 are synthesized either by stromal fibroblasts, infiltrating macrophages or vascular pericytes (
Wolf et al., 1993;
Okada et al., 1995;
Heppner et al., 1996;
Nielsen et al., 1997 &
2001;
Chenard et al., 1999). In animal models, it has been found that expression of an autoactivating form of MMP-3 under the control of the whey acidic protein promoter induces premalignant and malignant lesions in the mammary glands. Moreover overexpression of a natural inhibitor of MMPs, tissue inhibitor of MMP (TIMP)-1, inhibits tumor formation in MMP-3 transgenic mice (
Sternlicht et al., 1999). More interestingly, Blavier et al. recently reported that the expression of several MMPs including MMP-2, -3, -9,-13, and -14 was increased in hyperplastic glands and mammary tumors of MMTV-Wnt1 transgenic mice. Furthermore, when MMTV-Wnt1 mice were crossed with transgenic mice overexpressing a natural MMP inhibitor, TIMP2, in the mammary gland, the double transgenic mice displayed an increase in tumor latency and a reduction in tumor formation (
Blavier et al., 2006). MMP-2, -3, -7, -9, -13 and -14 are all known target genes of the Wnt/β-catenin pathway (
Crawford et al., 1999;
Takahashi et al., 2002;
Tamamura et al., 2005;
Wu et al., 2007). In the present study, we demonstrated that mammary glands from MMTV-LRP6 transgenic mice exhibit significantly higher levels of MMPs than WT littermate controls. Therefore, upregulation of MMPs could also account for mammary hyperplasia in MMTV-LRP6 mice.
Whole mount staining of mammary gland is a well-established and recommended method to identify early premalignant lesions of the mammary epithelium (
Cardiff et al., 2000). In our mammary gland model, we found that the MMTV-LRP6 female mice exhibit mammary gland hyperplasia. However, none of the MMTV-LRP6 mice developed adenocarcinoma of breast for more than an 18-month span. Therefore, it is possible that the extent of the Wnt/β-catenin activation upon LRP6 overexpression is sufficient to cause mammary gland hyperplasia but not sufficient to lead to breast cancer in virgin mice. It will be interesting to examine whether multiparous MMTV-LRP6 mice develop breast cancer. Crossing MMTV-LRP6 mice with MMTV-Wnt mice will allow us to test whether LRP6 and Wnt1 synergistically promote breast cancer tumorigenesis. Together, these studies should help to define whether LRP6 and Wnt ligands are novel targets for breast cancer therapy.