In normal cells under normoxia (~8% oxygen level in tissues), the hypoxia-inducible factor-1α (HIF-1α) protein is constantly synthesized and immediately subjected to an O
2-dependent prolyl hydroxylation. This modification then targets HIF-1α to the ubiquitination-proteasome machinery for degradation (
Semenza, 2003 
). As a result, the overall steady-state level of HIF-1α is kept low. Under hypoxia, however, HIF-1α hydroxylation and subsequent degradation are suppressed, resulting in a rise in the HIF-1α level in the cells. The increased HIF-1α then forms a functional heterodimer with the constitutively present HIF-1β (ARNT), the master transcriptional complex, called HIF-1. HIF-1 translocates into the nucleus and regulates expression of hypoxia response element–containing genes in a p300/CBP-dependent manner (
Arany et al., 1996 
). In contrast, HIF-1α proteins are kept at a constitutive level in many tumors. This is caused by the tissue hypoxia generated by outgrowth of the rapidly proliferating tumor cells over the surrounding vascular network, creating a distance that is longer than the reach of the oxygen supply from the nearest blood circulation (
Bertout et al., 2008 
). Under constant ischemia, the tumor cells then undergo genetic changes to adapt alternative and self-supporting mechanisms for continued survival, expansion, and progression until neovascularization around them is complete. Thus action of oncogenes, inhibition of tumor suppressor genes, and deactivation of the enzymes involved in HIF-1α ubiquitination and degradation could all contribute to the deregulated expression of HIF-1α in tumor cells (
Majmundar et al., 2010 
). The deregulated HIF-1α plays a crucial role in tumorigenesis in animal models. Down-regulation of deregulated HIF-1α expression or inhibition of the HIF-1α action slows tumor growth and renders the tumor more susceptible to killing by radiotherapy and chemotherapy (
Majmundar et al., 2010 
). In humans, the constitutively expressed HIF-1α is linked to large tumor size, high grade, and lymph node–negative metastasis, which make the tumor less accessible to radiotherapy and chemotherapy (
Hutchison et al., 2004 
). Therefore the constitutively expressed HIF-1α in tumor cells has become a marker to predict possible outcomes of patients with tumor metastasis. Whereas sabotaging the deregulated HIF-1α in tumor cells could in concept prevent tumor progression, directly targeting the intracellularly located HIF-1α or the enzymes that regulate HIF-1α stability is challenging (
Poon et al., 2009 
).
The human heat shock protein-90 (Hsp90) chaperone family includes four confirmed members—the cytosolic Hsp90α and Hsp90β, the endoplasmic reticulum GRP74, and the mitochondrial TRAP1, which are encoded by distinct genes (
Chen et al., 2005 
). As with the overexpression (accumulation) of HIF-1α in tumor cells, Hsp90α has also been found either quantitatively overexpressed or qualitatively overactivated in a variety of tumors (
Kamal et al., 2003 
). These “extra” or “overactive” Hsp90α proteins are believed to bind and protect the stability of oncogene products inside the cell (
Welch and Feramisco, 1982 
;
Grenert et al., 1997 
;
Neckers and Neckers, 2002 
). Such a seemingly higher degree of protection by Hsp90α in tumor cells than their proto-oncoprotein counterparts in surrounding normal cells has been taken as the basis for a strategy for developing anticancer drugs (
Whitesell et al., 1994 
;
Trepel et al., 2010 
). Geldanamycin (GM, or benzoquinone ansamycin) and its derivatives, which bind and block the ATP-binding and ATP hydrolysis functions of Hsp90, have been the focus of drug development for more than a decade (Neckers and Neckers, 2002

). GM proved to be too toxic even in animal models (
Supko et al., 1995 
). A modified form of GM, benzoquinone ansamycin 17-allylaminogeldanamycin (17-AAG), showed promising efficacy at a dose range with tolerable toxicity in preclinical studies and has entered several phase 1 and phase 2/3 clinical trials since 1999 (
Solit and Chiosis 2008 
;
Trepel et al., 2010 
). Several newer generations of chemically modified and less toxic GM-related drugs are being developed in ongoing clinical trials. However, the main hurdle for these drugs remains as how to selectively target the oncogene-protecting activity of Hsp90 in tumors and spare the physiological function of Hsp90 in normal cells.
The figure of 1–2% of the total cellular proteins has been widely used to describe the unusual abundance of Hsp90 protein inside most types of mammalian cells. If one takes ~7000 proteins per cell, that content of Hsp90 proteins would be 70- to 150-fold higher than that of any of other cellular proteins.
Csermely et al. (1998 
) argued that, if intracellular chaperoning were the only assigned function for Hsp90, such an overproduction of a single protein in cells would not be well tolerated by evolution. They speculated that the major cellular function of Hsp90 might be another, yet-unrecognized one that would require such an abundant storage of the protein. Recent studies have discovered a surprising need for normal cells to secrete the “overstocked” Hsp90α for tissue repair (
Li et al., 2011 
) and for tumor cells to constitutively secrete Hsp90α for invasion and metastasis (
Tsutsumi and Neckers 2007 
). Secretion of Hsp90 and/or its role in invasion and/or metastasis have been reported in more than a dozen human tumors (
Li et al., 2011 
).
Kuroita et al. (1992 
) reported purification of Hsp90α from conditioned media of human hybridoma SH-76 cells.
Eustace et al. (2004 
) reported Hsp90α, but not Hsp90β, in conditioned media of HT-1080 fibrosarcoma cells.
Wang et al. (2009 
) reported secretion of Hsp90α by MCF-7 human breast cells.
Suzuki and Kulkarni (2010 
) found Hsp90β secreted by MG63 osteosarcoma cells.
Chen et al. (2010) 
reported secretion of Hsp90α by the colorectal cancer cell line HCT-8. Work by Trutrumi and colleagues implied secretion of Hsp90α by a variety of tumor cell lines (
Tsutsumi et al., 2008 
).
What is the relationship between HIF-1α and secretion of Hsp90? HIF-1α is a key upstream regulator of Hsp90α secretion (
Li et al., 2007 
;
Woodley et al., 2009 
). Because constitutive accumulation of HIF-1α occurs in >40% of the tumors in humans (
Dales et al., 2005 
;
Poon et al., 2009 
), the secreted Hsp90α could be a new and effective target for treatment of these HIF-1α–positive tumors. In the present study, we have tested this possibility by using the estrogen receptor (ER)–negative and aryl hydrocarbon (Ah)–nonresponsive breast cancer cell line MDA-MB-231. We proved the importance of the “HIF-1α > Hsp90α secretion” axis in control of cancer cell migration and invasion for the first time. More important, we identified a critical 115–amino acid epitope, F-5, in secreted Hsp90α that provides potentially a new therapeutic target for HIF-1α–positive breast cancers and likely beyond.