FST, initially identified in ovarian follicular fluid, was shown to play a role in cell growth, differentiation and development of ovarian cells
[39],
[40]. FST is also shown to regulate tumor progression, angiogenesis, metastasis and apoptosis
[11],
[41],
[42], and acts as an antagonist to activin function. Activin is frequently overexpressed in many cancers including ovarian carcinogenesis
[43],
[44]. Families with history of breast cancer have 50% increased risk of developing ovarian cancer due to germ line mutations in either
BRCA1 or
BRCA2 tumor suppressor genes.
BRCA1, in particular, plays a major role in hereditary predisposition for breast and ovarian cancer susceptibility
[45],
[46]. Even though, the role of BRCA1 has been established in cases of hereditary breast and ovarian cancer, its function in ovarian surface epithelial (OSE) cells needs further assessment. The relation between the OSE cells and its link to ovarian cancer has expanded recently due to the ability of cultured OSE to give rise to an ovarian adenocarcinoma in experimental models
[47].
Although FST is mainly found in follicular fluids, its expression has been detected in many tissues including ovary, kidney, brain, testis, pancreas, gut, heart, uterus, skeletal muscle, lung, breast, prostate and pituitary indicating that the function of FST may not only be confined to the reproductive system
[48],
[49]. BRCA1 is also expressed at variable levels in a wide range of normal and pathological human tissues, but mostly it was investigated in relation to tumor suppression in breast, prostate and ovarian cancer. Hypothetically, FST overexpression could be beneficial in treating ovarian tumors with high expression of Activin. Ectopic expression of BRCA1 in ovarian cells may induce the expression of FST and this FST expression in turn plays an antagonistic role to inhibit the cancer promoting function of activin. This phenomenon may very well exist in breast and prostate too, but it needs further investigation. Although this hypothesis may not work with tumor tissues where FST expression is high when compared to its normal expression such as in rodent liver tumors
[50], but BRCA1 may offer a tumor suppressive function in the tumors with high activin expression such as human ovarian cancer.
Several key proteins such as activin, inhibin and FST, besides the hormones secreted by the pituitary gland, regulate the process of folliculogenesis. Moreover, activin treatment in ovarian cancer cell lines was shown to induce increased cell proliferation, whereas simultaneous FST treatment in such activin producing cell lines inhibits cell multiplication
[10],
[51]. Activin is shown to play a complex role in cancer progression and requires careful interpretation with respect to tumorigenesis. Activin effects are cell-type specific such as proliferative effect of activin is observed in cultured tumor epithelial cells obtained from ovarian carcinoma specimens
[10], whereas in breast cancer cell line, MCF-7, activin slows the growth of breast tumor cells by inducing G0/G1 cell cycle arrest
[52]. We studied mRNA expression of BRCA1, FST, Activin, and SMAD6 proteins in SKOV3 and IOSE cells as well as investigated the ability of these cells to secrete FST in culture medium with respect to BRCA1 expression. It is important to note that IOSE cells were of significant interest since majority of ovarian cancers arise in ovarian surface epithelium. IOSE 592F cells isolated from an ovarian cancer patient with a deletion mutation in
BRCA1 secreted significantly low levels of FST in the medium compared to IOSE 7576 and IOSE 397. The TGF-β superfamily members, activin and its antagonist FST, act as a pleiotropic growth factor system that controls cell proliferation, differentiation, and apoptosis of numerous cell types
[10],
[51],
[53],
[54]. Activin is regulated by TGF-ß members and is a known stimulator of ovarian carcinogenesis
[55],
[56]. These results indicate a novel role for the tumor suppressor BRCA1 in ovarian carcinogenesis.
SMAD6, an inhibitory SMAD member of TGF-ß family of proteins, exert an inhibitory effect towards the stimulatory action of the TGF-ß signaling pathway proteins
[57]. Activin, TGF-β1 and BMP-7 are some of the TGF-ß family members known to modulate SMAD6 expression
[58]. Polymorphism study utilizing ovarian tissues from ovarian cancer patients reveal that mutations in SMAD6 gene are unlikely to be involved in ovarian carcinogenesis
[59]. However, studies with human SMAD6 demonstrate that SMAD6 partially inhibits the function of activin during mesoderm formation
[60]. Moreover, ectopic expression of SMAD6 in xenopus embryos was able to entirely block the effects of BMP-4 signaling
[61] leading to developmental defects. It is known that activin receptor like kinase 2 (ALK2) interacts with Activin as well as BMPII and TBRII receptors
[62], and these ALK2 interactions are sufficient to induce epithelial-mesenchymal transmission (EMT) in heart. SMAD6, which is downstream of ALK2, inhibits EMT in endocardial cells
[63] underlining the importance of SMAD6 in cancer development
[26]. Additional work is required to link the function of SMAD6 with FST in relation to human ovarian carcinogenesis. Our microarray results suggest that BRCA1 selectively modulates SMAD6 expression in ovarian cancer cells. Although there are no reports showing involvement of SMAD6 in ovarian cancer, the stimulation of SMAD6 by BRCA1 as observed in our study may be suggestive of cytoprotective role of SMAD6 in ovarian cancer, and thus needs further investigation.
To date, regulation of
FST gene is not well established. Recently, bone morphogenetic protein 2 (BMP-2) and forkhead domain transcription factor L2 (FOXL2) were shown to regulate FST expression in mouse ovary. Moreover, FST expression was also shown to be reduced in Wnt4 null mouse during early ovarian development suggesting positive regulation of
FST gene by BMP2, FOXL2 and Wnt4
[64]. In addition, expression of FST has been shown to inhibit the up-regulation of Sp6, which is a member of the Sp family of transcription factors that regulate a wide range of cellular functions in ameloblasts
[65]. FOXL2 is known as a candidate modulator of smad binding element (SBE1) function. FOXL2 binds to SMAD3 but not to SMAD2 or SMAD4
[66] and its association with SMAD6 is not yet established. FST might modulate ovarian functions by interacting with other family members of TGF-ß superfamily, especially with bone morphogenetic proteins (BMPs). FST interacts with GDF-9, BMP-15, BMP-6, BMP-4, and BMP-7 within ovarian cells
[67],
[68]. BMPs are involved in contradictory roles of cancer inhibition as well as cancer progression. BRCA1 may induce its cytoprotective effect via modulating the expression of both SMAD6 and FST
[69], and in turn, may induce BMP signaling pathways, which may then inhibit or delay the progression of ovarian cancer, specifically epithelial-origin ovarian cancer.
Cellular proliferation, migration, and differentiation are critical functions of cells that in part, assist in tissue rebuilding and repair. Activin has been shown to inhibit cell proliferation but promote cell migration
[70],
[71]. As an antagonist of activin function, FST expression in cells will have an immense potential in regulating normal cellular homeostasis. Although FST originally has been found in the ovarian follicular fluid, recent reports implicate its role in the regulation of various types of cancer development and/or prevention. In addition, FST was also shown to be expressed in the migrating endothelial cells and simultaneously induce basic fibroblast growth factor (bFGF), thus demonstrating its role in functional regulation of endothelial cells
[72]. Interplay between wound healing, angiogenesis and remodeling of molecular matrix serves as an important step for the progression of any cancer including ovarian carcinogenesis. Our data demonstrate that down-regulation of FST leads to reduced cell migration (less wound healing) when compared with the experimental controls. It may interfere with the normal cellular process and normal wound healing, delayed or incomplete, and thus leading to other factors that eventually determine the oncogenic transformation of the cells. Studies using prostate and liver tumors show that genes involving wound healing were highly activated, whereas tumors originated from breast and colon cancer displayed mixed results with regards to the activation of wound healing genes
[73]. Role of angiogenesis has been well documented in the progression of tumor growth and metastasis. Reports suggest that FST overexpression leads to induction of angiogenesis and simultaneously demonstrate the inhibitory action on Activin function in ovarian carcinogenesis. FST overexpressing tumors showed reduced tumor growth when compared with mock control
[42]. Thus, additional
in-vivo experiments will allow us to justify the possible role of FST as regulator of ovarian carcinogenesis. In this manuscript, we have shown that BRCA1 induces FST expression in SKOV3 and IOSE cells and this FST induction may be mediated by several other potential genes such as
FOXL2,
BMP-2, and
Sp6. Moreover, BRCA1 induced FST modulation may be tissue-specific such as human ovarian tissue. Finally, additional studies specifically examining the interplay between BRCA1 and FST and its effect(s) on cellular processes may be helpful in devising targeted treatment for human ovarian cancer.