Abstract
Aims: To identify variables having a critical role in prostate cancer patients experiencing osteometastasis.
Background: Prostatic carcinoma is a multifactorial complex disorder that exhibits an increased propensity to develop bone metastasis. An interplay of inflammatory and bone remodeling parameters promotes the formation of pre-metastatic niches in bones of patients, which could render them more vulnerable to skeletal disabilities.
Objective: To evaluate the multi-dynamic inter-relationship of circulating variables in prostate cancer patients experiencing osteo-metastasis.
Materials and Methods: Fifty-seven (n=57) men with clinically confirmed prostate cancer, fifty-nine (n=59) with skeletal metastases, and one hundred (n=100) healthy subjects i.e., men aging from 53-84 years with no clinical evidence of prostate were recruited from the Jinnah Hospital Lahore, Pakistan. Informed consent was obtained, and a venous blood sample was drawn and stored at -70oC until assayed. Levels of variables were evaluated using appropriate methods. Levels of Matrix Metalloproteinases (MMPs), Osteopontin (OPN), TGH- β, and sRANKL were estimated by the ELISA method. Each sample was suspended and the given protocol was employed. ELISA readings were obtained for the estimation of all variables.
Results: Highly significant (P˂0.05) differential expression of oxidative stress, inflammatory cytokines, and bone remodeling variables were observed in localized and osteo-metastatic CA prostate patients. A strong positive correlation was revealed among OPN, sRANKL, MMP-7, MMP-9, PSA, and TGF-β (OPN vs. MMP-7, r=0.698* and OPN vs. MMP-9, r=0.765**, OPN vs. RANKL, =0.856*, sRANKL vs. MMP-9, r=0.825**, TGF- β vs. RANKL, r=0.868* and PSA vs. TGF- β, r=0.752*); lower levels of OPG were estimated in metastasized patients, showing that both osteolytic and osteoblastic phases of bone remodeling occur simultaneously.
Conclusion: The altered oxidative and inflammatory responses endorse Matrix Metalloproteinases (MMPs) increased activity, RANKL/OPG imbalance, and enhanced bone matrix proteins turnover, which can foster the process of osteo-metastasis. The perturbed RANKL/OPG drift and enhanced PSA levels are associated with increased TGF-β activity to aggravate Epithelial Mesenchymal transition (EM) and osteo-tropism of prostate cancer. Thus, designing novel targets of these major variables can minimize the incidence of prostate cancer patients.
Keywords: Prostate specific antigen, osteopontin, osteoprotegrin, transforming growth factor-beta, prostate cancer, MMP.
Graphical Abstract
[http://dx.doi.org/10.1016/j.eururo.2016.08.002] [PMID: 27591931]
[http://dx.doi.org/10.1016/j.urology.2015.12.039] [PMID: 26768714]
[http://dx.doi.org/10.1016/j.eururo.2016.10.008] [PMID: 28029399]
[http://dx.doi.org/10.1101/cshperspect.a033688] [PMID: 29661810]
[http://dx.doi.org/10.1016/j.clgc.2014.08.001] [PMID: 25262852]
[http://dx.doi.org/10.2147/CMAR.S40151] [PMID: 24833918]
[http://dx.doi.org/10.1007/s00520-015-2908-1] [PMID: 26329397]
[http://dx.doi.org/10.1007/978-1-4615-3398-6_18]
[http://dx.doi.org/10.1016/j.jbo.2016.02.005] [PMID: 27761370]
[http://dx.doi.org/10.1016/j.ctrv.2016.02.002] [PMID: 26907461]
[http://dx.doi.org/10.1016/j.eururo.2013.09.046] [PMID: 24207135]
[http://dx.doi.org/10.1093/annonc/mdv222] [PMID: 26205393]
[http://dx.doi.org/10.1038/nrclinonc.2014.70] [PMID: 24821212]
[http://dx.doi.org/10.1080/21681805.2019.1570328] [PMID: 30777478]
[http://dx.doi.org/10.1016/j.celrep.2016.11.019] [PMID: 27926866]
[http://dx.doi.org/10.1007/s00011-016-0985-3] [PMID: 27653961]
[http://dx.doi.org/10.1038/nrc3803] [PMID: 25342630]
[http://dx.doi.org/10.1007/s00432-017-2464-9] [PMID: 28647857]
[http://dx.doi.org/10.2174/15680096113139990035] [PMID: 23597197]
[http://dx.doi.org/10.1210/en.2016-1606] [PMID: 27783536]
[http://dx.doi.org/10.2147/OTT.S135867] [PMID: 28794644]
[http://dx.doi.org/10.1016/j.eururo.2017.12.008] [PMID: 29275833]
[http://dx.doi.org/10.1186/bcr2781] [PMID: 21176175]
[http://dx.doi.org/10.1002/pros.23489] [PMID: 29383751]
[http://dx.doi.org/10.1007/978-1-4614-5662-9_2]
[http://dx.doi.org/10.18632/oncotarget.10110] [PMID: 27331624]
[http://dx.doi.org/10.1158/0008-5472.CAN-04-3448] [PMID: 15781644]
[http://dx.doi.org/10.1016/j.biomaterials.2019.119402] [PMID: 31400612]
[http://dx.doi.org/10.1200/JCO.2018.36.6_suppl.160]
[http://dx.doi.org/10.1007/s12032-017-0980-8] [PMID: 28560682]
[http://dx.doi.org/10.1111/iju.13505] [PMID: 29345000]
[http://dx.doi.org/10.1038/s41580-018-0080-4] [PMID: 30459476]
[http://dx.doi.org/10.1590/S1677-55382011000300002] [PMID: 21756376]
[http://dx.doi.org/10.1038/nrc2748] [PMID: 20029421]
[http://dx.doi.org/10.1016/j.critrevonc.2017.02.013] [PMID: 28325265]
[http://dx.doi.org/10.3892/ol.2019.10138] [PMID: 30988819]
[http://dx.doi.org/10.1016/0304-4165(79)90289-7] [PMID: 760819]
[http://dx.doi.org/10.1016/B978-0-12-091302-2.50032-3]
[http://dx.doi.org/10.1158/0008-5472.CAN-07-5259] [PMID: 18339858]
[http://dx.doi.org/10.1016/j.redox.2014.12.001] [PMID: 25560241]
[http://dx.doi.org/10.1073/pnas.0806268105] [PMID: 18757741]
[http://dx.doi.org/10.1016/j.tibs.2014.02.002] [PMID: 24647116]
[http://dx.doi.org/10.1172/JCI66353] [PMID: 23921124]
[http://dx.doi.org/10.1089/ars.2006.8.1315] [PMID: 16910779]
[http://dx.doi.org/10.2174/1574892813666180213164700] [PMID: 29446748]
[http://dx.doi.org/10.1016/j.canlet.2016.03.042] [PMID: 27037062]
[http://dx.doi.org/10.1002/ptr.5428] [PMID: 26310849]
[http://dx.doi.org/10.1038/aps.2016.34] [PMID: 27292614]
[http://dx.doi.org/10.1089/jmf.2011.2024] [PMID: 22784044]
[PMID: 21971569]
[http://dx.doi.org/10.1016/j.fct.2010.04.007] [PMID: 20385199]
[http://dx.doi.org/10.1038/nm.2919] [PMID: 23104132]
[http://dx.doi.org/10.1016/j.mrfmmm.2010.12.016] [PMID: 21216256]
[http://dx.doi.org/10.1158/0008-5472.CAN-04-0389] [PMID: 15313910]
[http://dx.doi.org/10.1016/0303-7207(90)90227-Y] [PMID: 2095355]
[http://dx.doi.org/10.1016/j.phrs.2019.04.030] [PMID: 31028902]
[http://dx.doi.org/10.1186/1476-4598-6-18] [PMID: 17343740]
[http://dx.doi.org/10.1016/j.yexcr.2009.10.012] [PMID: 19850036]
[http://dx.doi.org/10.1007/s00223-017-0365-1] [PMID: 29147721]
[http://dx.doi.org/10.1093/jnci/djh169] [PMID: 15199115]
[http://dx.doi.org/10.1074/jbc.M001123200] [PMID: 10747989]
[http://dx.doi.org/10.1038/nrc2345] [PMID: 18292776]
[http://dx.doi.org/10.3892/or.2018.6504] [PMID: 29917166]
[http://dx.doi.org/10.1158/0008-5472.CAN-07-2126] [PMID: 18172307]
[http://dx.doi.org/10.1038/onc.2013.184] [PMID: 23728342]
[http://dx.doi.org/10.1038/nrclinonc.2011.67] [PMID: 21556025]
[http://dx.doi.org/10.1007/s00345-017-2145-y] [PMID: 29204705]
[http://dx.doi.org/10.1093/nar/gkh677] [PMID: 15240830]
[PMID: 28416910]
[http://dx.doi.org/10.2174/2212697X03666151203202934]
[http://dx.doi.org/10.1016/B978-0-12-374895-9.00002-5]
[http://dx.doi.org/10.1038/sj.cr.7290266] [PMID: 15686629]
[http://dx.doi.org/10.1158/1078-0432.CCR-05-1849] [PMID: 16533764]
[http://dx.doi.org/10.1002/jcp.20147] [PMID: 15389580]