ABSTRACT
Activated protein C (APC) and protein C inhibitor (PCI) are the major components of
the anticoagulant protein C pathway. Recently, APC and PCI have been demonstrated
to play many roles not only in the regulation of hemostasis but also in cell inflammation,
proliferation, apoptosis, tumor cell migration, invasion, and metastasis. Here we
summarize the role of APC and PCI in malignancy.
APC increases migration of ovarian cancer cells and choriocarcinoma cells in a Transwell
invasion assay in the presence of plasminogen activator inhibitor (PAI)-1; this finding
suggests that APC stimulates urokinase-type plasminogen activator (uPA) by forming
a complex with PAI-1 leading to activation of extracellular matrix proteases and increased
invasion. It was recently reported that APC, independent of PAI-1, may increase invasion
and chemotaxis of breast cancer cells by activating specific signaling pathways through
endothelial protein C receptor (EPCR) and protease-activated receptor (PAR)-1. APC
also increased proliferation of vascular endothelial cells and angiogenesis by EPCR-mediated
activation of mitogen-activated protein kinase (MAPK), phosphatidylinositol 3-kinase
(PI3K), and endothelial nitric oxide synthase (eNOS) pathways.
On the other hand, we have previously reported that both uPA and PCI are synthesized
in renal proximal tubular epithelial cells (RPTECs) and that PCI expression in RPTEC-derived
tumor cells is significantly decreased compared with normal RPTECs. The RPTEC-derived
renal carcinoma cell line Caki-1 also showed decreased expression of PCI. PCI inhibited
in vitro invasive activity of Caki-1 and breast cancer cells by its protease inhibitory
activity. However, PCI was found to inhibit the growth and metastatic potential of
breast cancer cells independent of its protease inhibitory activity in severe combined
immunodeficient mice. PCI can also inhibit angiogenesis in vivo and in vitro assays
independent of its protease inhibitory activity.
Overall, these data show that APC promotes tumor cell invasion by EPCR-mediated and
PAR-1-mediated protease activity and that PCI inhibits tumor cell invasion in vitro
by its protease inhibitory activity and suppresses tumor cell growth, metastasis,
and angiogenesis independent of its protease inhibitory activity.
KEYWORDS
Activated protein C - protein C inhibitor - SERPIN - angiogenesis
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Dr. Koji Suzuki
Department of Molecular Pathobiology, Mie University Graduate School of Medicine
Tsu-city, Mie 514-8507, Japan
Email: suzuki@doc.medic.mie-u.ac.jp