PGRMC1 and cancer implications
We demonstrate a higher abundance of hypophosphorylated PGRMC1 isoforms in the specific subpopulation of clinically relevant ER-α-negative cancers. Further studies in a larger patient collective will be necessary to correlate specific PGRMC1 isoforms with other tumor markers in addition to ER-α.
We identified three two-dimensional spots corresponding to PGRMC1 (Additional data file
1 [Table S1] and Figure
3), two of which were significantly more abundant in ER-α-negative tumors (spots 1–22 and 1–23 in Figure
3). Phosphatase treatment of primary breast cancer proteins demonstrated that these different isoforms of PGRMC1 differed at least partly in their phosphorylation status (Figure
4).
PGRMC1 was previously reported to be more abundant in a variety of cancers, including breast cancer (although differential ER-α status was not reported), and a perinuclear localization was suggested to implicate it in a role involving cytochrome P450 activation and steroid metabolism [
34]. The differential abundance of PGRMC1 protein between breast cancers of different ER-α status is notable because we previously identified the distantly related cytochrome b5-domain feudesin/SPUF protein and cytochrome b5 itself to have been slightly yet significantly differentially abundant between breast tumors that were all positive for the ER-α but which differed in the expression level of the cytoplasmic progesterone receptor [
19]. Indeed, cytochrome b5 was also marginally yet significantly more abundant in the ER-α-positive tumors in our present study (1.2-fold [
P = 0.03]; spot 1–32 in Figure
3). Hughes and colleagues [
35] recently reported that PGRMC1 and a fungal homolog are present in evolutionarily conserved protein complexes with respective members of the cytochrome P450 class of enzymes, including the Cyp51A1 protein, which is involved in the production of cholesterol from lanosterol. Furthermore, they demonstrated that reduction in the level of PGRMC1 mRNA and protein produced an elevation in lanosterol levels. A variety of experiments suggest a role of cholesterol in the biology of PGRMC1, as reviewed by Cahill [
20]. The rate-limiting enzyme of the mevalonate pathway leading to cholesterol synthesis is hydroxymethylglutarate-coenzyme A reductase, and this enzyme is both regulated by cholesterol levels [
36,
37] and is diagnostic of a recently identified class of poor prognosis apocrine breast cancers that were both ER-α and progesterone receptor negative [
38].
The results presented in Figure
8 indicate that PGRMC1 is abundantly expressed in a population of ER-α-negative and GLUT-1-positive cells in the hypoxic zone surrounding necrotic tumor tissue. GLUT-1 is a membrane glucose transporter that is important in the enhanced rates of anaerobic metabolism of tumors, known as the Warburg effect [
33]. Intriguingly, because not all PGRMC1-positive cells expressed GLUT-1 (Figure
8, vi), the population of PGRMC1-expressing cells may have given rise to those expressing GLUT-1, suggesting avenues for future experimentation.
The GLUT-1 and HIF-1 positive cells occupying the hypoxic tumor microenvironment adjacent to necrotic zones are resilient to chemotherapy and frequently give rise to metastases. Although a literature search revealed no directly reported association between the mevalonate pathway and hypoxia, the Wilm's tumor suppressor protein WT1 is thought to suppress growth by downregulating the mevalonate pathway [
39], and the hypoxic expression of WT1 is regulated by HIF-1 [
40].
Hypoxic conditions have been shown to promote phenotypic de-differentiation in ductal breast carcinoma
in situ. In mammary ductal
in situ breast cancer of comedo-type, ductal carcinoma
in situ (DCIS) cells surrounding the central necrosis exhibited high HIF-1α protein levels, down-regulated ER-α, and increased expression of the epithelial breast stem cell marker CK-19 [
41]. These cells lost their polarization and acquired an increased nucleus/cytoplasm ratio, which are hallmarks of poor architectural and cellular differentiation. CK-19 is one marker for a cell population that contains mammary multipotent progenitor cells [
42]. Therefore, hypoxia might induce dedifferentiation of epithelial cells, thereby promoting an aggressive phenotype in breast cancer. The hypoxia-induced downregulation of ER-α expression in DCIS has potential clinical relevance and suggests a reason that some ER-α-positive tumors become resistant to anti-estrogen treatment. Because PGRMC1 is upregulated in the cells close to the necrotic area, it conceivably plays a role in this phenomenon.
HIF-1 also induces the angiogenic growth factor vascular endothelial growth factor [
33]. Swiatek-De Lange and colleagues [
43] implicated PGRMC1 in the activation of vascular endothelial growth factor gene expression in retinal glial cells. Interestingly, PGRMC1 (AI010357 EST [VEMA] ventral midline antigen) was observed to be one of a number of genes upregulated in the late phase of a wound healing model involving injured spinal cord [
26], at a time when vascular morphogenesis occurs in the healing tissue.
PGRMC1 protein affects the response to oxidative damage in the MCF-7 breast cancer cell line, influencing their susceptibility to oxidative cell death [
22]. It is unclear whether this reflects a normal function of PGRMC1 or is a function of the conditions of over-expression. However, under these conditions, some of our phosphorylation site PGRMC1 mutants exhibited enhanced survival (Figure
6). Both survival and failure to induce Akt phosphorylation were associated with somewhat higher levels of the exogenous S56A/S180A mutant PGRMC1 protein detected by Western blot (Figure
7), but our data do not demonstrate that this higher level is reproducible, and similar levels of the other mutants did not protect against cell death, suggesting that elevated exogenous PGRMC1 protein abundance levels
per se were not responsible for enhanced survival of MCF-7 cells expressing the S56A/S180A mutant. Indeed, over-expression of PGRMC1 above endogenous levels increased susceptibility to peroxide-induced death [
22] (Figure
7). It is possible that the failure of the S56A/S180A mutant to be phosphorylated on those residues leads to accumulation of some biologically active species that is/are perhaps inappropriately cleared. For instance, sterol levels regulate the ubiquitination and degradation of both Insig-1 and hydroxymethylglutarate-coenzyme A reductase to downregulate the mevalonate pathway [
44,
45], and PGRMC1 interacts directly with Insig-1 [
32].
The possible mechanism of survival of the S56A/S180 mutant deserves some consideration. Phosphorylation of S56 presumably blocks the interaction of PGRMC1 with another protein(s) through the predicted proline-rich SH3 target domain centered on P62, whereas phosphorylation of S181 presumably blocks phosphorylation of the adjacent Y179, which would be necessary for interaction with one or more presumed SH2-domain proteins [
20]. Phosphorylation of Y179 probably requires the prior regulatory dephosphorylation of S180. C128 was essential for the vital function of the S56A/S180 mutant, and it is quite possible that dimerization via a cystine-mediated disulfide bond [
20] is required for the rescuing function. Mutation of cysteine to serine is unlikely to have greatly affected protein structure. Furthermore, the inability of phosphorylated Y179 to interact with one or more unidentified SH2 domain-containing proteins may be responsible for the susceptibility of the Y179F/S180A to growth in charcoal-treated FCS.