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. 2021 May 15;11(5):2188-2201.
eCollection 2021.

Role of krüppel-like factor 8 for therapeutic drug-resistant multi-organ metastasis of breast cancer

Affiliations

Role of krüppel-like factor 8 for therapeutic drug-resistant multi-organ metastasis of breast cancer

Jie Hao et al. Am J Cancer Res. .

Abstract

Metastasis and drug resistance are intertwined processes that are responsible for the vast majority of patient deaths from breast cancer. The underlying mechanisms remain incompletely understood. We previously demonstrated that KLF8 activates CXCR4 transcription in metastatic breast cancer. Here, we report a novel role of KLF8-CXCR4 signaling for converting single organ metastasis into multiple organ metastasis associated with chemotherapeutic resistance. We show that KLF8 expression in metastatic breast cancer cells can be over-induced by chemotherapeutic drugs. Analysis of data from large-cohorts of patients indicates that post-chemotherapy there is a close correlation between the aberrant high levels of KLF8 and CXCR4 and that this correlation is well associated with drug resistance, metastasis, and poor prognosis. To mimic their aberrant high levels, we overexpressed KLF8 or CXCR4 in a human breast cancer cell line known to metastasize only to the lungs after intravenous injection in nude mice. As expected, these cells become more resistant to chemotherapeutic drugs. Surprisingly, these KLF8 or CXCR4 overexpressing cells, even implanted orthotopically, metastasized extensively to multiple organs particularly the CXCL12-rich organs. Tube formation assay, Ki67 staining and Western blotting revealed that KLF8 or CXCR4 overexpression enhanced angiogenesis involving increased expression and secretion of VEGF protein. We also found that KLF8 or CXCR4 overexpression strongly enhanced formation of filopodium-like protrusions and proliferation via CXCR4 stimulation in a 3D culture model mimicking the colonization step of metastasis. Taken together, these results suggest that the chemo-induction of KLF8 upregulation be critical for drug resistance and systemic metastasis through enhanced tumor angiogenesis and colonization via CXCR4 over-activation and that KLF8-CXCR4 signaling axis may be a new therapeutic target for drug-resistant breast cancer metastasis.

Keywords: CXCR4; KLF8; breast cancer; drug resistance; metastasis.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Chemotherapeutic Induction of KLF8-CXCR4 overexpression is related to therapeutic resistant metastasis. A. Aberrant high levels of KLF8 and CXCR4 are correlated with drug resistance and metastasis associated with poor survival. Kaplan-Meier Plots, illustrating the correlation, are based on the public database of cancer patient samples (Oncomine). B. Chemotherapeutic drugs induce an increase in KLF8 expression in LM2 cells. LM2 cells in culture were treated with the chemotherapeutic drugs doxorubicin (Doxo; 0.5 µM), paclitaxol (Pacl; 2.5 µM), cisplatin (Cisp; 3 µM), or DMSO vehicle for 5 days followed by quantitative real-time PCR analysis of KLF8 expression in the cells. C. Overexpression of KLF8 grants drug resistance via CXCR4. LM2 cells overexpressing HA-KLF8 (LM2-KLF8), HA-CXCR4 (LM2-CXCR4) or empty vector (LM2-Vector) were generated. Expression were confirmed by anti-HA blotting. Sensitivity of the cells to doxorubicin treatment were examined in the presence or absence of CXCL12 in the medium.
Figure 2
Figure 2
Overexpression of KLF8 drives massive metastasis to multiple organs through CXCR4 signaling. (A) The results of tissue specific BLI imaging 7 weeks after orthotopic injection of the LM-KLF8, LM2-CXCR4 or LM2-Vector cells showing multiple organic metastasis, especially to CXCL12 rich organs. (B) Quantitative analysis of the intensity of tissue specific BLI is shown in (A). (C) Differential metastatic rates to different organs. Animals injected with KLF8 and CXCR4 overexpression cells exhibit bioluminescent evidence of metastasis to more secondary organs compared to the control group. The BLI imaging was carried out as described in the Materials and methods.
Figure 3
Figure 3
KLF8 overexpression enhances angiogenesis in vitro. A. KLF8 overexpression promotes endothelial cell proliferation through CXCR4. HUVEC cells treated by condition medium from LM2-vector, LM2-KLF8, LM2-CXCR4 with or without supplement of CXCL12. Two days after the treatment, Ki67 immunofluorescence staining (Red) was used to test endothelial cell proliferation. B. KLF8 overexpression enhances endothelial tube formation via CXCR4. Representative images of HUVEC tubes (CytoTracker™-labeled) under culture with conditional medium collected from LM2-Vector, LM2-KLF8 and LM2-CXCR4 cells in the presence or absence of CXCL12. C. KLF8 overexpression upregulates VEGF expression and secretion via CXCR4. VEGFA protein levels in cancer cell supernatant and whole cell lysis were examined by Western blotting and quantified with Bio-Rad Imager normalized to GAPDH value. *P<0.05; **P<0.01; ***P<0.001.
Figure 4
Figure 4
KLF8 overexpression triggers FLP formation through CXCR4-CXCL12 pathway. A. Illustration of the Matrigel On Top (MoT) culture. B, C. The LM2-Vector, LM2-KLF8 and LM2-CXCR4 cells were grown in the MoT culture in the absence or presence of CXCL12 for 48 hours before co-stained with phalloidin (red) and DAPI (blue). The white arrows point to FLPs that were counted in five colonies per treatment group. *P<0.05. **P<0.01.
Figure 5
Figure 5
KLF8 overexpression promotes metastatic proliferation through CXCR4-CXCL12 pathway. A and B. Metastatic proliferation rate is measured by counting cell number in each colony over a 10-day period of MoT culture in the absence or presence of CXCL12. Indicated cells were stained as described in Figure 4. Cell number per colony was counted in five colonies for each treatment group at the three different time points shown. **P<0.0001 compared to the -CXCL12 group; ^^P<0.0001 compared to LM2-Vector +CXCL12 group. C. The MoT cells on day 2 were subject to co-immunofluorescent staining with an antibody for the proliferation marker Ki67 (red) and DAPI (blue) followed by fluorescent as well as differential interference contrast (DIC) microscopies.
Figure 6
Figure 6
KLF8 overexpression enhances colonization and angiogenesis in the lung via CXCR4. A. The LM2-Vector, LM2-KLF8 or LM2-CXCR4 cells were injected into the mammary fat pad. The lung metastases were visualized immunohistochemical staining of GFP reporter expressed in the tumor cells. B. VEGFA expression in the lung tissues were examined by immunohistochemical staining. The percentage contributions of high positive, positive, low positive, and negative, respectively were analyzed with ImageJ plus IHC Profiler plugin in each of 5 images per group. The histoscore (H-score) was then calculated and graphed for quantitative comparison for statistical significance using One-way ANOVA. **P<0.01; ***P<0.001.

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