No abstract

The phosphoinositide 3-kinase (PI3K) pathway regulates a multitude of cellular processes. Deregulation of PI3K signaling is often observed in human cancers. A major effector of PI3K is Akt/protein kinase B (PKB). Recent studies have pointed to distinct roles of Akt/PKB isoforms in cancer cell signaling. Studies have shown that Akt1 (PKBA) can attenuate breast cancer cell motility, whereas Akt2 (PKBB) enhances this phenotype. Here, we have evaluated the mechanism by which Akt1 blocks the migration of breast cancer cells through the transcription factor NFAT. A major effector of Akt/PKB is glycogen synthase kinase-3B (GSK-3B), also a NFAT kinase. Inhibition of GSK-3B using short hairpin RNA or a selective inhibitor potently blocks breast cancer cell migration concomitant with a reduction in NFAT activity. GSK-3B-mediated inhibition of NFAT activity is due to proteasomal degradation. Experiments using GSK-3B mutants, which are unresponsive to Akt/PKB, reveal that inhibition of cell migration by Akt/PKB is mediated by GSK-3B. These effects are recapitulated at the levels of NFAT degradation by the proteasome. Our studies show that activation of Akt/PKB leads to inactivation of the effector GSK-3B and the outcome of this signaling event is degradation of NFAT by the proteasome and subsequent inhibition of cell migration.

Patients with neurological emergencies are common and consume a disproportionate amount of resources in the ED. Emergency physician training must target the modern evaluation of patients with a large variety of neurological emergencies and place special emphasis on the evaluation of patients with weakness, seizures, headache, and dizziness.