There is a clinical need for noninvasive biomarkers of tumor hypoxia for prognostic and predictive studies, radiotherapy planning, and therapy monitoring. Oxygen-enhanced MRI (OE-MRI) is an emerging imaging technique for quantifying the spatial distribution and extent of tumor oxygen delivery in vivo. In OE-MRI, the longitudinal relaxation rate of protons (DR 1 ) changes in proportion to the concentration of molecular oxygen dissolved in plasma or interstitial tissue fluid. Therefore, well-oxygenated tissues show positive DR 1 . We hypothesized that the fraction of tumor tissue refractory to oxygen challenge (lack of positive DR 1 , termed "Oxy-R fraction") would be a robust biomarker of hypoxia in models with varying vascular and hypoxic features. Here, we demonstrate that OE-MRI signals are accurate, precise, and sensitive to changes in tumor pO 2 in highly vascular 786-0 renal cancer xenografts. Furthermore, we show that Oxy-R fraction can quantify the hypoxic fraction in multiple models with differing hypoxic and vascular phenotypes, when used in combination with measurements of tumor perfusion. Finally, Oxy-R fraction can detect dynamic changes in hypoxia induced by the vasomodulator agent hydralazine. In contrast, more conventional biomarkers of hypoxia (derived from blood oxygenation-level dependent MRI and dynamic contrast-enhanced MRI) did not relate to tumor hypoxia consistently. Our results show that the Oxy-R fraction accurately quantifies tumor hypoxia noninvasively and is immediately translatable to the clinic.

To elucidate the physiological significance of MEK5 in vivo, we have examined the effect of mek5 gene elimination in mice. Heterozygous mice appear to be healthy and were fertile. However, mek5 ؊/؊ embryos die at approximately embryonic day 10.5 (E10.5). The phenotype of the mek5 ؊/؊ embryos includes abnormal cardiac development as well as a marked decrease in proliferation and an increase in apoptosis in the heart, head, and dorsal regions of the mutant embryos. The absence of MEK5 does not affect cell cycle progression but sensitizes mouse embryonic fibroblasts (MEFs) to the ability of sorbitol to enhance caspase 3 activity. Further studies with mek5 ؊/؊ MEFs indicate that MEK5 is required for mediating extracellular signalregulated kinase 5 (ERK5) activation and for the regulation of the transcriptional activity of myocyte enhancer factor 2. Overall, this is the first study to rigorously establish the role of MEK5 in vivo as an activator of ERK5 and as an essential regulator of cell survival that is required for normal embryonic development.The mitogen-activated protein kinase (MAPK) cascades constitute a complex network of signaling pathways that are involved in the regulation of numerous cell functions (9). They consist of the sequential activation of protein kinases that include MAPKs, MAPK/extracellular signal-regulated kinase (ERK) kinases (MEKs or MKKs), and MEK kinases (MEKKs) (9). MAPKs are activated by dual phosphorylation on threonine (T) and tyrosine (Y) residues within a T-X-Y motif by MEKs. MEKs are activated by MEKKs. Two main mechanisms have been proposed to ensure specific transmission of the signals from upstream kinases to MAPKs (38, 40): (i) scaffold proteins that assemble the different components of a cascade; (ii) physical interactions between the components of a cascade. Both mechanisms may operate in parallel and allow different responses of the same MAPK signaling pathways to different stimuli.At least four MAPK subfamilies have been identified: ERK1/2, ERK5, c-Jun NH 2 -terminal protein kinases (JNKs), and p38 MAPKs. MAPK activators include MEK1 and MEK2 for ERK1/2, MEK5 for ERK5, MKK4 and MKK7 for JNKs, and MKK3 and MKK6 for p38 MAPKs (9). Targeted deletion of the mapk and mek/mkk genes has contributed substantially to our increased understanding of the physiological role of these pathways in development and pathogenesis. In particular, the recent elimination of the erk5 gene in mice has provided genetic evidence that ERK5 is required for normal cardiac development (31,34,42). ERK5, also known as big MAPK, is almost twice the size (815 amino acids) of the other MAPKs (45). Its unique COOH-terminal tail contains a myocyte enhancer factor 2 (MEF2)-interacting domain and a potent transcriptional activation domain (12). The ERK5 catalytic NH 2 -terminal domain is 50% identical to ERK2. The activity of a number of transcription factors has been shown to be regulated by ERK5, including MEF2, c-Fos and Fra-1, Sap1, c-Myc, and NF-B (6,11,13,15,28,37). In vitro, the ERK5 signaling pathway has...

SignificanceMacrophages can be functionally reprogrammed by the tumor microenvironment to further tumor growth and malignancy. In this study, we have discovered that this pathological process is dependent on the ERK5 MAPK. Accordingly, we demonstrated that inactivation of ERK5 in macrophages blocked the phosphorylation of STAT3, a transcription factor crucial for determining macrophage polarity, and impaired the growth of melanoma and carcinoma grafts. These results raise the possibility that targeting protumor macrophages via anti-ERK5 therapy constitutes a very attractive strategy for cancer treatment. This is important given that the detection of large numbers of macrophages in human tumors often correlates with poor prognosis, but also with a poor response of the tumor to anticancer agents.

Chronic inflammation is a hallmark of many cancers, yet the pathogenic mechanisms that distinguish cancer-associated inflammation from benign persistent inflammation are still mainly unclear. Here, we report that the protein kinase ERK5 controls the expression of a specific subset of inflammatory mediators in the mouse epidermis, which triggers the recruitment of inflammatory cells needed to support skin carcinogenesis. Accordingly, inactivation of ERK5 in keratinocytes prevents inflammation-driven tumorigenesis in this model. In addition, we found that anti-ERK5 therapy cooperates synergistically with existing antimitotic regimens, enabling efficacy of subtherapeutic doses. Collectively, our findings identified ERK5 as a mediator of cancer-associated inflammation in the setting of epidermal carcinogenesis. Considering that ERK5 is expressed in almost all tumor types, our findings suggest that targeting tumor-associated inflammation via anti-ERK5 therapy may have broad implications for the treatment of human tumors. Cancer Res; 75(4); 742-53. Ó2015 AACR.