GRP78, a well characterized chaperone in the endoplasmic reticulum, is critical to the unfolded protein response. More recently, it has been identified on the cell surface, where it has many roles. On cancer cells, it functions as a signaling receptor coupled to proproliferative/antiapoptotic and promigratory mechanisms. In the current study, we demonstrate that ligation of prostate cancer cell surface GRP78 by its natural ligand, activated ␣ 2 -macroglobulin (␣ 2 M*), results in a 2-3-fold upregulation in the synthesis of prostate-specific antigen (PSA). The PSA is secreted into the medium as an active proteinase, where it binds to native ␣ 2 M. The resultant ␣ 2 M⅐PSA complexes bind to GRP78, causing a 1.5-2-fold increase in the activation of MEK1/2, ERK1/2, S6K, and Akt, which is coupled with a 2-3-fold increase in DNA and protein synthesis. PSA is a marker for the progression of prostate cancer, but its mechanistic role in the disease is unclear. The present studies suggest that PSA may be involved in a signal transduction-dependent feedback loop, whereby it promotes a more aggressive behavior by human prostate cancer cells.Prostate-specific antigen (PSA) 2 is a serine proteinase that complexes with serum proteinase inhibitors, including ␣ 2 -macroglobulin (␣ 2 M) (1). Monitoring of PSA is generally recommended in men over 50 years old to screen for prostate cancer; however, there is significant controversy with respect to its use as a marker for the appearance of the disease (1-6). By contrast, substantial data support its use in monitoring progression and metastasis (1, 2, 5). Recently, a Phase II controlled trial suggested that immunization against PSA prolongs patient survival, suggesting a direct role for PSA in the pathobiology of the disease (7). Studies have shown that PSA produced by metastatic prostate cancer cells is involved in bone remodeling, a common feature in the bony metastasis of this disease (8). There is, however, little other evidence indicating a direct role for PSA in disease progression. ␣ 2 M is synthesized by many tissues, particularly the liver; however, it is also produced locally in prostate stromal tissue, where it is available to complex with PSA (9). When a proteinase attacks the so-called "bait region," thiol esters in each of the four ␣ 2 M subunits rupture, and the protein undergoes a very large conformational change, exposing receptor recognition sites in each subunit (10). Two receptors have been identified for activated forms of ␣ 2 M (␣ 2 M*), namely the LDL receptor-related protein (LRP) and cell surface-associated GRP78 (glucose-regulated protein of M r ϳ78,000) (10, 11). In addition to proteinases, exposure of ␣ 2 M to small primary amines or ammonia, by direct attack on the thiol esters, produces ␣ 2 M* (10). Although GRP78 is primarily known as a resident endoplasmic reticulum chaperone, it appears on the cell surface of many types of malignant cells, including human prostate cancer (12-16). Here it has many functions, including serving as an ␣ 2 M* signaling re...