Abstract. Persistent human papilloma virus (HPV) infection induces chronic inflammation resulting in human cervical cancer. However, the mechanisms underlying carcinogenesis via chronic inflammation remain largely unclear. We investigated the role of pro-inflammatory factors in epithelial-mesenchymal transition (EMT) and cancer stem cell-like (CSCL) characteristics of HeLa cells exposed to TNF-α with or without TGF-β. We then determined the role of NF-κB/Twist signal axis in the pathogenesis of cervical cancer. We found that HeLa cells exposed to TNF-α following chronic treatment with TGF-β exhibited EMT, self-renewal and high mobility. Knockdown of NF-κBp65 inhibited NF-κB and Twist1 expression, and EMT and CSCL properties of HeLa cells following co-treatment with TNF-α and TGF-β. Conversely, overexpression of NF-κBp65 potentiated the above effects. However, knockdown or overexpression of Twist1 had no effect on NF-κBp65 expression, but inhibited or promoted EMT and CSCL features. Notably, overexpression of Twist1 rescued NF-κBp65 knockdown. Our results demonstrate the role of NF-κB/Twist signaling axis in which HeLa cells treated with TNF-α following chronic exposure to TGF-β induce EMT and CSCL properties. The NF-κB/Twist signal axis may represent an effective therapeutic target in cervical cancer.
IntroductionCervical cancer is a key factor associated with morbidity and mortality in women worldwide (1). Infection with human papilloma viruses (HPV) triggers carcinogenesis. Most of the precancerous lesions do not progress to invasive carcinoma, suggesting that HPV is not the only factor contributing to the development of cervical cancer (2,3). However, persistent HPV infection alters the pro-inflammatory cytokine profile, resulting in chronic inflammation and recurrence of cervical cancer (4). Cancer stem cells (CSCs) play a vital role in cancer initiation and metastasis (5). Metastasis results in treatment failure and death (6). Epithelial-mesenchymal transition (EMT) has been implicated as the key factor in CSCs transformation (7,8). EMT has been shown to induce reversion to a CSC-like phenotype, linking CSCs and EMT (9,10).NF-κB is a classic transcription factor activated by inflammatory stimuli, such as LPS (11), TNF-α (12) and IL-10 (13). Activated NF-κB induces extensive gene expression in immune response (TNF-α), angiogenesis (VEGF), invasion (MMP-9) and EMT (Twist) (14-17). Furthermore, NF-κB, a pleiotropic transcription factor, has been implicated in . In mammary epithelial cells, EMT is upregulated via overexpression of NF-κBp65 (17).The transcriptional factor TWIST mediates EMT and cancer metastasis (18,19). In uterine cancers, Twist overexpression promotes invasion and metastasis (20-23). However, the role of NF-κB/Twist axis in cervical cancer has not been investigated. In this study, we focused on the role of NF-κB/ Twist axis in vitro, by co-treatment of human cervical cancer cell line HeLa with TNF-α and TGF-β.
Materials and methodsReagents. DMEM was obtained from Gibco, FBS from PAA, trypsin a...