Targeting Hyaluronic Acid Family for Cancer Chemoprevention and Therapy

Abstract

Hyaluronic acid or hyaluronan (HA) is perhaps one of the most uncomplicated large polymers that regulates several normal physiological processes and, at the same time, contributes to the manifestation of a variety of chronic and acute diseases, including cancer. Members of the HA signaling pathway (HA synthases, HA receptors, and HYAL-1 hyaluronidase) have been experimentally shown to promote tumor growth, metastasis, and angiogenesis, and hence each of them is a potential target for cancer therapy. Furthermore, as these members are also overexpressed in a variety of carcinomas, targeting of the HA family is clinically relevant. A variety of targeted approaches have been developed to target various HA family members, including small-molecule inhibitors and antibody and vaccine therapies. These treatment approaches inhibit HA-mediated intracellular signaling that promotes tumor cell proliferation, motility, and invasion, as well as induction of endothelial cell functions. Being nontoxic, nonimmunogenic, and versatile for modifications, HA has been used in nanoparticle preparations for the targeted delivery of chemotherapy drugs and other anticancer compounds to tumor cells through interaction with cell-surface HA receptors. This review discusses basic and clinical translational aspects of targeting each HA family member and respective treatment approaches that have been described in the literature.

Tumor-Associated Hyaluronan Limits Efficacy of Monoclonal Antibody Therapy

“…Conversely, increased hyaluronidase activity has been detected in tumor tissues and/or serum from several primary and metastatic cancers (3-5, 39, 40). Although hyaluronidase expression (predominantly associated with hyaluronidase 1, which has very little enzymatic activity at physiologic activity) in the tumor has been shown to potentially increase metastasis in some preclinical animal models (3,39,40), PEGPH20 treatment did not increase metastasis in an HA high tumor xenograft model and PEGPH20 in combination with gemcitabine reduced metastasis burden in a KPC mouse model (3,11). Although, the possibility of increasing metastasis following HA depletion by PEGPH20 cannot be ruled out by the current studies, available literature indicates that an increase in metastatic potential by PEGPH20 treatment is unlikely (3,11).…”

Inhibition of Systemic Hyaluronan Synthesis Exacerbates Murine Hepatic Carcinogenesis

“…As an integral component of the ECM, HA influences the behavior of tumor and stromal cells in proliferation, motility, invasion, and stemness through the activation of phosphatidylinositol-3 kinase (PI3K)/AKT and extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathways (29,30). HA accumulation in tumor tissues indicates tumor progression and poor prognosis in patients with cancer (31)(32)(33)(34).…”

Involvement of glycogen debranching enzyme in bladder cancer

“…Hyaladherins, or proteins that bind to extracellular HA, can be either cell surface receptors or extracellular matrix proteins (21). Two of these cell surface hyaladherins, RHAMM and CD44, are clinically significant in various cancer models (16,19,22). These hyaladherins have been demonstrated to provide multi-drug resistance, assist with anchorage independent growth, and cell motility of cancer cells (23)(24)(25).…”

“…Located in the extracellular matrix, HA can bind to cell surface receptors designed for different sized HA (18). HA is biologically relevant in angiogenesis, anchorage independent growth and for allowing cell-to-cell interactions with cancer tissue and surrounding stromal tissue (16,19). The significance of HA in cancer biology provided a reason to further investigate HAS2-mediated HA synthesis in AGL low bladder cancer.…”