In most human breast cancers, lowering of TGFβ receptor-or Smad gene expression combined with increased levels of TGFβs in the tumor microenvironment is sufficient to abrogate TGFβs tumor suppressive effects and to induce a mesenchymal, motile and invasive phenotype. In genetic mouse models, TGFβ signaling suppresses de novo mammary cancer formation but promotes metastasis of tumors that have broken through TGFβ tumor suppression. In mouse models of "triple-negative" or basal-like breast cancer, treatment with TGFβ neutralizing anti-bodies or receptor kinase inhibitors strongly inhibits development of lung-and bone metastases. These TGFβ antagonists do not significantly affect tumor cell proliferation or apoptosis. Rather, they de-repress anti-tumor immunity, inhibit angiogenesis and reverse the mesenchymal, motile, invasive phenotype characteristic of basal-like and HER2-positive breast cancer cells. Patterns of TGFβ target genes upregulation in human breast cancers suggest that TGFβ may drive tumor progression in estrogenindependent cancer, while it mediates a suppressive host cell response in estrogen-dependent luminal cancers. In addition, TGFβ appears to play a key role in maintaining the mammary epithelial (cancer) stem cell pool, in part by inducing a mesenchymal phenotype, while differentiated, estrogen receptorpositive, luminal cells are unresponsive to TGFβ because the TGFBR2 receptor gene is transcriptionally silent. These same cells respond to estrogen by downregulating TGFβ, while antiestrogens act by upregulating TGFβ. This model predicts that inhibiting TGFβ signaling should drive the differentiation of mammary stem cells into ductal cells. Consequently, TGFβ antagonists may convert basal-like or HER2-positive cancers to a more epithelioid, non-proliferating (and, perhaps, non-metastatic) phenotype. Conversely, these agents might antagonize the therapeutic effects of anti-estrogens in estrogen-dependent luminal cancers. These predictions need to be addressed prospectively in clinical trials and should inform the selection of patient populations most likely to benefit from this novel anti-metastatic therapeutic approach.© Springer Science+Business Media, LLC. 2008 e-mail: E-mail: michael.reiss@umdnj.edu.
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TGFβ in health and disease
Physiological functions of TGFβThe TGFβ family of polypeptides comprises a group of highly conserved dimeric proteins with a molecular weight of approximately 25 kDa [1]. They are ubiquitously expressed in eukaryotes and typically secreted into the extracellular milieu in an inactive form, where they become locally activated in response to the appropriate stimuli [2][3][4]. As shown in Fig. 1A, the TGFβ signaling pathway is highly conserved from lower organisms, such as D. melanogaster, to man. TGFβ binds to the type II TGFβ receptor (TβR-II) kinase. The type I receptor (TβR-I) is then recruited into the ligand/TβR-II complex and phosphorylated and activated by the TβR-II kinase. The activated TβR-I receptor then phosphorylates receptor-ass...