1. Hyperinsulinemia enhances c-Myc-mediated mammary tumor development and advances metastatic progression to the lung in a mouse model of type 2 diabetes
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Hui Sun, Ruslan Novosyadlyy, Shoshana Yakar, Nyosha Alikhani, Derek LeRoith, Rosalyn D. Ferguson, and Yvonne Fierz
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Blood Glucose ,Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Mice, Transgenic ,Dioxoles ,Receptor, IGF Type 1 ,Proto-Oncogene Proteins c-myc ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Surgical oncology ,Cell Line, Tumor ,Hyperinsulinism ,Diabetes mellitus ,Internal medicine ,Hyperinsulinemia ,Animals ,Hypoglycemic Agents ,Insulin ,Medicine ,Phosphorylation ,Cell Proliferation ,030304 developmental biology ,Medicine(all) ,0303 health sciences ,Mammary tumor ,Lung ,business.industry ,Mammary Neoplasms, Experimental ,medicine.disease ,Receptor, Insulin ,Tumor Burden ,3. Good health ,Endocrinology ,medicine.anatomical_structure ,Diabetes Mellitus, Type 2 ,Matrix Metalloproteinase 9 ,030220 oncology & carcinogenesis ,Cancer research ,Female ,business ,Proto-Oncogene Proteins c-akt ,Neoplasm Transplantation ,Research Article - Abstract
Introduction Hyperinsulinemia, which is common in early type 2 diabetes (T2D) as a result of the chronically insulin-resistant state, has now been identified as a specific factor which can worsen breast cancer prognosis. In breast cancer, a high rate of mortality persists due to the emergence of pulmonary metastases. Methods Using a hyperinsulinemic mouse model (MKR+/+) and the metastatic, c-Myc-transformed mammary carcinoma cell line Mvt1, we investigated how high systemic insulin levels would affect the progression of orthotopically inoculated primary mammary tumors to lung metastases. Results We found that orthotopically injected Mvt1 cells gave rise to larger mammary tumors and to a significantly higher mean number of pulmonary macrometastases in hyperinsulinemic mice over a period of six weeks (hyperinsulinemic, 19.4 ± 2.7 vs. control, 4.0 ± 1.3). When Mvt1-mediated mammary tumors were allowed to develop and metastasize for approximately two weeks and were then surgically removed, hyperinsulinemic mice demonstrated a significantly higher number of lung metastases after a four-week period (hyperinsulinemic, 25.1 ± 4.6 vs. control, 7.4 ± 0.42). Similarly, when Mvt1 cells were injected intravenously, hyperinsulinemic mice demonstrated a significantly higher metastatic burden in the lung than controls after a three-week period (hyperinsulinemic, 6.0 ± 1.63 vs. control, 1.5 ± 0.68). Analysis of Mvt1 cells both in vitro and in vivo revealed a significant up-regulation of the transcription factor c-Myc under hyperinsulinemic conditions, suggesting that hyperinsulinemia may promote c-Myc signaling in breast cancer. Furthermore, insulin-lowering therapy using the beta-adrenergic receptor agonist CL-316243 reduced metastatic burden in hyperinsulinemic mice to control levels. Conclusions Hyperinsulinemia in a mouse model promotes breast cancer metastasis to the lung. Therapies to reduce insulin levels in hyperinsulinemic patients suffering from breast cancer could lessen the likelihood of metastatic progression.
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