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Initially correlated with hematopoietic precursors, the surface expression of CD133 was also found in epithelial and nonepithelial cells from adult tissues in which it has been associated with a number of biological events. CD133 is expressed in solid tumors as well, including breast cancer, in which most of the studies have been focused on its use as a surface marker for the detection of cells with stem-like properties (i.e., cancer stem cells (CSCs)). Differently with other solid tumors, very limited and in part controversial are the information about the significance of CD133 in breast cancer, the most common malignancy among women in industrialized countries. In this review, we summarize the latest findings about the implication of CD133 in breast tumors, highlighting its role in tumor cells with a triple negative phenotype in which it directly regulates the expression of proteins involved in metastasis and drug resistance. We provide updates about the prognostic role of CD133, underlining its value as an indicator of increased malignancy of both noninvasive and invasive breast tumor cells. The molecular mechanisms at the basis of the regulation of CD133 levels in breast tumors have also been reviewed, highlighting experimental strategies capable to restrain its level that could be taken into account to reduce malignancy and/or to prevent the progression of breast tumors.

During prostate cancer progression cancer cells undergo a variety of molecular alterations that lead to the acquisition of uncontrolled growth properties. One such set of molecular alterations is mediated by the PI3K/Akt signaling pathway. Here, we describe a regulatory system that modulates the phosphoinosited 3-kinase/Akt (PI3K/Akt) pathway downstream of secreted Clusterin (sCLU) in normal and cancer prostate cells. The overexpression of sCLU is very frequent in prostate cancer, and can lead to Akt-activation. This prompted us to investigate how sCLU overexpression influences PI3K/Akt signaling network in a study model represented by human epithelial prostate PNT1A cells stably transfected with sCLU or with empty vector alone. We found that CLU cells show a marked differential phosphorylation of several members of the PI3K/Akt cascade, and in particular of Akt2. Moreover, we found that the phosphatase PHLPP1, known to dephosphorylate Akt2 at S473, is severely downregulated in CLU compared to MOCK cells. We thus investigated whether sCLU alters PHLPP1 protein stability or expression. Our results indicate that sCLU indeed stimulates PHLPP1 degradation by β-TrCP. Interestingly, we further demonstrated that sCLU alters also PHLPP1 through the negative regulator miR-190. Next, because sCLU has been reported to inhibit or to stimulate the aggressive behavior of cancer cells depending on the cell model, we investigated the effects of CLU overexpression or addition of recombinant Clusterin to the medium on cell migration and invasion in PNT1A cell line, which is not expected to display an invasive phenotype, and in the cancer prostate epithelial cell lines LNCaP and PC3. The result was extremely clear: not only CLU overexpression gives PNT1A cells the same behavior of wild-type PC3 cells, but also increases the migration and invasion index of all the above cell models by two to four times, compared to controls. As a confirmation, in the same model silencing of Clusterin abrogates migration of CLU cells. Next, the effect of Akt single-isoform silencing on cell migration was explored. While silencing of Akt1 affected migration only slightly, silencing of Akt2 prevented migration of both MOCK and CLU cells completely. The same result was obtained by pharmacological inhibition of Akt2. All together our results, clearly demonstrate for the first time that Clusterin can switch the low migration phenotype of normal prostate cells towards a high migration phenotype through the modulation of the expression of the PHLPP1 and, in turn, the activity of Akt2., Italian Journal of Anatomy and Embryology, Vol. 122, No. 1 (Supplement) 2017

Reduced oxygen availability plays a crucial role in malignancy of solid tumors, including breast cancer. Even if the presence of hypoxic areas is common in all breast lesions, no data clearly correlate low oxygenation with the acquisition of malignant features by non-invasive cells, particularly by cells from ductal carcinoma in situ (DCIS), the most frequently diagnosed tumor in women in industrialized countries [1]. We demonstrated that 96 hours of culture under moderate hypoxia is sufficient to induce in DCIS-derived cells motility and epithelial-to-mesenchymal transition (EMT) and to enlarge the number of cells expressing the stem cell marker CD133, indicative of their increased malignant potential. Administration of all-trans retinoic acid (ATRA), a well-known anti-leukemic drug with an anti-tumor role in invasive breast tumor cells [2], supports the epithelial phenotype of DCIS-derived cells cultured under hypoxia and reduces the number of CD133 positive cells, abrogating almost completely the effects of poor oxygenation. In DCIS-derived cells, as in leukemic cells, ATRA up-regulates the β2 isoform of PI-PLC (PLC-β2), ectopically expressed in invasive breast tumors in which counteracts the effects of hypoxia on both EMT and CD133 levels [3]. This suggests that the mechanisms triggered by ATRA in non-invasive breast tumor cells cultured under hypoxia may, at least in part, depend on PLC-β2 activity. Overall, we assigned to hypoxia a role in increasing the malignant potential of DCIS-derived cells and identified in ATRA, currently used in treating acute promyelocytic leukemia (APL), an agonist potentially useful in preventing malignant progression of non-invasive breast lesions with hypoxic areas., Italian Journal of Anatomy and Embryology, Vol. 122, No. 1 (Supplement) 2017

Ductal carcinoma in situ (DCIS), which represents the most frequently diagnosed tumor in women in industrialized countries, may be a crucial step in the progression of breast lesions to invasive ductal carcinoma (IDC) (1). Among the signaling molecules deregulated in breast tumors, the beta2 isoform of the phosphoinositide-dependent phospholipase C (PLC-b2) strongly correlates with malignancy of invasive tumors and breast tumor-derived cells (2, 3). In breast tumor-derived cell lines cultured under hypoxia, PLC-b2 regulates the levels of cancer stem cell and epithelial-to-mesenchymal transition (EMT) markers (4), suggesting its involvement in breast cancer progression. By using archival FFPE breast tumor samples, we demonstrated that PLC-β2 is up-regulated in DCIS, in which it inversely correlates to the levels of miR-146a, known to act as a tumor suppressor in breast cancer (5). By using the MCF10DCIS cell line, a well-established model of DCIS-derived cells, we demonstrated that the de-regulation of miR-146a is sufficient to modulate the expression of PLC-β2, in turn able to affect the epithelial-to-mesenchymal shift as well as the number of cells expressing CD133. These data indicate that miR-146a and PLC-β2 are members of an intracellular network able to ensure the maintenance of the non-invasive phenotype of DCIS and suggest that alterations in their levels can determine the appearance of an invasive phenotype. The potential prognostic relevance of PLC-β2/miR-146a relationship was investigated in primary DCIS from patients who developed an invasive ductal carcinoma in the contralateral breast. The PLC-β2/miR-146a correlation was found negative in primary DCIS from patients who did not recur and strongly positive in DCIS from patients who developed a contralateral IDC. We propose that the assessment of the correlation between the levels of PLC-β2 and miR-146a in primary DCIS at diagnosis could be beneficial to identify patients with either low or high propensity to develop invasive recurrence. Since a major problem in the management of patients with DCIS is the lack of reliable prognostic markers, our results might be of value in selecting the most appropriate therapies for individual women with non-invasive breast neoplasia., Italian Journal of Anatomy and Embryology, Vol. 121, No. 1 (Supplement) 2016

Surface CD133 and EpCAM, proliferation and invasiveness in breast derived cell lines. In A, representative cytofluorimetrical evaluation of CD133 and EpCAM surface levels in MCF7 and MDA-MB-468 cells after labelling with a PE-conjugated anti-CD133 antibody or with a FITC-conjugated anti-EpCAM antibody. The staining with isotype matched antibodies (IgG) is used as a control. The expression of each antigen is shown on a biparametric dot plot and the percentage and MFI of positive cells are indicated at the upper right of each panel. In B, MDA-MB-231, MCF7 and MDA-MB-468 cells were subjected to dynamic monitoring of proliferation and invasion through Matrigel using the xCELLigence RTCA system. Cell Index (CI) is reported and error bars indicate ÂąSD. The correspondent Slope analysis, that describes the steepness, incline, gradient, and changing rate of the CI curves over time, is shown on the right. The data were collected from three separate experiments (PDF 364 kb)

Hypoxia plays a crucial role in malignant progression of solid tumors, including breast cancer, since neoplastic cells adapt to low oxygen availability by modulating the expression of genes involved in survival, proliferation, metabolic reprogramming, stem cell maintenance, EMT, angiogenesis, invasion and metastasis (1). Among the signaling molecules deregulated in breast tumors, the beta2 isoform of the phosphoi- nositide-dependent phospholipase C (PLC-β2) is expressed in the large majority of primary invasive tumors from all histological subtypes in which it strongly correlates with malignancy and with a poor prognosis (2). PLC-β2 is also expressed in breast tumor- derived cells, in which it improves proliferation and motility and sustains invasion capability (3). A decreased PLC-β2 expression is induced by hypoxia in the BT-474 and MCF7 cell lines, that is correlated with the hypoxia-induced modulation of the EMT markers E-cadherin and Vimentin, as well as of the stem cell marker CD133. In contrast, hypoxia induced the increase of PLC-β2 levels in MDA-MB-231 cells, in which it supports the hypoxia-related reorganization of actin cytoskeleton. In all examined cell lines, the prevention of the effects of hypoxia on PLC-β2 also reduced the recovery of HIF-1α, in turn able to exert a phenotype-related role in modulating EMT and expression of CD133 during the cell response to low oxygen. Our data highlighted a peculiar effect of low oxygen availability on PLC-β2 expression in breast tumor cells with different phenotypes and allocate PLC-β2 in the complex and interconnected transcriptional activity induced by hypoxia. Our results also suggest that the forced modulation of PLC-β2 programmed on the basis of the tumor phenotype may prevent malignant progression of breast neoplasia as a consequence of intra-tumoral hypoxia., Italian Journal of Anatomy and Embryology, Vol. 120, No. 1 (Supplement) 2015

Limited oxygen availability plays a critical role in the malignant progression of breast cancer by orchestrating a complex modulation of the gene transcription largely dependent on the tumor phenotype. Invasive breast tumors belonging to different molecular subtypes are characterized by over-expression of PLC-β2, whose amount positively correlates with the malignant evolution of breast neoplasia and supports the invasive potential of breast tumor cells. Here we report that hypoxia modulates the expression of PLC-β2 in breast tumor cells in a phenotype-related manner, since a decrease of the protein was observed in the BT-474 and MCF7 cell lines while an increase was revealed in MDA-MB-231 cells as a consequence of low oxygen availability. Under hypoxia, the down-modulation of PLC-β2 was mainly correlated with the decrease of the EMT marker E-cadherin in the BT-474 cells and with the up-regulation of the stem cell marker CD133 in MCF7 cells. The increase of PLC-β2 induced by low oxygen in MDA-MB-231 cells supports the hypoxia-related reorganization of actin cytoskeleton and sustains invasion capability. In all examined cell lines, but with an opposite role in the ER-positive and ER-negative cells, PLC-β2 was involved in the hypoxia-induced increase of HIF-1α, known to affect both EMT and CD133 expression. Our data include PLC-β2 in the complex and interconnected signaling pathways induced by low oxygen availability in breast tumor cells and suggest that the forced modulation of PLC-β2 programmed on the basis of tumor phenotype may prevent the malignant progression of breast neoplasia as a consequence of intra-tumoral hypoxia. © 2016 Wiley Periodicals, Inc.

Vav1, normally restricted to hematopoietic cells, results ectopically expressed in solid tumors, including breast cancer (Sebban et al., 2013) in which, contrarily to other neoplasias, seems to be higher in tumors from patients who remained diseasefree than in patients who developed recurrence (Lane et al., 2008). The significance of Vav1 expression in breast tumors was evaluated by immunohistochemical analysis on TMAs containing invasive breast tumors from patients without lymph node involvement. Our findings indicate that Vav1 is expressed in almost all investigated cancers and shows a peculiar localization inside the nucleus of tumor cells. High amounts of nuclear Vav1 positively correlates with low incidence of relapse, regardless phenotype and molecular subtype of the neoplasia. Experiments performed with breast tumor-derived cells showing different morphology, immunoprofile and invasive properties indicated that Vav1 negatively modulates their invasiveness in vitro and their metastatic efficiency in vivo, possibly by affecting the expression of genes involved in invasion and/or metastasis of breast cancer. Since the high heterogeneity of breast tumors makes difficult to predict the evolution of early neoplasias, the evaluation of nuclear Vav1 levels may help in profiling and management of early breast cancer patients. In addition, Vav1 may serve as a target for new therapies designed to prevent breast cancer progression., Italian Journal of Anatomy and Embryology, Vol 119, No 1 (Supplement) 2014

Originally considered a marker of hematopoietic stem cells, CD133/prominin is a highly glycosylated trans-membrane protein expressed in various tissues, such as breast, in which it seems to regulate ductal branching but not regenerative capacity [1]. CD133 is also expressed in various solid tumors, including breast cancer, in which CD133-positivity seems to identify a restricted subgroup of tumor stem cells [2]. CD133 expression was heterogeneous in different breast carcinomas but, in triple- negative (ER-, PR-, HER2-) invasive ductal breast carcinoma, CD133 correlates with tumor size, metastasis and clinical stage [3]. In order to establish a correlation between the surface recognition of CD133 and the phenotype of tumor cells, the highly invasive breast-derived MDA-MB-231 cells (ER-, PR-, HER2-) were subjected to immunomagnetic separation of CD133+ and CD133- subpopulations, which were analyzed for malignant properties. In comparison to CD133- cells, the expression of CD133 characterizes cells with a larger adhesion area, lower proliferation rate and reduced migration speed. This phenotype correlates with altered expression of malignancy-associated proteins and with a peculiar pattern of PLC, in turn involved in proliferation and motility of breast tumor cells (4-6). This suggests that, in triple negative ductal breast tumor-derived cells, the expression of CD133 characterizes a small subset of cells with a less undifferentiated phenotype. The reduced expression of CD133 at membrane level may constitute a marker of the switch of tumor cells from a less malignant to a mature phenotype since it correlates with the de-regulation of proteins involved in cell proliferation, motility and invasion., Italian Journal of Anatomy and Embryology, Vol 117, No 2 (Supplement) 2012