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Integrated Omics-Based Pathway Analyses Uncover CYP Apaya et al. Journal of Experimental & Clinical Cancer Research (2019) 38:187 https://doi.org/10.1186/s13046-019-1187-y RESEARCH Open Access Integrated omics-based pathway analyses uncover CYP epoxygenase-associated networks as theranostic targets for metastatic triple negative breast cancer Maria Karmella Apaya1,2,3, Jeng-Yuan Shiau2†, Guo-Shiou Liao4†, Yu-Jen Liang5, Chia-Wei Chen5, Hsin-Chou Yang5, Chi-Hong Chu4, Jyh-Cherng Yu4* and Lie-Fen Shyur1,2,6,7* Abstract Background: Current prognostic tools and targeted therapeutic approaches have limited value for metastatic triple negative breast cancer (TNBC). Building upon current knowledge, we hypothesized that epoxyeicosatrienoic acids (EETs) and related CYP450 epoxygenases may have differential roles in breast cancer signaling, and better understanding of which may uncover potential directions for molecular stratification and personalized therapy for TNBC patients. Methods: We analyzed the oxylipin metabolome of paired tumors and adjacent normal mammary tissues from patients with pathologically confirmed breast cancer (N = 62). We used multivariate statistical analysis to identify important metabolite contributors and to determine the predictive power of tumor tissue metabolite clustering. In vitro functional assays using a panel of breast cancer cell lines were carried out to further confirm the crucial roles of endogenous and exogenous EETs in the metastasis transformation of TNBC cells. Deregulation of associated downstream signaling networks associated with EETs/CYPs was established using transcriptomics datasets from The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). Comparative TNBC proteomics using the same tissue specimens subjected to oxylipin metabolomics analysis was used as validation set. Results: Metabolite-by-metabolite comparison, tumor immunoreactivity, and gene expression analyses showed that CYP epoxygenases and arachidonic acid-epoxygenation products, EET metabolites, are strongly associated with TNBC metastasis. Notably, all the 4 EET isomers (5,6-, 8,9-, 11,12-, and 14,15-EET) was observed to profoundly drive the metastasis transformation of mesenchymal-like TNBC cells among the TNBC (basal- and mesenchymal-like), HER2-overexpressing and luminal breast cancer cell lines examined. Our pathway analysis revealed that, in hormone-positive breast cancer subtype, CYP epoxygenase overexpression is more related to immune cell-associated signaling, while EET-mediated Myc, Ras, MAPK, EGFR, HIF-1α, and NOD1/2 signaling are the molecular vulnerabilities of metastatic CYP epoxygenase-overexpressing TNBC tumors. (Continued on next page) * Correspondence: [email protected]; [email protected] †Jeng-Yuan Shiau and Guo-Shiou Liao contributed equally to this work. 4Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan 1Molecular and Biological Agricultural Sciences Program, Taiwan International Graduate Program, Academia Sinica, Taipei 115, Taiwan and National Chung Hsing University, Taichung 402, Taiwan Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Apaya et al. Journal of Experimental & Clinical Cancer Research (2019) 38:187 Page 2 of 22 (Continued from previous page) Conclusions: This study suggests that categorizing breast tumors according to their EET metabolite ratio classifiers and CYP epoxygenase profiles may be useful for prognostic and therapeutic assessment. Modulation of CYP epoxygenase and EET-mediated signaling networks may offer an effective approach for personalized treatment of breast cancer, and may be an effective intervention option for metastatic TNBC patients. Keywords: CYP450 epoxygenase, Epoxyeicosatrienoic acid, Metastasis, Oxylipin metabolome, Triple negative breast cancer Background Recent lipidomics findings show that phospholipids Molecular subtyping and immunohistopathological (IHC) and membrane-derived mediators are the main contrib- examination of estrogen receptor (ER), progesterone re- utors to the aggressive and metastatic phenotype of ER ceptor (PR) and human epidermal growth factor receptor or PR negative tumors [16]. These lipid autocoids in- (HER2) status serve as frontline guides for clinical fluence inter- and intracellular metabolic and inflam- decision-making in breast cancer (BC) therapy [1, 2]. matory signaling, which are two important cancer Current therapeutic approaches, however, are still ineffect- hallmarks [17, 18]. Among these lipid products, eicos- ive for triple negative breast cancer (TNBC, ER−/PR anoids, a group of metabolites derived from oxidative −/HER2−) patients, which account for approximately 15% transformation of arachidonic acid (AA) by cyclooxy- of all invasive mammary tumors [3, 4]. Currently, IHC genase (COX), lipoxygenase (LOX) or cytochrome analysis and gene expression profiling are the methods P450 (CYP) enzymes may have a major impact on used for sub-classification of “TNBC” tumors, which may malignant cell transformation and TNBC metastasis include basal-like 1, basal-like 2, immunomodulatory, progression [19]. While the cancer-associated eicosa- mesenchymal, mesenchymal-stem-like, and luminal an- noids derived from COX and LOX, e.g., prostaglandin drogen receptor-positive clusters [5–8]. However, this E2 (PGE2) and hydroxyeicosatetraenoic acids (HETEs), sub-classification scheme is ambiguous and still has lim- are well-established, the roles of CYP-derived mediators ited translational applications [8, 9]. Although systemic are more enigmatic [20, 21]. Aside from the xenobiotic chemotherapy may attenuate the aggressive nature of the metabolizing CYPs primarily found in the liver, which are disease, most TNBC patients have a disproportionally high important in drug metabolism and resistance, the tendency to develop rapid onset visceral and distal metas- pro-metastatic, angiogenic and anti-apoptotic functions of tasis, recurrence, and decreased survival rate [6–8]. Better extrahepatic CYPs (the CYP2J and CYP2C families) are of understanding of molecular signatures for TNBC is thus interest in cancer research [22–25]. needed to identify prognostic markers for clinical outcome CYP2J/2C catalyzes conversion of AA to 4 regioiso- prediction and to develop suitable personalized medicine meric epoxyeicosatrienoic acids, viz., 5,6-EET, 8,9-EET, for TNBC patients. 11,12-EET and 14,15-EET [21]. Several studies utilizing In recent years, the development of analytical tech- in vitro and in vivo models have highlighted the relation- niques for genomics, proteomics and metabolomics ana- ship between specific EET (e.g., 14,15-EET) signaling lyses has provided a more global insight into the and breast cancer progression [23, 26–28]. Expression of molecular biology of TNBC [9]. For example, gene ex- CYP2C8/9 and CYP2J2, and/or high level of 14,15-EET pression profiling helps stratify molecular features of detected in patients were found to be positively correlated TNBC tumors [10–12], methylome sequencing data has with aggressiveness of human BC [29], or that might be highlighted the prognostic value of epigenetic changes involved in breast cancer cell epithelial-mesenchymal [13] and global metabolomics and proteomics analyses transition and cisplatin resistance [30]. The biological sig- correlate decreased citrate, increased sarcosine and nificance of these findings and their translational implica- 2-hydroxyglutarate levels, and differentiated long-chain tions, however, are still elusive because information on the fatty acid metabolism-related proteins with the different global and comprehensive effects of all EET metabolites, BC subtypes [14, 15]. However, information derived from alone or in combination, on breast cancer metastasis have individual omics data types may be constrained to the dis- not been closely examined. We hypothesized that isomers covery of less inclusive molecular signatures with limited of this endogenous EET metabolite class are key players in translational applications. Integrating biological informa- regulating the multi-layered network signaling in breast tion derived from cohorts of multiple level high resolution cancer. In particular, we are interested in exploring the molecular analysis, e.g., The Cancer Genome Atlas roles of EETs in hormone-independent signaling processes (TCGA), with multi-omics, cross-platform data compari- in TNBC. son may ultimately lead to refinement of existing diagnos- In this study, we examined the global oxylipin metab- tic classification and therapeutic options for TNBC. olite profiles of breast cancer tumors and show the Apaya et al. Journal of Experimental & Clinical Cancer Research (2019) 38:187 Page 3 of 22 importance of EET metabolites in relation to hormone scraped from the upper surface of the membrane using a receptor subtype, metastasis status and prospective clin- cotton swab. Cells remaining on the underside were ical outcomes.
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