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ER Stress, Hypoxia Tolerance and Tumor Progression
Abstract
The development of chronic and fluctuating hypoxic regions in tumors has profound consequences for malignant progression, response to therapy and overall patient survival. Understanding the events involved in hypoxia tolerance will offer new opportunities for antitumor modalities. A universal response of tumor cells to hypoxia is a rapid and substantial decrease in the rates of macromolecular synthesis. Hypoxia induces phosphorylation of the translation initiation factor eIF2alpha on Ser51 via activation of the endoplasmic reticulum (ER) resident kinase PERK and that this modification is required for the rapid downregulation of global protein synthesis by this hypoxic stress. PERK-dependent phosphorylation of eIF2alpha is one component of the Unfolded Protein Response (UPR), a coordinated program that promotes cell survival under conditions of ER stress. Inactivation of PERK or eIF2alpha phosphorylation impairs cell survival under hypoxia, and transformed cells with inactivating PERK or eIF2alpha mutations form tumors in nude mice that are slower growing, and have higher levels of apoptosis in hypoxic areas compared to tumors with an intact UPR. Expression of the transcription factor ATF4, a downstream effector of eIF2alpha phosphorylation, is also upregulated by hypoxia in vitro and in human tumors and increases hypoxia tolerance. A second UPR pathway mediated by activation of IRE1 and its downstream target XBP1 is also required for hypoxia tolerance in vitro and for tumor growth. These results reveal a critical role for UPR activation for tumor cell resistance to hypoxia and tumor growth promotion and suggest that the UPR may be an attractive target for anti-tumor modalities.
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“Folding capacity may therefore be compromised if oxygen or ATP concentrations are limiting, but this is likely to be a secondary mechanism (315).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [315]
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BackgroundER stress and genomic instability induced by gamma radiation in mice primary cultured glial cells
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“Microenvironment of tumor cells may be similar to a physiological stress condition and cells manage to acquire a survival function (Koumenis, 2006), PRDX2 is a member of the peroxiredoxin family of antioxidant enzymes (PRDX 1–6), which perform important functions in the maintenance of the…”
BackgroundVarlamova, E. G., Khabatova, V. V., Gudkov, S. V., & Turovsky, E. A. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24032411 · Cited by 21
“On the one hand, ER stress, which plays a key role in tumor pathogenesis, can lead to tumor progression and resistance to chemoradiotherapy [46,47].”
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“The endoplasmic reticulum (ER) plays essential roles in protein folding, transport, and synthesis, but the microenvironment of the ER can be disturbed by ER stress [5,6] through Ca2+ deficiency, hypoxia, and N-terminal glycosylation dysfunction, and this disturbance is accompanied by an excessive accumulation of unfol…”
BackgroundAn N-terminal 78 amino acid truncation of REIC/Dkk-3 effectively induces apoptosis
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DNA or not DNA —that is the question determining the design of platinum anticancer drugs
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“In order to answer these questions, we have assessed the efficiency of NMD, which targets the mRNA bound by CBP80/20 but not eIF4E, under prolonged hypoxic conditions in which steady-state translation is blocked to a significant degree [7,8,10,11].”
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“Previous studies have reported that GRP78 cysteine oxidation enhances cell survival during stress (27), and that GRP78, PERK, IRE1 and ATF6 overexpression in cancer is correlated with cell proliferation and survival signaling (28-31).”
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The Role of HTS in Drug Discovery at the University of Michigan
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BackgroundMicroRNA-210 knockdown contributes to apoptosis caused by oxygen glucose deprivation in PC12 cells
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Endoplasmic Reticulum: ER Stress
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“ER stress plays a key role in tumor pathogenesis, and recent studies have shown that ER stress promotes the process of tumor progression and resistance to chemoradiotherapy.(41,42) When cancer cells were treated with drugs such as cisplatin or sorafenib, ER stress-induced UPR signaling was seen as a compensatory mecha…”
BackgroundAre cachexia-associated tumors transmitTERS of ER stress?
Yamagata, A. S., & Freire, P. P. (2021) · Biochemical Society Transactions · doi:10.1042/bst20210496 · Cited by 7
Zhou, D., Wang, J., Yang, K., et al. (2020) · PubMed · doi:10.3779/j.issn.1009-3419.2020.104.22 · Cited by 6
Endoplasmic Reticulum Stress as a Target of Therapy Against Oxidative Stress and Hypoxia
Inagi, R. (2010) · Humana Press eBooks · doi:10.1007/978-1-60761-857-7_33 · Cited by 6
“Of note, the hypoxia-induced adaptive UPR is crucial to the survival of tumor cells [ 4 ].”
BackgroundGkouveris, I., Nikitakis, N. G., Aseervatham, J., & Ogbureke, K. U. E. (2018) · International Journal of Oncology · doi:10.3892/ijo.2018.4590 · Cited by 7
“For example, Fujimoto et al reported that PERK inhibition induces apoptosis of cancer stem cells (58), whereas Koumenis reported that the expression of PERK, and its target molecule eIF2, are correlated with increased tumor growth and survival under hypoxic conditions (59).”
Prognostic Role of Unfolded Protein Response-Related Genes in Hepatocellular Carcinoma
Zhang, S., Li, X., Zheng, Y., Hu, H., Liu, J., Zhang, S., Tang, C., Mo, Z., & Kuang, W. (2023) · Current Protein and Peptide Science · doi:10.2174/1389203724666230816090504 · Cited by 5
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CNPY2 in Solid Tumors: Mechanisms, Biomarker Potential, and Therapeutic Implications
Chowdhury, S. M., Hong, F., Rolfo, C. D., Li, Z., He, K., Wesolowski, R., Mortazavi, A., & Meng, L. (2025) · Biology · doi:10.3390/biology14020214 · Cited by 3
“One important aspect of the tumor microenvironment in cancer is the induction of ER stress, a process triggered by the accumulation of misfolded proteins that can inadvertently promote tumor growth [61,62].”
Snijders, A. M., Liu, Y., Su, L., Huang, Y., & Mao, J. (2015) · Oncotarget · doi:10.18632/oncotarget.6328 · Cited by 3
Epigenetic Regulation of Endoplasmic Reticulum Stress
Barroso, K., & Chevet, É. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802389-1.00015-0 · Cited by 3
A wrinkle in the unfolding of hypoxic response: HIF and ATF4
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Metadata
- Authors
- Koumenis, C.
- Affiliations
- Wake Forest University Health Sciences (US)
- Corresponding author
- Koumenis, Constantinos
- Venue
- Current Molecular Medicine
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2006-02-01
- Volume
- 6
- Issue
- 1
- Pages
- 55-69
- ISSN
- 1566-5240 (ISSN-L)
- OpenAlex
- W2000859982
- Cited by
- 231
- References
- 0
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 7 · 2023: 11 · 2022: 6 · 2021: 4 · 2020: 12 · 2019: 8 · 2018: 7 · 2017: 8 · 2016: 14 · 2015: 20 · 2014: 19 · 2013: 16 · 2012: 15
- FWCI
- 7.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Molecular Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R01 CA94214, R01CA094214)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Endoplasmic Reticulum Stress and Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
- Keywords
- endoplasmic reticulum stress, hypoxia tolerance, tumor progression, unfolded protein response, PERK, eIF2α phosphorylation, ATF4, IRE1, XBP1, tumor hypoxia, apoptosis
- MeSH terms
- Animals, Endoplasmic Reticulum, Humans, Neoplasms, Cell Hypoxia, Protein Folding, Disease Progression, eIF-2 Kinase
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