GSK3-beta Signaling in Medullary Thyroid Cancer

描述（申请人提供）：甲状腺髓样癌（MTC）是一种源自产生降钙素的甲状腺c细胞的神经内分泌肿瘤，占甲状腺癌病例的3-5%。虽然手术是MTC患者唯一可能治愈的治疗方法，但几乎所有患者在全甲状腺切除术和中央淋巴结清扫后都会出现持续性或复发性疾病。此外，没有有效的替代方法来治疗许多与无法治愈的MTC相关的衰弱症状，如气道阻塞、潮红、腹痛和腹泻。我们在体外和体内研究表明，通过抑制GSK3B激活raf-1可显著抑制人MTC细胞的生长并减少激素分泌。在本提案中，我们将探索利用GSK3B抑制剂（如锂）改善转移性MTC患者手术结果的潜力。在第一个目标中，我们将建立2个复发/持续性MTC的动物模型，以确定GSK3B抑制剂是否会抑制肿瘤生长并抑制体内激素的产生。在第二个目标中，我们计划表征大量人类甲状腺肿瘤样本，包括MTC和正常甲状腺组织，以表达raf-1和GSK3B信号通路成员。来自这些分析的数据将有助于预测哪些患者可能对锂和其他GSK抑制化合物更有反应。在第三个目标中，我们将描述GSK3B在raf-1介导的生长抑制和激素抑制中的作用。我们发现，raf-1的激活也会导致磷酸化的、失活的GSK3B的增加，并且用GSK3B抑制剂（如氯化锂和SB216763）治疗MTC细胞可以再现raf-1的作用。我们将确定raf-1介导的生长和激素抑制是否依赖于GSK3B的抑制，以及GSK3B是否是raf-1的主要下游靶点。总之，本研究为理解MTC的生物学提供了一种新的途径，并可能为治疗和缓解这种疾病提供新的见解。公共卫生相关性：甲状腺髓样癌（MTC）是一种源自产生降钙素的甲状腺c细胞的神经内分泌肿瘤，占甲状腺癌病例的3-5%。虽然手术是MTC患者唯一可能治愈的治疗方法，但几乎所有患者在全甲状腺切除术和中央淋巴结清扫后都会出现持续性或复发性疾病。此外，没有有效的替代方法来治疗许多与无法治愈的MTC相关的衰弱症状。我们已经证明，通过抑制糖原合成酶激酶-3- β (GSK3B)激活raf-1可以显著抑制人MTC细胞的生长并减少激素分泌。在本提案中，我们将探索利用GSK3B抑制剂改善转移性MTC患者手术结果的潜力。

DESCRIPTION (provided by applicant): Medullary thyroid cancer (MTC) is a neuroendocrine tumor derived from the calcitonin-producing thyroid C-cells and accounts for 3-5% of cases of thyroid cancer. While surgery is the only potentially curative therapy for patients with MTC, almost all patients will have persistent or recurrent disease after total thyroidectomy and central lymph node dissection. Moreover, there is no effective alternative to treat many of the debilitating symptoms associated with incurable MTC such as airway obstruction, flushing, abdominal pain and diarrhea. We have shown that activation of raf-1 through inhibition of GSK3B markedly suppresses cellular growth and reduces hormone secretion in human MTC cells in vitro and in vivo. In this proposal, we will explore the potential to utilize GSK3B inhibitors such as lithium to improve surgical outcomes for patient with metastatic MTC. In the first aim, we will develop 2 animal models of recurrent/persistent MTC to determine if GSK3B inhibitors will inhibit tumor growth and suppress hormone production in vivo. In the second aim, we plan to characterize a large number of human thyroid tumor samples, including MTC, and normal thyroid tissue for expression of raf-1 and GSK3B signaling pathway members. The data from these analyses will help predict which patients may be more likely to respond to lithium and other GSK inhibiting compounds. In the third aim, we will delineate the role of GSK3B in raf-1-mediated growth suppression and hormone inhibition. We have found that raf-1 activation also results in an increase in phosphorylated, inactive GSK3B, and that treatment of MTC cells with GSK3B inhibitors, such as lithium chloride and SB216763, can recapitulate the effects of raf-1. We will determine whether or not raf-1-mediated growth and hormone suppression is dependent upon GSK3B inhibition, and if GSK3B is the main downstream target of raf-1. In summary, the studies in this proposal represent a novel approach to understanding the biology of MTC, and may provide new insights to treating and palliating this disease. PUBLIC HEALTH RELEVANCE: Medullary thyroid cancer (MTC) is a neuroendocrine tumor derived from the calcitonin- producing thyroid C-cells and accounts for 3-5% of cases of thyroid cancer. While surgery is the only potentially curative therapy for patients with MTC, almost all patients will have persistent or recurrent disease after total thyroidectomy and central lymph node dissection. Moreover, there is no effective alternative to treat many of the debilitating symptoms associated with incurable MTC. We have shown that activation of raf-1 through inhibition of glycogen synthase kinase-3-beta (GSK3B) markedly suppresses cellular growth and reduces hormone secretion in human MTC cells in vitro and in vivo. In this proposal, we will explore the potential to utilize GSK3B inhibitors to improve surgical outcomes for patients with metastatic MTC.