Voltage-gated Na⁺ channel activity increases colon cancertranscriptional activity and invasion via persistent MAPK signaling

© 2015 Macmillan Publishers Limited. All rights reserved. Functional expression of voltage-gated Na+ channels (VGSCs) has been demonstrated in multiple cancer cell types where channel activity induces invasive activity. The signaling mechanisms by which VGSCs promote oncogenesis remain poorly understood. We explored the signal transduction process critical to VGSC-mediated invasion on the basis of reports linking channel activity to gene expression changes in excitable cells. Coincidentally, many genes transcriptionally regulated by the SCN5A isoform in colon cancer have an over-representation of cis-acting sites for transcription factors phosphorylated by ERK1/2 MAPK. We hypothesized that VGSC activity promotes MAPK activation to induce transcriptional changes in invasion-related genes. Using pharmacological inhibitors/activators and siRNA-mediated gene knockdowns, we correlated channel activity with Rap1-dependent persistent MAPK activation in the SW620 human colon cancer cell line. We further demonstrated that VGSC activity induces downstream changes in invasion-related gene expression via a PKA/ERK/c-JUN/ELK-1/ETS-1 transcriptional pathway. This is the first study illustrating a molecular mechanism linking functional activity of VGSCs to transcriptional activation of invasion-related genes

Pharmacological and nutritional targeting of voltage-gated sodium channels in the treatment of cancers

International audienc

Therapeutic value of voltage-gated sodium channel inhibitors in breast, colorectal and prostate cancer : a systematic review

Although survival rates of breast, colon and prostate cancers are improving, deaths from these tumors frequently occur due to metastasis. Voltage-gated Na+ channels (VGSCs) are membrane proteins, which regulate membrane current and cellular migration during nervous system organogenesis. VGSCs are also expressed in fibroblasts, immune cells, glia and metastatic cancer cells. VGSCs regulate migration and invasion of breast, bowel and prostate cancer cells, suggesting that they may be novel anti-metastatic targets. We conducted a systematic review of clinical and preclinical studies testing the effects of VGSC-inhibiting drugs in cancer. 204 publications were identified, of which two human, two mouse and 20 in vitro publications were included. In the clinical studies, the effect of these drugs on survival and metastatic relapse is not clear. The 22 preclinical studies collectively suggest that several VGSC-inhibiting drugs inhibit cancer proliferation, migration and invasion. None of the human and only six of the preclinical studies directly investigated the effect of the drugs on VGSC activity. Studies were difficult to compare due to lack of standardized methodology and outcome measures. We conclude that the benefits of VGSC inhibitors require further investigation. Standardization of future studies and outcome measures should enable meaningful study comparisons

Sodium channel-inhibiting drugs and survival of breast, colon and prostate cancer: a population-based study

Metastasis is the leading cause of cancer-related deaths. Voltage-gated sodium channels (VGSCs) regulate invasion and metastasis. Several VGSC-inhibiting drugs reduce metastasis in murine cancer models. We aimed to test the hypothesis that patients taking VGSC-inhibiting drugs who developed cancer live longer than those not taking these drugs. A cohort study was performed on primary care data from the QResearch database, including patients with breast, bowel or prostate cancer. Cox proportional hazards regression was used to compare the survival from cancer diagnosis of patients taking VGSC-inhibiting drugs with those not exposed to these drugs. Median time to death was 9.7 years in the exposed group and 18.4 years in the unexposed group, and exposure to these medications significantly increased mortality. Thus, exposure to VGSC-inhibiting drugs associates with reduced survival in breast, bowel and prostate cancer patients. This finding is not consistent with the preclinical data. Despite the strengths of this study including the large sample size, the study is limited by missing information on potentially important confounders such as cancer stage, co-morbidities and cause of death. Further research, which is able to account for these confounding issues, is needed to investigate the relationship between VGSC-inhibiting drugs and cancer survival

Role of voltage-gated sodium channel NaV1.5 and β4 auxiliary subunit in the in vitro and in vivo breast cancer cells invasiveness

L’expression anormale du canal sodique Nav1.5 dans le cancer du sein est corrélée au développement métastatique et à une mortalité augmentée. Le canal Nav1.5 est localisé dans les invadopodes des cellules cancéreuses mammaires humaines MDA-MB-231 et augmente leur activité protéolytique par une modulation allostérique de l’échangeur NHE-1 et l’activation de protéases acides. In vivo, dans un modèle de xénogreffe sur souris NMRI nude, l’expression de Nav1.5 potentialise la colonisation des poumons par les cellules cancéreuses mammaires humaines. Cette colonisation métastatique est inhibée par un traitement à la ranolazine, un inhibiteur pharmacologique des canaux Nav1.5. La sous-unité β4, auxiliaire des canaux Nav, voit son expression diminuer au cours de la progression cancéreuse, ce qui est associé in vitro à une augmentation de l’invasivité cellulaire. Cette augmentation d’invasivité semble indépendante du canal Nav1.5 et pourrait être associée à une transition des cellules vers un phénotype amiboïde. En conclusion, l’expression de Nav1.5 et la perte d’expression de β4 semblent jouer des rôles complémentaires dans l’invasivité des cellules cancéreuses.The abnormal expression of sodium channel Nav1.5 in breast cancer is correlated with metastatic development and an increased mortality. The Nav1.5 channel is located in invadopodia in human breast cancer cells MDA-MB-231, where it increases proteolytic activity by allosteric modulation of exchanger NHE-1 and activation of acidic proteases. In vivo, in a xenograft model in nude NMRI mice, the expression of Nav1.5 potentiates lung colonization by human breast cancer cells. Metastatic colonization is inhibited by treatment with ranolazine, a pharmacological inhibitor of Nav1.5. The β4 subunit, an auxiliary subunit of Nav channels, is expressed at low levels or lost when tumors are more aggressive, and its suppression in vitro increases celI invasiveness. This increase seems to be independent of Nav1.5 and could be associated with the transition of cells to an amoeboid phenotype. In conclusion, Nav1.5 expression and the loss of β4 expression seem to play complementary roles in the invasiveness of cancer cells