ECM Integrin interactions have previously been shown to control cell survival and ECM has been implicated in ovarian cancer drug resistance as well as lung cancer drug resistance. The development of doxor ubicin resistance exhibited strong changes in pathways associated with proteasome degradation, This is particu larly interesting considering that bortezomib, a protea some inhibitor, has been found effective in combination therapy with doxorubicin in several studies. Because of the specific proteasome genes found altered, as well as the presence of cell cycle genes differentially expressed, it is likely that the proteasome pathway changes affect the cell cycle. It has been shown that doxorubicin can affect G2 M transition and cyclin B1 activity, and changes in the cell cycle may therefore influence the response to doxorubicin through changes in apoptosis sensitivity.
Paclitaxel resistance was associated with changes in pathways important for mRNA and protein synthesis, oxidative stress and glycolysis. The exact mechanisms by which these pathways can affect the resistance to paclitaxel remain under investigation, but changes in apoptosis sensitivity is a certain possibility since a total noob general mRNA degradation and oxidative stress have been implicated in apoptosis. In conclusion, we have generated drug resistant ovar ian cancer cell lines through exposure to three differ ent chemotherapeutic drugs and identified gene expression patterns altered during the development of chemoresistance. Among the genes that are consis tently elevated we identify previously known genes such as ABCB1 and genes of the MAGEA family.
Among the genes downregulated, selleck we find genes such as MSMB and PRSS family members that are impli cated for the first time in drug resistance. Overall, we find that different drug resistance phenotypes have dif ferent expression patterns and we identify many novel genes that may be important in the development of cisplatin, doxorubicin and paclitaxel resistance. Path way analysis suggests enticing new mechanisms for the development of resistance to cisplatin, doxorubicin, and paclitaxel in ovarian cancer and we find that each resistance phenotype is associated with specific path way alterations. Whether the identified path ways are causally related to drug resistance remains to be determined and it will be important to follow up these findings with mechanistic studies to better understand the roles of the genes and pathways we have identified.
Background Ovarian cancer is the leading gynecological malignancy, affecting more than 200,000 women per annum world wide. This is largely due to high rates of chemore sistant recurrence associated with the disease. Primary ovarian cancer develops silently, with most patients symp tom free, only presenting at an advanced stage.