Research Papers:

GLI1-mediated regulation of side population is responsible for drug resistance in gastric cancer

Beiqin Yu, Dongsheng Gu, Xiaoli Zhang, Jianfang Li, Bingya Liu and Jingwu Xie _

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Oncotarget. 2017; 8:27412-27427. https://doi.org/10.18632/oncotarget.16174

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Beiqin Yu1,2, Dongsheng Gu2, Xiaoli Zhang2, Jianfang Li1, Bingya Liu1, Jingwu Xie2

1Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

2Department of Pediatrics, The Wells Center for Pediatrics Research and IU Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN 46202, USA

Correspondence to:

Jingwu Xie, email: [email protected]

Bingya Liu, email: [email protected]

Keywords: GLI1, hedgehog, cisplatin, gastric cancer, chemoresistance

Received: September 16, 2016    Accepted: January 24, 2017    Published: March 14, 2017


Gastric cancer is the third leading cause of cancer-related mortality worldwide. Chemotherapy is frequently used for gastric cancer treatment. Most patients with advanced gastric cancer eventually succumb to the disease despite some patients responded initially to chemotherapy. Thus, identifying molecular mechanisms responsible for cancer relapse following chemotherapy will help design new ways to treat gastric cancer. In this study, we revealed that the residual cancer cells following treatment with chemotherapeutic reagent cisplatin have elevated expression of hedgehog target genes GLI1, GLI2 and PTCH1, suggestive of hedgehog signaling activation. We showed that GLI1 knockdown sensitized gastric cancer cells to CDDP whereas ectopic GLI1 expression decreased the sensitivity. Further analyses indicate elevated GLI1 expression is associated with an increase in tumor sphere formation, side population and cell surface markers for putative cancer stem cells. We have evidence to support that GLI1 is critical for maintenance of putative cancer stem cells through direct regulation of ABCG2. In fact, GLI1 protein was shown to be associated with the promoter fragment of ABCG2 through a Gli-binding consensus site in gastric cancer cells. Disruption of ABCG2 function, through ectopic expression of an ABCG2 dominant negative construct or a specific ABCG2 inhibitor, increased drug sensitivity of cancer cells both in culture and in mice. The relevance of our studies to gastric cancer patient care is reflected by our discovery that high ABCG2 expression was associated with poor survival in the gastric cancer patients who underwent chemotherapy. Taken together, we have identified a molecular mechanism by which gastric cancer cells gain chemotherapy resistance.

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