Research Papers:

Human carcinoma-associated mesenchymal stem cells promote ovarian cancer chemotherapy resistance via a BMP4/HH signaling loop

Lan G. Coffman _, Yun-Jung Choi, Karen McLean, Benjamin L. Allen, Marina Pasca di Magliano and Ronald J. Buckanovich

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Oncotarget. 2016; 7:6916-6932. https://doi.org/10.18632/oncotarget.6870

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Lan G. Coffman1, Yun-Jung Choi1, Karen McLean2, Benjamin L. Allen3, Marina Pasca di Magliano3,4 and Ronald J. Buckanovich1,2

1 Division of Hematology Oncology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA

2 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor, Michigan, USA

3 Department of Cell and Developmental Biology, University of Michigan Medical Center, Ann Arbor, Michigan, USA

4 Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA

Correspondence to:

Lan G. Coffman, email:

Keywords: ovarian cancer, mesenchymal stem cell, tumor microenvironment, BMP4, Hedgehog

Received: September 14, 2015 Accepted: January 01, 2016 Published: January 09, 2016


The tumor microenvironment is critical to cancer growth and therapy resistance. We previously characterized human ovarian carcinoma-associated mesenchymal stem cells (CA-MSCs). CA-MSCs are multi-potent cells that can differentiate into tumor microenvironment components including fibroblasts, myofibroblasts and adipocytes. We previously reported CA-MSCs, compared to normal MSCs, express high levels of BMP proteins and promote tumor growth by increasing numbers of cancer stem-like cells (CSCs). We demonstrate here that ovarian tumor cell-secreted Hedgehog (HH) induces CA-MSC BMP4 expression. CA-MSC-derived BMP4 reciprocally increases ovarian tumor cell HH expression indicating a positive feedback loop. Interruption of this loop with a HH pathway inhibitor or BMP4 blocking antibody decreases CA-MSC-derived BMP4 and tumor-derived HH preventing enrichment of CSCs and reversing chemotherapy resistance. The impact of HH inhibition was only seen in CA-MSC-containing tumors, indicating the importance of a humanized stroma. These results are reciprocal to findings in pancreatic and bladder cancer, suggesting HH signaling effects are tumor tissue specific warranting careful investigation in each tumor type. Collectively, we define a critical positive feedback loop between CA-MSC-derived BMP4 and ovarian tumor cell-secreted HH and present evidence for the further investigation of HH as a clinical target in ovarian cancer.

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