Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier

Abstract Background Elevated basal cortisol levels are present in women with primary and metastatic breast cancer. Although cortisol's potential role in breast‐to‐brain metastasis has yet to be sufficiently studied, prior evidence indicates that it functions as a double‐edged sword—cortisol ind...

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Main Authors: Robert A. Herrera, Krutika Deshpande, Vahan Martirosian, Behnaz Saatian, Alex Julian, Rachel Eisenbarth, Diganta Das, Mukund Iyer, Josh Neman
Format: Article
Language:English
Published: Wiley 2022-04-01
Series:Cancer Reports
Subjects:
Online Access:https://doi.org/10.1002/cnr2.1351
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author Robert A. Herrera
Krutika Deshpande
Vahan Martirosian
Behnaz Saatian
Alex Julian
Rachel Eisenbarth
Diganta Das
Mukund Iyer
Josh Neman
author_facet Robert A. Herrera
Krutika Deshpande
Vahan Martirosian
Behnaz Saatian
Alex Julian
Rachel Eisenbarth
Diganta Das
Mukund Iyer
Josh Neman
author_sort Robert A. Herrera
collection DOAJ
description Abstract Background Elevated basal cortisol levels are present in women with primary and metastatic breast cancer. Although cortisol's potential role in breast‐to‐brain metastasis has yet to be sufficiently studied, prior evidence indicates that it functions as a double‐edged sword—cortisol induces breast cancer metastasis in vivo, but strengthens the blood‐brain‐barrier (BBB) to protect the brain from microbes and peripheral immune cells. Aims In this study, we provide a novel examination on whether cortisol's role in tumor invasiveness eclipses its supporting role in strengthening the CNS barriers. We expanded our study to include the blood‐cerebrospinal fluid barrier (BCSFB), an underexamined site of tumor entry. Methods and Results Utilizing in vitro BBB and BCSFB models to measure barrier strength in the presence of hydrocortisone (HC). We established that lung tumor cells migrate through both CNS barriers equally while breast tumors cells preferentially migrate through the BCSFB. Furthermore, HC treatment increased breast‐to‐brain metastases (BBM) but not primary breast tumor migratory capacity. When examining the transmigration of breast cancer cells across the BCSFB, we demonstrate that HC induces increased traversal of BBM but not primary breast cancer. We provide evidence that HC increases tightness of the BCSFB akin to the BBB by upregulating claudin‐5, a tight junction protein formerly acknowledged as exclusive to the BBB. Conclusion Our findings indicate, for the first time that increased cortisol levels facilitate breast‐to‐brain metastasis through the BCSFB—a vulnerable point of entry which has been typically overlooked in brain metastasis. Our study suggests cortisol plays a pro‐metastatic role in breast‐to‐brain metastasis and thus caution is needed when using glucocorticoids to treat breast cancer patients.
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spelling doaj.art-4a99a9b2dc594de281964cbb548352102022-12-22T00:31:38ZengWileyCancer Reports2573-83482022-04-0154n/an/a10.1002/cnr2.1351Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrierRobert A. Herrera0Krutika Deshpande1Vahan Martirosian2Behnaz Saatian3Alex Julian4Rachel Eisenbarth5Diganta Das6Mukund Iyer7Josh Neman8Department of Molecular Microbiology and Immunology Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USADepartment of Neurological Surgery Keck School of Medicine, University of Southern California Los Angeles California USAAbstract Background Elevated basal cortisol levels are present in women with primary and metastatic breast cancer. Although cortisol's potential role in breast‐to‐brain metastasis has yet to be sufficiently studied, prior evidence indicates that it functions as a double‐edged sword—cortisol induces breast cancer metastasis in vivo, but strengthens the blood‐brain‐barrier (BBB) to protect the brain from microbes and peripheral immune cells. Aims In this study, we provide a novel examination on whether cortisol's role in tumor invasiveness eclipses its supporting role in strengthening the CNS barriers. We expanded our study to include the blood‐cerebrospinal fluid barrier (BCSFB), an underexamined site of tumor entry. Methods and Results Utilizing in vitro BBB and BCSFB models to measure barrier strength in the presence of hydrocortisone (HC). We established that lung tumor cells migrate through both CNS barriers equally while breast tumors cells preferentially migrate through the BCSFB. Furthermore, HC treatment increased breast‐to‐brain metastases (BBM) but not primary breast tumor migratory capacity. When examining the transmigration of breast cancer cells across the BCSFB, we demonstrate that HC induces increased traversal of BBM but not primary breast cancer. We provide evidence that HC increases tightness of the BCSFB akin to the BBB by upregulating claudin‐5, a tight junction protein formerly acknowledged as exclusive to the BBB. Conclusion Our findings indicate, for the first time that increased cortisol levels facilitate breast‐to‐brain metastasis through the BCSFB—a vulnerable point of entry which has been typically overlooked in brain metastasis. Our study suggests cortisol plays a pro‐metastatic role in breast‐to‐brain metastasis and thus caution is needed when using glucocorticoids to treat breast cancer patients.https://doi.org/10.1002/cnr2.1351BBBBCSFBbreast‐to‐brain metastasiscortisol
spellingShingle Robert A. Herrera
Krutika Deshpande
Vahan Martirosian
Behnaz Saatian
Alex Julian
Rachel Eisenbarth
Diganta Das
Mukund Iyer
Josh Neman
Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier
Cancer Reports
BBB
BCSFB
breast‐to‐brain metastasis
cortisol
title Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier
title_full Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier
title_fullStr Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier
title_full_unstemmed Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier
title_short Cortisol promotes breast‐to‐brain metastasis through the blood‐cerebrospinal fluid barrier
title_sort cortisol promotes breast to brain metastasis through the blood cerebrospinal fluid barrier
topic BBB
BCSFB
breast‐to‐brain metastasis
cortisol
url https://doi.org/10.1002/cnr2.1351
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