MUC1 extracellular domain confers resistance of epithelial cancer cells to anoikis

Anoikis, a special apoptotic process occurring in response to loss of cell adhesion to the extracellular matrix, is a fundamental surveillance process for maintaining tissue homeostasis. Resistance to anoikis characterises cancer cells and is a pre-requisite for metastasis. This study shows that overexpression of the transmembrane mucin protein MUC1 prevents initiation of anoikis in epithelial cancer cells in response to loss of adhesion. We show that this effect is largely attributed to the elongated and heavily glycosylated extracellular domain of MUC1 that protrudes high above the cell membrane and hence prevents activation of the cell surface anoikis-initiating molecules such as integrins and death receptors by providing them a mechanically ‘homing'' microenvironment. As overexpression of MUC1 is a common feature of epithelial cancers and as resistance to anoikis is a hallmark of both oncogenic epithelial–mesenchymal transition and metastasis, MUC1-mediated cell resistance to anoikis may represent one of the fundamental regulatory mechanisms in tumourigenesis and metastasis.Anoikis, the apoptotic process that occurs in cells that have lost adhesion to the extracellular matrix (ECM),^1,2 is a fundamental process for maintaining tissue homeostasis. It removes displaced epithelial/endothelial cells and thus prevents them from seeding to inappropriate sites. Resistance to anoikis contributes prominently to tumourigenesis and, in particular, to metastasis by allowing survival of cancer cells that have invaded into the blood or lymphatic circulation and thus facilitating their metastatic spread to remote sites.³Initiation of anoikis starts from the cell surface through activation of the cell surface anoikis-initiating molecules, for example, integrins, cadherins and death receptors, in response to loss of cell adhesion. Loss of the integrin-mediated cell basement matrix contact,⁴ loss of the E-cadherin-mediated cell–cell contact^5,6 or ligation of the cell surface death receptors with their ligands^4,7 all induce conformational changes or oligomerization of these cell surface anoikis-initiating molecules. This triggers a series of events leading to activation of either the caspase-8-mediated extrinsic apoptotic signalling pathway or the mitochondrion-mediated intrinsic apoptotic signalling pathway.MUC1 is a large transmembrane mucin protein that is expressed exclusively on the apical side of normal epithelial and some other cell types. MUC1 consists of a large extracellular domain, a transmembrane region and a short cytoplasmic tail. The MUC1 extracellular domain contains a variable number of tandem repeats that are heavily glycosylated (up to 50% of the MUC1 molecular weight) with complex O-linked mucin-type glycans⁸ and flanked by a unique N-terminal domain and an SEA domain. In the SEA domain, autocleavage takes place resulting in a heterodimer but both moieties remain firmly attached. The cytoplasmic tail of MUC1 contains 72 amino acids and harbours several phosphorylation sites and is able to interact with various growth factor receptors and intracellular signalling proteins.^{9, 10, 11}MUC1 is overexpressed up to at least 10-fold in epithelial cancers¹² and overexpression of MUC1 is closely associated with high metastatic potential and poor prognosis in many cancer types.¹³ In epithelial cancer cells, MUC1 loses its apical membrane polarization and becomes expressed over the entire cell surface.^14,15 In epithelial cancer cells, MUC1 also shows reduced expression of complex O-glycans and increased expression of short oncofetal oligosaccharides such as GalNAc-α (Tn antigen), sialylated GalNAc-α (sialyl-Tn antigen) and Galβ1,3GalNAc-α (Thomsen–Friedenreich, TF antigen).¹⁶ Immunological targeting of cancer-associated MUC1 has been under intensive investigation as a strategy for cancer treatment.^17,18 Our recent studies have shown that interaction of TF antigen on cancer-associated MUC1 with the galactoside-binding galectins promotes metastasis by enhancing tumour cell heterotypic adhesion to the vascular endothelium and also by increasing tumour cell homotypic aggregation for the potential formation of tumour emboli.^19–21In this report, we describe a new role of MUC1 in anoikis. We show that overexpression of MUC1 in epithelial cells prevents initiation of anoikis in response to loss of cell adhesion, an effect that is found to be attributed substantially to the MUC1 extracellular domain.