BRONX, N.Y., July 11, 2013 /PRNewswire-USNewswire/ -- Researchers at Albert
Einstein College of Medicine of Yeshiva University have found that nerves play a
critical role in both the development and spread of prostate tumors. Their
findings, using both a mouse model and human prostate tissue, may lead to new
ways to predict the aggressiveness of prostate cancer and to novel therapies for
preventing and treating the disease. The study published online today in the
July 12 edition of Science.
Prostate cancer is second to skin cancer as the most common cancer in men. The
National Cancer Institute estimates that 238,590 new cases of prostate cancer
will be diagnosed in 2013, and 29,720 men will die from the disease.
The study was led by stem-cell expert Paul Frenette, M.D., professor of medicine
and of cell biology and director of the Ruth L. and David S. Gottesman Institute
for Stem Cell and Regenerative Medicine Research at Einstein. In earlier
research, Dr. Frenette and colleagues had discovered that the sympathetic
nervous system regulates hematopoeitic stem cell niches--the sites in the bone
marrow where red blood cells are formed.
Nerves are commonly found around tumors, but their role in the growth and
progression of cancer has not been clear. "Since there might be similarities
between the hematopoeitic stem cell niche and the stem cell niches found in
cancer, we thought that sympathetic nerves might also have a role in tumor
development," said Dr. Frenette. "It turns out that in prostate cancer, not only
are sympathetic nerves involved, but so too are parasympathetic nerves."
The body's autonomic nervous system (governing functions that we don't
consciously control, such as heart rate) is divided into two branches. The
sympathetic nervous system, or SNS, modulates the body's "fight or flight
response" by, for example, revving up the heart rate and constricting blood
vessels. The parasympathetic nervous system, or PNS, generally acts in
opposition to the SNS to keep bodily functions in balance.
The researchers discovered the role of nerves in prostate cancer by first
injecting human prostate cancer cells into mice and then systematically
disabling various parts of the SNS and PNS and observing how the cells fared. A
control group of mice were administered the cancer cells but underwent no
The study found that the autonomic nervous system's two branches have
complementary functions in the development and spread of prostate cancer. The
SNS helps initiate the early phases of the disease, while the PNS is involved in
the later stages when the cancer spreads.
More specifically, the researchers found that the SNS promotes tumor growth by
producing the neurotransmitter norepinephrine, which then binds to and
stimulates two types of adrenergic receptors (beta-2 and beta-3) on the surface
of the stromal cells in the tumor (adrenergic receptors are targeted by
adrenaline and noradrenaline, also known respectively as epinephrine and
norepinephrine). "This is consistent with recent epidemiological studies showing
that the use of beta-blockers, which lower blood pressure by blocking
beta-adrenergic receptors, is associated with improved survival of prostate
cancer patients," said Dr. Frenette.
As for the PNS's role in cancer progression, it makes tumor cells invade other
tissues and travel to distant parts of the body (tumor metastasis) when its
nerve fibers release acetylcholine, which activates a signaling pathway in
stromal cells of the tumor microenvironment. (Stromal cells make up connective
"Our findings raise the tantalizing possibility that drugs targeting both
branches of the autonomic nervous system may be useful therapies for prostate
cancer," Dr. Frenette added.
To see whether their findings were relevant to human cancer, the researchers
analyzed nerve fiber densities in prostate tissue specimens taken from 43
patients with prostate cancer who had not undergone any treatment.
Patients who turned out to have aggressive prostate cancers had a higher density
of nerve fibers within tumors and in normal prostate tissue surrounding their
tumors compared with patients who had less aggressive tumors. "More work needs
to be done, but the findings suggest that nerve density assessment merits
further study as a possible predictive marker of prostate cancer
aggressiveness," said Dr. Frenette.
Whether these findings apply to other forms of cancer is uncertain. "Clinical
studies show that breast cancer patients who took beta blockers did better than
those who were not taking beta blockers," said Dr. Frenette. "This suggests that
the same mechanisms are involved, but that remains to be seen."
The paper is titled "Autonomic Nerve Development Contributes to Prostate Cancer
Progression." Other Einstein authors are Claire Magnon, Ph.D. Juan Lin, Ph.D.,
and Xiaonan Xue, Ph.D. Additional contributors are Simon J. Hall, M.D., at Icahn
School of Medicine at Mount Sinai, New York, NY; Leah Gerber and Stephen J.
Freedland, M.D., both at Durham VA Medical Center and Duke University, Durham,
The study was supported by an Idea Development award from the Department of
Defense (W81XWH-07-1-0165) and grants from the National Institutes of Health.
Albert Einstein College of Medicine has a pending U.S. patent application
relating to the use of adrenergic and muscarinic receptors antagonists for
cancer therapy, which is currently available for licensing.
About Albert Einstein College of Medicine of Yeshiva University
Albert Einstein College of Medicine of Yeshiva University is one of the nation's
premier centers for research, medical education and clinical investigation.
During the 2012-2013 academic year, Einstein is home to 742 M.D. students, 245
Ph.D. students, 116 students in the combined M.D./Ph.D. program , and 360
postdoctoral research fellows. The College of Medicine has more than 2,000
full-time faculty members located on the main campus and at its clinical
affiliates. In 2012, Einstein received over $160 million in awards from the NIH.
This includes the funding of major research centers at Einstein in diabetes,
cancer, liver disease, and AIDS. Other areas where the College of Medicine is
concentrating its efforts include developmental brain research, neuroscience,
cardiac disease, and initiatives to reduce and eliminate ethnic and racial
health disparities. Its partnership with Montefiore Medical Center , the
University Hospital and academic medical center for Einstein, advances clinical
and translational research to accelerate the pace at which new discoveries
become the treatments and therapies that benefit patients. Through its extensive
affiliation network involving Montefiore, Jacobi Medical Center -Einstein's
founding hospital, and five other hospital systems in the Bronx, Manhattan, Long
Island and Brooklyn, Einstein runs one of the largest residency and fellowship
training programs in the medical and dental professions in the United States.
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SOURCE Albert Einstein College of Medicine