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HIV-protease inhibitors impair angiogenesis and tumor progression by targeting MMP-9 in a transgenic mouse model of spontaneous cervical carcinogenesis

Journal article published in 2011 by S. Capano, F. Maione ORCID, C. Meda, P. Monini, B. Ensoli ORCID, F. Bussolino, E. Giraudo
This paper was not found in any repository; the policy of its publisher is unknown or unclear.
This paper was not found in any repository; the policy of its publisher is unknown or unclear.

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Abstract

Cervical cancer is one of the most common malignancy worldwide. Recent studies have shown that HIV-protease inhibitors (HIV-PIs), widely used in highly antiretroviral therapy, led to a reduced incidence and regression of HIV-associated tumors in infected patients. Evidences indicate that this antitumor effect is not only the result of drug-mediated HIV suppression and immune reconstitution, but also of direct anti-angiogenic and anti-tumor actions. Herein we sought to evaluate whether HIV-PIs could impair events leading to cervical cancer employing a mouse model of spontaneous cervical cancer, K14-HPV/E2. We performed a prevention-intervention trial aimed to prevent or regress tumor progression and angiogenesis by treating mice with Indinavir, Saquinavir and Ritonavir. HIV-PIs indirectly inhibited tumor growth and incidence by exerting an antiangiogenic effect and, consequently, by inducing tumor apoptosis. We further performed a regression trial, starting treatments when the mice had invasive tumors, to evaluate if HIV-PIs were able to regress or stabilize tumor progression. Interestingly HIV-PIs dramatically reduced tumor burden and invasiveness by increasing collagen-IV expression compared to controls. Remarkably, in both treatments, HIV-PIs completely inhibited matrix metalloprotease (MMP)-9 activity in tumors compared to controls. Since MMP-9 is involved in the mobilization of VEGF-A from the matrix, we evaluated the formation of VEGF-A-VEGR-2 complex in tumor vessels. Of note HIV-PIs strongly reduced the amount of VEGF bound to its receptor VEGFR2, in parallel to a dramatic reduction in MMP-9 activity, suggesting that HIV-PIs, by targeting MMP-9, impair the VEGF-A pathway and therefore inhibit tumor angiogenesis. We conclude that HIV-PIs have anti-angiogenic and anti-tumor effects on cervical carcinogenesis unrelated to their antiviral activity and that these drugs could represent new antiangiogenic targets that can be easily transferred to the clinic.