LOX expression is regulated by
hypoxia-inducible factors (HIFs), and, hence, LOX expression is often upregulated in
hypoxic breast and head and neck tumors. Patients with high LOX-expressing tumors have poor overall survival. In fact, recent research has shown overexpression of LOX as crucial to promoting tumor growth and metastasis in several cancers, including breast cancer, non-small cell lung cancer, and colorectal cancer. LOX expression was also detected in megakaryocytes, or bone marrow cells responsible for the production of platelets. Data derived from a mouse model of myelofibrosis implicated LOX in bone marrow fibrosis. In a rodent model of breast cancer, a small-molecule or antibody inhibitors of LOX abolished metastasis. LOX secreted by hypoxic breast tumor cells crosslinks
collagen in the
basement membrane and is essential for
CD11b+ myeloid cell recruitment. CD11b+ cells in turn adhere to crosslinked collagen and produce
matrix metalloproteinase-2, which cleaves collagen, enhancing the invasion of metastasizing tumor cells. In contrast, LOX inhibition prevents CD11b+ cell recruitment and metastatic growth. In cells lacking TGF-β receptors, a deficiency that is characteristic of
lung cancer, lysyl oxidase is found in high concentrations. LOX immunostaining has revealed that high LOX expression is associated with high extent of carcinoma invasion in samples obtained from surgically removed lung
adenocarcinomas. Additionally, LOX expression is an indicator of 5-year survival in patients, with a 71% chance of survival for patients with low LOX levels, compared to 43% for patients with high LOX levels. Thus, upregulation of lysyl oxidase is a predictor of poor prognosis in early-stage adenocarcinoma patients. Lysyl oxidase has been newly implicated in tumor
angiogenesis, or
blood vessel formation, both
in vivo and
in vitro. Subcutaneous tumor-derived LOX was shown to increase
vascular endothelial growth factor (VEGF) expression and secretion, which then promotes angiogenesis by phosphorylation of
protein kinase B, or Akt, through platelet-derived growth factor receptor β (
PDGFRB). High levels of LOX were associated with high blood vessel density in patient samples. Clinically relevant LOX inhibitors may help slow cancer progression by downregulating crucial growth factors that promote solid tumor progression. Hence, inhibitors of the LOX enzyme may be useful in preventing angiogenesis, tumor progression, and metastasis as well as treating other fibrotic disease involving remodeling of the
extracellular matrix, including neurodegenerative and cardiovascular diseases. == See also ==