Encyclopedia of Signaling Molecules

2018 Edition
| Editors: Sangdun Choi


Reference work entry
DOI: https://doi.org/10.1007/978-3-319-67199-4_101998


Historical Background

The human survivin gene was first cloned and described by Ambrosini et al. in 1997 as a unique and smallest member of inhibitor of apoptosis protein family (IAP) (Ambrosini et al. 1997). IAPs are diverse group of signaling molecules with wide range of physiological role, from the inhibition of apoptosis to cell cycle progression. IAPs have nine family members: X-linked IAP, cIAP1, cIAP2, neuronal apoptosis inhibitor protein, melanoma IAP, IAP-like protein 2, livin, apollon, and survivin. The first IAP was isolated as a baculovirus gene product and identified by the presence of baculovirus IAP repeat (BIR). All the members of IAP family are generally characterized by presence of one or more copies of BIR at N-terminus and ring finger domain at their carboxyl terminus except survivin which contains a single BIR domain but no ring finger motif as it is replaced by an alpha helix coil. The BIR domain is supposed to be important for antiapoptotic function, whereas the coiled domain probably interacts with tubulin structures in mammals (Jaiswal et al. 2015).

Structure and Transcription

The gene encoding survivin is of 14.5 kb, located at the telomeric region of the chromosome 17q25. It consists of four exons and three introns. As this is the smallest member of IAP gene family, it contains an N terminal domain, i.e., single baculovirus IAP repeat (BIR), a 70-amino acid zinc finger fold and extended C-terminus (α-helical coiled coil). In humans, at least five alternative spice variants of survivin have been identified. The pre-mRNA of survivin has four exons and an extra exon-2B, whereas the mature wild-type (WT) survivin transcript is composed of four exons which translate into a protein of 142 amino acids. The variation in exon/intron arrangement during splicing leads to different splice variants like survivin-2B, survivin-3B, survivin-deltaEx3, survivin-2α and survivin-3α. Survivin-2B is generated by introduction of 69 bp nucleotide fragment from intron-2 with creation of additional and alternative exon named 2B between exon-2 and exon-3, whereas survivin-3B is generated by incorporating 165 bp nucleotide fragment from intron-3, creating an alternative exon named 3B. Another variant survivin deltaEx3 is generated by alternative splicing with loss of exon-3 and as well as frameshift with extension of reading frame to open reading frame of 3′ untranslated region. Survivin-2α is generated by introducing a 197 bp tail from intron-2 of which only two of the nucleotides are coding since this contains an early stop codon. Likewise, survivin-3α is generated by introducing a 209 bp terminus from intron-2 (Fig. 1). The survivin gene promoter consists of canonical CpG islands and many (about seven) Sp1 sites but lacks TATA box. Its proximal promoter spans about 269 bp, containing transcriptional repressor element CDE (cell cycle-dependent element) and CHR (cell cycle gene homology region), which are responsible for the increase of its activity during G2/M phase of cell cycle (Garg et al. 2016).
Survivin, Fig. 1

Structure of survivin along with its splice variants

Expression and Regulation of Its Transcription

Survivin in Normal Cells

Survivin is strongly expressed in fetal tissue, whereas its expression in normal adult tissue is developmentally regulated and reported to be minimal in most terminally differentiated tissues. Its physiologic expression in normal cells/tissues is limited to T cells (peripheral blood adult T cell, thymocytes, memory T cells), CD34+ cells (cord blood, adult bone marrow cells), neutrophils, megakaryocytes, arterial muscle, gastrointestinal tract mucosa, keratinocyte, melanocyte, brain, cervical mucosa, ovary, testis, breast, and placenta (Fukuda and Pelus 2006).

Distribution of survivin and its splicing variant in subcellular compartments is also elucidated. Wild-type survivin and survivin-2B predominantly localize in cytoplasm. Whereas, survivin-2α, almost equally between the cytoplasm and nucleus, but survivin-ΔEx3 localizes in both the mitochondria and nucleus. However, in mitotic cells, survivin-ΔEx3 appeared to translocate and colocalize with the mitotic spindle (Li et al. 2005).

In Vascular Endothelial Cells

Expression of survivin in normal endothelial cells is regulated by the angiogenic cytokines, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), angiopoietin 1, and hypoxia/reoxygenation through a cascade of phosphatidylinositol 3-kinase/Akt pathway. Experimental studies in human umbilical vascular endothelial cells (HUVEC) suggested the role of angiopoietin 1 and interleukin-11 in survivin-mediated inhibition of apoptosis via forkhead-related transcription factor pathway and signal transducer and activator of transcription-3 pathway, respectively.

In Hematopoiesis and Blood Cells

Differential expression of survivin is noticed during erythroid versus megakaryocyte development as survivin is noticed to be expressed in maturing erythroid cells, whereas it’s no to little expression in murine megakaryocytes like myeloid progenitor cells suggesting that survivin expression is required in megakaryocytes and erythroid progenitor cells and that survivin plays a significant role in erythropoiesis. Interestingly, survivin downregulation is an essential component of megakaryocyte maturation and thus may play a role in platelet formation. Consistent high level of survivin expression in CD34+ hematopoietic stem and progenitor cells, as compared with lineage-committed CD34 cells or blood mononuclear cells, indicates its downregulation with maturation of differentiation of hematopoietic cells.

Likewise, expression of survivin diminishes in mature blood neutrophils as compared with its immature counterpart. But in vitro and in vivo upregulation of survivin in mature neutrophils could be achieved through stimulation with neutrophil growth and survival factors (granulocyte colony-stimulating factor or granulocyte macrophage colony-stimulating factor) and inflammatory conditions, respectively.

Expression of survivin in splenic T cells and human adult peripheral blood T lymphocytes can be induced by interleukin-2 plus anti-CD3, concanavalin A (7), or phytohemagglutinin. But for effector T cell proliferation, induction of survivin by co-stimulatory signal of OX40 is required during late G1 phase.

In Adult Stem Cells

The putative role of survivin in embryological development and maintenance of adult stem cells is supported by cumulative evidences of its expression in these CD34+ totipotent cells. Hematopoietic growth factors, i.e., thrombopoietin, stem cell factor, and Flt3 ligand, stimulate proliferation, cell cycle progression, and survival of CD34+ cells by upregulation of survivin expression through downstream of mitogen-activated protein kinase p42/p44 and phosphatidylinositol 3-kinase. In addition, survivin-mediated inhibition of apoptosis of hematopoietic progenitor cells via a p21-dependent mechanism suggests a functional link between survivin and p21 in regulating hematopoietic cell division.

In Other Adult Tissues

Survivin expression in adult tissues like liver, neurons, is upregulated by ischemia/ hypoxia. Furthermore, the Fas agonistic antibody Jo2 induces survivin expression in liver indicating its potential role in hepatocyte proliferation and apoptosis. Significant apoptosis in the cerebrum, cerebellum, brainstem, spinal cord, and retina during in vivo survivin deletion in neuronal precursor cells suggests its antiapoptotic function in neuronal development. In reproductive system, stem cell factor and human chorionic gonadotropin seem to induce survivin expression in testes and in ovarian granulosa cells suggesting that survivin may have a regulatory role in spermatogenesis and oogenesis (Fukuda and Pelus 2006; Zhang et al. 2006) (Fig. 2).
Survivin, Fig. 2

Regulators of survivin expression. A wide range of molecules and pathways are involved in positive and negative regulators affecting survivin expression in both physiological and pathological conditions

Survivin in Tumor Cells

Survivin is predominantly present in the cytosol of tumor cells with minimal nuclear expression mainly restricted to kinetochores of metaphase chromosomes. Cytosolic survivin is believed to function as apoptotic suppressor, while nuclear survivin is postulated to regulate cell division. Mitochondrial survivin has been also detected and also shown to be released to cytosol in response to cellular stress and stimuli. Additionally, extracellular pool of survivin has also been shown to exist as exosomes (40–100 nm membrane vesicles) secreted from tumor cells and taken up by surrounding cells. The exosomal survivin is believed to have the ability to empower the tumor cells by proliferation and invasive potential and resistance to the therapy and finally act as a negative predictor of prognosis (Garg et al. 2016).

Survivin and Embryonic Development

Till now, various experimental studies suggested that survivin shows a strict regulated expression during embryonic development and play an important biphasic role in the control of embryonic cell mitosis/cytokinesis and apoptosis. During mitosis, function of survivin mainly focuses at metaphase and anaphase and localizes to two main subcellular pools. One pool of survivin is directly associated with centrosomes, microtubules of the metaphase and anaphase spindle, suggesting its regulatory role in microtubule dynamics. The second pool of survivin restricted to the kinetochores of metaphase chromosomes which is associated with regulators of cytokinesis, i.e., subunits of the chromosomal passenger complex (CPC), such as Aurora B kinase, INCENP, and Borealin/Dasra. This supports a vital role of survivin in proper chromosome segregation and cytokinesis. Recently another putative role of survivin as a central regulator of spindle formation is proposed, which explains its contribution in proper targeting of CPC to kinetochores and, in addition, stabilization of the microtubules, thus contributing to bipolar spindle formation. In mouse embryos, survivin showed a strong expression in several apoptosis-regulated fetal tissues with a pattern independent of Bcl-2, suggesting its pivotal role in organogenesis (Chen et al. 2016; Li 2003). Even in mouse preimplantation embryos, expression of survivin and its splice variants are observed in several stages of embryogenesis from unfertilized oocyte to blastocyst stage. Disrupted microtubules leading to formation of polypoid and survival failure in Null embryos furthermore support the unique role of survivin in mitosis. On the other hand, few experimental studies which also revealed the survivin knockout in early mouse embryo show induction of apoptosis in addition to disrupted mitosis mainly in neuronal cells of the central nervous system (Altieri 2003; Mita et al. 2008).

Though various postulations have been laid down, the role of survivin in inhibition of apoptosis is controversial. Initially, selective binding and degradation of activated caspases, i.e., 3 ,7, 9 by survivin, have been suggested. This model was challenged by observations like survivin lacks structural motifs necessary for caspase binding. Later on, few researchers suggested inhibition of caspase-9 by survivin through its binding with hepatitis B X-interaction protein (HBXIP) to procaspase-9. Furthermore, antiapoptotic role of survivin could be explained by its association with X-linked IAP via their conserved BIR domain, thus increasing X-linked IAP stability and leading to the synergistic inhibition of caspase-9 activation. Finally, another mechanism of inhibition of intrinsic pathway of apoptosis by survivin gained some attention as it explains direct binding of survivin to proapoptotic protein (secondary mitochondria-derived activator of caspase, SMAC/DIABLO), an activator of caspase-9 (Chen et al. 2016; Li 2003).

Survivin in Tumor Biology

Besides its restricted expression in embryonic tissue, few terminally differentiated cells and stem cells, observations for altered regulation of survivin in various human cancers, i.e., colon, esophagus, pancreas, liver, uterus, and lungs, are mounting up. Various mechanisms have been explored in the context of supposed role of survivin in tumorigenesis, i.e., inhibition of apoptosis pathways, regulation of cytokinesis and cell cycle progression, role in cell survival, and participation in a variety of well-established proliferation pathways such as the Wnt, hypoxia, TGF, and Notch signaling pathways (Fig. 3):
  1. (i).

    Inhibition of apoptosis has been widely reported in a number of cancers such as breast, liver, and lung cancers. Overexpression of survivin is associated with inhibition of cell death initiated via the extrinsic or intrinsic apoptotic pathways. Interestingly, contradiction on the interaction between survivin and caspases has been reported. Few studies indicate direct inhibition of caspase-3, 7, and 9 by survivin, whereas others support indirect mechanisms like inhibition cytochrome c- and caspase-8-induced DEVD (Asp-Glu-Val-Asp) cleavage activity, thus resulting in decreased activity.

  2. (ii).

    The cell cycle-specific regulation of survivin has been highlighted in many experimental and clinical researches. Multiple roles of survivin are suggested such as survivin-mediated mitosis after phosphorylation by CDK1 (cyclin-dependent kinase-1) and acceleration of S-phase through survivin-CDK4 interaction mainly in hepatoma cells.

  3. (iii).
    Survivin can influence the cell survival by affecting both the apoptosis and cell cycle progression through interaction with a master molecule, i.e., p53. A variety of studies have suggested the functional association of these molecules in the view of following observations like:
    1. 1.

      Presence of two putative p53 binding sites within the survivin promoter.

    2. 2.

      Consistent and aberrant expression of survivin and disruption of wild-type p53 in association with tumorigenesis.

    3. 3.

      Antagonism in function like wild-type p53, but not mutated p53, can repress survivin transcriptional level, and that survivin loss of function partially mediates the p53-dependent apoptotic pathway.

    4. 4.

      Chromatin deacetylation of the survivin promoter suggests that modification of chromatin may contribute to survivin expression silencing by p53. In addition, survivin regulates p53 expression as it modifies p53 degradation through the caspase-3/mouse double minute two homologue (MDM2) complex, mainly in lung and breast cancer.

  4. (iv).

    Increased evidences of regulation of angiogenesis in tumor cells by upregulation of vascular endothelial cell growth factor (VEGF) denote about the survivin-mediated tumor progression. Though the exact mechanism is not much explored, induction of VEGF by PI3K/Akt enhanced β-catenin-Tcf/Lef-dependent transcription has been largely suggested.

  5. (v).
    Survivin-mediated cell proliferation pathways: In multiple cancers like breast, colorectal, lung, and prostate cancers and melanoma, the role of survivin-mediated Wnt/β catenin signaling pathway has been highlighted in tumorigenesis as Wnt signaling induces nuclear translocation of β-catenin to form β-catenin/T cell factor (TCF) transcriptional activator. This complex upregulates survivin transcription. Similarly, in hypoxia, hypoxia-inducible factor-1 transcription factor can regulate the survivin expression by direct binding to its promoter. It has been also observed that Notch-1 signaling activation is associated with elevated HIF-1α, which functions as a coactivator by interacting with activated form of Notch-1 (N1ICD, Notch-1 intracellular domain), following the association of RBP-Jκ (recombination signal binding protein for immunoglobulin kappa J region) to the survivin promoter, finally leading to the transcriptional activation of survivin. Likewise, STAT3 also plays a vital role in survivin-mediated tumor cell proliferation by its influence on survivin transcription. Additionally, structural similarity between these molecules imparts effect on inhibition of STAT3 transactivation following lysine acetylation of survivin (Chen et al. 2016; Garg 2016).
    Survivin, Fig. 3

    Putative role of survivin in tumorigenesis through three prominent mechanisms, i.e., inhibition of apoptosis, facilitation of angiogenesis, and induction of cell proliferation


Currently, there is no impactful evidence suggesting an association of survivin splicing variant with tumorigenesis. Few clinical research studies indicated the altered expression of survivin-ΔEx3, survivin-2B, and survivin in gastric cancer, irrespective of clinicopathological parameters like their histological type, grade, or stage. Interestingly, observations like the level of survivin-ΔEx3 is shown to be inversely correlated with apoptotic index and structural resemblance of survivin-ΔEx3 to novel antiapoptotic protein encoded by open reading frame K7 of Kaposi’s sarcoma-associated herpesvirus are suggestive of its putative antiapoptotic role. It is also reported that survivin-2B expression was prominent in benign rather than the malignant benign tumors, whereas survivin-ΔEx3 expression was increased in comparison with survivin-2B expression in leukemia patients. In addition, the unlikely subcellular localization of survivin-ΔEx3 (in nucleus) and survivin-2B (in cytoplasm) also suggests their potential contrast roles in tumor progression and/or tumorigenesis (Li 2005; Li et al. 2005).


Since its discovery, various in vitro and in vivo studies suggested the diverse role of survivin in physiological and pathological conditions as an antiapoptotic molecule, regulator of mitosis/cytokinesis, and angiogenesis promoter. Furthermore, mounting evidences like involvement of survivin in multiple proliferation signaling pathways and clinical correlation with tumor progression, therapeutic resistance, and poor prognosis open the opportunity for development of suitable individualized therapeutic strategies like immunotherapy Ad gene therapy targeting survivin with more efficiency and specificity for tumor cells, but minimal cytotoxicity against healthy cells.


  1. Altieri DC. Survivin, versatile modulation of cell division and apoptosis in cancer. Oncogene. 2003;22:8581–9. doi:10.1038/sj.onc.1207113.PubMedCrossRefGoogle Scholar
  2. Ambrosini G, Adida C, Altieri DC. A novel anti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med. 1997;3(8):917–21.PubMedCrossRefGoogle Scholar
  3. Chen X, Duan N, Zhang C, Zhang W. Survivin and tumorigenesis: molecular mechanisms and therapeutic strategies. J Cancer. 2016;7(3):314–23. doi:10.7150/jca.13332.PubMedPubMedCentralCrossRefGoogle Scholar
  4. Fukuda S, Pelus LM. Survivin, a cancer target with an emerging role in normal adult tissue. Mol Cancer Ther. 2006;5(5):1087–98.PubMedCrossRefGoogle Scholar
  5. Garg H, Suri P, Gupta JC, Talwar GP, Dubey S. Survivin: a unique target for tumor therapy. Cancer Cell Int. 2016;16:49. doi:10.1186/s12935-016-0326-1.PubMedPubMedCentralCrossRefGoogle Scholar
  6. Jaiswal PK, Goel A, Mittal RD. Survivin: a molecular biomarker in cancer. Indian J Med Res. 2015 Apr;141(4):389–97. doi:10.4103/0971-5916.159250.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Li F. Survivin study: what is the next wave? J Cell Physiol. 2003;197(1):8–29.PubMedCrossRefGoogle Scholar
  8. Li F. Role of survivin and its splice variants in tumorigenesis. Br J Cancer. 2005;92(2):212–6.PubMedCrossRefGoogle Scholar
  9. Li F, Yang J, Ramnath N, Javle MM, Tan D. Nuclear or cytoplasmic expression of survivin: what is the significance? Int J Cancer J Int du Cancer. 2005;114(4):509–12. doi:10.1002/ijc.20768.CrossRefGoogle Scholar
  10. Mita AC, Mita MM, Nawrocki ST, Giles FJ. Survivin: key regulator of mitosis and apoptosis and novel target for cancer therapeutics. Mol Pathways Clin Cancer Res. 2008;14(16):5000–5. doi:10.1158/1078-0432.CCR-08-0746.CrossRefGoogle Scholar
  11. Zhang M, Yang J, Li F. Transcriptional and posttranscriptional controls of survivin in cancer cells: Essential interfaces for developing novel approaches for cancer treatment. J Exp Clin Cancer Res: CR. 2006;25(3):391.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.MGM Dental College and HospitalNavi MumbaiIndia
  2. 2.Indian Association of Oral and Maxillofacial PathologistsAndheriIndia
  3. 3.Maharashtra State Dental CouncilMumbai, MaharashtraIndia