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Kallikreins as Biomarkers in Human Malignancies

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Biomarkers in Cancer

Abstract

The human tissue kallikrein and kallikrein-related peptidases are secreted serine proteases, which are expressed in a broad spectrum of tissues, fulfilling a plethora of physiological functions. During the past few years, the KLK family members have drawn a constantly increasing attention regarding their biomarker capabilities. The frequently observed deregulated KLK expression patterns in human malignancies, along with their active involvement in cancer pathobiology and the successful utilization of PSA/KLK3 in routine clinical practice, prompted researchers to evaluate the clinical significance of KLKs. KLK members have been proposed as tissue and/or serological biomarkers for early diagnosis, effective prognosis, and treatment monitoring of cancer patients. This chapter presents an overview of the current knowledge concerning the immense potential of KLKs as biomarkers in human malignancies.

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Abbreviations

%fPSA:

Ratio of fPSA to Total PSA

AD:

Alzheimer’s Disease

ALL:

Acute Lymphoblastic Leukemia

BC:

Breast Cancer

BPH:

Benign Prostate Hyperplasia

CA125:

Cancer Antigen 125

CaP:

Prostate Cancer

CAP18:

Cationic Antimicrobial Protein 18

CC:

Cervical Cancer

CNS:

Central Nervous System

CRC:

Colorectal Cancer

DFS:

Disease-Free Survival

ECM:

Extracellular Matrix

EMT:

Epithelial-to-Mesenchymal Transition

ER:

Estrogen Receptor

fPSA:

Free PSA

GC:

Gastric Cancer

IGFBPs:

Insulin-like Growth Factor-Binding Proteins

IGFs:

Insulin-like Growth Factors

IHC:

Immunohistochemistry

KLKs:

Kallikreins

LEKTI:

Lymphoepithelial Kazal-Type-Related Inhibitor

MMPs:

Matrix Metalloproteinases

MS:

Multiple Sclerosis

NAF:

Nipple Aspirate Fluid

NS:

Netherton Syndrome

NSCLC:

Non-small Cell Lung Cancer

OC:

Ovarian Cancer

OS:

Overall Survival

PARs:

Proteinase-Activated Receptors

PCR:

Polymerase Chain Reaction

PD:

Parkinson’s Disease

PR:

Progesterone Receptor

PSA/KLK3:

Prostate-Specific Antigen

RCC:

Renal Cell Carcinoma

REG4:

Regenerating Islet-Derived Family, Member 4

SNPs:

Single-Nucleotide Polymorphisms

SPINK5:

Serine Peptidase Inhibitor Kazal-Type 5

TC:

Testicular Cancer

tPSA:

Total PSA

uPA-uPAR:

Urokinase-Type Plasminogen Activator and Its Receptor

UPSC:

Uterine Papillary Serous Carcinoma

UTR:

Untranslated Region

VTCN1:

V-Set Domain-Containing T-Cell Activation Inhibitor 1

References

  • Alexopoulou DK, Papadopoulos IN, Scorilas A. Clinical significance of kallikrein-related peptidase (KLK10) mRNA expression in colorectal cancer. Clin Biochem. 2013;46:1453–61.

    Article  CAS  PubMed  Google Scholar 

  • Ashby EL, Kehoe PG, Love S. Kallikrein-related peptidase 6 in Alzheimer’s disease and vascular dementia. Brain Res. 2010;1363:1–10.

    Article  CAS  PubMed  Google Scholar 

  • Avgeris M, Mavridis K, Scorilas A. Kallikrein-related peptidase genes as promising biomarkers for prognosis and monitoring of human malignancies. Biol Chem. 2010;391:505–11.

    Article  CAS  PubMed  Google Scholar 

  • Avgeris M, Papachristopoulou G, Polychronis A, Scorilas A. Down-regulation of kallikrein-related peptidase 5 (KLK5) expression in breast cancer patients: a biomarker for the differential diagnosis of breast lesions. Clin Proteomics. 2011;8:5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Avgeris M, Mavridis K, Scorilas A. Kallikrein-related peptidases in prostate, breast, and ovarian cancers: from pathobiology to clinical relevance. Biol Chem. 2012;393:301–17.

    Article  CAS  PubMed  Google Scholar 

  • Batra J, O’Mara T, Patnala R, Lose F, Clements JA. Genetic polymorphisms in the human tissue kallikrein (KLK) locus and their implication in various malignant and non-malignant diseases. Biol Chem. 2013;393:1365–90.

    Google Scholar 

  • Bayani J, Diamandis EP. The physiology and pathobiology of human kallikrein-related peptidase 6 (KLK6). Clin Chem Lab Med. 2011;50:211–33.

    PubMed  Google Scholar 

  • Blaber M, Yoon H, Juliano MA, Scarisbrick IA, Blaber SI. Functional intersection of the kallikrein-related peptidases (KLKs) and thrombostasis axis. Biol Chem. 2010;391:311–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Black MH, Diamandis EP. The diagnostic and prognostic utility of prostate-specific antigen for diseases of the breast. Breast Cancer Res Treat. 2000;59:1–14.

    Article  CAS  PubMed  Google Scholar 

  • Black MH, Giai M, Ponzone R, Sismondi P, Yu H, Diamandis EP. Serum total and free prostate-specific antigen for breast cancer diagnosis in women. Clin Cancer Res. 2000;6:467–73.

    CAS  PubMed  Google Scholar 

  • Borgono CA, Diamandis EP. The emerging roles of human tissue kallikreins in cancer. Nat Rev Cancer. 2004;4:876–90.

    Article  CAS  PubMed  Google Scholar 

  • Borgono CA, Michael IP, Diamandis EP. Human tissue kallikreins: physiologic roles and applications in cancer. Mol Cancer Res. 2004;2:257–80.

    CAS  PubMed  Google Scholar 

  • Carlsson S, Maschino A, Schroder F, et al. Predictive value of four kallikrein markers for pathologically insignificant compared with aggressive prostate cancer in radical prostatectomy specimens: results from the European Randomized Study of Screening for Prostate Cancer section Rotterdam. Eur Urol. 2013;64:693–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chow TF, Crow M, Earle T, El-Said H, Diamandis EP, Yousef GM. Kallikreins as microRNA targets: an in silico and experimental-based analysis. Biol Chem. 2008;389:731–8.

    Article  CAS  PubMed  Google Scholar 

  • Deperthes D, KĂĽndig C. Kallikrein-related peptidases as pharmaceutical targets. In: Magdolen V, Sommerhoff CP, Fritz H, Schmitt M, editors. Kallikrein-related peptidases: characterization, regulation, and interactions within the protease web, vol. 1. Berlin/Boston: De Gruyter; 2012. p. 161–86.

    Google Scholar 

  • Diamandis EP, Scorilas A, Fracchioli S, et al. Human kallikrein 6 (hK6): a new potential serum biomarker for diagnosis and prognosis of ovarian carcinoma. J Clin Oncol. 2003;21:1035–43.

    Article  CAS  PubMed  Google Scholar 

  • Diamandis EP, Scorilas A, Kishi T, et al. Altered kallikrein 7 and 10 concentrations in cerebrospinal fluid of patients with Alzheimer’s disease and frontotemporal dementia. Clin Biochem. 2004;37:230–7.

    Article  CAS  PubMed  Google Scholar 

  • Dong Y, Kaushal A, Brattsand M, Nicklin J, Clements JA. Differential splicing of KLK5 and KLK7 in epithelial ovarian cancer produces novel variants with potential as cancer biomarkers. Clin Cancer Res. 2003;9:1710–20.

    CAS  PubMed  Google Scholar 

  • Dorn J, Harbeck N, Kates R, et al. Impact of expression differences of kallikrein-related peptidases and of uPA and PAI-1 between primary tumor and omentum metastasis in advanced ovarian cancer. Ann Oncol. 2011a;22:877–83.

    Article  CAS  PubMed  Google Scholar 

  • Dorn J, Magdolen V, Gkazepis A, et al. Circulating biomarker tissue kallikrein-related peptidase KLK5 impacts ovarian cancer patients’ survival. Ann Oncol. 2011b;22:1783–90.

    Article  CAS  PubMed  Google Scholar 

  • Dorn J, Milou V, Kulasingam V, Schmalfeldt B, Diamandis EP, Schmitt M. Clinical relevance of kallikrein-related peptidases in ovarian cancer. In: Magdolen V, Sommerhoff CP, Fritz H, Schmitt M, editors. Kallikrein-related peptidases: novel cancer-related biomarkers, vol. 2. Berlin/Boston: De Gruyter; 2012. p. 145–66.

    Google Scholar 

  • Dorn J, Bayani J, Yousef GM, et al. Clinical utility of kallikrein-related peptidases (KLK) in urogenital malignancies. Thromb Haemost. 2013;110:408–22.

    Article  CAS  PubMed  Google Scholar 

  • Eissa A, Cretu D, Soosaipillai A, et al. Serum kallikrein-8 correlates with skin activity, but not psoriatic arthritis, in patients with psoriatic disease. Clin Chem Lab Med. 2013;51:317–25.

    Article  CAS  PubMed  Google Scholar 

  • Emami N, Diamandis EP. New insights into the functional mechanisms and clinical applications of the kallikrein-related peptidase family. Mol Oncol. 2007;1:269–87.

    Article  PubMed  Google Scholar 

  • Emami N, Diamandis EP. Utility of kallikrein-related peptidases (KLKs) as cancer biomarkers. Clin Chem. 2008;54:1600–7.

    Article  CAS  PubMed  Google Scholar 

  • Florou D, Mavridis K, Scorilas A. The kallikrein-related peptidase 13 (KLK13) gene is substantially up-regulated after exposure of gastric cancer cells to antineoplastic agents. Tumour Biol. 2012;33:2069–78.

    Article  CAS  PubMed  Google Scholar 

  • Gabril M, White NM, Moussa M, et al. Immunohistochemical analysis of kallikrein-related peptidases in the normal kidney and renal tumors: potential clinical implications. Biol Chem. 2010;391:403–9.

    Article  CAS  PubMed  Google Scholar 

  • Goettig P, Magdolen V, Brandstetter H. Natural and synthetic inhibitors of kallikrein-related peptidases (KLKs). Biochimie. 2010;92:1546–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • HeuzĂ©-Vourc’H N, Courty Y. Pathophysiology of kallikrein-related peptidases in lung cancer. In: Magdolen V, Sommerhoff CP, Fritz H, Schmitt M, editors. Kallikrein-related peptidases: novel cancer-related biomarkers, vol. 2. Berlin/Boston: De Gruyter; 2012. p. 3–26.

    Google Scholar 

  • Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  • Kioulafa M, Kaklamanis L, Stathopoulos E, Mavroudis D, Georgoulias V, Lianidou ES. Kallikrein 10 (KLK10) methylation as a novel prognostic biomarker in early breast cancer. Ann Oncol. 2009;20:1020–5.

    Article  CAS  PubMed  Google Scholar 

  • Kontos CK, Scorilas A. Kallikrein-related peptidases (KLKs): a gene family of novel cancer biomarkers. Clin Chem Lab Med. 2012;50:1877–91.

    Article  CAS  PubMed  Google Scholar 

  • Kontos CK, Chantzis D, Papadopoulos IN, Scorilas A. Kallikrein-related peptidase 4 (KLK4) mRNA predicts short-term relapse in colorectal adenocarcinoma patients. Cancer Lett. 2012;330:106–12.

    Article  PubMed  Google Scholar 

  • Kontos CK, Mavridis K, Talieri M, Scorilas A. Kallikrein-related peptidases (KLKs) in gastrointestinal cancer: mechanistic and clinical aspects. Thromb Haemost. 2013;110:450–7.

    Article  CAS  PubMed  Google Scholar 

  • Kryza T, Achard C, Parent C, et al. Angiogenesis stimulated by human kallikrein-related peptidase 12 acting via a platelet-derived growth factor B-dependent paracrine pathway. FASEB J. 2013;28:740–51.

    Article  PubMed  Google Scholar 

  • Kuzmanov U, Jiang N, Smith CR, Soosaipillai A, Diamandis EP. Differential N-glycosylation of kallikrein 6 derived from ovarian cancer cells or the central nervous system. Mol Cell Proteomics. 2009;8:791–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lawrence MG, Lai J, Clements JA. Kallikreins on steroids: structure, function, and hormonal regulation of prostate-specific antigen and the extended kallikrein locus. Endocr Rev. 2010;31:407–46.

    Article  CAS  PubMed  Google Scholar 

  • Lilja H, Ulmert D, Vickers AJ. Prostate-specific antigen and prostate cancer: prediction, detection and monitoring. Nat Rev Cancer. 2008;8:268–78.

    Article  CAS  PubMed  Google Scholar 

  • Luo LY, Diamandis EP, Look MP, Soosaipillai AP, Foekens JA. Higher expression of human kallikrein 10 in breast cancer tissue predicts tamoxifen resistance. Br J Cancer. 2002;86:1790–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Magklara A, Scorilas A, Stephan C, et al. Decreased concentrations of prostate-specific antigen and human glandular kallikrein 2 in malignant versus nonmalignant prostatic tissue. Urology. 2000;56:527–32.

    Article  CAS  PubMed  Google Scholar 

  • Mavridis K, Scorilas A. Prognostic value and biological role of the kallikrein-related peptidases in human malignancies. Future Oncol. 2010;6:269–85.

    Article  CAS  PubMed  Google Scholar 

  • Mavridis K, Schmitt M, Scorilas A. Kallikrein-related peptidases as biomarkers in personalized cancer medicine. In: Magdolen V, Sommerhoff CP, Fritz H, Schmitt M, editors. Kallikrein-related peptidases: novel cancer-related biomarkers, vol. 2. Berlin/Boston: De Gruyter; 2012. p. 201–18.

    Google Scholar 

  • Mavridis K, Stravodimos K, Scorilas A. Quantified KLK15 gene expression levels discriminate prostate cancer from benign tumors and constitute a novel independent predictor of disease progression. Prostate. 2013;73:1191–201.

    Article  CAS  PubMed  Google Scholar 

  • Mavridis K, Avgeris M, Scorilas A. Targeting kallikrein-related peptidases in prostate cancer. Expert Opin Ther Targets. 2014;18:365–83.

    Article  CAS  PubMed  Google Scholar 

  • Nakamura T, Scorilas A, Stephan C, Jung K, Soosaipillai AR, Diamandis EP. The usefulness of serum human kallikrein 11 for discriminating between prostate cancer and benign prostatic hyperplasia. Cancer Res. 2003;63:6543–6.

    CAS  PubMed  Google Scholar 

  • Obiezu CV, Diamandis EP. Human tissue kallikrein gene family: applications in cancer. Cancer Lett. 2005;224:1–22.

    Article  CAS  PubMed  Google Scholar 

  • Ogawa K, Utsunomiya T, Mimori K, et al. Clinical significance of human kallikrein gene 6 messenger RNA expression in colorectal cancer. Clin Cancer Res. 2005;11:2889–93.

    Article  CAS  PubMed  Google Scholar 

  • Oikonomopoulou K, Hansen KK, Baruch A, Hollenberg MD, Diamandis EP. Immunofluorometric activity-based probe analysis of active KLK6 in biological fluids. Biol Chem. 2008a;389:747–56.

    Article  CAS  PubMed  Google Scholar 

  • Oikonomopoulou K, Li L, Zheng Y, et al. Prediction of ovarian cancer prognosis and response to chemotherapy by a serum-based multiparametric biomarker panel. Br J Cancer. 2008b;99:1103–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Oikonomopoulou K, Diamandis EP, Hollenberg MD. Kallikrein-related peptidases: proteolysis and signaling in cancer, the new frontier. Biol Chem. 2010;391:299–310.

    CAS  PubMed  Google Scholar 

  • Paliouras M, Diamandis EP. The kallikrein world: an update on the human tissue kallikreins. Biol Chem. 2006;387:643–52.

    Article  CAS  PubMed  Google Scholar 

  • Paliouras M, Borgono C, Diamandis EP. Human tissue kallikreins: the cancer biomarker family. Cancer Lett. 2007;249:61–79.

    Article  CAS  PubMed  Google Scholar 

  • Pampalakis G, Sotiropoulou G. Tissue kallikrein proteolytic cascade pathways in normal physiology and cancer. Biochim Biophys Acta. 2007;1776:22–31.

    CAS  PubMed  Google Scholar 

  • Pasic MD, Olkhov E, Bapat B, Yousef GM. Epigenetic regulation of kallikrein-related peptidases: there is a whole new world out there. Biol Chem. 2012;393:319–30.

    Article  CAS  PubMed  Google Scholar 

  • Petraki CD, Gregorakis AK, Vaslamatzis MM, et al. Prognostic implications of the immunohistochemical expression of human kallikreins 5, 6, 10 and 11 in renal cell carcinoma. Tumour Biol. 2006;27:1–7.

    Article  CAS  PubMed  Google Scholar 

  • Planque C, Li L, Zheng Y, et al. A multiparametric serum kallikrein panel for diagnosis of non-small cell lung carcinoma. Clin Cancer Res. 2008;14:1355–62.

    Article  CAS  PubMed  Google Scholar 

  • Prezas P, Scorilas A, Yfanti C, et al. The role of human tissue kallikreins 7 and 8 in intracranial malignancies. Biol Chem. 2006;387:1607–12.

    CAS  PubMed  Google Scholar 

  • Rabien A, Fritzsche F, Jung M, et al. High expression of KLK14 in prostatic adenocarcinoma is associated with elevated risk of prostate-specific antigen relapse. Tumour Biol. 2008;29:1–8.

    Article  CAS  PubMed  Google Scholar 

  • Roman-Gomez J, Jimenez-Velasco A, Agirre X, et al. The normal epithelial cell-specific 1 (NES1) gene, a candidate tumor suppressor gene on chromosome 19q13.3-4, is downregulated by hypermethylation in acute lymphoblastic leukemia. Leukemia. 2004;18:362–5.

    Article  CAS  PubMed  Google Scholar 

  • Romero Otero J, Garcia Gomez B, Campos Juanatey F, Touijer KA. Prostate cancer biomarkers: an update. Urol Oncol. 2014;32:252–60.

    Article  CAS  PubMed  Google Scholar 

  • Rosen DG, Wang L, Atkinson JN, et al. Potential markers that complement expression of CA125 in epithelial ovarian cancer. Gynecol Oncol. 2005;99:267–77.

    Article  CAS  PubMed  Google Scholar 

  • Sauter ER, Klein G, Wagner-Mann C, Diamandis EP. Prostate-specific antigen expression in nipple aspirate fluid is associated with advanced breast cancer. Cancer Detect Prev. 2004;28:27–31.

    Article  PubMed  Google Scholar 

  • Scarisbrick IA, Linbo R, Vandell AG, et al. Kallikreins are associated with secondary progressive multiple sclerosis and promote neurodegeneration. Biol Chem. 2008;389:739–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schmitt M, Magdolen V, Yang F, et al. Emerging clinical importance of the cancer biomarkers kallikrein-related peptidases (KLK) in female and male reproductive organ malignancies. Radiol Oncol. 2013;47:319–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shariat SF, Semjonow A, Lilja H, Savage C, Vickers AJ, Bjartell A. Tumor markers in prostate cancer I: blood-based markers. Acta Oncol. 2011;50 Suppl 1:61–75.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shaw JL, Diamandis EP. Distribution of 15 human kallikreins in tissues and biological fluids. Clin Chem. 2007;53:1423–32.

    Article  CAS  PubMed  Google Scholar 

  • Shih Ie M, Salani R, Fiegl M, et al. Ovarian cancer specific kallikrein profile in effusions. Gynecol Oncol. 2007;105:501–7.

    Article  PubMed  Google Scholar 

  • Sotiropoulou G, Pampalakis G. Targeting the kallikrein-related peptidases for drug development. Trends Pharmacol Sci. 2012;33:623–34.

    Article  CAS  PubMed  Google Scholar 

  • Sotiropoulou G, Pampalakis G, Diamandis EP. Functional roles of human kallikrein-related peptidases. J Biol Chem. 2009;284:32989–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Stenman UH, Abrahamsson PA, Aus G, et al. Prognostic value of serum markers for prostate cancer. Scand J Urol Nephrol Suppl. 2005;216:64–81.

    Google Scholar 

  • Stephan C, Jung K, Lein M, Diamandis EP. PSA and other tissue kallikreins for prostate cancer detection. Eur J Cancer. 2007;43:1918–26.

    Article  CAS  PubMed  Google Scholar 

  • Sun D, Lee YS, Malhotra A, et al. miR-99 family of MicroRNAs suppresses the expression of prostate-specific antigen and prostate cancer cell proliferation. Cancer Res. 2011;71:1313–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Talieri M, Zoma M, Devetzi M, Scorilas A, Ardavanis A. Kallikrein-related peptidase 6 (KLK6)gene expression in intracranial tumors. Tumour Biol. 2012;33:1375–83.

    Article  CAS  PubMed  Google Scholar 

  • Ulmert D, O’Brien MF, Bjartell AS, Lilja H. Prostate kallikrein markers in diagnosis, risk stratification and prognosis. Nat Rev Urol. 2009;6:384–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Unal D, Tasdemir A, Oguz A, et al. Is human kallikrein-11 in gastric cancer treated with surgery and adjuvant chemoradiotherapy associated with survival? Pathol Res Pract. 2013;209:779–83.

    Article  CAS  PubMed  Google Scholar 

  • White NM, Mathews M, Yousef GM, Prizada A, Popadiuk C, Dore JJ. KLK6 and KLK13 predict tumor recurrence in epithelial ovarian carcinoma. Br J Cancer. 2009;101:1107–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • White NM, Bui A, Mejia-Guerrero S, et al. Dysregulation of kallikrein-related peptidases in renal cell carcinoma: potential targets of miRNAs. Biol Chem. 2010;391:411–23.

    Article  CAS  PubMed  Google Scholar 

  • White NM, Youssef YM, Fendler A, Stephan C, Jung K, Yousef GM. The miRNA-kallikrein axis of interaction: a new dimension in the pathogenesis of prostate cancer. Biol Chem. 2012;393:379–89.

    Article  CAS  PubMed  Google Scholar 

  • Yousef GM. microRNAs: a new frontier in kallikrein research. Biol Chem. 2008;389:689–94.

    Article  CAS  PubMed  Google Scholar 

  • Yousef GM, Chang A, Scorilas A, Diamandis EP. Genomic organization of the human kallikrein gene family on chromosome 19q13.3-q13.4. Biochem Biophys Res Commun. 2000;276:125–33.

    Article  CAS  PubMed  Google Scholar 

  • Yousef GM, Obiezu CV, Luo LY, et al. Human tissue kallikreins: from gene structure to function and clinical applications. Adv Clin Chem. 2005;39:11–79.

    Article  PubMed  Google Scholar 

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Michaelidou, K., Kladi-Skandali, A., Scorilas, A. (2015). Kallikreins as Biomarkers in Human Malignancies. In: Preedy, V., Patel, V. (eds) Biomarkers in Cancer. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7681-4_18

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