title: Dual role of macrophage migration inhibitory factor (MIF) in human breast cancer.
abstract: BACKGROUND
  Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine and mediator of acute and chronic inflammatory diseases. MIF is overexpressed in various tumours and has been suggested as a molecular link between chronic inflammation and cancer. MIF overexpression is observed in breast cancer but its causal role in the development of this tumour entity is unclear.
  
  
  METHODS
  MIF levels in breast cancer cell lines were determined by ELISA and Western blot. CD74 was measured by Western blot, fluorescence microscopy and flow cytometry. Cell proliferation was studied by BrdU incorporation, cell adhesion by Matrigel adhesion assay, and cell invasion by migration assay through Matrigel-coated filters using the Transwell system. MIF expression in primary human breast cancers was measured by tissue microarray and a semi-quantitative immunoreactivity score (IRS) and comparison with histopathological parameters and patient outcome data.
  
  
  RESULTS
  MIF was abundantly expressed in the non-invasive breast cancer cell lines MDA-MB-468 and ZR-75-1, but not in invasive MDA-MB-231 cells, which in turn expressed higher levels of the MIF-receptor CD74. Stimulation with exogenous MIF led to a dramatic upregulation of MIF secretion (50-fold) in MDA-MB-231 cells. Autocrine MIF promoted tumour cell proliferation, as indicated by blockade of MIF or CD74 in MDA-MB-231 and MDA-MB-468, and MDA-MB-231 invasiveness was enhanced by exogenous MIF. We correlated the expression of MIF with histopathological parameters and patient outcome data, using a tissue microarray of 175 primary invasive breast cancers and 35 normal control tissues. MIF was upregulated in breast cancer versus normal tissue (median IRS = 8 versus 6). MIF expression showed positive correlations with progesterone (p = 0.006) and estrogen (p = 0.028) receptor expression, markers of a favourable prognosis and a negative correlation to tumour size (p = 0.007). In line with these data, disease-specific overall (OS) as well as recurrence-free (RFS) survival was significantly improved in breast cancer patients with abundant cytosolic MIF expression compared to MIF low expressers (5-year OS = 67% versus 50%, p = 0.0019; 5-year RFS = 52% versus 36%, p = 0.0327).
  
  
  CONCLUSIONS
  We conclude that intracellular expression of MIF in breast cancer cells is beneficial, whereas extracellular MIF may play a pro-oncogenic role in promoting breast cancer cell-stroma interactions.
authors: Department of Biochemistry and Molecular Cell Biology, RWTH Aachen University Hospital, Aachen, Germany. eva.verjans@rwth-aachen.de
authors: Eva
authors: E
authors: Verjans
authors: Erik
authors: E
authors: Noetzel
authors: Nuran
authors: N
authors: Bektas
authors: Anke K
authors: AK
authors: Schütz
authors: Hongqi
authors: H
authors: Lue
authors: Birgitt
authors: B
authors: Lennartz
authors: Arndt
authors: A
authors: Hartmann
authors: Edgar
authors: E
authors: Dahl
authors: Jürgen
authors: J
authors: Bernhagen
mesh_terms: D000944:Antigens, Differentiation, B-Lymphocyte / Q000096:biosynthesis; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism*; D002448:Cell Adhesion; D045744:Cell Line, Tumor; D049109:Cell Proliferation; D003094:Collagen / Q000737:chemistry; D004338:Drug Combinations; D004797:Enzyme-Linked Immunosorbent Assay; D015972:Gene Expression Regulation, Neoplastic; D000949:Histocompatibility Antigens Class II / Q000096:biosynthesis; D006801:Humans; D007797:Laminin / Q000737:chemistry; D008263:Macrophage Migration-Inhibitory Factors / Q000378:metabolism / Q000502:physiology*; D008856:Microscopy, Fluorescence / Q000379:methods; D009361:Neoplasm Invasiveness; D011509:Proteoglycans / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D000944:Antigens, Differentiation, B-Lymphocyte; D014408:Biomarkers, Tumor; D004338:Drug Combinations; D000949:Histocompatibility Antigens Class II; D007797:Laminin; D008263:Macrophage Migration-Inhibitory Factors; D011509:Proteoglycans; C045084:invariant chain; C059485:matrigel; D003094:Collagen