ABSTRACT
Understanding the cell-of-origin of ovarian high grade serous cancer (HGSC) is the prerequisite for efficient prevention and early diagnosis of this most lethal gynecological cancer. Recently, a mesenchymal type of ovarian HGSC with the poorest prognosis among ovarian cancers was identified by both TCGA and AOCS studies. The cell-of-origin of this subtype of ovarian cancer is unknown. While pursuing studies to understand the role of the Hippo pathway in ovarian granulosa cell physiology and pathology, we unexpectedly found that the Yes-associated protein 1 (YAP1), the major effector of the Hippo signaling pathway, induced dedifferentiation and reprogramming of the ovarian granulosa cells, a unique type of ovarian follicular cells with mesenchymal lineage and high plasticity, leading to the development of high grade ovarian cancer with serous features. Our research results unveil a potential cell-of-origin for a subtype of HGSC with mesenchymal features.
ABSTRACT
Although the role of the Hippo signaling pathway in development and tumorigenesis has been extensively studied in multiple organs, its role in ovarian follicle development remains largely unknown. Here, we report that Yes-Associated Protein 1 (YAP1), the major effector of Hippo signaling, is spatiotemporally expressed in ovarian granulosa cells and plays a critical role in the regulation of follicle development. We found that the active form of YAP1 (nuclear YAP1) was predominantly expressed in proliferative granulosa cells, whereas the inactive form of YAP1 (cytoplasmic YAP1) was mainly detected in luteal cells (terminally differentiated granulosa cells). Pharmacological inhibition of YAP1 activity disrupted mouse ovarian follicle development in vitro and in vivo. Foxl2 promoter-driven knockout of Yap1 in ovarian granulosa cells resulted in increased apoptosis of granulosa cells, decreased number of corpora lutea, reduced ovarian size, and subfertility in transgenic mice. However, Cyp19a1 promoter-driven knockout of Yap1 in differentiated granulosa cells of preovulatory follicles and luteal cells of corpora lutea had no effect on ovarian morphology and fertility. Mechanistic studies demonstrated that YAP1 interacted with epidermal growth factor receptor and TGF-ß signaling pathways to regulate granulosa cell proliferation, differentiation, and survival. Results from this study identify YAP1 as a critical regulator of granulosa cell proliferation and differentiation. Balanced expression and activation of YAP1 is essential for follicle development and successful reproduction. YAP1 is a promising target for treatment of subfertility associated with abnormal granulosa cell function.-Lv, X., He, C., Huang, C., Wang, H., Hua, G., Wang, Z., Zhou, J., Chen, X., Ma, B., Timm, B. K., Maclin, V., Dong, J., Rueda, B. R., Davis, J. S., Wang, C. Timely expression and activation of YAP1 in granulosa cells is essential for ovarian follicle development.
Subject(s)
Adaptor Proteins, Signal Transducing/physiology , Cell Cycle Proteins/physiology , Granulosa Cells/metabolism , Ovarian Follicle/growth & development , Adaptor Proteins, Signal Transducing/antagonists & inhibitors , Adaptor Proteins, Signal Transducing/deficiency , Adaptor Proteins, Signal Transducing/genetics , Adult , Animals , Aromatase/genetics , Cell Cycle Proteins/antagonists & inhibitors , Cell Cycle Proteins/deficiency , Cell Cycle Proteins/genetics , Cell Differentiation , Cell Division , Cell Line , Cell Nucleus/metabolism , Cytoplasm/metabolism , ErbB Receptors/metabolism , Female , Forkhead Box Protein L2/genetics , Gene Knockout Techniques , Genes, Synthetic , Granulosa Cells/cytology , Hippo Signaling Pathway , Humans , Mice , Mice, Inbred C57BL , Organ Culture Techniques , Ovarian Follicle/cytology , Ovarian Follicle/metabolism , Promoter Regions, Genetic , Protein Serine-Threonine Kinases/physiology , Protein Transport , Recombinant Proteins/metabolism , Signal Transduction/genetics , Transforming Growth Factor beta/physiology , Verteporfin/pharmacology , YAP-Signaling ProteinsABSTRACT
BACKGROUND: Ovarian hyperstimulation syndrome is a known complication of ovarian stimulation, particularly with injectable gonadotropins. Spontaneous ovarian hyperstimulation is rare and often involves a conformational change in the follicle-stimulating hormone receptor, increasing its binding with human chorionic gonadotropin or thyroid-stimulating hormone. Few data are available regarding the management or outcomes of spontaneous ovarian hyperstimulation syndrome. CASE: A 23-year-old white female without history of infertility treatment presented with ovarian hyperstimulation syndrome in two pregnancies. The patient was treated by paracentesis catheter placement and albumin replacement. She had regression of symptoms between 11 weeks and 12 weeks of gestation in both pregnancies and delivered healthy term infants. CONCLUSION: The case presented involves a patient with spontaneous severe ovarian hyperstimulation syndrome in two successive pregnancies. The patient was managed aggressively with paracentesis and albumin replacement resulting in two successful pregnancies.
