Abstract
Synthetic serine protease inhibitors, such as nafamostat mesilate, gabexate mesilate and ulinastatin inhibit various kinds of plasma proteinases and are widely used for treatment of pancreatitis, disseminated intravascular coagulation and as an anticoagulant for hemolysis. Several reports describe in preclinical cancer models that synthetic serine protease inhibitors induce apoptosis, prevent tumor invasion or metastasis, and sensitize chemotherapy by inhibiting NF-κB activity, proteinases such as urokinase-type plasminogen activator (u-PA) and matrix metalloproteinases (MMPs) and trypsin combined with protease-activated receptor-2 (PAR-2). Nafamostat mesilate, the first synthetic serine protease inhibitor that underwent clinical testing, has showed impressive anti-tumor effect and manageable toxicities in Phase I and II trials by combination chemotherapy of gemcitabine with nafamostat mesilate for unresectable pancreatic cancer. Synthetic serine protease inhibitors have minimal adverse effects and will have a potential to become a new therapeutic option for cancer patients. Below we discuss the rationale behind targeting the serine protease inhibitor for cancer therapy, and review the preclinical and clinical data.
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References
Hedstrom L (2002) Serine protease mechanism and specificity. Chem Rev 102:4501–4524
Silverman GA, Bird PI, Carrell RW, Church FC, Coughlin PB, Gettins PG, Irving JA, Lomas DA, Luke CJ, Moyer RW, Pemberton PA, Remold-O’Donnell E, Salvesen GS, Travis J, Whisstock JC (2001) The serpins are an expanding superfamily of structurally similar but functionally diverse proteins. Evolution, mechanism of inhibition, novel functions, and a revised nomenclature. J Biol Chem 276:33293–33296
DeClerck YA, Imren S (1994) Protease inhibitors: role and potential therapeutic use in human cancer. Eur J Cancer 30A:2170–2180
Fujii S, Hitomi Y (1981) New synthetic inhibitors of C1r, C1 esterase, thrombin, kallikrein and trypsin. Biochim Biophys Acta 661:342–345
Iwaki M, Ino Y, Motoyoshi A, Ozeki M, Sato T, Kurumi M, Aoyama T. (1986) Pharmacological studies of FUT-175, nafamostat mesilate. V. Effects on the pancreatic enzymes and experimental acute pancreatitis in rats. Jpn J Phamacol 41: 155–162
Takahashi H, Takizawa S, Tatewaki W, Nagai K, Wada K, Hanano M, Shibata A (1989) Nafamostat mesilate (FUT-175) in the treatment of patients with disseminated intravascular coagulations. Thomb Haemost 62:372
Ohtake Y, Hirasawa H, Sugai T, Oda S, Shiga H, Matsuda K, Kitamura N (1991) Nafamostat mesilate as anticoagulant in continuous hemofiltration and continuous hemodiafiltration. Contr Nephrol 93:215–217
Kitagawa H, Chang H, Fujita T (1995) Hyperkalemia Due to Nafamostat Mesylate. N Engl J Med 332:687
Ohno H, Kosaki G, Kambayashi J, Imaoka S, Hirata F (1980) FOY: [ethyl P-(6-guanidinohexanoyloxy) benzoate] methanesulfonate as a serine proteinase inhibitor. I. Inhibition of thrombin and factor Xa in vitro. Thromb Res 19:579–588
Chen HM, Chen JC, Hwang TL, Jan YY, Chen MF (2000) Prospective and randomized study of gabexate mesilate for the treatment of severe acute pancreatitis with organ dysfunction. Hepatogastroenterology 47:1147–1150
Inoue K, Takano H (2010) Urinary trypsin inhibitor as a therapeutic option for endotoxin-related inflammatory disorders. Expert Opin Investig Drugs 19:513–520
Amer BA, David B (1996) An essential role for NF-κB in preventing TNF-alpha-induced cell death. Science 274:782–784
Karin M, Lin A (2002) NF-κB at the crossroads of life and death. Nature Immunol 3:221–227
Matsumoto G, Namekawa J, Muta M, Nakamura T, Bando H, Tohyama K, Toi M, Umezawa K (2005) Targeting of nuclear factor κB pathways by Dehydroxymethyleoxyquinomicin, a novel inhibitor of breast carcinomas: antitumor and antiangiogenic potential in vivo. Clin Cancer Res 11:1287–1293
Huang S, Pettaway CA, Uehara H, Bucana CD, Fidler IJ (2001) Blockade of NF-κB activity in human prostate cancer cells is associated with suppression of angiogenesis, invasion, and metastasis. Oncogene 20:4188–4197
Uwagawa T, Li Z (2007) Chang Zhe, Xia Q, Peng B, Sclabas GM, Ishiyama S, Hung MC, Evans DB, Abbruzzese JL, Chiano PJ. Mechanisms of synthetic serine protease inhibitor (FUT-175)-mediated cell death. Cancer 109:2142–2153
Furukawa K, Iida T, Shiba H, Fujiwara Y, Uwagawa T, Shimada Y, Misawa T, Ohashi T, Yanaga K (2010) Anti-tumor effect by inhibition of NF-κB activation using nafamostat mesilate for pancreatic cancer in a mouse model. Oncol Rep 24:843–850
Fujiwara Y, Furukawa K, Haruki K, Shimada Y, Iida T, Shiba H, Uwagawa T, Ohashi T, Yanaga K (2011) Nafamostat mesilate can prevent adhesion, invasion and peritoneal dissemination of pancreatic cancer thorough nuclear factor kappa-B inhibition. J Hepatobiliary Pancreat Sci 18:731–739
Uwagawa T, Chiano PJ, Gocyo T, Hirohara S, Misawa T, Yanaga K (2009) Combination chemotherapy of nafamostat mesilate with gemcitabine for pancreatic cancer targeting NF-κB activation. Anticancer Res 29:3173–3178
Haruki K, Shiba H, Fujiwara Y, Furukawa K, Iwase R, Uwagawa T, Misawa T, Ohashi T, Yanaga K (2012) Inhibition of nuclear factor-κB enhances the antitumor effect of paclitaxel against gastric cancer with peritoneal dissemination in mice. Dig Dis Sci [Epub ahead of print]
Uwagawa T, Misawa T, Sakamoto T, Ito R, Gocho T, Shiba H, Wakiyama S, Hirohara S, Sadaoka S, Yanaga K (2009) A phase I study of full-dose gemcitabine and regional arterial infusion of nafamostat mesilate for advanced pancreatic cancer. Ann Oncol 20:239–243
Uwagawa T, Misawa T, Tsutsui N, Ito R, Gocho T, Hirohara S, Sadaoka S, Yanaga K (2011) Phase II study of gemcitabine in combination with regional arterial infusion of nafamostat mesilate for advanced pancreatic cancer. Am J Clin Oncol [Epub ahead of print]
Furukawa K, Ohashi T, Haruki K, Fujiwara Y, Iida T, Shiba H, Uwagawa T, Kobayashi H, Yanaga K (2011) Combination treatment using adenovirus vector-mediated tumor necrosis factor-alpha gene transfer and a NF-κB inhibitor for pancreatic cancer in mice. Cancer Lett 306:92–98
Takahashi H, Funahashi H, Sawai H, Matsuo Y, Yamamoto M, Okada Y, Takeyama H, Manabe T (2007) Synthetic serine protease inhibitor, gabexate mesilate, prevents nuclear factor-kappaB activation and increases TNF-alpha-mediated apoptosis in human pancreatic cancer cells. Dig Dis Sci 52:2646–2652
Wang H, Sun X, Gao F, Zhong B, Zhang YH, Sun Z (2012) Effect of ulinastatin on growth inhibition, apoptosis of breast carcinoma cells is related to a decrease in signal conduction of JNk-2 and NF-κB. J Exp Clin Cancer Res 31:2
Liotta LA, Stetler-Stevenson WG (1991) Tumor invasion and metastasis: an imbalance of positive and negative regulation. Cancer Res 15:5054s–5059s
Naito K, Kanbayashi N, Nakajima S, Murai T, Arakawa K, Nishimura S, Okuyama A (1994) Inhibition of growth of human tumor cells in nude mice by a metalloproteinase inhibitor. Int J Cancer 58:730–735
Reich R, Thompson EW, Iwamoto Y, Martin GR, Deason JR, Fuller GC, Miskin R (1988) Effects of inhibitors of plasminogen activator, serine proteinases, and collagenase IV on the invasion of basement membranes by metastatic cells. Cancer Res 48:3307–3312
Nguyen M, Arkell J, Jackson CJ (1999) Thrombin rapidly and efficiently activates gelatinase A in human microvascular endothelial cells via a mechanism independent of active MT1 matrix metalloproteinase. Lab Invest 79:467–475
Ramos-DeSimone N, Hahn-Dantona E, Sipley J, Nagase H, French DL, Quigley JP (1999) Activation of matrix metalloproteinase-9 (MMP-9) via a converging plasmin/stromelysin-1 cascade enhances tumor cell invasion. J Biol Chem 274:13066–13076
Uchima Y, Sawada T, Nishihara T, Maeda K, Ohira M, Hirakawa K (2004) Inhibition and mechanism of a protease inhibitor in human pancreatic cancer cells. Pancreas 29:123–131
Yoon WH, Jung YJ, Kim TD, Li G, Park BJ, Kim JY, Lee YC, Kim JM, Park JI, Park HD, No ZS, Lim K, Hwang SD, Kim YS (2004) Gabexate mesilate inhibits colon cancer growth, invasion, and metastasis by reducing matrix matalloproteinases and angiogenesis. Clin Cancer Res 10:4517–4526
Koivunen E, Saksela O, Itkonen O, Osman S, Huhtala ML, Stenman UH (1991) Human colon carcinoma, fibrosarcoma and leukemia cell lines produce tumor-associated trypsinogen. Int J Cancer 47:592–596
Nystedt S, Emilsson K, Larsson AK, Strömbeck B, Sundelin J (1995) Molecular cloning and functional expression of the gene encoding the human proteinase-activated receptor 2. Eur J Biochem 232:84–89
Darmoul D, Gratio V, Devaud H, Laburthe M (2004) Protease-activated receptor 2 in colon cancer: trypsin-induced MAPK phosphorylation and cell proliferation are mediated by epidermal growth factor receptor transactivation. J Biol Chem 279:20927–22094
Miyata S, Koshikawa N, Yasumitsu H, Miyazaki K (2000) Trypsin stimulates integrin alpha(5)beta(1)-dependent adhesion to fibronectin and proliferation of human gastric carcinoma cells through activation of proteinase-activated receptor-2. J Biol Chem 275:4592–4598
Ohta T, Shimizu K, Yi S, Takamura H, Amaya K, Kitagawa H, Kayahara M, Ninomiya I, Fushida S, Fujimura T, Nishimura G, Miwa K (2003) Protease-activated receptor-2 expression and the role of trypsin in cell proliferation in human pancreatic cancers. Int J Oncol 23:61–66
Nakanuma S, Tajima H, Okamoto K, Hayashi H, Nakagawara H, Onishi I, Takamura H, Kitagawa H, Fushida S, Tani T, Fujimura T, Kayahara M, Ohta T, Wakayama T, Iseki S, Harada S (2010) Tumor-derived trypsin enhances proliferation of intrahepatic cholangiocarcinoma cells by activating protease-activated receptor-2. Int J Oncol 36:793–800
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Furukawa, K., Uwagawa, T., Yanaga, K. (2013). Anti-Tumor Effect of Synthetic Serine Protease Inhibitor. In: Fang, E., Ng, T. (eds) Antitumor Potential and other Emerging Medicinal Properties of Natural Compounds. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6214-5_13
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DOI: https://doi.org/10.1007/978-94-007-6214-5_13
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