Hyperprolactinemia-inducing antipsychotics increase breast cancer risk by activating JAK-STAT5 in precancerous lesions.

Background: Psychiatric medications are widely prescribed in the USA. Many antipsychotics cause serum hyperprolactinemia as an adverse side effect; prolactin-Janus kinase 2 (JAK2)-signal transducer and activator of transcription 5 (STAT5) signaling both induces cell differentiation and suppresses ap...

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Publicado en:Breast Cancer Research Vol. 20; no. 1
Autores principales: Johnston, A. N., Bu, W., Hein, S., Garcia, S., Camacho, L., Xue, L., Qin, L., Nagi, C., Hilsenbeck, S. G., Kapali, J., Podsypanina, K., Nangia, J., Li, Y.
Formato: research Journal Article
Publicado: BioMed Central 5/19/2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 5/19/2018
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      pub: BioMed Central
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        atl: Hyperprolactinemia-inducing antipsychotics increase breast cancer risk by activating JAK-STAT5 in precancerous lesions.
      aug:
        au:
          Johnston, A. N.
          Bu, W.
          Hein, S.
          Garcia, S.
          Camacho, L.
          Xue, L.
          Qin, L.
          Nagi, C.
          Hilsenbeck, S. G.
          Kapali, J.
          Podsypanina, K.
          Nangia, J.
          Li, Y.
        affil: Translational Biology and Molecular Medicine, Baylor College of Medicine 77030 Houston TX USA
      sug:
        subj:
          Precancerous Conditions
          Breast Neoplasms
          Carrier Proteins
          Proteins
          Female
          Breast Pathology
          Heterocyclic Compounds Adverse Effects
          Risperidone Adverse Effects
          Signal Transduction Drug Effects
          Hyperpituitarism Chemically Induced
          Breast Neoplasms Epidemiology
          Mice
          Human
          Breast Neoplasms Pathology
          Breast Neoplasms Chemically Induced
          Apoptosis Drug Effects
          Risk Factors
          Antipsychotic Agents Adverse Effects
          Precancerous Conditions Chemically Induced
          Hyperpituitarism Epidemiology
          Precancerous Conditions Pathology
          Hyperpituitarism Pathology
          Breast Drug Effects
          Hyperpituitarism
          Animal Studies
          Cell Differentiation Drug Effects
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Impact of Events Scale
          Scales
          Female
      ab: Background: Psychiatric medications are widely prescribed in the USA. Many antipsychotics cause serum hyperprolactinemia as an adverse side effect; prolactin-Janus kinase 2 (JAK2)-signal transducer and activator of transcription 5 (STAT5) signaling both induces cell differentiation and suppresses apoptosis. It is controversial whether these antipsychotics increase breast cancer risk.Methods: We investigated the impact of several antipsychotics on mammary tumorigenesis initiated by retrovirus-mediated delivery of either ErbB2 or HRas or by transgenic expression of Wnt-1.Results: We found that the two hyperprolactinemia-inducing antipsychotics, risperidone and pimozide, prompted precancerous lesions to progress to cancer while aripiprazole, which did not cause hyperprolactinemia, did not. We observed that risperidone and pimozide (but not aripiprazole) caused precancerous cells to activate STAT5 and suppress apoptosis while exerting no impact on proliferation. Importantly, we demonstrated that these effects of antipsychotics on early lesions required the STAT5 gene function. Furthermore, we showed that only two-week treatment of mice with ruxolitinib, a JAK1/2 inhibitor, blocked STAT5 activation, restored apoptosis, and prevented early lesion progression.Conclusions: Hyperprolactinemia-inducing antipsychotics instigate precancerous cells to progress to cancer via JAK/STAT5 to suppress the apoptosis anticancer barrier, and these cancer-promoting effects can be prevented by prophylactic anti-JAK/STAT5 treatment. This preclinical work exposes a potential breast cancer risk from hyperprolactinemia-inducing antipsychotics in certain patients and suggests a chemoprevention regime that is relatively easy to implement compared to the standard 5-year anti-estrogenic treatment in women who have or likely have already developed precancerous lesions while also requiring hyperprolactinemia-inducing antipsychotics.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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