Cross-Talk Between P21-Activated Kinase 4 And Er Alpha Signaling Triggers Endometrial Cancer Cell Proliferation

Cross-talk between estrogen receptor alpha (ER alpha) and signal transduction pathways plays an important role in the progression of endometrial cancer (EC). Here, we show that 17 beta-estradiol (E-2) stimulation increases p21-activated kinase 4 (Pak4) expression and activation in ER-positive EC cells. The estrogen-induced Pak4 activation is mediated via the PI3K/AKT pathway. Estrogen increases Pak4 and phosphorylated-Pak4 (p-Pak4) nuclear accumulation, and Pak4 in turn enhances ER alpha trans-activation. Depletion or functional inhibition of Pak4 abrogates EC cell proliferation induced by E-2, whereas overexpression of Pak4 rescues cell proliferation decreased by inhibiting the estrogen pathway. Pak4 knockdown decreases cyclin D1 expression and induces G1-S arrest. Importantly, Pak4 suppression inhibits E-2 induced EC tumor growth in vivo, in a mouse xenograft model. These data demonstrate that estrogen stimulation increases Pak4 expression and activation, which in turn enhances ER alpha transcriptional activity and ER alpha-dependent gene expression, resulting in increased proliferation of EC cells. Thus inhibition of Pak4-ER alpha signaling may represent a novel therapeutic strategy against endometrial carcinoma.