The cytosolic Ca
2+ is a crucial second messenger involved in controlling diverse cellular functions, such as proliferation, differentiation, survival, migration, and gene expressions
[65][66][67]. The increase in the cytosolic Ca
2+ levels is mainly contributed by the Ca
2+ fluxes from the extracellular space or the internal Ca
2+ storage. Store-operated Ca
2+ entry (SOCE), which constitutes the release of Ca
2+ from the ER and the influx of Ca
2+ through the plasmalemmal store-operated Ca
2+ (SOC) channel, is the primary pathway to increase the cytosolic Ca
2+ levels in non-excitable cells
[68][69]. The molecular determinants underlying the activation of SOCE comprise two families of proteins, the ER Ca
2+sensors, stromal interaction molecule 1 (STIM1) and STIM2, and the pore-forming proteins of the SOC channel, Orai1 to Orai3
[68][70][71]. STIM proteins are the ER-resident transmembrane protein with several functional domains and protein-protein interaction motifs essential for SOCE activation (see reviews in
[72][73]). Once ER Ca
2+ is depleted, STIM proteins aggregate into oligomers that translocate toward the plasma membrane junctions to interact with and activate Orai proteins, allowing the Ca
2+ entry. STIM molecules were identified as the microtubule-interacting protein via the direction with the microtubule-plus-end-tracking proteins EB1 and EB3
[74][75]. Several studies have demonstrated the essential roles of microtubules and microtubule-plus-end-tracking mechanisms in the translocation of STIM1 toward the ER-plasma membrane junctions and the following SOCE activation
[76][77][78]. With the use of the direct stochastic optical reconstruction microscopy (dSTORM), the recent study provided the ultrastructural view into the activation, aggregation, and translocation of STIM1, as well as the interaction between STIM1, microtubules, and EBs during the dynamic process of SOCE of cervical cancer cells
[79]. Upon ER Ca
2+ depletion, the activated STIM1 interacted with EB1 regardless of undergoing aggregation. Moreover, EB1 silencing did not impair aggregation, but the trafficking of STIM1 to the ER-plasma membrane; and EB3 compensates for the crosstalk between STIM1 and microtubule after EB1-silencing. Results from dSTORM imaging provided novel insights into STIM1 trafficking that is independent of the aggregated state and revealed the role of the microtubule network, end-binding protein EB1, and EB3 in SOCE
[79].
The details of structural insights, molecular characterization, physiological functions, pathological defects of STIM and Orai proteins, as well as their dynamic protein-protein interactions that mediated the mediate the activation of SOCE, have been extensively investigated and comprehensively reviewed
[80][81][82][83][84][85][86][87][88][89][90]. Increasing evidence demonstrating the essential roles of STIM and Orai proteins have made them potential prognostic biomarkers or antitumor therapeutic targets
[91][92][93][94][95][96][97]. Here researchers updated the recent advances on the importance of STIM/Orai-dependent SOCE in cervical epithelial carcinogenesis and tumor malignant behaviors and the emerging development of SOCE mechanisms as the selective therapeutic target in cervical cancer.
2.2. Diagnostic and Prognostic Values of SOCE in Cervical Carcinogenesis
Aberrated overexpression of STIM1 or Orai1 and thus upregulated SOCE activity have been observed in several types of human cancers, including cervical cancers. STIM1 and Orai1 are overexpressed in tumor tissues when compared with non-cancerous or precancerous tissues in patients with cervical cancers
[76][77][98][99]. The distinct distribution of overexpressed STIM1 was identified in the invasive tumor front of the surgical specimens of human cervical cancer
[107]. The studies in human cervical cancer indicated that poorer clinical outcomes, such as larger tumor size and elevated lymph node metastasis, are correlated with STIM1 upregulation in primary tumors
[98], highlighting the clinical significance of STIM1 in cervical cancer progression.
Regarding STIM2, the recent study on a limited number of surgical specimens of cervical cancer showed a decreased tumoral STIM2 expression when compared with non-cancerous epithelium, whereas a higher tumoral STIM2 level when compared with invasive tumor front
[76]. The simultaneous STIM1 and STIM2 immunostaining showed that, despite the overexpression of both isoforms in tumor tissues, STIM1 is the principle ER Ca
2+-sensing molecule detected in the invasive tumor front
[76]. These imply that STIM1 is associated with tumor growth and invasion, whereas STIM2 is mainly correlated with tumor growth. Therefore, using the STIM1/STIM2 ratio as a marker of cervical cancer aggressiveness might be promising and worth further evaluation.
2.3. Recent Development of Therapeutics Targeting SOCE in Cervical Carcinogenesis
Given the importance of SOCE tumor biology and cancer progression, it is plausible to suggest that the blockade of STIM1/Orai1-dependent Ca
2+ signaling can be a practical therapeutic approach for cervical cancer. Studies on preclinical animal models have demonstrated the potentials of several small-molecule SOCE inhibitors in cancer therapies
[108][109][110][111][112]. However, these SOCE inhibitors have not been approved for clinical use for cancer therapies. For example, SKF-96365 and 2-aminoethoxydiphenyl borate (2-APB), two of the potent pharmacological blockers of SOCE, prevented the tumor growth and angiogenesis in human cervical cancer-implanted SCID mice
[98]. Further evidence from the overexpression or silencing of STIM1 and Orai1 supported that in vivo anti-tumor effects of SKF-96365 or 2-APB involve the blockade of STIM1/Orai1 complex
[77][98].
Due to the ubiquitous expression of STIM and Orai protein, as well as their essential roles in the human immune system, including antitumor immunity, developing cancer cell-specific SOCE modulators is essential for effective antitumor therapeutics. For example, a study in the model of human cervical cancer has suggested that the different regulatory effects on the microtubule-dependent STIM1 trafficking between non-cancerous epithelial and cancerous cells could be the key to target cancer cell-specific mechanisms of SOCE activation
[77]. Reversible acetylation of α-tubulin on Lys40 is important for regulating microtubule stability and function and thus modulating cell motility
[113][114][115]. The histone deacetylase 6 (HDAC6) is a unique cytosol-localized HDAC member known as a prominent α-tubulin deacetylase
[116][117]. It was found that the microtubule-dependent STIM1 translocation and subsequent SOCE activation of cervical cancer cells, but not in non-cancerous epithelial cells, was abrogated upon hyperacetylation of α-tubulin by pharmacological blockade or silencing of HDAC6
[77]. Thus, the microtubule-associated HDAC6 can be a cancer-specific target of malignant phenotypes mediated by STIM1-dependent SOCE, at least for cervical cancers with upregulation of HDAC6 and STIM1.
A recent investigation demonstrated the important role of the lysosomal cysteine protease cathepsin S in regulating STIM1 trafficking
[118]. It highlighted the potential of the α-ketoamide-based highly selective cathepsin S inhibitor RJW-58 in the suppression of cervical cancer cell migration and invasion of cervical cancer cells
[118]. Cathepsin S, a lysosomal cysteine protease, has been reported to be associated with the degradation of the extracellular matrix, thus promoting cell migration and invasion
[119]. Results of immunoprecipitation assays demonstrated that cathepsin S interacted with STIM1, which was reversed by RNAi-mediated silencing and enzymatic inhibition of cathepsin S. Analyses of confocal microscopic and super-resolution imaging indicated that cathepsin S inhibition led to STIM1 puncta accumulation in the ER and interrupted the STIM1-EB1 interaction, a critical step for STIM1 trafficking towards the cell periphery. In addition, RNAi-mediated silencing and enzymatic inhibition of cathepsin S significantly decreased SOCE and reduced the activity of downstream Ca
2+-dependent effectors NFAT1 and Rac1. These results provide new insight into the potential of a highly-selective cathepsin S inhibitor RJW-58 as a promising anti-cancer treatment that targets microtubule-dependent STIM1 translocation and subsequent SOCE activation
[118].