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2018 ; 20
(1
): 42
Nephropedia Template TP
gab.com Text
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English Wikipedia
Hyperprolactinemia-inducing antipsychotics increase breast cancer risk by
activating JAK-STAT5 in precancerous lesions
#MMPMID29778097
Johnston AN
; Bu W
; Hein S
; Garcia S
; Camacho L
; Xue L
; Qin L
; Nagi C
; Hilsenbeck SG
; Kapali J
; Podsypanina K
; Nangia J
; Li Y
Breast Cancer Res
2018[May]; 20
(1
): 42
PMID29778097
show ga
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.