Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer Patients

Type 2 diabetes is a risk factor for colorectal cancer (CRC) development and progression. However, metformin-treated diabetic CRC patients tend to have better clinical outcomes than those managed by other means. To better characterize the molecular underpinnings of metformin’s protective effects, we...

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Main Authors: Mary L. Fay, Chris Nicol, Christine Orr, Brooke Wilson, David Hurlbut, Harriet Feilotter, Scott Davey
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/3/138
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author Mary L. Fay
Chris Nicol
Christine Orr
Brooke Wilson
David Hurlbut
Harriet Feilotter
Scott Davey
author_facet Mary L. Fay
Chris Nicol
Christine Orr
Brooke Wilson
David Hurlbut
Harriet Feilotter
Scott Davey
author_sort Mary L. Fay
collection DOAJ
description Type 2 diabetes is a risk factor for colorectal cancer (CRC) development and progression. However, metformin-treated diabetic CRC patients tend to have better clinical outcomes than those managed by other means. To better characterize the molecular underpinnings of metformin’s protective effects, we performed a targeted transcriptomic analysis of primary CRC tissue samples (<i>n</i> = 272). A supervised learning algorithm pinpointed molecular features that discriminate between metformin-treated and diet-controlled diabetic CRC samples, as well as those that discriminated between non-diabetic samples based on their five-year overall survival status. Our results show downregulation of TMEM132 in metformin-treated samples (<i>p</i> = 0.05) and non-diabetics with good clinical outcomes (<i>p</i> = 0.05) relative to diet-controlled and non-diabetics with poor survival, respectively. Furthermore, upregulation of SCNN1A is observed in metformin-treated samples (<i>p</i> = 0.04) and non-diabetics with good clinical outcomes (<i>p</i> = 0.01) relative to diet-controlled samples and those with poor clinical outcomes, respectively. We also show that the antiapoptotic protein sFas is downregulated in metformin-treated samples relative to diet-controlled samples (<i>p</i> = 0.005). These findings suggest a role for the unfolded protein response in mediating metformin-related CRC-protective effects by enhancing apoptosis and suggest the investigation of these proteins as targets for novel CRC therapies.
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spelling doaj-art-51bbeb68d5094564b2807751ed48a91b2025-08-20T03:43:30ZengMDPI AGCurrent Oncology1198-00521718-77292025-02-0132313810.3390/curroncol32030138Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer PatientsMary L. Fay0Chris Nicol1Christine Orr2Brooke Wilson3David Hurlbut4Harriet Feilotter5Scott Davey6Division of Cancer Biology and Genetics, Sinclair Cancer Research Institute at Queen’s University, Kingston, ON K7L 3N6, CanadaDivision of Cancer Biology and Genetics, Sinclair Cancer Research Institute at Queen’s University, Kingston, ON K7L 3N6, CanadaDepartment of Pathology and Molecular Medicine, Queen’s University, Kingston, ON K7L 3N6, CanadaDepartment of Oncology, Queen’s University, Kingston, ON K7L 3N6, CanadaDepartment of Pathology and Molecular Medicine, Queen’s University, Kingston, ON K7L 3N6, CanadaDepartment of Pathology and Molecular Medicine, Queen’s University, Kingston, ON K7L 3N6, CanadaDivision of Cancer Biology and Genetics, Sinclair Cancer Research Institute at Queen’s University, Kingston, ON K7L 3N6, CanadaType 2 diabetes is a risk factor for colorectal cancer (CRC) development and progression. However, metformin-treated diabetic CRC patients tend to have better clinical outcomes than those managed by other means. To better characterize the molecular underpinnings of metformin’s protective effects, we performed a targeted transcriptomic analysis of primary CRC tissue samples (<i>n</i> = 272). A supervised learning algorithm pinpointed molecular features that discriminate between metformin-treated and diet-controlled diabetic CRC samples, as well as those that discriminated between non-diabetic samples based on their five-year overall survival status. Our results show downregulation of TMEM132 in metformin-treated samples (<i>p</i> = 0.05) and non-diabetics with good clinical outcomes (<i>p</i> = 0.05) relative to diet-controlled and non-diabetics with poor survival, respectively. Furthermore, upregulation of SCNN1A is observed in metformin-treated samples (<i>p</i> = 0.04) and non-diabetics with good clinical outcomes (<i>p</i> = 0.01) relative to diet-controlled samples and those with poor clinical outcomes, respectively. We also show that the antiapoptotic protein sFas is downregulated in metformin-treated samples relative to diet-controlled samples (<i>p</i> = 0.005). These findings suggest a role for the unfolded protein response in mediating metformin-related CRC-protective effects by enhancing apoptosis and suggest the investigation of these proteins as targets for novel CRC therapies.https://www.mdpi.com/1718-7729/32/3/138colorectal cancertype 2 diabetesmetforminunfolded protein response
spellingShingle Mary L. Fay
Chris Nicol
Christine Orr
Brooke Wilson
David Hurlbut
Harriet Feilotter
Scott Davey
Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer Patients
Current Oncology
colorectal cancer
type 2 diabetes
metformin
unfolded protein response
title Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer Patients
title_full Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer Patients
title_fullStr Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer Patients
title_full_unstemmed Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer Patients
title_short Downregulation of the Unfolded Protein Response Links Metformin Treatment to Good Clinical Outcomes in Colorectal Cancer Patients
title_sort downregulation of the unfolded protein response links metformin treatment to good clinical outcomes in colorectal cancer patients
topic colorectal cancer
type 2 diabetes
metformin
unfolded protein response
url https://www.mdpi.com/1718-7729/32/3/138
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