A1 Refereed original research article in a scientific journal

Adrenal-derived factors drive progression of sclerotic prostate cancer in bone;




AuthorsHagberg Thulin, Malin; Li, Lei; Abrahamsson, Sanna; Landin, Andreas; Horkeby, Karin; Wu, Jianyao; Lagerquist, Marie K.; Ohlsson, Claes; Poutanen, Matti

PublisherBioScientifica

Publication year2026

Journal: Endocrine-Related Cancer

Article numbere250309

Volume33

Issue6

ISSN1351-0088

eISSN1479-6821

DOIhttps://doi.org/10.1530/ERC-25-0309

Publication's open availability at the time of reportingOpen Access

Publication channel's open availability Partially Open Access publication channel

Web address https://doi.org/10.1530/ERC-25-0309

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/527003449

Self-archived copy's licenceCC BY

Self-archived copy's versionPublisher`s PDF


Abstract

Bone metastasis is a leading cause of death in prostate cancer (PC) patients. Although androgen deprivation therapy (ADT) combined with novel androgen‐targeted agents constitutes the cornerstone of systemic treatment, its efficacy is limited. We investigated the adrenal contribution to promoting progression of castration-resistant PC (CRPC) within bone using a preclinical intratibial xenograft model (VCaP, 22Rv1, and LNCaP cells). Mice underwent orchiectomy (ORX) to mimic ADT, with or without adrenalectomy (ORX + ADX) to eliminate adrenal contribution. A significant increase in bone mineral density (BMD) was observed in tumor-grafted tibiae in ORX-treated mice compared with controls (P < 0.001), indicating a strong tumor-induced sclerotic response. In contrast, ORX + ADX reduced tumor take rate by approximately 50% and decreased tumor-induced BMD by over 80% (P < 0.001). Transcriptomic analysis revealed that ADX downregulated tumor-induced transcripts in bone by over 90%, including osteogenic (Lox, Sparcl1, Bmp2, Postn, and Col1a1) and pro-angiogenic (Bmper, Pecam-1, and Esam) signatures. In addition, BMP, PI3K/Akt, and ERK1/2 signaling pathways were associated with the tumor-induced bone response. Both high serum progesterone and intratumoral levels of dihydrotestosterone (DHT) were associated with the sclerotic bone phenotype. ADX markedly reduced intratumoral DHT and downregulated glycolytic genes (HK2, PFK2, and LDHA) and secretory proteins expressed by the tumor, including stanniocalcin 2, potentially mediating paracrine effects in the sclerotic bone response. Altogether, these findings highlight the critical role of adrenal-dependent androgen synthesis, particularly via progesterone, in driving the sclerotic CRPC in bone. Our findings suggest that a comprehensive blockade of adrenal contribution is essential to prevent the sclerotic bone response associated with CRPC.



Keywords:
Adrenal glandsBone metastasisdihydrotestosteroneosteogenesissclerotic bone

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Funding information in the publication
This work was supported by the Swedish Research Council (Grant No.: VR 2020-01836, MP), the Swedish Cancer Foundation (Grant No.: 211889 Pj, MP), the Swedish Prostate Cancer Foundation (Grant Nos: 2020, 2022, MHT), and Assar Gabrielson’s foundation for preclinical research (Grant Nos: FB21-93, FB22-105, FB23-103, MHT). This work was also supported by grants from the Swedish state under the agreement between the Swedish government and the county councils (the ALF agreement; Grant No.: ALFGBG-965821, MP) and Cancer Foundation Finland (MP).


Last updated on 11/08/2026 08:28:45 AM