Fig. 7
Expression of YAP and ET-1/ETAR as a prognostic signature in HG-SOC patients. a, b Relative EDNRA (ETAR), CCNA, and CTGF mRNA expression levels in 30 HG-SOC human specimens normalized for CYPA mRNA expression were analyzed for their correlation: a EDNRA and CTGF correlation, b EDNRA and CCNA correlation. c YAP, ETAR, and ET-1 expression was evaluated by IB analysis of 21 HG-SOC human specimens and six normal ovarian tissues. Tubulin was used as loading control. d, e Overall survival (OS) and disease free survival (DFS) of HG-SOC patients with high (z score > 0.5) and low (z score < 0.5) combined expression levels of ETAR, β-arr1 correlated with YAP gene signature (CTGF, ANKRD1 and CYR61) (p < 0.014 for OS; p < 0.009 for DFS) (d). e OS and DFS of HG-SOC patients with high (z score > 0) and low (z score < 0) combined signature of ETAR, β-arr1, and YAP (p < 0.009 for OS; p < 0.01 for DFS). Survival analyses from TCGA data set were evaluated by Kaplan–Meier method and a log rank test was used to establish the statistical significance of the distance between curves. High and low gene expression values were defined basing on the z-scores of the signals. f Schematic model of ETAR-dependent YAP activation in HG-SOC models. Mechanistically, nuclear β-arr1 binds mutp53/YAP/transcriptional factor complex to regulate target gene expression. In parallel, ET-1 activates RhoA GTPase, actin dynamics and LATS, for YAP nuclear localization in HG-SOC, through a non-canonical β-arr1/Trio pathway. Integrating these important routes, β-arr1 appears as an emerging hub node, which characterizes important properties that control aggressive features of HG-SOC. Blunting ET-1R/β-arr1-mediated signaling by using macitentan may impair mutp53/YAP/transcriptional machinery, inhibiting tumor growth, metastasis, and rewiring HG-SOC to survive to chemotherapy attack
