Calcium/calmodulin-dependent protein kinase II and its endogenous inhibitor ? in medullary thyroid cancer.

PURPOSE: Calcium/calmodulin dependent kinase II (CaMKII) is involved in the regulation of cell proliferation. Its endogenous inhibitor (hCaKIIN?) is expressed in some cell types. We determined the role of CaMKII in RET-stimulated proliferation and hCaMKIIN? in medullary thyroid carcinoma (MTC). Experimental design: We analyzed the role of RET mutants on CaMKII activation in NIH3T3 and in MTC cell lines, and determined the effect of CaMKII inhibition on RET/ERK pathway and cell proliferation. Then the expression of hCaKIIN? mRNA was determined by real-time PCR in primary MTC and it was correlated with some clinicopathological parameters. RESULTS: RETC634Y e RETM918T mutants expressed in NIH3T3 cells induced CaMKII activation. CaMKII was activated in unstimulated MTC cells carrying the same RET mutants, and it was inhibited by RET inhibition. Inhibition of CaMKII in these cells induced a reduction of Raf-1, MEK and ERK phosphorylation, cyclin D expression and cell proliferation. hCaKIIN? mRNA expression in primary MTC was very variable and did not correlate with gender and age at diagnosis. Serum calcitonin, (R2 = 0.032, p= 0.017), tumor volume (p= 0.0079), lymph node metastasis (p= 0.033) and staging (p= 0.0652) were negatively correlated with the hCaKIIN mRNA expression. CONCLUSIONS: CaMKII is activated by RET mutants and is activated at baseline in MTC cells were it mediates the oncogenic pathway leading to cell proliferation. The mRNA expression of its endogenous inhibitor hCaKIIN? inversely correlates with the severity of MTC. CaMKII might represent a new target for MTC therapy, and hCaKIIN? is a marker of disease extension.