ArticleBMC biology2026
Increased prolactin levels in pregnancy affect colorectal cancer aggressiveness.
Article in BMC biology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundColorectal cancer (CRC) is diagnosed during approximately 1 in 13,000 pregnancies and is associated with worse outcomes, including a higher incidence of metastatic disease at diagnosis and reduced maternal survival compared to non-pregnant patients. In this study, we investigated two key contributors to this phenomenon: (1) the increased cancer aggressiveness driven by elevated prolactin (PRL) levels during pregnancy and (2) the limited treatment options available to pregnant CRC patients.
resultsFor the first time, we demonstrate that pregnancy-level PRL directly enhances JAK2/STAT3 and JAG1/NOTCH1 signaling in CRC cells, promoting epithelial-mesenchymal transition (EMT) and cancer stem-like protein expression. We developed and fitted a computational model of the JAK2/STAT3 signaling pathway to our in vitro data, identifying specific nodes within the cascade that are most sensitive to PRL fluctuations during pregnancy. Clinically, we highlight data from CRC cases at Vanderbilt University Medical Center, which underscore the more advanced stage at diagnosis in pregnant patients and the limited treatment options available due to concerns about fetal safety. Additionally, we show that PRL exposure sensitizes CRC cells to TRAIL-induced apoptosis, supporting the potential of TRAIL-based therapies, particularly in liposomal form, as a pregnancy-compatible treatment approach.
conclusionsThis study provides the first mechanistic link between pregnancy-level prolactin and increased CRC aggressiveness through JAK2/STAT3 and JAG1/NOTCH1 signaling. It also suggests a novel therapeutic direction by demonstrating that PRL sensitizes CRC cells to TRAIL-induced apoptosis. Together, our findings highlight the need for new therapeutic strategies for safe and effective treatment of CRC in pregnant patients. RESUMEN: El cáncer colorrectal (CRC) se diagnostica durante aproximadamente 1 de cada 13.000 embarazos y se asocia con peores pronósticos, incluyendo una mayor incidencia de metastásis en el momento del diagnóstico y una menor supervivencia en comparación con pacientes no embarazadas. En este estudio investigamos dos factores clave que contribuyen a este fenómeno: (1) el aumento de la agresividad de las células cancerígenas causado por los niveles elevados de prolactina (PRL) durante el embarazo, y (2) las limitaciones de las opciones terapéuticas disponibles para pacientes embarazadas con CRC. RESULTADOS: Por primera vez demostramos que los niveles de PRL durante el embarazo aumentan la señalización JAK2/STAT3 y JAG1/NOTCH1 en células de CRC, incrementando la transición epitelio-mesénquima (EMT) y la expresión de proteínas asociadas a un fenotipo de células madre cancerosas. Desarrollamos y ajustamos un modelo in silico de la vía de señalización JAK2/STAT3 basado en nuestros datos in vitro, identificando nodos específicos dentro de la cascada que son especialmente sensibles a las fluctuaciones de PRL durante el embarazo. Clínicamente, destacamos datos de casos de CRC del Vanderbilt University Medical Center, que muestran un estadío más avanzado en el diagnóstico en pacientes embarazadas y las opciones terapéuticas restringidas debido a preocupaciones sobre la seguridad fetal. Además, mostramos que la exposición a PRL sensibiliza a las células de CRC a la apoptosis inducida por TRAIL, lo que respalda el potencial de terapias basadas en TRAIL, particularmente en liposomas, como un enfoque terapéutico compatible con el embarazo. CONCLUSIONES: Este estudio proporciona el primer vínculo mecanístico entre los niveles de prolactina durante el embarazo y el aumento de la agresividad del CRC a través de la señalización JAK2/STAT3 y JAG1/NOTCH1. También sugerimos una nueva dirección terapéutica al demostrar que la PRL sensibiliza las células de CRC a la apoptosis inducida por TRAIL. En conjunto, el estudio subraya la necesidad de nuevas estrategias terapéuticas para el tratamiento seguro y eficaz del CRC en pacientes embarazadas.
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