Autophagy signaling mediated by non-coding RNAs: Impact on breast cancer progression and treatment

Breast cancer (BC) is the most common diagnosed cancer and leading cause of cancer related death in women overall (Sung et al., 2021). Statistically, the benign type of breast cancer, which is treatable with surgery, dominates the malignant type (Cowin et al., 2005). The changed characteristics at the molecular level of cancerous cells, increase the potential for metastasis in the early stages and can be used in the classification and targeted treatment of breast cancer. Change in the expression pattern of progesterone, estrogen receptors (PR and ER) as well as human epidermal growth factor receptor 2 (HER2) in cancerous cells, manipulates the sensitivity of cancer cells to the pertinent factor and creates a four-member category; (I) triple-negative (TNBC or basal-like), (II) HER2+, (III) Luminal A, (IV) Luminal B (Gulzar et al., 2018; Turkoz et al., 2013). The two types of ductal and lobular cells, present in the breast tissue, have the greatest potential to become cancerous. On the other hand, the combination of origin with a propensity for invasion creates a large category of which ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), invasive lobular carcinoma (ILC), and invasive ductal carcinoma (IDC) are the four main members. IDC and ILC are the most common forms of breast cancer, accounting for 80 % and 15 % of all breast cancer cases, respectively (Christgen et al., 2021; Weigelt et al., 2010; McCart Reed et al., 2021). Genetic predisposition, age, gender, abortion, breastfeeding, diabetes, lifestyle, smoking, drugs, chemicals, menstrual, and menopause age are among the risk factors of breast cancer (Momenimovahed and Salehiniya, 2019; Kispert and McHowat, 2017; Shaukat et al., 2013). With the advancement of imaging technology in the field of breast cancer screening such as mammography, the possibility of diagnosis in the early stages has arisen and the chance of ideal treatment and survival of the affected person has increased (Niell et al., 2017). Autophagy is a highly conserved and controlled cytoplasmic catabolic process. This selective destructive system plays a vital role in the continuation of the cell lifecycle by degradation and reutilizing inept and even redundant components in the cell. Sequestration, transport to lysosome, degradation respectively are the general steps of autophagy. Micro-autophagy, macro-autophagy and chaperone-mediated autophagy (CMA) are three known types of cell autophagy, the common point of which is the delivery of the cargo to the lysosome (Talebian et al., 2020; Parzych and Klionsky, 2014; Glick et al., 2010; Mizushima, 2007). About 1–2 % of transcribed RNA is translated into protein and the rest is known as non-coding RNA (ncRNA). Biologically, this wide population of non-coding RNAs is meaningfully related to the wide range of their biological functions. Participation in DNA replication, transcription, translation, regulation of gene expression, and RNA splicing is among the most important roles attributed to non-coding RNAs (Kaikkonen et al., 2011; Santosh et al., 2015; Qu and Adelson, 2012). Many studies have illustrated that non-coding RNAs play a significant role in gene silencing and chromatin remodeling, leading to the alteration of gene expression and signaling pathways which overall change cellular behavior including cell proliferation, metastasis, and autophagy (Dvorská et al., 2021; Ashrafizadeh et al., 2023). This article will review the regulatory role of non-coding RNAs (ncRNAs) in the autophagy process associated with breast cancer.

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