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AOP: 298

Title

A descriptive phrase which references both the Molecular Initiating Event and Adverse Outcome.It should take the form “MIE leading to AO”. For example, “Aromatase inhibition leading to reproductive dysfunction” where Aromatase inhibition is the MIE and reproductive dysfunction the AO. In cases where the MIE is unknown or undefined, the earliest known KE in the chain (i.e., furthest upstream) should be used in lieu of the MIE and it should be made clear that the stated event is a KE and not the MIE. More help

Increase in reactive oxygen species (ROS) leading to human treatment-resistant gastric cancer via chronic ROS

Short name

A name that succinctly summarises the information from the title. This name should not exceed 90 characters. More help

Increase in ROS leading to human treatment-resistant gastric cancer via chronic ROS

The current version of the Developer's Handbook will be automatically populated into the Handbook Version field when a new AOP page is created.Authors have the option to switch to a newer (but not older) Handbook version any time thereafter. More help

Handbook Version v2.0

Graphical Representation

A graphical representation of the AOP.This graphic should list all KEs in sequence, including the MIE (if known) and AO, and the pair-wise relationships (links or KERs) between those KEs. More help

Click to download graphical representation template Explore AOP in a Third Party Tool

Authors

The names and affiliations of the individual(s)/organisation(s) that created/developed the AOP. More help

Shihori Tanabe¹⁾, Sabina Quader²⁾, Ryuichi Ono³⁾, Horacio Cabral⁴⁾, Ed Perkins⁵⁾

¹Division of Risk Assessment, Center for Biological Safety and Research, National Institute of Health Sciences, Japan

²Innovation Centre of NanoMedicine (iCONM), Kawasaki Institute of Industrial Promotion, Japan

³Division of Cellular and Molecular Toxicology, Center for Biological Safety and Research, National Institute of Health Sciences, Japan

⁴Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Japan

⁵Environmental Laboratory, US Army Engineer Research and Development Center, United States

Point of Contact

The user responsible for managing the AOP entry in the AOP-KB and controlling write access to the page by defining the contributors as described in the next section. More help

Shihori Tanabe (email point of contact)

Contributors

Users with write access to the AOP page. Entries in this field are controlled by the Point of Contact. More help

Shihori Tanabe

Coaches

This field is used to identify coaches who supported the development of the AOP.Each coach selected must be a registered author. More help

Edward Perkins

OECD Information Table

Provides users with information concerning how actively the AOP page is being developed and whether it is part of the OECD Workplan and has been reviewed and/or endorsed. OECD Project: Assigned upon acceptance onto OECD workplan. This project ID is managed and updated (if needed) by the OECD. OECD Status: For AOPs included on the OECD workplan, ‘OECD status’ tracks the level of review/endorsement of the AOP . This designation is managed and updated by the OECD. Journal-format Article: The OECD is developing co-operation with Scientific Journals for the review and publication of AOPs, via the signature of a Memorandum of Understanding. When the scientific review of an AOP is conducted by these Journals, the journal review panel will review the content of the Wiki. In addition, the Journal may ask the AOP authors to develop a separate manuscript (i.e. Journal Format Article) using a format determined by the Journal for Journal publication. In that case, the journal review panel will be required to review both the Wiki content and the Journal Format Article. The Journal will publish the AOP reviewed through the Journal Format Article. OECD iLibrary published version: OECD iLibrary is the online library of the OECD. The version of the AOP that is published there has been endorsed by the OECD. The purpose of publication on iLibrary is to provide a stable version over time, i.e. the version which has been reviewed and revised based on the outcome of the review. AOPs are viewed as living documents and may continue to evolve on the AOP-Wiki after their OECD endorsement and publication. More help

OECD Project #	OECD Status	Reviewer's Reports	Journal-format Article	OECD iLibrary Published Version
1.58	Under Review

This AOP was last modified on June 12, 2025 02:06

Revision dates for related pages

Page	Revision Date/Time
Treatment-resistant gastric cancer	June 12, 2025 01:33
Chronic reactive oxygen species	June 12, 2025 02:03
Increase, porcupine-induced Wnt secretion and Wnt signaling activation	June 04, 2025 02:36
beta-catenin activation	November 25, 2022 01:14
Epithelial Mesenchymal Transition	April 24, 2024 00:44
Increase, Reactive oxygen species	June 12, 2025 01:27
Increase, ROS leads to Increase, porcupine-induced Wnt secretion and Wnt signaling activation	March 14, 2025 16:54
Chronic ROS leads to Increase, porcupine-induced Wnt secretion and Wnt signaling activation	June 12, 2025 02:09
Increase, porcupine-induced Wnt secretion and Wnt signaling activation leads to beta-catenin activation	November 09, 2021 01:23
beta-catenin activation leads to EMT	April 23, 2024 17:35
EMT leads to Resistant gastric cancer	April 23, 2024 17:37
Wnt	May 29, 2019 03:59
WNT2	May 29, 2019 03:59
Porcupine	January 19, 2020 21:19
Wntless	January 19, 2020 21:20
Ionizing Radiation	May 07, 2019 12:12
ferric nitrilotriacetate	May 27, 2020 02:40

Abstract

A concise and informative summation of the AOP under development that can stand-alone from the AOP page. The aim is to capture the highlights of the AOP and its potential scientific and regulatory relevance. More help

This AOP entitled “Increase in reactive oxygen species (ROS) leading to human treatment-resistant gastric cancer via chronic ROS” consists of MIE as KE1115 “Increase, ROS” followed by KE1 as KE1753 “Chronic ROS,” KE2 as KE1754 “porcupine-induced Wnt secretion and Wnt signaling activation,” KE3 as KE1755 “beta-catenin activation,” KE4 as KE1457 “epithelial-mesenchymal transition (EMT),” and AO as KE1651 “human treatment-resistant gastric cancer.” ROS has multiple roles in disease, such as the development and progression of cancer or apoptotic induction, causing anti-tumor effects. In this AOP, we focus on sustained levels of chronic reactive oxygen species (ROS) in inducing therapy resistance in human gastric cancer. Epithelial-mesenchymal transition (EMT), a cellular phenotypic change from epithelial to mesenchymal-like features, demonstrates cancer stem cell-like characteristics in human gastric cancer. EMT is induced by Wnt/beta-catenin signaling, providing the rationale to have Wnt secretion and beta-catenin activation as KE1 and KE2 on the AOP, respectively. The AOP might be useful for the development of anti-cancer drugs or the prediction of adverse effects of therapeutics, which are possible regulatory relevance.

AOP Development Strategy

Context

Used to provide background information for AOP reviewers and users that is considered helpful in understanding the biology underlying the AOP and the motivation for its development.The background should NOT provide an overview of the AOP, its KEs or KERs, which are captured in more detail below. More help

Strategy

Provides a description of the approaches to the identification, screening and quality assessment of the data relevant to identification of the key events and key event relationships included in the AOP or AOP network.This information is important as a basis to support the objective/envisaged application of the AOP by the regulatory community and to facilitate the reuse of its components. Suggested content includes a rationale for and description of the scope and focus of the data search and identification strategy/ies including the nature of preliminary scoping and/or expert input, the overall literature screening strategy and more focused literature surveys to identify additional information (including e.g., key search terms, databases and time period searched, any tools used). More help

The references related to reactive oxygen species and human treatment-resistant gastric cancer were serched in PubMed.

Gene expression analysis was performed in diffuse- and intestinal-type gastric cancer to elucidate mechanisms of epithelial-mesenchymal transition in human treatment-resistant gastric cancer.

Summary of the AOP

This section is for information that describes the overall AOP.The information described in section 1 is entered on the upper portion of an AOP page within the AOP-Wiki. This is where some background information may be provided, the structure of the AOP is described, and the KEs and KERs are listed. More help

Events:

Molecular Initiating Events (MIE)

An MIE is a specialised KE that represents the beginning (point of interaction between a prototypical stressor and the biological system) of an AOP. More help

Key Events (KE)

A measurable event within a specific biological level of organisation. More help

Adverse Outcomes (AO)

An AO is a specialized KE that represents the end (an adverse outcome of regulatory significance) of an AOP. More help

Type	Event ID	Title	Short name

MIE	1115	Increase, Reactive oxygen species	Increase, ROS
MIE	1753	Chronic reactive oxygen species	Chronic ROS

KE	1754	Increase, porcupine-induced Wnt secretion and Wnt signaling activation	Increase, porcupine-induced Wnt secretion and Wnt signaling activation
KE	1755	beta-catenin activation	beta-catenin activation
KE	1457	Epithelial Mesenchymal Transition	EMT

1651

Treatment-resistant gastric cancer

Resistant gastric cancer

Relationships Between Two Key Events (Including MIEs and AOs)

This table summarizes all of the KERs of the AOP and is populated in the AOP-Wiki as KERs are added to the AOP.Each table entry acts as a link to the individual KER description page. More help

Title	Adjacency	Evidence	Quantitative Understanding

Increase, ROS leads to Increase, porcupine-induced Wnt secretion and Wnt signaling activation	adjacent	Moderate	Moderate
Chronic ROS leads to Increase, porcupine-induced Wnt secretion and Wnt signaling activation	adjacent	Moderate	Moderate
Increase, porcupine-induced Wnt secretion and Wnt signaling activation leads to beta-catenin activation	adjacent	Moderate	Moderate
beta-catenin activation leads to EMT	adjacent	Moderate	Moderate
EMT leads to Resistant gastric cancer	adjacent	Moderate	Moderate

Network View

This network graphic is automatically generated based on the information provided in the MIE(s), KEs, AO(s), KERs and Weight of Evidence (WoE) summary tables. The width of the edges representing the KERs is determined by its WoE confidence level, with thicker lines representing higher degrees of confidence. This network view also shows which KEs are shared with other AOPs. More help

Prototypical Stressors

A structured data field that can be used to identify one or more “prototypical” stressors that act through this AOP. Prototypical stressors are stressors for which responses at multiple key events have been well documented. More help

Name
Wnt
WNT2
Porcupine
Wntless
Ionizing Radiation
ferric nitrilotriacetate

Life Stage Applicability

The life stage for which the AOP is known to be applicable. More help

Life stage	Evidence
All life stages	High

Taxonomic Applicability

Latin or common names of a species or broader taxonomic grouping (e.g., class, order, family) can be selected.In many cases, individual species identified in these structured fields will be those for which the strongest evidence used in constructing the AOP was available. More help

Term	Scientific Term	Evidence	Link
Homo sapiens	Homo sapiens	High	NCBI

Sex Applicability

The sex for which the AOP is known to be applicable. More help

Sex	Evidence
Unspecific	High

Overall Assessment of the AOP

Addressess the relevant biological domain of applicability (i.e., in terms of taxa, sex, life stage, etc.) and Weight of Evidence (WoE) for the overall AOP as a basis to consider appropriate regulatory application (e.g., priority setting, testing strategies or risk assessment). More help

Attached file:

1. Support for Biological Plausibility of KERs
MIE1 => KE1: Increase, ROS lead to porcupine-induced Wnt secretion and Wnt signaling activation	Biological Plausibility of the MIE1 => KE1 is moderate. Rationale: Increase in ROS caused by/causes DNA damage, which will alter several signaling pathways, including Wnt signaling. ROS stimulate inflammatory factor production and Wnt/beta-catenin signaling (Vallée & Lecarpentier, 2018).
MIE2 => KE1: Chronic ROS leads to porcupine-induced Wnt secretion and Wnt signaling activation	Biological Plausibility of the MIE2 => KE1 is moderate. Rationale: Sustained ROS increase caused by/causes DNA damage, which will alter several signaling pathways, including Wnt signaling. Macrophages accumulate into injured tissue to recover the tissue damage, which may be followed by porcupine-induced Wnt secretion. ROS stimulate inflammatory factor production and Wnt/beta-catenin signaling (Vallée & Lecarpentier, 2018).
KE1 => KE2: Porcupine-induced Wnt secretion and Wnt signaling activation leads to beta-catenin activation	Biological Plausibility of the KE1 => KE2 is moderate. Rationale: Secreted Wnt ligand stimulates Wnt/beta-catenin signaling, in which beta-catenin is activated. Wnt ligand binds to the Frizzled receptor, which leads to GSK3beta inactivation. GSK3beta inactivation leads to beta-catenin dephosphorylation, which avoids the ubiquitination of the b-catenin and stabilizes the beta-catenin (Clevers & Nusse, 2012).
KE2 => KE3: beta-catenin activation leads to Epithelial-mesenchymal transition (EMT)	Biological Plausibility of the KE2 => KE3 is moderate. Rationale: beta-catenin activation, whose mechanism includes the stabilization of the dephosphorylated beta-catenin and translocation of b-catenin into the nucleus, induces the formation of beta-catenin-TCF complex and transcription of transcription factors such as Snail, Zeb and Twist (Clevers & Nusse, 2012) (Ahmad et al., 2012; Pearlman et al., 2017; Sohn et al., 2019; Yang W et al., 2019). EMT-related transcription factors, including Snail, ZEB, and Twist, are up-regulated in cancer cells (Diaz et al., 2014). The transcription factors such as Snail, ZEB, and Twist bind to the E-cadherin (CDH1) promoter and inhibit the CDH1 transcription via the consensus E-boxes (5’-CACCTG-3’ or 5’-CAGGTG-3’), which leads to EMT (Diaz et al., 2014).
KE3 => AO: Epithelial-mesenchymal transition (EMT) leads to treatment-resistant gastric cancer	Biological Plausibility of the KE3 => AO is moderate. Rationale: Some populations of the cells exhibiting EMT demonstrate the feature of cancer stem cells (CSCs), which are related to cancer malignancy (Shibue & Weinberg, 2017; Tanabe, 2015a, 2015b; Tanabe et al., 2015). The EMT phenomenon is related to cancer metastasis and cancer therapy resistance (Smith & Bhowmick, 2016; Tanabe, 2013). In EMT, increased expression of enzymes that degrade the extracellular matrix components and a decrease in adhesion to the basement membrane induce cell escape from the basement membrane and metastasis (Smith & Bhowmick, 2016). Morphological changes observed during EMT are associated with therapy resistance (Smith & Bhowmick, 2016).
2. Support for essentiality of KEs
KE1: Porcupine-induced Wnt secretion and Wnt signaling activation	Essentiality of the KE1 is moderate. Rationale for Essentiality of KEs in the AOP: The Wnt signaling activation is essential for the subsequent beta-catenin activation and cancer resistance.
KE2: beta-catenin activation	Essentiality of the KE2 is moderate. Rationale for Essentiality of KEs in the AOP: beta-catenin activation is essential for Wnt-induced cancer resistance.
KE3: Epithelial-mesenchymal transition (EMT)	Essentiality of the KE3 is moderate. Rationale for the Essentiality of KEs in the AOP: EMT is essential for promoting Wnt-induced cancer and acquiring resistance to anti-cancer drugs.
3. Empirical support for KERs
MIE1 => KE1: Increase, ROS lead to porcupine-induced Wnt secretion and Wnt signaling activation	Empirical Support of the MIE1 => KE1 is moderate. Rationale: The production of ROS by DNA double-strand break causes tissue damage (Gao et al., 2019). ROS-related signaling induces Wnt/beta-catenin pathway activation (Pérez et al., 2017).
MIE2 => KE1: Chronic ROS leads to porcupine-induced Wnt secretion and Wnt signaling activation	Empirical Support of the MIE2 => KE1 is moderate. Rationale: The production of ROS and DNA double-strand break causes tissue damage (Gao et al., 2019). ROS signaling induces Wnt/beta-catenin signaling (Pérez et al., 2017).
KE1 => KE2: Porcupine-induced Wnt secretion and Wnt signaling activation leads to beta-catenin activation	Empirical Support of the KE1 => KE2 is moderate. Rationale: Dishevelled (DVL), a positive regulator of Wnt signaling, forms the complex with FZD and leads to trigger the Wnt signaling together with Wnt coreceptor low-density lipoprotein (LDL) receptor-related protein 6 (LRP6) (Clevers & Nusse, 2012; Jiang et al., 2015). Wnt binds to FZD and activates the Wnt signaling (Clevers & Nusse, 2012; Janda et al., 2012; Nile et al., 2017). Wnt binding towards FZD induces the formation of the protein complex with LRP5/6 and DVL, leading to the downstream signaling activation including beta-catenin (Clevers & Nusse, 2012).
KE2 => KE3: beta-catenin activation leads to Epithelial-mesenchymal transition (EMT)	Empirical Support of the KE2 => KE3 is moderate. Rationale: The inhibition of c-MET, which is overexpressed in diffuse-type gastric cancer, induced an increase in phosphorylated beta-catenin and a decrease in beta-catenin and Snail (Sohn et al., 2019). The garcinol, which has an anti-cancer effect, increases phosphorylated beta-catenin, decreases beta-catenin and ZEB1/ZEB2, and inhibits EMT (Ahmad et al., 2012). The inhibition of sortilin by AF38469 (a sortilin inhibitor) or small interference RNA (siRNA) results in a decrease in beta-catenin and Twist expression in human glioblastoma cells (Yang W. et al., 2019). Histone deacetylase inhibitors affect EMT-related transcription factors, including ZEB, Twist, and Snail (Wawruszak et al., 2019). Snail and Zeb induce EMT and suppress E-cadherin (CDH1) (Batlle et al., 2000; Diaz et al., 2014; Peinado et al., 2007).
KE3 => AO: Epithelial-mesenchymal transition (EMT) leads to Treatment-resistant gastric cancer	Empirical Support of the KE3 => AO is moderate. Rationale: EMT activation induces the expression of multiple members of the ATP-binding cassette (ABC) transporter family, which results in doxorubicin resistance (Saxena et al., 2011; Shibue & Weinberg, 2017). TGFbeta-1-induced EMT results in acquiring cancer stem cell (CSC)-like properties (Pirozzi et al., 2011; Shibue & Weinberg, 2017). Snail-induced EMT induces cancer metastasis and resistance to dendritic cell-mediated immunotherapy (Kudo-Saito et al., 2009). Zinc finger E-box-binding homeobox (ZEB1)-induced EMT results in relief of miR-200-mediated repression of programmed cell death 1 ligand (PD-L1) expression, a major inhibitory ligand for the programmed cell death protein (PD-1) immune-checkpoint protein on CD8⁺ cytotoxic T lymphocyte (CTL), subsequently the CD8⁺ T cell immunosuppression and metastasis (Chen et al., 2014).

Domain of Applicability

Addressess the relevant biological domain(s) of applicability in terms of sex, life-stage, taxa, and other aspects of biological context. More help

The AOP298 applies to Homo sapiens (human), all life stages, and both male and female.

Essentiality of the Key Events

The essentiality of KEs can only be assessed relative to the impact of manipulation of a given KE (e.g., experimentally blocking or exacerbating the event) on the downstream sequence of KEs defined for the AOP. Consequently, evidence supporting essentiality is assembled on the AOP page, rather than on the independent KE pages that are meant to stand-alone as modular units without reference to other KEs in the sequence. The nature of experimental evidence that is relevant to assessing essentiality relates to the impact on downstream KEs and the AO if upstream KEs are prevented or modified. This includes: Direct evidence: directly measured experimental support that blocking or preventing a KE prevents or impacts downstream KEs in the pathway in the expected fashion. Indirect evidence: evidence that modulation or attenuation in the magnitude of impact on a specific KE (increased effect or decreased effect) is associated with corresponding changes (increases or decreases) in the magnitude or frequency of one or more downstream KEs. More help

Sustained ROS contributes to the initiation and development of human gastric cancer (Gu H. 2018).

Wnt signaling is involved in cancer malignancy (Tanabe, 2018).

Upon stimulation with Wnt ligand to the Frizzled receptor, Wnt/beta-catenin signaling is activated. Wnt/beta-catenin consists of GSK3 beta inactivation, beta-catenin activation, and up-regulation of transcription factors such as Zeb, Twist, and Snail. The transcription factors Zeb, Twist and Snail relate to the activation of EMT-related genes. EMT is regulated with various gene networks (Tanabe, 2015c).

Evidence Assessment

Addressess the biological plausibility, empirical support, and quantitative understanding from each KER in an AOP. More help

The Wnt signaling promotes EMT and cancer malignancy in colorectal cancer (Lazarova & Bordonaro, 2017). Although the potential pathways other than Wnt signaling exist in EMT induction and the mechanism underlaid cancer malignancy, Wnt signaling is one of the main pathways to induce EMT and cancer malignancy (Polakis, 2012).

Known Modulating Factors

Modulating factors (MFs) may alter the shape of the response-response function that describes the quantitative relationship between two KES, thus having an impact on the progression of the pathway or the severity of the AO.The evidence supporting the influence of various modulating factors is assembled within the individual KERs. More help

Modulating Factor (MF)	Influence or Outcome	KER(s) involved

Quantitative Understanding

Optional field to provide quantitative weight of evidence descriptors. More help

Wnt signaling activates the CSCs to promote cancer malignancy (Reya & Clevers, 2005). The responses in KEs related to Wnt signaling, Frizzled activation, GSK3beta inactivation, beta-catenin activation, Snail, Zeb, and Twist activation are dose-dependently related. The quantification of EMT and cancer malignancy would require further investigation.

Considerations for Potential Applications of the AOP (optional)

Addressess potential applications of an AOP to support regulatory decision-making.This may include, for example, possible utility for test guideline development or refinement, development of integrated testing and assessment approaches, development of (Q)SARs / or chemical profilers to facilitate the grouping of chemicals for subsequent read-across, screening level hazard assessments or even risk assessment. More help

AOP entitled “Increase in reactive oxygen species (ROS) and chronic ROS leading to human treatment-resistant gastric cancer” might be utilized for the development and risk assessment of anti-cancer drugs. EMT is involved in the acquisition of drug resistance, which is one of the critical features of cancer malignancy. The assessment of the activity of the EMT network would serve as a prediction of the adverse effects of or responsiveness to anti-cancer drugs (Tanabe et al., 2023). The detection methods for increases in ROS in this AOP have future regulatory potentials to assess the human health effects of radiation or ROS-related diseases. The detection methods for human treatment-resistant gastric cancer have future regulatory potentials to diagnose the diseases.

References

List of the literature that was cited for this AOP. More help

Ahmad, A., Sarkar, S. H., Bitar, B., Ali, S., Aboukameel, A., Sethi, S., . . . Sarkar, F. H. (2012). Garcinol regulates EMT and Wnt signaling pathways in vitro and in vivo, leading to anticancer activity against breast cancer cells. Mol Cancer Ther, 11(10), 2193-2201. doi:10.1158/1535-7163.MCT-12-0232-T

Batlle, E., Sancho, E., Francí, C., Domínguez, D., Monfar, M., Baulida, J., & García de Herreros, A. (2000). The transcription factor Snail is a repressor of E-cadherin gene expression in epithelial tumour cells. Nature Cell Biology, 2(2), 84-89. doi:10.1038/35000034

Chen, L., Gibbons, D. L., Goswami, S., Cortez, M. A., Ahn, Y.-H., Byers, L. A., . . . Qin, F. X.-F. (2014). Metastasis is regulated via microRNA-200/ZEB1 axis control of tumour cell PD-L1 expression and intratumoral immunosuppression. Nature communications, 5, 5241-5241. doi:10.1038/ncomms6241

Clevers, H., & Nusse, R. (2012). Wnt/beta-catenin signaling and disease. Cell, 149(6), 1192-1205. doi:10.1016/j.cell.2012.05.012

Diaz, V. M., Vinas-Castells, R., & Garcia de Herreros, A. (2014). Regulation of the protein stability of EMT transcription factors. Cell Adh Migr, 8(4), 418-428. doi:10.4161/19336918.2014.969998

Gao, Q., Zhou, G., Lin, S.-J., Paus, R., & Yue, Z. (2019). How chemotherapy and radiotherapy damage the tissue: Comparative biology lessons from feather and hair models. Experimental dermatology, 28(4), 413-418. doi:10.1111/exd.13846

Janda, C. Y., Waghray, D., Levin, A. M., Thomas, C., & Garcia, K. C. (2012). Structural basis of Wnt recognition by Frizzled. Science, 337(6090), 59-64. doi:10.1126/science.1222879

Kudo-Saito, C., Shirako, H., Takeuchi, T., & Kawakami, Y. (2009). Cancer Metastasis Is Accelerated through Immunosuppression during Snail-Induced EMT of Cancer Cells. Cancer Cell, 15(3), 195-206. doi: 10.1016/j.ccr.2009.01.023

Lazarova, D., & Bordonaro, M. (2017). ZEB1 Mediates Drug Resistance and EMT in p300-Deficient CRC. Journal of Cancer, 8(8), 1453-1459. doi:10.7150/jca.18762

Nile, A. H., Mukund, S., Stanger, K., Wang, W., & Hannoush, R. N. (2017). Unsaturated fatty acyl recognition by Frizzled receptors mediates dimerization upon Wnt ligand binding. Proc Natl Acad Sci U S A, 114(16), 4147-4152. doi:10.1073/pnas.1618293114

Pearlman, R. L., Montes de Oca, M. K., Pal, H. C., & Afaq, F. (2017). Potential therapeutic targets of epithelial-mesenchymal transition in melanoma. Cancer Lett, 391, 125-140. doi:10.1016/j.canlet.2017.01.029

Peinado, H., Olmeda, D., & Cano, A. (2007). Snail, Zeb and bHLH factors in tumour progression: an alliance against the epithelial phenotype? Nat Rev Cancer, 7(6), 415-428. doi:10.1038/nrc2131

Pérez, S., Taléns-Visconti, R., Rius-Pérez, S., Finamor, I., & Sastre, J. (2017). Redox signaling in the gastrointestinal tract. Free radical biology & medicine, 104, 75-103. doi:10.1016/j.freeradbiomed.2016.12.048

Pirozzi, G., Tirino, V., Camerlingo, R., Franco, R., La Rocca, A., Liguori, E., . . . Rocco, G. (2011). Epithelial to mesenchymal transition by TGFβ-1 induction increases stemness characteristics in primary non small cell lung cancer cell line. PLoS One, 6(6), e21548-e21548. doi:10.1371/journal.pone.0021548

Polakis, P. (2012). Wnt signaling in cancer. Cold Spring Harb Perspect Biol, 4(5). doi:10.1101/cshperspect.a008052

Reya, T., & Clevers, H. (2005). Wnt signalling in stem cells and cancer. Nature, 434(7035), 843-850. doi:10.1038/nature03319

Saxena, M., Stephens, M. A., Pathak, H., & Rangarajan, A. (2011). Transcription factors that mediate epithelial-mesenchymal transition lead to multidrug resistance by upregulating ABC transporters. Cell death & disease, 2(7), e179-e179. doi:10.1038/cddis.2011.61

Shibue, T., & Weinberg, R. A. (2017). EMT, CSCs, and drug resistance: the mechanistic link and clinical implications. Nat Rev Clin Oncol, 14(10), 611-629. doi:10.1038/nrclinonc.2017.44

Sohn, S. H., Kim, B., Sul, H. J., Kim, Y. J., Kim, H. S., Kim, H., . . . Zang, D. Y. (2019). INC280 inhibits Wnt/beta-catenin and EMT signaling pathways and its induce apoptosis in diffuse gastric cancer positive for c-MET amplification. BMC Res Notes, 12(1), 125. doi:10.1186/s13104-019-4163-x

Tanabe, S. (2013). Perspectives of gene combinations in phenotype presentation. World journal of stem cells, 5(3), 61-67. doi:10.4252/wjsc.v5.i3.61

Tanabe, S. (2015a). Origin of cells and network information. World journal of stem cells, 7(3), 535-540. doi:10.4252/wjsc.v7.i3.535

Tanabe, S. (2015b). Signaling involved in stem cell reprogramming and differentiation. World journal of stem cells, 7(7), 992-998. doi:10.4252/wjsc.v7.i7.992

Tanabe, S. (2015c). Overview of gene regulation in stem cell network to identify therapeutic targets utilizing genome databases. Insights Stem Cells, 1(1).

Tanabe, S., Aoyagi, K., Yokozaki, H., & Sasaki, H. (2015). Regulated genes in mesenchymal stem cells and gastric cancer. World journal of stem cells, 7(1), 208-222. doi:10.4252/wjsc.v7.i1.208

Tanabe S, Quader S, Ono R, Cabral H, Aoyagi K, Hirose A, Perkins EJ, Yokozaki H, Sasaki H. (2023). Regulation of Epithelial–Mesenchymal Transition Pathway and Artificial Intelligence-Based Modeling for Pathway Activity Prediction. Onco, 3(1):13-25. doi: 10.3390/onco3010002

Vallée, A., & Lecarpentier, Y. (2018). Crosstalk Between Peroxisome Proliferator-Activated Receptor Gamma and the Canonical WNT/β-Catenin Pathway in Chronic Inflammation and Oxidative Stress During Carcinogenesis. Frontiers in immunology, 9, 745-745. doi:10.3389/fimmu.2018.00745

Wawruszak, A., Kalafut, J., Okon, E., Czapinski, J., Halasa, M., Przybyszewska, A., . . . Stepulak, A. (2019). Histone Deacetylase Inhibitors and Phenotypical Transformation of Cancer Cells. Cancers (Basel), 11(2). doi:10.3390/cancers11020148

Yang, W., Wu, P. F., Ma, J. X., Liao, M. J., Wang, X. H., Xu, L. S., . . . Yi, L. (2019). Sortilin promotes glioblastoma invasion and mesenchymal transition through GSK-3beta/beta-catenin/twist pathway. Cell Death Dis, 10(3), 208. doi:10.1038/s41419-019-1449-9