Asparagine endopeptidase prompts breast cancer–related pericardial calcification by regulating IGF2 and integrin αvβ5

X Xuefeng Wang (Beijing National Laboratory for Condensed Matter Physics) J Jian Sun B Bin Lan (National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital) C Chunyu Wang (Center for Biotechnology and Interdisciplinary Studies) J Jiayi Ma (Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University) Q Qiaoting Hu (National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital) J Jun Liu H Haili Cheng (National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital) H Hong Wen J Jieyu Lin (National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital) X Xinyi Ren (Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University) H Huabin Yu (Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University) M Menghui Jiang (School of Public Health, Qingdao University) F Fangfang Chen J Jiayin Ye (Chinese Academy of Sciences Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences) J Jingjie Zhai (Chinese Academy of Sciences Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences) H Haokun Lan (Interdisciplinary Institute for Medical Engineering, Fuzhou University) K Kai Ouyang (Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University) Z Zihao Jing (Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University) L Libo Lv (Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University) Y Ying Chen W Weibin Zhuo (National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital) J Jing Lin Y Yu Chen J Jinsong Lu (Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University) Y Yufang Shi (The Fourth Affiliated Hospital of Soochow University, Institutes for Translational Medicine of Soochow University) Y Ying Wang

Abstract

Cardiac calcification, often seen in age-related diseases, impairs heart function, yet its association with malignant tumors remains largely overlooked. Our study revealed that pericardial calcification (PC) occurs in up to 80% of breast cancer patients with pulmonary metastasis. We demonstrate a reciprocal relationship where breast cancer drives PC, which in turn accelerates cancer progression in humans and mice. Lung metastases increase monocyte-derived macrophage and mesenchymal stem cell (MSC)-derived osteoblast infiltration in the pericardial tissue, triggering inflammation and calcification. Mechanistically, metastatic cancer cells in the lungs highly express and secrete asparagine endopeptidase (AEP), which cleaves IGF2BP3 to free IGF2. AEP and IGF2 contribute to PC by promoting osteoblast differentiation in heart tissue through integrin αvβ5 and IGF1R activation, respectively. Pharmacological blockade of integrin αvβ5 and IGF1R, especially when combined, effectively inhibits ectopic osteogenesis and disrupts the feedback loop between PC and cancer progression. These findings elucidate the interplay between metastatic breast cancer and PC and suggest therapeutic strategies to hinder breast cancer progression.

Article Details

Volume / Issue Vol. 122, Issue 49
Published December 09, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (27)

X

Xuefeng Wang

Beijing National Laboratory for Condensed Matter Physics

J

Jian Sun

B

Bin Lan

National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital

C

Chunyu Wang

Center for Biotechnology and Interdisciplinary Studies

J

Jiayi Ma

Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University

Q

Qiaoting Hu

National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital

J

Jun Liu

H

Haili Cheng

National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital

H

Hong Wen

J

Jieyu Lin

National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital

X

Xinyi Ren

Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University

H

Huabin Yu

Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University

M

Menghui Jiang

School of Public Health, Qingdao University

F

Fangfang Chen

J

Jiayin Ye

Chinese Academy of Sciences Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences

J

Jingjie Zhai

Chinese Academy of Sciences Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences

H

Haokun Lan

Interdisciplinary Institute for Medical Engineering, Fuzhou University

K

Kai Ouyang

Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University

Z

Zihao Jing

Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University

L

Libo Lv

Xiamen University-Fujian Cancer Hospital Research Center of Metabolism and Cancer, State Key Laboratory for Cellular Stress Biology, Xiamen University

Y

Ying Chen

W

Weibin Zhuo

National Health Commission Key Laboratory of Cancer Metabolism, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital

J

Jing Lin

Y

Yu Chen

J

Jinsong Lu

Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University

Y

Yufang Shi

The Fourth Affiliated Hospital of Soochow University, Institutes for Translational Medicine of Soochow University

Y

Ying Wang