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While interplay between BRCA1 and AURKA-RHAMM-TPX2-TUBG1 regulates mammary epithelial polarization, common genetic variation in HMMR (gene product RHAMM) may be associated with risk of breast cancer in BRCA1 mutation carriers. Following on these observations, we further assessed the link between the AURKA-HMMR-TPX2-TUBG1 functional module and risk of breast cancer in BRCA1 or BRCA2 mutation carriers. Forty-one single nucleotide polymorphisms (SNPs) were genotyped in 15,252 BRCA1 and 8,211 BRCA2 mutation carriers and subsequently analyzed using a retrospective likelihood approach. The association of HMMR rs299290 with breast cancer risk in BRCA1 mutation carriers was confirmed: per-allele hazard ratio (HR) = 1.10, 95% confidence interval (CI) 1.04 - 1.15, p = 1.9 x 10\(^{-4}\) (false discovery rate (FDR)-adjusted p = 0.043). Variation in CSTF1, located next to AURKA, was also found to be associated with breast cancer risk in BRCA2 mutation carriers: rs2426618 per-allele HR = 1.10, 95% CI 1.03 - 1.16, p = 0.005 (FDR-adjusted p = 0.045). Assessment of pairwise interactions provided suggestions (FDR-adjusted p\(_{interaction}\) values > 0.05) for deviations from the multiplicative model for rs299290 and CSTF1 rs6064391, and rs299290 and TUBG1 rs11649877 in both BRCA1 and BRCA2 mutation carriers. Following these suggestions, the expression of HMMR and AURKA or TUBG1 in sporadic breast tumors was found to potentially interact, influencing patients' survival. Together, the results of this study support the hypothesis of a causative link between altered function of AURKA-HMMR-TPX2-TUBG1 and breast carcinogenesis in BRCA1/2 mutation carriers.
b-adrenergic receptors (b-ARs) participate strongly in the development of cardiac hypertrophy and human heart failure. Stimulation of b-adrenergic receptors with catecholamines as well as cardiac overexpression of b1-ARs or of Gas-proteins in transgenic mice induces cardiac hypertrophy. However, direct activation of their downstream targets, such as adenylyl cyclase (AC) or protein kinase A do not promote a significant degree of cardiac hypertrophy. These findings suggest that additional events may occur and that these events require Gas-protein activation. A hypertrophic pathway involving Gaq-protein coupled receptors has recently been described. Upon activation of Gaq-coupled receptors Gbg-subunits are released from Gaq and bind directly to the activated Raf/Mek/Erk cascade. Direct interaction between bg-subunits and activated Erk1/2 leads to an additional autophosphorylation of Erk2 at threonine 188, which mediates cardiac hypertrophy. Murine hearts, as well as isolated cardiomyocytes present an increase in Erk2Thr188-phosphorylation upon b-AR activation. Similarly overexpression of phosphorylation deficient Erk2 mutants (Erk2T188S and Erk2T188A) reduces b-AR mediated cardiomyocyte hypertrophy. Increase in left ventricular wall thickness, fibrosis and up-regulation of natriuretic peptide synthesis, which are physiological features for cardiac hypertrophy, are strongly inhibited in transgenic mice with a cardiac expression of Erk2T188S after two weeks of sustained isoproterenol treatment. It could further be shown in this work that b-AR mediated cardiac hypertrophy requires two distinct pathways initiated by Gs-protein activation: the canonical phosphorylation of Erk1/2 via adenylyl cyclase and the direct interaction of released bg-subunits with activated Erk1/2. Coincidence of both events leads to Erk2Thr188-phosphorylation, which activates then different transcription factors responsible for cardiac hypertrophy. Sequestration of bg-subunits by overexpression of the C-terminus of GRK2 bark-ct and inhibition of adenylyl cyclase efficiently reduced the hypertrophic response to isoproterenol, whereas direct activation of AC by forskolin failed to induce Erk2Thr188-phosphorylation and cardiomyocyte hypertrophy. These findings may help to develop new therapeutic strategies for the prevention of cardiac hypertrophy and maladaptive remodeling of the heart.