Alterations of Wnt signaling appear to be involved in the pathogenesis of
osteosarcoma, presenting mutations of
adenomatous polyposis coli (APC) and epigenetic downregulation of Wnt inhibitory factor 1. However, the precise role of Wnt effectors in the
bone cancer progression remains unclear. We previously showed that Wnt/β-
catenin/
T-cell factor (TCF) activation are responsible for the repression of
syndecan-2, a key modulator of apoptosis and chemosensitivity in
osteosarcoma cells, suggesting a role of Wnt signaling in chemoresistance. In this study, we investigated the functional relationship between
syndecan-2, Wnt/β-
catenin/TCF signaling and chemosensitivity in these cells. To this goal, we selected resistant
osteosarcoma cells from sensitive human cell lines using repeated exposures to
doxorubicin. In
doxorubicin-responsive but not in
doxorubicin-resistant-derived cells
syndecan-2 expression was upregulated by
doxorubicin treatment. Moreover,
syndecan-2 overexpression restored the sensitivity to
doxorubicin in resistant-derived cells. We found that
syndecan-2 induction by
doxorubicin is
forkhead box protein O3A (Foxo3a)-dependent. Foxo3a overexpression resulted in increased
syndecan-2 expression in sensitive and resistant-derived cells.
Doxorubicin modulated Foxo3a binding on
syndecan-2 gene promoter and induced Foxo-dependent inhibition of Wnt/TCF activity. Conversely, β-
catenin/TCF activation impaired
syndecan-2 induction by
doxorubicin, indicating that Wnt signaling is competing with the action of the cytotoxic
drug. However, β-
catenin was also found to be required for Foxo3a activity. Consistently, Dickkopf 1 (DKK1) and
secreted frizzled-related protein 1 (sFRP-1) altered
doxorubicin action in sensitive cells, whereas inhibition of TCF activity strongly decreased cell viability and increased sensitivity to
doxorubicin in sensitive and resistant cells. TCF inhibition also increased the effect of
doxorubicin treatment in an orthotopic bone
tumor model in mice. Altogether, these data provide evidence that the repression of
syndecan-2 by Wnt/β-
catenin/TCF signaling contributes to the resistance of
osteosarcoma cells to
doxorubicin and suggest that TCF inhibition may represent a novel therapeutic strategy in
osteosarcoma.