One of the most common malignancies in the world is breast cancer. Although the prognosis for breast cancer has been progressed in recent years, drug resistance is still a problem (
1-
4).
In the 1990s, taxanes became widely applied in breast cancer treatment; however, recurrence and metastasis still happened due to the cancer resistance of taxanes (
5). Bone is the most common site of breast cancer metastasis (
3,
6).
Intervention of taxanes, with spindle microtubule dynamics, leads to cell cycle arrest in G2/M phase, followed by apoptosis. Microtubule associated proteins (MAPs) introduced as endogenous regulators for microtubule stability, promotion or inhibition microtubule polymerization and subsequently cell cycle progression or mitotic arrest (
5-
10).
MAP-tau is expressed in normal breast epithelial cells and breast cancer, and its gene is located in the long arm of chromosome 17. This protein is the best microtubule stabilizing protein that functions to bundle, space, and assemble microtubules.
Tau can bind to the inner and outer side of microtubules, and compete with taxane for binding to the same site at the inner side of the microtubules which may lead to a taxane-resistant phenotype. Loss of
tau expression may lead to microtubule susceptibility to paclitaxel-induced damage (
5-
7,
9,
10). In the gene expression assay of human breast cancer,
tau can serve as a new biomarker for predicting sensitivity to chemotherapeutic agents (
5). Modulation of response to taxanes by reduction of
Tau expression remains a very interesting phenomenon (
11).
Stathmin (also called Op18 and p19) is a cytosolic phosphor-protein which phosphorylate in response to various extracellular signals such as cell division and differentiation. Stathmin can induce the depolymerization of microtubules in vitro and in vivo, due to its phosphorylation-state. Proper assembly of the mitotic spindle requires desphosphorylation and inactivation of stathmin before cell entry into mitosis. Because of the ability of stathmin to remodel microtubule, stathmin has an important role in tumor cell migration and invasion. In breast cancer cell lines,
stathmin overexpression leads to reduced sensitivity to taxane due to delayed entry into mitosis (
12-
14).
Microtubule associated proteins (MAPs) may be related to varying therapeutic response rates in breast cancer patients and resistance to taxanes.
Cannabinoids are a group of 21-carbon-containing terpenophenolic compounds produced by
Cannabis species.
Cannabis sativa may cause antitumor effects by various mechanisms, including inhibition of cell growth and tumor angiogenesis invasion, induction of cell death, and metastasis (
15-
18).
There are two receptors associated to Cannabinoids (CB1 and CB2) which may be potential targets in breast cancer (
19,
20). Studies have shown that the cannabinoid receptors CB1 and CB2 are overexpressed in primary human breast tumors compared with normal breast tissue and cannabinoid receptor agonists inhibit breast cancer cell growth and metastasis in vivo (
1,
4).
According to evidence, THC (Tetrahydrocannabinol), a natural component from
C. Sativa, had antiangiogenic and antiproliferative effects. Activity THC at the membrane level, leading to disruption of membranes structure which affect the selective permeability of the plasma membrane, decrease the expression of cell-surface receptors and cell-cell communication. THC may affect the actual transport of neurotransmitters subsequently reducing tau protein and microtubule assembly (
20).