Gap junctions and cancer: new functions for an old story

Cancer was one of the first pathologies to be associated with gap-junction defect. Despite the evidence accumulated over the last 40-year period, the molecular involvement of gap junctions and their structural proteins (connexins) in cancer has not been elucidated. The lack of a satisfying explanation may come from the complexity of the disease, evolving through various stages during tumor progression, with cancer cells exhibiting different phenotypes. Here, the question of the involvement of gap junctions has been readdressed by considering the connexin expression/function level at different fundamental stages of carcinogenesis (cell proliferation, cell invasion, and cancer cell dissemination). By performing this analysis, it becomes clear that gap junctions are probably differently involved, depending on the stage of the cancer progression considered. In particular, the most recent data suggest that connexins may act on cell growth by controlling gene expression through a variety of processes (independent of or dependent on the gap-junctional communication capacity). During invasion, connexins have been demonstrated to enhance adherence of cancer cells to the stroma, migration, and probably their dissemination by establishing communication with the endothelial barrier. All these data present a complex picture of connexins in various functions, depending on the cell phenotype.