Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 8/2017

01-08-2017 | Original Article – Cancer Research

GLI-mediated Keratin 17 expression promotes tumor cell growth through the anti-apoptotic function in oral squamous cell carcinomas

Authors: Yurie Mikami, Shinsuke Fujii, Kengo Nagata, Hiroko Wada, Kana Hasegawa, Misaki Abe, Reiko U. Yoshimoto, Shintaro Kawano, Seiji Nakamura, Tamotsu Kiyoshima

Published in: Journal of Cancer Research and Clinical Oncology | Issue 8/2017

Login to get access

Abstract

Purpose

Keratin 17 (KRT17) has been suggested as a potential diagnostic marker of squamous cell carcinoma including oral squamous cell carcinoma (OSCC). The current study was conducted to clarify the function of KRT17 and its expression mechanism in OSCC.

Methods

Immunohistochemical analyses were carried out to examine the expression of KRT17, GLI family zinc finger (GLI)-1, GLI-2, or cleaved caspase-3 in OSCCs. The expression of KRT17, GLI-1, or GLI-2 was investigated among OSCC cell lines, and the effects of loss-of-function of KRT17 or GLI, using siRNA or inhibitor, on the cell growth of the OSCC cell line HSC-2 particularly with respect to apoptosis were examined.

Results

Immunohistochemical analyses of tissue specimens obtained from 78 OSCC patients revealed that KRT17 was not observed in non-tumor regions but was strongly expressed at high frequencies in tumor regions. Knockdown of KRT17 increased the number of cleaved caspase-3-positive cells, leading to the reduction of cell number. Loss-of-function of GLI-1 or GLI-2 also increased the cell numbers of apoptotic cells positive for staining of Annexin-V and propidium iodide (PI) and the terminal deoxynucleotidyl transferase dUTP-biotin nick-end labeling (TUNEL) method, and induced DNA fragmentation. This inhibitory effect on cell growth was partially rescued by exogenous KRT17 expression. In the KRT17-positive regions in OSCCs, GLI-1 or GLI-2 was frequently detected, and the number of cells with cleaved caspase-3 positive was decreased.

Conclusions

KRT17 promotes tumor cell growth, at least partially, through its anti-apoptotic effect as a result of the KRT17 overexpression by GLIs in OSCC.
Appendix
Available only for authorised users
Literature
go back to reference Atale N, Gupta S, Yadav UC, Rani V (2014) Cell-death assessment by fluorescent and nonfluorescent cytosolic and nuclear staining techniques. J Microsc 255:7–19CrossRefPubMed Atale N, Gupta S, Yadav UC, Rani V (2014) Cell-death assessment by fluorescent and nonfluorescent cytosolic and nuclear staining techniques. J Microsc 255:7–19CrossRefPubMed
go back to reference Barnes L, Eveson JW, Reichart P, Sidransky D (eds) (2005) Pathology and Genetics of Head and Neck Tumours, 3rd edn. IARC, France Barnes L, Eveson JW, Reichart P, Sidransky D (eds) (2005) Pathology and Genetics of Head and Neck Tumours, 3rd edn. IARC, France
go back to reference Bianchi N, Depianto D, Mcgowan K, Gu C, Coulombe PA (2005) Exploiting the Keratin 17 gene promoter to visualize live cells in epithelial appendages of mice. Mol Cell Biol 25:7249–7259CrossRefPubMedPubMedCentral Bianchi N, Depianto D, Mcgowan K, Gu C, Coulombe PA (2005) Exploiting the Keratin 17 gene promoter to visualize live cells in epithelial appendages of mice. Mol Cell Biol 25:7249–7259CrossRefPubMedPubMedCentral
go back to reference Bortoluzzi MC, Yurgel LS, Dekker NP, Jordan RC, Regezi JA (2004) Assessment of p63 expression in oral squamous cell carcinomas and dysplasias. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:698–704CrossRefPubMed Bortoluzzi MC, Yurgel LS, Dekker NP, Jordan RC, Regezi JA (2004) Assessment of p63 expression in oral squamous cell carcinomas and dysplasias. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:698–704CrossRefPubMed
go back to reference Carrilho C, Alberto M, Buane L, David L (2004) Keratins 8, 10, 13, and 17 are useful markers in the diagnosis of human cervix carcinomas. Hum Pathol 35:546–551CrossRefPubMed Carrilho C, Alberto M, Buane L, David L (2004) Keratins 8, 10, 13, and 17 are useful markers in the diagnosis of human cervix carcinomas. Hum Pathol 35:546–551CrossRefPubMed
go back to reference Chidzonga MM (2006) Oral malignant neoplasia: a survey of 428 cases in two Zimbabwean hospitals. Oral Oncol 42:177–183CrossRefPubMed Chidzonga MM (2006) Oral malignant neoplasia: a survey of 428 cases in two Zimbabwean hospitals. Oral Oncol 42:177–183CrossRefPubMed
go back to reference Chidzonga MM, Mahomva L (2006) Squamous cell carcinoma of the oral cavity, maxillary antrum and lip in a Zimbabwean population: a descriptive epidemiological study. Oral Oncol 42:184–189CrossRefPubMed Chidzonga MM, Mahomva L (2006) Squamous cell carcinoma of the oral cavity, maxillary antrum and lip in a Zimbabwean population: a descriptive epidemiological study. Oral Oncol 42:184–189CrossRefPubMed
go back to reference Cohen-Kerem R, Madah W, Sabo E, Rahat MA, Greenberg E, Elmalah I (2004) Cytokeratin-17 as a potential marker for squamous cell carcinoma of the larynx. Ann Otol Rhinol Laryngol 113:821–827CrossRefPubMed Cohen-Kerem R, Madah W, Sabo E, Rahat MA, Greenberg E, Elmalah I (2004) Cytokeratin-17 as a potential marker for squamous cell carcinoma of the larynx. Ann Otol Rhinol Laryngol 113:821–827CrossRefPubMed
go back to reference Dimery IW, Hong WK (1993) Overview of combined modality therapies for head and neck cancer. J Natl Cancer Inst 85:95–111CrossRefPubMed Dimery IW, Hong WK (1993) Overview of combined modality therapies for head and neck cancer. J Natl Cancer Inst 85:95–111CrossRefPubMed
go back to reference Fujii S, Matsumoto S, Nojima S, Morii E, Kikuchi A (2015) Arl4c expression in colorectal and lung cancers promotes tumorigenesis and may represent a novel therapeutic target. Oncogene 34:4834–4844CrossRefPubMed Fujii S, Matsumoto S, Nojima S, Morii E, Kikuchi A (2015) Arl4c expression in colorectal and lung cancers promotes tumorigenesis and may represent a novel therapeutic target. Oncogene 34:4834–4844CrossRefPubMed
go back to reference Fujii S, Shinjo K, Matsumoto S, Harada T, Nojima S, Sato S et al (2016) Epigenetic upregulation of ARL4C, due to DNA hypomethylation in the 3′-untranslated region, promotes tumorigenesis of lung squamous cell carcinoma. Oncotarget 7:81571–81587PubMedPubMedCentral Fujii S, Shinjo K, Matsumoto S, Harada T, Nojima S, Sato S et al (2016) Epigenetic upregulation of ARL4C, due to DNA hypomethylation in the 3′-untranslated region, promotes tumorigenesis of lung squamous cell carcinoma. Oncotarget 7:81571–81587PubMedPubMedCentral
go back to reference Gonnissen A, Isebaert S, Mckee CM, Dok R, Haustermans K, Muschel RJ (2016) The hedgehog inhibitor GANT61 sensitizes prostate cancer cells to ionizing radiation both in vitro and in vivo. Oncotarget 7:84286–84298PubMedPubMedCentral Gonnissen A, Isebaert S, Mckee CM, Dok R, Haustermans K, Muschel RJ (2016) The hedgehog inhibitor GANT61 sensitizes prostate cancer cells to ionizing radiation both in vitro and in vivo. Oncotarget 7:84286–84298PubMedPubMedCentral
go back to reference Honami T, Shimo T, Okui T, Kurio N, Hassan NM, Iwamoto M et al (2012) Sonic hedgehog signaling promotes growth of oral squamous cell carcinoma cells associated with bone destruction. Oral Oncol 48:49–55CrossRefPubMed Honami T, Shimo T, Okui T, Kurio N, Hassan NM, Iwamoto M et al (2012) Sonic hedgehog signaling promotes growth of oral squamous cell carcinoma cells associated with bone destruction. Oral Oncol 48:49–55CrossRefPubMed
go back to reference Huang L, Walter V, Hayes DN, Onaitis M (2014) Hedgehog-GLI signaling inhibition suppresses tumor growth in squamous lung cancer. Clin Cancer Res 20:1566–1575CrossRefPubMedPubMedCentral Huang L, Walter V, Hayes DN, Onaitis M (2014) Hedgehog-GLI signaling inhibition suppresses tumor growth in squamous lung cancer. Clin Cancer Res 20:1566–1575CrossRefPubMedPubMedCentral
go back to reference Ikeda K, Tate G, Suzuki T, Mitsuya T (2008) Coordinate expression of cytokeratin 8 and cytokeratin 17 immunohistochemical staining in cervical intraepithelial neoplasia and cervical squamous cell carcinoma: an immunohistochemical analysis and review of the literature. Gynecol Oncol 108:598–602CrossRefPubMed Ikeda K, Tate G, Suzuki T, Mitsuya T (2008) Coordinate expression of cytokeratin 8 and cytokeratin 17 immunohistochemical staining in cervical intraepithelial neoplasia and cervical squamous cell carcinoma: an immunohistochemical analysis and review of the literature. Gynecol Oncol 108:598–602CrossRefPubMed
go back to reference Khanom R, Nguyen CT, Kayamori K, Zhao X, Morita K, Miki Y et al (2016) Keratin 17 is induced in oral cancer and facilitates tumor growth. PLoS One 11:e0161163CrossRefPubMedPubMedCentral Khanom R, Nguyen CT, Kayamori K, Zhao X, Morita K, Miki Y et al (2016) Keratin 17 is induced in oral cancer and facilitates tumor growth. PLoS One 11:e0161163CrossRefPubMedPubMedCentral
go back to reference Kim S, Wong P, Coulombe PA (2006) A keratin cytoskeletal protein regulates protein synthesis and epithelial cell growth. Nature 441:362–365CrossRefPubMed Kim S, Wong P, Coulombe PA (2006) A keratin cytoskeletal protein regulates protein synthesis and epithelial cell growth. Nature 441:362–365CrossRefPubMed
go back to reference Kitamura R, Toyoshima T, Tanaka H, Kawano S, Kiyosue T, Matsubara R et al (2012) Association of cytokeratin 17 expression with differentiation in oral squamous cell carcinoma. J Cancer Res Clin Oncol 138:1299–1310CrossRefPubMedPubMedCentral Kitamura R, Toyoshima T, Tanaka H, Kawano S, Kiyosue T, Matsubara R et al (2012) Association of cytokeratin 17 expression with differentiation in oral squamous cell carcinoma. J Cancer Res Clin Oncol 138:1299–1310CrossRefPubMedPubMedCentral
go back to reference Kiyoshima T, Yoshida H, Wada H, Nagata K, Fujiwara H, Kihara M et al (2013) Chemoresistance to concanamycin A1 in human oral squamous cell carcinoma is attenuated by an HDAC inhibitor partly via suppression of Bcl-2 expression. PLoS One 8:e80998CrossRefPubMedPubMedCentral Kiyoshima T, Yoshida H, Wada H, Nagata K, Fujiwara H, Kihara M et al (2013) Chemoresistance to concanamycin A1 in human oral squamous cell carcinoma is attenuated by an HDAC inhibitor partly via suppression of Bcl-2 expression. PLoS One 8:e80998CrossRefPubMedPubMedCentral
go back to reference Kurokawa H, Yamashita Y, Tokudome S, Kajiyama M (1997) Combination assay for tumor markers in oral squamous cell carcinoma. J Oral Maxillofac Surg 55:964–966CrossRefPubMed Kurokawa H, Yamashita Y, Tokudome S, Kajiyama M (1997) Combination assay for tumor markers in oral squamous cell carcinoma. J Oral Maxillofac Surg 55:964–966CrossRefPubMed
go back to reference Llewellyn CD, Linklater K, Bell J, Johnson NW, Warnakulasuriya KA (2003) Squamous cell carcinoma of the oral cavity in patients aged 45 years and under: a descriptive analysis of 116 cases diagnosed in the South East of England from 1990 to 1997. Oral Oncol 39:106–114CrossRefPubMed Llewellyn CD, Linklater K, Bell J, Johnson NW, Warnakulasuriya KA (2003) Squamous cell carcinoma of the oral cavity in patients aged 45 years and under: a descriptive analysis of 116 cases diagnosed in the South East of England from 1990 to 1997. Oral Oncol 39:106–114CrossRefPubMed
go back to reference Matsuo K, Ishibashi Y, Kobayashi I, Ozeki S, Ohishi M, Tange T et al (1994) New human oral squamous carcinoma cell line and its tumorigenic subline producing granulocyte colony-stimulating factor. Jpn J Cancer Res 85:1257–1262CrossRefPubMed Matsuo K, Ishibashi Y, Kobayashi I, Ozeki S, Ohishi M, Tange T et al (1994) New human oral squamous carcinoma cell line and its tumorigenic subline producing granulocyte colony-stimulating factor. Jpn J Cancer Res 85:1257–1262CrossRefPubMed
go back to reference McGowan KM, Coulombe PA (1998) Onset of keratin 17 expression coincides with the definition of major epithelial lineages during skin development. J Cell Biol 143:469–486CrossRefPubMedPubMedCentral McGowan KM, Coulombe PA (1998) Onset of keratin 17 expression coincides with the definition of major epithelial lineages during skin development. J Cell Biol 143:469–486CrossRefPubMedPubMedCentral
go back to reference Mikami T, Cheng J, Maruyama S, Kobayashi T, Funayama A, Yamazaki M et al (2011) Emergence of keratin 17 vs. loss of keratin 13: their reciprocal immunohistochemical profiles in oral carcinoma in situ. Oral Oncol 47:497–503CrossRefPubMed Mikami T, Cheng J, Maruyama S, Kobayashi T, Funayama A, Yamazaki M et al (2011) Emergence of keratin 17 vs. loss of keratin 13: their reciprocal immunohistochemical profiles in oral carcinoma in situ. Oral Oncol 47:497–503CrossRefPubMed
go back to reference Mikami T, Maruyama S, Abé T, Kobayashi T, Yamazaki M, Funayama A et al (2015) Keratin 17 is co-expressed with 14-3-3 sigma in oral carcinoma in situ and squamous cell carcinoma and modulates cell proliferation and size but not cell migration. Virchows Arch 466:559–569CrossRefPubMed Mikami T, Maruyama S, Abé T, Kobayashi T, Yamazaki M, Funayama A et al (2015) Keratin 17 is co-expressed with 14-3-3 sigma in oral carcinoma in situ and squamous cell carcinoma and modulates cell proliferation and size but not cell migration. Virchows Arch 466:559–569CrossRefPubMed
go back to reference Miyoshi H, Blömer U, Takahashi M, Gage FH, Verma IM (1998) Development of a self-inactivating lentivirus vector. J Virol 72:8150–8157PubMedPubMedCentral Miyoshi H, Blömer U, Takahashi M, Gage FH, Verma IM (1998) Development of a self-inactivating lentivirus vector. J Virol 72:8150–8157PubMedPubMedCentral
go back to reference Morifuji M, Taniguchi S, Sakai H, Nakabeppu Y, Ohishi M (2000) Differential expression of cytokeratin after orthotopic implantation of newly established human tongue cancer cell lines of defined metastatic ability. Am J Pathol 156:1317–1326CrossRefPubMedPubMedCentral Morifuji M, Taniguchi S, Sakai H, Nakabeppu Y, Ohishi M (2000) Differential expression of cytokeratin after orthotopic implantation of newly established human tongue cancer cell lines of defined metastatic ability. Am J Pathol 156:1317–1326CrossRefPubMedPubMedCentral
go back to reference Nieto MA (2013) Epithelial plasticity: a common theme in embryonic and cancer cells. Sci 342:1234850CrossRef Nieto MA (2013) Epithelial plasticity: a common theme in embryonic and cancer cells. Sci 342:1234850CrossRef
go back to reference Nybakken K, Perrimon N (2002) Hedgehog signal transduction: recent findings. Curr Opin Genet Dev 12:503–511CrossRefPubMed Nybakken K, Perrimon N (2002) Hedgehog signal transduction: recent findings. Curr Opin Genet Dev 12:503–511CrossRefPubMed
go back to reference Pan X, Hobbs RP, Coulombe PA (2013) The expanding significance of keratin intermediate filaments in normal and diseased epithelia. Curr Opin Cell Biol 25:47–56CrossRefPubMed Pan X, Hobbs RP, Coulombe PA (2013) The expanding significance of keratin intermediate filaments in normal and diseased epithelia. Curr Opin Cell Biol 25:47–56CrossRefPubMed
go back to reference Pasca di Magliano M, Hebrok M (2003) Hedgehog signalling in cancer formation and maintenance. Nat Rev Cancer 3:903–911CrossRefPubMed Pasca di Magliano M, Hebrok M (2003) Hedgehog signalling in cancer formation and maintenance. Nat Rev Cancer 3:903–911CrossRefPubMed
go back to reference Ruiz i Altaba A, Sánchez P, Dahmane N (2002) Gli and hedgehog in cancer: tumours, embryos and stem cells. Nat Rev Cancer 2:361–372CrossRefPubMed Ruiz i Altaba A, Sánchez P, Dahmane N (2002) Gli and hedgehog in cancer: tumours, embryos and stem cells. Nat Rev Cancer 2:361–372CrossRefPubMed
go back to reference Sankar S, Tanner JM, Bell R, Chaturvedi A, Randall RL, Beckerle MC et al (2013) A novel role for keratin 17 in coordinating oncogenic transformation and cellular adhesion in Ewing sarcoma. Mol Cell Biol 33:4448–4460CrossRefPubMedPubMedCentral Sankar S, Tanner JM, Bell R, Chaturvedi A, Randall RL, Beckerle MC et al (2013) A novel role for keratin 17 in coordinating oncogenic transformation and cellular adhesion in Ewing sarcoma. Mol Cell Biol 33:4448–4460CrossRefPubMedPubMedCentral
go back to reference Sasaki H, Nishizaki Y, Hui C, Nakafuku M, Kondoh H (1999) Regulation of Gli2 and Gli3 activities by an amino-terminal repression domain: implication of Gli2 and Gli3 as primary mediators of Shh signaling. Development 17:3915–3924 Sasaki H, Nishizaki Y, Hui C, Nakafuku M, Kondoh H (1999) Regulation of Gli2 and Gli3 activities by an amino-terminal repression domain: implication of Gli2 and Gli3 as primary mediators of Shh signaling. Development 17:3915–3924
go back to reference Schantz SP, Yu GP (2002) Head and neck cancer incidence trends in young Americans, 1973–1997, with a special analysis for tongue cancer. Arch Otolaryngol Head Neck Surg 128:268–274CrossRefPubMed Schantz SP, Yu GP (2002) Head and neck cancer incidence trends in young Americans, 1973–1997, with a special analysis for tongue cancer. Arch Otolaryngol Head Neck Surg 128:268–274CrossRefPubMed
go back to reference Sobin LH, Gospodarowicz MK, Wittekind C (eds) (2009) TNM classification of malignant tumors, 7th edn. UICC, Switzerland Sobin LH, Gospodarowicz MK, Wittekind C (eds) (2009) TNM classification of malignant tumors, 7th edn. UICC, Switzerland
go back to reference Sun Y, Guo W, Ren T, Liang W, Zhou W, Lu Q et al (2014) Gli1 inhibition suppressed cell growth and cell cycle progression and induced apoptosis as well as autophagy depending on ERK1/2 activity in human chondrosarcoma cells. Cell Death Dis 5:e979CrossRefPubMedPubMedCentral Sun Y, Guo W, Ren T, Liang W, Zhou W, Lu Q et al (2014) Gli1 inhibition suppressed cell growth and cell cycle progression and induced apoptosis as well as autophagy depending on ERK1/2 activity in human chondrosarcoma cells. Cell Death Dis 5:e979CrossRefPubMedPubMedCentral
go back to reference Takahashi H, Shikata N, Senzaki H, Shintaku M, Tsubura A (1995) Immunohistochemical staining patterns of keratins in normal oesophageal epithelium and carcinoma of the oesophagus. Histopathology 26:45–50CrossRefPubMed Takahashi H, Shikata N, Senzaki H, Shintaku M, Tsubura A (1995) Immunohistochemical staining patterns of keratins in normal oesophageal epithelium and carcinoma of the oesophagus. Histopathology 26:45–50CrossRefPubMed
go back to reference Toyoshima T, Vairaktaris E, Nkenke E, Schlegel KA, Neukam FW, Ries J (2008) Cytokeratin 17 mRNA expression has potential for diagnostic marker of oral squamous cell carcinoma. J Cancer Res Clin Oncol 134:515–521CrossRefPubMed Toyoshima T, Vairaktaris E, Nkenke E, Schlegel KA, Neukam FW, Ries J (2008) Cytokeratin 17 mRNA expression has potential for diagnostic marker of oral squamous cell carcinoma. J Cancer Res Clin Oncol 134:515–521CrossRefPubMed
go back to reference van de Rijn M, Perou CM, Tibshirani R, Haas P, Kallioniemi O, Kononen J et al (2002) Expression of cytokeratins 17 and 5 identifies a group of breast carcinomas with poor clinical outcome. Am J Pathol 161:1991–1996CrossRefPubMedPubMedCentral van de Rijn M, Perou CM, Tibshirani R, Haas P, Kallioniemi O, Kononen J et al (2002) Expression of cytokeratins 17 and 5 identifies a group of breast carcinomas with poor clinical outcome. Am J Pathol 161:1991–1996CrossRefPubMedPubMedCentral
go back to reference Wang MT, Holderfield M, Galeas J, Delrosario R, To MD, Balmain A et al (2015) K-Ras promotes tumorigenicity through suppression of non-canonical Wnt signaling. Cell 163:1237–1251CrossRefPubMed Wang MT, Holderfield M, Galeas J, Delrosario R, To MD, Balmain A et al (2015) K-Ras promotes tumorigenicity through suppression of non-canonical Wnt signaling. Cell 163:1237–1251CrossRefPubMed
go back to reference Yamamoto E, Miyakawa A, Kohama G (1984) Mode of invasion and lymph node metastasis in squamous cell carcinoma of the oral cavity. Head Neck Surg 6:938–947CrossRefPubMed Yamamoto E, Miyakawa A, Kohama G (1984) Mode of invasion and lymph node metastasis in squamous cell carcinoma of the oral cavity. Head Neck Surg 6:938–947CrossRefPubMed
go back to reference Yan M, Wang L, Zuo H, Zhang Z, Chen W, Mao L et al (2011) HH/GLI signalling as a new therapeutic target for patients with oral squamous cell carcinoma. Oral Oncol 47:504–509CrossRefPubMed Yan M, Wang L, Zuo H, Zhang Z, Chen W, Mao L et al (2011) HH/GLI signalling as a new therapeutic target for patients with oral squamous cell carcinoma. Oral Oncol 47:504–509CrossRefPubMed
Metadata
Title
GLI-mediated Keratin 17 expression promotes tumor cell growth through the anti-apoptotic function in oral squamous cell carcinomas
Authors
Yurie Mikami
Shinsuke Fujii
Kengo Nagata
Hiroko Wada
Kana Hasegawa
Misaki Abe
Reiko U. Yoshimoto
Shintaro Kawano
Seiji Nakamura
Tamotsu Kiyoshima
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 8/2017
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-017-2398-2

Other articles of this Issue 8/2017

Journal of Cancer Research and Clinical Oncology 8/2017 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine