The cancer stem cells that specialise in generating new malignant cells play a key role in spreading the disease.
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‘Stiffness and hypoxia cause integrin-linked kinase to behave abnormally, which in turn triggers cancer stem-cell formation.’
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The cancer stem cells that specialise in generating new malignant cells represent only a small proportion of the total cells in a tumour, but researchers believe they play a key role in spreading the disease. 
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Using cultures of human breast-cancer cells and mouse mammary-cancer cells, Nelson and her colleagues discovered an association between a protein called integrin-linked kinase and the creation of cancer stem cells.
The researchers created a range of human and mouse breast-cancer cultures reflecting different tissue conditions and showed that stiff hypoxic cultures did indeed promote cancer stem cells. But when they eliminated the integrin-linked kinase from those samples, they found that the cancer stem cells stopped forming.
Conversely, when they forced abnormal levels of integrin-linked kinase in samples containing softer or less hypoxic tissue, cancer stem cells formed. They also confirmed a significant association between tumour stiffness, integrin-linked kinase and cancer stem cell presence in samples from human breast-cancer patients.
"We could see tumour cells expressing cancer stem-cell markers and integrin-linked kinase located at regions with high collagen, which is used to estimate stiffness in a tumour," said Mei-Fong Pang, Researcher at the Princeton University.
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There are likely other features in tumours that cause cancer stem cells to form, but the findings indicate that stiff, hypoxic conditions and their effects on integrin-linked kinase are two of the most prominent ones.
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