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MSC-derived high molecular weight (HMW) HA causes enrichment of CD44 in the nucleus of the cancer cells, which associates with the LOX promoter, driving its transcription. Immature LOX is secreted to the extracellular space where it is processed into the mature 32kDa form (LOX) and the 19kDa pro-LOX (LOX-PP). Active LOX then drives a cascade of signalling events that lead to Twist induction, onset of EMT, and cancer cell dissemination.
