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PGE2 promotes tumor initiation and growth via DNA methylation and cancer stem cells. PGE2 binds to its receptors (EP1–EP4) to suppress certain tumor suppressor and DNA repair genes by DNA methylation via induction of expression of the DNA methyltransferases DNMT1 and DNMT3B. PGE2 also promotes cancer stem cell formation and expansion by activating NF-κB via EP4-dependent PI3K/MAPK pathways.
