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. 2019 Mar 5;11(3):308. doi: 10.3390/cancers11030308

Figure 1.

Figure 1

Complex signaling following activation of muscarinic receptors in colon cancer cells. Subtype 3 muscarinic receptors (M3R) are activated by bile acids (BA) or acetylcholine (ACh). The epidermal growth factor receptor (EGFR) is transactivated by heparin binding epidermal growth factor (HB-EGF), released from pro-HB-EGF by the actions of matrix metalloproteinase-7 (MMP-7), an enzyme whose expression and activation is also a result of M3R activation (a ‘feed-forward’ mechanism). Signaling proceeds downstream via the extracellular related kinase 1/2 (ERK1/2) and phosphatidylinositol-3-kinase (PI3K) pathways, thereby inducing changes in the transcription of genes that promote cancer progression (cell proliferation, survival, migration and invasion).