Molecular analysis of Annexin expression in cancer

BMC Cancer. 2022 Sep 19;22(1):994. doi: 10.1186/s12885-022-10075-8.


Background: Uptake of apoptotic cells induces a tolerogenic phenotype in phagocytes and promotes peripheral tolerance. The highly conserved Annexin core domain, present in all members of the Annexin family, becomes exposed on the apoptotic cell-surface and triggers tolerogenic signalling in phagocytes via the Dectin-1 receptor. Consequently, Annexins exposed on tumour cells upon cell death are expected to induce tolerance towards tumour antigens, inhibiting tumour rejection.

Methods: Expression analysis for all Annexin family members was conducted in cancer cell lines of diverse origins. Presentation of Annexins on the cell surface during apoptosis of cancer cell lines was investigated using surface washes and immunoblotting. Expression data from the GEO database was analysed to compare Annexin levels between malignant and healthy tissue.

Results: Six Annexins at least were consistently detected on mRNA and protein level for each investigated cell line. AnxA1, AnxA2 and AnxA5 constituted the major part of total Annexin expression. All expressed Annexins translocated to the cell surface upon apoptosis induction in all cell lines. Human expression data indicate a correlation between immune infiltration and overall Annexin expression in malignant compared to healthy tissue.

Conclusions: This study is the first comprehensive analysis of expression, distribution and presentation of Annexins in cancer.

Keywords: Annexins; Apoptotic cells; Immunosuppression; Peripheral tolerance; Tumour microenvironment.

MeSH terms

  • Annexin A5
  • Annexins* / genetics
  • Annexins* / metabolism
  • Antigens, Neoplasm
  • Humans
  • Neoplasms* / genetics
  • RNA, Messenger


  • Annexin A5
  • Annexins
  • Antigens, Neoplasm
  • RNA, Messenger