Figure 1 Morphological and physiological changes

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Figure 1 Morphological and physiological changes associated with the epithelial-to-mesenchymal transition (EMT) Figure 1 | Morphological and physiological changes associated with the epithelial-to-mesenchymal transition (EMT). a | A schematic overview of EMT-associated changes in cell physiology. Activation of the EMT programme induces profound changes in various aspects of cell morphology and physiology, most notably in cell–cell junctions, cytoskeletal composition, cellular interactions with the extracellular matrix (ECM), and cell polarity. b | Summary of the physiological outcomes of EMT in carcinoma: the profile of the shapes illustrates how the extent of invasiveness, the tumour-initiating ability, and degree of drug resistance change across the spectrum of EMT-programme activation. Carcinoma cells invade surrounding tissues either by individual-cell migration or multicellular migration (as cell cohorts). In general, migration of individual cells, which requires the strong activation of the EMT programme, results in faster tissue invasion than occurs by multicellular migration, the mode of migration that predominates when the EMT programme is only weakly activated189. The tumour-initiating ability of carcinoma cells is also affected by the level of EMT-programme activation, peaking at an intermediate level of EMT in these cells; extensive EMT activation is usually detrimental to tumour-initiating ability149. The drug resistance of carcinoma cells also seems to be maximal at an intermediate level of EMT-programme activation, but plateaus (rather than declines) with further activation of this programme149,184. MET, mesenchymal-to-epithelial transition. Shibue, T. & Weinberg, R. A. (2017) EMT, CSCs, and drug resistance: the mechanistic link and clinical implications Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2017.44