Justine Bellier

Stromal Modulators of TGF-β in Cancer

Transforming growth factor-β (TGF-β) is an intriguing cytokine exhibiting dual activities in malignant disease. It is an important mediator of cancer invasion, metastasis and angiogenesis, on the one hand, while it exhibits anti-tumor functions on the other hand. Elucidating the precise role of TGF-β in malignant development and progression requires a better understanding of the molecular mechanisms involved in its tumor suppressor to tumor promoter switch. One important aspect of TGF-β function is its interaction with proteins within the tumor microenvironment. Several stromal proteins have the natural ability to interact and modulate TGF-β function. Understanding the complex interplay between the TGF-β signaling network and these stromal proteins may provide greater insight into the development of novel therapeutic strategies that target the TGF-β axis. The present review highlights our present understanding of how stroma modulates TGF-β activity in human cancers.

Methylglyoxal-Mediated Stress Correlates with High Metabolic Activity and Promotes Tumor Growth in Colorectal Cancer

Cancer cells generally rely on aerobic glycolysis as a major source of energy. Methylglyoxal (MG), a dicarbonyl compound that is produced as a side product during glycolysis, is highly reactive and induces the formation of advanced glycation end-products that are implicated in several pathologies including cancer. All mammalian cells have an enzymatic defense against MG composed by glyoxalases GLO1 and GLO2 that converts MG to d-lactate. Colorectal cancer (CRC) is one of the most frequently occurring cancers with high morbidity and mortality. In this study, we used immunohistochemistry to examine the level of MG protein adducts, in a series of 102 CRC human tumors divided into four clinical stages. We consistently detected a high level of MG adducts and low GLO1 activity in high stage tumors compared to low stage ones suggesting a pro-tumor role for dicarbonyl stress. Accordingly, GLO1 depletion in CRC cells promoted tumor growth in vivo that was efficiently reversed using carnosine, a potent MG scavenger. Our study represents the first demonstration that MG adducts accumulation is a consistent feature of high stage CRC tumors. Our data point to MG production and detoxification levels as an important molecular link between exacerbated glycolytic activity and CRC progression.

Langerhans cell number is a strong and independent prognostic factor for head and neck squamous cell carcinomas

OBJECTIVES Head and neck squamous cell carcinomas (HNSCCs) exhibit great biological heterogeneity and relatively poor prognosis. Tobacco and alcohol consumption is involved in the cause of the majority of these cancers, but over the last several years, Human Papilloma Virus (HPV) infection has increased specifically in oropharyngeal cancers and become an additional risk factor. Here, we evaluated the number of Langerhans cells (LCs) in HNSCC and reporting its prognostic power in comparison to other risk factors. MATERIALS AND METHODS Our clinical series was composed of 25 tumor-free peritumoral epithelium, 64 low-grade dysplasia, 54 high-grade dysplasia and 125 carcinoma samples. HPV was detected by E6/E7 qPCR and p16 immunohistochemistry. CD1a-positive LCs were counted in intra-tumoral and stromal compartments as well as lymph nodes. MIP-3α was assessed in carcinomas using immunohistochemistry. RESULTS Univariate Cox regression analyses demonstrated that high LC number is associated with longer recurrence-free survival in both intra-tumoral and stromal compartments and longer overall survival in stromal compartment. Tobacco and alcohol habits, but not HPV status, are also correlated with poor prognoses in terms of recurrence. Multivariate analyses reported stromal LC number as a strong prognostic factor independent of tobacco, alcohol and HPV status. Moreover, LC number is higher in tumors and invaded lymph nodes than dysplastic lesions but it decreases in HPV-positive cancer patients. Further, LC number correlates with MIP-3α expression. CONCLUSION These findings suggest that LC number is a significant and independent prognostic factor for HNSCC. LC infiltration is increased in cancer lesions but decrease with HPV infection.

Hormetic potential of methylglyoxal, a side-product of glycolysis, in switching tumours from growth to death

Metabolic reprogramming toward aerobic glycolysis unavoidably favours methylglyoxal (MG) and advanced glycation end products (AGEs) formation in cancer cells. MG was initially considered a highly cytotoxic molecule with potential anti-cancer value. However, we have recently demonstrated that MG enhanced tumour growth and metastasis. In an attempt to understand this dual role, we explored MG-mediated dicarbonyl stress status in four breast and glioblastoma cancer cell lines in relation with their glycolytic phenotype and MG detoxifying capacity. In glycolytic cancer cells cultured in high glucose, we observed a significant increase of the conversion of MG to D-lactate through the glyoxalase system. Moreover, upon exogenous MG challenge, glycolytic cells showed elevated amounts of intracellular MG and induced de novo GLO1 detoxifying enzyme and Nrf2 expression. Thus, supporting the adaptive nature of glycolytic cancer cells to MG dicarbonyl stress when compared to non-glycolytic ones. Finally and consistent with the pro-tumoural role of MG, we showed that low doses of MG induced AGEs formation and tumour growth in vivo, both of which can be reversed using a MG scavenger. Our study represents the first demonstration of a hormetic effect of MG defined by a low-dose stimulation and a high-dose inhibition of tumour growth.

High stromal Foxp3-positive T cell number combined to tumor stage improved prognosis in head and neck squamous cell carcinoma

OBJECTIVES Head and neck squamous cell carcinomas (HNSCC), one of the most frequent cancers in the world, are largely infiltrated by inflammatory immune cells. Our aim was to evaluate the number of Foxp3+ T cells in HNSCC, reporting its prognostic power in comparison to other risk factors. MATERIAL AND METHODS Our clinical series was composed of 21 tumor-free peri-tumoral epithelia, 49 low grade dysplasia, 43 high grade dysplasia and 110 carcinoma samples including some cases with HPV infection. In vivo experiments were conducted on 80 C3H/HeN mice which were orthotopically injected with SCCVII CT, E7, E6 and E6/E7 cell lines. RESULTS Foxp3+ T cell infiltration increased with tumor progression from normal epithelia, dysplasia to carcinoma and the increase is more important in HPV+ patients than in negative ones. Animal experiments revealed that E7 oncoprotein expression was significantly associated with an increase in Foxp3+ T cell recruitment in tumor, a delay in tumor onset and improved animal survival. Univariate Cox regression analyses demonstrated that high Foxp3+ T cell number in stromal compartment is associated with longer patient recurrence-free and overall survivals. Foxp3+ T cell number improved the prognostic value of tumor stage. Multivariate analyses reported that stromal Foxp3+ T cell number is a strong prognostic factor independent of classical risk factors such as tobacco, alcohol, and HPV status. CONCLUSION Foxp3+ T cell number is a significant prognostic factor for HNSCC, improving the tumor stage, and that viral E7 may play a role in the Foxp3+ T cell infiltration to the tumor.

High infiltration of CD68+ macrophages is associated with poor prognoses of head and neck squamous cell carcinoma patients and is influenced by human papillomavirus

Incidence of human papillomavirus (HPV)-related head and neck squamous cell carcinomas (HNSCCs) has increased over the last few decades. The reaction of the host immune system to these tumors remains biologically complex. Here, we investigated CD68+ macrophage numbers, reporting the prognostic value in comparison to other risk factors. We also examined CD68+ macrophage infiltration during disease progression regarding the impact of HPV infection, and we studied the role of HPV16-E6/E7 oncoproteins in CD68+ macrophage recruitment. CD68+ macrophage numbers were evaluated in 10 cases of tumor-free peri-tumoral epithelia, 43 cases of low-grade dysplasia, 45 cases of high-grade dysplasia and 110 cases of carcinoma. Our in vivo model was developed in 80 C3H/HeN mice orthotopically injected with HPV16-E6, -E7 or -E6/E7-transfected SCC-VII cell lines. High CD68+ macrophage numbers in the intra-tumoral compartment were associated with shorter patient survival (recurrence-free survival: p = 0.001; overall survival: p = 0.01). Multivariate analyses reported that CD68+ macrophage infiltration and tumor stage were strong and independent prognostic factors of HNSCC. CD68+ macrophage numbers increased during HNSCC progression both in intra-epithelial (p < 0.001) and stromal compartments (p < 0.001). A higher density of CD68+ macrophages was observed in advanced stages (p = 0.004). Patients with transcriptionally active HPV infections had higher CD68+ macrophage density than did HPV-negative patients (p = 0.003). CD68+ macrophage infiltration was higher in HPV-E7+ and −E6/E7+ mouse tumors than in -E6+ tumors (p = 0.029 and p < 0.001). In conclusion, the extent of CD68+ macrophage infiltration is a significant prognostic factor for HNSCC patients. The recruitment of macrophages increases during disease progression and is influenced by the HPV virus.

Myoferlin controls mitochondrial structure and activity in pancreatic ductal adenocarcinoma, and affects tumor aggressiveness

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related death. Therapeutic options remain very limited and are based on classical chemotherapies. Energy metabolism reprogramming appears as an emerging hallmark of cancer and is considered a therapeutic target with considerable potential. Myoferlin, a ferlin family member protein overexpressed in PDAC, is involved in plasma membrane biology and has a tumor-promoting function. In the continuity of our previous studies, we investigated the role of myoferlin in the context of energy metabolism in PDAC. We used selected PDAC tumor samples and PDAC cell lines together with small interfering RNA technology to study the role of myoferlin in energetic metabolism. In PDAC patients, we showed that myoferlin expression is negatively correlated with overall survival and with glycolytic activity evaluated by 18F-deoxyglucose positron emission tomography. We found out that myoferlin is more abundant in lipogenic pancreatic cancer cell lines and is required to maintain a branched mitochondrial structure and a high oxidative phosphorylation activity. The observed mitochondrial fission induced by myoferlin depletion led to a decrease of cell proliferation, ATP production, and autophagy induction, thus indicating an essential role of myoferlin for PDAC cell fitness. The metabolic phenotype switch generated by myoferlin silencing could open up a new perspective in the development of therapeutic strategies, especially in the context of energy metabolism.

Murine stroma adopts a human-like metabolic phenotype in the PDX model of colorectal cancer and liver metastases

Cancer research is increasingly dependent of patient-derived xenograft model (PDX). However, a major point of concern regarding the PDX model remains the replacement of the human stroma with murine counterpart. In the present work we aimed at clarifying the significance of the human-to-murine stromal replacement for the fidelity of colorectal cancer (CRC) and liver metastasis (CRC-LM) PDX model. We have conducted a comparative metabolic analysis between 6 patient tumors and corresponding PDX across 4 generations. Metabolic signatures of cancer cells and stroma were measured separately by MALDI-imaging, while metabolite changes in entire tumors were quantified using mass spectrometry approach. Measurement of glucose metabolism was also conducted in vivo using [18F]-fluorodeoxyglucose (FDG) and positron emission tomography (PET). In CRC/CRC-LM PDX model, human stroma was entirely replaced at the second generation. Despite this change, MALDI-imaging demonstrated that the metabolic profiles of both stromal and cancer cells remained stable for at least four generations in comparison to the original patient material. On the tumor level, profiles of 86 water-soluble metabolites as well as 93 lipid mediators underlined the functional stability of the PDX model. In vivo PET measurement of glucose uptake (reflecting tumor glucose metabolism) supported the ex vivo observations. Our data show for the first time that CRC/CRC-LM PDX model maintains the functional stability at the metabolic level despite the early replacement of the human stroma by murine cells. The findings demonstrate that human cancer cells actively educate murine stromal cells during PDX development to adopt the human-like phenotype.

PO-225 Dual role of methylglyoxal, a glycolysis side-product, in cancer

Introduction Methylglyoxal (MG) is spontaneously produced during glycolysis. MG reacts with proteins, lipids and DNA, thus inducing a dicarbonyl stress. Glyoxalase 1 (GLO1) detoxifies MG into D-Lactate. High MG is notably associated with diabetes and cancer as the latter presents a deregulated energy metabolism where tumour cells use glycolysis rather than mitochondrial respiration. The impact of MG on cancer is ambiguous as some studies reported an anti-tumour and others a pro-tumour effect upon GLO1 silencing. Material and methods In this study, we aimed to evaluate the effect of MG stress on a panel of cancer cell lines: MDA-MB-231 known to be glycolytic and MCF7 cells known to be more oxidative breast cancer cells and U87-MG and U251 glioblastoma cell lines. We characterised glycolysis, MG production and detoxification under different conditions in these cell lines. U87-MG tumour growth upon MG treatment was evaluated using the chick chorioallantoic membrane tumour model (CAM). Results and discussions We observed that only MDA-MB-231 and U87-MG cell lines are able to increase their glycolysis flux upon glucose stimulation. In these conditions, both cell lines increased their MG production and detoxification via the glyoxalase system. Under exogenous MG treatment, both glycolytic cell lines showed increased expression of both NRF2 and its target gene GLO1, whereas no ROS accumulation was detected. Upon GLO1 activity inhibition, an alternative MG detoxification system, the aldo-keto reductase (AKR) enzymes, is significantly increased at least in U87-MG cells. Finally, U87-MG cells xenografted on CAM and treated with MG showed an increased growth at low MG doses while high doses reduced tumour growth. Both effects could be reversed by co-treatment with a potent MG-scavenger, L-Carnosine. Conclusion Our data demonstrate for the first time that cancer cells are not equal when facing MG stress. Their response to MG is mainly dependent upon energy metabolism and detoxification capacity (including GLO1 and AKRs). Reduced glutathione level is also an important feature to consider. Ongoing studies will help identify the molecular mecanisms underlying MG dual effect in cancer.

PO-219 Methylglyoxal-induced dicarbonyl stress: role in melanoma progression and response to therapy

Introduction Methylglyoxal (MG) is an endogenous dicarbonyl spontaneously produced during glycolysis able to react with proteins, lipids and DNA, inducing a carbonyl stress. Glyoxalase 1 (GLO1) detoxifies MG into D-Lactate. High MG is notably associated with diabetes and cancer. Melanoma is the most deadly form of skin cancer. Therapy is notably based on the inhibition of the MAPK pathway, often over activated. Unfortunately, BRAF and MEK inhibitors are briefly efficient as tumours rapidly develop resistance mechanisms. Melanoma tumours are generally highly glycolytic and therefore inevitably produce high amounts of MG, accumulating Advanced Glycation End products (AGEs). Phenformin, a metformin analogue with MG-scavenging properties, improves the therapeutic effect of BRAF inhibition. This observation is in good accordance with our hypothesis that MG could be involved in progression and resistance of melanoma. Material and methods This study aims to assess the metabolic profile of various human melanoma cell lines comprising BRAF and/or MEK inhibitors sensitive and resistant cells. First, we plan to explore thoroughly dicarbonyl stress status in these cell lines and in patient tissues. Next, we will subject melanoma cells to anti-carbonyl stress agents such as l-carnosine and aminoguanidine alone or in combination with MAPK pathway inhibitors and assess their effect on tumour cell survival. Results and discussions IHC staining of argpyrimidines, MG-derived AGEs, in a collection of melanoma samples showed that MG carbonyl stress is a constant feature in melanoma. MG AGEs were detectable in both BRAF inhibitors sensitive and resistant cell lines: A375 and A2058, respectively. Interestingly, the treatment of these cells with exogenous MG induced different responses: A375 cells increased their MG detoxification system and their metabolic activity as assessed by their increased GLUT1 and GLUT3 glucose transporters and PGC1alpha mitochondrial regulator. Whereas, A2058 resistant melanoma cells showed a decrease of both GLO1 activity and the metabolic markers investigated. Conclusion Ongoing experiments will help to understand these phenotypes and to further characterise a serie of WT and BRAF mutated melanoma cells. We plan to assess carbonyl stress in a larger human melanoma collection to investigate the correlation with tumour stage, metastasis, overall survival and resistance to therapy. Finally, we will test the efficacy of a combined therapy using BRAF and/or MEK inhibitors and MG scavenger molecules such as carnosine.