Cancer Res. 2022 May 3;82(9):1753-1761. doi: 10.1158/0008-5472.CAN-21-2463.
UNLABELLED: Heart failure and cancer are the leading cause of deaths worldwide. While heart failure and cancer have been considered separate diseases, it is becoming evident that they are highly connected and affect each other's outcomes. Recent studies using experimental mouse models have suggested that heart failure promotes tumor progression. The mouse models used involve major irreversible surgery. Here, we induced heart hypertrophy via expression of activating transcription factor 3 (ATF3) in cardiomyocytes, followed by cancer cells' implantation. Tumors developing in ATF3-transgenic mice grew larger and displayed a more highly metastatic phenotype compared with tumors in wild-type mice. To address whether ATF3 expression or the cardiac outcome are necessary for tumor progression, ATF3 expression was turned off after cardiac hypertrophy development followed by cancer cell implantation. The tumor promotion phenotype and the enhancement of metastatic properties were preserved, suggesting that the failing heart per se is sufficient to promote tumor progression. Serum derived from ATF3-transgenic mice enhanced cancer cell proliferation and increased cancer cell metastatic properties in vitro. Using a cytokine array panel, multiple factors responsible for promoting tumor cell proliferation and the metastatic phenotype were identified. Interestingly, the failing heart and the tumor separately and simultaneously contributed to higher levels of these factors in the serum as well as other tissues and organs. These data suggest the existence of intimate cross-talk between the hypertrophied heart and the tumor that is mediated by secreted factors, leading to cancer promotion and disease deterioration. SIGNIFICANCE: This work highlights the importance of early diagnosis and treatment of heart failure prior to reaching the irreversible stage that can exacerbate cancer progression.
未加标签:心力衰竭和癌症是全球主要的死亡原因。虽然心力衰竭和癌症被认为是两种独立的疾病,但越来越明显的是,它们之间存在高度关联,并相互影响各自的结果。最近使用实验性小鼠模型的研究表明,心力衰竭会促进肿瘤的进展。所使用的小鼠模型涉及主要的不可逆手术。在这里,我们通过在心肌细胞中表达激活转录因子 3 (ATF3) 诱导心肌肥大,然后植入癌细胞。与野生型小鼠相比,ATF3 转基因小鼠中形成的肿瘤更大,并表现出更高的转移性表型。为了确定 ATF3 表达或心脏结果是否对肿瘤进展是必要的,我们在心肌肥大发展后关闭了 ATF3 表达,然后植入癌细胞。肿瘤促进表型和转移性特性的增强得以保留,这表明衰竭的心脏本身足以促进肿瘤的进展。来自 ATF3 转基因小鼠的血清增强了癌细胞的增殖,并增加了癌细胞的体外转移性特性。使用细胞因子阵列面板,确定了多个负责促进肿瘤细胞增殖和转移性表型的因子。有趣的是,衰竭的心脏和肿瘤分别且同时导致血清以及其他组织和器官中这些因子的水平升高。这些数据表明,肥大的心脏和肿瘤之间存在密切的相互作用,这种相互作用是由分泌因子介导的,导致癌症的促进和疾病的恶化。
意义:这项工作强调了在心力衰竭达到可能加剧癌症进展的不可逆阶段之前,早期诊断和治疗心力衰竭的重要性。
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