Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Boston, Massachusetts.
Cancer Res. 2022 Aug 16;82(16):2848-2859. doi: 10.1158/0008-5472.CAN-21-3552.
African-American (AA) men are more likely to be diagnosed with and die from prostate cancer than European American (EA) men. Despite the central role of the androgen receptor (AR) transcription factor in prostate cancer, little is known about the contribution of epigenetics to observed racial disparities. We performed AR chromatin immunoprecipitation sequencing on primary prostate tumors from AA and EA men, finding that sites with greater AR binding intensity in AA relative to EA prostate cancer are enriched for lipid metabolism and immune response genes. Integration with transcriptomic and metabolomic data demonstrated coinciding upregulation of lipid metabolism gene expression and increased lipid levels in AA prostate cancer. In a metastatic prostate cancer cohort, upregulated lipid metabolism associated with poor prognosis. These findings offer the first insights into ancestry-specific differences in the prostate cancer AR cistrome. The data suggest a model whereby increased androgen signaling may contribute to higher levels of lipid metabolism, immune response, and cytokine signaling in AA prostate tumors. Given the association of upregulated lipogenesis with prostate cancer progression, our study provides a plausible biological explanation for the higher incidence and aggressiveness of prostate cancer observed in AA men.
With immunotherapies and inhibitors of metabolic enzymes in clinical development, the altered lipid metabolism and immune response in African-American men provides potential therapeutic opportunities to attenuate racial disparities in prostate cancer.
非裔美国人(AA)比欧洲裔美国人(EA)更有可能被诊断出患有前列腺癌并因此死亡。尽管雄激素受体(AR)转录因子在前列腺癌中起着核心作用,但对于表观遗传学对观察到的种族差异的贡献知之甚少。我们对来自 AA 和 EA 男性的原发性前列腺肿瘤进行了 AR 染色质免疫沉淀测序,发现与 EA 前列腺癌相比,AA 中 AR 结合强度更高的部位富含脂质代谢和免疫反应基因。与转录组和代谢组数据的整合表明,AA 前列腺癌中脂质代谢基因表达上调和脂质水平增加。在转移性前列腺癌队列中,上调的脂质代谢与预后不良相关。这些发现首次提供了关于前列腺癌 AR 顺式作用元件中种族特异性差异的见解。数据表明,雄激素信号的增加可能导致 AA 前列腺肿瘤中更高水平的脂质代谢、免疫反应和细胞因子信号。鉴于上调的脂肪生成与前列腺癌进展相关,我们的研究为观察到的 AA 男性中前列腺癌发病率和侵袭性更高提供了合理的生物学解释。
鉴于免疫疗法和代谢酶抑制剂正在临床开发中,非裔美国人发生改变的脂质代谢和免疫反应为减弱前列腺癌中的种族差异提供了潜在的治疗机会。