Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA 94720, USA.
Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA 94720, USA.
Curr Biol. 2023 Jul 24;33(14):3002-3010.e6. doi: 10.1016/j.cub.2023.05.071. Epub 2023 Jun 23.
Malignant tumors trigger a complex network of inflammatory and wound repair responses, prompting Dvorak's characterization of tumors as "wounds that never heal." Some of these responses lead to profound defects in blood clotting, such as disseminated intravascular coagulopathy (DIC), which correlate with poor prognoses. Here, we demonstrate that a new tumor model in Drosophila provokes phenotypes that resemble coagulopathies observed in patients. Fly ovarian tumors overproduce multiple secreted components of the clotting cascade and trigger hypercoagulation of fly blood (hemolymph). Hypercoagulation occurs shortly after tumor induction and is transient; it is followed by a hypocoagulative state that is defective in wound healing. Cellular clotting regulators accumulate on the tumor over time and are depleted from the body, suggesting that hypocoagulation is caused by exhaustion of host clotting components. We show that rescuing coagulopathy by depleting a tumor-produced clotting factor improves survival of tumor-bearing flies, despite the fact that flies have an open (non-vascular) circulatory system. As clinical studies suggest that lethality in patients with high serum levels of clotting components can be independent of thrombotic events, our work establishes a platform for identifying alternative mechanisms by which tumor-driven coagulopathy triggers early mortality. Moreover, it opens up exploration of other conserved mechanisms of host responses to chronic wounds.
恶性肿瘤会引发一系列复杂的炎症和伤口修复反应,这促使 Dvorak 将肿瘤描述为“永不愈合的伤口”。其中一些反应会导致严重的凝血缺陷,例如弥散性血管内凝血(DIC),这与预后不良相关。在这里,我们展示了一种新的果蝇肿瘤模型,它会引发类似于患者中观察到的凝血疾病的表型。果蝇卵巢肿瘤过度产生凝血级联反应的多种分泌成分,并引发果蝇血液(血淋巴)的过度凝结。过度凝结发生在肿瘤诱导后不久且是短暂的;随后是一种低凝状态,这会导致伤口愈合缺陷。随着时间的推移,细胞凝血调节剂会在肿瘤上积累,并从体内耗尽,这表明低凝状态是由于宿主凝血成分的耗尽所致。我们表明,通过耗尽肿瘤产生的凝血因子来纠正凝血疾病可以提高荷瘤果蝇的存活率,尽管果蝇具有开放(非血管)的循环系统。由于临床研究表明,高血清凝血成分水平的患者的致死率可能与血栓形成事件无关,因此我们的工作为确定肿瘤驱动的凝血疾病引发早期死亡的其他替代机制提供了一个平台。此外,它还为探索宿主对慢性伤口的其他保守反应机制开辟了道路。