Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030.
Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030.
Proc Natl Acad Sci U S A. 2024 Aug 13;121(33):e2402903121. doi: 10.1073/pnas.2402903121. Epub 2024 Aug 5.
Immune checkpoint therapy has limited efficacy for patients with bone-metastatic castration-resistant prostate cancer (bmCRPC). To improve immunotherapy for bmCRPC, we aimed to identify the mechanism of bmCRPC-induced changes in the immune microenvironment. Among bmCRPC patients, higher levels of a 32-gene M2-like macrophage signature in bone metastasis samples correlated with shorter overall survival. Immunohistochemistry showed that CD206-positive (CD206) macrophages were enriched in bmCRPC bone biopsy specimens compared with primary tumors or lymph node metastases. In preclinical osteogenic prostate cancer (Pca) xenograft models, CD206 macrophages were recruited to areas with tumor-induced bone. RNA sequencing (RNAseq) analysis showed higher expression of an M2-like gene signature, with activated canonical and noncanonical Wnt pathways, in tumor-associated macrophages isolated from osteogenic tumors (bone-TAMs) than in TAMs isolated from nonosteogenic tumors (ctrl-TAMs). Mechanistic studies showed that endothelial cells (ECs) that had undergone EC-to-osteoblast (EC-to-OSB) transition, the precursors of tumor-induced OSBs, produced paracrine factors, including Wnts, CXCL14, and lysyl oxidase, which induced M2 polarization and recruited M2-like TAMs to the bone-tumor microenvironment (bone-TME). Bone-TAMs suppressed CD8 T cells' proliferation and cytolytic activity, and these effects were partially reversed by treating bone-TAMs with Wnt inhibitors. Genetic or pharmacological inhibition of Pca-induced EC-to-OSB transition reduced the levels of M2-like macrophages in osteogenic tumors. Our study demonstrates that Pca-induced EC-to-OSB transition drives immunosuppression in the bone-TME, suggesting that therapies that reduce Pca-induced bone formation may improve immunotherapeutic outcomes for bmCRPC.
免疫检查点疗法对患有骨转移去势抵抗性前列腺癌(bmCRPC)的患者疗效有限。为了提高 bmCRPC 的免疫治疗效果,我们旨在确定 bmCRPC 诱导的免疫微环境变化的机制。在 bmCRPC 患者中,骨转移样本中高水平的 32 基因 M2 样巨噬细胞特征与总生存期更短相关。免疫组化显示,与原发性肿瘤或淋巴结转移相比,bmCRPC 骨活检标本中富含 CD206 阳性(CD206)巨噬细胞。在临床前成骨性前列腺癌(Pca)异种移植模型中,CD206 巨噬细胞被招募到肿瘤诱导的骨区域。RNA 测序(RNAseq)分析显示,与非成骨性肿瘤(ctrl-TAMs)分离的 TAMs 相比,从成骨性肿瘤(bone-TAMs)分离的肿瘤相关巨噬细胞中表达更高的 M2 样基因特征,并且激活了经典和非经典 Wnt 途径。机制研究表明,经历内皮细胞(EC)向成骨细胞(EC-to-OSB)转变的 EC,即肿瘤诱导的 OSB 的前体,产生旁分泌因子,包括 Wnts、CXCL14 和赖氨酰氧化酶,这些因子诱导 M2 极化并招募 M2 样 TAMs 进入骨肿瘤微环境(bone-TME)。Bone-TAMs 抑制 CD8 T 细胞的增殖和细胞毒性活性,并且通过用 Wnt 抑制剂处理 Bone-TAMs,这些作用部分逆转。遗传或药理学抑制 Pca 诱导的 EC-to-OSB 转变降低了成骨性肿瘤中 M2 样巨噬细胞的水平。我们的研究表明,Pca 诱导的 EC-to-OSB 转变驱动了 bone-TME 中的免疫抑制,这表明减少 Pca 诱导的骨形成的疗法可能改善 bmCRPC 的免疫治疗效果。
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