Majumder Sarmila, Mishra Sanjay, Shinde Neelam, Cuitino Maria C, Bauer Morgan, Ahirwar Dinesh, Basree Mustafa M, Bharti Vijaya, Ormiston Kate, Mawalkar Resham, Alsammerai Sara, Sarathy Gautam, Vilgelm Anna E, Zhang Xiaoli, Ganju Ramesh K, Ramaswamy Bhuvaneswari
Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Department of Pathology, The Ohio State University, Columbus, OH, 43210, USA.
Breast Cancer Res. 2025 Jan 3;27(1):1. doi: 10.1186/s13058-024-01933-3.
Epidemiological studies associate an increase in breast cancer risk, particularly triple-negative breast cancer (TNBC), with lack of breastfeeding. This is more prevalent in African American women, with significantly lower rate of breastfeeding compared to Caucasian women. Prolonged breastfeeding leads to gradual involution (GI), whereas short-term or lack of breastfeeding leads to abrupt involution (AI) of the breast. Our previous study utilizing a murine model demonstrated precancerous changes, specifically hyperplasia, a non-obligate precursor of breast cancer in the mammary glands of AI mice. Here we investigated mechanisms during early events of AI that prompts precancerous changes in mouse mammary glands.
Uniparous FVB/N mice were randomized to AI and GI on postpartum day 7 when all pups were removed from AI dams. GI dams were allowed to nurse the pups till day 31. Cell death kinetics and gene expression were assessed by TUNEL assay and qPCR respectively. Immune cell changes were investigated by flow cytometry, cytokine array and multiplex immunofluorescence. 3D-organoid cultures were used for in vitro assay of luminal progenitor cells.
AI results in rapid cell death, DNA repair response, and immunosuppressive myeloid cells infiltration, leading to a chronically inflamed microenvironment. GI elicits a more controlled immune response and extended cell death. At the peak of cell death, AI glands harbored more immunosuppressive myeloid-derived suppressor cells (MDSCs) and CD206 + M2-like macrophages, known to promote oncogenic events, compared to GI glands. AI glands exhibit an enrichment of CCL9-producing MDSCs and CD206 + M2-like macrophages that promote expansion of ELF5 + /ERα- luminal cells, both in vitro and in vivo. Multiplex imaging of AI glands demonstrated an increase in ELF5 + /WNT5a + luminal cells alongside a reduction in the ELF5 + /ERα + population when involution appeared histologically complete. A significantly higher number of CD206 + cells in post involution AI gland attests to a chronically inflamed state induced by AI.
Our findings reveal significant disparities between AI and GI gland dynamics at the early phase of involution. CCL9, secreted by immune cells at the peak of cell death promotes expansion of Elf5 + /ERα- luminal progenitor cells, the putative precursors of TNBC connecting early events of AI with increased breast cancer risk.
流行病学研究表明,乳腺癌风险增加,尤其是三阴性乳腺癌(TNBC),与缺乏母乳喂养有关。这在非裔美国女性中更为普遍,其母乳喂养率明显低于白人女性。长时间母乳喂养会导致乳腺逐渐退化(GI),而短期或缺乏母乳喂养会导致乳腺突然退化(AI)。我们之前利用小鼠模型进行的研究表明,AI小鼠乳腺中存在癌前变化,特别是增生,这是乳腺癌的一种非必然前体。在此,我们研究了AI早期事件中促使小鼠乳腺发生癌前变化的机制。
将单胎FVB/N小鼠在产后第7天随机分为AI组和GI组,此时将所有幼崽从AI组母鼠处移除。GI组母鼠被允许哺育幼崽至第31天。分别通过TUNEL检测和qPCR评估细胞死亡动力学和基因表达。通过流式细胞术、细胞因子阵列和多重免疫荧光研究免疫细胞变化。3D类器官培养用于管腔祖细胞的体外检测。
AI导致快速细胞死亡、DNA修复反应和免疫抑制性髓系细胞浸润,导致慢性炎症微环境。GI引发更可控的免疫反应和延长的细胞死亡。在细胞死亡高峰期,与GI组乳腺相比,AI组乳腺中含有更多已知可促进致癌事件的免疫抑制性髓系来源抑制细胞(MDSCs)和CD206 + M2样巨噬细胞。AI组乳腺表现出产生CCL9的MDSCs和CD206 + M2样巨噬细胞富集,它们在体外和体内均促进ELF5 + /ERα-管腔细胞的扩增。AI组乳腺的多重成像显示,当退化在组织学上完成时,ELF5 + /WNT5a +管腔细胞增加,同时ELF5 + /ERα +细胞群体减少。退化后AI组乳腺中CD206 +细胞数量显著增加,证明AI诱导了慢性炎症状态。
我们的研究结果揭示了退化早期AI组和GI组乳腺动态之间的显著差异。细胞死亡高峰期免疫细胞分泌的CCL9促进了Elf5 + /ERα-管腔祖细胞的扩增,这些祖细胞是TNBC的假定前体,将AI的早期事件与乳腺癌风险增加联系起来。