Abstract

Simple SummaryCancer-associated fibroblasts (CAFs) are the major cellular component of the tumor microenvironment and have been shown to stimulate tumor growth, epithelial-to-mesenchymal transition (EMT), invasion, and radio-resistance. Radio-resistance leading to disease relapse is one of the major challenges in long-term survival and outcome in head and neck squamous cell carcinoma (HNSCC). Therefore, it is essential to search for predictive markers and new targets for treatment using clinically relevant in vitro tumor models. We show that CAFs alter the expression of HNSCC tumor cell genes, many of which are associated with proliferation, differentiation, and metastasis. Moreover, the expression pattern of selected CAF-regulated genes differed between HNSCC tumor tissue and the adjacent non-tumoral tissue. Two CAF-regulated genes, MMP9 and FMOD, were found to be associated with overall survival (OS) in patients treated with radiotherapy.Cancer-associated fibroblasts (CAFs) are known to increase tumor growth and to stimulate invasion and metastasis. Increasing evidence suggests that CAFs mediate response to various treatments. HNSCC cell lines were co-cultured with their patient-matched CAFs in 2D and 3D in vitro models, and the tumor cell gene expression profiles were investigated by cDNA microarray and qRT-PCR. The mRNA expression of eight candidate genes was examined in tumor biopsies from 32 HNSCC patients and in five biopsies from normal oral tissue. Differences in overall survival (OS) were tested with Kaplan–Meier long-rank analysis. Thirteen protein coding genes were found to be differentially expressed in tumor cells co-cultured with CAFs in 2D and 81 in 3D when compared to tumor cells cultured without CAFs. Six of these genes were upregulated both in 2D and 3D (POSTN, GREM1, BGN, COL1A2, COL6A3, and COL1A1). Moreover, two genes upregulated in 3D, MMP9 and FMOD, were significantly associated with the OS. In conclusion, we demonstrated in vitro that CAF-derived signals alter the tumor cell expression of multiple genes, several of which are associated with differentiation, epithelial-to-mesenchymal transition (EMT) phenotype, and metastasis. Moreover, six of the most highly upregulated genes were found to be overexpressed in tumor tissue compared to normal tissue.

Highlights

  • Cancer of the head and neck is the seventh most common form of cancer worldwide

  • cancer-associated fibroblasts (CAFs) were distributed around tumor cell colonies in a similar pattern as observed in patient derived tumor samples (Figure 1A)

  • Tumor cells were separated from CAFs by Magnetic Activated Cell Sorting (MACS), and the purity of the tumor cell cultures were verified by microscopy

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Summary

Introduction

Cancer of the head and neck is the seventh most common form of cancer worldwide. About 90% of cases are head and neck squamous cell carcinomas (HNSCC), which have their origin in the mucosa of the oral cavity, pharynx, larynx, and nasal cavity [1]. Rather than being understood as malignant cells growing in isolation, cancer has over the past decades been recognized as a complex tissue where many different cell types and extracellular matrix interact in a multipart ecosystem This results in the creation of a distinct microenvironment within the tumor [3]. One of the most crucial elements of the microenvironment is the cancer-associated fibroblasts (CAFs) These cells modulate the tumor’s fate by increasing tumor growth [4], epithelial-to-mesenchymal transition (EMT) [5], the invasive potential [6], and metastasis [7] by secretion of soluble factors or by modification of extracellular matrix components [8]. This study was undertaken to investigate the influence of CAFs on the gene expression profile of tumor cells in 2D and 3D co-cultures, and to assess the potential impact of CAF-regulated genes on radiotherapy response and OS of the patients diagnosed with HNSCC

Cells and Culture Conditions
Co-Culture of Tumor Cells and CAFs
Microarray Analysis
Tumor Material and Patient Characteristics
Statistical Analysis
Microarray Analysis in 2D Cultures
Microarray Analysis in 3D Cultures
Verification of Microarray Results Using qRT-PCR
Conclusions
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