Abstract

BackgroundThe poor prognosis of esophageal squamous cell carcinoma (ESCC) highlights the need for novel strategies against this disease. Our previous study suggested the involvement of CCL2 and tumor associated macrophages (TAMs) in esophageal carcinogenesis. Despite the recognition of TAMs as a promising target for cancer treatment, mechanisms underlying its infiltration, activation and tumor-promotive function in ESCC remain unknown.MethodsHuman esophageal tissue array and TCGA database were used to evaluate the clinical relevance of CCL2 and TAMs in ESCC. F344 rats and C57BL/6 mice were treated with N-nitrosomethylbenzylamine (NMBA) to establish orthotopic models of esophageal carcinogenesis. CCL2/CCR2 gene knockout mice and macrophage-specific PPARG gene knockout mice were respectively used to investigate the role of infiltration and polarization of TAMs in ESCC. CCL2-mediated monocyte chemotaxis was estimated in malignantly transformed Het-1A cells. THP-1 cells were used to simulate TAMs polarization in vitro. RNA-sequencing was performed to uncover the mechanism.ResultsIncreasing expression of CCL2 correlated with TAMs accumulation in esophageal carcinogenesis, and they both predicts poor prognosis in ESCC cohort. Animal studies show blockade of CCL2-CCR2 axis strongly reduces tumor incidence by hindering TAMs recruitment and thereby potentiates the antitumor efficacy of CD8+ T cells in the tumor microenvironment. More importantly, M2 polarization increases PD-L2 expression in TAMs, resulting in immune evasion and tumor promotion through PD-1 signaling pathway.ConclusionThis study highlights the role of CCL2-CCR2 axis in esophageal carcinogenesis. Our findings provide new insight into the mechanism of immune evasion mediated by TAMs in ESCC, suggesting the potential of TAMs-targeted strategies for ESCC prevention and immunotherapy.

Highlights

  • The poor prognosis of esophageal squamous cell carcinoma (ESCC) highlights the need for novel strategies against this disease

  • We demonstrated the antitumor activity of Chemokine ligand 2 (CCL2)-chemokine receptor 2 (CCR2) blockade in esophageal carcinogenesis and deciphered the mechanism underlying tumor evasion induced by tumor associated macrophages (TAMs)

  • CCL2 and TAMs correlate with esophageal carcinogenesis and predicts poor prognosis in ESCC patients To evaluate the association of CCL2 and TAMs in esophageal carcinogenesis, we firstly determined the distribution of CCL2 with human tumor tissue microarrays constructed from ESCC patients

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Summary

Introduction

The poor prognosis of esophageal squamous cell carcinoma (ESCC) highlights the need for novel strategies against this disease. Despite the recognition of TAMs as a promising target for cancer treatment, mechanisms underlying its infiltration, activation and tumor-promotive function in ESCC remain unknown. The incidence of esophageal adenocarcinoma (EAC) is increasing in Western countries, esophageal squamous cell carcinoma (ESCC) is still the predominant type, accounting for 90% of all esophageal cancer cases [2, 3]. Due to the lack of targeted approaches for early diagnosis and treatment, the five-year survival rate of ESCC patients remains dismal [4]. The poor outcome urges development of novel preventive and therapeutic strategies against this disease, which highlights the need for better understanding of ESCC carcinogenesis

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