Abstract

Chronic inflammation is a risk factor for lung cancer, and low-dose aspirin intake reduces lung cancer risk. However, the roles that specific inflammatory cells and their products play in lung carcinogenesis have yet to be fully elucidated. In mice, alveolar macrophage numbers increase as lung tumors progress, and pulmonary macrophage programing changes within 2 weeks of carcinogen exposure. To examine how macrophages specifically affect lung tumor progression, they were depleted in mice bearing urethane-induced lung tumors using clodronate-encapsulated liposomes. Alveolar macrophage populations decreased to ≤50% of control levels after 4–6 weeks of liposomal clodronate treatment. Tumor burden decreased by 50% compared to vehicle treated mice, and tumor cell proliferation, as measured by Ki67 staining, was also attenuated. Pulmonary fluid levels of insulin-like growth factor-I, CXCL1, IL-6, and CCL2 diminished with clodronate liposome treatment. Tumor-associated macrophages expressed markers of both M1 and M2 programing in vehicle and clodronate liposome-treated mice. Mice lacking CCR2 (the receptor for macrophage chemotactic factor CCL2) had comparable numbers of alveolar macrophages and showed no difference in tumor growth rates when compared to similarly treated wild-type mice suggesting that while CCL2 may recruit macrophages to lung tumor microenvironments, redundant pathways can compensate when CCL2/CCR2 signaling is inactivated. Depletion of pulmonary macrophages rather than inhibition of their recruitment may be an advantageous strategy for attenuating lung cancer progression.

Highlights

  • Lung cancer is responsible for 29% of all cancer deaths in North America, making it more lethal than breast, colon, prostate, and pancreatic cancer combined [1]

  • Decreased Ki67 staining indicated that cell division slowed as a result of macrophage depletion in vivo, an observation complementing previous results showing that macrophage co-culture and exposure to macrophage conditioned media increased tumor cell proliferation in vitro [26]

  • Clodronate exposure decreased bronchoalveolar lavage fluid (BALF) levels of insulin-like growth factor-I (IGF-I), IL-6, CXCL1, and CCL2 and increased VEGF levels while not affecting most of the other factors examined, suggesting that alveolar macrophages may not be their primary source in murine lungs

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Summary

Introduction

Lung cancer is responsible for 29% of all cancer deaths in North America, making it more lethal than breast, colon, prostate, and pancreatic cancer combined [1]. Limiting chronic inflammation may halt the rapid growth and progression of this disease [6, 7] since longterm, low-dose aspirin use reduces the risk of death from lung AC by 45%. Patients with non-AC subtypes of lung cancer were not protected by aspirin use, suggesting that chronic inflammation may be uniquely important for AC progression [7]. Increased numbers of pulmonary macrophages correlate with poor prognosis in NSCLC patients [8,9,10], and alveolar macrophage numbers increase during lung tumor progression in mouse models of AC [11, 12]. Chronic inflammation drives lung tumor growth and progression in mouse models and human disease, and alveolar macrophages facilitate much of this effect

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