Abstract

In colorectal cancer (CRC), cancer-associated fibroblasts (CAFs) are the most abundant component from the tumor microenvironment (TM). CAFs facilitate tumor progression by inducing angiogenesis, immune suppression and invasion, thus altering the organization/composition of the extracellular matrix (i.e., desmoplasia) and/or activating epithelial-mesenchymal transition (EMT). Soluble factors from the TM can also contribute to cell invasion through secretion of cytokines and recently, IL-33/ST2 pathway has gained huge interest as a protumor alarmin, promoting progression to metastasis by inducing changes in TM. Hence, we analyzed IL-33 and ST2 content in tumor and healthy tissue lysates and plasma from CRC patients. Tissue localization and distribution of these molecules was evaluated by immunohistochemistry (using localization reference markers α-smooth muscle actin or α-SMA and E-cadherin), and clinical/histopathological information was obtained from CRC patients. In vitro experiments were conducted in primary cultures of CAFs and normal fibroblasts (NFs) isolated from tumor and healthy tissue taken from CRC patients. Additionally, migration and proliferation analysis were performed in HT29 and HCT116 cell lines. It was found that IL-33 content increases in left-sided CRC patients with lymphatic metastasis, with localization in tumor epithelia associated with abundant desmoplasia. Although ST2 content showed similarities between tumor and healthy tissue, a decreased immunoreactivity was observed in left-sided tumor stroma, associated to metastasis related factors (advanced stages, abundant desmoplasia, and presence of tumor budding). A principal component analysis (including stromal and epithelial IL-33/ST2 and α-SMA immunoreactivity with extent of desmoplasia) allowed us to distinguish clusters of low, intermediate and abundant desmoplasia, with potential to develop a diagnostic signature with benefits for further therapeutic targets. IL-33 transcript levels from CAFs directly correlated with CRC cell line migration induced by CAFs conditioned media, with rhIL-33 inducing a mesenchymal phenotype in HT29 cells. These results indicate a role of IL-33/ST2 in tumor microenvironment, specifically in the interaction between CAFs and epithelial tumor cells, thus contributing to invasion and metastasis in left-sided CRC, most likely by activating desmoplasia.

Highlights

  • Colorectal cancer (CRC) is one of the most frequent types of cancer, with the third highest incidence in men and the second in women worldwide; with more than half of all cases occurring in developed countries [1]

  • Since stromal ST2 showed inverse correlation with stage and amount of desmoplasia, we evaluated other clinical factors involved in CRC prognosis, such as lymph node (LN) metastasis, tumor budding (TB) and macrophage markers, analyzed by IHC

  • We observed an association between tumor and stromal IL-33 and ST2 localization with desmoplasia in CRC patients, coupled with IL-33 increased in left-sided CRC patients with LN metastasis

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Summary

Introduction

Colorectal cancer (CRC) is one of the most frequent types of cancer, with the third highest incidence in men and the second in women worldwide; with more than half of all cases occurring in developed countries [1]. In Chile, crude death rate has duplicated in the past years, being the fourth most deadly cancer in men and third on women [1, 2]. CRC is a multifactorial pathology that occurs with the formation of a focus of aberrant crypt, progresses with the appearance of polyps, adenoma and carcinoma, which comprises the final stage of malignant epithelial transformation [3, 4]. Cancer associated fibroblasts (CAFs) are the most abundant stromal cells and can mediate a fibrotic response to a chronic inflammatory milieu [9]

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