Abstract

BackgroundInnate immune cells such as macrophages are abundantly present within malignant ascites, where they share the microenvironment with ovarian cancer stem cells (CSC).MethodsTo mimic this malignant ascites microenvironment, we created a hanging-drop hetero-spheroid model to bring CSCs and macrophages in close association. Within these hetero-spheroids, CD68+ macrophages (derived from U937 or peripheral blood monocytes) make up ~ 20% of the population, while the rest are ovarian cancer cells and ovarian cancer stem cells (derived from the high grade serous ovarian cancer cell line, OVCAR3).ResultsOur results indicate that CSCs drive the upregulation of M2 macrophage marker CD206 within hetero-spheroids, compared to bulk ovarian cancer cells, implying an inherently more immuno-suppressive program. Moreover, an increased maintenance of elevated aldehyde dehydrogenase (ALDH) activity is noted within hetero-spheroids that include pre-polarized CD206+ M2 macrophages, implying a reciprocal interaction that drives pro-tumoral activation as well as CSC self-renewal. Consistent with enriched CSCs, we also observe increased levels of pro-tumoral IL-10 and IL-6 cytokines in the CSC/M2-macrophage hetero-spheroids. CSC/M2-macrophage hetero-spheroids are also less sensitive to the chemotherapeutic agent carboplatin and are subsequently more invasive in transwell assays. Using inhibitors of WNT secretion in both CSCs and macrophages, we found that CSC-derived WNT ligands drove CD206+ M2 macrophage activation, and that, conversely, macrophage-derived WNT ligands enriched ALDH+ cells within the CSC compartment of hetero-spheroids. Upon examination of specific WNT ligand expression within the monocyte-derived macrophage system, we observed a significant elevation in gene expression for WNT5B. In CSCs co-cultured with macrophages within hetero-spheroids, increases in several WNT ligands were observed, and this increase was significantly inhibited when WNT5B was knocked down in macrophages.ConclusionsOur data implies that macrophage- initiated WNT signaling could play a significant role in the maintenance of stemness, and the resulting phenotypes of chemoresistance and invasiveness. Our results indicate paracrine WNT activation during CSC/M2 macrophages interaction constitutes a positive feedback loop that likely contributes to the more aggressive phenotype, which makes the WNT pathway a potential target to reduce the CSC and M2 macrophage compartments in the tumor microenvironment.

Highlights

  • Late stage epithelial ovarian cancer presents frequently with peritoneal carcinomatosis, and is associated with the formation of malignant ascites

  • Presence of phorbol myristate acetate (PMA), U937 and Peripheral blood mononuclear cells (PBMCs) monocytes differentiated into macrophages, and over the course of 72 h, they were organized as a compacted mass of cells within hanging drop cultures (Fig. 1a)

  • Differentiated macrophages were indicated as M0 macrophages, implying differentiation with no cytokine stimulation. 74.6 ± 8.2% of U937 monocytes differentiated into M0 macrophages expressed the pan macrophage marker CD68

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Summary

Introduction

Late stage epithelial ovarian cancer presents frequently with peritoneal carcinomatosis, and is associated with the formation of malignant ascites. Ovarian cancer cells interact with macrophages in anchorage independent conditions and grow as spheroids within the malignant ascites, which can result in tumor metastasis even during the early stage of peritoneal dissemination [7]. In the ovarian cancer microenvironment, macrophages are activated into a tumor-associated macrophage (M2-like, “M2”, alternatively activated) phenotype primarily through education by tumor-derived cytokines, chemokines and other tumor cell-derived factors [8, 9]. A high ratio of M1/M2 macrophages is associated with an improved prognosis in ovarian cancer, whereas lower M1/M2 ratio is indicative of a poor prognosis [10,11,12] Innate immune cells such as macrophages are abundantly present within malignant ascites, where they share the microenvironment with ovarian cancer stem cells (CSC)

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