Abstract

Hemoglobin (Hb) released during red blood cell lysis can initiate TLR4-dependent signaling and trigger NF-κB activation in surrounding cells. Observations of chronic bleeding in various cancers leads us to hypothesize that Hb and Hb degradation products released from lysed RBC near cancer nests might modulate local TLR4-positive cells. We addressed the hypothesis in vitro by measuring Hb- and biliverdin (Bv)-induced NF-κB signaling in an engineered human TLR4 reporter cell model (HEK-BlueTM hTLR4). Therein, TLR4 stimulation was assessed by measuring NF-κB-dependent secreted alkaline phosphatase (SEAP). hTLR4 reporter cells incubated with 8 ηM lipopolysaccharide (LPS) or 20-40 μM fungal mannoprotein (FM) produced significant amounts of SEAP. hTLR4 reporter cells also produced SEAP in response to human, but not porcine or bovine, Hb. HEK-Blue Null2TM reporter cells lacking TLR4 did not respond to LPS, FM, or Hb. Bv was non-stimulatory in reporter cells. When Bv was added to Hb-stimulated reporter cells, SEAP production was reduced by 95%, but when Bv was applied during LPS and FM stimulation, SEAP production was reduced by 33% and 27%, respectively. In conclusion, Hb initiated NF-κB signaling that was dependent upon TLR4 expression and that Bv can act as a TLR4 antagonist. Moreover, this study suggests that hemorrhage and extravascular hemolysis could provide competitive Hb and Bv signaling to nearby cells expressing TLR4, and that this process could modulate NF-κB signaling in TLR4-positive cancer cells and cancer-infiltrating leukocytes.

Highlights

  • The spontaneous onset of bleeding among cancer patients can occur in a spectrum of presentations, ranging from chronic occult bleeding to sudden profound bleeding [1,2]

  • We found that bovine and porcine Hb did not stimulate these TLR4 reporter cells

  • red blood cells (RBCs)-derived Bv and Bu can remain in injured tissues until Hb and its catabolites are scavenged or further degraded

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Summary

Introduction

The spontaneous onset of bleeding among cancer patients can occur in a spectrum of presentations, ranging from chronic occult bleeding to sudden profound bleeding [1,2]. Hemorrhages in and around tumor masses are quite common in lung, bladder, gastric, and colorectal cancers where it is attributable to tumor invasion or occlusion of blood vessels. Studies examining hemoglobin (Hb)-induced changes in cancer survival and progression are uncommon in the literature; a novel study by Yin et al [3] provided new evidence that red blood cells (RBCs) and Hb activate the reactive oxygen species-NF-κB pathway in both tumor cells and macrophages. Hb on the immune response [4,5,6,7,8]. In these data, it is suggested that Hb-induced interleukin-10 (IL-10). The authors suggest that this action is accomplished through interleukin-10,

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