Abstract

BackgroundSoluble fibrin (sFn) is a marker for disseminated intravascular coagulation and may have prognostic significance, especially in metastasis. However, a role for sFn in the etiology of metastatic cancer growth has not been extensively studied. We have reported that sFn cross-linked platelet binding to tumor cells via the major platelet fibrin receptor αIIbβ3, and tumor cell CD54 (ICAM-1), which is the receptor for two of the leukocyte β2 integrins (αLβ2 and aMβ2). We hypothesized that sFn may also affect leukocyte adherence, recognition, and killing of tumor cells. Furthermore, in a rat experimental metastasis model sFn pre-treatment of tumor cells enhanced metastasis by over 60% compared to untreated cells. Other studies have shown that fibrin(ogen) binds to the monocyte integrin αMβ2. This study therefore sought to investigate the effect of sFn on β2 integrin mediated monocyte adherence and killing of tumor cells.MethodsThe role of sFn in monocyte adherence and cytotoxicity against tumor cells was initially studied using static microplate adherence and cytotoxicity assays, and under physiologically relevant flow conditions in a microscope perfusion incubator system. Blocking studies were performed using monoclonal antibodies specific for β2 integrins and CD54, and specific peptides which inhibit sFn binding to these receptors.ResultsEnhancement of monocyte/tumor cell adherence was observed when only one cell type was bound to sFn, but profound inhibition was observed when sFn was bound to both monocytes and tumor cells. This effect was also reflected in the pattern of monocyte cytotoxicity. Studies using monoclonal blocking antibodies and specific blocking peptides (which did not affect normal coagulation) showed that the predominant mechanism of fibrin inhibition is via its binding to αMβ2 on monocytes, and to CD54 on both leukocytes and tumor cells.ConclusionsFn inhibits monocyte adherence and cytotoxicity of tumor cells by blocking αLβ2 and αMβ2 binding to tumor cell CD54. These results demonstrate that sFn is immunosuppressive and may be directly involved in the etiology of metastasis. Use of specific peptides also inhibited this effect without affecting coagulation, suggesting their possible use as novel therapeutic agents in cancer metastasis.

Highlights

  • Soluble fibrin is a marker for disseminated intravascular coagulation and may have prognostic significance, especially in metastasis

  • Effect of Soluble fibrin (sFn) on monocyte/tumor cell adherence in static microplate assays Experiments were performed to determine the effect of sFn pre-incubation of either monocytes, tumor cells, or both on monocyte adherence to A375 melanoma cells in static microtiter plate assays (Figure 2)

  • Addition of sFn treated monocytes to untreated tumor cells increased adherence (38.75 ± 1%; P < 0.05 compared to untreated control), but to a significantly lower degree than tumor cell pretreatment with sFn

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Summary

Introduction

Soluble fibrin (sFn) is a marker for disseminated intravascular coagulation and may have prognostic significance, especially in metastasis. This study sought to investigate the effect of sFn on β2 integrin mediated monocyte adherence and killing of tumor cells. Many cancer patients exhibit clinically significant hemostatic abnormalities, about 50% of all patients (>90% with metastases) have abnormal laboratory coagulation parameters [1], including soluble fibrin (sFn) [2,3,4], which may be an early marker undiagnosed malignancy [5]. We have reported a direct role for sFn in melanoma metastasis in an experimental model [6]. Several studies suggest that sFn may be a prognostic marker in cancer [8,9], but no clinical studies have been performed to directly associate sFn with increased metastasis. There a number of reports describing a direct clinical association with other coagulation proteins, including tissue factor (TF: reviewed in [10]), Factor VIII [11], and thrombin (reviewed in [12])

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