Aged Microenvironment Research Articles

Changes in Aged Fibroblast Lipid Metabolism Induce Age-Dependent Melanoma Cell Resistance to Targeted Therapy via the Fatty Acid Transporter FATP2.

Older patients with melanoma (>50 years old) have poorer prognoses and response rates to targeted therapy compared with young patients (<50 years old), which can be driven, in part, by the aged microenvironment. Here, we show that aged dermal fibroblasts increase the secretion of neutral lipids, especially ceramides. When melanoma cells are exposed to the aged fibroblast lipid secretome, or cocultured with aged fibroblasts, they increase the uptake of lipids via the fatty acid transporter FATP2, which is upregulated in melanoma cells in the aged microenvironment and known to play roles in lipid synthesis and accumulation. We show that blocking FATP2 in melanoma cells in an aged microenvironment inhibits their accumulation of lipids and disrupts their mitochondrial metabolism. Inhibiting FATP2 overcomes age-related resistance to BRAF/MEK inhibition in animal models, ablates tumor relapse, and significantly extends survival time in older animals. SIGNIFICANCE: These data show that melanoma cells take up lipids from aged fibroblasts, via FATP2, and use them to resist targeted therapy. The response to targeted therapy is altered in aged individuals because of the influences of the aged microenvironment, and these data suggest FATP2 as a target to overcome resistance.See related commentary by Montal and White, p. 1255.This article is highlighted in the In This Issue feature, p. 1241.

Metformin Abrogates Age-Associated Ovarian Fibrosis.

The ovarian cancer risk factors of age and ovulation are curious because ovarian cancer incidence increases in postmenopausal women, long after ovulations have ceased. To determine how age and ovulation underlie ovarian cancer risk, we assessed the effects of these risk factors on the ovarian microenvironment. Aged C57/lcrfa mice (0-33 months old) were generated to assess the aged ovarian microenvironment. To expand our findings into human aging, we assembled a cohort of normal human ovaries (n = 18, 21-71 years old). To validate our findings, an independent cohort of normal human ovaries was assembled (n = 9, 41-82 years old). We first validated the presence of age-associated murine ovarian fibrosis. Using interdisciplinary methodologies, we provide novel evidence that ovarian fibrosis also develops in human postmenopausal ovaries across two independent cohorts (n = 27). Fibrotic ovaries have an increased CD206+:CD68+ cell ratio, CD8+ T-cell infiltration, and profibrotic DPP4+αSMA+ fibroblasts. Metformin use was associated with attenuated CD8+ T-cell infiltration and reduced CD206+:CD68+ cell ratio. These data support a novel hypothesis that unifies the primary nonhereditary ovarian cancer risk factors through the development of ovarian fibrosis and the formation of a premetastatic niche, and suggests a potential use for metformin in ovarian cancer prophylaxis.See related commentary by Madariaga et al., p. 523.

How the ageing microenvironment influences tumour progression.

Most cancers arise in individuals over the age of 60. As the world population is living longer and reaching older ages, cancer is becoming a substantial public health problem. It is estimated that, by 2050, more than 20% of the world's population will be over the age of 60 - the economic, healthcare and financial burdens this may place on society are far from trivial. In this Review, we address the role of the ageing microenvironment in the promotion of tumour progression. Specifically, we discuss the cellular and molecular changes in non-cancerous cells during ageing, and how these may contribute towards a tumour permissive microenvironment; these changes encompass biophysical alterations in the extracellular matrix, changes in secreted factors and changes in the immune system. We also discuss the contribution of these changes to responses to cancer therapy as ageing predicts outcomes of therapy, including survival. Yet, in preclinical studies, the contribution of the aged microenvironment to therapy response is largely ignored, with most studies designed in 8-week-old mice rather than older mice that reflect an age appropriate to the disease being modelled. This may explain, in part, the failure of many successful preclinical therapies upon their translation to the clinic. Overall, the intention of this Review is to provide an overview of the interplay that occurs between ageing cell types in the microenvironment and cancer cells and how this is likely to impact tumour metastasis and therapy response.

GLP-1 inhibits PKCβ2 phosphorylation to improve the osteogenic differentiation potential of hPDLSCs in the AGE microenvironment

Background and objectiveAdvanced glycation end products (AGEs) have been hypothesized as the etiologic factors of diabetic periodontitis. The discovery of incretins (including GLP-1 and GIP) provides a novel therapy for the treatment of diabetes. Recent reports have shown that glucagon-like peptide-1 (GLP-1) is an important modulator of bone growth and remodeling. The aim of this study was to clarify the mechanism of how GLP-1 weakens/inhibits the effect of AGEs in hPDLSCs (human periodontal ligament stem cells). Materials and methodsThe hPDLSCs were cultured under simulated conditions of osteogenic culture, AGEs, AGEs + GLP-1, AGEs + GLP-1 + PMA and AGEs + GLP-1 + LY333531. The phenomenon and related mechanism of cell osteogenesis under different microenvironments were evaluated by Alizarin red staining, ALP staining and quantitative activity measurement, RT-qPCR, western blotting and immunofluorescence staining. ResultsRT-qPCR showed that AGEs negatively regulated the expression of osteogenic differentiation markers (ALP, BSP, OPN, and Runx2); in contrast, GLP-1 increased the expression of these markers. Furthermore, the expression of RAGE and pPKCβ (PKC phosphorylation) in the AGE group was upregulated, while the expression of RAGE and pPKCβ was decreased in the GLP-1 group compared with the AGE group. ConclusionsAGEs impaired the osteogenic potential of hPDLSCs via PKCβ2. Our phenomenon showed that GLP-1 could reverse the function of AGEs on osteogenic potential. In addition, the mechanism of GLP-1 weakens/inhibits the effect of AGEs in hPDLSCs, possibly by inhibiting PKCβ2 phosphorylation.

Cell-Extrinsic Stressors from the Aging Bone Marrow (BM) Microenvironment Promote Dnmt3a-Mutant Clonal Hematopoiesis

Trowbridge: Fate Therapeutics: Patents & Royalties: patent license.

Angiocrine signals regulate quiescence and therapy resistance in bone metastasis.

Bone provides supportive microenvironments for hematopoietic stem cells (HSCs) and mesenchymal stem cells (MSCs) and is a frequent site of metastasis. While incidences of bone metastases increase with age, the properties of the bone marrow microenvironment that regulate dormancy and reactivation of disseminated tumor cells (DTCs) remain poorly understood. Here, we elucidate the age-associated changes in the bone secretome that trigger proliferation of HSCs, MSCs, and DTCs in the aging bone marrow microenvironment. Remarkably, a bone-specific mechanism involving expansion of pericytes and induction of quiescence-promoting secretome rendered this proliferative microenvironment resistant to radiation and chemotherapy. This bone-specific expansion of pericytes was triggered by an increase in PDGF signaling via remodeling of specialized type H blood vessels in response to therapy. The decline in bone marrow pericytes upon aging provides an explanation for loss of quiescence and expansion of cancer cells in the aged bone marrow microenvironment. Manipulation of blood flow — specifically, reduced blood flow — inhibited pericyte expansion, regulated endothelial PDGF-B expression, and rendered bone metastatic cancer cells susceptible to radiation and chemotherapy. Thus, our study provides a framework to recognize bone marrow vascular niches in age-associated increases in metastasis and to target angiocrine signals in therapeutic strategies to manage bone metastasis.

Abstract SY30-01: A wrinkle in TiME: How the aging TME drives tumor progression

Abstract Most cancers arise after the age of 50, and the molecular mechanisms that underlie this observation are not well understood. Our overarching goal is to elucidate and target the age-related changes that drive tumor progression. We have made the seminal discovery that aged fibroblasts secrete, or stop secreting, key molecules that affect multiple aspects of tumorigenesis. Our current investigations include: the loss of molecules that maintain ECM integrity, resulting in changes in mechanotransduction and increased metastasis; the secretion of molecules that increase resistance to targeted therapy; the secretion of macromolecules such as lipids that are taken up by melanoma cells in the aged microenvironment, affecting tumor cell metabolism; changes in the aged immune tumor microenvironment; the secretion of non-canonical Wnt molecules that affect cell signaling leading to angiogenesis, metastasis, and therapy resistance. Overall, our studies indicate that the age of the mouse models we study, as well as the patients we treat must be considered in order to understand tumor progression and therapy resistance. Citation Format: Ashani T. Weeraratna. A wrinkle in TiME: How the aging TME drives tumor progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr SY30-01.

In vitro aged, hiPSC-origin engineered heart tissue models with age-dependent functional deterioration to study myocardial infarction

Deaths attributed to ischemic heart disease increased by 41.7% from 1990 to 2013. This is primarily due to an increase in the aged population, however, research on cardiovascular disease (CVD) has been overlooking aging, a well-documented contributor to CVD. The use of young animals is heavily preferred due to lower costs and ready availability, despite the prominent differences between young and aged heart structure and function. Here we present the first human induced pluripotent stem cell (hiPSC)-derived cardiomyocyte (iCM)-based, in vitro aged myocardial tissue model as an alternative research platform. Within 4 months, iCMs go through accelerated senescence and show cellular characteristics of aging. Furthermore, the model tissues fabricated using aged iCMs, with stiffness resembling that of aged human heart, show functional and pharmacological deterioration specific to aged myocardium. Our novel tissue model with age-appropriate physiology and pathology presents a promising new platform for investigating CVD or other age-related diseases. Statement of SignificanceIn vitro and in vivo models of cardiovascular disease are aimed to provide crucial insight on the pathology and treatment of these diseases. However, the contribution of age-dependent cardiovascular changes is greatly underestimated through the use of young animals and premature cardiomyocytes. Here, we developed in vitro aged cardiac tissue models that mimic the aged heart tissue microenvironment and cellular phenotype and present the first evidence that age-appropriate in vitro disease models can be developed to gain more physiologically-relevant insight on development, progression, and amelioration of cardiovascular diseases.

Abstract # 2060 Microglia are extrinsically primed by the aged microenvironment

Microglia are responsible for propagating inflammatory signals from the periphery to the brain, where they drive the behavioral sickness response. With normal aging, these cells develop a pro-inflammatory, “primed” profile with increased expression of inflammatory mediators. A critical question is if this priming can be reversed. CSF1R antagonism results in elimination of microglia in the adult brain followed by rapid repopulation. Therefore, we hypothesized CSF1R antagonist-mediated microglial depletion in the aged brain would result in repopulation of new, unprimed microglia. Here we provide evidence that microglia in adult and aged mice were robustly eliminated following oral administration of CSF1R antagonist PLX5622. When antagonism was stopped, microglia repopulated the adult and aged brain at the same rate and efficiency with new cells no longer burdened with lipofuscin, the hallmark lipid debris of aging. However, RNA-Seq analysis of FACS-sorted microglia revealed these new microglia had the same primed mRNA profile. Moreover, RNA-Seq analysis of the brain microenvironment provided evidence of astrogliosis in aged mice independent of microglial depletion/repopulation. Lastly, peripheral immune challenge still caused an exaggerated microglial inflammatory response in the aged brain with prolonged behavioral deficits. These data are interpreted to indicate the microenvironment of the aged brain significantly influences the profile of repopulating/proliferating microglia. Taken together, aged microglia proliferate and repopulate the CNS, but the repopulating microglia still adopt a pro-inflammatory profile characteristic of aging.

Abstract # 3175 Mycobacterium vaccae immunization protects aged rats from surgery-elicited neuroinflammation and cognitive dysfunction

Advanced age is a major risk factor for developing postoperative cognitive dysfunction (POCD). Age-related neuroinflammatory “priming” may contribute to POCD: peripheral immune stimuli (e.g., infection or surgery) cause exaggerated pro-inflammatory responses in the aged brain that can elicit pathology. Exposure to micro-organisms with immunoregulatory and anti-inflammatory properties may be a promising strategy to quell neuroinflammatory priming. We hypothesized that immunization with Mycobacterium vaccae (M. vaccae; NCTC11659) would reduce neuroinflammation and cognitive impairments in aged rats post-surgery. Aged (24mos) and adult (3mos) male F344XBN rats received subcutaneous injections of heat-killed M. vaccae (3 injections, once per week) and then 5 days following the final M. vaccae injection rats underwent a laparotomy or sham (anesthesia control) procedure. Three days post-surgery, rats were trained in a fear conditioning paradigm or tissue was collected. Aged (but not young) rats showed post-operative memory deficits. Prophylactic treatment with M. vaccae protected aged rats from surgery induced-cognitive impairments. Furthermore, M. vaccae treatment shifted the aged pro-inflammatory hippocampal microenvironment (increased IL-1beta and NFKBIA) towards an anti-inflammatory phenotype (increased IL-4 and Arg1). Microglia may mediate the anti-inflammatory effects of M. vaccae in the brain: prior in vivo treatment with M. vaccae reduced hyperinflammatory responses to ex vivo lipopolysaccharide in microglia isolated from aged rats. Overall, our novel data suggest that M. vaccae can re-direct a primed neuroimmune environment in aged rats and prevent POCD.

Reduced frequency of resistance-type exercise training promotes adaptation of the aged skeletal muscle microenvironment.

The purpose of this study was to characterize the growth and remodeling molecular signaling response in aged skeletal muscle following 1 mo of "resistance-type exercise" training. Male Fischer 344 × Brown Norway hybrid rats aged 3 (young) and 30 mo (old) underwent stretch-shortening contraction (SSC) loading 2 or 3 days/wk; muscles were removed 72 h posttraining. Young rats SSC loaded 3 (Y3x) or 2 days/wk (Y2x) adapted via increased work performance. Old rats SSC loaded 3 days/wk (O3x) maladapted via decreased negative work; however, old rats SSC loaded 2 days/wk (O2x) adapted through improved negative and positive work. Y3x, Y2x, and O2x, but not O3x, displayed hypertrophy via larger fiber area and myonuclear domains. Y3x, Y2x, and O2x differentially expressed 19, 30, and 8 phosphatidylinositol 3-kinase-Akt genes, respectively, whereas O3x only expressed 2. Bioinformatics analysis revealed that rats in the adapting groups presented growth and remodeling processes (i.e., increased protein synthesis), whereas O3x demonstrated inflammatory signaling. In conclusion, reducing SSC-loading frequency in aged rodents positively influences the molecular signaling microenvironment, promoting muscle adaptation. NEW & NOTEWORTHY Decreasing resistance-type exercise training frequency in old rodents led to adaptation through enhancements in performance, fiber areas, and myonuclear domains. Modifying frequency influenced the molecular environment through improvements in phosphatidylinositol 3-kinase-Akt pathway-specific expression and bioinformatics indicating increased protein synthesis. Reducing training frequency may be appropriate in older individuals who respond unfavorably to higher frequencies (i.e., maladaptation); overall, modifying the parameters of the exercise prescription can affect the cellular environment, ultimately leading to adaptive or maladaptive outcomes.

The Aged Microenvironment Influences the Tumorigenic Potential of Malignant Prostate Epithelial Cells.

The incidence of prostate cancer is directly linked to age, but age-associated changes that facilitate prostate cancer development and progression are poorly understood. This study investigated age-related changes in the prostate microenvironment for their influence on prostate cancer behavior. Prostate cancer cells implanted orthotopically into the prostate demonstrated accelerated tumor growth in aged compared with young mice. Metastatic lesions following intravenous injection were also more numerous in aged mice. Tumors from young and aged mice showed no significant differences concerning their proliferation index, apoptosis, or angiogenesis. However, analysis of tumor-infiltrating immune cells by IHC and RNA sequencing (RNA-seq) revealed elevated numbers of macrophages in prostates from aged mice, which are quickly polarized towards a phenotype resembling protumorigenic tumor-associated macrophages upon tumor cell engraftment. Older patients with prostate cancer (>60 years old) in The Cancer Genome Atlas Prostate Adenocarcinoma (TCGA-PRAD) dataset displayed higher expression of macrophage markers (CD163 and VSIG4) which associated with higher rates of biochemical relapse. Remodeling of the collagenous extracellular matrix (ECM) was associated with prostate cancer growth and invasion in the aged microenvironment. Moreover, the collagen matrix extracted from aged mice enhanced the invasiveness and proliferation of prostate cancer cells in vitro. Together, these results demonstrate that the aged prostatic microenvironment can regulate the growth and metastasis of malignant prostate cells, highlighting the role of resident macrophages and their polarization towards a protumorigenic phenotype, along with remodeling of the ECM. IMPLICATIONS: These findings demonstrate the importance of age-associated tumor microenvironment alterations in regulating key aspects of prostate cancer progression.

Remodeling of the Collagen Matrix in Aging Skin Promotes Melanoma Metastasis and Affects Immune Cell Motility.

Physical changes in skin are among the most visible signs of aging. We found that young dermal fibroblasts secrete high levels of extracellular matrix (ECM) constituents, including proteoglycans, glycoproteins, and cartilage-linking proteins. The most abundantly secreted was HAPLN1, a hyaluronic and proteoglycan link protein. HAPLN1 was lost in aged fibroblasts, resulting in a more aligned ECM that promoted metastasis of melanoma cells. Reconstituting HAPLN1 inhibited metastasis in an aged microenvironment, in 3-D skin reconstruction models, and in vivo. Intriguingly, aged fibroblast-derived matrices had the opposite effect on the migration of T cells, inhibiting their motility. HAPLN1 treatment of aged fibroblasts restored motility of mononuclear immune cells, while impeding that of polymorphonuclear immune cells, which in turn affected regulatory T-cell recruitment. These data suggest that although age-related physical changes in the ECM can promote tumor cell motility, they may adversely affect the motility of some immune cells, resulting in an overall change in the immune microenvironment. Understanding the physical changes in aging skin may provide avenues for more effective therapy for older patients with melanoma. SIGNIFICANCE: These data shed light on the mechanochemical interactions that occur between aged skin, tumor, and immune cell populations, which may affect tumor metastasis and immune cell infiltration, with implications for the efficacy of current therapies for melanoma.See related commentary by Marie and Merlino, p. 19.This article is highlighted in the In This Issue feature, p. 1.

Aging of Bone Marrow Microenvironment Promotes Myeloid Bias of Hematopoietic Progenitors and Is a Target in Age-Related Myeloproliferative Neoplasms

Background: BM HSC accumulate during aging but are functionally impaired; however, it remains debated whether this aging results from HSC-intrinsic and/or -extrinsic mechanisms. Myeloid malignancies are more frequent in the elderly, but whether the aged microenvironment predisposes to these malignancies is unclear. Myeloid-biased HSC and especially platelet-primed HSC expand in aged mice. However, both platelet-primed and unprimed old HSCs exhibit myeloid bias, possibly suggesting a microenvironmental participation. Moreover, some hallmarks of murine hematopoietic aging (like increased platelets) are present in premature aging (Hutchinson-Gilford progeria syndrome, HGPS) and are exacerbated in age-related myeloproliferative neoplasms (MPN), where we found that niche heterogeneity can influence disease progression (ASH abstract ID 113495). Given that aging increases myelopoiesis in physiology, HGPS and MPN (despite their heterogenous genetic background), we hypothesized that shared microenvironmental alterations influence HSC lineage bias during agingResults: HSCs, perisinusoidal megakaryocytes (Mk) and myelopoietic cytokines increase in the BM of HGPS mice, resembling normally aged mice. However, WT recipients of HGPS BM cells do not reproduce myeloid bias, indicating that premature aging affects hematopoiesis in HGPS in a non-HSC-autonomous manner. We have investigated niche contributions to lineage bias during physiological aging because HGPSmice do not tolerate myeloablation. Consistently with recent findings (Nat Med 2018;24:782-91) HSC niches decrease near bone (endosteal BM) and expand further from bone in aged mice, but we observed different vascular changes mainly consisting of halved endosteal transition zone vessels with associated Nes-GFP+ cells and 4-fold-increased non-endosteal capillaries with Nes-GFP+ cells. However, contrasting the afore mentioned study but in agreement with other reports, we found aging-related increase of BM noradrenergic innervation, which promotes megakaryopoiesis in WT mice, but not in mice lacking β2 and β3 adrenergic receptors (ARs). Yet, these receptors exhibit opposite effects on microenvironmental regulation of myelopoiesis. β2-AR-agonist promotes Mk differentiation from human CD34+ HSCs co-cultured with MS-5 cells or in WT (but not IL-6 KO) primary murine BM culture. Consequently, adult β2-AR KO mice exhibit decreased Mk-lineage cells, which correlated with reduced BM IL-6. In contrast, adult β3-AR KO mice exhibit increased mature Mk near sinusoids, which correlated with tripled Cxcl12 mRNA expression in non-endosteal BM. Mechanistically β3-AR regulates Cxcl12-dependent HSPC and megakaryocyte localization, nitric oxide (NO) production and expression of myelopoietic cytokines. In vitro, β3-AR-agonist-treated stromal cells decrease human and murine HSPC differentiation into Mk. This effect requires Nos1-dependent NO production, since Nos1-/- mice have high circulating platelets and β3-AR agonist specifically increases lymphoid-biased HSCs in primary BM cultures in a Nos1-dependent manner. Finally, Mk increased in β3-AR KO mice transplanted with MPN BM cells, whereas Mk decreased in MPN mice treated with β3-AR agonist. To test the clinical relevance of our findings, we measured plasma nitrates and myelopoietic cytokines in MPN patients (median age=62) chronically treated only with β3-AR agonist, who show improved myelofibrosis correlated by rescued nestin+ niches (Blood 2016;128:3108), which is consistent with previous results in mice (Nature 2014;512:78-81). We found inverse correlations between the concentration of nitrates and myelopoietic cytokinesConclusions: microenvironmental aging promotes myeloid bias through similar cytokines (e.g. IL1β, IL6) during premature or physiological aging. In the latter, HSC supporting niches decrease near bone but expand further from bone. Increased BM sympathetic noradrenergic innervation promotes β2-AR-IL-6-dependent myeloid bias. Reduction of endosteal niches decreases β3-AR-NO-dependent inhibition of myelopoietic cytokines. However, chronic treatment with β3-AR-agonist does not rejuvenate overall hematopoiesis but decreases exacerbated megakaryopoiesis in mice and humans with MPNs. Therefore, niche aging promotes myeloid bias and might represent a therapeutic target in age-related myeloproliferative disorders DisclosuresNo relevant conflicts of interest to declare.

Forced turnover of aged microglia induces an intermediate phenotype but does not rebalance CNS environmental cues driving priming to immune challenge

Microglia are the resident innate immune cells of the central nervous system. Limited turnover throughout the lifespan leaves microglia susceptible to age-associated dysfunction. Indeed, we and others have reported microglia develop a pro-inflammatory or “primed” profile with age, characterized by increased expression of inflammatory mediators (e.g., MHC-II, CD68, IL-1β). Moreover, immune challenge with lipopolysaccharide (LPS) causes an exaggerated and prolonged neuroinflammatory response mediated by primed microglia in the aged brain. Recent studies show colony-stimulating factor 1 receptor (CSF1R) antagonism results in rapid depletion of microglia without significant complications. Therefore, we hypothesized that CSF1R antagonist-mediated depletion of microglia in the aged brain would result in repopulation with new and unprimed microglia. Here we provide novel evidence that microglia in the brain of adult (6–8 weeks old) and aged (16–18 months old) BALB/c mice were depleted following 3-week oral PLX5622 administration. When CSF1R antagonism was stopped, microglia repopulated equally in the adult and aged brain. Microglial depletion and repopulation reversed age-associated increases in microglial CD68+ lysosome enlargement and lipofuscin accumulation. Microglia-specific RNA sequencing revealed 511 differentially expressed genes with age. Of these, 117 genes were reversed by microglial repopulation (e.g., Apoe, Tgfb2, Socs3). Nevertheless, LPS challenge still induced an exaggerated microglial inflammatory response in the aged brain compared to adults. RNA sequencing of whole-brain tissue revealed an age-induced inflammatory signature, including reactive astrocytes, that was not restored by microglial depletion and repopulation. Furthermore, the microenvironment of the aged brain produced soluble factors that influenced developing microglia ex vivo and induced a profile primed to LPS challenge. Thus, the aged brain microenvironment promotes microglial priming despite repopulation of new microglia. Collectively, aged microglia proliferate and repopulate the brain, but these new cells still adopt a pro-inflammatory profile in the aged brain.

Age Correlates with Response to Anti-PD1, Reflecting Age-Related Differences in Intratumoral Effector and Regulatory T-Cell Populations.

Purpose: We have shown that the aged microenvironment increases melanoma metastasis, and decreases response to targeted therapy, and here we queried response to anti-PD1.Experimental Design: We analyzed the relationship between age, response to anti-PD1, and prior therapy in 538 patients. We used mouse models of melanoma, to analyze the intratumoral immune microenvironment in young versus aged mice and confirmed our findings in human melanoma biopsies.Results: Patients over the age of 60 responded more efficiently to anti-PD-1, and likelihood of response to anti-PD-1 increased with age, even when we controlled for prior MAPKi therapy. Placing genetically identical tumors in aged mice (52 weeks) significantly increased their response to anti-PD1 as compared with the same tumors in young mice (8 weeks). These data suggest that this increased response in aged patients occurs even in the absence of a more complex mutational landscape. Next, we found that young mice had a significantly higher population of regulatory T cells (Tregs), skewing the CD8+:Treg ratio. FOXP3 staining of human melanoma biopsies revealed similar increases in Tregs in young patients. Depletion of Tregs using anti-CD25 increased the response to anti-PD1 in young mice.Conclusions: While there are obvious limitations to our study, including our inability to conduct a meta-analysis due to a lack of available data, and our inability to control for mutational burden, there is a remarkable consistency in these data from over 500 patients across 8 different institutes worldwide. These results stress the importance of considering age as a factor for immunotherapy response. Clin Cancer Res; 24(21); 5347-56. ©2018 AACR See related commentary by Pawelec, p. 5193.

3182 - Npm1ca Overcomes the Differentiation Block of DNMT3A-Mutant LT-HSCs to Transition MDS to Myeloproliferative Disorder

The clinical significance of aging-associated clonal hematopoietic expansion remains a barrier to predicting risk of hematopoietic malignancy in personalized medicine. DNA methyltransferase 3A (DNMT3A) mutation is a common event in aging clonal hematopoiesis, and DNMT3A and nucleophosmin 1 (NPM1) mutations frequently co-occur in human myeloid malignancies. The mechanisms by which DNMT3A and NPM1 mutations cooperate, and whether they are sufficient to cause myeloid malignancy, are unclear. Here, using an inducible mouse model replicating the most common DNMT3A mutation found in human clonal hematopoiesis and AML (mouse Dnmt3aR878H/+), we observe an expansion and differentiation block acting at the level of long-term hematopoietic stem cells (LT-HSCs) that is accelerated when these cells are placed into an aged BM microenvironment. This differentiation block progresses to myelodysplastic syndrome (MDS) upon transplantation stress. Combining this model with a novel inducible mouse model replicating the most common NPM1 mutation found in human AML (mouse Npm1cA/+), we observe that Npm1 mutation is sufficient to overcome the impaired differentiation of Dnmt3a-mutant LT-HSCs and drives the transition from BM failure to myeloproliferative disorder (MPD) stemming from granulocyte-macrophage progenitors (GMPs). Together, our data reveal that the hematopoietic cell extrinsic BM microenvironment plays a significant role in the development of Dnmt3a-mutant clonal hematopoiesis and supports a model in which Dnmt3a mutation preceeds acquisition of Npm1 mutation in the life history of myeloproliferative disorders. Furthermore, Dnmt3a-mutant clonal hematopoiesis versus Dnmt3a- and Npm1-mutant MPD derive from distinct cell populations within the hematopoietic stem and progenitor cell compartment. Importantly, this data will be informative in the development of cell context-specific interventions to prevent progression from clonal hematopoiesis to BM failure to myeloproliferative disorders.

Mycobacterium vaccae immunization protects aged rats from surgery-elicited neuroinflammation and cognitive dysfunction.

Aging is a major risk factor for developing postoperative cognitive dysfunction. Neuroinflammatory processes, which can play a causal role in the etiology of postoperative cognitive dysfunction, are potentiated or primed as a function of aging. Here we explored whether exposure to a microorganism with immunoregulatory and anti-inflammatory properties, Mycobacterium vaccae NCTC 11659 (M.vaccae), could ameliorate age-associated neuroinflammatory priming. Aged (24months) and adult (3months) male F344XBN rats were immunized with heat-killed M.vaccae (3 injections, once per week) before undergoing a laparotomy or anesthesia control procedure. Aged, but not young rats, showed postoperative learning/memory deficits in a fear-conditioning paradigm. Importantly, M.vaccae immunization protected aged rats from these surgery-induced cognitive impairments. M.vaccae immunization also shifted the aged proinflammatory hippocampal microenvironment toward an anti-inflammatory phenotype. Furthermore, M.vaccae immunization reduced age-related hyperinflammatory responses in isolated hippocampal microglia. Overall, our novel data suggest that M.vaccae can induce an anti-inflammatory milieu in the aged brain and thus mitigate the neuroinflammatory and cognitive impairments induced by surgery.

Abstract 993: Wnt-er is coming: WNT5A promotes a slow cycling phenotype via p53 in conditions of stress

Abstract Resistance to targeted therapy and chemotherapy increases with age. Previously, we found that aged skin fibroblasts secrete sFRP2, which decreases ß-catenin, MITF, and APE1 in melanoma cells, and promotes invasion. Loss of APE1, a key redox effector, increased DNA damage in melanoma cells and caused the cells to become resistant to targeted therapy. Here we show that the aging tumor microenvironment drives a slow cycling phenotype in melanoma cells via WNT5A and p53. We found WNT5A expression in melanoma cells correlates with p53 expression and a higher percent of slow cycling cells. Knocking down WNT5A decreases both p53 expression and the percent of slow cycling cells. When we isolated slow cycling cells by flow cytometry, we found that they have increased WNT5A, p53, and p21 expression. Analysis of patient tumors in the TCGA data base revealed that patients with higher than average p53 expression, also express WNT5A. To determine if WNT5A and p53 may be promoting the survival of metastatic melanoma in an aged microenvironment, we examined tumors from young and aged C57/BL6 mice generated using Yumm1.7 cells. We found that tumors in aged mice have a higher percentage of cells expressing p53 and increased WNT5A expression compared to tumors in young mice. Treatment of human melanoma cells with conditioned media from aged dermal fibroblasts decreases proliferation and increases the percent of slow cycling. Inhibition of p53 re-sensitizes human melanoma cells in conditioned media from aged fibroblasts to combination BRAFi/MEKi. These data suggest, it may be these slow cycling cells driven by WNT5A and p53, which are enriched in an aging microenvironment, that are driving resistance to targeted therapy in aged patients. Citation Format: Marie R. Webster, Mitchell Fane, Amanpreet Kaur, Gretchen Alicea, Brett L. Ecker, Abibatou Ndoye, Curtis Kugel, Subhasree Basu, Alexander Valiga, Jessica L. Appleton, Maureen E. Murphy, Ashani Weeraratna. Wnt-er is coming: WNT5A promotes a slow cycling phenotype via p53 in conditions of stress [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 993.

MicroRNA-31a-5p from aging BMSCs links bone formation and resorption in the aged bone marrow microenvironment.

The alteration of age‐related molecules in the bone marrow microenvironment is one of the driving forces in osteoporosis. These molecules inhibit bone formation and promote bone resorption by regulating osteoblastic and osteoclastic activity, contributing to age‐related bone loss. Here, we observed that the level of microRNA‐31a‐5p (miR‐31a‐5p) was significantly increased in bone marrow stromal cells (BMSCs) from aged rats, and these BMSCs demonstrated increased adipogenesis and aging phenotypes as well as decreased osteogenesis and stemness. We used the gain‐of‐function and knockdown approach to delineate the roles of miR‐31a‐5p in osteogenic differentiation by assessing the decrease of special AT‐rich sequence‐binding protein 2 (SATB2) levels and the aging of BMSCs by regulating the decline of E2F2 and recruiting senescence‐associated heterochromatin foci (SAHF). Notably, expression of miR‐31a‐5p, which promotes osteoclastogenesis and bone resorption, was markedly higher in BMSCs‐derived exosomes from aged rats compared to those from young rats, and suppression of exosomal miR‐31a‐5p inhibited the differentiation and function of osteoclasts, as shown by elevated RhoA activity. Moreover, using antagomiR‐31a‐5p, we observed that, in the bone marrow microenvironment, inhibition of miR‐31a‐5p prevented bone loss and decreased the osteoclastic activity of aged rats. Collectively, our results reveal that miR‐31a‐5p acts as a key modulator in the age‐related bone marrow microenvironment by influencing osteoblastic and osteoclastic differentiation and that it may be a potential therapeutic target for age‐related osteoporosis.