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      LC3-associated phagocytosis in bone marrow macrophages suppresses acute myeloid leukemia progression through STING activation

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          Abstract

          The bone marrow (BM) microenvironment regulates acute myeloid leukemia (AML) initiation, proliferation, and chemotherapy resistance. Following cancer cell death, a growing body of evidence suggests an important role for remaining apoptotic debris in regulating the immunologic response to and growth of solid tumors. Here, we investigated the role of macrophage LC3–associated phagocytosis (LAP) within the BM microenvironment of AML. Depletion of BM macrophages (BMMs) increased AML growth in vivo. We show that LAP is the predominate method of BMM phagocytosis of dead and dying cells in the AML microenvironment. Targeted inhibition of LAP led to the accumulation of apoptotic cells (ACs) and apoptotic bodies (ABs), resulting in accelerated leukemia growth. Mechanistically, LAP of AML-derived ABs by BMMs resulted in stimulator of IFN genes (STING) pathway activation. We found that AML-derived mitochondrial damage–associated molecular patterns were processed by BMMs via LAP. Moreover, depletion of mitochondrial DNA (mtDNA) in AML-derived ABs showed that it was this mtDNA that was responsible for the induction of STING signaling in BMMs. Phenotypically, we found that STING activation suppressed AML growth through a mechanism related to increased phagocytosis. In summary, we report that macrophage LAP of apoptotic debris in the AML BM microenvironment suppressed tumor growth.

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          Macrophage polarization: tumor-associated macrophages as a paradigm for polarized M2 mononuclear phagocytes.

          Mononuclear phagocytes are versatile cells that can express different functional programs in response to microenvironmental signals. Fully polarized M1 and M2 (or alternatively activated) macrophages are the extremes of a continuum of functional states. Macrophages that infiltrate tumor tissues are driven by tumor-derived and T cell-derived cytokines to acquire a polarized M2 phenotype. These functionally polarized cells, and similarly oriented or immature dendritic cells present in tumors, have a key role in subversion of adaptive immunity and in inflammatory circuits that promote tumor growth and progression.
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            Activation of apoptosis signalling pathways by reactive oxygen species.

            Reactive oxygen species (ROS) are short-lived and highly reactive molecules. The generation of ROS in cells exists in equilibrium with a variety of antioxidant defences. At low to modest doses, ROS are considered to be essential for regulation of normal physiological functions involved in development such as cell cycle progression and proliferation, differentiation, migration and cell death. ROS also play an important role in the immune system, maintenance of the redox balance and have been implicated in activation of various cellular signalling pathways. Excess cellular levels of ROS cause damage to proteins, nucleic acids, lipids, membranes and organelles, which can lead to activation of cell death processes such as apoptosis. Apoptosis is a highly regulated process that is essential for the development and survival of multicellular organisms. These organisms often need to discard cells that are superfluous or potentially harmful, having accumulated mutations or become infected by pathogens. Apoptosis features a characteristic set of morphological and biochemical features whereby cells undergo a cascade of self-destruction. Thus, proper regulation of apoptosis is essential for maintaining normal cellular homeostasis. ROS play a central role in cell signalling as well as in regulation of the main pathways of apoptosis mediated by mitochondria, death receptors and the endoplasmic reticulum (ER). This review focuses on current understanding of the role of ROS in each of these three main pathways of apoptosis. The role of ROS in the complex interplay and crosstalk between these different signalling pathways remains to be further unravelled during the coming years.
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              Acute Myeloid Leukemia.

                Author and article information

                Contributors
                Journal
                J Clin Invest
                J Clin Invest
                J Clin Invest
                The Journal of Clinical Investigation
                American Society for Clinical Investigation
                0021-9738
                1558-8238
                1 March 2022
                1 March 2022
                1 March 2022
                1 March 2022
                : 132
                : 5
                : e153157
                Affiliations
                [1 ]Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
                [2 ]Earlham Institute, Norwich, United Kingdom.
                [3 ]Department of Haematology, Norfolk and Norwich University Hospitals NHS Trust, Norwich, United Kingdom.
                [4 ]Quadram Institute, Norwich, United Kingdom.
                Author notes
                Address correspondence to: Stuart Rushworth, Kristian Bowles, or Naiara Beraza, Department of Molecular Haematology, Norwich Medical School, Norwich Research Park, Norwich, NR4 7UQ, United Kingdom. Email: s.rushworth@ 123456uea.ac.uk (SAR); k.bowles@ 123456uea.ac.uk (KMB); naiara beraza@ 123456quadram.ac.uk (NB).
                Author information
                http://orcid.org/0000-0002-5395-9982
                http://orcid.org/0000-0003-0531-2807
                http://orcid.org/0000-0002-3477-6814
                http://orcid.org/0000-0002-9033-2580
                http://orcid.org/0000-0003-0718-0940
                http://orcid.org/0000-0003-1334-4526
                http://orcid.org/0000-0002-3711-7558
                Article
                153157
                10.1172/JCI153157
                8884913
                34990402
                6ca93e41-809b-4385-a96b-178459d94f2a
                © 2022 Moore et al.

                This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 14 July 2021
                : 22 December 2021
                Funding
                Funded by: Medical Research Council, https://doi.org/10.13039/501100000265;
                Award ID: MR/T02934X/1
                Funded by: Wellcome Trust, https://doi.org/10.13039/100004440;
                Award ID: Welcome Trust Clinical PhD Fellowship
                Funded by: Rosetrees Trust, https://doi.org/10.13039/501100000833;
                Award ID: M742
                Funded by: BBSRC
                Award ID: BB/R012490/1: BBS/E/F/000PR10353,BBS/E/F/000PR10355
                Categories
                Research Article

                hematology,oncology,autophagy,leukemias,mitochondria
                hematology, oncology, autophagy, leukemias, mitochondria

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