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      Resolvins suppress tumor growth and enhance cancer therapy

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          Abstract

          Cancer therapy reduces tumor burden by killing tumor cells, yet it simultaneously creates tumor cell debris that may stimulate inflammation and tumor growth. Sulciner et al. demonstrate that specific resolvins (RvD1, RvD2, and RvE1) inhibit tumor growth and enhance cancer therapy through the clearance of tumor cell debris.

          Abstract

          Cancer therapy reduces tumor burden by killing tumor cells, yet it simultaneously creates tumor cell debris that may stimulate inflammation and tumor growth. Thus, conventional cancer therapy is inherently a double-edged sword. In this study, we show that tumor cells killed by chemotherapy or targeted therapy (“tumor cell debris”) stimulate primary tumor growth when coinjected with a subthreshold (nontumorigenic) inoculum of tumor cells by triggering macrophage proinflammatory cytokine release after phosphatidylserine exposure. Debris-stimulated tumors were inhibited by antiinflammatory and proresolving lipid autacoids, namely resolvin D1 (RvD1), RvD2, or RvE1. These mediators specifically inhibit debris-stimulated cancer progression by enhancing clearance of debris via macrophage phagocytosis in multiple tumor types. Resolvins counterregulate the release of cytokines/chemokines, including TNFα, IL-6, IL-8, CCL4, and CCL5, by human macrophages stimulated with cell debris. These results demonstrate that enhancing endogenous clearance of tumor cell debris is a new therapeutic target that may complement cytotoxic cancer therapies.

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            Angiostatin: a novel angiogenesis inhibitor that mediates the suppression of metastases by a Lewis lung carcinoma.

            The phenomenon of inhibition of tumor growth by tumor mass has been repeatedly studied, but without elucidation of a satisfactory mechanism. In our animal model, a primary tumor inhibits its remote metastases. After tumor removal, metastases neovascularize and grow. When the primary tumor is present, metastatic growth is suppressed by a circulating angiogenesis inhibitor. Serum and urine from tumor-bearing mice, but not from controls, specifically inhibit endothelial cell proliferation. The activity copurifies with a 38 kDa plasminogen fragment that we have sequenced and named angiostatin. A corresponding fragment of human plasminogen has similar activity. Systemic administration of angiostatin, but not intact plasminogen, potently blocks neovascularization and growth of metastases. We here show that the inhibition of metastases by a primary mouse tumor is mediated, at least in part, by angiostatin.
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              A novel pathway combining calreticulin exposure and ATP secretion in immunogenic cancer cell death.

              Surface-exposed calreticulin (ecto-CRT) and secreted ATP are crucial damage-associated molecular patterns (DAMPs) for immunogenic apoptosis. Inducers of immunogenic apoptosis rely on an endoplasmic reticulum (ER)-based (reactive oxygen species (ROS)-regulated) pathway for ecto-CRT induction, but the ATP secretion pathway is unknown. We found that after photodynamic therapy (PDT), which generates ROS-mediated ER stress, dying cancer cells undergo immunogenic apoptosis characterized by phenotypic maturation (CD80(high), CD83(high), CD86(high), MHC-II(high)) and functional stimulation (NO(high), IL-10(absent), IL-1β(high)) of dendritic cells as well as induction of a protective antitumour immune response. Intriguingly, early after PDT the cancer cells displayed ecto-CRT and secreted ATP before exhibiting biochemical signatures of apoptosis, through overlapping PERK-orchestrated pathways that require a functional secretory pathway and phosphoinositide 3-kinase (PI3K)-mediated plasma membrane/extracellular trafficking. Interestingly, eIF2α phosphorylation and caspase-8 signalling are dispensable for this ecto-CRT exposure. We also identified LRP1/CD91 as the surface docking site for ecto-CRT and found that depletion of PERK, PI3K p110α and LRP1 but not caspase-8 reduced the immunogenicity of the cancer cells. These results unravel a novel PERK-dependent subroutine for the early and simultaneous emission of two critical DAMPs following ROS-mediated ER stress.
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                Author and article information

                Journal
                J Exp Med
                J. Exp. Med
                jem
                jem
                The Journal of Experimental Medicine
                The Rockefeller University Press
                0022-1007
                1540-9538
                02 January 2018
                : 215
                : 1
                : 115-140
                Affiliations
                [1 ]Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
                [2 ]Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
                [3 ]Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
                [4 ]Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
                [5 ]Vascular Biology Program, Boston Children's Hospital, Harvard Medical School, Boston, MA
                [6 ]Department of Pathology, Boston Children’s Hospital, Harvard Medical School, Boston, MA
                [7 ]Department of Anesthesia, Boston Children’s Hospital, Harvard Medical School, Boston, MA
                [8 ]Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA
                [9 ]Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
                [10 ]Division of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
                [11 ]Department of Pediatric Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, Boston, MA
                [12 ]The William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London, London, England, UK
                [13 ]Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA
                [14 ]Institute of Systems Biology, Seattle, WA
                Author notes
                Correspondence to Charles N. Serhan: cserhan@ 123456bwh.harvard.edu ;
                [*]

                M.L. Sulciner, C.N. Serhan, M.M. Gilligan, D.K. Mudge, M.W. Kieran, S. Huang, and D. Panigrahy contributed equally to this paper.

                Author information
                http://orcid.org/0000-0003-4627-8545
                http://orcid.org/0000-0002-7342-9858
                http://orcid.org/0000-0003-2068-3331
                http://orcid.org/0000-0003-2184-7692
                Article
                20170681
                10.1084/jem.20170681
                5748851
                29191914
                db024976-b7f5-4b6a-9bff-396af73e04cb
                © 2018 Sulciner et al.

                This article is distributed under the terms of an Attribution–Noncommercial–Share Alike–No Mirror Sites license for the first six months after the publication date (see http://www.rupress.org/terms/). After six months it is available under a Creative Commons License (Attribution–Noncommercial–Share Alike 4.0 International license, as described at https://creativecommons.org/licenses/by-nc-sa/4.0/).

                History
                : 12 April 2017
                : 15 September 2017
                : 11 October 2017
                Funding
                Funded by: National Institutes of Health, DOI https://doi.org/10.13039/100000002;
                Award ID: R01 AI079320
                Funded by: National Institutes of Health, DOI https://doi.org/10.13039/100000002;
                Award ID: CA169354
                Funded by: National Cancer Institute, DOI https://doi.org/10.13039/100000054;
                Award ID: RO1 01CA170549-02
                Award ID: ROCA148633-01A4
                Award ID: GM095467
                Funded by: Kamen Foundation, DOI https://doi.org/10.13039/501100007670;
                Funded by: Wellcome Trust, DOI https://doi.org/10.13039/100004440;
                Award ID: 086867/Z/08
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                Research Articles
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                Medicine
                Medicine

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