Obesity triggers tumoral senescence and renders poorly immunogenic malignancies amenable to senolysis

Analysis of the risk of oncological adverse events associated with infliximab in combination with azathioprine compared to monotherapy: insights from the FAERS database

Objective

This study aimed to evaluate the risk of tumor formation with infliximab or azathioprine monotherapy versus their combination, using the FDA Adverse Event Reporting System (FAERS) database.

Methods

Data were extracted from the FAERS database for patients treated with infliximab, azathioprine, and combination therapy from Q1 2004 to Q2 2024. Signal mining employed methods such as Reported Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Multiple Gamma-Poisson Scaling Assessment (MGPSA) and Bayesian Confidence Interval Progressive Neural Network (BCPNN).

Results

Our analysis of the FAERS database revealed that the highest number of reported cases involved skin-related tumors, both individually and in combination. In terms of sex, the risk of cancer was higher in men compared to women in the infliximab-only and combination groups; however, no sex difference was observed in the azathioprine-only group. Regarding age, we noted an increasing incidence of adverse tumor events in middle-aged and elderly individuals compared to minors, except in the azathioprine group, where age was not identified as an independent risk factor. Additionally, body weight was not found to be an independent risk factor in any of the three medication groups. After controlling for age, sex, and body weight, combination therapy did not increase the risk of tumor development compared to the azathioprine group alone. In contrast, for patients using infliximab alone, combination therapy not only did not elevate the risk of tumor development but also appeared to reduce it. The results of the Weber distribution suggest a random failure-type profile for the infliximab and azathioprine-only group, while an early failure-type profile was observed for the combination therapy. Furthermore, we analyzed the median time to onset and cumulative incidence rates, revealing no significant differences in median time to tumor onset or cumulative incidence rates between the combination therapy and the single agent.

Conclusion

After adjusting for age, sex, and body weight, combination therapy did not significantly increase tumor development risk compared to the azathioprine-only group. Additionally, in patients on infliximab monotherapy, combination therapy appeared to reduce the risk of tumor development.

Hydrogen sulfide mitigates mitochondrial dysfunction and cellular senescence in diabetic patients: Potential therapeutic applications

Diabetes induces a pro-aging state characterized by an increased abundance of senescent cells in various tissues, heightened chronic inflammation, reduced substance and energy metabolism, and a significant increase in intracellular reactive oxygen species (ROS) levels. This condition leads to mitochondrial dysfunction, including elevated oxidative stress, the accumulation of mitochondrial DNA (mtDNA) damage, mitophagy defects, dysregulation of mitochondrial dynamics, and abnormal energy metabolism. These dysfunctions result in intracellular calcium ion (Ca2+) homeostasis disorders, telomere shortening, immune cell damage, and exacerbated inflammation, accelerating the aging of diabetic cells or tissues. Hydrogen sulfide (H2S), a novel gaseous signaling molecule, plays a crucial role in maintaining mitochondrial function and mitigating the aging process in diabetic cells. This article systematically explores the specific mechanisms by which H2S regulates diabetes-induced mitochondrial dysfunction to delay cellular senescence, offering a promising new strategy for improving diabetes and its complications.

Relationship between obesity indexes and triglyceride glucose index with gastrointestinal cancer among the US population

Background

Previous studies have found that obesity is closely related to gastrointestinal cancer (GIC), but there is insufficient evidence to compare the relationship between various obesity indexes and triglyceride glucose index with GIC.

Methods

This study analyzed the relationship between Body mass index (BMI), lipid accumulation product (LAP), Triglyceride glucose (TyG), Triglyceride glucose-body mass index (TyG-BMI), Triglyceride glucose-waist circumference (TyG-Waist), Triglyceride Waist-to-Height Ratio (TyG-WHtR), Visceral adiposity index (VAI), Waist circumference (Waist), Waist-to-Height Ratio (WHtR), and Weight-adjusted waist index (WWI) and GIC. The data from National Health and Nutrition Examination Survey from 1999 to 2018 was utilized. We conducted weighted multiple logistic regression to analyze the relationship between GIC and obesity indexes and subgroup analysis was carried out for further study. After that, survival analysis and restricted cubic spline (RCS)was used to analyze the relationship between various obesity indexes and the prognosis of GIC.

Results

Logistic regression showed that TyG [Q4 vs Q1: OR (95 %CI) = 2.082(1.016 ∼ 4.269)] and LAP [Q4 vs Q1: OR (95 %CI) = 2.046(1.010 ∼ 4.145)] were related to GIC. Survival analysis and RCS found BMI [Q4 vs Q1: HR (95 %CI) = 0.369(0.176 ∼ 0.773)], Waist [Q4 vs Q1: HR (95 %CI) = 0.381(0.193 ∼ 0.753)], and WWI [Q4 vs Q1: HR (95 %CI) = 0.403(0.188 ∼ 0.864)] were significantly related to the prognosis of GIC.

Conclusion

There is a complex relationship between obesity and TyG with GIC. Certain indexes may be utilized to assist patients in developing suitable prevention and lifestyle strategies.

Senescence: A new kid in the block of the metabolic response to surgical trauma

Tumor growth is associated to chronic metabolic changes which inform the clinical phenotype and the outcome of patients with cancer. Surgery further triggers a cascade of acute neuro-immune responses leading to hypermetabolic and catabolic state. The metabolic mechanisms associated to surgical stress are well described. Preventive and therapeutic strategies have been developed, yet they appear not to benefit all surgical patients with cancer, even in the presence of a similar tumor type as well surgical procedures. Recent studies show that aging is associated with enrichment of senescent cells in different organs and tissues. Senescent cells are characterized by a specific senescence-associated secretory phenotype (SASP), which limits the potential for resilience of tissues and organs. Enhancement of the metabolic and functional recovery of patients with cancer undergoing surgery may therefore require additional therapies addressing SASP and senescent cells. Preliminary results obtained in experimental models recommend to further explore the role of senescence in mediating the metabolic changes and tissue resistance to efficient recovery.

Revisiting sensitivity of senescent cells to BH3 mimetics

B cell leukemia/lymphoma 2 (BCL2) homology domain 3 (BH3) mimetics were reported to selectively kill senescent cells and improve age-related diseases. Defining why these cells show increased sensitivity to these molecules will help to identify new pharmacological compounds with senolytic activity. Here, we discuss how recent research findings provide new clues to understand this vulnerability.

Current senolytics: Mode of action, efficacy and limitations, and their future

Senescence is a cellular state characterized by its near-permanent halted cell cycle and distinct secretory phenotype. Although senescent cells have a variety of beneficial physiological functions, progressive accumulation of these cells due to aging or other conditions has been widely shown to provoke deleterious effects on the normal functioning of the same or higher-level biological organizations. Recently, erasing senescent cells in vivo, using senolytics, could ameliorate diseases identified with an elevated number of senescent cells. Since then, researchers have struggled to develop new senolytics each with different selectivity and potency. In this review, we have gathered and classified the proposed senolytics and discussed their mechanisms of action. Moreover, we highlight the heterogeneity of senolytics regarding their effect sizes, and cell type specificity as well as comment on the exploited strategies to improve these features. Finally, we suggest some prospective routes for the novel methods for ablation of senescent cells.

Fat Biology in Triple-Negative Breast Cancer: Immune Regulation, Fibrosis, and Senescence

Obesity, now officially recognized as a disease requiring intervention, has emerged as a significant health concern due to its strong association with elevated susceptibility to diverse diseases and various types of cancer, including breast cancer. The link between obesity and cancer is intricate, with obesity exerting a significant impact on cancer recurrence and elevated mortality rates. Among the various subtypes of breast cancer, triple-negative breast cancer (TNBC) is the most aggressive, accounting for 15% to 20% of all cases. TNBC is characterized by low expression of estrogen receptors and progesterone receptors as well as the human epidermal growth factor 2 receptor protein. This subtype poses distinct challenges in terms of treatment response and exhibits strong invasiveness. Furthermore, TNBC has garnered attention because of its association with obesity, in which excess body fat and reduced physical activity have been identified as contributing factors to the increased incidence of this aggressive form of breast cancer. In this comprehensive review, the impact of obesity on TNBC was explored. Specifically, we focused on the three key mechanisms by which obesity affects TNBC development and progression: modification of the immune profile, facilitation of fibrosis, and initiation of senescence. By comprehensively examining these mechanisms, we illuminated the complex interplay between TNBC and obesity, facilitating the development of novel approaches for prevention, early detection, and effective management of this challenging disease.

The relationship between central obesity and risk of breast cancer: a dose-response meta-analysis of 7,989,315 women

Purpose

Central obesity may contribute to breast cancer (BC); however, there is no dose-response relationship. This meta-analysis examined the effects of central obesity on BC and their potential dose-response relationship.

Methods

In the present study, PubMed, Medline, Embase, and Web of Science were searched on 1 August 2022 for published articles. We included the prospective cohort and case-control studies that reported the relationship between central obesity and BC. Summary effect size estimates were expressed as risk ratios (RRs) or odds ratios (ORs) with 95% confidence intervals (95% CI) and were evaluated using random-effect models. The inconsistency index (I2) was used to quantify the heterogeneity magnitude derived from the random-effects Mantel-Haenszel model.

Results

This meta-analysis included 57 studies (26 case-control and 31 prospective cohort) as of August 2022. Case-control studies indicated that waist circumference (WC) (adjusted OR = 1.18; 95% CI: 1.00-1.38; P = 0.051) and waist-to-hip ratio (WHR) (adjusted OR = 1.28; 95% CI: 1.07-1.53; P = 0.008) were significantly positively related to BC. Subgroup analysis showed that central obesity measured by WC increased the premenopausal (adjusted OR = 1.15; 95% CI: 0.99-1.34; P = 0.063) and postmenopausal (adjusted OR = 1.18; 95% CI: 1.03-1.36; P = 0.018) BC risk and the same relationship appeared in WHR between premenopausal (adjusted OR = 1.38; 95% CI: 1.19-1.59; P < 0.001) and postmenopausal (adjusted OR = 1.41; 95% CI: 1.22-1.64; P < 0.001). The same relationship was observed in hormone receptor-positive (HR+) (adjusted ORWC = 1.26; 95% CI: 1.02-1.57; P = 0.035, adjusted ORWHR = 1.41; 95% CI: 1.00-1.98; P = 0.051) and hormone receptor-negative (HR-) (adjusted ORWC = 1.44; 95% CI: 1.13-1.83; P = 0.003, adjusted ORWHR = 1.42; 95% CI: 0.95-2.13; P = 0.087) BCs. Prospective cohort studies indicated that high WC (adjusted RR = 1.12; 95% CI: 1.08-1.16; P < 0.001) and WHR (adjusted RR = 1.05; 95% CI: 1.018-1.09; P = 0.017) may increase BC risk. Subgroup analysis demonstrated a significant correlation during premenopausal (adjusted RR = 1.08; 95% CI: 1.02-1.14; P = 0.007) and postmenopausal (adjusted RR = 1.14; 95% CI: 1.10-1.19; P < 0.001) between BC and central obesity measured by WC, and WHR was significantly positively related to BC both premenopausal (adjusted RRpre = 1.04; 95% CI: 0.98-1.11; P = 0.169) and postmenopausal (adjusted RRpost = 1.04; 95% CI: 1.02-1.07; P = 0.002). Regarding molecular subtype, central obesity was significantly associated with HR+ (adjusted ORWC = 1.13; 95% CI: 1.07-1.19; P < 0.001, adjusted ORWHR = 1.03; 95% CI: 0.98-1.07; P = 0.244) and HR- BCs (adjusted ORWC =1.11; 95% CI: 0.99-1.24; P = 0.086, adjusted ORWHR =1.01; 95% CI: 0.91-1.13; P = 0.808). Our dose-response analysis revealed a J-shaped trend in the relationship between central obesity and BC (measured by WC and WHR) in case-control studies and an inverted J-shaped trend between BMI (during premenopausal) and BC in the prospective cohort.

Conclusion

Central obesity is a risk factor for premenopausal and postmenopausal BC, and WC and WHR may predict it. Regarding the BC subtype, central obesity is proven to be a risk of ER+ and ER- BCs. The dose-response analysis revealed that when BMI (during premenopausal) exceeded 23.40 kg/m2, the risk of BC began to decrease, and WC higher than 83.80 cm or WHR exceeded 0.78 could efficiently increase the BC risk.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022365788.

AURKA inhibitor-induced PD-L1 upregulation impairs antitumor immune responses

Introduction

Tumor immunotherapy targeting PD-L1 has emerged as one of the powerful tools for tumor therapy. Numerous studies indicate that tumor-targeted drugs critically have an influence on the interaction between the immune system and tumors by changing the expression of PD-L1, which is beneficial for immunotherapy. Our study provided novel evidence for improving the drug regimen in tumor targeted therapy and immunotherapy.

Methods

The expression of PD-L1 on SKBR3, MDA-MB-231, MCF7, 4T1, MC38 and B16 cells was evaluated by flow cytometry after treatment with six preclinical targeted drugs (ARN-509, AZD3514, Galeterone, Neratinib, MLN8237 and LGK974). AURKA was knockdowned by using the specific siRNA or CRISPR-Cas9 technology. In the 4T1-breast tumor and colorectal cancer xenograft tumor models, we determined the number of infiltrated CD3+ and CD8+ T cells in tumor tissues by IHC.

Results

We found that AURKA inhibitor MLN8237 promoted the expression of PD-L1 in a time- and concentration-dependent manner while exerted its antitumor effect. Knockdown of AURKA could induce the upregulation of PD-L1 on SKBR3 cells. MLN8237-induced PD-L1 upregulation was mainly associated with the phosphorylation of STAT3. In the 4T1-breast tumor xenograft model, the infiltrated CD3+ and CD8+ T cells decreased after treatment with MLN8237. When treated with MLN8237 in combination with anti-PD-L1 antibody, the volumes of tumor were significantly reduced and accompanied by increasing the infiltration of CD3+ and CD8+ T cells in colorectal cancer xenograft tumor model.

Discussion

Our data demonstrated that MLN8237 improved the effect of immunology-related therapy on tumor cells by interacting with anti-PD-L1 antibody, which contributed to producing creative sparks for exploring the possible solutions to overcoming drug resistance to tumor targeted therapy.