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Yuan F, Hu Y, Xu F, Feng X. A review of obstructive sleep apnea and lung cancer: epidemiology, pathogenesis, and therapeutic options. Front Immunol 2024; 15:1374236. [PMID: 38605948 PMCID: PMC11007033 DOI: 10.3389/fimmu.2024.1374236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
Despite undeniable advances in modern medicine, lung cancer still has high morbidity and mortality rates. Lung cancer is preventable and treatable, and it is important to identify new risk factors for lung cancer, especially those that can be treated or reversed. Obstructive sleep apnea (OSA) is a very common sleep-breathing disorder that is grossly underestimated in clinical practice. It can cause, exacerbate, and worsen adverse outcomes, including death and various diseases, but its relationship with lung cancer is unclear. A possible causal relationship between OSA and the onset and progression of lung cancer has been established biologically. The pathophysiological processes associated with OSA, such as sleep fragmentation, intermittent hypoxia, and increased sympathetic nervous excitation, may affect normal neuroendocrine regulation, impair immune function (especially innate and cellular immunity), and ultimately contribute to the occurrence of lung cancer, accelerate progression, and induce treatment resistance. OSA may be a contributor to but a preventable cause of the progression of lung cancer. However, whether this effect exists independently of other risk factors is unclear. Therefore, by reviewing the literature on the epidemiology, pathogenesis, and treatment of lung cancer and OSA, we hope to understand the relationships between the two and promote the interdisciplinary exchange of ideas between basic medicine, clinical medicine, respiratory medicine, sleep medicine, and oncology.
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Affiliation(s)
- Fang Yuan
- Department of Respiratory, The First Hospital of Jiujiang City, Jiujiang, China
| | - Yanxia Hu
- Department of Respiratory, The First Hospital of Jiujiang City, Jiujiang, China
| | - Fei Xu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xujun Feng
- Department of Respiratory, The First Hospital of Jiujiang City, Jiujiang, China
- Department of Respiratory and Critical Care Medicine, Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
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2
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Cubillos-Zapata C, Troncoso-Acevedo F, Díaz-García E, Alfaro E, Gotera-Rivera C, Pérez-Warnisher T, Peces-Barba G, Seijo LM, García-Río F. Sleep apnoea increases biomarkers of immune evasion, lymphangiogenesis and tumour cell aggressiveness in high-risk patients and those with established lung cancer. ERJ Open Res 2024; 10:00777-2023. [PMID: 38375428 PMCID: PMC10875459 DOI: 10.1183/23120541.00777-2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 11/15/2023] [Indexed: 02/21/2024] Open
Abstract
Background Intermittent hypoxaemia and obstructive sleep apnoea (OSA) have been linked to lung cancer through as yet unidentified pathophysiological mechanisms. This study evaluates the effect of OSA on serum levels of biomarkers of immunosurveillance, lymphangiogenesis and intrinsic tumour cell aggressiveness in high-risk individuals screened for lung cancer and patients with established lung cancer. Methods Serum samples from individuals participating in a lung cancer screening cohort (SAILS study) or with newly diagnosed lung cancer (SAIL study) were analysed. All patients underwent home sleep apnoea testing. Soluble levels of programmed cell death-1 (PD-1), programmed cell death ligand-1 (PD-L1), cytotoxic T-lymphocyte antigen-4, midkine (MDK), paraspeckle component-1 (PSPC1), transforming growth factor-β1 (TGF-β1), SMAD3, matrix metalloproteinase-2 and co-stimulus receptor of the tumour necrosis factor family of receptors (CD137) were determined by ELISA. Results The presence of moderate-to-severe OSA was associated with increased levels of PSPC1, MDK, PD-L1 and PD-1 in screened individuals, and with higher values of PSPC1, TGF-β1, PD-L1 and PD-1 in patients with established lung cancer. The findings correlated with nocturnal intermittent hypoxaemia indices. Conclusion Moderate-to-severe OSA is associated with increased expression of serum biomarkers of immune evasion, lymphangiogenesis and tumour cell aggressiveness in high-risk individuals screened for lung cancer and those with established disease.
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Affiliation(s)
- Carolina Cubillos-Zapata
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
| | - Fernanda Troncoso-Acevedo
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Elena Díaz-García
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
| | - Enrique Alfaro
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Carolina Gotera-Rivera
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - Germán Peces-Barba
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Luis M. Seijo
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Clínica Universidad de Navarra, Madrid, Spain
- L.M. Seijo and F. García-Río contributed equally to this article as lead authors and supervised the work
| | - Francisco García-Río
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- L.M. Seijo and F. García-Río contributed equally to this article as lead authors and supervised the work
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Martinez-Garcia MA. Linking obstructive sleep apnoea and lung cancer: a further step down the road. ERJ Open Res 2024; 10:01050-2023. [PMID: 38375432 PMCID: PMC10875466 DOI: 10.1183/23120541.01050-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 02/21/2024] Open
Abstract
There are various pathophysiological pathways linking obstructive sleep apnoea and lung cancer https://bit.ly/48qtqOO.
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Affiliation(s)
- Miguel Angel Martinez-Garcia
- Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria la Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Gómez-Olivas JD, Campos-Rodriguez F, Nagore E, Martorell A, García-Rio F, Cubillos C, Hernandez L, Bañuls J, Arias E, Ortiz P, Cabriada V, Gardeazabal J, Montserrat JM, Carrera C, Masa JF, Gomez de Terreros J, Abad J, Boada A, Mediano O, Castillo-Garcia M, Chiner E, Landete P, Mayos M, Fortuna A, Barbé F, Sanchez-de-la-Torre M, Cano-Pumarega I, Perez-Gil A, Gomez-Garcia T, Cullen D, Somoza M, Formigon M, Aizpuru F, Oscullo G, Garcia-Ortega A, Almendros I, Farré R, Gozal D, Martinez-Garcia MA. Role of Sleep Apnea and Long-Term CPAP Treatment in the Prognosis of Patients With Melanoma: A Prospective Multicenter Study of 443 Patients. Chest 2023; 164:1551-1559. [PMID: 37348828 DOI: 10.1016/j.chest.2023.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 05/20/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND OSA has been associated with increased incidence and aggressiveness of melanoma. However, the long-term impact of OSA and CPAP treatment on the prognosis of melanoma remains unexplored. RESEARCH QUESTION Are OSA and CPAP treatment associated independently with a poor prognosis for cutaneous melanoma? STUDY DESIGN AND METHODS Four hundred forty-three patients with a diagnosis of cutaneous melanoma (2012-2015) underwent a sleep study within 6 months of diagnosis. The main 5-year outcome of the study was a composite of melanoma recurrence, metastasis, or mortality. Patients were divided into four groups: baseline apnea-hypopnea index (AHI) of fewer than 10 events/h (no OSA; control group), OSA treated with CPAP and good adherence, untreated or poor CPAP adherence in moderate (AHI, 10-29 events/h), and severe OSA (AHI, ≥ 30 events/h). Survival analysis was used to determine the independent role of OSA and CPAP treatment on melanoma composite outcome. RESULTS Three hundred ninety-one patients (88.2%) were available for analysis at 5-year follow-up (mean age, 65.1 ± 15.2 years; 49% male; Breslow index, 1.7 ± 2.5 mm). One hundred thirty-nine patients had AHI of fewer than 10 events/h (control group); 78 patients with OSA were adherent to CPAP; and 124 and 50 patients had moderate and severe OSA, respectively, without CPAP treatment. Median follow-up was 60 months (interquartile range, 51-74 months). During follow-up, 32 relapses, 53 metastases, and 52 deaths occurred (116 patients showed at least one of the main composite outcomes). After adjusting for age, sex, sentinel lymph nodes affected at diagnosis, BMI, diabetes, nighttime with an oxygen saturation below 90%, Breslow index, Epworth sleepiness scale scores, and melanoma treatment, moderate (hazard ratio [HR], 2.45; 95% CI, 1.09-5.49) and severe OSA (HR, 2.96; 95% CI, 1.36-6.42) were associated with poorer prognosis of melanoma compared with the control group. However, good adherence to CPAP avoided this excess risk (HR, 1.66; 95% CI, 0.71-3.90). INTERPRETATION Moderate to severe untreated OSA is an independent risk factor for poor prognosis of melanoma. Treatment with CPAP is associated with improved melanoma outcomes compared with untreated moderate to severe OSA.
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Affiliation(s)
- Jose Daniel Gómez-Olivas
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Francisco Campos-Rodriguez
- Respiratory Department, Instituto Andaluz de Investigación, Seville, Spain; Hospital Valme, IBIS, Instituto Andaluz de Investigación, Seville, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Eduardo Nagore
- Dermatology Department, Instituto Valenciano de Oncologia, Hospital de Manises, Valencia, Spain
| | | | - Francisco García-Rio
- Respiratory Department, Hospital Universitario La Paz, IdiPaz, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Carolina Cubillos
- Respiratory Department, Hospital Universitario La Paz, IdiPaz, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Luis Hernandez
- Respiratory Department, Hospital General Universitario Balmis de Alicante, UMH, Spain; Clinical Medicine Department, UMH, Spain
| | - Jose Bañuls
- Dermatology Department, Hospital General Universitario Balmis de Alicante, UMH, Spain; Clinical Medicine Department, UMH, Spain
| | - Eva Arias
- Respiratory Department, Hospital Universitario 12 de Octubre, Spain
| | - Pablo Ortiz
- Dermatology Department, Hospital Universitario 12 de Octubre, Spain
| | - Valentin Cabriada
- Respiratory Department, Hospital Universitario Cruces, Barakaldo, Spain
| | - Juan Gardeazabal
- Dermatology Department, Hospital Universitario Cruces, Barakaldo, Spain
| | - Josep Maria Montserrat
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Clinic-IDIBAPS, Spain
| | | | - Juan Fernando Masa
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario San Pedro de Alcantara, Caceres, Spain
| | - Javier Gomez de Terreros
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario San Pedro de Alcantara, Caceres, Spain
| | - Jorge Abad
- Respiratory Department, Hospital Universitario Germans Trials I Pujol, Spain
| | - Adam Boada
- Dermatology Department, Hospital Universitario Germans Trials I Pujol, Spain
| | - Olga Mediano
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Marta Castillo-Garcia
- Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Eusebi Chiner
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Pedro Landete
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Mercedes Mayos
- Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Spain
| | - Ana Fortuna
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Spain
| | - Ferrán Barbé
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Spain; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. IRBLleida, Lleida, Spain
| | - Manuel Sanchez-de-la-Torre
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Spain; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. IRBLleida, Lleida, Spain
| | | | - Amalia Perez-Gil
- Dermatology Department, Instituto Andaluz de Investigación, Seville, Spain
| | - Teresa Gomez-Garcia
- Respiratory Department, Fundacion Jimenez Diaz, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Daniela Cullen
- Dermatology Department, Fundacion Jimenez Diaz, Madrid, Spain
| | - Maria Somoza
- Respiratory Department, Consorcio Sanitario Terrassa, Spain
| | | | - Felipe Aizpuru
- Biostatistical Service, BioAraba, Health Research Institute, OSI Araba University Hospital, Basque Health Service, University of the Basque Country, Leioa, Spain
| | - Grace Oscullo
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Alberto Garcia-Ortega
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Isaac Almendros
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Unitat de Biofisica i Bioenginyeria, Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - Ramón Farré
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Unitat de Biofisica i Bioenginyeria, Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - David Gozal
- Department of Child Health and Child Health Research Institute, School of Medicine, The University of Missouri, Columbia, MO
| | - Miguel Angel Martinez-Garcia
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain.
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Oscullo G, Gomez-Olivas JD, Martínez-García MÁ. Sleep apnoea, intermittent hypoxia and cutaneous melanoma incidence and aggressiveness. More than a coincidence? Sleep Med 2023; 108:8-10. [PMID: 37302169 DOI: 10.1016/j.sleep.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/13/2023]
Affiliation(s)
- Grace Oscullo
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Miguel Ángel Martínez-García
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain.
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Zheng L, Liu Q, Li R, Chen S, Tan J, Li L, Dong X, Huang C, Wen T, Liu J. Targeting MDK Abrogates IFN-γ-Elicited Metastasis inCancers of Various Origins. Front Oncol 2022; 12:885656. [PMID: 35747815 PMCID: PMC9210922 DOI: 10.3389/fonc.2022.885656] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
IFN-γ is a pleiotropic cytokine with immunomodulatory and tumoricidal functions. It has been used as an anti-tumor agent in adjuvant therapies for various cancers. Paradoxically, recent advances have also demonstrated pro-tumorigenic effects of IFN-γ, especially in promoting cancer metastasis, with the mechanism remains unclear. This will undoubtedly hinder the application of IFN-γ in cancer treatment. Here, we verified that IFN-γ treatment led to activation of the epithelial-to-mesenchymal transition (EMT) programme and metastasis in cell lines of various cancers, including the kidney cancer cell line Caki-1, the lung cancer cell line A549, the cervical carcinoma cell line CaSki, the breast cancer cell line BT549 and the colon cancer cell line HCT116. We further disclosed that midkine (MDK), an emerging oncoprotein and EMT inducer, is a common responsive target of IFN-γ in these cell lines. Mechanistically, IFN-γ upregulated MDK via STAT1, a principle downstream effector in the IFN-γ signalling. MDK is elevated in the majority of cancer types in the TCGA database, and its overexpression drove EMT activation and cancer metastasis in all examined cell lines. Targeting MDK using a specific MDK inhibitor (iMDK) broadly reversed IFN-γ-activated EMT, and subsequently abrogated IFN-γ-triggered metastasis. Collectively, our data uncover a MDK-dependent EMT inducing mechanism underlying IFN-γ-driven metastasis across cancers which could be attenuated by pharmacological inhibition of MDK. Based on these findings, we propose that MDK may be used as a potential therapeutic target to eliminate IFN-γ-elicited pro-metastatic adverse effect, and that combined MDK utilization may expand the application of IFN-γ in cancer and improve the clinical benefits from IFN-γ-based therapies.
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Affiliation(s)
- Luyu Zheng
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Qun Liu
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ruijun Li
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shibin Chen
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jingyu Tan
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lina Li
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xichen Dong
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Changzhi Huang
- State Key Laboratory of Molecular Oncology, Beijing Key Laboratory for Carcinogenesis and Cancer Prevention, Department of Etiology and Carcinogenesis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Jian Liu, ; Tao Wen, ; Changzhi Huang,
| | - Tao Wen
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- *Correspondence: Jian Liu, ; Tao Wen, ; Changzhi Huang,
| | - Jian Liu
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Oncology, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China
- *Correspondence: Jian Liu, ; Tao Wen, ; Changzhi Huang,
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Gambino F, Bonsignore MR. Can CPAP protect from cancer incidence in obstructive sleep apnoea patients? No evidence yet. Eur Respir J 2022; 59:59/4/2102742. [DOI: 10.1183/13993003.02742-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 10/22/2021] [Indexed: 11/05/2022]
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Xia T, Chen D, Liu X, Qi H, Wang W, Chen H, Ling T, Otkur W, Zhang CS, Kim J, Lin SC, Piao HL. Midkine noncanonically suppresses AMPK activation through disrupting the LKB1-STRAD-Mo25 complex. Cell Death Dis 2022; 13:414. [PMID: 35487917 PMCID: PMC9054788 DOI: 10.1038/s41419-022-04801-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/23/2022] [Accepted: 03/30/2022] [Indexed: 11/09/2022]
Abstract
Midkine (MDK), a secreted growth factor, regulates signal transduction and cancer progression by interacting with receptors, and it can be internalized into the cytoplasm by endocytosis. However, its intracellular function and signaling regulation remain unclear. Here, we show that intracellular MDK interacts with LKB1 and STRAD to disrupt the LKB1-STRAD-Mo25 complex. Consequently, MDK decreases the activity of LKB1 to dampen both the basal and stress-induced activation of AMPK by glucose starvation or treatment of 2-DG. We also found that MDK accelerates cancer cell proliferation by inhibiting the activation of the LKB1-AMPK axis. In human cancers, compared to other well-known growth factors, MDK expression is most significantly upregulated in cancers, especially in liver, kidney and breast cancers, correlating with clinical outcomes and inversely correlating with phosphorylated AMPK levels. Our study elucidates an inhibitory mechanism for AMPK activation, which is mediated by the intracellular MDK through disrupting the LKB1-STRAD-Mo25 complex.
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Muscogiuri G, Zanata I, Barrea L, Cozzolino A, Filice E, Messina E, Colao A, Faggiano A. A practical nutritional guideline to manage neuroendocrine neoplasms through chronotype and sleep. Crit Rev Food Sci Nutr 2022; 63:7546-7563. [PMID: 35285728 DOI: 10.1080/10408398.2022.2047882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Chronotype is the attitude of subjects to carry out their daily activities mainly in the morning ("lark") or in the evening ("owl"). The intermediate chronotype is located between these two categories. It has been demonstrated that chronotype can influence the incidence, course and response to treatments of tumors. In particular patients diagnosed with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) and evening chronotype are characterized by unhealthy lifestyle, obesity, metabolic syndrome, a worsen cardiometabolic profile, a poor prognosis with a progressive disease and the development of metastasis. In addition, evening chronotype has been associated with sleep disturbances, which in turn have been related to tumor development and progression of tumors. There is a strict connection between sleep disturbances and NENs because of the hyperactivation of proangiogenic factors that caused aberrant neoangiogenesis. A nutritional tailored approach could represent a tool to align subjects with evening chronotype to physiological biological rhythms based on the properties of some macro and micronutrients of being substrate for melatonin synthesis. Thus, we aimed to provide an overview on the association of chronotype categories and sleep disturbances with NENs and to provide nutritional advices to manage subjects with NENs and these disturbances of circadian rhythm.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile,", Università Federico II di Napoli, Naples, Italy
| | - Isabella Zanata
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Naples, Italy
| | - Alessia Cozzolino
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Emanuele Filice
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Erika Messina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile,", Università Federico II di Napoli, Naples, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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López-Alonso I, López-Martínez C, Martín-Vicente P, Amado-Rodríguez L, González-López A, Mayordomo-Colunga J, Del Busto C, Bernal M, Crespo I, Astudillo A, Arias-Guillén M, Fueyo A, Almendros I, Otero J, Sanz-Fraile H, Farré R, Albaiceta GM. Mechanical ventilation promotes lung tumor spread by modulation of cholesterol cell content. Eur Respir J 2021; 60:13993003.01470-2021. [PMID: 34887328 DOI: 10.1183/13993003.01470-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/22/2021] [Indexed: 11/05/2022]
Abstract
Mechanical stretch of cancer cells can alter their invasiveness. During mechanical ventilation, lungs may be exposed to an increased amount of stretch, but the consequences on lung tumors have not been explored. To characterize the influence of mechanical ventilation on the behavior of lung tumors, invasiveness assays and transcriptomic analyses were performed in cancer cell lines cultured in static conditions or under cyclic stretch. Mice harbouring lung melanoma implants were submitted to mechanical ventilation and metastatic spread was assessed. Additional in vivo experiments were performed to determine the mechano-dependent specificity of the response. Incidence of metastases was studied in a cohort of lung cancer patients that received mechanical ventilation compared with a matched group of non-ventilated patients. Stretch increases invasiveness in melanoma B16F10luc2 and lung adenocarcinoma A549 cells. We identified a mechanosensitive upregulation of pathways involved in cholesterol processing in vitro, leading to an increase in PCSK9 and LDLR expression, a decrease in intracellular cholesterol and preservation of cell stiffness. A course of mechanical ventilation in mice harboring melanoma implants increased brain and kidney metastases two weeks later. Blockade of PCSK9 using a monoclonal antibody increased cell cholesterol and stiffness and decreased cell invasiveness in vitro and metastasis in vivo In patients, mechanical ventilation increased PCSK9 abundance in lung tumors and the incidence of metastasis, thus decreasing survival. Our results suggest that mechanical stretch promote invasiveness of cancer cells, which may have clinically relevant consequences. Pharmacological manipulation of cholesterol endocytosis could be a novel therapeutic target in this setting.
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Affiliation(s)
- Inés López-Alonso
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain .,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.,These authors contributed equally
| | - Cecilia López-Martínez
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,These authors contributed equally
| | - Paula Martín-Vicente
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Laura Amado-Rodríguez
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.,Unidad de Cuidados Intensivos Cardiológicos. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Adrián González-López
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Department of Anesthesiology and Operative Intensive Care Medicine CCM/CVK, Charité - Universitätsmedizin Berlin, Germany
| | - Juan Mayordomo-Colunga
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Unidad de Cuidados Intensivos Pediátricos. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Cecilia Del Busto
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Unidad de Cuidados Intensivos Polivalente. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marina Bernal
- Servicio de Medicina Interna. Fundación Jiménez Díaz, Madrid, Spain
| | - Irene Crespo
- Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Spain
| | - Aurora Astudillo
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Miguel Arias-Guillén
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Servicio de Neumología. Hospital Unviersitario Central de Asturias. Oviedo, Spain
| | - Antonio Fueyo
- Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.,Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
| | - Isaac Almendros
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Unitat Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,Institut Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
| | - Jorge Otero
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Unitat Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Héctor Sanz-Fraile
- Unitat Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Ramón Farré
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Unitat Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,Institut Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
| | - Guillermo M Albaiceta
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.,Unidad de Cuidados Intensivos Cardiológicos. Hospital Universitario Central de Asturias, Oviedo, Spain.,Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Spain
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11
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Díaz-García E, García-Tovar S, Casitas R, Jaureguizar A, Zamarrón E, Sánchez-Sánchez B, Sastre-Perona A, López-Collazo E, Garcia-Rio F, Cubillos-Zapata C. Intermittent Hypoxia Mediates Paraspeckle Protein-1 Upregulation in Sleep Apnea. Cancers (Basel) 2021; 13:cancers13153888. [PMID: 34359789 PMCID: PMC8345391 DOI: 10.3390/cancers13153888] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 01/06/2023] Open
Abstract
Simple Summary Patients with obstructive sleep apnea (OSA) exhibit an intermittent hypoxia-dependent paraspeckle protein-1 (PSPC1) increase, which is eventually delivered to the plasma through its cleavage from OSA monocytes by matrix metalloprotease-2, promoting tumor growth factor (TGFβ) expression and increasing epithelial-to-mesenchymal transition in a tumor functional model using a melanoma cell line. These results connect the phenomena of sleep apnea with increased plasma PSPC1 levels, which has a functional effect on the TGFβ pathway and accelerates tumor progression. Abstract As some evidence suggests that hypoxia might be an inducer of nuclear paraspeckle formation, we explore whether intermittent hypoxia (IH)-mediated paraspeckle protein-1 (PSPC1) overexpression might contribute to the activation of tumor growth factor (TGF)β-SMAD pathway in patients with obstructive sleep apnea (OSA). This activation would promote changes in intracellular signaling that would explain the increased cancer aggressiveness reported in these patients. Here, we show that patients with OSA exhibit elevated PSPC1 levels both in plasma and in monocytes. Our data suggest that PSPC1 is ultimately delivered to the plasma through its cleavage from OSA monocytes by matrix metalloproteinase-2 (MMP2). In addition, IH promotes PSPC1, TGFβ, and MMP2 expression in monocytes through the hypoxia-inducible factor. Lastly, both PSPC1 and TGFβ induce increased expression of genes that drive the epithelial-to-mesenchymal transition. Our study details the mechanism by which hypoxemia upmodulates the extracellular release of PSPC1 by means of MMP2, such that plasma PSPC1 together with TGFβ activation signaling further promotes tumor metastasis and supports cancer aggressiveness in patients with OSA.
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Affiliation(s)
- Elena Díaz-García
- Grupo de Enfermedades Respiratorias, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (E.D.-G.); (S.G.-T.)
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (R.C.); (A.J.); (E.L.-C.)
| | - Sara García-Tovar
- Grupo de Enfermedades Respiratorias, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (E.D.-G.); (S.G.-T.)
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (R.C.); (A.J.); (E.L.-C.)
| | - Raquel Casitas
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (R.C.); (A.J.); (E.L.-C.)
- Servicio de Neumología, Hospital Universitario La Paz, 28029 Madrid, Spain; (E.Z.); (B.S.-S.)
| | - Ana Jaureguizar
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (R.C.); (A.J.); (E.L.-C.)
- Servicio de Neumología, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Ester Zamarrón
- Servicio de Neumología, Hospital Universitario La Paz, 28029 Madrid, Spain; (E.Z.); (B.S.-S.)
| | - Begoña Sánchez-Sánchez
- Servicio de Neumología, Hospital Universitario La Paz, 28029 Madrid, Spain; (E.Z.); (B.S.-S.)
| | - Ana Sastre-Perona
- Grupo deTerapias Experimentales y Biomarcadores en Cáncer, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain;
| | - Eduardo López-Collazo
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (R.C.); (A.J.); (E.L.-C.)
- Grupo de Respuesta Inmune Innata, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain
| | - Francisco Garcia-Rio
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (R.C.); (A.J.); (E.L.-C.)
- Servicio de Neumología, Hospital Universitario La Paz, 28029 Madrid, Spain; (E.Z.); (B.S.-S.)
- Facultad de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Correspondence: (F.G.-R.); (C.C.-Z.); Tel.: +34-639-91-17-18 (F.G.-R.); +34-600-87-71-79 (C.C.-Z.)
| | - Carolina Cubillos-Zapata
- Grupo de Enfermedades Respiratorias, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain; (E.D.-G.); (S.G.-T.)
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (R.C.); (A.J.); (E.L.-C.)
- Correspondence: (F.G.-R.); (C.C.-Z.); Tel.: +34-639-91-17-18 (F.G.-R.); +34-600-87-71-79 (C.C.-Z.)
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