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Leng H, Zhang H, Li L, Zhang S, Wang Y, Chavda SJ, Galas-Filipowicz D, Lou H, Ersek A, Morris EV, Sezgin E, Lee YH, Li Y, Lechuga-Vieco AV, Tian M, Mi JQ, Yong K, Zhong Q, Edwards CM, Simon AK, Horwood NJ. Modulating glycosphingolipid metabolism and autophagy improves outcomes in pre-clinical models of myeloma bone disease. Nat Commun 2022; 13:7868. [PMID: 36550101 PMCID: PMC9780346 DOI: 10.1038/s41467-022-35358-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Patients with multiple myeloma, an incurable malignancy of plasma cells, frequently develop osteolytic bone lesions that severely impact quality of life and clinical outcomes. Eliglustat, a U.S. Food and Drug Administration-approved glucosylceramide synthase inhibitor, reduced osteoclast-driven bone loss in preclinical in vivo models of myeloma. In combination with zoledronic acid, a bisphosphonate that treats myeloma bone disease, eliglustat provided further protection from bone loss. Autophagic degradation of TRAF3, a key step for osteoclast differentiation, was inhibited by eliglustat as evidenced by TRAF3 lysosomal and cytoplasmic accumulation. Eliglustat blocked autophagy by altering glycosphingolipid composition whilst restoration of missing glycosphingolipids rescued autophagy markers and TRAF3 degradation thus restoring osteoclastogenesis in bone marrow cells from myeloma patients. This work delineates both the mechanism by which glucosylceramide synthase inhibition prevents autophagic degradation of TRAF3 to reduce osteoclastogenesis as well as highlighting the clinical translational potential of eliglustat for the treatment of myeloma bone disease.
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Affiliation(s)
- Houfu Leng
- grid.4991.50000 0004 1936 8948Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY UK
| | - Hanlin Zhang
- grid.4991.50000 0004 1936 8948Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY UK
| | - Linsen Li
- grid.16821.3c0000 0004 0368 8293Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Department of Pathophysiology, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Shuhao Zhang
- grid.4991.50000 0004 1936 8948Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY UK ,grid.147455.60000 0001 2097 0344Computational Biology Department, Carnegie Mellon University, Pittsburgh, PA 15217 USA
| | - Yanping Wang
- grid.263761.70000 0001 0198 0694Institutes of Biology and Medical Sciences, Soochow University, Suzhou, P.R. China
| | - Selina J. Chavda
- grid.83440.3b0000000121901201Department of Hematology, UCL Cancer Institute, University College London, London, UK
| | - Daria Galas-Filipowicz
- grid.83440.3b0000000121901201Department of Hematology, UCL Cancer Institute, University College London, London, UK
| | - Hantao Lou
- grid.4991.50000 0004 1936 8948Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ UK
| | - Adel Ersek
- grid.8273.e0000 0001 1092 7967Norwich Medical School, University of East Anglia, James Watson Road, Norwich, NR4 7UQ UK
| | - Emma V. Morris
- grid.4991.50000 0004 1936 8948Nuffield Department of Surgical Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD UK
| | - Erdinc Sezgin
- grid.4714.60000 0004 1937 0626Science for Life Laboratory, Department of Women’s and Children’s Health, Karolinska Institute, Solna, Sweden ,grid.173746.00000 0004 0606 3678MRC Weatherall Institute of Molecular Medicine, MRC Human Immunology Unit, Oxford, OX3 9DS UK
| | - Yi-Hsuan Lee
- grid.4991.50000 0004 1936 8948Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY UK ,grid.8273.e0000 0001 1092 7967Norwich Medical School, University of East Anglia, James Watson Road, Norwich, NR4 7UQ UK
| | - Yunsen Li
- grid.263761.70000 0001 0198 0694Institutes of Biology and Medical Sciences, Soochow University, Suzhou, P.R. China
| | - Ana Victoria Lechuga-Vieco
- grid.4991.50000 0004 1936 8948Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY UK
| | - Mei Tian
- grid.8547.e0000 0001 0125 2443Human Phenome Institute, Fudan University, 825 Zhangheng Road, Shanghai, P.R. China
| | - Jian-Qing Mi
- grid.412277.50000 0004 1760 6738Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, RuiJin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Kwee Yong
- grid.83440.3b0000000121901201Department of Hematology, UCL Cancer Institute, University College London, London, UK
| | - Qing Zhong
- grid.16821.3c0000 0004 0368 8293Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Department of Pathophysiology, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Claire M. Edwards
- grid.4991.50000 0004 1936 8948Nuffield Department of Surgical Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD UK ,grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD UK
| | - Anna Katharina Simon
- grid.4991.50000 0004 1936 8948Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY UK
| | - Nicole J. Horwood
- grid.4991.50000 0004 1936 8948Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Oxford, OX3 7FY UK ,grid.8273.e0000 0001 1092 7967Norwich Medical School, University of East Anglia, James Watson Road, Norwich, NR4 7UQ UK
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2
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Whitburn J, Rao SR, Morris EV, Tabata S, Hirayama A, Soga T, Edwards JR, Kaya Z, Palmer C, Hamdy FC, Edwards CM. Metabolic profiling of prostate cancer in skeletal microenvironments identifies G6PD as a key mediator of growth and survival. Sci Adv 2022; 8:eabf9096. [PMID: 35213227 PMCID: PMC8880772 DOI: 10.1126/sciadv.abf9096] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The spread of cancer to bone is invariably fatal, with complex cross-talk between tumor cells and the bone microenvironment responsible for driving disease progression. By combining in silico analysis of patient datasets with metabolomic profiling of prostate cancer cells cultured with bone cells, we demonstrate the changing energy requirements of prostate cancer cells in the bone microenvironment, identifying the pentose phosphate pathway (PPP) as elevated in prostate cancer bone metastasis, with increased expression of the PPP rate-limiting enzyme glucose-6-phosphate dehydrogenase (G6PD) associated with a reduction in progression-free survival. Genetic and pharmacologic manipulation demonstrates that G6PD inhibition reduces prostate cancer growth and migration, associated with changes in cellular redox state and increased chemosensitivity. Genetic blockade of G6PD in vivo results in reduction of tumor growth within bone. In summary, we demonstrate the metabolic plasticity of prostate cancer cells in the bone microenvironment, identifying the PPP and G6PD as metabolic targets for the treatment of prostate cancer bone metastasis.
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Affiliation(s)
- Jessica Whitburn
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Srinivasa R. Rao
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Emma V. Morris
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Sho Tabata
- Institute for Advanced Biosciences, Keio University, Yamagata, Japan
| | - Akiyoshi Hirayama
- Institute for Advanced Biosciences, Keio University, Yamagata, Japan
| | - Tomoyoshi Soga
- Institute for Advanced Biosciences, Keio University, Yamagata, Japan
| | - James R. Edwards
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Zeynep Kaya
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Charlotte Palmer
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Freddie C. Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Claire M. Edwards
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Corresponding author.
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3
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Gámez B, Morris EV, Olechnowicz SWZ, Webb S, Edwards JR, Sowman A, Turner CJ, Edwards CM. The antidiabetic drug metformin acts on the bone microenvironment to promote myeloma cell adhesion to preosteoblasts and increase myeloma tumour burden in vivo. Transl Oncol 2022; 15:101301. [PMID: 34890968 PMCID: PMC8665410 DOI: 10.1016/j.tranon.2021.101301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/10/2021] [Accepted: 11/26/2021] [Indexed: 01/25/2023] Open
Abstract
Multiple myeloma is a haematological malignancy that is dependent upon interactions within the bone microenvironment to drive tumour growth and osteolytic bone disease. Metformin is an anti-diabetic drug that has attracted attention due to its direct antitumor effects, including anti-myeloma properties. However, the impact of the bone microenvironment on the response to metformin in myeloma is unknown. We have employed in vitro and in vivo models to dissect out the direct effects of metformin in bone and the subsequent indirect myeloma response. We demonstrate how metformin treatment of preosteoblasts increases myeloma cell attachment. Metformin-treated preosteoblasts increased osteopontin (OPN) expression that upon silencing, reduced subsequent myeloma cell adherence. Proliferation markers were reduced in myeloma cells cocultured with metformin-treated preosteoblasts. In vivo, mice were treated with metformin for 4 weeks prior to inoculation of 5TGM1 myeloma cells. Metformin-pretreated mice had an increase in tumour burden, associated with an increase in osteolytic bone lesions and elevated OPN expression in the bone marrow. Collectively, we show that metformin increases OPN expression in preosteoblasts, increasing myeloma cell adherence. In vivo, this translates to an unexpected indirect pro-tumourigenic effect of metformin, highlighting the importance of the interdependence between myeloma cells and cells of the bone microenvironment.
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Affiliation(s)
- Beatriz Gámez
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
| | - Emma V Morris
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
| | - Sam W Z Olechnowicz
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Siobhan Webb
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - James R Edwards
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Aneka Sowman
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Christina J Turner
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Claire M Edwards
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
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4
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Abstract
Multiple myeloma (MM) is a haematological malignancy characterised by the proliferation and accumulation of terminally differentiated abnormal plasma cells in the bone marrow. Patients suffer from bone pain, factures, anaemia, osteolytic lesions and renal failure. Despite recent advancement in therapy MM remains an incurable disease due to the emergences of drug resistance and frequent relapse. For many decades, research has been heavily focused on understanding the relationship between bone cells such as osteoblast, osteocytes and osteoclasts and the infiltrating tumour cells. However, it is now clear that the tumour-supportive bone microenvironment including cellular and non-cellular components play an important role in driving MM progression and bone disease. One of the most abundant cell types in the bone microenvironment is the bone marrow adipocyte (BMAd). Once thought of as inert space filling cells, they have now been recognised as having specialised functions, signalling in an autocrine, paracrine and endocrine manner to support normal systemic homeostasis. BMAds are both an energy store and a source of secreted adipokines and bioactive substances, MM cells are able to hijack this metabolic machinery to fuel migration, growth and survival. With global obesity on the rise, it has never been more important to further understand the contribution these cells have in both normal and disease settings. The aim of this review is to summarise the large body of emerging evidence supporting the interplay between BMAds and MM cells and to delineate how they fit into the vicious cycle of disease.
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Affiliation(s)
- Emma V Morris
- Nuffield Dept. of Surgical Sciences, University of Oxford, UK.
| | - Claire M Edwards
- Nuffield Dept. of Surgical Sciences, University of Oxford, UK; Nuffield Dept. of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
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5
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Morris EV, Edwards CM. Morphogens and growth factor signalling in the myeloma bone-lining niche. Cell Mol Life Sci 2021; 78:4085-4093. [PMID: 33570672 PMCID: PMC8164571 DOI: 10.1007/s00018-021-03767-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/07/2021] [Accepted: 01/16/2021] [Indexed: 12/11/2022]
Abstract
Multiple myeloma is a malignancy caused by the clonal expansion of abnormal plasma cells. Myeloma cells have proven to be incredibly successful at manipulating their microenvironment to promote growth and to evade modern therapies. They have evolved to utilise the integral signalling pathways of the bone and bone marrow to drive disease progression. The bone marrow is often described in the context of a single structure that fills the bone cavity and supports normal haematopoiesis. However, within that structure exists two anatomically different niches, the perivascular niche and the endosteal niche. These contain different cell types functioning to support normal immune and blood cell production as well as healthy bone. These cells secrete numerous signalling molecules that can influence myeloma cell biology and behaviour. The endosteal niche is home to specific bone cell lineages and plays a pivotal role in myeloma cell establishment and survival. This review will concentrate on some of the signalling pathways that are hijacked by myeloma cells to shape a favourable environment, and the different influences myeloma cells are exposed to depending on their spatial location within the bone marrow.
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Affiliation(s)
- Emma V Morris
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Claire M Edwards
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. .,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, UK.
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6
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Gamez B, Morris EV, Olechnowicz SW, Sowman A, Turner CJ, Edwards CM. Preventative metformin treatment increases myeloma tumour burden and bone disease in vivo. Bone Rep 2020. [DOI: 10.1016/j.bonr.2020.100681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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7
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Gamez B, Morris EV, Olechnowicz SW, Aneka S, Turner CJ, Lwin ST, Drake MT, Edwards CM. Cholesterol promotes myeloma cell viability and increases bone marrow myeloma tumour burden in vivo. Bone Rep 2020. [DOI: 10.1016/j.bonr.2020.100331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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8
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Morris EV, Suchacki KJ, Hocking J, Cartwright R, Sowman A, Gamez B, Lea R, Drake MT, Cawthorn WP, Edwards CM. Myeloma Cells Down-Regulate Adiponectin in Bone Marrow Adipocytes Via TNF-Alpha. J Bone Miner Res 2020; 35:942-955. [PMID: 31886918 PMCID: PMC9328417 DOI: 10.1002/jbmr.3951] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 12/09/2019] [Accepted: 12/14/2019] [Indexed: 02/06/2023]
Abstract
Multiple myeloma is caused by abnormal plasma cells that accumulate in the bone marrow and interact with resident cells of the bone microenvironment to drive disease progression and development of an osteolytic bone disease. Bone marrow adipocytes (BMAds) are emerging as having important endocrine functions that can support myeloma cell growth and survival. However, how BMAds respond to infiltrating tumor cells remains poorly understood. Using the C57BL/KaLwRij murine model of myeloma, bone marrow adiposity was found to be increased in early stage myeloma with BMAds localizing along the tumor-bone interface at later stages of disease. Myeloma cells were found to uptake BMAd-derived lipids in vitro and in vivo, although lipid uptake was not associated with the ability of BMAds to promote myeloma cell growth and survival. However, BMAd-derived factors were found to increase myeloma cell migration, viability, and the evasion of apoptosis. BMAds are a major source of adiponectin, which is known to be myeloma-suppressive. Myeloma cells were found to downregulate adiponectin specifically in a model of BMAds but not in white adipocytes. The ability of myeloma cells to downregulate adiponectin was dependent at least in part on TNF-α. Collectively our data support the link between increased bone marrow adiposity and myeloma progression. By demonstrating how TNF-α downregulates BMAd-derived adiponectin, we reveal a new mechanism by which myeloma cells alter the bone microenvironment to support disease progression. © 2019 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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Affiliation(s)
- Emma V Morris
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,NIHR Oxford BRC, Oxford, UK.,Oxford Centre for Translational Myeloma Research, Oxford, UK
| | - Karla J Suchacki
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Joseph Hocking
- NIHR Oxford BRC, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Oxford, UK
| | - Rachel Cartwright
- NIHR Oxford BRC, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Oxford, UK
| | - Aneka Sowman
- NIHR Oxford BRC, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Oxford, UK
| | - Beatriz Gamez
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,NIHR Oxford BRC, Oxford, UK.,Oxford Centre for Translational Myeloma Research, Oxford, UK
| | - Ryan Lea
- NIHR Oxford BRC, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Oxford, UK
| | - Matthew T Drake
- Kogod Center on Aging and Division of Endocrinology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - William P Cawthorn
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Claire M Edwards
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,NIHR Oxford BRC, Oxford, UK.,Oxford Centre for Translational Myeloma Research, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Oxford, UK
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9
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Gooding S, Olechnowicz SWZ, Morris EV, Armitage AE, Arezes J, Frost J, Repapi E, Edwards JR, Ashley N, Waugh C, Gray N, Martinez-Hackert E, Lim PJ, Pasricha SR, Knowles H, Mead AJ, Ramasamy K, Drakesmith H, Edwards CM. Transcriptomic profiling of the myeloma bone-lining niche reveals BMP signalling inhibition to improve bone disease. Nat Commun 2019; 10:4533. [PMID: 31586071 PMCID: PMC6778199 DOI: 10.1038/s41467-019-12296-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 08/30/2019] [Indexed: 12/28/2022] Open
Abstract
Multiple myeloma is an incurable, bone marrow-dwelling malignancy that disrupts bone homeostasis causing skeletal damage and pain. Mechanisms underlying myeloma-induced bone destruction are poorly understood and current therapies do not restore lost bone mass. Using transcriptomic profiling of isolated bone lining cell subtypes from a murine myeloma model, we find that bone morphogenetic protein (BMP) signalling is upregulated in stromal progenitor cells. BMP signalling has not previously been reported to be dysregulated in myeloma bone disease. Inhibition of BMP signalling in vivo using either a small molecule BMP receptor antagonist or a solubilized BMPR1a-FC receptor ligand trap prevents trabecular and cortical bone volume loss caused by myeloma, without increasing tumour burden. BMP inhibition directly reduces osteoclastogenesis, increases osteoblasts and bone formation, and suppresses bone marrow sclerostin levels. In summary we describe a novel role for the BMP pathway in myeloma-induced bone disease that can be therapeutically targeted.
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Affiliation(s)
- Sarah Gooding
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre Blood Theme, University of Oxford, Oxford, UK
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
| | - Sam W Z Olechnowicz
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
- Nuffield Dept. of Surgical Sciences, University of Oxford, Oxford, UK
| | - Emma V Morris
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
- Nuffield Dept. of Surgical Sciences, University of Oxford, Oxford, UK
| | - Andrew E Armitage
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Joao Arezes
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Joe Frost
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Emmanouela Repapi
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - James R Edwards
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
- Nuffield Dept. of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Neil Ashley
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Craig Waugh
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Nicola Gray
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Erik Martinez-Hackert
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI, 48824, USA
| | - Pei Jin Lim
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Sant-Rayn Pasricha
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Helen Knowles
- Nuffield Dept. of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Adam J Mead
- Oxford University Hospitals NHS Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre Blood Theme, University of Oxford, Oxford, UK
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Karthik Ramasamy
- Oxford University Hospitals NHS Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre Blood Theme, University of Oxford, Oxford, UK
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Hal Drakesmith
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.
- NIHR Oxford Biomedical Research Centre Blood Theme, University of Oxford, Oxford, UK.
| | - Claire M Edwards
- NIHR Oxford Biomedical Research Centre Blood Theme, University of Oxford, Oxford, UK.
- Oxford Centre for Translational Myeloma Research, University of Oxford, Oxford, UK.
- Nuffield Dept. of Surgical Sciences, University of Oxford, Oxford, UK.
- Nuffield Dept. of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK.
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10
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Abstract
Multiple Myeloma (MM) is an incurable haematological malignancy and is the second most common blood cancer in adults; it is caused by the clonal expansion of abnormal plasma cells within the bone marrow and characterized by osteolytic bone lesions, bone pain, renal disease, and immunodeficiency. MM cells infiltrate the bone marrow where they hijack the microenvironment to sustain growth and survival. The contribution to this process by resident bone cells is well defined. However, the role of bone marrow adipocytes is less clear. As one of the most abundant cell types in the bone marrow these cells are surprisingly understudied. However, in the last few decades they have been recognised as having endocrine function. Adipocytes are metabolically active cells that secrete adipokines, growth factors, and inflammatory mediators, they influence the behaviour and function of neighbouring cells; and have the potential to dysregulate normal bone homeostasis. This review discusses how adipocytes contribute to the metastatic niche in multiple myeloma and cancers that metastasise to the bone and how these new discoveries may contribute to further understanding the mechanisms driving the devastating bone disease associated with MM.
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Affiliation(s)
- Emma V Morris
- Nuffield Dept. of Surgical Sciences, University of Oxford, Oxford, UK
| | - Claire M Edwards
- Nuffield Dept. of Surgical Sciences, University of Oxford, Oxford, UK; Nuffield Dept. of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
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11
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Morris EV, Edwards CM. Adipokines, adiposity, and bone marrow adipocytes: Dangerous accomplices in multiple myeloma. J Cell Physiol 2018; 233:9159-9166. [PMID: 29943829 DOI: 10.1002/jcp.26884] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 05/23/2018] [Indexed: 12/18/2022]
Abstract
Obesity has become a global epidemic influencing the establishment and progression of a wide range of diseases, such as diabetes, cardiovascular disease, and cancer. In 2016, International Agency for Research on Cancer reported that obesity is now associated with 13 different cancers, one of which is multiple myeloma (MM), a destructive cancer of plasma cells that predominantly reside in the bone marrow. Obesity is the accumulation of excess body fat, which causes metabolic, endocrine, immunologic, and inflammatory-like changes. Obesity is usually associated with an increase in visceral and/or subcutaneous fat; however, an additional fat depot that also responds to diet-induced changes is bone marrow adipose tissue (BMAT). There have been several studies over the past few decades that have identified BMAT as a key driver in MM progression. Adipocytes secrete numerous adipokines, such as leptin, adiponectin, resistin, adipsin, and visfatin, which when secreted at normal controlled levels have protective properties. However, in obesity these levels of secretion change, coupled with an increase in adipocyte number and size causing a profound and lasting effect on the bone microenvironment, contributing to MM cell growth, survival, and migration as well as potentially fueling bone destruction. Obesity is a modifiable risk factor making it an attractive option for targeted therapy. This review discusses the link between obesity, monoclonal gammopathy of undetermined significance (a benign condition that precedes MM), and myeloma, and the contribution of key adipokines to disease establishment and progression.
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Affiliation(s)
- Emma V Morris
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Claire M Edwards
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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12
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Abstract
The bone marrow is a favored site for a number of cancers, including the hematological malignancy multiple myeloma, and metastasis of breast and prostate cancer. This specialized microenvironment is highly supportive, not only for tumor growth and survival but also for the development of an associated destructive cancer-induced bone disease. The interactions between tumor cells, osteoclasts and osteoblasts are well documented. By contrast, despite occupying a significant proportion of the bone marrow, the importance of bone marrow adipose tissue is only just emerging. The ability of bone marrow adipocytes to regulate skeletal biology and hematopoiesis, combined with their metabolic activity, endocrine functions, and proximity to tumor cells means that they are ideally placed to impact both tumor growth and bone disease. This review discusses the recent advances in our understanding of how marrow adipose tissue contributes to bone metastasis and cancer-induced bone disease.
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Affiliation(s)
- Emma V. Morris
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Claire M. Edwards
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- *Correspondence: Claire M. Edwards,
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Morris EV, Isaacs B, Brislen W. Falls in the elderly in hospital. Nurs Times 1981; 77:1522-1524. [PMID: 6795598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Abstract
All falls which occurred in a geriatric hospital in period of one year were carefully recorded by nursing staff. Falls occurred most often in admission wards, less in rehabilitation wards and even less in long-stay wards. The incidence of falls was very much lower when patients were confined to bed as a result of industrial action by staff. Very few falls resulted in bone injury. The completion of accident reports by nurses after non-injurious falls is unproductive.
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