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Wu AML, Gossa S, Samala R, Chung MA, Gril B, Yang HH, Thorsheim HR, Tran AD, Wei D, Taner E, Isanogle K, Yang Y, Dolan EL, Robinson C, Difilippantonio S, Lee MP, Khan I, Smith QR, McGavern DB, Wakefield LM, Steeg PS. Aging and CNS Myeloid Cell Depletion Attenuate Breast Cancer Brain Metastasis. Clin Cancer Res 2021; 27:4422-4434. [PMID: 34083229 PMCID: PMC9974011 DOI: 10.1158/1078-0432.ccr-21-1549] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Breast cancer diagnosed in young patients is often aggressive. Because primary breast tumors from young and older patients have similar mutational patterns, we hypothesized that the young host microenvironment promotes more aggressive metastatic disease. EXPERIMENTAL DESIGN Triple-negative or luminal B breast cancer cell lines were injected into young and older mice side-by-side to quantify lung, liver, and brain metastases. Young and older mouse brains, metastatic and naïve, were analyzed by flow cytometry. Immune populations were depleted using antibodies or a colony-stimulating factor-1 receptor (CSF-1R) inhibitor, and brain metastasis assays were conducted. Effects on myeloid populations, astrogliosis, and the neuroinflammatory response were determined. RESULTS Brain metastases were 2- to 4-fold higher in young as compared with older mouse hosts in four models of triple-negative or luminal B breast cancer; no age effect was observed on liver or lung metastases. Aged brains, naïve or metastatic, contained fewer resident CNS myeloid cells. Use of a CSF-1R inhibitor to deplete myeloid cells, including both microglia and infiltrating macrophages, preferentially reduced brain metastasis burden in young mice. Downstream effects of CSF-1R inhibition in young mice resembled that of an aged brain in terms of myeloid numbers, induction of astrogliosis, and Semaphorin 3A secretion within the neuroinflammatory response. CONCLUSIONS Host microenvironmental factors contribute to the aggressiveness of triple-negative and luminal B breast cancer brain metastasis. CSF-1R inhibitors may hold promise for young brain metastasis patients.
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Affiliation(s)
- Alex Man Lai Wu
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Selamawit Gossa
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Ramakrishna Samala
- School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Monika A. Chung
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Brunilde Gril
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Howard H. Yang
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Helen R. Thorsheim
- School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Andy D. Tran
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.,CCR Microscopy Core, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Debbie Wei
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Esra Taner
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Kristine Isanogle
- Laboratory Animal Sciences Program, Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, Maryland
| | - Yuan Yang
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Emma L. Dolan
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Christina Robinson
- Laboratory Animal Sciences Program, Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, Maryland
| | - Simone Difilippantonio
- Laboratory Animal Sciences Program, Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, Maryland
| | - Maxwell P. Lee
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Imran Khan
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Quentin R. Smith
- School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Dorian B. McGavern
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Lalage M. Wakefield
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Patricia S. Steeg
- Women’s Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
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Abstract
This study investigated the relationship between adult attention deficit hyperactivity disorder (ADHD) and trauma. Fifty-eight adults admitted to hospital with musculoskeletal trauma were evaluated using scales that determine the presence of ADHD in childhood and adulthood. Each patient was also interviewed by an adult psychiatrist and a child and adolescent psychiatrist. The control group consisted of 30 adult patients with complaints other than trauma who did not have a history of repetitive traumas. There were 36 (62.2%) cases of ADHD in the patient group compared with four (13.3%) in the control group; this difference was statistically significant. When the level of trauma was evaluated, ADHD was identified in 23 of the 26 (88.5%) patients with high energy traumas compared with 14 of the 32 (43.8%) patients with low energy traumas; this difference was also statistically significant. This study shows that patients with adult ADHD are more prone to injuries, particularly high energy traumas such as motor vehicle accidents. Patients who have repeated high energy traumas should be evaluated by a psychiatrist for ADHD.
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Affiliation(s)
- A Kaya
- Department of Orthopaedics and Traumatology, Ufuk University, Ankara, Turkey
| | - Y Taner
- Department of Child and Adolescent Psychiatry, Ufuk University, Ankara, Turkey
| | - B Guclu
- Department of Orthopaedics and Traumatology, Ufuk University, Ankara, Turkey
| | - E Taner
- Health Care and Sports Centre, Gazi University, Ankara, Turkey
| | - Y Kaya
- Department of Neurology, Başkent University, Ankara, Turkey
| | - HG Bahcivan
- Department of Psychiatry, Ufuk University, Ankara, Turkey
| | - IT Benli
- Department of Orthopaedics and Traumatology, Ufuk University, Ankara, Turkey
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