Harnessing redox signaling to overcome therapeutic-resistant cancer dormancy

Dormancy occurs when cells preserve viability but stop proliferating, which is considered an important cause of tumor relapse, which may occur many years after clinical remission. Since the life cycle of dormant cancer cells is affected by both intracellular and extracellular factors, gene mutation or epigenetic regulation of tumor cells may not fully explain the mechanisms involved. Recent studies have indicated that redox signaling regulates the formation, maintenance, and reactivation of dormant cancer cells by modulating intracellular signaling pathways and the extracellular environment, which provides a molecular explanation for the life cycle of dormant tumor cells. Indeed, redox signaling regulates the onset of dormancy by balancing the intrinsic pathways, the extrinsic environment, and the response to therapy. In addition, redox signaling sustains dormancy by managing stress homeostasis, maintaining stemness and immunogenic equilibrium. However, studies on dormancy reactivation are still limited, partly explained by redox-mediated activation of lipid metabolism and the transition from the tumor microenvironment to inflammation. Encouragingly, several drug combination strategies based on redox biology are currently under clinical evaluation. Continuing to gain an in-depth understanding of redox regulation and develop specific methods targeting redox modification holds the promise to accelerate the development of strategies to treat dormant tumors and benefit cancer patients.     

Cancer dormancy. VII. A regulatory role for CD8+ T cells and IFN-gamma in establishing and maintaining the tumor-dormant state

Dormant tumor cells resistant to ablative cancer therapy represent a significant clinical obstacle due to later relapse. Experimentally, the murine B cell lymphoma (BCL1) is used as a model of tumor dormancy in mice vaccinated with the BCL1 Ig. Here, we used this model to explore the cellular mechanisms underlying dormancy. Our previous studies have demonstrated that T cell-mediated immunity is an important component in the regulation of tumor dormancy because Id-immune T cells adoptively transferred into passively immunized SCID mice challenged with BCL1 cells significantly increased the incidence and duration of the dormant state. We have extended these observations and demonstrate that CD8+, but not CD4+, T cells are required for the maintenance of dormancy in BCL1 Ig-immunized BALB/c mice. In parallel studies, the transfer of Id-immune CD8+ cells, but not Id-immune CD4+ cells, conferred significant protection to SCID mice passively immunized with nonprotective levels of polyclonal anti-Id and then challenged with BCL1 cells. Furthermore, the ability of CD8+ T cells to induce a state of dormancy in passively immunized SCID mice was completely abrogated by treatment with neutralizing alpha-IFN-gamma mAbs in vivo. In vitro studies demonstrated that IFN-gamma alone or in combination with reagents to cross-link the surface Ig induced both cell cycle arrest and apoptosis in a BCL1 cell line. Collectively, these data demonstrate a role for CD8+ T cells via endogenous production of IFN-gamma in collaboration with humoral immunity to both induce and maintain a state of tumor dormancy.     

细胞休眠在肿瘤耐药和复发中的作用（英文）

Despite progresses achieved in the therapy of tumors, the prognosis of patients is still limited by reccurence of residual tumor cells. Cancer cell dormancy plays a pivotal role in cancer relapse and drug resistance. In recent years, tumor cells undergoing EMT(epithelial-mesenchymal transition), CSCs(cancer stem cells) and CTCs(circulating tumor cells) are proved to share some common characteristics and show a cell cycle arrest phenotype. Thus, understanding the dormant stage of tumor cells could facilitate us in discovering ways to accelerate the development of tumor therapy and prevent its reccurence. In this review, we summarize the specific process of tumor cell dormancy induced by pharmacotherapy, and consider that dormancy is an initiative response rather than a passive defense to cytotoxicity. Besides, we probe into the mechanisms of tumor cell dormancy-mediated drug resistance, anticipating paving a way to target dormant tumor cells and result in better clinical outcomes.     

细胞休眠在肿瘤耐药和复发中的作用

目前对于肿瘤的药物治疗已经取得了一定的进展,然而,治疗后残存肿瘤细胞的复发仍然是导致肿瘤治疗失败的主要原因．肿瘤细胞休眠在肿瘤复发及耐药中发挥着重要的作用．近年来,研究发现上皮间质转化(epithelial-mesenchymal transition,EMT)的肿瘤细胞,肿瘤干细胞(cancer stem cells,CSCs)以及循环肿瘤细胞(circulating tumor cells,CTCs)都显示出细胞周期阻滞的状态．因此,对于休眠阶段肿瘤细胞的研究将可能促进肿瘤的治疗及预防肿瘤的复发．本文总结了药物治疗诱导肿瘤细胞发生休眠的具体过程,同时认为休眠是肿瘤细胞面对药物治疗所采取的主动防御措施,而非被动逃避过程．探究药物诱导性肿瘤细胞的休眠机制对于靶向休眠肿瘤细胞治疗及提高临床治疗效果都具有非常重要的意义．     

Glypican-3 (GPC3) inhibits metastasis development promoting dormancy in breast cancer cells by p38 MAPK pathway activation

GPC3 is a proteoglycan involved in the control of proliferation and survival, which has been linked to several tumor types. In this respect, we previously demonstrated that normal breast tissues exhibit high levels of GPC3, while its expression is diminished in tumors. However, the role of the GPC3 downregulation in breast cancer progression and its molecular and cellular operational machineries are not fully understood.In this study we showed that GPC3 reverts the epithelial-to-mesenchymal transition (EMT) underwent by mammary tumor cells, blocks metastatic spread and induces dormancy at secondary site. Using genetically modified murine breast cancer cell sublines, we demonstrated that the phospho-Erk/phospho-p38 ratio is lower in GPC3 reexpressing cells, while p21, p27 and SOX2 levels are higher, suggesting a dormant phenotype. In vivo metastasis assays confirmed that GPC3 reexpressing cells reduce their metastatic ability. Interestingly, the presence of dormant cells was evidenced in the lungs of inoculated mice. Dormant cells could reactivate their proliferative capacity, remain viable as well as tumorigenic, but they reentered in dormancy upon reaching secondary site. We also proved that GPC3 inhibits metastasis through p38 pathway activation. The in vivo inhibition of p38 induced an increase in cell invasion of GPC3 reexpressing orthotropic tumors as well as in spontaneous and experimental metastatic dissemination.In conclusion, our study shows that GPC3 returns mesenchymal-like breast cancer cells to an epithelial phenotype, impairs in vivo metastasis and induces tumor dormancy through p38 MAPK signaling activation. These results help to identify genetic determinants of dormancy and suggest the translational potential of research focusing in GPC3.     

SMAD signaling and redox imbalance cooperate to induce prostate cancer cell dormancy

Metastasis involves the dissemination of single or small clumps of cancer cells through blood or lymphatic vessels and their extravasation into distant organs. Despite the strong regulation of metastases development by a cell dormancy phenomenon, the dormant state of cancer cells remains poorly characterized due to the difficulty of in vivo studies. We have recently shown in vitro that clonogenicity of prostate cancer cells is regulated by a dormancy phenomenon that is strongly induced when cells are cultured both at low cell density and in a slightly hypertonic medium. Here, we characterized by RT-qPCR a genetic expression signature of this dormant state which combines the presence of both stemness and differentiation markers. We showed that both TFGβ/BMP signaling and redox imbalance are required for the full induction of this dormancy signature and cell quiescence. Moreover, reconstruction experiments showed that TFGβ/BMP signaling and redox imbalance are sufficient to generate a pattern of genetic expression displaying all characteristic features of the dormancy signature. Finally, we observed that low cell density was sufficient to activate TGFβ/BMP signaling and to generate a slight redox imbalance thus priming cells for dormancy that can be attained with a co-stimulus like hypertonicity, most likely through an increased redox imbalance. The identification of a dual regulation of dormancy provides a framework for the interpretation of previous reports showing a restricted ability of BMP signaling to regulate cancer cell dormancy in vivo and draws attention on the role of oxidative stress in the metastatic process.     

A dormant state modulated by osmotic pressure controls clonogenicity of prostate cancer cells

Cell dormancy constitutes a limiting step of the metastatic process by preventing the proliferation of isolated cancer cells disseminated at distant sites from the primary tumor. The study of cancer cell dormancy is severely hampered by the lack of biological samples so that the mechanisms that regulate cell dormancy have not been extensively explored. In this work, we describe the rapid induction in vitro of a dormant state in prostate cancer cells by exposure to a slightly hypertonic growth medium. This quiescence is observed only when cells are seeded at low density and, once established, requires additional stimuli besides osmotic pressure to be reversed. Media conditioned by cells grown at high density can partially prevent or reverse dormancy, a phenomenon which can be reproduced with citric acid. In addition to this role of small metabolites, inactivation of the p53 and smad pathways also counters the entry into dormancy, whereas exposure to activin A induces it to some extent. Thus, this easily inducible dormancy reproduces several features associated with the dormancy of stem cells and cancer cells in vivo.     

An In Vitro System to Study Tumor Dormancy and the Switch to Metastatic Growth

Recurrence of breast cancer often follows a long latent period in which there are no signs of cancer, and metastases may not become clinically apparent until many years after removal of the primary tumor and adjuvant therapy. A likely explanation of this phenomenon is that tumor cells have seeded metastatic sites, are resistant to conventional therapies, and remain dormant for long periods of time ^1-4.The existence of dormant cancer cells at secondary sites has been described previously as quiescent solitary cells that neither proliferate nor undergo apoptosis ^5-7. Moreover, these solitary cells has been shown to disseminate from the primary tumor at an early stage of disease progression ^8-10 and reside growth-arrested in the patients'' bone marrow, blood and lymph nodes ^1,4,11. Therefore, understanding mechanisms that regulate dormancy or the switch to a proliferative state is critical for discovering novel targets and interventions to prevent disease recurrence. However, unraveling the mechanisms regulating the switch from tumor dormancy to metastatic growth has been hampered by the lack of available model systems. in vivo and ex vivo model systems to study metastatic progression of tumor cells have been described previously ^1,12-14. However these model systems have not provided in real time and in a high throughput manner mechanistic insights into what triggers the emergence of solitary dormant tumor cells to proliferate as metastatic disease. We have recently developed a 3D in vitro system to model the in vivo growth characteristics of cells that exhibit either dormant (D2.OR, MCF7, K7M2-AS.46) or proliferative (D2A1, MDA-MB-231, K7M2) metastatic behavior in vivo . We demonstrated that tumor cells that exhibit dormancy in vivo at a metastatic site remain quiescent when cultured in a 3-dimension (3D) basement membrane extract (BME), whereas cells highly metastatic in vivo readily proliferate in 3D culture after variable, but relatively short periods of quiescence. Importantly by utilizing the 3D in vitro model system we demonstrated for the first time that the ECM composition plays an important role in regulating whether dormant tumor cells will switch to a proliferative state and have confirmed this in in vivo studies^15-17. Hence, the model system described in this report provides an in vitro method to model tumor dormancy and study the transition to proliferative growth induced by the microenvironment.Download video file.^{(58M, mov)}     

Structural Changes in the Vascular Cambium of Pinus strobus L. during an Annual Cycle

The changes in the ultrastructure of cambial cells of easternwhite pine (Pinus strobus L.) during an annual cycle are observedand recorded as are relationships of cambial cells during dormancyand at resumption of cambial activity. Cambial activity wasresumed late in March or early in April, when a few cells dividedpericlinally. Cambial activity reached a maximum during thelatter part of May with 15 to 20 undifferentiated cells present.In July it declined markedly, and the number of undifferentiatedcells equalled that of the dormant period. The xylem and phloemtissue cells produced late in the annual cycle overwinteredat varying developmental stages. In October cambial cells structurallyresembled dormant cells. The number of dormant cells in easternwhite pine cambium varied from 6 to 10. Active cells were characterizedby a large central vacuole, by an abundance of all cell organelles,and by thin cell walls. Dormant cells were characterized bynumerous small vacuoles, by structurally and quantitativelymodified cell organelles, and by relatively thick cell walls.     

Winter cold influences the spatial and age distributions of the North American treehole mosquito Anopheles barberi

Summary We conducted experiments to assess the importance of winter cold and photoperiod as factors affecting the spatial and age distributions of overwintering larvae of the treehole mosquito Anopheles barberi. Larval dormancy in A. barberi was induced by photoperiods with 14.75 h of light or less per 24 h cycle. About 75% of the larvae entering dormancy were in the second instar regardless of photoperiod. Dormant second instar larvae survived freezing at-15° C for 24 h better than dormant third instar larvae. Larvae were more likely to survive freezing at-15° C in water from treeholes in which they were commonly found in nature than in water from treeholes in which they were unlikely to occur. Female oviposition was significantly higher into water from treeholes in which larvae were likely to be found than in either water from treeholes in which larvae were not commonly found or distilled water. These findings suggest that, in the northern part of its range, the distribution of A. barberi and the age structure of overwintering cohorts are influenced by extreme winter cold. The mechanisms responsible for the distribution of larvae and the overwintering age structure are, respectively, female oviposition behavior and larval photoperiodism.     

Engineered <Emphasis Type="Italic">In Vitro</Emphasis> Models of Tumor Dormancy and Reactivation

Metastatic recurrence is a major hurdle to overcome for successful control of cancer-associated death. Residual tumor cells in the primary site, or disseminated tumor cells in secondary sites, can lie in a dormant state for long time periods, years to decades, before being reactivated into a proliferative growth state. The microenvironmental signals and biological mechanisms that mediate the fate of disseminated cancer cells with respect to cell death, single cell dormancy, tumor mass dormancy and metastatic growth, as well as the factors that induce reactivation, are discussed in this review. Emphasis is placed on engineered, in vitro, biomaterial-based approaches to model tumor dormancy and subsequent reactivation, with a focus on the roles of extracellular matrix, secondary cell types, biochemical signaling and drug treatment. A brief perspective of molecular targets and treatment approaches for dormant tumors is also presented. Advances in tissue-engineered platforms to induce, model, and monitor tumor dormancy and reactivation may provide much needed insight into the regulation of these processes and serve as drug discovery and testing platforms.     

Dormant forms of mycobacteria

Dormant states of bacteria with drastically decreased metabolic activity, enhanced resistance to harmful factors, and absence of cell division is a form for surviving unfavorable environmental conditions. This state does not necessarily imply formation of highly differentiated spores and cysts; it has been demonstrated for non-spore-forming bacteria, including pathogenic ones. The latency of a number of infectious diseases is generally believed to be related to the capacity of bacteria (including Mycobacterium tuberculosis, an infective agent of tuberculosis) to produce dormant forms. Indeed, some results of histological investigation and modeling of latent infections in animals, as well as results obtained with in vitro models, support the hypothesis of production of dormant forms by tuberculosis bacteria. In the present review, existing experimental models of dormant form production in mycobacteria are considered, as well as modern data concerning the mechanisms of their formation and their relation to the “nonculturable” state. The mechanisms of reversion to culturability and the role of extracellular factors in reactivation of dormant forms are discussed in detail.     

Immunogenic,cellular, and angiogenic drivers of tumor dormancy‐a melanoma view

In tumor cells, the ability to maintain viability over long time periods without proliferation is referred to as a state of dormancy. Maintenance of dormancy is controlled by numerous cellular and environmental factors, from immune surveillance and tumor–stroma interaction to intracellular signaling. Interference of dormancy (to an ‘awaken’ state) is associated with reduced response to therapy, resulting in relapse or in metastatic burst. Thus, maintaining a dormant state should prolong therapeutic responses and delay metastasis. Technical obstacles in studying tumor dormancy have limited our understanding of underlying mechanisms and hampered our ability to target dormant cells. In this review, we summarize the progress of research in the field of immunogenic, angiogenic, and cellular dormancy in diverse malignancies with particular attention to our current understanding in melanoma.     

Green and blue light photoreceptors are involved in maintenance of dormancy in imbibed annual ryegrass (Lolium rigidum) seeds

Light plays an important role in two separate processes within the seeds of Lolium rigidum (annual ryegrass). Dormant seeds of L. rigidum remain dormant when imbibed in the light, but once seeds have lost dormancy through dark-stratification, light stimulates their germination. This study characterizes the light qualities and quantities which are effective in maintenance of dormancy. Dormant seeds were stratified under narrow- and broad-waveband light to identify the potential photoreceptors involved in dormancy maintenance, and to determine whether dark-induced dormancy loss is reversible by light. Blue and green light both mediated dormancy maintenance in a far-red-independent manner. Red light resulted in dormancy maintenance only when far-red wavelengths were excluded, suggesting a redundant function of phytochrome. At low fluence rates, white light was more effective than monochromatic light, suggesting the action of multiple photoreceptors in dormancy maintenance. By contrast, nondormant seeds did not germinate unless provided with red light. These results indicate that seed dormancy maintenance is potentially mediated through the actions of blue and green light photoreceptors. Seed dormancy could thus be added to the growing list of plant responses that may be mediated by green light in a cryptochrome-independent manner.     

Osteoblastic protein kinase D1 contributes to the prostate cancer cells dormancy via GAS6-circadian clock signaling

Disseminated prostate cancer (PCa) is known to have a strong propensity for bone marrow. These disseminated tumor cells (DTCs) can survive in bone marrow for years without obvious proliferation, while maintaining the ability to develop into metastatic lesions. However, how DTCs kept dormant and recur is still uncertain. Here, we focus on the role of osteoblastic protein kinase D1 (PKD1) in PCa (PC-3 and DU145) dormancy using co-culture experiments. Using flow cytometry, western blotting, and immunofluorescence, we observed that in co-cultures osteoblasts could induce a dormant state in PCa cells, which is manifested by a fewer cell divisions, a decrease Ki-67-positive populations and a lower ERK/p38 ratio. In contrast, silencing of PKD1 gene in osteoblasts impedes co-cultured prostate cancer cell's dormancy ability. Mechanismly, protein kinase D1 (PKD1) in osteoblasts induces PCa dormancy via activating CREB1, which promoting the expression and secretion of growth arrest specific 6 (GAS6). Furthermore, GAS6-induced dormancy signaling significantly increased the expression of core circadian clock molecules in PCa cells, and a negative correlation of circadian clock proteins (BMAL1, CLOCK and DEC2) with recurrence-free survival is observed in metastatic prostate cancer patients. Interestingly, the expression of cell cycle factors (p21, p27, CDK1 and PCNA) which regulated by circadian clock also upregulated in response to GAS6 stimulation. Taken together, we provide evidence that osteoblastic PKD1/CREB1/GAS6 signaling regulates cellular dormancy of PCa cells, and highlights the importance of circadian clock in PCa cells dormancy.     

Cytochemieal Observation on Garlic Clove before and after Temperature-Modulated Break of Dormancy

Usually, garlic clove keeps itself in dormancy during summer months and tends to break their dormancy as the climate becomes cooler toward autumn. Prolonged storage of garlic clove under relatively high temperature is a good measure taken in practics to retain its dormancy and refrain from sprouting. In fact, if garlic is stored around 30 ℃, its dormancy can be extended to more than six months while its exposure to low temperature (4 ℃) for a short duration will eventualy break its dormancy. The Dormant release can be diagnosed in the upper epidermis by signs of nuclear disintegration and appearance of APase, ATPase and POase activities. The nuclei in dormant epidermal cells keep their characteristic round shape and in the central position of the cells which are devoid of the enzyme activities mentioned. In case the clove is kept in 30℃ over a year, partial disintegration of the cells evacuation of the constituents also take place, as clearly shown by numerous proteinaceous granules suspended in the interior and by “nuclear extrusion” across the intercellular boundary.