bims-cagime Biomed News
on Cancer, aging and metabolism
Issue of 2021–10–31
forty-one papers selected by
Kıvanç Görgülü, Technical University of Munich
  1. SLC25A39 is necessary for mitochondrial glutathione import in mammalian cells.
  2. Temporal proteomics during neurogenesis reveals large-scale proteome and organelle remodeling via selective autophagy.
  3. GCN2 adapts protein synthesis to scavenging-dependent growth.
  4. Lysosomal targetomics of ghr KO mice shows chaperone-mediated autophagy degrades nucleocytosolic acetyl-coA enzymes.
  5. Cell cycle-independent integration of stress signals by Xbp1 promotes Non-G1/G0 quiescence entry.
  6. Metabolic requirements of the metastatic cascade.
  7. Cytoplasmic DNA: sources, sensing, and role in aging and disease.
  8. The KRAS-regulated kinome identifies WEE1 and ERK coinhibition as a potential therapeutic strategy in KRAS-mutant pancreatic cancer.
  9. Loss of acinar cell VMP1 triggers spontaneous pancreatitis in mice.
  10. Obesity, Senescence, and Senolytics.
  11. Regulation of mitochondrial cargo-selective autophagy by post-translational modifications.
  12. Mitochondrial calcium exchange in physiology and disease.
  13. Strategies for late phase preclinical and early clinical trials of senolytics.
  14. 3D Collagen-Nanocellulose Matrices Model the Tumour Microenvironment of Pancreatic Cancer.
  15. Glycogen metabolism links glucose homeostasis to thermogenesis in adipocytes.
  16. Molecular modelling of the FOXO4-TP53 interaction to design senolytic peptides for the elimination of senescent cancer cells.
  17. DNA methylation signatures reveal that distinct combinations of transcription factors specify human immune cell epigenetic identity.
  18. Pancreatic cancer cells render tumor-associated macrophages metabolically reprogrammed by a GARP and DNA methylation-mediated mechanism.
  19. Phase I Study of Preoperative Chemoradiotherapy Using Gemcitabine Plus Nab-Paclitaxel for Patients Who Have Localized Pancreatic Ductal Adenocarcinoma With Contact or Invasion to Major Arteries.
  20. Identification of long-lived proteins in the mitochondria reveals increased stability of the electron transport chain.
  21. Oxygen and metabolic reprogramming in the tumor microenvironment influences metastasis homing.
  22. The impact of physiological metabolite levels on serine uptake, synthesis and utilization in cancer cells.
  23. Phase I Dose Escalation Trial Using 3-Fraction SBRT for Locally Advanced Pancreatic Cancer.
  24. Integrated loss- and gain-of-function screens define a core network governing human embryonic stem cell behavior.
  25. Single-cell transcriptomics reveals a conserved metaplasia program in pancreatic injury.
  26. Deep learning and alignment of spatially resolved single-cell transcriptomes with Tangram.
  27. Crosstalk between autophagy inhibitors and endosome-related secretory pathways: a challenge for autophagy-based treatment of solid cancers.
  28. Hepatocytic p62 suppresses ductular reaction and tumorigenesis in mouse livers with mTORC1 activation and defective autophagy.
  29. Metabolite discovery through global annotation of untargeted metabolomics data.
  30. Microenvironmental IL-6 inhibits anti-cancer immune responses generated by cytotoxic chemotherapy.
  31. Autophagy is induced and modulated by cholesterol depletion through transcription of autophagy-related genes and attenuation of flux.
  32. Harnessing the predictive power of preclinical models for oncology drug development.
  33. Mitochondrial phenotypes in purified human immune cell subtypes and cell mixtures.
  34. Phase separation drives the self-assembly of mitochondrial nucleoids for transcriptional modulation.
  35. The lysosome as an imperative regulator of autophagy and cell death.
  36. HER2 mediates clinical resistance to the KRASG12C inhibitor sotorasib, which is overcome by co-targeting SHP2.
  37. Daily caloric restriction limits tumor growth more effectively than caloric cycling regardless of dietary composition.
  38. Tutorial: methods for three-dimensional visualization of archival tissue material.
  39. The mitochondrial permeability transition: Recent progress and open questions.
  40. SBRT for the Treatment of Isolated Local Recurrence of Resected Pancreatic Cancer.
  41. Sarcopenia as a Predictor of Survival in Patients with Pancreatic Adenocarcinoma After Pancreatectomy.
  1. Nature. 2021 Oct 27.
    SLC25A39 is necessary for mitochondrial glutathione import in mammalian cells.
    Ying Wang, Frederick S Yen, Xiphias Ge Zhu, Rebecca C Timson, Ross Weber, Changrui Xing, Yuyang Liu, Benjamin Allwein, Hanzhi Luo, Hsi-Wen Yeh, Søren Heissel, Gokhan Unlu, Eric R Gamazon, Michael G Kharas, Richard Hite, Kıvanç Birsoy.
      Glutathione (GSH) is a small-molecule thiol that is abundant in all eukaryotes and has key roles in oxidative metabolism1. Mitochondria, as the major site of oxidative reactions, must maintain sufficient levels of GSH to perform protective and biosynthetic functions2. GSH is synthesized exclusively in the cytosol, yet the molecular machinery involved in mitochondrial GSH import remains unknown. Here, using organellar proteomics and metabolomics approaches, we identify SLC25A39, a mitochondrial membrane carrier of unknown function, as a regulator of GSH transport into mitochondria. Loss of SLC25A39 reduces mitochondrial GSH import and abundance without affecting cellular GSH levels. Cells lacking both SLC25A39 and its paralogue SLC25A40 exhibit defects in the activity and stability of proteins containing iron-sulfur clusters. We find that mitochondrial GSH import is necessary for cell proliferation in vitro and red blood cell development in mice. Heterologous expression of an engineered bifunctional bacterial GSH biosynthetic enzyme (GshF) in mitochondria enables mitochondrial GSH production and ameliorates the metabolic and proliferative defects caused by its depletion. Finally, GSH availability negatively regulates SLC25A39 protein abundance, coupling redox homeostasis to mitochondrial GSH import in mammalian cells. Our work identifies SLC25A39 as an essential and regulated component of the mitochondrial GSH-import machinery.
    DOI:  https://doi.org/10.1038/s41586-021-04025-w
  2. Mol Cell. 2021 Oct 15. pii: S1097-2765(21)00800-5. [Epub ahead of print]
    Temporal proteomics during neurogenesis reveals large-scale proteome and organelle remodeling via selective autophagy.
    Alban Ordureau, Felix Kraus, Jiuchun Zhang, Heeseon An, Sookhee Park, Tim Ahfeldt, Joao A Paulo, J Wade Harper.
      Cell state changes are associated with proteome remodeling to serve newly emergent cell functions. Here, we show that NGN2-driven conversion of human embryonic stem cells to induced neurons (iNeurons) is associated with increased PINK1-independent mitophagic flux that is temporally correlated with metabolic reprogramming to support oxidative phosphorylation. Global multiplex proteomics during neurogenesis revealed large-scale remodeling of functional modules linked with pluripotency, mitochondrial metabolism, and proteostasis. Differentiation-dependent mitophagic flux required BNIP3L and its LC3-interacting region (LIR) motif, and BNIP3L also promoted mitophagy in dopaminergic neurons. Proteomic analysis of ATG12-/- iNeurons revealed accumulation of endoplasmic reticulum, Golgi, and mitochondria during differentiation, indicative of widespread organelle remodeling during neurogenesis. This work reveals broad organelle remodeling of membrane-bound organelles during NGN2-driven neurogenesis via autophagy, identifies BNIP3L's central role in programmed mitophagic flux, and provides a proteomic resource for elucidating how organelle remodeling and autophagy alter the proteome during changes in cell state.
    Keywords:  autophagy; iNeurons; mitophagy; proteomics
    DOI:  https://doi.org/10.1016/j.molcel.2021.10.001
  3. Cell Syst. 2021 Oct 21. pii: S2405-4712(21)00382-3. [Epub ahead of print]
    GCN2 adapts protein synthesis to scavenging-dependent growth.
    Michel Nofal, Tim Wang, Lifeng Yang, Connor S R Jankowski, Sophia Hsin-Jung Li, Seunghun Han, Lance Parsons, Alexander N Frese, Zemer Gitai, Tracy G Anthony, Martin Wühr, David M Sabatini, Joshua D Rabinowitz.
      Pancreatic cancer cells with limited access to free amino acids can grow by scavenging extracellular protein. In a murine model of pancreatic cancer, we performed a genome-wide CRISPR screen for genes required for scavenging-dependent growth. The screen identified key mediators of macropinocytosis, peripheral lysosome positioning, endosome-lysosome fusion, lysosomal protein catabolism, and translational control. The top hit was GCN2, a kinase that suppresses translation initiation upon amino acid depletion. Using isotope tracers, we show that GCN2 is not required for protein scavenging. Instead, GCN2 prevents ribosome stalling but without slowing protein synthesis; cells still use all of the limiting amino acids as they emerge from lysosomes. GCN2 also adapts gene expression to the nutrient-poor environment, reorienting protein synthesis away from ribosomes and toward lysosomal hydrolases, such as cathepsin L. GCN2, cathepsin L, and the other genes identified in the screen are potential therapeutic targets in pancreatic cancer.
    Keywords:  Cathepsin L; GCN2; PDAC; lysosomes; macropinocytosis; protein scavenging; protein synthesis; translation
    DOI:  https://doi.org/10.1016/j.cels.2021.09.014
  4. Autophagy. 2021 Oct 27.
    Lysosomal targetomics of ghr KO mice shows chaperone-mediated autophagy degrades nucleocytosolic acetyl-coA enzymes.
    S Joseph Endicott, Alexander C Monovich, Eric L Huang, Evelynn I Henry, Dennis N Boynton, Logan J Beckmann, Michael J MacCoss, Richard A Miller.
      Mice deficient for GHR (growth hormone receptor; ghr KO) have a dramatic lifespan extension, and elevated levels of hepatic chaperone-mediated autophagy (CMA). Using quantitative proteomics to identify protein changes in purified liver lysosomes and whole liver lysates, we provide evidence that elevated CMA in ghr KO mice downregulates proteins involved in ribosomal structure, translation initiation and elongation, and nucleocytosolic acetyl-coA production. Following up on these initial proteomics findings, we used a cell culture approach to show that CMA is necessary and sufficient to regulate the abundance of ACLY and ACSS2, the two enzymes that produce nucleocytosolic (but not mitochondrial) acetyl-coA. Inhibition of CMA in NIH3T3 cells has been shown to lead to aberrant accumulation of lipid droplets. We show that this lipid droplet phenotype is rescued by knocking down ACLY or ACSS2, suggesting that CMA regulates lipid droplet formation by controlling ACLY and ACSS2. This evidence leads to a model of how constitutive activation of CMA can shape specific metabolic pathways in long-lived endocrine mutant mice.
    Keywords:  aging; autophagy; growth hormone; metabolism; proteomics
    DOI:  https://doi.org/10.1080/15548627.2021.1990670
  5. J Cell Biol. 2022 Jan 03. pii: e202103171. [Epub ahead of print]221(1):
    Cell cycle-independent integration of stress signals by Xbp1 promotes Non-G1/G0 quiescence entry.
    Orlando Argüello-Miranda, Ashley J Marchand, Taylor Kennedy, Marielle A X Russo, Jungsik Noh.
      Cellular quiescence is a nonproliferative state required for cell survival under stress and during development. In most quiescent cells, proliferation is stopped in a reversible state of low Cdk1 kinase activity; in many organisms, however, quiescent states with high-Cdk1 activity can also be established through still uncharacterized stress or developmental mechanisms. Here, we used a microfluidics approach coupled to phenotypic classification by machine learning to identify stress pathways associated with starvation-triggered high-Cdk1 quiescent states in Saccharomyces cerevisiae. We found that low- and high-Cdk1 quiescent states shared a core of stress-associated processes, such as autophagy, protein aggregation, and mitochondrial up-regulation, but differed in the nuclear accumulation of the stress transcription factors Xbp1, Gln3, and Sfp1. The decision between low- or high-Cdk1 quiescence was controlled by cell cycle-independent accumulation of Xbp1, which acted as a time-delayed integrator of the duration of stress stimuli. Our results show how cell cycle-independent stress-activated factors promote cellular quiescence outside G1/G0.
    DOI:  https://doi.org/10.1083/jcb.202103171
  6. Curr Opin Syst Biol. 2021 Dec;pii: 100381. [Epub ahead of print]28
    Metabolic requirements of the metastatic cascade.
    Stanislav Drapela, Ana P Gomes.
      Metastases represent a major cause of cancer-associated deaths. Despite extensive research, targeting metastasis remains the main obstacle in cancer therapy. Therefore, it is of tremendous importance to elucidate the mechanisms that impinge on the different steps of the metastatic cascade. Metabolic plasticity is a cornerstone of the tumorigenic process that not only enables cancer cells to rapidly proliferate but also thrive and retain vitality. Plasticity of the metabolic networks that wire cancer cells is of utmost importance during the metastatic cascade when cancer cells are at their most vulnerable and have to survive in a panoply of inhospitable environments as they make their journey to form metastatic lesions. Here, we highlight which metabolic processes are known to power metastasis formation and lay the foundation for additional work aimed at discovering regulatory nodes of metabolic plasticity that can be used to target metastatic disease.
    DOI:  https://doi.org/10.1016/j.coisb.2021.100381
  7. Cell. 2021 Oct 28. pii: S0092-8674(21)01117-X. [Epub ahead of print]184(22): 5506-5526
    Cytoplasmic DNA: sources, sensing, and role in aging and disease.
    Karl N Miller, Stella G Victorelli, Hanna Salmonowicz, Nirmalya Dasgupta, Tianhui Liu, João F Passos, Peter D Adams.
      Endogenous cytoplasmic DNA (cytoDNA) species are emerging as key mediators of inflammation in diverse physiological and pathological contexts. Although the role of endogenous cytoDNA in innate immune activation is well established, the cytoDNA species themselves are often poorly characterized and difficult to distinguish, and their mechanisms of formation, scope of function and contribution to disease are incompletely understood. Here, we summarize current knowledge in this rapidly progressing field with emphases on similarities and differences between distinct cytoDNAs, their underlying molecular mechanisms of formation and function, interactions between cytoDNA pathways, and therapeutic opportunities in the treatment of age-associated diseases.
    Keywords:  aging; cancer; cytoplasmic DNA; cytoplasmic chromatin fragment; micronucleus; mitochondrial DNA; retrotransposon; senescence
    DOI:  https://doi.org/10.1016/j.cell.2021.09.034
  8. J Biol Chem. 2021 Oct 21. pii: S0021-9258(21)01141-8. [Epub ahead of print] 101335
    The KRAS-regulated kinome identifies WEE1 and ERK coinhibition as a potential therapeutic strategy in KRAS-mutant pancreatic cancer.
    J Nathaniel Diehl, Jennifer E Klomp, Kayla R Snare, Priya S Hibshman, Devon R Blake, Zane D Kaiser, Thomas S K Gilbert, Elisa Baldelli, Mariaelena Pierobon, Björn Papke, Runying Yang, Richard G Hodge, Naim U Rashid, Emanuel F Petricoin, Laura E Herring, Lee M Graves, Adrienne D Cox, Channing J Der.
      Oncogenic KRAS drives cancer growth by activating diverse signaling networks, not all of which have been fully delineated. We set out to establish a system-wide profile of the KRAS-regulated kinase signaling network (kinome) in KRAS-mutant pancreatic ductal adenocarcinoma (PDAC). We knocked down KRAS expression in a panel of six cell lines, and then applied Multiplexed Inhibitor Bead/Mass Spectrometry (MIB/MS) to monitor changes in kinase activity and/or expression. We hypothesized that depletion of KRAS would result in downregulation of kinases required for KRAS-mediated transformation, and in upregulation of other kinases that could potentially compensate for the deleterious consequences of the loss of KRAS. We identified 15 upregulated and 13 downregulated kinases in common across the panel of cell lines. In agreement with our hypothesis, all 15 of the upregulated kinases have established roles as cancer drivers (e.g., SRC, TGFBR1, ILK), and pharmacologic inhibition of one of these upregulated kinases, DDR1, suppressed PDAC growth. Interestingly, 11 of the 13 downregulated kinases have established driver roles in cell cycle progression, particularly in mitosis (e.g., WEE1, Aurora A, PLK1). Consistent with a crucial role for the downregulated kinases in promoting KRAS-driven proliferation, we found that pharmacologic inhibition of WEE1 also suppressed PDAC growth. The unexpected paradoxical activation of ERK upon WEE1 inhibition led us to inhibit both WEE1 and ERK concurrently, which caused further potent growth suppression and enhanced apoptotic death compared to WEE1 inhibition alone. We conclude that system-wide delineation of the KRAS-regulated kinome can identify potential therapeutic targets for KRAS-mutant pancreatic cancer.
    Keywords:  DDR1; RAS protein; WEE1; cancer biology; extracellular-signal-regulated kinase (ERK); kinome; mitogen-activated protein kinase (MAPK); pancreatic cancer; proteomics
    DOI:  https://doi.org/10.1016/j.jbc.2021.101335
  9. Autophagy. 2021 Oct 28. 1-11
    Loss of acinar cell VMP1 triggers spontaneous pancreatitis in mice.
    Shaogui Wang, Xiaojuan Chao, Xiaoxiao Jiang, Tiantian Wang, Yssa Rodriguez, Ling Yang, Pal Pacher, Hong-Min Ni, Wen-Xing Ding.
      The pathogenesis of pancreatitis has been linked to disruption of organelle homeostasis including macroautophagy/autophagy dysfunction and endoplasmic reticulum (ER) stress. However, the direct impact of aberrant organelle function on pancreatitis initiation and progression is largely unknown. Recently an ER membrane protein, VMP1 (vacuole membrane protein 1), has been reported to play a crucial role in autophagosome formation. Notably, we found that VMP1 is downregulated in both human chronic pancreatitis (CP) and experimental mouse acute pancreatitis (AP). Pancreatic acinar cell-specific vmp1 deletion promotes inflammation, acinar-to-ductal metaplasia, and fibrosis in mice, sharing histological similarities with human CP. Mechanistically, loss of pancreatic VMP1 leads to defective autophagic degradation and ER stress as well as activation of the NFE2L2/Nrf2 pathway. Genetic ablation of NFE2L2 attenuated pancreatitis in VMP1-deficient mice. Our data highlight the importance of VMP1 in modulating an integrated organelle stress response and its functional role in maintaining pancreas homeostasis in the context of CP.Abbreviations: AMY: amylase; ADM: acinar-to-ductal metaplasia; AP: acute pancreatitis; CASP3: caspase 3; CP: chronic pancreatitis; DDIT3/CHOP: DNA damage inducible transcript 3; DKO, double knockout; ER: endoplasmic reticulum; GCLC: glutamate-cysteine ligase catalytic subunit; GCLM: glutamate-cysteine ligase modifier subunit; HSPA5/BIP: heat shock protein family A (Hsp70) member 5; KO: knockout; KRT19/CK19: keratin 19; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MPO: myeloperoxidase; NFE2L2/NRF2: nuclear factor, erythroid 2 like 2; ND: normal donor; NQO1: NAD(P)H quinone dehydrogenase 1; PCNA: proliferating cell nuclear antigen; RIPA: radio-immunoprecipitation; SQSTM1/p62: sequestosome 1; SOX9: SRY-box transcription factor 9; TAP: trypsinogen activation peptide; TFEB: transcription factor EB; TUNEL: terminal deoxynucleotidyl transferase dUTP nick end labeling; UB: ubiquitin; VMP1: vacuole membrane protein 1; XBP1: X-box binding protein 1; YAP1, Yes1 associated transcriptional regulator; ZG: zymogen granule.
    Keywords:  Autophagy; ER stress; Nrf2; oxidative stress; p62
    DOI:  https://doi.org/10.1080/15548627.2021.1990672
  10. Handb Exp Pharmacol. 2021 Oct 26.
    Obesity, Senescence, and Senolytics.
    Selim Chaib, Tamara Tchkonia, James L Kirkland.
      Obesity is a major risk factor for the development of comorbidities such as type 2 diabetes, neurodegenerative disorders, osteoarthritis, cancer, cardiovascular and renal diseases. The onset of obesity is linked to an increase of senescent cells within adipose tissue and other organs. Cellular senescence is a stress response that has been shown to be causally linked to aging and development of various age-related diseases such as obesity. The senescence-associated-secretory phenotype of senescent cells creates a chronic inflammatory milieu that leads to local and systemic dysfunction. The elimination of senescent cells using pharmacological approaches (i.e., senolytics) has been shown to delay, prevent, or alleviate obesity-related organ dysfunction.
    Keywords:  Adipose tissue; Cellular senescence; Obesity; SASP; Senolytics
    DOI:  https://doi.org/10.1007/164_2021_555
  11. J Biol Chem. 2021 Oct 21. pii: S0021-9258(21)01145-5. [Epub ahead of print] 101339
    Regulation of mitochondrial cargo-selective autophagy by post-translational modifications.
    Anna Lechado Terradas, Katharina Zittlau, Boris Macek, Milana Fraiberg, Zvulun Elazar, Philipp J Kahle.
      Mitochondria are important organelles in eukaryotes. Turnover and quality control of mitochondria are regulated at the transcriptional and post-translational level by several cellular mechanisms. Removal of defective mitochondrial proteins is mediated by mitochondria resident proteases or by proteasomal degradation of individual proteins. Clearance of bulk mitochondria occurs via a selective form of autophagy termed mitophagy. In yeast and some developing metazoan cells (e.g. oocytes and reticulocytes), mitochondria are largely removed by ubiquitin-independent mechanisms. In such cases the regulation of mitophagy is mediated via phosphorylation of mitochondria-anchored autophagy receptors. On the other hand, ubiquitin-dependent recruitment of cytosolic autophagy receptors occurs in situations of cellular stress or disease, where dysfunctional mitochondria would cause oxidative damage. In mammalian cells, a well-studied ubiquitin-dependent mitophagy pathway induced by mitochondrial depolarization is regulated by the mitochondrial protein kinase PINK1 that upon activation recruits the ubiquitin ligase parkin. Here we review mechanisms of mitophagy with an emphasis on post-translational modifications that regulate various mitophagy pathways. We describe the autophagy components involved with particular emphasis on post-translational modifications. We detail the phosphorylations mediated by PINK1 and parkin-mediated ubiquitylations of mitochondrial proteins that can be modulated by deubiquitylating enzymes. We also discuss the role of accessory factors regulating mitochondrial fission/fusion and the interplay with pro- and anti-apoptotic Bcl-2 family members. Comprehensive knowledge of the processes of mitophagy is essential for the understanding of vital mitochondrial turnover in health and disease.
    Keywords:  autophagy; mitochondria; phosphorylation; protein kinase PINK1; ubiquitin ligase parkin; ubiquitylation
    DOI:  https://doi.org/10.1016/j.jbc.2021.101339
  12. Physiol Rev. 2021 10 26.
    Mitochondrial calcium exchange in physiology and disease.
    Joanne F Garbincius, John W Elrod.
      The uptake of calcium into and extrusion of calcium from the mitochondrial matrix is a fundamental biological process that has critical effects on cellular metabolism, signaling, and survival. Disruption of mitochondrial calcium (mCa2+) cycling is implicated in numerous acquired diseases such as heart failure, stroke, neurodegeneration, diabetes, and cancer, and is genetically linked to several inherited neuromuscular disorders. Understanding the mechanisms responsible for mCa2+ exchange therefore holds great promise for the treatment of these diseases. The past decade has seen the genetic identification of many of the key proteins that mediate mitochondrial calcium uptake and efflux. Here, we present an overview of the phenomenon of mCa2+ transport, and a comprehensive examination of the molecular machinery that mediates calcium flux across the inner mitochondrial membrane: the mitochondrial uniporter complex (consisting of MCU, EMRE, MICU1, MICU2, MICU3, MCUB, and MCUR1), NCLX, LETM1, the mitochondrial ryanodine receptor, and the mitochondrial permeability transition pore. We then consider the physiological implications of mCa2+ flux and evaluate how alterations in mCa2+ homeostasis contribute to human disease. This review concludes by highlighting opportunities and challenges for therapeutic intervention in pathologies characterized by aberrant mCa2+ handling and by summarizing critical unanswered questions regarding the biology of mCa2+ flux.
    Keywords:  calcium; energetics; metabolism; mitochondria; oxidative phosphorylation
    DOI:  https://doi.org/10.1152/physrev.00041.2020
  13. Mech Ageing Dev. 2021 Oct 23. pii: S0047-6374(21)00163-9. [Epub ahead of print]200 111591
    Strategies for late phase preclinical and early clinical trials of senolytics.
    Erin O Wissler Gerdes, Avanish Misra, Jair Machado Espindola Netto, Tamar Tchkonia, James L Kirkland.
      Cellular senescence and the hallmarks of aging contribute to age-related disease and dysfunction. The Unitary Theory of Fundamental Aging Mechanisms highlights the interdependence among the hallmarks of aging and suggests that by intervening in one fundamental aging process, most or all of the other processes could be impacted. Accumulation of senescent cells is associated with frailty, cardiovascular disease, obesity, diabetes, cognitive decline, and other age- and/or chronic disease-related disorders, suggesting that senescent cells are a target for intervention. Early preclinical data using senolytics, agents that target senescent cells, show promising results in several aging and disease models. The first in-human trials using the senolytic combination of Dasatinib and Quercetin indicated reduced senescent cell burden in adipose tissue of diabetic kidney disease patients and improved physical function in patients with idiopathic pulmonary fibrosis. Clinical trials with other senolytics, including the flavonoid Fisetin and BCL-xL inhibitors, are underway. These results from preclinical and early clinical trials illustrate the potential of senolytics to alleviate age-related dysfunction and diseases. However, multiple clinical trials across different aging and disease models are desperately needed. Parallel trials across institutions through the Translational Geroscience Network are facilitating testing to determine whether senolytics can be translated into clinical application.
    Keywords:  Dasatinib; Fisetin; Quercetin; Senolytics; Translational Geroscience Network; Unitary Theory of Fundamental Aging Processes
    DOI:  https://doi.org/10.1016/j.mad.2021.111591
  14. Front Digit Health. 2021 ;3 704584
    3D Collagen-Nanocellulose Matrices Model the Tumour Microenvironment of Pancreatic Cancer.
    Rodrigo Curvello, Verena Kast, Mohammed H Abuwarwar, Anne L Fletcher, Gil Garnier, Daniela Loessner.
      Three-dimensional (3D) cancer models are invaluable tools designed to study tumour biology and new treatments. Pancreatic ductal adenocarcinoma (PDAC), one of the deadliest types of cancer, has been progressively explored with bioengineered 3D approaches by deconstructing elements of its tumour microenvironment. Here, we investigated the suitability of collagen-nanocellulose hydrogels to mimic the extracellular matrix of PDAC and to promote the formation of tumour spheroids and multicellular 3D cultures with stromal cells. Blending of type I collagen fibrils and cellulose nanofibres formed a matrix of controllable stiffness, which resembled the lower profile of pancreatic tumour tissues. Collagen-nanocellulose hydrogels supported the growth of tumour spheroids and multicellular 3D cultures, with increased metabolic activity and matrix stiffness. To validate our 3D cancer model, we tested the individual and combined effects of the anti-cancer compound triptolide and the chemotherapeutics gemcitabine and paclitaxel, resulting in differential cell responses. Our blended 3D matrices with tuneable mechanical properties consistently maintain the growth of PDAC cells and its cellular microenvironment and allow the screening of anti-cancer treatments.
    Keywords:  collagen; extracellular matrix; hydrogels; nanocellulose; pancreatic cancer; stiffness
    DOI:  https://doi.org/10.3389/fdgth.2021.704584
  15. Nature. 2021 Oct 27.
    Glycogen metabolism links glucose homeostasis to thermogenesis in adipocytes.
    Omer Keinan, Joseph M Valentine, Haopeng Xiao, Sushil K Mahata, Shannon M Reilly, Mohammad Abu-Odeh, Julia H Deluca, Benyamin Dadpey, Leslie Cho, Austin Pan, Ruth T Yu, Yang Dai, Christopher Liddle, Michael Downes, Ronald M Evans, Aldons J Lusis, Markku Laakso, Edward T Chouchani, Mikael Ryde'n, Alan R Saltiel.
      Adipocytes increase energy expenditure in response to prolonged sympathetic activation via persistent expression of uncoupling protein 1 (UCP1)1,2. Here we report that the regulation of glycogen metabolism by catecholamines is critical for UCP1 expression. Chronic β-adrenergic activation leads to increased glycogen accumulation in adipocytes expressing UCP1. Adipocyte-specific deletion of a scaffolding protein, protein targeting to glycogen (PTG), reduces glycogen levels in beige adipocytes, attenuating UCP1 expression and responsiveness to cold or β-adrenergic receptor-stimulated weight loss in obese mice. Unexpectedly, we observed that glycogen synthesis and degradation are increased in response to catecholamines, and that glycogen turnover is required to produce reactive oxygen species leading to the activation of p38 MAPK, which drives UCP1 expression. Thus, glycogen has a key regulatory role in adipocytes, linking glucose metabolism to thermogenesis.
    DOI:  https://doi.org/10.1038/s41586-021-04019-8
  16. EBioMedicine. 2021 Oct 21. pii: S2352-3964(21)00439-4. [Epub ahead of print]73 103646
    Molecular modelling of the FOXO4-TP53 interaction to design senolytic peptides for the elimination of senescent cancer cells.
    Hillary H Le, Suleyman S Cinaroglu, Elise C Manalo, Aysegul Ors, Michelle M Gomes, Burcin Duan Sahbaz, Karla Bonic, Carlos A Origel Marmolejo, Arnaud Quentel, Justin S Plaut, Taryn E Kawashima, E Sila Ozdemir, Sanjay V Malhotra, Yavuz Ahiska, Ugur Sezerman, Gunseli Bayram Akcapinar, Joshua C Saldivar, Emel Timucin, Jared M Fischer.
       BACKGROUND: Senescent cells accumulate in tissues over time as part of the natural ageing process and the removal of senescent cells has shown promise for alleviating many different age-related diseases in mice. Cancer is an age-associated disease and there are numerous mechanisms driving cellular senescence in cancer that can be detrimental to recovery. Thus, it would be beneficial to develop a senolytic that acts not only on ageing cells but also senescent cancer cells to prevent cancer recurrence or progression.
    METHODS: We used molecular modelling to develop a series of rationally designed peptides to mimic and target FOXO4 disrupting the FOXO4-TP53 interaction and releasing TP53 to induce apoptosis. We then tested these peptides as senolytic agents for the elimination of senescent cells both in cell culture and in vivo.
    FINDINGS: Here we show that these peptides can act as senolytics for eliminating senescent human cancer cells both in cell culture and in orthotopic mouse models. We then further characterized one peptide, ES2, showing that it disrupts FOXO4-TP53 foci, activates TP53 mediated apoptosis and preferentially binds FOXO4 compared to TP53. Next, we show that intratumoural delivery of ES2 plus a BRAF inhibitor results in a significant increase in apoptosis and a survival advantage in mouse models of melanoma. Finally, we show that repeated systemic delivery of ES2 to older mice results in reduced senescent cell numbers in the liver with minimal toxicity.
    INTERPRETATION: Taken together, our results reveal that peptides can be generated to specifically target and eliminate FOXO4+ senescent cancer cells, which has implications for eradicating residual disease and as a combination therapy for frontline treatment of cancer.
    FUNDING: This work was supported by the Cancer Early Detection Advanced Research Center at Oregon Health & Science University.
    Keywords:  Cancer; FOXO4; Senolytic; TP53
    DOI:  https://doi.org/10.1016/j.ebiom.2021.103646
  17. Immunity. 2021 Oct 19. pii: S1074-7613(21)00407-6. [Epub ahead of print]
    DNA methylation signatures reveal that distinct combinations of transcription factors specify human immune cell epigenetic identity.
    Roshni Roy, Senthilkumar Ramamoorthy, Benjamin D Shapiro, Mary Kaileh, Dena Hernandez, Dimitra Sarantopoulou, Sampath Arepalli, Sören Boller, Amit Singh, Arsun Bektas, Jaekwan Kim, Ann Zenobia Moore, Toshiko Tanaka, Julia McKelvey, Linda Zukley, Cuong Nguyen, Tonya Wallace, Christopher Dunn, Robert Wersto, William Wood, Yulan Piao, Kevin G Becker, Christopher Coletta, Supriyo De, Jyoti Misra Sen, Alexis Battle, Nan-Ping Weng, Rudolf Grosschedl, Luigi Ferrucci, Ranjan Sen.
      Epigenetic reprogramming underlies specification of immune cell lineages, but patterns that uniquely define immune cell types and the mechanisms by which they are established remain unclear. Here, we identified lineage-specific DNA methylation signatures of six immune cell types from human peripheral blood and determined their relationship to other epigenetic and transcriptomic patterns. Sites of lineage-specific hypomethylation were associated with distinct combinations of transcription factors in each cell type. By contrast, sites of lineage-specific hypermethylation were restricted mostly to adaptive immune cells. PU.1 binding sites were associated with lineage-specific hypo- and hypermethylation in different cell types, suggesting that it regulates DNA methylation in a context-dependent manner. These observations indicate that innate and adaptive immune lineages are specified by distinct epigenetic mechanisms via combinatorial and context-dependent use of key transcription factors. The cell-specific epigenomics and transcriptional patterns identified serve as a foundation for future studies on immune dysregulation in diseases and aging.
    Keywords:  DNA methylation; epigenetics; gene expression; human immunity; innate cells; lymphocytes; transcription factors
    DOI:  https://doi.org/10.1016/j.immuni.2021.10.001
  18. Signal Transduct Target Ther. 2021 Oct 29. 6(1): 366
    Pancreatic cancer cells render tumor-associated macrophages metabolically reprogrammed by a GARP and DNA methylation-mediated mechanism.
    Mengwen Zhang, Xingyi Pan, Kenji Fujiwara, Noelle Jurcak, Stephen Muth, Jiaojiao Zhou, Qian Xiao, Anqi Li, Xu Che, Zihai Li, Lei Zheng.
      How tumor-associated macrophages transit from a predominant antitumor M1-like phenotype to a protumoral M2-like phenotype during the development of pancreatic ductal adenocarcinoma (PDA) remains to be elucidated. We thus conducted a study by employing a PDA-macrophage co-culture system, an "orthotopic" PDA syngeneic mouse model, and human PDA specimens, together with macrophages derived from GARP knockout mice and multiple analytic tools including whole-genome RNA sequencing, DNA methylation arrays, multiplex immunohistochemistry, metabolism measurement, and invasion/metastasis assessment. Our study showed that PDA tumor cells, through direct cell-cell contact, induce DNA methylation and downregulation of a panel of glucose metabolism and OXPHOS genes selectively in M1-like macrophages, leading to a suppressed glucose metabolic status in M1-like but not in M2-like macrophages. Following the interaction with PDA tumor cells, M1-like macrophages are reprogrammed phenotypically to M2-like macrophages. The interaction between M1-like macrophages and PDA cells is mediated by GARP and integrin αV/β8, respectively. Blocking either GARP or integrin would suppress tumor-induced DNA methylation in Nqo-1 gene and the reprogramming of M1-like macrophages. Glucose-response genes such as Il-10 are subsequently activated in tumor-educated M1-like macrophages. Partly through Il-10 and its receptor Il-10R on tumor cells, M1-like macrophages functionally acquire a pro-cancerous capability. Both exogenous M1-like and M2-like macrophages promote metastasis in a mouse model of PDA while such a role of M1-like macrophages is dependent on DNA methylation. Our results suggest that PDA cells are able to reprogram M1-like macrophages metabolically and functionally through a GARP-dependent and DNA methylation-mediated mechanism to adopt a pro-cancerous fate.
    DOI:  https://doi.org/10.1038/s41392-021-00769-z
  19. Pancreas. 2021 Sep 01. 50(8): 1230-1235
    Phase I Study of Preoperative Chemoradiotherapy Using Gemcitabine Plus Nab-Paclitaxel for Patients Who Have Localized Pancreatic Ductal Adenocarcinoma With Contact or Invasion to Major Arteries.
    Aoi Hayasaki, Masashi Kishiwada, Yasuhiro Murata, Haruna Komatsubara, Yuki Nakagawa, Koki Maeda, Toru Shinkai, Daisuke Noguchi, Kazuyuki Gyoten, Takehiro Fujii, Yusuke Iizawa, Akihiro Tanemura, Naohisa Kuriyama, Hiroyuki Sakurai, Shuji Isaji, Shugo Mizuno.
       OBJECTIVES: This study aimed to assess the feasibility of preoperative chemoradiotherapy using gemcitabine plus nab-paclitaxel (GnP) and to determine the recommended dose (RD) of nab-paclitaxel for patients with localized pancreatic ductal adenocarcinoma (PDAC).
    METHODS: The participants had localized PDAC with contact or invasion to major arteries. They received GnP on days 1, 15, 29, and 43. The dose of gemcitabine was fixed at 600 mg/m2, whereas that of nab-paclitaxel was at 3 dose levels in accordance with a standard 3 + 3 dose escalation scheme. Three-dimensional radiotherapy was administered concurrently to a total dose of 50.4 Gy per 28 fractions.
    RESULTS: The study cohort comprised 15 patients. Grade 3 or 4 neutropenia was observed in 4 (26.7%), leukopenia in 1 (6.7%), biliary infection in 2 (13.3%), appetite loss and nausea in 1 (6.7%), and anaphylaxis in 1 (6.7%). The RD was determined as level 2 (gemcitabine, 600 mg/m2; nab-paclitaxel, 100 mg/m2). Three patients underwent pancreatectomy after additional chemotherapy and achieved R0 resection.
    CONCLUSIONS: The RD of nab-paclitaxel in our chemoradiotherapy protocol using GnP was 100 mg/m2 with gemcitabine 600 mg/m2 and 3-dimensional conformal radiotherapy to a total dose of 50.4 Gy per 28 fractions for patients with localized PDAC.
    DOI:  https://doi.org/10.1097/MPA.0000000000001902
  20. Dev Cell. 2021 Oct 22. pii: S1534-5807(21)00809-1. [Epub ahead of print]
    Identification of long-lived proteins in the mitochondria reveals increased stability of the electron transport chain.
    Shefali Krishna, Rafael Arrojo E Drigo, Juliana S Capitanio, Ranjan Ramachandra, Mark Ellisman, Martin W Hetzer.
      In order to combat molecular damage, most cellular proteins undergo rapid turnover. We have previously identified large nuclear protein assemblies that can persist for years in post-mitotic tissues and are subject to age-related decline. Here, we report that mitochondria can be long lived in the mouse brain and reveal that specific mitochondrial proteins have half-lives longer than the average proteome. These mitochondrial long-lived proteins (mitoLLPs) are core components of the electron transport chain (ETC) and display increased longevity in respiratory supercomplexes. We find that COX7C, a mitoLLP that forms a stable contact site between complexes I and IV, is required for complex IV and supercomplex assembly. Remarkably, even upon depletion of COX7C transcripts, ETC function is maintained for days, effectively uncoupling mitochondrial function from ongoing transcription of its mitoLLPs. Our results suggest that modulating protein longevity within the ETC is critical for mitochondrial proteome maintenance and the robustness of mitochondrial function.
    Keywords:  age mosaicism; aging; electron transport chain; heterogeneity; long-lived proteins; mitochondria; muscle; neurons; protein homeostasis; supercomplexes
    DOI:  https://doi.org/10.1016/j.devcel.2021.10.008
  21. Cancer Biol Ther. 2021 Oct 25. 1-20
    Oxygen and metabolic reprogramming in the tumor microenvironment influences metastasis homing.
    Vinod S Bisht, Kuldeep Giri, Deepak Kumar, Kiran Ambatipudi.
      Tumor metastasis is the leading cause of cancer mortality, often characterized by abnormal cell growth and invasion to distant organs. The cancer invasion due to epithelial to mesenchymal transition is affected by metabolic and oxygen availability in the tumor-associated micro-environment. A precise alteration in oxygen and metabolic signaling between healthy and metastatic cells is a substantial probe for understanding tumor progression and metastasis. Molecular heterogeneity in the tumor microenvironment help to sustain the metastatic cell growth during their survival shift from low to high metabolic-oxygen-rich sites and reinforces the metastatic events. This review highlighted the crucial role of oxygen and metabolites in metastatic progression and exemplified the role of metabolic rewiring and oxygen availability in cancer cell adaptation. Furthermore, we have also addressed potential applications of altered oxygen and metabolic networking with tumor type that could be a signature pattern to assess tumor growth and chemotherapeutics efficacy in managing cancer metastasis.
    Keywords:  Cancer metabolism; angeogenesis; cancer recurrence; dormancy; lymphogenesis; metabolic reprogramming; metastasis
    DOI:  https://doi.org/10.1080/15384047.2021.1992233
  22. Nat Commun. 2021 Oct 26. 12(1): 6176
    The impact of physiological metabolite levels on serine uptake, synthesis and utilization in cancer cells.
    Marc Hennequart, Christiaan F Labuschagne, Mylène Tajan, Steven E Pilley, Eric C Cheung, Nathalie M Legrave, Paul C Driscoll, Karen H Vousden.
      Serine is a non-essential amino acid that is critical for tumour proliferation and depletion of circulating serine results in reduced tumour growth and increased survival in various cancer models. While many cancer cells cultured in a standard tissue culture medium depend on exogenous serine for optimal growth, here we report that these cells are less sensitive to serine/glycine depletion in medium containing physiological levels of metabolites. The lower requirement for exogenous serine under these culture conditions reflects both increased de novo serine synthesis and the use of hypoxanthine (not present in the standard medium) to support purine synthesis. Limiting serine availability leads to increased uptake of extracellular hypoxanthine, sparing available serine for other pathways such as glutathione synthesis. Taken together these results improve our understanding of serine metabolism in physiologically relevant nutrient conditions and allow us to predict interventions that may enhance the therapeutic response to dietary serine/glycine limitation.
    DOI:  https://doi.org/10.1038/s41467-021-26395-5
  23. Int J Radiat Oncol Biol Phys. 2021 Nov 01. pii: S0360-3016(21)01298-0. [Epub ahead of print]111(3S): e70-e71
    Phase I Dose Escalation Trial Using 3-Fraction SBRT for Locally Advanced Pancreatic Cancer.
    M Reyngold, S D Karam, C Hajj, A J Wu, P B Romesser, J J Cuaron, E D Yorke, T Schefter, B L Jones, Y Vinogradskiy, C H Crane, K A Goodman.
       PURPOSE/OBJECTIVE(S): This prospective multi-institutional study aimed to determine the safety and maximally tolerated dose of 3-fraction stereotactic body radiotherapy (SBRT) for locally advanced pancreatic cancer (LAPC).
    MATERIALS/METHODS: Patients with localized, histologically confirmed pancreatic adenocarcinoma deemed unresectable on radiographic multidisciplinary review without distant progression following induction chemotherapy for at least 2 months were eligible. Patients received 3-fraction LINAC-based SBRT at 3 dose levels, 27Gy, 30Gy and 33Gy following a modified 3+3 design, allowing for enrollment of additional patients at the last dose level during the 90-day observation period, provided no dose-limiting toxicities (DLTs) were observed. DLTs were defined as ≥ Grade 3 treatment-related GI toxicity within 90 days of RT as scored by CTCAE v.4. The secondary endpoints were overall survival (OS), local progression-free and distant metastasis-free survival (LPFS and DMFS, respectively), treatment-related toxicity and quality of life.
    RESULTS: Between 3/2016 and 4/2019, 23 consecutive evaluable LAPC patients were enrolled at two academic hospitals (14 and 9 patients, respectively), including 8 patients at 27Gy, 8 patients at 30Gy and 7 patients at 33Gy. The median age was 67 years (range 52 - 79 years), 9 patients (39%) were male, all were stage III, 12 (52%) had a head/uncinate tumor location, with a median tumor size of 3.5cm (range, 1.0 - 6.4cm) and a median CA19-9 of 60U/mL (range, < 1 - 4880U/mL). All received chemotherapy for a median of 4.0 months (range 2.5 -11.4 months). There was no grade ≥ 3 abdominal pain, dyspepsia, diarrhea, nausea, vomiting, or gastrointestinal hemorrhage. Four patients experienced grade ≥3 hematologic or metabolic adverse events not related to RT. Four patients underwent resections (pancreaticoduodenectomy = 3, Appleby = 1). Two-year rates of LPFS, DMFS and OS were 26.5%, 25.1% and 29.2%, respectively.
    CONCLUSION: For select LAPC patients, dose escalation to the target dose of 33Gy in 3 fractions resulted in no DLTs and disease outcomes comparable to conventional RT. These results warrant further exploration of hypofractionated SBRT schemes to maximize tumor control while enabling efficient integration of RT with systemic therapy for more expedient treatment options for these high-risk LAPC patients.
    DOI:  https://doi.org/10.1016/j.ijrobp.2021.07.428
  24. Genes Dev. 2021 Oct 28.
    Integrated loss- and gain-of-function screens define a core network governing human embryonic stem cell behavior.
    Kamila Naxerova, Bruno Di Stefano, Jessica L Makofske, Emma V Watson, Marit A de Kort, Timothy D Martin, Mohammed Dezfulian, Dominik Ricken, Eric C Wooten, Mitzi I Kuroda, Konrad Hochedlinger, Stephen J Elledge.
      Understanding the genetic control of human embryonic stem cell function is foundational for developmental biology and regenerative medicine. Here we describe an integrated genome-scale loss- and gain-of-function screening approach to identify genetic networks governing embryonic stem cell proliferation and differentiation into the three germ layers. We identified a deep link between pluripotency maintenance and survival by showing that genetic alterations that cause pluripotency dissolution simultaneously increase apoptosis resistance. We discovered that the chromatin-modifying complex SAGA and in particular its subunit TADA2B are central regulators of pluripotency, survival, growth, and lineage specification. Joint analysis of all screens revealed that genetic alterations that broadly inhibit differentiation across multiple germ layers drive proliferation and survival under pluripotency-maintaining conditions and coincide with known cancer drivers. Our results show the power of integrated multilayer genetic screening for the robust mapping of complex genetic networks.
    Keywords:  genetic screening; germ layer formation; human embryonic stem cells
    DOI:  https://doi.org/10.1101/gad.349048.121
  25. Gastroenterology. 2021 Oct 22. pii: S0016-5085(21)03665-9. [Epub ahead of print]
    Single-cell transcriptomics reveals a conserved metaplasia program in pancreatic injury.
    Zhibo Ma, Nikki K Lytle, Bob Chen, Nidhi Jyotsana, Sammy Weiser Novak, Charles J Cho, Leah Caplan, Olivia Ben-Levy, Abigail C Neininger, Dylan T Burnette, Vincent Q Trinh, Marcus C B Tan, Emilee A Patterson, Rafael Arrojo E Drigo, Rajshekhar R Giraddi, Cynthia Ramos, Anna L Means, Ichiro Matsumoto, Uri Manor, Jason C Mills, James R Goldenring, Ken S Lau, Geoffrey M Wahl, Kathleen E DelGiorno.
       BACKGROUND & AIMS: Acinar to ductal metaplasia (ADM) occurs in the pancreas in response to tissue injury and is a potential precursor for adenocarcinoma. The goal of these studies was to define the populations arising from ADM, the associated transcriptional changes, and markers of disease progression.
    METHODS: Acinar cells were lineage-traced with enhanced yellow fluorescent protein (EYFP) to follow their fate upon injury. Transcripts of over 13,000 EYFP+ cells were determined using single-cell RNA sequencing (scRNA-seq). Developmental trajectories were generated. Data were compared to gastric metaplasia, KrasG12D-induced neoplasia, and human pancreatitis. Results were confirmed by immunostaining and electron microscopy. KrasG12D was expressed in injury-induced ADM using several inducible Cre drivers. Surgical specimens of chronic pancreatitis from 15 patients were evaluated by immunostaining.
    RESULTS: ScRNA-seq of ADM revealed emergence of a mucin/ductal population resembling gastric pyloric metaplasia. Lineage trajectories suggest that some pyloric metaplasia cells can generate tuft and enteroendocrine cells (EECs). Comparison to KrasG12D-induced ADM identifies populations associated with disease progression. Activation of KrasG12D expression in HNF1B+ or POU2F3+ ADM populations leads to neoplastic transformation and formation of MUC5AC+ gastric-pit-like cells. Human pancreatitis samples also harbor pyloric metaplasia with a similar transcriptional phenotype.
    CONCLUSIONS: Under conditions of chronic injury, acinar cells undergo a pyloric-type metaplasia to mucinous progenitor-like populations, which seed disparate tuft cell and EEC lineages. ADM-derived EEC subtypes are diverse. KrasG12D expression is sufficient to drive neoplasia when targeted to injury-induced ADM populations and offers an alternative origin for tumorigenesis. This program is conserved in human pancreatitis, providing insight into early events in pancreas diseases.
    Keywords:  ADM; Enteroendocrine cells; Tuft cells; paligenosis; plasticity
    DOI:  https://doi.org/10.1053/j.gastro.2021.10.027
  26. Nat Methods. 2021 Oct 28.
    Deep learning and alignment of spatially resolved single-cell transcriptomes with Tangram.
    Tommaso Biancalani, Gabriele Scalia, Lorenzo Buffoni, Raghav Avasthi, Ziqing Lu, Aman Sanger, Neriman Tokcan, Charles R Vanderburg, Åsa Segerstolpe, Meng Zhang, Inbal Avraham-Davidi, Sanja Vickovic, Mor Nitzan, Sai Ma, Ayshwarya Subramanian, Michal Lipinski, Jason Buenrostro, Nik Bear Brown, Duccio Fanelli, Xiaowei Zhuang, Evan Z Macosko, Aviv Regev.
      Charting an organs' biological atlas requires us to spatially resolve the entire single-cell transcriptome, and to relate such cellular features to the anatomical scale. Single-cell and single-nucleus RNA-seq (sc/snRNA-seq) can profile cells comprehensively, but lose spatial information. Spatial transcriptomics allows for spatial measurements, but at lower resolution and with limited sensitivity. Targeted in situ technologies solve both issues, but are limited in gene throughput. To overcome these limitations we present Tangram, a method that aligns sc/snRNA-seq data to various forms of spatial data collected from the same region, including MERFISH, STARmap, smFISH, Spatial Transcriptomics (Visium) and histological images. Tangram can map any type of sc/snRNA-seq data, including multimodal data such as those from SHARE-seq, which we used to reveal spatial patterns of chromatin accessibility. We demonstrate Tangram on healthy mouse brain tissue, by reconstructing a genome-wide anatomically integrated spatial map at single-cell resolution of the visual and somatomotor areas.
    DOI:  https://doi.org/10.1038/s41592-021-01264-7
  27. Mol Cancer. 2021 Oct 27. 20(1): 140
    Crosstalk between autophagy inhibitors and endosome-related secretory pathways: a challenge for autophagy-based treatment of solid cancers.
    Martina Raudenska, Jan Balvan, Michal Masarik.
      Autophagy is best known for its role in organelle and protein turnover, cell quality control, and metabolism. The autophagic machinery has, however, also adapted to enable protein trafficking and unconventional secretory pathways so that organelles (such as autophagosomes and multivesicular bodies) delivering cargo to lysosomes for degradation can change their mission from fusion with lysosomes to fusion with the plasma membrane, followed by secretion of the cargo from the cell. Some factors with key signalling functions do not enter the conventional secretory pathway but can be secreted in an autophagy-mediated manner.Positive clinical results of some autophagy inhibitors are encouraging. Nevertheless, it is becoming clear that autophagy inhibition, even within the same cancer type, can affect cancer progression differently. Even next-generation inhibitors of autophagy can have significant non-specific effects, such as impacts on endosome-related secretory pathways and secretion of extracellular vesicles (EVs). Many studies suggest that cancer cells release higher amounts of EVs compared to non-malignant cells, which makes the effect of autophagy inhibitors on EVs secretion highly important and attractive for anticancer therapy. In this review article, we discuss how different inhibitors of autophagy may influence the secretion of EVs and summarize the non-specific effects of autophagy inhibitors with a focus on endosome-related secretory pathways. Modulation of autophagy significantly impacts not only the quantity of EVs but also their content, which can have a deep impact on the resulting pro-tumourigenic or anticancer effect of autophagy inhibitors used in the antineoplastic treatment of solid cancers.
    Keywords:  Amphisomes; Autophagy; Autophagy inhibitors; Cancer; Endosomes; Exosomes; Extracellular vesicles; Multivesicular bodies; Non-conventional secretory pathways
    DOI:  https://doi.org/10.1186/s12943-021-01423-6
  28. J Hepatol. 2021 Oct 25. pii: S0168-8278(21)02151-6. [Epub ahead of print]
    Hepatocytic p62 suppresses ductular reaction and tumorigenesis in mouse livers with mTORC1 activation and defective autophagy.
    Xiaojuan Chao, Shaogui Wang, Sam Fulte, Xiaowen Ma, Forkhan Ahamed, Wei Cui, Zhipeng Liu, Thomas Rülicke, Kurt Zatloukal, Wei-Xing Zong, Wanqing Liu, Hong-Min Ni, Wen-Xing Ding.
       BACKGROUND & AIMS: Either activation of mTORC1 due to loss of Tsc1 (Tuberous Sclerosis Complex 1) or defective hepatic autophagy due to loss of Atg5 leads to spontaneous liver tumorigenesis in mice. The purpose of this study was to investigate the mechanisms of how autophagy impacts mTORC1 activation-mediated liver metabolic changes and tumorigenesis.
    METHODS: Atg5 Flox/Flox (Atg5F/F) and Tsc1F/F mice were crossed with albumin Cre mice to generate liver-specific Atg5 knockout (L-Atg5 KO), L-Tsc1 KO and L-Atg5/Tsc1 double KO (DKO) mice. These mice were crossed with p62/Sqstm1F/F (p62) and whole body Nrf2 KO mice to generate L-Atg5/Tsc1/p62 and L-Atg5/Tsc1, Nrf2 triple KO (TKO) mice. These mice were housed for various time points up to 12 months, and blood and liver tissues were harvested for biochemical and histological analysis RESULTS: Deletion of Atg5 in L-Tsc1 KO mice inhibited liver tumorigenesis, but increased mortality of L-Tsc1 KO mice accompanied by drastically enhanced hepatic ductular reaction (DR), hepatocyte degeneration and metabolic reprogramming. Deletion of p62 reversed DR, hepatocyte degeneration and metabolic reprogramming as well as the mortality of L-Atg5/Tsc1 DKO mice, but unexpectedly promoted liver tumorigenesis via activation of a group of oncogenic signaling pathways. Nrf2 ablation markedly improved DR with increased hepatocyte population and improved metabolic reprogramming and survival of the L- Atg5/Tsc1 DKO mice without tumor formation. Decreased p62 and increased mTOR activity was also found in a subset of human hepatocellular carcinoma.
    CONCLUSIONS: These results reveal previously undescribed functions of hepatic p62 in suppressing tumorigenesis and regulating liver cell repopulation and metabolic reprogramming resulting from persistent mTORC1 activation and defective autophagy.
    LAY SUMMARY: Metabolic liver disease and viral hepatitis are common chronic liver diseases and risk factors of hepatocellular carcinoma, which are often associated with impaired hepatic autophagy with increased mTOR activation. Using multiple genetic engineered mice that are defective of hepatic autophagy with persistent mTOR activation, we dissected the complex interplay among mTOR, autophagy, p62 and Nrf2 on liver cell repopulation, metabolic reprogramming and redox homeostasis in liver tumorigenesis. Our results uncovered an unexpected novel tumor suppressor function of p62/Sqstm1 by regulating liver cell repopulation, ductular reaction and metabolic reprogramming in liver tumorigenesis.
    Keywords:  Atg5; HCC; Nrf2; Tsc1; fibrosis; p62
    DOI:  https://doi.org/10.1016/j.jhep.2021.10.014
  29. Nat Methods. 2021 Oct 28.
    Metabolite discovery through global annotation of untargeted metabolomics data.
    Li Chen, Wenyun Lu, Lin Wang, Xi Xing, Ziyang Chen, Xin Teng, Xianfeng Zeng, Antonio D Muscarella, Yihui Shen, Alexis Cowan, Melanie R McReynolds, Brandon J Kennedy, Ashley M Lato, Shawn R Campagna, Mona Singh, Joshua D Rabinowitz.
      Liquid chromatography-high-resolution mass spectrometry (LC-MS)-based metabolomics aims to identify and quantify all metabolites, but most LC-MS peaks remain unidentified. Here we present a global network optimization approach, NetID, to annotate untargeted LC-MS metabolomics data. The approach aims to generate, for all experimentally observed ion peaks, annotations that match the measured masses, retention times and (when available) tandem mass spectrometry fragmentation patterns. Peaks are connected based on mass differences reflecting adduction, fragmentation, isotopes, or feasible biochemical transformations. Global optimization generates a single network linking most observed ion peaks, enhances peak assignment accuracy, and produces chemically informative peak-peak relationships, including for peaks lacking tandem mass spectrometry spectra. Applying this approach to yeast and mouse data, we identified five previously unrecognized metabolites (thiamine derivatives and N-glucosyl-taurine). Isotope tracer studies indicate active flux through these metabolites. Thus, NetID applies existing metabolomic knowledge and global optimization to substantially improve annotation coverage and accuracy in untargeted metabolomics datasets, facilitating metabolite discovery.
    DOI:  https://doi.org/10.1038/s41592-021-01303-3
  30. Nat Commun. 2021 Oct 28. 12(1): 6218
    Microenvironmental IL-6 inhibits anti-cancer immune responses generated by cytotoxic chemotherapy.
    Eric H Bent, Luis R Millán-Barea, Iris Zhuang, Daniel R Goulet, Julia Fröse, Michael T Hemann.
      Cytotoxic chemotherapeutics primarily function through DNA damage-induced tumor cell apoptosis, although the inflammation provoked by these agents can stimulate anti-cancer immune responses. The mechanisms that control these distinct effects and limit immunogenic responses to DNA-damage mediated cell death in vivo are currently unclear. Using a mouse model of BCR-ABL+ B-cell acute lymphoblastic leukemia, we show that chemotherapy-induced anti-cancer immunity is suppressed by the tumor microenvironment through production of the cytokine IL-6. The chemotherapeutic doxorubicin is curative in IL-6-deficient mice through the induction of CD8+ T-cell-mediated anti-cancer responses, while moderately extending lifespan in wild type tumor-bearing mice. We also show that IL-6 suppresses the effectiveness of immune-checkpoint inhibition with anti-PD-L1 blockade. Our results suggest that IL-6 is a key regulator of anti-cancer immune responses induced by genotoxic stress and that its inhibition can switch cancer cell clearance from primarily apoptotic to immunogenic, promoting and maintaining durable anti-tumor immune responses.
    DOI:  https://doi.org/10.1038/s41467-021-26407-4
  31. Cell Death Discov. 2021 Oct 29. 7(1): 320
    Autophagy is induced and modulated by cholesterol depletion through transcription of autophagy-related genes and attenuation of flux.
    Keren E Shapira, Guy Shapira, Eran Schmukler, Metsada Pasmanik-Chor, Noam Shomron, Ronit Pinkas-Kramarski, Yoav I Henis, Marcelo Ehrlich.
      Perturbations to cellular homeostasis, including reduction of the cholesterol level, induce autophagy, a self-digestion process of cellular constituents through an autophagosomal-lysosomal pathway. In accord with its function as a membrane organizer and metabolic sentinel, the cellular response to cholesterol depletion comprises multiple phenomena, including the activation of transcriptional responses, accumulation of reactive oxygen species (ROS), and activation of stress-related signaling pathways. However, the molecular mechanisms by which cholesterol depletion regulates autophagy and the putative involvement of transcriptional responses, ROS and/or stress-related signaling in autophagy regulation in this biological context are not fully understood. Here, we find that cholesterol depletion regulates autophagy at three different levels. First, employing RNA-seq, we show that cholesterol depletion increases the expression of autophagy-related genes independent of ROS or JNK activity. Second, analysis of LC3 lipidation and intracellular localization, and of p62 levels and degradation kinetics, reveals that cholesterol depletion mediates autophagy induction while interfering with autophagic flux. Of note, only the latter depends on ROS accumulation and JNK activity. In view of the common use of cholesterol-reducing drugs as therapeutic agents, our findings have important implications for multiple cellular settings in which autophagy plays a prominent role.
    DOI:  https://doi.org/10.1038/s41420-021-00718-3
  32. Nat Rev Drug Discov. 2021 Oct 26.
    Harnessing the predictive power of preclinical models for oncology drug development.
    Alexander Honkala, Sanjay V Malhotra, Shivaani Kummar, Melissa R Junttila.
      Recent progress in understanding the molecular basis of cellular processes, identification of promising therapeutic targets and evolution of the regulatory landscape makes this an exciting and unprecedented time to be in the field of oncology drug development. However, high costs, long development timelines and steep rates of attrition continue to afflict the drug development process. Lack of predictive preclinical models is considered one of the key reasons for the high rate of attrition in oncology. Generating meaningful and predictive results preclinically requires a firm grasp of the relevant biological questions and alignment of the model systems that mirror the patient context. In doing so, the ability to conduct both forward translation, the process of implementing basic research discoveries into practice, as well as reverse translation, the process of elucidating the mechanistic basis of clinical observations, greatly enhances our ability to develop effective anticancer treatments. In this Review, we outline issues in preclinical-to-clinical translatability of molecularly targeted cancer therapies, present concepts and examples of successful reverse translation, and highlight the need to better align tumour biology in patients with preclinical model systems including tracking of strengths and weaknesses of preclinical models throughout programme development.
    DOI:  https://doi.org/10.1038/s41573-021-00301-6
  33. Elife. 2021 Oct 26. pii: e70899. [Epub ahead of print]10
    Mitochondrial phenotypes in purified human immune cell subtypes and cell mixtures.
    Shannon Rausser, Caroline Trumpff, Marlon A McGill, Alex Junker, Wei Wang, Siu-Hong Ho, Anika Mitchell, Kalpita R Karan, Catherine E Monk, Suzanne C Segerstrom, Rebecca G Reed, Martin Picard.
      Using a high-throughput mitochondrial phenotyping platform to quantify multiple mitochondrial features among molecularly-defined immune cell subtypes, we quantify the natural variation in citrate synthase, mitochondrial DNA copy number (mtDNAcn), and respiratory chain enzymatic activities in human neutrophils, monocytes, B cells, and naïve and memory T lymphocyte subtypes. In mixed peripheral blood mononuclear cells (PBMCs) from the same individuals, we show to what extent mitochondrial measures are confounded by both cell type distributions and contaminating platelets. Cell subtype-specific measures among women and men spanning 4 decades of life indicate potential age- and sex-related differences, including an age-related elevation in mtDNAcn, which are masked or blunted in mixed PBMCs. Finally, a proof-of-concept, repeated-measures study in a single individual validates cell type differences and also reveals week-to-week changes in mitochondrial activities. Larger studies are required to validate and mechanistically extend these findings. These mitochondrial phenotyping data build upon established immunometabolic differences among leukocyte sub-populations, and provide foundational quantitative knowledge to develop interpretable blood-based assays of mitochondrial health.
    Keywords:  cell biology; human; immunology; inflammation
    DOI:  https://doi.org/10.7554/eLife.70899
  34. Nat Struct Mol Biol. 2021 Oct 28.
    Phase separation drives the self-assembly of mitochondrial nucleoids for transcriptional modulation.
    Qi Long, Yanshuang Zhou, Hao Wu, Shiwei Du, Mingli Hu, Juntao Qi, Wei Li, Jingyi Guo, Yi Wu, Liang Yang, Ge Xiang, Liang Wang, Shouhua Ye, Jiayuan Wen, Heng Mao, Junwei Wang, Hui Zhao, Wai-Yee Chan, Jinsong Liu, Yonglong Chen, Pilong Li, Xingguo Liu.
      Mitochondria, the only semiautonomous organelles in mammalian cells, possess a circular, double-stranded genome termed mitochondrial DNA (mtDNA). While nuclear genomic DNA compaction, chromatin compartmentalization and transcription are known to be regulated by phase separation, how the mitochondrial nucleoid, a highly compacted spherical suborganelle, is assembled and functions is unknown. Here we assembled mitochondrial nucleoids in vitro and show that mitochondrial transcription factor A (TFAM) undergoes phase separation with mtDNA to drive nucleoid self-assembly. Moreover, nucleoid droplet formation promotes recruitment of the transcription machinery via a special, co-phase separation that concentrates transcription initiation, elongation and termination factors, and retains substrates to facilitate mtDNA transcription. We propose a model of mitochondrial nucleoid self-assembly driven by phase separation, and a pattern of co-phase separation involved in mitochondrial transcriptional regulation, which orchestrates the roles of TFAM in both mitochondrial nucleoid organization and transcription.
    DOI:  https://doi.org/10.1038/s41594-021-00671-w
  35. Cell Mol Life Sci. 2021 Oct 30.
    The lysosome as an imperative regulator of autophagy and cell death.
    Kewal Kumar Mahapatra, Soumya Ranjan Mishra, Bishnu Prasad Behera, Shankargouda Patil, David A Gewirtz, Sujit Kumar Bhutia.
      Lysosomes are single membrane-bound organelles containing acid hydrolases responsible for the degradation of cellular cargo and maintenance of cellular homeostasis. Lysosomes could originate from pre-existing endolysosomes or autolysosomes, acting as a critical juncture between autophagy and endocytosis. Stress that triggers lysosomal membrane permeabilization can be altered by ESCRT complexes; however, irreparable damage to the membrane results in the induction of a selective lysosomal degradation pathway, specifically lysophagy. Lysosomes play an indispensable role in different types of autophagy, including microautophagy, macroautophagy, and chaperone-mediated autophagy, and various cell death pathways such as lysosomal cell death, apoptotic cell death, and autophagic cell death. In this review, we discuss lysosomal reformation, maintenance, and degradation pathways following the involvement of the lysosome in autophagy and cell death, which are related to several pathophysiological conditions observed in humans.
    Keywords:  Autolysosome; Autophagic cell death; Autophagic lysosome reformation; Autophagy; Lysosome
    DOI:  https://doi.org/10.1007/s00018-021-03988-3
  36. Eur J Cancer. 2021 Oct 26. pii: S0959-8049(21)01146-1. [Epub ahead of print]159 16-23
    HER2 mediates clinical resistance to the KRASG12C inhibitor sotorasib, which is overcome by co-targeting SHP2.
    Cassandra S L Ho, Alicia I Tüns, Hans-Ulrich Schildhaus, Marcel Wiesweg, Barbara M Grüner, Balazs Hegedus, Martin Schuler, Alexander Schramm, Sebastian Oeck.
       INTRODUCTION: Mutant RAS guanosine triphosphate hydrolases (GTPases) are key oncogenic drivers in many cancers. The KRASG12C variant has recently become targetable by a new drug class specifically locking KRASG12C in its inactive guanosine diphosphate (GDP)-bound state. Clinical activity was demonstrated in patients with advanced lung cancers harbouring KRASG12C mutations but was limited by the development of resistance.
    METHODS: A biopsy from progressing lung cancer of a patient treated with the KRASG12C inhibitor sotorasib was obtained, and the underlying resistance factors were analysed. Mechanistic studies were performed in vitro and in vivo to uncover strategies to overcome resistance to KRASG12C inhibition.
    RESULTS: We demonstrated acquisition of HER2 copy number gain and KRASG12C mutation retention in the post-progression biopsy. To explore HER2 gain as the relevant resistance mechanism, we generated KRASG12C lung cancer models overexpressing HER2. MAPK pathway signalling remained active despite KRASG12C inhibitor treatment. Combined pharmacological inhibition of KRASG12C and SHP2 synergistically overcame HER2-mediated resistance in vitro and in vivo.
    CONCLUSIONS: These findings establish HER2 copy number gain as a clinically relevant mechanism of resistance to pharmacological KRASG12C inhibition that can be overcome by co-targeting SHP2.
    Keywords:  Acquired resistance; KRAS(G12C) inhibition; Lung cancer; SHP2 inhibition
    DOI:  https://doi.org/10.1016/j.ejca.2021.10.003
  37. Nat Commun. 2021 Oct 27. 12(1): 6201
    Daily caloric restriction limits tumor growth more effectively than caloric cycling regardless of dietary composition.
    Laura C D Pomatto-Watson, Monica Bodogai, Oye Bosompra, Jonathan Kato, Sarah Wong, Melissa Carpenter, Eleonora Duregon, Dolly Chowdhury, Priya Krishna, Sandy Ng, Emeline Ragonnaud, Roberto Salgado, Paula Gonzalez Ericsson, Alberto Diaz-Ruiz, Michel Bernier, Nathan L Price, Arya Biragyn, Valter D Longo, Rafael de Cabo.
      Cancer incidence increases with age and is a leading cause of death. Caloric restriction (CR) confers benefits on health and survival and delays cancer. However, due to CR's stringency, dietary alternatives offering the same cancer protection have become increasingly attractive. Short cycles of a plant-based diet designed to mimic fasting (FMD) are protective against tumorigenesis without the chronic restriction of calories. Yet, it is unclear whether the fasting time, level of dietary restriction, or nutrient composition is the primary driver behind cancer protection. Using a breast cancer model in mice, we compare the potency of daily CR to that of periodic caloric cycling on FMD or an isocaloric standard laboratory chow against primary tumor growth and metastatic burden. Here, we report that daily CR provides greater protection against tumor growth and metastasis to the lung, which may be in part due to the unique immune signature observed with daily CR.
    DOI:  https://doi.org/10.1038/s41467-021-26431-4
  38. Nat Protoc. 2021 Oct 29.
    Tutorial: methods for three-dimensional visualization of archival tissue material.
    Tariq Sami Haddad, Peter Friedl, Navid Farahani, Darren Treanor, Inti Zlobec, Iris Nagtegaal.
      Analysis of three-dimensional patient specimens is gaining increasing relevance for understanding the principles of tissue structure as well as the biology and mechanisms underlying disease. New technologies are improving our ability to visualize large volume of tissues with subcellular resolution. One resource often overlooked is archival tissue maintained for decades in hospitals and research archives around the world. Accessing the wealth of information stored within these samples requires the use of appropriate methods. This tutorial introduces the range of sample preparation and microscopy approaches available for three-dimensional visualization of archival tissue. We summarize key aspects of the relevant techniques and common issues encountered when using archival tissue, including registration and antibody penetration. We also discuss analysis pipelines required to process, visualize and analyze the data and criteria to guide decision-making. The methods outlined in this tutorial provide an important and sustainable avenue for validating three-dimensional tissue organization and mechanisms of disease.
    DOI:  https://doi.org/10.1038/s41596-021-00611-4
  39. FEBS J. 2021 Oct 28.
    The mitochondrial permeability transition: Recent progress and open questions.
    Paolo Bernardi, Michela Carraro, Giovanna Lippe.
      Major progress has been made in defining the basis of the mitochondrial permeability transition, a Ca2+ -dependent permeability increase of the inner membrane that has puzzled mitochondrial research for almost 70 years. Initially considered an artifact of limited biological interest by most, over the years the permeability transition has raised to the status of regulator of mitochondrial ion homeostasis and of druggable effector mechanism of cell death. The permeability transition is mediated by opening of channel(s) modulated by matrix cyclophilin D, the permeability transition pore(s) (PTP). The field has received new impulse (i) from the hypothesis that the PTP may originate from a Ca2+ -dependent conformational change of F-ATP synthase; and (ii) from the reevaluation of the long-standing hypothesis that it originates from the adenine nucleotide translocator (ANT). Here, we provide a synthetic account of the structure of ANT and F-ATP synthase in order to discuss potential and controversial mechanisms through which they may form high-conductance channels; and review some intriguing findings from the wealth of early studies of PTP modulation that still await an explanation. We hope that this review will stimulate new experiments addressing the many outstanding problems, and thus contribute to the eventual solution of the puzzle of the permeability transition.
    Keywords:  ATP synthase; Mitochondria; adenine nucleotide translocator; calcium transport; channels; cyclophilin; cyclosporin; permeability transition
    DOI:  https://doi.org/10.1111/febs.16254
  40. Int J Radiat Oncol Biol Phys. 2021 Nov 01. pii: S0360-3016(21)01278-5. [Epub ahead of print]111(3S): e61
    SBRT for the Treatment of Isolated Local Recurrence of Resected Pancreatic Cancer.
    L K Morris, J Viehman, J R M Baclay, D T Chang, S J Kerans, J K Molitoris, W F Regine, K L Johung, K R Jethwa, S S Neibart, S K Jabbour, C L Hallemeier.
       PURPOSE/OBJECTIVE(S): Following curative resection for pancreatic ductal adenocarcinoma (PDAC), there are high rates of local recurrence. The optimal treatment of patients with isolated local recurrence (ILR) - recurrence in the abdomen without distant metastases - is not known. This study evaluated stereotactic body radiation therapy (SBRT) as a treatment option for ILR.
    MATERIALS/METHODS: A multi-institutional retrospective analysis was performed on patients with ILR of PDAC following oncologic surgical resection treated with SBRT. Patient demographics, tumor and prior treatment characteristics, details of recurrence, SBRT treatment design and dosimetry, and patient follow-up and toxicity data were recorded from the medical record. Progression and overall survival estimates were calculated using cumulative incidence and Kaplan-Meier models, respectively.
    RESULTS: Between January 2010 and December 2020, 34 patients (17 males and 17 females, median age 69 years) were treated at five institutions in the United States. At the time of initial resection, most patients had T3 tumors (71%) and involved lymph nodes (71%). 31 of 34 (91%) patients underwent a Whipple procedure and 3 (9%) had a distal pancreatectomy. The R0 resection rate was 68%. 29% and 85% received neoadjuvant or adjuvant chemotherapy, respectively; and 12% and 27% had prior neoadjuvant or adjuvant radiation courses around the time of initial surgical resection. Median time to ILR was 18.7mos. The most common location of recurrence was in the pancreatic remnant or near the superior mesenteric artery. All patients underwent 5-fraction photon (28 patients) or proton (6 patients) SBRT to a median dose of 3500cGy (range 3000-4000cGy) with a median BED of 5950cGy (α/β = 10). Median follow-up after SBRT was 3.05 years. The 1-year and 2-year cumulative incidence of cancer progression were 72% (95% CI 56-93%) and 92% (95% CI 76-100%). Distant metastasis was the most common site of first recurrence (15 of 23 recurrences, 65%). 6 patients (25%) had local failure as site of first recurrence. Prior radiation was not associated with increased risk of progression after SBRT (HR 1.31 95% CI 0.56-3.07, P = 0.54). 1-year and 2-year overall survival was 64% (95% CI 49-84%) and 40% (95% CI 25-64%), with a median survival of 1.2 years from time of SBRT. Four patients (12%) developed grade 3 toxicities within one year after completion of SBRT. There were no grade 4-5 toxicities.
    CONCLUSION: For treatment of PDAC ILR after surgical resection, SBRT was well tolerated and offered high rates of local tumor control with low treatment-related toxicity.
    DOI:  https://doi.org/10.1016/j.ijrobp.2021.07.408
  41. Ann Surg Oncol. 2021 Oct 30.
    Sarcopenia as a Predictor of Survival in Patients with Pancreatic Adenocarcinoma After Pancreatectomy.
    Hadass Rom, Shlomit Tamir, Jeroen L A Van Vugt, Yael Berger, Gali Perl, Sara Morgenstern, Ana Tovar, Baruch Brenner, Daniel Benchimol, Hanoch Kashtan, Eran Sadot.
       OBJECTIVE: To determine whether sarcopenia can potentially predict worse survival after resection of pancreatic ductal adenocarcinoma.
    BACKGROUND: Sarcopenia is correlated with poor outcomes in hepatopancreatobiliary malignancies, but the relationship of both its qualitative and quantitative features with patient survival after pancreatectomy has not been investigated in a western population.
    PATIENTS AND METHODS: Preoperative cross-sectional computed tomography scans of consecutive patients who underwent pancreatectomy in 2005-2017 were evaluated for skeletal muscle index (SMI), intramuscular adipose tissue content (IMAC), and visceral-to-subcutaneous adipose tissue area ratio (VSR). Sex-specific categorical cut-offs were determined. Findings were correlated with outcome.
    RESULTS: The study included 111 patients, 47% of whom were female, with a median age of 67 years (range: 35-87 years), and median body mass index of 23 kg/m2 (range: 16-40 kg/m2); 77% had a Whipple procedure and 66% received adjuvant chemotherapy. Low SMI correlated with poor overall survival (OS) (P = 0.007), disease-specific survival (DSS) (P = 0.006), and recurrence-free survival (RFS) (P = 0.01). High IMAC correlated with poor OS (P = 0.04). Patients with high IMAC tended to have a shorter DSS (P = 0.09), with no correlation with RFS (P = 0.6). VSR was not associated with survival. Multivariable analysis yielded an independent association of low SMI with OS (HR = 1.7, 95%CI: 1.1-2.8, P = 0.02), DSS (HR = 1.8, 95%CI: 1.03-3.2, P = 0.04), and RFS (HR = 1.8, 95%CI: 1.1-2.8, P = 0.01), and of high IMAC with OS (HR = 1.9, 95%CI: 1.1-3.1, P = 0.01).
    CONCLUSION: Both qualitative and quantitative measures of skeletal muscle were independently associated with impaired survival in patients with resectable PDAC. Sarcopenia might serve as an early radiographic surrogate of aggressive tumor behavior, with potential implications for clinical decision-making and future study.
    Keywords:  Intramuscular adipose tissue; Pancreatectomy; Pancreatic ductal adenocarcinoma; Sarcopenia; Skeletal muscle; Survival; Visceral adipose tissue subcutaneous adipose tissue
    DOI:  https://doi.org/10.1245/s10434-021-10995-y
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