Free heme exacerbates colonic injury induced by anti-cancer therapy.

Gastrointestinal inflammation and bleeding are commonly induced by cancer radiotherapy and chemotherapy but mechanisms are unclear. We demonstrated an increased number of infiltrating heme oxygenase-1 positive (HO-1+) macrophages (Mø, CD68+) and the levels of hemopexin (Hx) in human colonic biopsies from patients treated with radiation or chemoradiation versus non-irradiated controls or in the ischemic intestine compared to matched normal tissues. The presence of rectal bleeding in these patients was also correlated with higher HO-1+ cell infiltration. To functionally assess the role of free heme released in the gut, we employed myeloid-specific HO-1 knockout (LysM-Cre : Hmox1flfl), hemopexin knockout (Hx-/-) and control mice. Using LysM-Cre : Hmox1flfl conditional knockout (KO) mice, we showed that a deficiency of HO-1 in myeloid cells led to high levels of DNA damage and proliferation in colonic epithelial cells in response to phenylhydrazine (PHZ)-induced hemolysis. We found higher levels of free heme in plasma, epithelial DNA damage, inflammation, and low epithelial cell proliferation in Hx-/- mice after PHZ treatment compared to wild-type mice. Colonic damage was partially attenuated by recombinant Hx administration. Deficiency in Hx or Hmox1 did not alter the response to doxorubicin. Interestingly, the lack of Hx augmented abdominal radiation-mediated hemolysis and DNA damage in the colon. Mechanistically, we found an altered growth of human colonic epithelial cells (HCoEpiC) treated with heme, corresponding to an increase in Hmox1 mRNA levels and heme:G-quadruplex complexes-regulated genes such as c-MYC, CCNF, and HDAC6. Heme-treated HCoEpiC cells exhibited growth advantage in the absence or presence of doxorubicin, in contrast to poor survival of heme-stimulated RAW247.6 Mø. In summary, our data indicate that accumulation of heme in the colon following hemolysis and/or exposure to genotoxic stress amplifies DNA damage, abnormal proliferation of epithelial cells, and inflammation as a potential etiology for gastrointestinal syndrome (GIS).

CAR-T Cell Therapy and the Gut Microbiota.

Chimeric antigen receptor (CAR) - T cell cancer therapy has yielded promising results in treating hematologic malignancies in clinical studies, and a growing number of CAR-T regimens are approved for clinical usage. While the therapy is considered of great potential in expanding the cancer immunotherapy arsenal, more than half of patients receiving CAR-T infusions do not respond, while others develop significant adverse effects, collectively indicating a need for optimization of CAR-T treatment to the individual. The microbiota is increasingly suggested as a major modulator of immunotherapy responsiveness. Studying causal microbiota roles possibly contributing to CAR-T therapy efficacy, adverse effects reduction, and prediction of patient responsiveness constitutes an exciting area of active research. Herein, we discuss the latest developments implicating human microbiota involvement in CAR-T therapy, while highlighting challenges and promises in harnessing the microbiota as a predictor and modifier of CAR-T treatment towards optimized efficacy and minimization of treatment-related adverse effects.

CXCL8 Signaling in the Tumor Microenvironment.

The tumor microenvironment represents a dynamic and complex cellular network involving intricate communications between the tumor and highly heterogeneous groups of cells, including tumor-supporting immune and inflammatory cells, cancer-associated fibroblasts, endothelial cells, tumor-associated macrophages, adipose cells, and pericytes. Associated with a variety of growth factors, chemokines, cytokines, and other signaling molecules, the interaction between the tumor microenvironment and the tumor cells empowers aggressiveness of tumor by enhancing its survivability. CXCL8 (also known as Interleukin 8), a multifunctional proinflammatory chemokine that was initially classified as a neutrophil chemoattractant, recently has been found to be a key contributor in tumorigenesis. The upregulation of CXCL8 at the tumor invasion front in several human cancers suggests its interplay between the tumor and its microenvironment rendering tumor progression by enhancing angiogenesis, tumor genetic diversity, survival, proliferation, immune escape, metastasis, and multidrug resistance. The autocrine and paracrine modulation of CXCL8 via the chemokine receptors CXCR1/2 promotes several intracellular signaling cascades that fosters tumor-associated inflammation, reprogramming, epithelial-mesenchymal transition, and neovascularization. Hence, decrypting the regulatory/signaling cascades of CXCL8 and its downstream effects may harbor prognostic clinical prospects of a tumor microenvironment-oriented cancer therapeutics.