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Phosphodiesterase type 5 inhibitors enhance chemotherapy in preclinical models of esophageal adenocarcinoma by targeting cancer-associated fibroblasts

Phosphodiesterase type 5 inhibitors enhance chemotherapy in preclinical models of esophageal adenocarcinoma by targeting cancer-associated fibroblasts
Phosphodiesterase type 5 inhibitors enhance chemotherapy in preclinical models of esophageal adenocarcinoma by targeting cancer-associated fibroblasts

The chemotherapy resistance of esophageal adenocarcinomas (EACs) is underpinned by cancer cell extrinsic mechanisms of the tumor microenvironment (TME). We demonstrate that, by targeting the tumor-promoting functions of the predominant TME cell type, cancer-associated fibroblasts (CAFs) with phosphodiesterase type 5 inhibitors (PDE5i), we can enhance the efficacy of standard-of-care chemotherapy. In ex vivo conditions, PDE5i prevent the transdifferentiation of normal fibroblasts to CAF and abolish the tumor-promoting function of established EAC CAFs. Using shotgun proteomics and single-cell RNA-seq, we reveal PDE5i-specific regulation of pathways related to fibroblast activation and tumor promotion. Finally, we confirm the efficacy of PDE5i in combination with chemotherapy in close-to-patient and in vivo PDX-based model systems. These findings demonstrate that CAFs drive chemotherapy resistance in EACs and can be targeted by repurposing PDE5i, a safe and well-tolerated class of drug administered to millions of patients world-wide to treat erectile dysfunction.

cancer-associated fibroblasts, chemotherapy, esophageal adenocarcinoma, phosphodiesterase type 5 inhibitors, preclinical models
2666-3791
Sharpe, Benjamin P.
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Hayden, Annette
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Manousopoulou, Antigoni
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Cowie, Andrew
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Walker, Robert C.
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Harrington, Jack
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Izadi, Fereshteh
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Breininger, Stella P.
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Gibson, Jane
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Pickering, Oliver
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Jaynes, Eleanor
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Kyle, Ewan
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Saunders, John H.
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Parsons, Simon L.
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Ritchie, Alison A.
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Clarke, Philip A.
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Collier, Pamela
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Mongan, Nigel P.
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Bates, David O.
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Yacqub-Usman, Kiren
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Garbis, Spiros D.
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Walters, Zoë
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Rose-Zerilli, Matthew
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Grabowska, Anna M.
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Underwood, Timothy J.
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Sharpe, Benjamin P.
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Hayden, Annette
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Manousopoulou, Antigoni
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Cowie, Andrew
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Walker, Robert C.
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Harrington, Jack
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Izadi, Fereshteh
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Breininger, Stella P.
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Gibson, Jane
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Pickering, Oliver
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Jaynes, Eleanor
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Kyle, Ewan
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Saunders, John H.
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Parsons, Simon L.
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Ritchie, Alison A.
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Clarke, Philip A.
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Collier, Pamela
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Mongan, Nigel P.
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Bates, David O.
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Yacqub-Usman, Kiren
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Garbis, Spiros D.
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Walters, Zoë
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Rose-Zerilli, Matthew
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Grabowska, Anna M.
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Underwood, Timothy J.
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Sharpe, Benjamin P., Hayden, Annette, Manousopoulou, Antigoni, Cowie, Andrew, Walker, Robert C., Harrington, Jack, Izadi, Fereshteh, Breininger, Stella P., Gibson, Jane, Pickering, Oliver, Jaynes, Eleanor, Kyle, Ewan, Saunders, John H., Parsons, Simon L., Ritchie, Alison A., Clarke, Philip A., Collier, Pamela, Mongan, Nigel P., Bates, David O., Yacqub-Usman, Kiren, Garbis, Spiros D., Walters, Zoë, Rose-Zerilli, Matthew, Grabowska, Anna M. and Underwood, Timothy J. (2022) Phosphodiesterase type 5 inhibitors enhance chemotherapy in preclinical models of esophageal adenocarcinoma by targeting cancer-associated fibroblasts. Cell Reports Medicine, 3 (6), [100541]. (doi:10.1016/j.xcrm.2022.100541).

Record type: Article

Abstract

The chemotherapy resistance of esophageal adenocarcinomas (EACs) is underpinned by cancer cell extrinsic mechanisms of the tumor microenvironment (TME). We demonstrate that, by targeting the tumor-promoting functions of the predominant TME cell type, cancer-associated fibroblasts (CAFs) with phosphodiesterase type 5 inhibitors (PDE5i), we can enhance the efficacy of standard-of-care chemotherapy. In ex vivo conditions, PDE5i prevent the transdifferentiation of normal fibroblasts to CAF and abolish the tumor-promoting function of established EAC CAFs. Using shotgun proteomics and single-cell RNA-seq, we reveal PDE5i-specific regulation of pathways related to fibroblast activation and tumor promotion. Finally, we confirm the efficacy of PDE5i in combination with chemotherapy in close-to-patient and in vivo PDX-based model systems. These findings demonstrate that CAFs drive chemotherapy resistance in EACs and can be targeted by repurposing PDE5i, a safe and well-tolerated class of drug administered to millions of patients world-wide to treat erectile dysfunction.

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Accepted/In Press date: 28 January 2022
e-pub ahead of print date: 21 June 2022
Published date: 21 June 2022
Additional Information: Funding Information: the authors would like to thank the core facilities that contributed to this work: the Research Histology at Department of Cellular Pathology, Southampton General Hospital for conducting histology and immunohistochemistry experiments; the Biomedical Imaging Unit at Southampton General Hospital for use of their bioimaging equipment and expertise, namely in fluorescent laser-scanning confocal microscopy and digital slide scanning. Gene expression data in Figure 1C ewers partly based on data generated by the TCGA Research Network: https://www.cancer.gov/tcga. The data used for the analyses described in this manuscript were obtained from the Genotype-Tissue Expression (GTEx) Project, which was supported by the Common Fund of the Office of the Director of the National Institutes of Health and by NCI, NHGRI, NHLBI, NIDA, NIMH, and NINDS. Funding: Medical Research Council UK Clinician Scientist Fellowship to T.J.U. “Exploring stromal-epithelial interactions in oesophageal cancer” G1002565 IDN0. 99762; Cancer Research UK & Royal College of Surgeons of England Advanced Clinician Scientist Fellowship to T.J.U. “Cellular interplay in oesophageal cancer.” A23924. A.H. performed experiments, interpreted results, conducted analysis, and wrote manuscript; A.M. performed experiments, interpreted results, and wrote manuscript; A.C. performed experiments, interpreted results, and wrote manuscript; R.W. performed experiments, interpreted results, and wrote manuscript; B.P.S. interpreted results, conducted analysis, and wrote manuscript; J.H. performed experiments; F.I. performed analysis and interpreted results; S.P.B. interpreted results and wrote manuscript; J.G. and O.P. performed analysis and interpreted results; E.J. contributed resources; E.K. performed experiments; J.H.S. S.P. A.A.R. P.A.C. N.P.M. D.O.B. K.Y-U,. and P.C. performed experiments, interpreted results, and wrote manuscript; S.D.G. performed experiments, interpreted results, and wrote manuscript; M.R.Z. performed experiments, interpreted results, and wrote manuscript; A.G. designed study, interpreted results, and wrote manuscript; T.J.U. raised funding, designed study, performed experiments, interpreted results, and wrote manuscript. All authors revised the manuscript and approved the final version. S.D.G. is Founder, President, CEO, and CTO of Proteas Bioanalytics, Inc. A.M. is CSO of Proteas Bioanalytics, Inc. They confirm that they were not affiliated when the work published in this study was carried out. All other authors declare no competing interests. One or more of the authors of this paper self-identifies as an underrepresented ethnic minority in science. One or more of the authors of this paper self-identifies as a member of the LGBTQ+ community. One or more of the authors of this paper self-identifies as living with a disability. Funding Information: the authors would like to thank the core facilities that contributed to this work: the Research Histology at Department of Cellular Pathology, Southampton General Hospital for conducting histology and immunohistochemistry experiments; the Biomedical Imaging Unit at Southampton General Hospital for use of their bioimaging equipment and expertise, namely in fluorescent laser-scanning confocal microscopy and digital slide scanning. Gene expression data in Figure 1 C ewers partly based on data generated by the TCGA Research Network: https://www.cancer.gov/tcga . The data used for the analyses described in this manuscript were obtained from the Genotype-Tissue Expression (GTEx) Project, which was supported by the Common Fund of the Office of the Director of the National Institutes of Health and by NCI, NHGRI, NHLBI, NIDA, NIMH, and NINDS. Funding: Medical Research Council UK Clinician Scientist Fellowship to T.J.U. “Exploring stromal-epithelial interactions in oesophageal cancer” G1002565 IDN0. 99762 ; Cancer Research UK & Royal College of Surgeons of England Advanced Clinician Scientist Fellowship to T.J.U. “Cellular interplay in oesophageal cancer.” A23924 .
Keywords: cancer-associated fibroblasts, chemotherapy, esophageal adenocarcinoma, phosphodiesterase type 5 inhibitors, preclinical models

Identifiers

Local EPrints ID: 468689
URI: http://eprints.soton.ac.uk/id/eprint/468689
ISSN: 2666-3791
PURE UUID: 303599e6-c9b5-40fa-8374-d14b481a4749
ORCID for Jane Gibson: ORCID iD orcid.org/0000-0002-0973-8285
ORCID for Zoë Walters: ORCID iD orcid.org/0000-0002-1835-5868
ORCID for Matthew Rose-Zerilli: ORCID iD orcid.org/0000-0002-1064-5350
ORCID for Timothy J. Underwood: ORCID iD orcid.org/0000-0001-9455-2188

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Date deposited: 22 Aug 2022 17:13
Last modified: 17 Mar 2024 03:48

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Contributors

Author: Benjamin P. Sharpe
Author: Annette Hayden
Author: Antigoni Manousopoulou
Author: Andrew Cowie
Author: Robert C. Walker
Author: Jack Harrington
Author: Fereshteh Izadi
Author: Stella P. Breininger
Author: Jane Gibson ORCID iD
Author: Oliver Pickering
Author: Eleanor Jaynes
Author: Ewan Kyle
Author: John H. Saunders
Author: Simon L. Parsons
Author: Alison A. Ritchie
Author: Philip A. Clarke
Author: Pamela Collier
Author: Nigel P. Mongan
Author: David O. Bates
Author: Kiren Yacqub-Usman
Author: Spiros D. Garbis
Author: Zoë Walters ORCID iD
Author: Anna M. Grabowska

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