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5-HT orchestrates histone serotonylation and citrullination to drive neutrophil extracellular traps and liver metastasis
Kaiyuan Liu, … , Kai Zhang, Helen He Zhu
Kaiyuan Liu, … , Kai Zhang, Helen He Zhu
Published February 4, 2025
Citation Information: J Clin Invest. 2025;135(8):e183544. https://doi.org/10.1172/JCI183544.
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Research Article Cell biology Oncology

5-HT orchestrates histone serotonylation and citrullination to drive neutrophil extracellular traps and liver metastasis

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Abstract

Serotonin (5-HT) is a neurotransmitter that has been linked to tumorigenesis. Whether and how 5-HT modulates cells in the microenvironment to regulate tumor metastasis is largely unknown. Here, we demonstrate that 5-HT was secreted by neuroendocrine prostate cancer (NEPC) cells to communicate with neutrophils and to induce the formation of neutrophil extracellular traps (NETs) in the liver, which in turn facilitated the recruitment of disseminated cancer cells and promoted liver metastasis. 5-HT induced histone serotonylation (H3Q5ser) and orchestrated histone citrullination (H3cit) in neutrophils to trigger chromatin decondensation and facilitate the formation of NETs. Interestingly, we uncovered in this process a reciprocally reinforcing effect between H3Q5ser and H3cit and a crosstalk between the respective writers enzyme transglutaminase 2 (TGM2) and peptidylarginine deiminase 4 (PAD4). Genetic ablation or pharmacological targeting of TGM2, or inhibition of the 5-HT transporter (SERT) with the FDA-approved antidepressant drug fluoxetine reduced H3Q5ser and H3cit modifications, suppressed NET formation, and effectively inhibited NEPC, small-cell lung cancer, and thyroid medullary cancer liver metastasis. Collectively, the 5-HT–triggered production of NETs highlights a targetable neurotransmitter/immune axis that drives liver metastasis of NE cancers.

Authors

Kaiyuan Liu, Yingchao Zhang, Genyu Du, Xinyu Chen, Lingling Xiao, Luyao Jiang, Na Jing, Penghui Xu, Chaoxian Zhao, Yiyun Liu, Huifang Zhao, Yujiao Sun, Jinming Wang, Chaping Cheng, Deng Wang, Jiahua Pan, Wei Xue, Pengcheng Zhang, Zhi-Gang Zhang, Wei-Qiang Gao, Shu-Heng Jiang, Kai Zhang, Helen He Zhu

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Figure 1

Neutrophil infiltration and NETs are detected in NEPC liver metastasis.

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Neutrophil infiltration and NETs are detected in NEPC liver metastasis.
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(A) Immune cell profiles of liver metastases (metas) based on the SU2C PCa dataset (n = 26). Neutro, neutrophils; Mac-M1, M1 macrophages; Mac-M2, M2 macrophages; Mono, monocytes. (B) Neutrophils are the most enriched immune cell component in liver metastases based on the SU2C dataset (adrenal metastases, n = 2; bone metastases, n = 82; liver metastases, n = 26; lymph node metastases, n = 79; prostate tumor, n = 5; soft tissue, n = 14). (C and D) Flow cytometric plots (C) and quantification (D) of CD11b+Ly6G+ neutrophils in liver (n = 4 mice). (E and F) IHC and IF staining (E) and quantification (F) of NETs in liver (n = 5 mice). Scale bars: 50 μm; 25μm (inserts); original magnification, ×9 (inserts). (G and H) IF staining (G) and quantification (H) of NETs (H3cit+) in MPO+ neutrophils in livers from vehicle- and DNase-I–treated NEPC tumor–bearing mice (n = 6 mice). Scale bar: 50 μm. (I and J) H&E-stained images (I) of livers from vehicle- and DNase-I–treated NEPC tumor–bearing mice (scale bars: 4 mm) and quantification (J) of liver metastases following vehicle or DNase-I treatment of mice inoculated by i.v. injection of Rb1Δ/Δ Trp53Δ/Δ organoids (n = 6 mice). (K) Survival curves for vehicle- and DNase-I–treated NEPC tumor–bearing mice (n = 8 mice). **P < 0.01, by log-rank test. (L) Quantification of migrated Rb1Δ/Δ Trp53Δ/Δ PCa cells in Boyden chambers recruited by murine primary neutrophils or NETs (n = 4 biological replicates). (M) Quantification of Rb1Δ/Δ Trp53Δ/Δ PCa cells adhesion in murine primary neutrophils or NETs (n = 4 biological replicates). *P < 0.05, **P < 0.01, and ***P < 0.001, by 2-tailed Student’s t test (H, J, L, and M), log-rank test (K), 1-way ANOVA followed by Tukey’s test (D and F), and 1-way ANOVA followed by Dunnett’s test (B). Data are shown as the mean ± SEM.

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