[HTML][HTML] Efferocytosis produces a prometastatic landscape during postpartum mammary gland involution

JC Stanford, C Young, D Hicks… - The Journal of …, 2014 - Am Soc Clin Investig
JC Stanford, C Young, D Hicks, P Owens, A Williams, DB Vaught, MM Morrison, J Lim…
The Journal of clinical investigation, 2014Am Soc Clin Investig
Breast cancers that occur in women 2–5 years postpartum are more frequently diagnosed at
metastatic stages and correlate with poorer outcomes compared with breast cancers
diagnosed in young, premenopausal women. The molecular mechanisms underlying the
malignant severity associated with postpartum breast cancers (ppBCs) are unclear but relate
to stromal wound-healing events during postpartum involution, a dynamic process
characterized by widespread cell death in milk-producing mammary epithelial cells (MECs) …
Breast cancers that occur in women 2–5 years postpartum are more frequently diagnosed at metastatic stages and correlate with poorer outcomes compared with breast cancers diagnosed in young, premenopausal women. The molecular mechanisms underlying the malignant severity associated with postpartum breast cancers (ppBCs) are unclear but relate to stromal wound-healing events during postpartum involution, a dynamic process characterized by widespread cell death in milk-producing mammary epithelial cells (MECs). Using both spontaneous and allografted mammary tumors in fully immune–competent mice, we discovered that postpartum involution increases mammary tumor metastasis. Cell death was widespread, not only occurring in MECs but also in tumor epithelium. Dying tumor cells were cleared through receptor tyrosine kinase MerTK–dependent efferocytosis, which robustly induced the transcription of genes encoding wound-healing cytokines, including IL-4, IL-10, IL-13, and TGF-β. Animals lacking MerTK and animals treated with a MerTK inhibitor exhibited impaired efferocytosis in postpartum tumors, a reduction of M2-like macrophages but no change in total macrophage levels, decreased TGF-β expression, and a reduction of postpartum tumor metastasis that was similar to the metastasis frequencies observed in nulliparous mice. Moreover, TGF-β blockade reduced postpartum tumor metastasis. These data suggest that widespread cell death during postpartum involution triggers efferocytosis-induced wound-healing cytokines in the tumor microenvironment that promote metastatic tumor progression.
The Journal of Clinical Investigation