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Tumor-Induced IL-6 Reprograms Host Metabolism to Suppress Anti-tumor Immunity

Published version
Peer-reviewed

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Authors

Flint, TR 
Janowitz, T 
Connell, CM 
Roberts, EW 
Denton, AE 

Abstract

In patients with cancer, the wasting syndrome, cachexia, is associated with caloric deficiency. Here, we describe tumor-induced alterations of the host metabolic response to caloric deficiency that cause intratumoral immune suppression. In pre-cachectic mice with transplanted colorectal cancer or autochthonous pancreatic ductal adenocarcinoma (PDA), we find that IL-6 reduces the hepatic ketogenic potential through suppression of PPARalpha, the transcriptional master regulator of ketogenesis. When these mice are challenged with caloric deficiency, the resulting relative hypoketonemia triggers a marked rise in glucocorticoid levels. Multiple intratumoral immune pathways are suppressed by this hormonal stress response. Moreover, administering corticosterone to elevate plasma corticosterone to a level that is lower than that occurring in cachectic mice abolishes the response of mouse PDA to an immunotherapy that has advanced to clinical trials. Therefore, tumor-induced IL-6 impairs the ketogenic response to reduced caloric intake, resulting in a systemic metabolic stress response that blocks anti-cancer immunotherapy.

Description

Keywords

pancreatic cancer, cachexia, cancer immunology, hepatic metabolism, interleukin-6, PPARalpha, stress, ketogenesis, glucocorticoids, cancer immunotherapy

Journal Title

Cell Metabolism

Conference Name

Journal ISSN

1550-4131
1932-7420

Volume Title

24

Publisher

Elsevier (Cell Press)
Sponsorship
Cancer Research UK (CB4270)
Medical Research Council (MC_UU_12012/1)
Cancer Research UK (15678)
Medical Research Council (MC_UU_12012/5)
Medical Research Council (MC_PC_12012)
We also thank the University of Cambridge, Cancer Research UK, the CRUK Cambridge Institute Core Facilities, and Hutchison Whampoa Limited. This work was also supported by the Lustgarten Foundation for Pancreatic Cancer Research, the Ludwig Institute for Cancer Research, the NIHR Biomedical Research Centre, and the Cambridge ECMC. T.R.F. was supported by the Rosetrees Trust and the Cambridge School of Clinical Medicine’s MB/PhD Programme, T.J. was supported by the Wellcome Trust Translational Medicine and Therapeutics Programme and the University of Cambridge Department of Oncology (RJAG/076), C.M.C. was supported by the Cambridge University Hospitals NHS Foundation Trust, E.W.R. was supported by the CRI Irvington Postdoctoral Fellowship Program, and A.P.C. was supported by the Medical Research Council (MRC) Metabolic Diseases Unit (MRC_MC_UU_12012/1). D.T.F. is a Distinguished Scholar of the Lustgarten Foundation.