CAF culture supernatant boosted cancer cell malignancy under glucose-deficient conditions
CAFs and normal fibroblasts (NFs) isolated from primary cultures of four tumor masses and skin were validated by flow cytometry using antibodies against fibroblast activation protein (FAP) and CD90. In contrast to the negative staining in H460 cells, > 91% of CAFs and NFs were positive for FAP and CD90 (Additional file 1: Fig. S1A). To determine effects of cell-free media, supernatants were collected from the culture media from H460 cells, NFs, and CAFs. H460 cells were treated with the supernatants for 24 h, followed by incubation for further 24 h in either complete or glucose-deficient media. Compared to the NF and H460 supernatants, CAF-supernatant significantly enhanced the viability of H460 cells. Particularly, treatment with CAF 1, 3 and 4 supernatants increased the viability of H460 cells under glucose-deficient condition (Fig. 1A). Moreover, pretreatment with CAF supernatant for 24 h increased resistance to cisplatin under glucose-deficient conditions (Fig. 1B). Treatment with cisplatin for 16 h induced total apoptosis in H460 cells that were pretreated with H460 and NF supernatants by 79% and 34%, respectively. In contrast, the total apoptosis significantly decreased to 23% following pretreatment with CAF supernatant and was further suppressed to around 14% under glucose-deficient conditions. Although treatment with NF supernatant reduced total apoptosis compared with H460 supernatant under glucose-deficient conditions, it was lower than treatment with CAF supernatants (Fig. 1C). Under glucose-deficient condition, incubation of H460 cells with CAF supernatants exhibited a constant rate of apoptosis regardless of cisplatin treatment. Total apoptosis induced by cisplatin was lower in H460 cells treated with NF supernatant compared to the cells treated with H460 cell supernatant. This may be attributable to the growth factors secreted by fibroblasts (8).
SCD upregulation in CAFs stimulated lipogenesis in cancer cells
In xenografted tumors, lipid levels were high in CAFs and gradually decreased away from the CAFs (Fig. 2A). Oil red O staining revealed a similar pattern of lipids, which was exclusively detected in CAFs in tumor masses (Additional file 1: Fig. S1B). Analysis of fatty acids (FAs) in cell pellets revealed that OA (C18:1n9) was higher than saturated fatty acids (SFA) involving palmitic acids (C16:0) and stearic acids (C18:0) in CAFs, but was lower in NFs (Fig. 2B). However, other MUFAs including linoleic acid (18:2n6) and arachidonic acid (20:4n6), were not higher in CAFs. Published data indicate that arachidonic acid-synthesized molecule is decreased in CAFs by miR-522 and promotes the invasion and growth of cancer cells [39]. Additionally, CAFs isolated from individual tumor mass showed higher lipids amount than NFs and H460 cells (Additional file 1: Fig. S1C). Notably, SCD expression was significantly higher in CAFs than NFs (Fig. 2C). To investigate the function of SCD in FA synthesis, CAFs and NFs were treated with CAY10566, a selective inhibitor of SCD, and mRNA levels of ATP citrate lyase (ACLY), acetyl-CoA carboxylase (ACAC), and fatty acid synthase (FASN) were assessed. Comparative analyses revealed that high expression of SCD in CAFs increased the level of these genes but not in NFs (Fig. 2D). However, treatment of CAFs with CAY10566 reduced the amount of FA, particularly OA in the supernatant compared to non-treated counterpart (Additional file 1: Fig. S1D). Moreover, amount of saturated fatty acids was suppressed in supernatant from CAFs after treatment with CAY10566, suggesting the role of SCD in synthesis of fatty acid in CAFs. Accordingly, it has been shown that downregulation of lipogenesis genes in SCD-deleted mice suppresses both saturated fatty acids and monounsaturated fatty acids [40]. To determine whether CAF-derived FAs transferred to cancer cells, H460 cells were incubated with NF or CAF supernatant for one day, followed by measurement of FAs contents. OA was significantly higher in H460 cells treated with CAF supernatant than those treated with complete medium or NF supernatant, whereas content of SFAs was not changed by treatment with NF or CAF supernatants (Fig. 2E). The P2 population in H460 cells treated with NF supernatant was used as a comparison. Treatment of H460 cells with CAF supernatant significantly increased the P2 population to 31%, while it was reduced to 6.72% by CAY10566 treatment (Fig. 2F). In contrast, the P2 population in H460 treated with NF supernatant was not affected by CAY10566 treatment. To determine the role of FA from CAF-supernatant in H460 cells, we incubated H460 cells with supernatant from CAFs and NFs which were treated with CAY10566. In contrast to NF-supernatant, CAF supernatant increased SCD expression in H460 cells. However, CAFs supernatant from CAY10566-treated cells did not alter the SCD expression (Fig. 2G). Additionally, H460 cells treated with CAF supernatant showed increased expression of the lipid transporters, CD36 and SLC27A1 (Fig. 2H), but not ACLY, ACAC, and FASN (Additional file 1: Fig. S1E). Moreover, CAY10566 treatment significantly decreased the expression of CD36 and SLC27A1. In contrast, treatment with NF supernatant did not affect the expression of lipid transporters in cancer cells. For analysis of fatty acid, H460 cells were incubated with CAF-supernatant and sulfo-N-succinimidyl oleate (SSO), an inhibitor of lipid transporter. Compared to the non-treated cells, the amount of OA was significantly lower in SSO-treated H460 cells (Fig. 2I), suggesting the OA was transferred from CAF-supernatant to H460 cells through lipid transporter. Moreover, treatment of H460 cells with OA enhanced the mRNA expressions of SREBP-1c and FASN. Confirming this finding, SSO treatment suppressed their expressions regardless of OA presence (Additional file 1: Fig. S1F).
Lipid catabolism by cell-free FAs accelerated autophagy under glucose-deficient conditions
H460 cells treated with CAF supernatant showed greater fluorescence for lipids and FFA levels than those treated with NF supernatant and it was diminished under glucose-deficient conditions (Additional file 1: Fig. S2A, B). To further investigate of the role of cell-free FA, H460 culture media was supplemented with OA for one day. Lipid levels were evaluated in H460 cells using BODIPY staining. Addition of OA significantly increased the P3 population to approximately 85% in complete media, and to approximately 56% in glucose-deficient media (Fig. 3A). Expression levels of SREBP-1c and SCD were upregulated in H460 cells treated with CAF supernatant, which were further increased under glucose-deficient conditions (Additional file 1: Fig. S2C). Likewise, compared with cells cultured in complete media, lipid metabolism was further activated by OA treatment in glucose-starved cells, as indicated by upregulation of SREBP-1 precursor, -1c, and SCD (Fig. 3B, Additional file 1: Fig. S2D). In glucose-starved H460 cells, OA treatment increased the expression of autophagy indicators, BECN1 and LC3, but reduced mammalian target of rapamycin (mTOR) (Fig. 3C).
The P2 population of H460 cells were cultured in complete medium as a comparison to determine autophagosome using Cyto-ID. OA treatment increased the P2 population to 35%, which was further elevated to approximately 54% under glucose-deficient conditions (Additional file 1: Fig. S2E). Treatment with CAY10566 suppressed the P2 population by approximately 15% in glucose-starved H460 cells supplemented with OA (Fig. 3D). Additionally, under glucose-deficient conditions, OA treatment increased the expression of autophagosome markers, LC3-II and ATG5, which was reversed by treatment with CAY10566 (Additional file 1: Fig. S2F). Autophagosome maturation was targeted separately to assess the influence of autophagosome on SCD. Treatment with 3-methyladenine (3-MA) and chloroquine (CQ) blocked the autophagy response via inhibition of autophagosome formation and autophagosome–lysosome fusion, respectively [41]. OA treatment augmented the SCD and LC3-II expressions under glucose-deficient conditions compared to complete medium. However, 3-MA treatment suppressed their expressions in presence of OA and glucose deficiency (Fig. 3E). Moreover, supplement with CQ augmented SCD expression in complete medium compared to non-treatment.
OA treatment augmented cancer cell stemness properties in glucose-deficient conditions
In H460 cells, expression of the stemness markers, Nanog and Oct4, were increased by OA treatment, which were further upregulated under glucose-deficient conditions (Fig. 4A). Lipid levels determined by BODIPY staining were enhanced when the presence of OA compared to its absence. However, glucose deficiency suppressed the BODIPY staining in the cells (Fig. 4B and Additional file 1: Fig. S2G). These results suggested that activated lipid metabolism under glucose-deficient conditions in the presence of OA may augment cancer stemness. Approximately 36.22% of H460 cells treated with OA were positive for the CSC markers, CD133 and CD44, under glucose-deficient conditions, and the population was reduced to 19.86% following CAY10566 treatment (Fig. 4C). Moreover, under glucose-deficient conditions, spheroid formation in H460 cells was enhanced by OA treatment, and was reversed by CAY10566 treatment (Fig. 4D). Additionally, CAY10566 treatment induced a consistent the number of spheroids under glucose deficient conditions regardless of OA treatment.
SCD-enriched cancer stemness was achieved via F-actin-mediated YAP nuclear translocation
Under glucose-deficient conditions, yes-associated protein (YAP) and F-actin were mainly detected in the nuclei of H460 cells treated with CAF supernatant (Fig. 5A). In contrast, only faint YAP fluorescence was detected in the cytoplasm of H460 cells treated with either H460 or NF supernatant, which was not affected by glucose starvation. The abundance of side populations (SPs) in H460 cells was increased by treatment with CAF supernatant, which was further enhanced by glucose starvation, but not in cells treated with H460 or NF supernatant (Fig. 5B).
Genetically-engineered subclones of H460 cells were manufactured by lentiviral vector or CRISPR/cas9-based gene editing to elucidate the mechanisms involved in the control of cancer stemness by SCD. Compared with parental and mock cells, expression of SCD mRNA and protein were completely abrogated in SCD-KO cells (Additional file 1: Fig. S3A, B). SCD-pCDH cells had overexpressed SCD, while no change of SCD was observed in control Cas9 and pCDH transfected cells (Additional file 1: Fig. S3C). Additionally, analysis of FAs revealed that OA content was higher in SCD-pCDH cells than other subclones (Additional file 1: Fig. S3D). Downregulation of SCD decreases the MUFA content, but increases the content of SFA and lactate level [42]. Upregulated lactate by SCD inhibition might produce the content of SFA [43]. Moreover, the expressions of autophagy indicators, BECN1 and Atg5, were increased in SCD-pCDH cells but suppressed in SCD-KO cells compared to parental cells (Additional file 1: Fig. S3E).
Higher expression levels of Nanog and Oct4 were observed in SCD-pCDH cells compared with the parental cells; however, their expression levels were significantly lower in SCD-KO cells (Additional file 1: Fig. S3F). While only 7.61% of SCD-KO cells were positive for CD133 and/or CD44, 45% of SCD-pCDH cells were positive for these markers (Additional file 1: Fig. S3G). SP analyses in parental, SCD-KO, and SCD-pCDH cells revealed that the abundance of SPs was positively associated with SCD expression (Additional file 1: Fig. S3H). The number of spheroids was higher in SCD-pCDH cells than parental and SCD-KO cells. Additionally, OA treatment increased the spheroids in parental and SCD-pCDH cells, while the number of spheroid in SCD-KO cells was not affected by OA treatment (Additional file 1: Fig. S3I).
In contrast to the cytoplasmic localization in parental cells, high levels of YAP and F-actin were detected in the nuclei of SCD-pCDH cells (Fig. 5C, Additional file 1: S3J). SCD-KO cells showed lower expression of YAP and F-actin in the nuclei and cytoplasm compared with the parental cells. Cells were treated with an F-actin inhibitor, latrunculin A (Lat A), to evaluate the role of F-actin in the nuclear translocation of YAP. Nuclear was isolated from whole lysate and assessed their expressions (Additional file 1: Fig. S3K). Lat A treatment significantly suppressed nuclear expression of YAP and F-actin in SCD-pCDH cells (Fig. 5D), but not in parental or SCD-KO cells.
Strong fluorescence for F-actin levels were detected in the nuclei, with elongation of mitochondrial dynamics in SCD-pCDH cells (Additional file 1: Fig. S4A), whereas mitochondrial fragmentation was observed in SCD-KO cells. Moreover, analyses of mitochondrial membrane potential and mitochondrial calcium in parental, SCD-KO, and SCD-pCDH cells revealed that SCD played a crucial role in the integrity of mitochondrial function (Additional file 1: Fig. S4B, C). In mitochondria, activation of β-oxidation increases the ATP production by upregulation of the biogenesis. Moreover, ATP is necessary to reinforce the actin polymerization by stabilization the capping [44]. To determine actin polymerization was regulated by SCD-mediated β-oxidation, subclones of H460 cells were treated with the β-oxidation inhibitor, etomoxir (Eto). In SCD-pCDH cells, treatment with Eto suppressed ATP production and expression of F-actin, but increased p-cofilin (Fig. 5E, F). The level of ATP was lower in SCD-KO cells than parental cells, and were not affected by Eto treatment in these subclones. Additionally, Eto treatment suppressed the translocation of YAP in nuclei of SCD-pCDH cells (Additional file 1: Fig. S4D).
SCD promoted tumorigenesis in a mouse xenograft model
Parental, SCD-KO, or SCD-pCDH subclones of H460 cells were subcutaneously injected into immunodeficient mice, respectively. After four weeks, the tumor size was significantly larger in mice injected with SCD-pCDH cells than those with other subclones (Fig. 6A). Furthermore, tumors generated from SCD-KO cells were smaller than those from parental cells. Histologically, a large amount of lipids was detected not only within cancer cells, but also in the extracellular space of the tumor tissues generated from SCD-pCDH cells, whereas lipids were not observed in the tumor tissues from parental or SCD-KO cells (Fig. 6B). The SCD expression was higher in xenografted tumors produced by SCD-PCDH cells, than in those from parental cells, whereas its expression was not detected in tumors from SCD-KO cells (Additional file 1: Fig. S5A). Additionally, high level of lipids was also detected in the stromal cells. Additionally, aggressive features of cancer cells were observed in the SCD-pCDH subclone-derived tumor, as characterized by numerous mitotic figures, multiple large nucleoli, and necrosis (Fig. 6B). Tumor tissue generated from parental cells showed tumor cells arranged in solid sheet and glandular structures. In contrast, tumors derived from the SCD-KO subclone were encapsulated and had diffuse glandular structures. YAP fluorescence was faintly detected in the cytoplasm of cancer cells in parental or SCD-KO cell-derived tumors, whereas high levels of fluorescence were detected in the nuclei of cancer cells in SCD-pCDH cell-derived tumors (Fig. 6C). The YAP staining in the nucleus was higher in SCD-pCDH cell-derived tumors than that in parental and SCD-KO cells (Additional file 1: Fig. S5B).
To further assess the value of SCD expression as a prognostic biomarker of survival rate, Kaplan–Meier plots were implemented for patients with lung adenocarcinoma with follow-up analysis for 200 months (http://kmplot.com/analysis/index.php?p=service&cancer=lung). The analysis revealed that 1925 lung cancer and 719 adenocarcinoma patients with low expression of SCD had longer overall survival (OS), progression-free survival (PFS), and post-progression survival (PPS) than the patients with high expression of SCD (Fig. 6D). Specifically, the median PFS in lung cancer and adenocarcinoma patients with low SCD expression was 27.14 and 41.4 months, respectively, and was 12.1 and 18.63 months, respectively, in patients with high SCD expression. The Cancer Genome Atlas (TCGA) data [45] revealed that the lung adenocarcinoma patients with high SCD expression had lower survival rate than the patients with low SCD expression (Additional file 1: Fig. S5C). Likewise, Immunohistochemistry (IHC) for SCD expression on human lung tissue array revealed that the mean intensity score of SCD staining was higher in adenocarcinoma compared with normal lung tissue, and was positively associated with increase of tumor grade and clinical stage (Fig. 6E, F). Indeed, the percentage of SCD positive cells was increased with the grade and stage in lung adenocarcinoma tissues (Additional file 1: Fig. S5D).
Discussion
Functional changes of non-cancerous stromal cells influence cancer cell malignancy. CAFs are the main component of the tumor stroma and interact with cancer cells via direct or indirect crosstalk within the tumor microenvironment [46]. Mediators released from the CAFs contribute to cancer cell growth and chemoresistance [11, 47, 48]. The present study revealed that CAFs significantly increased the synthesis of OA that was transferred to neighboring cancer cells. Moreover, the CAF-derived OA enhanced cancer cell stemness via upregulation of SCD and downstream signaling pathways in In vitro and In vivo models.
Compared with NFs, lipid metabolism is significantly enhanced in CAFs [2, 49]. Our study also showed that the lipid metabolism was reprogrammed to increase the OA in CAFs under glucose deficient condition through activation of SCD. Furthermore, we found that the OA released from the CAFs was transferred to the lung adenocarcinoma cells through the lipid transporters. Analogously, our xenograft model revealed that lipid was predominantly detected in CAFs and its concentration was higher in the areas near CAFs. Our data indicated that OA derived from CAFs contributed to the reprogramming of lipid metabolism in cancer cells.
Unlike normal tissue, tumor growth requires a massive supply of glucose and oxygen for ATP production, resulting in glucose-deficient conditions [11, 50]. In turn, glucose deficiency modifies mitochondrial activity that affects the cancer cell phenotype [51]. Moreover, glucose starvation attenuates the response to cisplatin-based chemotherapy by upregulation of AMPK [52, 53]. Under glucose-deficient condition, lipid metabolism is activated by the autophagic response in cancer cells, which functions as an alternative energy source [54]. We demonstrated that autophagy and lipid metabolism were highly activated in lung adenocarcinoma cells by OA-transferred from CAFs under glucose-deficient condition. Additionally, we showed that SCD is essential for autophagosome maturation, particularly in the fusion with lysosomes. In line with our results, previous study reported that silencing of SCD interferes the fusion of autophagosome and lysosome [55]. Furthermore, we revealed that autophagosome synthesis regulated the SCD expression in cancer cells under the glucose deficient condition. The importance and detailed mechanisms involved in SCD regulation by autophagosome are limited and warrant further investigation.
Growing body of evidence indicates that CSCs exbibit a self-renewal capacity and express stemness markers like OCT4, NANOG and SOX2. And their stemness properties are maintained by intracellular mechanisms such as Wnt/β-catenin and Hippo pathways. Recent studies have shown that increased expression of SCD is correlated with cancer malignancy and promotes cancer stemness [27, 56]. It was shown that the chemical inhibitor of SCD suppressed tumor growth in mouse model [57]. In lung adenocarcinoma, an effector of Hippo pathway, YAP, plays a crucial role in the maintenance of stemness by physical interaction with Sox2 and Oct4 [58]. Nuclear translocation of YAP is essential for the maintenance of stemness, which is mediated by F-actin polymerization [59]. Expression of F-actin is significantly suppressed by SCD-inhibitor in lung adenocarcinoma [60]. Thus far, the molecular mechanism involved in SCD regulation of F-actin formation and nuclear YAP translocation was not comprehensively understood. Our study demonstrated that ATP production by β-oxidation was significantly increased in SCD-overexpressing cancer cells and was provided as a fuel for F-actin polymerization and nuclear translocation of YAP. Moreover, our xenograft model using cancer cell subclones with manipulated SCD expression also supported the role of SCD in the maintenance of CSC properties. The SCD-overexpressing subclones produced larger tumor masses that comprised of more malignant cells with higher level of nuclear YAP than those from the parental or KD subclones. Our data indicated that activation of the lipid metabolism by SCD is critical for the maintenance of stemness of cancer cells under glucose deficient condition.
The present study also explored the clinical relevance of SCD expression in lung cancer patients. Our data indicated that SCD expression was negatively correlated with survival rate in patients with lung adenocarcinomas. Moreover, SCD expression levels were increased along with tumor grade and stage, but was not detected in normal lung tissue. Previous reports showed that SCD expression was associated with stemness markers, such as CD24, CD133, SOX2, and CD44 [29, 61]. Collectively, our data indicate that increased level of SCD is associated with aggressiveness and poor prognosis of lung adenocarcinoma.
Taken together, our study illustrates that high level of OA in CAF-supernatant is transferred to lung adenocarcinoma cells via lipid transporter and reprograms the lipid metabolism by upregulated SCD under glucose-deficient conditions. Furthermore, the increased SCD expression augments stemness of cancer cell through actin-polymerization and subsequent YAP nuclear translocation. Clinically, high level of SCD expression is associated with poor prognosis in lung cancer patients. These findings suggest that regulation of the lipid metabolism by targeting SCD could be a potential way to develop clinically relevant therapies.