Low protein diet induced anti-cancer immune response

Abstract : Several arguments from the literature suggested the importance of diets in cancer development and in the efficacy of anti-cancer therapies. Calorie restriction (CR) suppresses cancer growth in various animal models and sensitizes tumor cells to targeted therapies (Meynet & Ricci, 2014). Thus, non-pharmacologic approaches such as CR have a growing interest in the clinic. Considering the nutrient addiction of cancer cells, we wondered which specific macronutrients contribute the most to anti-cancer effects. Therefore, we tested the reduction in specific macronutrient without decrease in general calorie intake on tumor development. We used two diets: reduced in carbohydrates (Low CHO, -25% carbohydrates) and diet reduced in protein (Low PROT, -25% proteins) on the Eµ-Myc transgenic mouse model of B-cell lymphoma. Syngeneic C57BL/6 mice were intravenously injected with primary Eμ-Myc cells. We observed that low PROT-diet, in spite of equal calorie intake among the groups, resulted in increase of the overall survival of Eµ-Myc-bearing C57BL/6 mice. Very importantly, we established that this pro-survival effect is immune system-dependent as both depletion of CD8+ T cells and use of immunodeficient NSG (NOD-SCID il2rγ) mouse model prevented the beneficial effect of the low PROT-diet on the tumor development. We reproduced and further extended our observations using subcutaneous injection of CT26 colorectal cancer cells in syngeneic immunocompetent BALB/c mice and B16 melanoma in C57BL/6 mice. As tumor cells are highly dependent on nutrients, we speculated that low PROT diet could induce ER stress in tumor cells. Indeed, we observed increase in proteins implicated in ER stress signaling – CHOP and sXBP1. Therefore, we treated low PROT-diet fed mice with two ER stress inhibitors, the general inhibitor TUDCA or MKC4485, which targets IRE1 RNAse activity. In both cases, inhibitors significantly prevented the effect of the Low PROT-diet on tumor development and on intratumoral number of CD8+ T cells. To eliminate any side effects of chemical inhibitors, we invalidated IRE1 in CT26 cells and obtained similar results, demonstrating that IRE1 signaling in tumor cells is a central event in the low PROT-diet induced anti-cancer immune response. In addition, we have uncovered RIG-I activation as a downstream event of IRE1 activation and by bioinformatic analysis correlated high-IRE1 signature with high immune infiltration and enhanced immunogenicity of cancer in patients bearing melanoma, glioblastoma and colorectal cancer. Hence, we have shown that the immune system response elicited under a Low PROT diet is a consequence of increased IRE1 activation in cancer cells.
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Józef Piotr Bossowski. Low protein diet induced anti-cancer immune response. Cellular Biology. Université Côte d'Azur, 2018. English. ⟨NNT : 2018AZUR4105⟩. ⟨tel-02271707⟩

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