Abstract 1057: Characterization and functional consequences of neuronal invasion in oral cancer
Authors: Scheff Nicole N. , Klares Richard , Schmidt Brian L. 
Published: August 2018

Abstract
Most oral cancer patients suffer severe, chronic pain promoted by oral cancer-induced changes in sensory nerves innervating the oral cavity. However, the impact of sensory neurons on carcinogenesis beyond nociceptive signaling is an understudied problem in oral cancer. We hypothesize that oral cancer and sensory neurons interact, such that, oral cancer induces sensitization, sprouting and plasticity in neurons, and efferent neuronal activity promotes oral carcinogenesis. Using an oral cancer subcutaneous xenograft model, we tested the impact of peripheral nerve presence on squamous cell carcinoma tumor growth in the mouse hindpaw. Mice that received a sciatic nerve axotomy one week prior to HSC-3 oral cancer cell inoculation developed significantly smaller tumors (28.23 ± 6.6 % of total paw area) compared to mice that received sham surgery (50.71 ± 2.48 %). These data suggest that peripheral neuron innervation supports oral cancer growth. Additionally, neuropeptides are released from primary afferent neurons and suppression of the immune response has been linked to peripheral neurotransmission. Using flow cytometry, we tested whether inhibition of peripheral sensory neurons impacted inflammation in response to oral cancer. Temporary nerve block with 1% bupivacaine injection into the lingual nerve prior to injection of supernatant from HSC-3 oral cancer cells resulted in significantly more CD45+ immune cell infiltration (21.66 ± 3.4 %) into the tongue compared to HSC-3 supernatant with intact nerve function (9.10 ± 1.2 %). These results suggest neuron-mediated suppression of cancer-evoked inflammation and support the premise that neurons and neuronal activity modulates the oral cancer microenvironment. High-resolution imaging of neuronal innervation into tongue cancer and its remodeling in response to pathological changes is challenging due to dense neuronal innervation in the tongue. We utilized a recently developed optical clearing protocol (CLARITY) that preserves protein integrity and three-dimensional structure of tissue and high-resolution microscopy to visualize and characterize sensory neuron innervation in thick 1 mm tongue sections from an orthotopic xenograft mouse model of oral cancer. In a preliminary study of neuronal innervation in a tongue HSC-3 xenograft model, we observed that PGP9.5+ neuronal fiber density was greater in the cancer environment and diminished with distance from the cancer. These data suggest that oral cancer induces plasticity and sprouting of innervating peripheral neurons. A better understanding of the nerve-cancer interaction has potential for development of new therapeutic strategies to treat oral cancer and oral cancer pain by targeting sensory neurons.
Citation Format: Nicole N. Scheff, Richard Klares, Brian L. Schmidt. Characterization and functional consequences of neuronal invasion in oral cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1057.