Abstract PR010: DICER1 cancer predisposition tumor promotion mediated non-cell autonomously via neutrophils and NETosis
Authors: Larsen Randolph K , Hanna Jason A , Jin Hongjian , Reed Kristen B , Kimbrough Darden W , Voung Kyna , Evans Myron K , Langdon Casey G , Drummond Catherine J , Garcia Matthew R , Finkelstein David , Schreiner Patrick A , Rehg Jerold E , Ann P Schultz Kris , Hatley Mark E 
Published: November 2024

Abstract
DICER1 cancer predisposition syndrome is a heritable condition where affected patients have increased risk of neoplasms including fusion-negative rhabdomyosarcoma (FN-RMS). The syndrome is defined by germline heterozygous loss of function mutations in DICER1, but it remains unclear exactly how these mutations predispose children to cancer. To gain insight into the role of Dicer1 loss in DICER1 cancer predisposition, we deleted the Dicer1 gene both in the germline or conditionally within the tumor cell in our previously established mouse model of FN-RMS. One would expect the germline loss of one allele to provide a sensitized background in the tumor cell to acquire a second hit mutation. However, we observed faster tumor onset and increased penetrance in mice with germline heterozygous Dicer1 loss (Dicer1 +/- ) but not in mice when Dicer1 loss was restricted to the tumor cells (Dicer1 Flox/+ ), demonstrating that haploinsufficient tumor suppressor activity of Dicer1 loss requires non-cell autonomous cell types. Single cell RNA sequencing (scRNA-Seq) revealed significant expansion of immature neutrophils in Dicer1 +/- tumors, which were enriched for proteases associated with neutrophil extracellular traps (NETs). NETs are webs of chromatin and proteases released when neutrophils in response to inflammatory stimuli in process termed NETosis. We show Dicer1 +/- murine and human tumors are enriched for neutrophils and tumor-bearing mice had abundant circulating NETs. NETs cause significant damage to the local extracellular matrix (ECM) and have been implicated in tumor promotion. In addition, neutrophil enrichment, we found that Dicer1 +/- tumors show significant ECM remodeling and are increased C5a, a potent neutrophil chemoattractant and NET-priming factor. These results suggest NETosis is upregulated in Dicer1 +/- FN-RMS tumors. Ligand-receptor pair analysis (iTALK) on the scRNA- Seq data revealed a putative interaction between a NET-derived ligand and EGFR and IGF1R on tumor cells, suggesting direct tumor promoting signaling from NET-to-tumor. We validated this novel FN-RMS promotion mechanism in vitro using human FN-RMS cell lines and observed that this NET-derived ligand promoted FN-RMS growth through both EGFR and IGF1R signaling. NET release requires citrullination of histone H3 mediated by peptidyl arginine deiminase 4 (PADI4) to facilitate decondensation of chromatin. We intercrossed the Padi4 -/- allele into our tumor model to genetically block NETosis and observed complete rescue of the accelerated tumor onset and increased penetrance observed in Dicer1 +/- mice. These results demonstrate that NETosis promotes the growth of Dicer1 +/- FN-RMS tumors and is required for Dicer1 +/- haploinsufficiency. These findings may be applicable to many DICER1 syndrome- associated cancers, as neutrophils which get converted to tumor promoters by heterozygous DICER1 loss are present in DICER1 syndrome patients regardless of tumor type and suggest targeting neutrophils/NET-release may reduce cancer risk in DICER1 +/- individuals.
Citation Format: Randolph K Larsen, Jason A Hanna, Hongjian Jin, Kristen B Reed, Darden W Kimbrough, Kyna Voung, Myron K Evans, Casey G Langdon, Catherine J Drummond, Matthew R Garcia, David Finkelstein, Patrick A Schreiner, Jerold E Rehg, Kris Ann P Schultz, Mark E Hatley. DICER1 cancer predisposition tumor promotion mediated non-cell autonomously via neutrophils and NETosis [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: RNAs as Drivers, Targets, and Therapeutics in Cancer; 2024 Nov 14-17; Bellevue, Washington. Philadelphia (PA): AACR; Mol Cancer Ther 2024;23(11_Suppl):Abstract nr PR010.