Abstract 2518: Elucidating the impact of obesity and weight loss on breast cancer tumor progression
Authors: Wolf Elysa M. , Fingleton Barbara , Hasty Alyssa H. 
Published: June 2022

Abstract
Obesity is an established risk factor for breast cancer and worsened prognosis, however the mechanisms for this link have not been fully elucidated. Additionally, the consequence of weight loss (WL) prior to the diagnosis of cancer has not been fully explored. One possible link is via the immune system. Obesity is associated with metabolic dysfunction as well as inflammation of the adipose tissue. While WL is a great tool to combat metabolic dysfunction, we have shown that following WL the adipose tissue does not properly reprogram its immunophenotype and remains in a heightened inflammatory state.
Accompanying the heightened inflammatory state and increased immune infiltration found in obesity, a novel subset of macrophages termed “lipid associated macrophages” (LAMs) with high expression of triggering receptor expressed on myeloid cells 2 (Trem2) have been discovered in adipose tissue of obese mice and humans. Data from our lab shows LAMs are found at low levels in the adipose tissue of lean mice and enhanced in weight gain (WG) and WL mice. While other investigators have shown Trem2-expressing tumor associated macrophages contribute to immunosuppression in the tumor microenvironment, the implications of enhanced Trem2+ LAMs found in obesity and WL have not been explored in the context of cancer. The purpose of this study is to elucidate the impact of obesity and WL on breast cancer tumor progression.
Female mice were ovariectomized to model post-menopause and to enable greater weight gain. High fat diet (HFD) and low fat diet (LFD) feeding paradigms were used to produce three diet groups: lean, WG, and WL. Lean mice were maintained on LFD for the entirety of the study. WG mice were fed LFD for 12 weeks followed by HFD for 12 weeks. Mice in the WL group were fed HFD for 12 weeks to establish obesity and then fed LFD for 12 weeks to achieve WL. Four weeks prior to the end of the dietary paradigm, mice were injected with E0771 mammary cancer cells into the mammary fat pad.
We confirmed that obesity drives accelerated tumor growth progression resulting in significantly increased tumor mass. We found that WL results in an intermediate phenotype between the lean and obese models, suggesting WL may provide some protection to tumor growth, but does not restore the tumor-bearing host to the same level of protection as a consistently lean model.
We also demonstrated significantly increased gene expression of both Adgre1 (gene for F4/80) and Trem2 in obese ovarian and mammary adipose tissue compared to lean adipose tissue. Future studies will focus on understanding the mechanistic links between heightened inflammation in obese and WL adipose tissue and tumor progression. Additionally, we aim to elucidate the contribution of Trem2-expressing immune cells to tumor progression in the obese and WL contexts.
Citation Format: Elysa M. Wolf, Barbara Fingleton, Alyssa H. Hasty. Elucidating the impact of obesity and weight loss on breast cancer tumor progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2518.