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KLF4-dependent perivascular cell plasticity mediates pre-metastatic niche formation and metastasis

Nature Medicine volume 23, pages 1176–1190 (2017)Cite this article

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Abstract

A deeper understanding of the metastatic process is required for the development of new therapies that improve patient survival. Metastatic tumor cell growth and survival in distant organs is facilitated by the formation of a pre-metastatic niche that is composed of hematopoietic cells, stromal cells and extracellular matrix (ECM). Perivascular cells, including vascular smooth muscle cells (vSMCs) and pericytes, are involved in new vessel formation and in promoting stem cell maintenance and proliferation. Given the well-described plasticity of perivascular cells, we hypothesized that perivascular cells similarly regulate tumor cell fate at metastatic sites. We used perivascular-cell-specific and pericyte-specific lineage-tracing models to trace the fate of perivascular cells in the pre-metastatic and metastatic microenvironments. We show that perivascular cells lose the expression of traditional vSMC and pericyte markers in response to tumor-secreted factors and exhibit increased proliferation, migration and ECM synthesis. Increased expression of the pluripotency gene Klf4 in these phenotypically switched perivascular cells promoted a less differentiated state, characterized by enhanced ECM production, that established a pro-metastatic fibronectin-rich environment. Genetic inactivation of Klf4 in perivascular cells decreased formation of a pre-metastatic niche and metastasis. Our data revealed a previously unidentified role for perivascular cells in pre-metastatic niche formation and uncovered novel strategies for limiting metastasis.

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Figure 1: Perivascular phenotypic switching is activated in the pre-metastatic lung.
Figure 2: NG2-expressing pericytes are activated in the pre-metastatic lung.
Figure 3: Metastatic-tumor-derived factors promote activation of KLF4-dependent perivascular cell phenotypic switching.
Figure 4: Activated smooth muscle cells secrete KLF4-dependent fibronectin-containing ECM that promotes tumor adhesion, migration and proliferation.
Figure 5: Perivascular-cell-specific Klf4 deletion decreases metastasis.
Figure 6: Inhibition of tumor cell binding to fibronectin recapitulates perivascular KLF4-dependent metastasis.

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Acknowledgements

We thank K. McKinnon and C. Thiele for their advice, and Z. Liu, M. Kasai, J. Zhu and K. Bhatt for their technical assistance. This work was supported by the US National Institutes of Health (grants 1ZIABC011332-07, 1ZIABC011334-07, NIH HL057353 and NIH HL135018).

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Authors and Affiliations

  1. Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA

    Meera Murgai, Wei Ju, Matthew Eason, Jessica Kline, Daniel W Beury, Sabina Kaczanowska, Haiyan Lei, Jack F Shern & Rosandra N Kaplan

  2. Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

    Markku M Miettinen

  3. Experimental Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

    Michael Kruhlak

  4. Robert M. Berne Cardiovascular Research Center, School of Medicine, University of Virginia, Charlottesville, Virginia, USA

    Olga A Cherepanova & Gary K Owens

  5. Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, Virginia, USA

    Olga A Cherepanova

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  1. Meera Murgai
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Contributions

M.M. conducted most of the experiments, performed data analysis, generated most of the experimental mice and was the primary writer of the manuscript; W.J. conducted in vivo metastasis studies and in vitro matrix experiments, generated RNA for sequencing and analyzed exosomal content by western blot; M.E. conducted in vitro immunostaining and western blot experiments; J.K. assisted with the generation of experimental mice and conducted image analysis; D.W.B. and S.K. assisted with mouse experiments, and generated and analyzed flow cytometry data; M.M.M. analyzed pathological tissue specimens; M.K. assisted with confocal image acquisition, analysis and figure preparation; H.L. and J.F.S. analyzed RNA-seq data and assisted with figure preparation; O.A.C. and G.K.O. generated preliminary data, provided initial experimental mice and provided advice throughout; R.N.K. supervised the project and provided guidance on experimental design, data interpretation and writing of the manuscript.

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Correspondence to Rosandra N Kaplan.

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Murgai, M., Ju, W., Eason, M. et al. KLF4-dependent perivascular cell plasticity mediates pre-metastatic niche formation and metastasis. Nat Med 23, 1176–1190 (2017). https://doi.org/10.1038/nm.4400

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