Malignant pleural mesothelioma nodules remodel their surroundings to vascularize and grow

Kovacs, Ildiko and Bugyik, Edina and Dezso, Katalin and Tarnoki-Zach, Julia and Mehes, Elod and Gulyas, Marton and Czirok, Andras and Lang, Elisabeth and Grusch, Michael and Schelch, Karin and Hegedus, Balazs and Horvath, Ildiko and Barany, Nandor and Megyesfalvi, Zsolt and Tisza, Anna and Lohinai, Zoltan and Hoda, Mir Alireza and Hoetzenecker, Konrad and Pezzella, Francesco and Paku, Sandor and Laszlo, Viktoria and Dome, Balazs (2022) Malignant pleural mesothelioma nodules remodel their surroundings to vascularize and grow. Translational Lung Cancer Research, 11 (6). pp. 991-1008. ISSN 22186751

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Abstract

Background: The microanatomical steps of malignant pleural mesothelioma (MPM) vascularization and the resistance mechanisms to anti-angiogenic drugs in MPM are unclear. Methods: We investigated the vascularization of intrapleurally implanted human P31 and SPC111 MPM cells. We also assessed MPM cell’s motility, invasion and interaction with endothelial cells in vitro. Results: P31 cells exhibited significantly higher two-dimensional (2D) motility and three-dimensional (3D) invasion than SPC111 cells in vitro. In co-cultures of MPM and endothelial cells, P31 spheroids permitted endothelial sprouting (ES) with minimal spatial distortion, whereas SPC111 spheroids repealed endothelial sprouts. Both MPM lines induced the early onset of submesothelial microvascular plexuses covering large pleural areas including regions distant from tumor colonies. The development of these microvascular networks occurred due to both intussusceptive angiogenesis (IA) and ES and was accelerated by vascular endothelial growth factor A (VEGF-A)-overexpression. Notably, SPC111 colonies showed different behavior to P31 cells. P31 nodules incorporated tumor-induced capillary plexuses from the earliest stages of tumor formation. P31 cells deposited a collagenous matrix of human origin which provided “space” for further intratumoral angiogenesis. In contrast, SPC111 colonies pushed the capillary plexuses away and thus remained avascular for weeks. The key event in SPC111 vascularization was the development of a desmoplastic matrix of mouse origin. Continuously invaded by SPC111 cells, this matrix transformed into intratumoral connective tissue trunks, providing a route for ES from the diaphragm. Conclusions: Here, we report two distinct growth patterns of orthotopically implanted human MPM xenografts. In the invasive pattern, MPM cells invade and thus co-opt peritumoral capillary plexuses. In the pushing/desmoplastic pattern, MPM cells induce a desmoplastic response within the underlying tissue which allows the ingrowth of a nutritive vasculature from the pleura.

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