Background Asymmetric dimethylarginine (ADMA), which is significantly elevated in the plasma of cancer patients, is formed via intracellular recycling of methylated proteins and serves as a precursor for resynthesis of arginine. However, the cause of ADMA elevation in cancers and its impact on the regulation of tumor immunity is not known. Methods Three mouse breast cell lines (normal breast epithelial HC11, breast cancer EMT6 and triple negative breast cancer 4T1) and their equivalent 3D stem cell culture were used to analyze the secretion of ADMA using ELISA and their responses to ADMA. Bone marrow-derived macrophages and/or RAW264.7 cells were used to determine the impact of increased extracellular ADMA on macrophage-tumor interactions. Gene/protein expression was analyzed through RNAseq, qPCR and flow cytometry. Protein functional analyses were conducted via fluorescent imaging (arginine uptake, tumor phagocytosis) and enzymatic assay (arginase activity). Cell viability was measured via MTS assay and/or direct cell counting using Countess III FL system. Results For macrophages, ADMA impaired proliferation and phagocytosis of tumor cells, and even caused death in cultures incubated without arginine. ADMA also led to an unusual macrophage phenotype, with increased expression of arginase, cd163 and cd206 but decreased expression of il10 and dectin-1. In contrast to the severely negative impacts on macrophages, ADMA had relatively minor effects on proliferation and survival of mouse normal epithelial HC11 cells, mouse breast cancer EMT6 and 4T1 cells, but there was increased expression of the mesenchymal markers, vimentin and snail2, and decreased expression of the epithelial marker, mucin-1 in EMT6 cells. When tumor cells were co-cultured ex vivo with tumor antigen in vivo-primed splenocytes, the tumor cells secreted more ADMA and there were alterations in the tumor cell arginine metabolic landscape, including increased expression of genes involved in arginine uptake, metabolism and methylation, and decreased expression of a gene that is responsible for arginine demethylation. Additionally, interferon-gamma, a cytokine involved in immune challenge, increased secretion of ADMA in tumor cells, a process attenuated by an autophagy inhibitor. Conclusion Our results suggest initial immune attack promotes autophagy in tumor cells, which then secrete ADMA to manipulate macrophage polarization favoring tumor tolerance.

Macrophages are the most abundant tumor infiltrating immune cells and perform diverse immune functions including phagocytosis and incitation of T cells to mount an immune attack against tumors. However, the macrophage plasticity can lead to different outcomes of tumor progression and the amino acid, arginine, plays a central role in macrophage dichotomy. The exact role of arginine on the management of macrophage polarization is not completely understood. We have discovered that a methylated arginine metabolite, asymmetric dimethylarginine (ADMA), serves as an important regulator of macrophage functions. Upon stimulation by ADMA, macrophages have reduced survival and show a delayed tumor-phagocytic capacity. Additionally, ADMA blocks the Nitric Oxide Synthase (NOS) but not the Arginase activity in macrophages leading to a tendency of M2-like phenotype polarization. ADMA has minor effect on tumor cell proliferation but significantly drives the epithelial to mesenchymal transition. Tumor cells, particularly the tumor stem cells, are the major sources of ADMA. Production and secretion of ADMA by tumor (stem) cells profoundly increase when co-cultured with activated T cells or treated with T cell associated inflammatory cytokine, interferon-gamma (IFN-r). IFN-r initiates autophagy of tumor (stem) cells and inhibition of autophagy reduces the output of ADMA by tumor (stem) cells. Similarly, IFN-r enhances the proteasomal degradation and inhibition of the proteasomal pathway also reduces the ADMA production induced by IFN-r. In summary, our work shows that tumor (stem) cells may escape from immune surveillance (such as their exposure to activated T lymphocytes or to cytotoxic cytokine, IFN-r) through the secretion of ADMA generated via both autophagic and proteasomal pathways. Citation Format: Yiling Chen, AKaychia T. Lowery, Andres Becerril, Zaida T. Laventure, Shareda Ferguson, Kuan-Hui Ethan Chen. Tumor stem cell derived asymmetric dimethylarginine drives immune evasion via functional modulation of macrophages [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 3847.