Inflammation is a fundamental physiological response orchestrated by innate immune cells to restore tissue homeostasis. Specialized pro-resolving mediators (SPMs) are involved in active resolution of inflammation but when inflammation is incomplete, chronic inflammation creates a favorable environment that fuels carcinogenesis and cancer progression. Conventional cancer therapy also strengthens cancer-related inflammation by inducing massive tumor cell death that activate surrounding immune-infiltrating cells such as tumor-associated macrophages (TAMs). Macrophages are key actors of both inflammation and its active resolution due to their plastic phenotype. In line with this high plasticity, macrophages can be hijacked by cancer cells to support tumor progression and immune escape, or therapy resistance. Impaired resolution of cancer-associated inflammation supported by TAMs may thus reinforces tumor progression. From this perspective, recent evidence suggests that stimulating macrophage’s pro-resolving functions using SPMs can promote inflammation resolution in cancer and improve anticancer treatments. Thus, TAMs’ re-education toward an antitumor phenotype by using SPMs opens a new line of attack in cancer treatment. Here, we review SPMs’ anticancer capacities with special attention regarding their effects on TAMs. We further discuss how this new therapeutic approach could be envisioned in cancer therapy.

Inflammation stimulates release of a heterogeneous population of beta EV with differential expression of immunogenic substances involved in immune cell recruitment and activation. HIGHLIGHTS-Stress engenders an up to four-fold increase in the volume of the vesiculome and enhanced auto-antigen release-Cytokines are selectively sorted into EV subspecies-TLR-binding microRNAs are enriched in sEV-EV from stressed beta cells promote dendritic and macrophage cell activation.

Beta cell failure and apoptosis following islet inflammation have been associated with autoimmune type 1 diabetes pathogenesis. As conveyors of biological active material, extracellular vesicles (EV) act as mediators in communication with immune effectors fostering the idea that EV from inflamed beta cells may contribute to autoimmunity. Evidence accumulates that beta exosomes promote diabetogenic responses, but relative contributions of larger vesicles as well as variations in the composition of the beta cell's vesiculome due to environmental changes have not been explored yet. Here, we made side-by-side comparisons of the phenotype and function of apoptotic bodies (AB), microvesicles (MV) and small EV (sEV) isolated from an equal amount of MIN6 beta cells exposed to inflammatory, hypoxic or genotoxic stressors. Under normal conditions, large vesicles represent 93% of the volume, but only 2% of the number of the vesicles. Our data reveal a consistently higher release of AB and sEV and to a lesser extent of MV, exclusively under inflammatory conditions commensurate with a 4-fold increase in the total volume of the vesiculome and enhanced export of immune-stimulatory material including the autoantigen insulin, microRNA, and cytokines. Whilst inflammation does not change the concentration of insulin inside the EV, specific Toll-like receptor-binding microRNA sequences preferentially partition into sEV. Exposure to inflammatory stress engenders drastic increases in the expression of monocyte chemoattractant protein 1 in all EV and of interleukin-27 solely in AB suggesting selective sorting towards EV subspecies. Functional in vitro assays in mouse dendritic cells and macrophages reveal further differences in the aptitude of EV to modulate expression of cytokines and maturation markers. These findings highlight the different quantitative and qualitative imprints of environmental changes in subpopulations of beta EV that may contribute to the spread of inflammation and sustained immune cell recruitment at the inception of the (auto-) immune response.

Chronic inflammation is associated with abnormal non-phlogistic clearance (efferocytosis) of apoptotic cells by macrophages and a defect of the resolution of inflammation pathways. The resolution of inflammation is an active immunological process mediated by specialized pro-resolving mediator (SPM) which target specific resolutive G-protein coupled receptors expressed by different immune cells and participate to the tissue homeostasis return after an injury. Defects in the clearance of (chemotherapy-induced) apoptotic tumor cell debris strengthens inflammation and has been associated with exacerbated tumor growth in several preclinical models. Proresolutive therapeutic approaches, such as using exogenous resolvin E1 (RvE1), the natural lipidic proresolutive ligand of the GPCR ChemR23, have been shown to dampen tumor-associated inflammation and to reduce tumor growth. Using single-cell RNA sequencing analysis, we found that ChemR23 is mainly expressed by tumor-associated macrophages in melanoma and lung cancers. Moreover, ChemR23 expression was barely expressed in non-inflamed tissues indicating a preferential expression on the inflamed or tumor site. We screened and identified an anti-ChemR23 mAb which induces RvE1-like Akt and ERK signaling in mouse and human macrophages and favors macrophage polarization towards a pro-resolutive phenotype. In vitro, the agonist antibody significantly increased the phagocytosis of apoptotic tumor primary mesothelioma cells by human tumor-polarized macrophages. In vivo, the agonist ChemR23 mAb accelerates the resolution of inflammation in an acute inflammatory model, as illustrated by a significant decrease of inflammatory macrophages and neutrophils infiltrates as compared to isotype control groups both in mice and non-human primate models. Similarly, ChemR23 triggering with the anti-ChemR23 mAb improved weight recovery, reduced diarrhea and decreased the development of colon neoplastic foci in a chronic colitis model coupled with the injection of a carcinogen agent. Furthermore, the administration of the anti-ChemR23 mAb as a monotherapy displayed some partial and complete antitumor responses in immunocompetent mouse models of subcutaneous colon carcinoma (MC38 and CT26) as well as orthotopic mesothelioma (AK7). Finally, using an orthotopic triple-negative breast cancer model (4T1), while we observed a limited impact on primary tumor growth, spontaneous metastasis development in the lung was significantly inhibited by the ChemR23 agonist mAb monotherapy. Our study reveals for the first time the therapeutic potential of triggering the proresolutive pathways using an anti-ChemR23 agonistic mAb to limit chronic inflammation in the tumor microenvironment and inhibit metastasis development. Citation Format: Vanessa Gauttier, Margot Lavy, Charlène Trilleaud, Kévin Biteau, Isabelle Girault, Lyssia Belarif, Géraldine Teppaz, Caroline Mary, Virginie Thépénier, Christophe Blanquart, Sophie Barillé-Nion, Nicolas Poirier. Triggering the resolution of inflammation with agonistic anti-ChemR23 antibody dampens inflammation-driven carcinogenesis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1766.