The current model for cancer development outlines a multistep process during which a cell acquires multiple genetic mutations. 1 However, several lines of investigation suggest that concomitant changes also occur in the surrounding tissue, with important consequences in the induction, selection and expansion of neoplastic cells. 2-4 Specific host factors available both locally, such as the stroma and surrounding normal cells, and distally, via humoral or diffusible factors, can provide the necessary information to create a permissive environment for malignant cell growth. 5,6 In particular, ECM composition and growth factor activity in the stroma can enhance the tumorigenicity of subsequently injected tumor cell lines. 7 Additionally, many malignancies can be initiated by infection, 8 -10 suggesting that cancer may arise in areas of inflammation as part of the normal host response. For instance, solid human tumors are often infiltrated by host immune and inflammatory cells. 11 Whereas increased levels of leukocyte infiltration into primary tumors are usually a good prognostic sign, 12 the presence of inflammatory cell infiltrates has been correlated with cytokine and growth factor production, which may provide a favorable microenvironment for neoplastic proliferation. [13][14][15][16] Clearance of apoptotic cells by phagocytes plays a significant role in the resolution of inflammation, 17 and although the lack of an inflammatory infiltrate is by definition a hallmark of death by apoptosis, several lines of investigation have challenged this concept. Indeed, apoptotic cells can evoke an inflammatory response depending on how apoptosis is initiated, in what cell type it occurs and whether or not particular cofactors are present. 18 -21 Considering that the nature of the microenvironment is one of several factors involved in the failure of tumor cells to proliferate, we tested whether apoptotic cells present in the host tissue environment could promote the growth of tumor cells in vivo. Results showed that (i) the presence of apoptotic cells in the tumor microenvironment positively modulates tumor take when the number of tumor cells alone is insufficient to produce tumors, (ii) injection of apoptotic cells induces an inflammatory response with an intense recruitment of neutrophils and macrophages and (iii) inflammatory cells recruited by apoptotic cells may be an important factor in promoting tumor engraftment when suboptimal concentrations of tumor cells are used. Taken together, our results provide new insights for the mechanisms underlying the microenvironment helper effect, with potential clinical implications for cancer therapy.
Material and methods
Cell culture, proliferation assay and reagentsThe murine melanocyte cell line melan-a (50th passage), 22 a kind gift of Dr. M. Rabinovitch (Discipline of Parasitology, Universidade Federal de São Paulo), was cultured in RPMI (pH 6.9) supplemented with 5% FCS and 200 nM 12-o-tetradecanoyl PMA (Sigma, St. Louis, MO). Tumor cell lines derived from melan-a (Tm1 and...