Role of Kupffer cells in the progression of CRC liver metastases after the first stage of ALPPS

Sci Rep. 2018 May 24;8(1):8089. doi: 10.1038/s41598-018-26082-4.

Abstract

Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been suggested as a potential therapy for extensive bilobar liver tumors, although in some circumstances this technique may induce tumor progression, a fact still not well studied. Our aim was to study tumor hepatic progression induced by the first step of ALPPS in a WAG/Rij rat syngenic model of metastatic colorectal carcinoma by subcapsular CC531 cell line inoculation. ALPPS induced: tumor progression on deportalized lobe and metastases; expression of hepatic vasculogenic factors (HIF1-α and VEGF); and a dramatic increase of Kupffer cells (KCs) and tumor-associated macrophages (TAMs). Interestingly, KCs expressed COX-2 (M1 polarization), while TAMs expressed mainly arginase-1 (M2 polarization). ALPPS also induced a decrease of tumor-infiltrating lymphocytes and an increase of intrahepatic T lymphocytes. Thus, ALPPS technique seems to induce a hypoxic environment, which enhances hepatic HIF1-α and VEGF expression and may promote KCs and TAMs polarization. Consequently, the regenerative stimulus seems to be driven by a pro-inflammatory and hypoxic environment, in which M1 intrahepatic macrophages expressing COX-2 and T-Lymphocytes play a key role, facts which may be related with the tumor progression observed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / therapy
  • Animals
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / therapy
  • Disease Progression
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Kupffer Cells / pathology
  • Kupffer Cells / physiology*
  • Ligation
  • Liver / pathology
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Macrophages / pathology
  • Macrophages / physiology
  • Male
  • Portal Vein / surgery
  • Postoperative Period
  • Rats
  • Treatment Failure
  • Tumor Cells, Cultured