Citrullinated histone H3 as a novel prognostic blood marker in patients with advanced cancer

PLoS One. 2018 Jan 11;13(1):e0191231. doi: 10.1371/journal.pone.0191231. eCollection 2018.

Abstract

Citrullinated histone H3 (H3Cit) is a central player in the neutrophil release of nuclear chromatin, known as neutrophil extracellular traps (NETs). NETs have been shown to elicit harmful effects on the host, and were recently proposed to promote tumor progression and spread. Here we report significant elevations of plasma H3Cit in patients with advanced cancer compared with age-matched healthy individuals. These elevations were specific to cancer patients as no increase was observed in severely ill and hospitalized patients with a higher non-malignant comorbidity. The analysis of neutrophils from cancer patients showed a higher proportion of neutrophils positive for intracellular H3Cit compared to severely ill patients. Moreover, the presence of plasma H3Cit in cancer patients strongly correlated with neutrophil activation markers neutrophil elastase (NE) and myeloperoxidase (MPO), and the inflammatory cytokines interleukin-6 and -8, known to induce NETosis. In addition, we show that high levels of circulating H3Cit strongly predicted poor clinical outcome in our cohort of cancer patients with a 2-fold increased risk for short-term mortality. Our results also corroborate the association of NE, interleukin-6 and -8 with poor clinical outcome. Taken together, our results are the first to unveil H3Cit as a potential diagnostic and prognostic blood marker associated with an exacerbated inflammatory response in patients with advanced cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / chemistry
  • Case-Control Studies
  • Citrullination
  • Extracellular Traps / immunology
  • Extracellular Traps / metabolism
  • Female
  • Histones / blood*
  • Histones / chemistry
  • Humans
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Male
  • Middle Aged
  • Neoplasms / blood*
  • Neoplasms / immunology
  • Neoplasms / mortality
  • Neutrophil Activation
  • Neutrophils / immunology
  • Neutrophils / metabolism
  • Prognosis

Substances

  • Biomarkers, Tumor
  • CXCL8 protein, human
  • Histones
  • IL6 protein, human
  • Interleukin-6
  • Interleukin-8

Grants and funding

This work was supported by grants from the Helleday Foundation (CT), the Jochnick Foundation (CT), the Swedish Research Council (MP), Knut and Alice Wallenberg Foundation (MP), Ragnar Söderberg Foundation (MP), and OE and Edla Johansson Foundation (CS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.