The Anti-fibrosis drug Pirfenidone modifies the immunosuppressive tumor microenvironment and prevents the progression of renal cell carcinoma by inhibiting tumor autocrine TGF-β

Cancer Biol Ther. 2022 Dec 31;23(1):150-162. doi: 10.1080/15384047.2022.2035629.

Abstract

Transforming growth factor-β (TGF-β) plays a critical role in regulating cell growth and differentiation. Epithelial to mesenchymal transition (EMT) induced by TGF-β promotes cancer cell migration, invasion, and proliferation. Pirfenidone (5-methyl-1-phenyl-2(1 H)-pyridone, PFD), an approved drug for treating pulmonary and renal fibrosis, is a potent TGF-β inhibitor and found reduced incidence of lung cancer and alleviated renal function decline. However, whether PFD plays a role in controlling renal cancer progression is largely unknown. In the present study, we demonstrated that high TGF-β1 expression was negatively associated with ten-year overall survival of patients with renal cancer. Functionally, blockade of TGF-β signaling with PFD significantly suppressed the progression of renal cancer in a murine model. Mechanistically, we revealed that PFD significantly decreased the expression and secretion of TGF-β both in vitro and in vivo tumor mouse model, which further prevented TGF-β-induced EMT and thus cell proliferation, migration, and invasion. Importantly, the downregulation of TGF-β upon PFD treatment shaped the immunosuppressive tumor microenvironment by limiting the recruitment of tumor-infiltrating MDSCs. Therefore, our study demonstrated that PFD prevents renal cancer progression by inhibiting TGF-β production of cancer cells and downstream signaling pathway, which might be presented as a therapeutic adjuvant for renal cancer.

Keywords: Pirfenidone; TGF-β; epithelial-to-mesenchymal transition; myeloid-derived suppressor cells (MDSC); renal cell carcinoma; tumor microenvironment (TME).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Carcinoma, Renal Cell* / drug therapy
  • Epithelial-Mesenchymal Transition
  • Female
  • Fibrosis
  • Humans
  • Kidney Neoplasms* / drug therapy
  • Male
  • Mice
  • Pyridones
  • Transforming Growth Factor beta
  • Transforming Growth Factor beta1 / metabolism
  • Tumor Microenvironment

Substances

  • Pyridones
  • Transforming Growth Factor beta
  • Transforming Growth Factor beta1
  • pirfenidone

Grants and funding

This work was supported by the Jiangsu Provincial Key Research and Development Program [BE2020641, BE2020640]; Jiangsu Provincial Medical Youth Talent [QNRC2016773]; National Natural Science Foundation of China [82072814, 81803080, 81871869]; Natural Science Foundation of Jiangsu Province [BK20161157, BK20180990]; Xuzhou Science and Technology Plan Project [KC16HG234]; Jiangsu Provincial Key Medical Discipline, The Project of Invigorating Health Care through Science, Technology and Education [CXTDA2017034, ZDXKA2016014]; Youth Technology Innovation Team of Xuzhou Medical University [TD202003]; Key Research Development project of Xuzhou [KC19082]; the Natural Science Key Project of Jiangsu Provincial Education Department [19KJA470001]; Post graduate Research & Practice Innovation Program of Jiangsu Province [KYCX18_2185]; Six Talent Peaks Project in Jiangsu Province [WSN-119].