Cancer immunotherapy has revolutionized the paradigm for the clinical management of cancer. While FDA-approved cancer immunotherapies thus far mainly exploit the adaptive immunity for therapeutic efficacy, there is a growing appreciation for the importance of innate immunity in tumor cell surveillance and eradication. The past decade has witnessed macrophages being thrust into the spotlight as critical effectors of an innate anti-tumor response. Promising evidence from preclinical and clinical studies have established targeting macrophage phagocytosis as an effective therapeutic strategy, either alone or in combination with other therapeutic moieties. Here, we review the recent translational advances in harnessing macrophage phagocytosis as a pivotal therapeutic effort in cancer treatment. In addition, this review emphasizes phagocytosis checkpoint blockade and the use of nanoparticles as effective strategies to potentiate macrophages for phagocytosis. We also highlight chimeric antigen receptor macrophages as a next-generation therapeutic modality linking the closely intertwined innate and adaptive immunity to induce efficacious anti-tumor immune responses.

Metabolism is an essential part of life that provides energy for cell growth. During metabolic flux, reactive electrophiles are produced that covalently modify macromolecules, leading to detrimental cellular effects. Methylglyoxal (MG) is an abundant electrophile formed from lipid, protein, and glucose metabolism at intracellular levels of 1–4 μM. MG covalently modifies DNA, RNA, and protein, forming advanced glycation end products (MG-AGEs). MG and MG-AGEs are associated with the onset and progression of many pathologies including diabetes, cancer, and liver and kidney disease. Regulating MG and MG-AGEs is a potential strategy to prevent disease, and they may also have utility as biomarkers to predict disease risk, onset, and progression. Here, we review recent advances and knowledge surrounding MG, including its production and elimination, mechanisms of MG-AGEs formation, the physiological impact of MG and MG-AGEs in disease onset and progression, and the latter in the context of its receptor RAGE. We also discuss methods for measuring MG and MG-AGEs and their clinical application as prognostic biomarkers to allow for early detection and intervention prior to disease onset. Finally, we consider relevant clinical applications and current therapeutic strategies aimed at targeting MG, MG-AGEs, and RAGE to ultimately improve patient outcomes.

Evasion of immunosurveillance is critical for cancer initiation and development. The expression of “don’t eat me” signals protects cancer cells from being phagocytosed by macrophages, and the blockade of such signals demonstrates therapeutic potential by restoring the susceptibility of cancer cells to macrophage-mediated phagocytosis. However, whether additional self-protective mechanisms play a role against macrophage surveillance remains unexplored. Here, we derived a macrophage-resistant cancer model from cells deficient in the expression of CD47, a major “don’t eat me” signal, via a macrophage selection assay. Comparative studies performed between the parental and resistant cells identified self-protective traits independent of CD47, which were examined with both pharmacological or genetic approaches in in vitro phagocytosis assays and in vivo tumor models for their roles in protecting against macrophage surveillance. Here we demonstrated that extracellular acidification resulting from glycolysis in cancer cells protected them against macrophage-mediated phagocytosis. The acidic tumor microenvironment resulted in direct inhibition of macrophage phagocytic ability and recruitment of weakly phagocytic macrophages. Targeting V-ATPase which transports excessive protons in cancer cells to acidify extracellular medium elicited a pro-phagocytic microenvironment with an increased ratio of M1-/M2-like macrophage populations, therefore inhibiting tumor development and metastasis. In addition, blockade of extracellular acidification enhanced cell surface exposure of CD71, targeting which by antibodies promoted cancer cell phagocytosis. Our results reveal that extracellular acidification due to the Warburg effect confers immune evasion ability on cancer cells. This previously unrecognized role highlights the components mediating the Warburg effect as potential targets for new immunotherapy harnessing the tumoricidal capabilities of macrophages.

Root parasitic weeds in Orobanchaceae pose a tremendous threat to agriculture worldwide. We used an in vitro assay to screen libraries of small molecules for those capable of inhibiting or enhancing haustorium development in the parasitic plant Triphysaria versicolor. Several redox-modifying molecules and one structural analog of 2,6-dimethoxybenzoquine (DMBQ) inhibited haustorium development in the presence of the haustorium-inducing factor DMBQ, some of these without apparent growth inhibition to the root. Triphysaria seedlings were able to acclimate to some of these redox inhibitors. Transcript levels of four early-stage haustorium genes were differentially influenced by inhibitors. These novel haustorium inhibitors highlight the importance of redox cycling for haustorium development and suggest the potential of controlling parasitic weeds by interrupting early-stage redox-signaling pathways.

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Extracellular vesicles (EVs) encompass a diverse set of membrane-derived particles released from cells and are found in numerous biological matrices and the extracellular space. Specific classes of EVs include apoptotic bodies, exosomes, and microvesicles, which vary in their size, origin, membrane protein expression, and interior cargo. EVs provide a mechanism for shuttling cargo between cells, which can influence cell physiology by transporting proteins, DNA, and RNA. EVs are an abundant component of the tumor microenvironment (TME) and are proposed to drive tumor growth and progression by communicating between fibroblasts, macrophages, and tumor cells in the TME. The cargo, source, and type of EV influences the pro- or anti-tumoral role of these molecules. Therefore, robust EV isolation and characterization techniques are required to ensure accurate elucidation of their association with disease. Here, we summarize different EV subclasses, methods for EV isolation and characterization, and a selection of current clinical trials studying EVs. We also review key studies exploring the role and impact of EVs in the TME, including how EVs mediate intercellular communication, drive cancer progression, and remodel the TME.

Triphysaria is a facultative parasitic plant in the Orobanchaceae that parasitizes the roots of a wide range of host plants including Arabidopsis , Medicago , rice and maize. The important exception to this broad host range is that Triphysaria rarely parasitize other Triphysaria . We explored self and kin recognition in Triphysaria versicolor and showed that exudates collected from roots of host species, Arabidopsis thaliana and Medicago truncatula , induced haustorium development when applied to the roots of Triphysaria seedlings in vitro while those collected from Triphysaria did not. In mixed exudate experiments, Triphysaria exudates did not inhibit the haustorium-inducing activity of those from host roots. Interestingly, when roots of Triphysari a seedlings were treated with either horseradish peroxidase or fungal laccase, the extracts showed haustorium-inducing factor (HIF) activity, suggesting that Triphysaria roots contain the proper substrates for producing HIFs. Transgenic Triphysaria roots overexpressing a fungal laccase gene TvLCC1 showed an increased responsiveness to a known HIF, 2,6-dimethoxy benzoquinone (DMBQ), in developing haustoria. Our results indicate kin recognition in Triphysaria is associated with the lack of active HIFs in root exudates. Treatment of Triphysaria roots with enzymatic oxidases activates or releases molecules that are HIFs. This study shows that exogenously applied oxidases can activate HIFs in Triphysaria roots that had no previous HIF activity. Further studies are necessary to determine if differential oxidase activities in host and parasite roots account for the kin recognition in haustorium development.

Diabetic kidney disease (DKD) affects over 30% of individuals with T1D, significantly increasing mortality risk in this population. Canonical tools to predict DKD such as glomerular filtration rate (GFR) or albumin excretion rate (AER) alone may not be sufficient to predict disease risk, as they often do not become apparent until significant kidney damage has already occurred. Therefore, there is an unmet need to identify additional clinically useful biomarkers to predict DKD risk. Methylglyoxal (MG) is an abundant, reactive electrophile produced during metabolic flux from glycolysis and protein and lipid metabolism. MG covalently modifies macromolecules such as DNA, RNA, and protein forming MG-advanced glycation end products (MG-AGEs). Both MG and MG-AGEs have been correlated with diabetes and cancer, but the ability of nucleoside MG-AGEs to predict DKD risk has not been examined. Using a novel mass spectrometry method, we measured levels of MG-AGEs in patient urinary samples collected from the DCCT/EDIC study and found MG-AGEs independently predicted DKD risk up to 16 years pre-diagnosis. This association was more significant than the association of AER, GFR, or HbA1c with DKD. In DKD, endothelial cells (ECs) become dysfunctional, which contributes to the development of the disease. To understand the extent to which MG-AGEs impact EC dysfunction, we synthesized pure MG-AGEs and exposed human umbilical vein endothelial cells (HUVECS) to these compounds. We found MG-AGEs activated pathways associated with the receptor for AGEs (RAGE) and EC dysfunction as evidenced by increased leukocyte adhesion, oxidative stress, pro-inflammatory gene expression, and NFkB activation. This suggests that MG-AGEs are not only predictive of DKD, but may also contribute to EC dysfunction preceding disease. Disclosure S.Lai: None. E.D.J.Lopez gonzalez: None. S.Shuck: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (X01DK118575); National Institutes of Health (1R21DK127285); Wanek Family Project to Cure T1D; Diabetes Complications Consortium