Role of Neutrophil PAD4 in Cancer Progression: Recent research has shed light on the role of neutrophil PAD4 in cancer progression, particularly in creating an immunosuppressive environment within tumors. This groundbreaking study, led by researchers Laura Garcia-Gerique and Yulia Nefedova from the Wistar Institute, has been published in Oncotarget and Cancer Research journals. The study identifies a novel mechanism by which neutrophil PAD4 promotes cancer progression, offering new avenues for therapeutic interventions.

Role of Neutrophil PAD4 in Cancer Progression- Cancer Research
The Mechanism: Neutrophil PAD4 and Myeloid-Derived Suppressor Cells (MDSC)
Neutrophil PAD4 is involved in the regulation of tumor progression through its impact on myeloid-derived suppressor cells (MDSC). These MDSCs, particularly pathologically activated neutrophils (PMN-MDSC), originate in the bone marrow and migrate to various sites, including tumor tissues.
They have a relatively short lifespan and are continually replaced from the bone marrow. These cells possess potent suppressive activity, inhibiting both antigen-specific immune responses of T cells and non-specific anti-CD3/CD28-stimulated responses. This creates a highly immunosuppressive environment within tumors, preventing their rejection via immunological mechanisms.
Beyond Immunosuppression: Facilitating Tumor Progression
In addition to their immunosuppressive role, PMN-MDSC employ non-immunological mechanisms to facilitate tumor progression. These include angiogenesis, remodeling of the extracellular matrix, and production of cytokines. In patients with solid tumors, levels of circulating MDSC have been positively associated with poor responses to therapy and represent an independent indicator of poor outcomes.
The New Discovery: Transcriptional Regulation of Neutrophil Migration
The study identified a new mechanism responsible for the transcriptional regulation of neutrophil migration. This new mechanism by which neutrophil PAD4 contributes to tumor progression opens up possibilities for therapeutic targeting. PAD4 inhibitors are currently in development and may enter early-phase clinical trials in the future.
The Enzymatic Activity of Neutrophil PAD4
The researchers used several transplantable and genetically engineered mouse models to demonstrate that tumor growth was accompanied by significantly elevated enzymatic activity of neutrophil PAD4.
This suggests that PAD4 is not just a bystander in the tumor microenvironment but actively contributes to the progression of the disease. The enzymatic activity of PAD4 could be a potential biomarker for assessing the aggressiveness of the tumor and the effectiveness of therapeutic interventions.
Targeted Deletion of PAD4 in Myeloid Cells
To further clarify the role of PAD4 in tumor progression, the researchers utilized PAD4fl/fl MRP8Cre mice with targeted deletion of PAD4 in myeloid cells, primarily neutrophils.
This allowed them to isolate the specific effects of PAD4 from other factors in the complex tumor microenvironment. The targeted deletion approach could be a precursor to more precise, personalized therapies that aim to disrupt PAD4 activity selectively.
Tumor-Infiltrating PMN-MDSC: A Double-Edged Sword
Tumor-infiltrating PMN-MDSC not only suppress immune responses but also employ non-immunological mechanisms like angiogenesis, extracellular matrix remodeling, and cytokine production to facilitate tumor progression.
This multi-faceted role makes them a challenging but promising target for cancer therapy. Understanding how to modulate these cells without compromising their essential functions in the body is a critical research question.
PAD4 Inhibitors: The Future of Cancer Therapy?
The study concludes with a note on the development of PAD4 inhibitors, which are expected to enter early-phase clinical trials soon. These inhibitors could serve as a new class of drugs that target the immunosuppressive and pro-tumorigenic activities of neutrophil PAD4.
If successful, PAD4 inhibitors could revolutionize the way we approach not just one but multiple types of cancer, offering a more effective and less toxic alternative to current therapies.
Broader Implications for Immuno-Oncology
The findings of this study have broader implications for the field of immuno-oncology. By targeting key regulators like PAD4, it may be possible to ‘re-educate’ the immune system to recognize and attack cancer cells more effectively.
This could pave the way for combination therapies that integrate PAD4 inhibition with other immunotherapeutic approaches, such as checkpoint inhibitors or CAR-T cell therapy, to achieve synergistic effects.
Conclusion: A Paradigm Shift in Cancer Treatment
The research on neutrophil PAD4 marks a significant step forward in our understanding of cancer progression and opens up new avenues for treatment. By targeting this key player in the tumor microenvironment, we move closer to a paradigm shift in cancer treatment, one that focuses on modulating the immune system to fight the disease more effectively.
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