Kynureninase Upregulation Is a Prominent Feature of NFR2-Activated Cancers and Is Associated with Tumor Immunosuppression and Poor Prognosis

Author:

León-Letelier Ricardo A.1ORCID,Abdel Sater Ali H.1ORCID,Chen Yihui1ORCID,Park Soyoung1,Wu Ranran1ORCID,Irajizad Ehsan2,Dennison Jennifer B.1,Katayama Hiroyuki1ORCID,Vykoukal Jody V.1,Hanash Samir1,Ostrin Edwin J.3ORCID,Fahrmann Johannes F.1

Affiliation:

1. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

3. Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

Abstract

The nuclear factor erythroid 2-related factor 2 (NRF2) pathway is frequently activated in various cancer types. Aberrant activation of NRF2 in cancer is attributed to gain-of-function mutations in the NRF2-encoding gene NFE2L2 or a loss of function of its suppressor, Kelch-like ECH-associated protein 1 (KEAP1). NRF2 activation exerts pro-tumoral effects in part by altering cancer cell metabolism. Previously, we reported a novel mechanism of NRF2 tumoral immune suppression through the selective upregulation of the tryptophan-metabolizing enzyme kynureninase (KYNU) in lung adenocarcinoma. In the current study, we explored the relevance of NRF2-mediated KYNU upregulation across multiple cancer types. Specifically, using a gene expression dataset for 9801 tumors representing 32 cancer types from The Cancer Genome Atlas (TCGA), we demonstrated that elevated KYNU parallels increased gene-based signatures of NRF2-activation and that elevated tumoral KYNU mRNA expression is strongly associated with an immunosuppressive tumor microenvironment, marked by high expression of gene-based signatures of Tregs as well as the immune checkpoint blockade-related genes CD274 (PDL-1), PDCD1 (PD-1), and CTLA4, regardless of the cancer type. Cox proportional hazard models further revealed that increased tumoral KYNU gene expression was prognostic for poor overall survival in several cancer types, including thymoma, acute myeloid leukemia, low-grade glioma, kidney renal papillary cell carcinoma, stomach adenocarcinoma, and pancreatic ductal adenocarcinoma (PDAC). Using PDAC as a model system, we confirmed that siRNA-mediated knockdown of NRF2 reduced KYNU mRNA expression, whereas activation of NFE2L2 (the coding gene for NRF2) through either small-molecule agonists or siRNA-mediated knockdown of KEAP1 upregulated KYNU in PDAC cells. Metabolomic analyses of the conditioned medium from PDAC cell lines revealed elevated levels of KYNU-derived anthranilate, confirming that KYNU was enzymatically functional. Collectively, our study highlights the activation of the NRF2–KYNU axis as a multi-cancer phenomenon and supports the relevance of tumoral KYNU as a marker of tumor immunosuppression and as a prognostic marker for poor overall survival.

Funder

MD Anderson Moonshot project

The American Lung Association

Lyda Hill Foundation

MDACC histology core

The University of Texas MD Anderson Cancer Center Duncan Family Institute for Cancer Prevention and Risk Assessment

University of Texas MD Anderson Cancer Center Moonshot Program

American Lung Association Lung Cancer Discovery Award

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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