Chemotherapy activates inflammasomes to cause inflammation-associated bone loss

Author:

Wang Chun1,Kaur Khushpreet1,Xu Canxin2,Abu-Amer Yousef34ORCID,Mbalaviele Gabriel1ORCID

Affiliation:

1. Division of Bone and Mineral Diseases, Washington University School of Medicine

2. Aclaris Therapeutics, Inc

3. Department of Orthopaedic Surgery, Washington University School of Medicine

4. Shriners Hospitals for Children

Abstract

Chemotherapy is a widely used treatment for a variety of solid and hematological malignancies. Despite its success in improving the survival rate of cancer patients, chemotherapy causes significant toxicity to multiple organs, including the skeleton, but the underlying mechanisms have yet to be elucidated. Using tumor-free mouse models, which are commonly used to assess direct off-target effects of anti-neoplastic therapies, we found that doxorubicin caused massive bone loss in wild-type mice, a phenotype associated with increased number of osteoclasts, leukopenia, elevated serum levels of danger-associated molecular patterns (DAMPs; e.g. cell-free DNA and ATP) and cytokines (e.g. IL-1β and IL-18). Accordingly, doxorubicin activated the absent in melanoma (AIM2) and NLR family pyrin domain containing 3 (NLRP3) inflammasomes in macrophages and neutrophils, causing inflammatory cell death pyroptosis and NETosis, which correlated with its leukopenic effects. Moreover, the effects of this chemotherapeutic agent on cytokine secretion, cell demise, and bone loss were attenuated to various extent in conditions of AIM2 and/or NLRP3 insufficiency. Thus, we found that inflammasomes are key players in bone loss caused by doxorubicin, a finding that may inspire the development of a tailored adjuvant therapy that preserves the quality of this tissue in patients treated with this class of drugs.

Funder

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Shriners Hospitals for Children

National Institute of Allergy and Infectious Diseases

National Institute on Aging

Publisher

eLife Sciences Publications, Ltd

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