1. Introduction
Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related death and is expected to rise by 2030. At time of diagnosis, 80% of patients have advanced disease that is ineligible for surgical resection, and 50% have metastasized tumors, leaving PDAC patients with an overall survival of less than a year [
1,
2,
3]. FOLFIRONOX or gemcitabine plus albumin-bound paclitaxel is the first-line standard of care for PDAC patients, with a majority progressing to second-line treatment due to chemoresistance [
3,
4]. The extracellular matrix (ECM) in PDAC, which is characterized by desmoplasia due to excess production of collagens and hyaluronan (HA), is considered a major contributor to therapeutic resistance. Increased tissue rigidity, interstitial fluidic pressure, and dampened immune response are outcomes of the highly dense tumor stroma. Previous studies have shown that drug penetration is significantly hindered with increased collagen and HA, and depletion of ECM components leads to better drug perfusion and decreased tumor growth in PDAC models [
5,
6]. In addition to serving as a biophysical barrier, ECM components act as signaling molecules that influence immune responses within tumors. Excess collagen is linked to low CD8
+ T cell infiltration and has been proposed as a biomarker for immunotherapy resistance, while upregulation of HA production in tumor cells correlates with immunosuppressive macrophage phenotypes [
7,
8].
Collagen I is highly abundant in desmoplastic tumors and is a fibril-forming collagen that is crosslinked by LOXL2, a lysyl oxidase that is upregulated in PDAC. Excessive collagen crosslinking leads to fibrosis and a stiff ECM that enhances migration of tumor cells and promotes stem cell transformation [
9]. PDAC cell metabolism and proliferation is reliant on collagen I. For example, proline availability is regulated by collagen biosynthesis, and signaling through the DDR1-NFκB-p62-NRF2 cascade leads to changes in mitochondrial protein expression [
10,
11,
12]. Furthermore, PDAC cells use collagen I in an autocrine signaling loop to promote an immunosuppressive tumor microenvironment (TME) with limited T cell infiltration [
13]. Collagen IV is also abundant in PDAC and has been proposed as a serum biomarker, as tumor cells actively secrete collagen IV in both primary and metastatic tumors, forming irregular basement membrane-like structures [
14]. Type IV collagen in PDAC has been associated with metastasis and angiogenesis, and production of collagen IV allows tumor cells to secrete and anchor to their own basement membrane through integrin receptors, supporting tumor cell survival [
15]. Metastasis is often seen in murine models engrafted with cancer cell lines known to produce more collagen IV through interaction with integrins on tumor cell surfaces [
16]. In addition to collagens, HA overexpression is prevalent in a majority of PDAC patients, as well as a plethora of other cancers [
17]. Low molecular weight HA expressed by PDAC cells interacts with cell surface signaling molecules to increase proliferation through the TLR4 signaling cascade, and in turn increases lymphatic permeability, cell adhesion and matrix remodeling to facilitate metastasis, local inflammation and fibrosis [
18,
19]. Collagen I, collagen IV, and HA are abundant in PDAC stroma and are negatively correlated with patient survival and chemotherapeutic response [
20,
21], making these ECM proteins enticing therapeutic targets that may delay disease progression and increase susceptibility to chemo- and immunotherapy.
Collagenases and hyaluronidases, enzymes that degrade collagen and HA respectively, are being explored in preclinical and clinical studies to sensitize PDAC tumors to the immune system and increase permeability for therapeutic intervention [
22]. Bacterial collagenases were first studied and isolated from
Clostridium histolyticum due to their ability to degrade human tissue [
23,
24], while bacterial hyaluronidases were characterized by Karl Meyer in the 1970s for their pathological role [
25]. The FDA has approved use of bacterial collagenases and hyaluronidases for various diseases, including the localized treatment of solid tumors. Since collagen and HA play an important role in tissue integrity throughout the body, systemic administration is not a viable option and intratumoral injection for localized treatment remains challenging [
26,
27,
28]. To overcome these challenges, we previously showed that attenuated
Salmonella typhimurium engineered to express collagenase or hyaluronidase selectively colonize PDAC tumors in mice and degrade collagen or HA, respectively, to increase sensitivity to immuno- and chemotherapy [
29,
30].
To attain a synergistic effect with increased ECM degradation and decreased tumor progression, we have employed ColH, a collagenase isolated from
Clostridium histolyticum [
31], and HylB, a hyaluronidase found in
Streptococcus agalactiae [
32], in order to effectively degrade the ECM within solid PDAC tumors, and we have engineered
E.coli strain BL21 to express both ColH and HylB as a single inducible agent with tumor specificity (BL21-TAN). BL21-TAN efficiently colonizes tumors, expresses both enzymes, and depletes collagen and HA content in PDAC tumor models, leading to an enhanced therapeutic outcome when combined with chemotherapeutic treatment. We predict that BL21-TAN has the potential to serve as a combination treatment to increase sensitivity of PDAC tumors to both chemotherapy and immunotherapy, significantly improving the outcomes of patients diagnosed with PDAC.
2. Materials and Methods
Animals and Cell Lines
C57BL/6 and NOD/SCID gamma (NSG) mice were bred and housed at the City of Hope (COH) Biomedical Research Center (BRC). For all studies, animals were handled according to standard IACUC guidelines under an approved protocol. KPC cells were generously provided by Dr. Laleh Melstrom. The UPN cell line was generated at COH from de-identified patient PDAC resection. BxPC3 was obtained commercially from ATCC (CRL-1687). KPC and UPN cells were maintained in DMEM and BxPC3 in RPMI. Both medias contained 10% FBS, 2mM L-glutamine, 100 units/mL penicillin, and 100 μg/mL streptomycin. Prior to tumor cell engraftment, cells were passaged ≤5 times at ≤80% confluency.
E.coli Strains and Generation of BL21-TAN
BL21 (DE3) chemically competent E. coli was obtained from New England Biolabs and cultured in LB media. The ColH (Genbank Accession no. BAA34542) and HylB (Genbank Accession no. AAA56749.1) amino acid sequences were used to synthesize a codon-optimized cDNA sequences inserted into the NcoI site of the pBAD-His-A bacterial expression vector (Biomatik), with a c-Myc tag fused to ColH and a hexahistadine tag fused to HylB. In-frame insertion of TAN into the pBAD vector allowed for expression of ColH and HylB upon induction with L-arabinose. Plasmids were transformed into BL21 (DE3) and spread onto LB plates containing 100 μg/mL ampicillin and incubated overnight at 37°C. Positive clones were identified by colony PCR.
Bacterial Growth, Viability, and Analysis of TAN Expression
BL21-TAN was cultured in media with (induced, I) or without (uninduced, U) 0.1% L-arabinose at 37°C, 225 rpm for time intervals ranging from 2 to 24 h. ColH was detected in bacterial lysates by Western blot using a primary monoclonal mouse anti-Myc antibody (R&D). HylB was detected in bacterial lysates by Western blot using primary monoclonal goat anti-His antibody (R&D). Growth kinetics were monitored through absorbance readings at 600 nm (Genesys 30, Thermo Fisher Scientific) up to 24 h. For immunofluorescence, uninduced and induced BL21-TAN grown for ~4 h were fixed with 4% paraformaldehyde at room temperature (RT) for 30 minutes, and permeabilized with 0.1% Triton-X 100/PBS pH=7.2 at RT for 30 minutes followed by lysozyme (Sigma, 100 μg/mL final concentration in 5 mM EDTA) treatment at RT for 45 minutes. Fixed/permeabilized bacteria were incubated with primary antibody (1:100) for 30 minutes with shaking in a humidified 37°C incubator followed by incubation with FITC-conjugated anti-mouse secondary (1:200, Abcam) and DAPI for 30 minutes with shaking in a humidified 37°C incubator.
Fluorometric Substrate Assays
BL21-TAN was cultured under uninduced or induced conditions for 4 h at 37°C. To measure collagenase activity, substrates consisting of bovine skin collagen type I, human placenta collagen type IV, and pig skin gelatin conjugated to FITC (Thermo Fisher Scientific) were used. The reaction was started by the addition of BL21-TAN under uninduced or induced conditions. Hyaluronidase activity was measured using hyaluronan conjugated to FITC (Thermo Fisher Scientific). Fluorescence intensity was captured using an iBright FL1500 Imaging System (Thermo Fisher Scientific). Fluorescence intensity was quantified in relation to the BL21-TAN uninduced control condition using ImageJ (NIH).
Immunohistochemistry/Immunofluorescence (IHC/IF)
FFPE tumors from C57BL/6 or NSG mice were sectioned (5 μm), transferred to glass slides, deparaffinized, and rehydrated. To determine
in vitro enzymatic function, slides were treated with BL21-TAN uninduced or induced for 4 h. To examine
in vivo colonization, expression, and function, mice were treated with BL21-TAN or BL21-eGFP control prior to tumor collection. Slides were stained with trichrome and cover slipped. Hematoxylin and methyl blue channels were separated using color deconvolution, and thresholds were set to cover positive staining area for hematoxylin (red) and the raw integrated density was used to measure the density of collagen. To determine HA density, slides were stained with HA-binding protein (HABP). (Millipore Sigma) BL21 colonization was detected using a primary anti-BL21 lysate antibody (R&D), ColH was detected using a primary monoclonal mouse anti-Myc antibody (R&D), and HylB was detected using primary monoclonal goat anti-His antibody (R&D). Brightfield and fluorescent images were acquired with a 63x 1.4NA Plan-Apochromat objective (630x total magnification). Stitching was performed using ZEN 2.3 Pro (Blue) software (Carl Zeiss Inc.). Quantification of brightfield images was performed using ImageJ (NIH) and quantification of fluorescence intensity was performed using Quantitative Pathology & Bioimage Analysis (QuPath) software (v0.2.1, University of Edinburgh, Edinburgh, UK) [
33].
Tumor Implantation, Administration, and Induction of BL21-TAN
For all experiments, 6-8 week-old mice were used. 2x106 BxPC3 cells or 5x105 KPC cells were subcutaneously injected into the right flank of NSG mice or C57Bl/6 mice, respectively, in a volume of 100 μL PBS using a 27-gauge needle. Mice with palpable tumors (>150mm3) were intravenously injected with 5x107 colony-forming units (CFUs) BL21-TAN or BL21-eGFP control per day for three consecutive days. Forty-eight hours following final BL21 administration, protein expression was induced by administration of 40 mg L-arabinose through intraperitoneal route. Forty-eight hours following induction, tumors were collected and analyzed via IHC/IF staining for colonization, enzymatic expression, and enzymatic function.
Combination Treatment Studies with Gemcitabine
Following BL21 induction treatment as described above, mice were subsequently administered gemcitabine (15 mg/kg) or PBS 48 hours post-induction. Maintenance doses of gemcitabine or PBS control were administered every 3 days thereafter.
Statistics
All statistical analyses were performed using Prism software by GraphPad (v9). Data was analyzed by performing Student’s t-test and 2-way ANOVA. Unless otherwise indicated, all error bars represent the standard error of the mean.
4. Discussion
Desmoplasia is a hallmark of PDAC which leads to obstructed drug penetration and immunosuppression, making effective therapeutic treatment difficult in PDAC patients [
5,
6]. Tumor metabolism, survival and migration is promoted by abundant, aberrant collagen and HA in PDAC tumors [
9,
10,
11,
12,
18,
19]. For these reasons, depletion of collagen and HA are anticipated to serve as an effective therapeutic intervention for desmoplastic tumors [
35,
49]. Various different avenues for targeting the fibrotic ECM are being explored, such as inducing the apoptosis of cells responsible for ECM deposition, inhibiting collagen synthesis and collagen cross-linking, and HA degradation to decrease interstitial fluid pressure. However, these therapies have had limited success in clinical trials due to difficulties with targeted delivery of molecules, insufficient tumor regression and increased disease progression [
50,
51]. Therefore, development of tumor-targeting, ECM depleting treatments are necessary.
Collagen and HA are integral components of the ECM present in most tissues. Therefore, to achieve targeted treatment while limiting systemic toxicity, we, along with other groups, previously employed tumor-colonizing bacteria engineered to deliver ECM-degrading enzymes directly to the tumor [
29,
52,
53]. Here, we have engineered gram-negative bacteria to deliver both collagenase and hyaluronidase, as a single agent therapeutic, to PDAC tumor models. We show that the engineered bacteria successfully colonize murine models of PDAC tumors, express ECM-degrading enzymes, and deplete tumor-derived collagen and HA.
Degradation of ECM-proteins increased biomaterial diffusion and distribution in tumor-like spheroids
in vitro and intratumoral distribution
in vivo [
54,
55,
56,
57]. Therefore, we theorized that BL21-TAN pre-treatment would increase penetration of gemcitabine in PDAC tumors, following degradation of tumor ECM. We showed that tumor-bearing mice pre-treated with BL21-TAN followed by gemcitabine had increased survival and decreased tumor burden compared to mice treated with gemcitabine alone. This indicates that BL21-TAN pre-treatment increases efficacy of chemotherapy in PDAC models, most likely by creating a less fibrotic microenvironment which facilitated diffusion of gemcitabine.
Tumor-derived collagen and HA differ in function and structure compared to healthy tissue and contribute to the immunosuppressive TME in solid tumors. Leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1), an inhibitory receptor, binds to collagen in the TME and leads to decreased immune activation and decreased immune cell infiltration [
7,
58]. HA promotes the differentiation of tumor-associated macrophages, resulting in increased immunosuppression within the TME through PD-1/PD-L1 signaling. Dense ECM also leads to interstitial fluid flow toward tumor margins, leading to the expression of TGFβ in cancer-associated fibroblasts, which polarizes regulatory T cell and immunosuppressive macrophage phenotypes [
59,
60]. Furthermore, increased organ stiffness, due to desmoplasia, is correlated to a poor immunotherapeutic response and has been suggested as a prognostic marker for immunotherapeutic intervention [
61,
62]. Future studies might consider looking into the infiltration and activation status of immune cells following treatment with BL21-TAN, as there is evidence that fibrotic, tumor-associated ECM contributes to the immunosuppressive TME.
Figure 1.
Tandem Construct Design and Expression Analysis in BL21 E. Coli Transformants. (A) The synthesized sequence encoding for both bacterial collagenase (ColH) and hyaluronidase (HylB) were engineered with independent 5’ ribosomal binding sites (RBS) and fused to a myc or his tag, respectively. The sequence was cloned downstream of the inducible pBAD promoter in the pBAD/HIS A plasmid and then transformed into BL21 to generate BL21-TAN. (B) BL21-TAN cultures were grown to exponential phase (shaking at 37°C) and then left alone (uninduced, U) or induced (I) at a final concentration of 0.02% L-arabinose for 4 hours. Bacterial pellets and culture media (CM) were then subjected to western blot analysis to detect for expression of ColH (anti-Myc) and HylB (anti-His). (C) BL21 transformed with control pBAD-eGFP plasmid (BL21-eGFP) and BL21-TAN were cultured to an optical density (OD600) of ~1. Cultures were either left uninduced (BL21-eGFP, BL21-TAN) or induced at 0.02% L-arabinose (BL21-TAN) and OD600 was measured over time. (D) Uninduced or induced BL21-eGFP (0.02% L-arabinose, 4 hours) were fixed in 4% paraformaldehyde and then stained simultaneously with anti-myc and anti-his to detect ColH and HylB expression, respectively. A representative, single bacterium for each condition is shown.
Figure 1.
Tandem Construct Design and Expression Analysis in BL21 E. Coli Transformants. (A) The synthesized sequence encoding for both bacterial collagenase (ColH) and hyaluronidase (HylB) were engineered with independent 5’ ribosomal binding sites (RBS) and fused to a myc or his tag, respectively. The sequence was cloned downstream of the inducible pBAD promoter in the pBAD/HIS A plasmid and then transformed into BL21 to generate BL21-TAN. (B) BL21-TAN cultures were grown to exponential phase (shaking at 37°C) and then left alone (uninduced, U) or induced (I) at a final concentration of 0.02% L-arabinose for 4 hours. Bacterial pellets and culture media (CM) were then subjected to western blot analysis to detect for expression of ColH (anti-Myc) and HylB (anti-His). (C) BL21 transformed with control pBAD-eGFP plasmid (BL21-eGFP) and BL21-TAN were cultured to an optical density (OD600) of ~1. Cultures were either left uninduced (BL21-eGFP, BL21-TAN) or induced at 0.02% L-arabinose (BL21-TAN) and OD600 was measured over time. (D) Uninduced or induced BL21-eGFP (0.02% L-arabinose, 4 hours) were fixed in 4% paraformaldehyde and then stained simultaneously with anti-myc and anti-his to detect ColH and HylB expression, respectively. A representative, single bacterium for each condition is shown.
Figure 2.
In Vitro Degradation of Collagens and Hyaluronic Acid by BL21-TAN. Hydrolysis reactions were performed using uninduced (U) or induced (I) BL21-TAN co-incubated with FITC-conjugated pig skin gelatin (A), bovine skin collagen type I (B), human placenta collagen type IV (C) or purified hyaluronic acid (HA) (D) in 50 mM Tris-HCl (pH 8.0) containing 10 mM CaCl2 at 37⁰C. Negative control includes culture media (LB). Increases in fluorescence intensity signifies degradation of FITC-conjugated target. Enzyme activity was measured by monitoring fluorescence (FITC) (ex: 495 nm, em: 519 nm). Data are expressed as mean ± error of mean of three independent experiments. ****p<0.0001, t-test.
Figure 2.
In Vitro Degradation of Collagens and Hyaluronic Acid by BL21-TAN. Hydrolysis reactions were performed using uninduced (U) or induced (I) BL21-TAN co-incubated with FITC-conjugated pig skin gelatin (A), bovine skin collagen type I (B), human placenta collagen type IV (C) or purified hyaluronic acid (HA) (D) in 50 mM Tris-HCl (pH 8.0) containing 10 mM CaCl2 at 37⁰C. Negative control includes culture media (LB). Increases in fluorescence intensity signifies degradation of FITC-conjugated target. Enzyme activity was measured by monitoring fluorescence (FITC) (ex: 495 nm, em: 519 nm). Data are expressed as mean ± error of mean of three independent experiments. ****p<0.0001, t-test.
Figure 3.
BL21-TAN Depletes PDAC-Derived Collagen and HA in Serial Tumor Sections. Serial sections of KPC, BxPC3, and de-identified patient (UPN) PDAC tumors were treated overnight with BL21-TAN under uninduced or induced conditions at 37°C. Sections were then stained by trichrome to detect collagen (A) or using biotin-labeled hyaluronic acid binding protein (HABP) followed by streptavidin-FITC. (B). Trichome images were deconvoluted using ImageJ to quantify collagen content (blue staining) in randomly selected fields (10) of each tumor section (C). Fluorescence intensity was used to quantify HA content (FITC/488 channel) was measured using ImageJ and normalized to uninduced treatment (D). Data are expressed as mean ± error of mean. **p<0.01; ***p<0.001; ****p<0.0001, t-test. Scale bar = 20 um.
Figure 3.
BL21-TAN Depletes PDAC-Derived Collagen and HA in Serial Tumor Sections. Serial sections of KPC, BxPC3, and de-identified patient (UPN) PDAC tumors were treated overnight with BL21-TAN under uninduced or induced conditions at 37°C. Sections were then stained by trichrome to detect collagen (A) or using biotin-labeled hyaluronic acid binding protein (HABP) followed by streptavidin-FITC. (B). Trichome images were deconvoluted using ImageJ to quantify collagen content (blue staining) in randomly selected fields (10) of each tumor section (C). Fluorescence intensity was used to quantify HA content (FITC/488 channel) was measured using ImageJ and normalized to uninduced treatment (D). Data are expressed as mean ± error of mean. **p<0.01; ***p<0.001; ****p<0.0001, t-test. Scale bar = 20 um.
Figure 4.
Intravenously administered BL21-TAN colonizes PDAC tumors and expresses both ColH and HylB. Mice bearing subcutaneous KPC or BxPC3 tumors (6-8mm diameter) were intravenously injected with 5x107 colony-forming units (CFUs) of BL21-TAN for three consecutive days. Twenty-four hours following the final injection, mice were either administered PBS (uninduced, U) or 40 mg L-arabinose (induced, I) intraperitoneally. Tumors were collected 48h post-induction and sections were evaluated for BL21-TAN colonization and enzyme expression by immunofluorescence using antibodies specific to BL21 E.coli, Myc-tag (ColH) and His-tag (HylB). Objective:100X oil. Scale bars = 10 um.
Figure 4.
Intravenously administered BL21-TAN colonizes PDAC tumors and expresses both ColH and HylB. Mice bearing subcutaneous KPC or BxPC3 tumors (6-8mm diameter) were intravenously injected with 5x107 colony-forming units (CFUs) of BL21-TAN for three consecutive days. Twenty-four hours following the final injection, mice were either administered PBS (uninduced, U) or 40 mg L-arabinose (induced, I) intraperitoneally. Tumors were collected 48h post-induction and sections were evaluated for BL21-TAN colonization and enzyme expression by immunofluorescence using antibodies specific to BL21 E.coli, Myc-tag (ColH) and His-tag (HylB). Objective:100X oil. Scale bars = 10 um.
Figure 5.
In Vivo Collagen and HA Depletion by BL21-TAN. NSG mice with subcutaneous BxPC3 xenografts (6-8mm diameter) were intravenously injected with 5x107 colony-forming units (CFUs) of BL21-eGFP control or BL21-TAN for three consecutive days by intravenous route. Twenty-four hours following the final injection, mice given BL21-TAN were administered 40 mg L-arabinose intraperitoneally. Tumors (n=8) were collected 48h post-induction and serial sections were evaluated for collagen using trichrome staining (A) and HA using HABP staining (B). Regions (box) from each image were magnified for greater resolution of collagen and HA (inset). Random fields (n=15, 10X objective) from each treatment group were used for deconvolution analysis to quantify collagen and HA content in multiple tumors (C). Data are expressed as mean ± error of mean. ****p<0.0001, t-test. Scale bars = 1 mm. .
Figure 5.
In Vivo Collagen and HA Depletion by BL21-TAN. NSG mice with subcutaneous BxPC3 xenografts (6-8mm diameter) were intravenously injected with 5x107 colony-forming units (CFUs) of BL21-eGFP control or BL21-TAN for three consecutive days by intravenous route. Twenty-four hours following the final injection, mice given BL21-TAN were administered 40 mg L-arabinose intraperitoneally. Tumors (n=8) were collected 48h post-induction and serial sections were evaluated for collagen using trichrome staining (A) and HA using HABP staining (B). Regions (box) from each image were magnified for greater resolution of collagen and HA (inset). Random fields (n=15, 10X objective) from each treatment group were used for deconvolution analysis to quantify collagen and HA content in multiple tumors (C). Data are expressed as mean ± error of mean. ****p<0.0001, t-test. Scale bars = 1 mm. .
Figure 6.
BL21-TAN Pre-Treatment of PDAC Tumors Enhances Efficacy of Gemcitabine. (A) NSG mice with subcutaneous BxPC3 xenografts (6-8mm diameter) were injected with 5x107 colony-forming units (CFUs) of BL21-eGFP control or BL21-TAN for three consecutive days by intravenous route. 24 hours following the final injection, mice were administered 40 mg L-arabinose (induction) or PBS control intraperitoneally. Gemcitabine (GEM) or vehicle (PBS) were injected intraperitoneally 48 hours after induction and maintenance doses were given every 3 days thereafter. Tumor growth (B) and mouse weights (C) were measured over time until control groups required euthanization. Data are expressed as mean ± error of mean. ***p<0.001; ****p<0.0001, 2way ANOVA.
Figure 6.
BL21-TAN Pre-Treatment of PDAC Tumors Enhances Efficacy of Gemcitabine. (A) NSG mice with subcutaneous BxPC3 xenografts (6-8mm diameter) were injected with 5x107 colony-forming units (CFUs) of BL21-eGFP control or BL21-TAN for three consecutive days by intravenous route. 24 hours following the final injection, mice were administered 40 mg L-arabinose (induction) or PBS control intraperitoneally. Gemcitabine (GEM) or vehicle (PBS) were injected intraperitoneally 48 hours after induction and maintenance doses were given every 3 days thereafter. Tumor growth (B) and mouse weights (C) were measured over time until control groups required euthanization. Data are expressed as mean ± error of mean. ***p<0.001; ****p<0.0001, 2way ANOVA.