Cancer-associated fibroblasts (CAFs) play an important role in colorectal cancer (CRC) progression and predict poor prognosis in CRC patients. However, the cellular origins of CAFs remain unknown, making it challenging to therapeutically target these cells.
Here, we aimed to identify the origins and contribution of colorectal CAFs associated with poor prognosis.
To determine the origin of CRC CAFs, we induced colitis-associated CRC in 5 different fate-mapping transgenic mouse lines with BrdU dosing to label newly born cells. RNA-sequencing of fluorescence activated cell sorting (FACS)-purified CRC CAFs was also performed to identify potential therapeutic targets in CAFs. To examine the prognostic significance of the key stromal targets we identified, we used CRC patient RNA-sequencing data and tissue microarrays. CRC organoids were injected into the colon of newly generated knockout mice to assess the mechanism by which one stromal gene target contributes to colorectal tumorigenesis.
Our lineage-tracing studies revealed that, in CRC, many ACTA2 + CAFs emerge through proliferation from intestinal pericryptal Leptin receptor (Lepr)+ cells. These Lepr -lineage CAFs, in turn, express melanoma cell adhesion molecule (MCAM/CD146), a CRC stroma-specific marker we identified using RNA-sequencing of sorted populations. High MCAM expression induced by TGF-β was inversely associated with patient survival in human CRC. In mice, stromal Mcam knockout attenuated orthotopically injected colorectal tumouroid growth and improved survival through decreased tumour-associated macrophage recruitment. Mechanistically, fibroblast MCAM interacted with interleukin-1 receptor 1 to augment nuclear factor-ĸB-IL34/CCL8 signalling that promotes macrophage chemotaxis.
In summary we have shown that during colorectal carcinogenesis, pericryptal Lepr-lineage cells proliferate to generate MCAM + CAFs that shape the tumour-promoting immune cold microenvironment. Preventing the expansion/differentiation of Lepr -lineage CAFs or inhibiting MCAM activity could be effective therapeutic approaches to treat immune-cold CRC.