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The Eph/ephrin system plays a vital role in diverse physiological events such as neurogenesis, vasculogenesis, and cell adhesion. Expression analysis of mRNA and protein in clinical samples revealed the involvement of the Eph/ephrin system in tumorigenesis, Alzheimer's disease, and atherosclerosis. Therefore, the Eph/ephrin system is considered a promising therapeutic target. However, no molecularly targeted drug against Ephs and ephrins is being used in the clinic thus far.Tumors are composed of various types of cells, including fibroblasts, immune cells, and endothelial cells. Recent studies showed the contribution of these cells to tumor growth, tumor progression, drug resistance, and metastasis. In this chapter, we discuss the role of Eph/ephrin system in the tumor microenvironment and describe its functions in tumor initiation, angiogenesis, cancer stem cell, tumor immunity, and also the metastatic environment.

Sterile inflammation within primary tumor tissues can spread to distant organs that are devoid of tumor cells. This happens in a manner dependent on tumor-led secretome, before the actual metastasis occurs. The premetastatic microenvironment is established in this way and is at least partly regulated by hijacking the host innate immune system. The biological manifestation of premetastasis include increased vascular permeability, cell mobilization via the blood stream, degradation of the extracellular matrix, immunosuppression, and host antineoplastic activities., (Copyright © 2020 Cold Spring Harbor Laboratory Press; all rights reserved.)

In mouse models of lung metastasis, before the appearance of significant metastases, localized changes in vascular permeability have been observed, which appear to set the stage for tumour growth. However, it is unclear whether this is also true in human patients. Here, we show that MD-2, a coreceptor for Toll-like receptor 4 that has a key role in the innate immune response, triggers the formation of regions of hyperpermeability in mice by upregulating C-C chemokine receptor type 2 (CCR2) expression. The CCR2-CCL2 system induces the abundant secretion of permeability factors such as serum amyloid A3 and S100A8. Disruption of MD-2 or CCR2 abrogates the formation of hyperpermeable regions, resulting in reduced tumour cell homing. Furthermore, fibrinogen, which is processed during permeability-mediated coagulation, is also localized in areas of elevated CCR2 expression in tumour-bearing human lungs. Our findings raise the possibility that CCR2 upregulation might represent a marker for regions of increased susceptibility to metastatic homing in lung cancer.

NF-κB activation is frequently found in a variety of tumors, especially in those that are resistant to chemotherapy. The malignant phenotypes of tumor cells that are required for invasion and metastasis could be established by the output of NF-κB signaling including interactions with white blood cells, anti-apoptosis and angiogenesis. Consequently, by utilizing the similar mechanisms for immune cells to migrate through the body, tumor cells migrate via blood stream, survive against selective pressures in other organs they stop by, achieve re-growth as metastasis, or make a clinical relapse by traveling back to the primary site.

Primary tumors secrete factors that alter the microenvironment of distant organs, rendering those organs as fertile soil for subsequent metastatic cancer cell colonization. Although the lungs are exposed to these factors ubiquitously, lung metastases usually develop as a series of discrete lesions. The underlining molecular mechanisms of the formation of these discrete lesions are not understood. Here we show that primary tumors induce formation of discrete foci of vascular hyperpermeability in premetastatic lungs. This is mediated by endothelial cell-focal adhesion kinase (FAK), which up-regulates E-selectin, leading to preferential homing of metastatic cancer cells to these foci. Suppression of endothelial-FAK or E-selectin activity attenuates the number of cancer cells homing to these foci. Thus, localized activation of endothelial FAK and E-selectin in the lung vasculature mediates the initial homing of metastatic cancer cells to specific foci in the lungs.

Accumulating evidence suggests that Toll-like receptor 4 (TLR4), a sensor for danger signals, is expressed not only in immune cells, but also in resident epithelial cells, and appears to participate in tissue homeostasis. To explain the premetastatic microenvironment created by the newly discovered endogenous TLR4 ligands, I propose a hypothesis of homeostatic inflammation that includes the classical danger hypothesis.

Organ specific metastasis might be based on the specific interactions between chemokines expressed in premetastatic sites and their receptors on tumor cells. The ligand/receptor system in host defense mechanism pertinent to immune cells like macrophages is supposed to be hijacked by tumor cells. Ectopic expression of receptors in tumor cells enables bidirectional signaling between primary tumors and distant metastatic organs. VEGF and TNFalpha secreted from primary tumors signal through circulatory system to stimulate lung endothelial cells and macrophages to enhance production of S100A8 and A9 as well as MIP-1alpha, which in turn stimulate primary tumor cells as well as macrophages in bone marrow to migrate over to the lungs presumably via local chemokine gradient. Although it is beyond discussion to determine which came first, tumor cells or macrophages, the bidirectional signals could amplify the migration of both cells to accomplish metastasis.

Primary tumours influence the environment in the lungs before metastasis. However, the mechanism of metastasis is not well understood. Here, we show that the inflammatory chemoattractants S100A8 and S100A9, whose expression is induced by distant primary tumours, attract Mac 1 (macrophage antigen 1)(+)-myeloid cells in the premetastatic lung. In addition, tumour cells use this mechanism, through activation of the mitogen-activated protein kinase (MAPK) p38, to acquire migration activity with pseudopodia for invasion (invadopodia). The expression of S100A8 and S100A9 was eliminated in lung Mac 1(+)-myeloid cells and endothelial cells deprived of soluble factors, such as vascular endothelial growth factor A (VEGF-A), tumour necrosis factor alpha (TNFalpha) and transforming growth factor beta (TGFbeta) both in vitro and in vivo. Neutralizing anti-S100A8 and anti-S100A9 antibodies blocked the morphological changes and migration of tumour cells and Mac 1(+)-myeloid cells. Thus, the S100A8 and S100A9 pathway may be common to both myeloid cell recruitment and tumour-cell invasion.

Vascular endothelial growth factor (VEGF) plays a central role in angiogenesis, which underlies tumor progressions such as metastasis. A unique biological feature is that VEGF, mainly produced by malignant cells, hits seemingly non-malignant endothelial cells of host origin. The expression level of VEGF or its receptors appears to be regulated by intrinsic factors such as genetic alterations as well as by extrinsic factors such as pO2 and cytokines. Receptor signals result in coordinated regulation of molecules responsible for growth, differentiation, matrix degradation, migration, adhesion, coagulation, permeability and so forth.

We have isolated the human homolog (hltk) of the murine tyrosine kinase gene ltk from a K-562 human leukemia cDNA library. The deduced protein sequence of hltk is 17 amino acids longer in the juxtamembrane domain and 28 amino acids shorter in the carboxy terminus than that of murine ltk. The partially identical splicing points of hltk to those of c-ros showed a close genetic linkage between the two. In Northern blot analysis of 35 human malignancies, hltk is preferentially expressed in leukemias (10 out of 18 cases) with no cell lineage specificity, but none of 17 nonleukemic neoplasms expressed hltk gene.

We detected constitutive expression of the granulocyte-macrophage colony-stimulating factor (GM-CSF) gene in 3 human solid tumors by Northern blot analysis. Two of them were also found to secrete the GM-CSF protein by colony forming unit-culture assay. Southern blot analysis of each tumor DNA showed no gross rearrangement of the GM-CSF gene. This is the first report that demonstrates expression of the GM-CSF gene in solid tumors at the mRNA level.