In this study, we used published prostate cancer scRNA-seq data to construct a single-cell transcriptome atlas of prostate cancer and explored the changes in the abundance and function of different cell subpopulations during drug resistance and metastasis in prostate cancer. The results suggested that the ecological composition of each cell subpopulation becomes more complex in the context of drug treatment. The cellular phenotype of the abundance-dominant subpopulations in different cell subpopulations facilitates drug resistance and metastasis of tumor cells. Here, we focus our analysis on CD4+ T cells, macrophages, endothelial cells, and tumor cells.
Immune cells, an important component of the TME, directly influence disease progression (Galluzzi, Humeau, Buque, Zitvogel, & Kroemer, 2020). CD4+ T cells assist B cells in antibody production, activate phagocytosis of macrophages, and recruit other immune cells to infected or inflamed areas of the body. Naive CD4+ T cells are activated to differentiate into specific subtypes after interacting with antigen-MHC complexes, including helper T cells, Tregs, and follicular helper T cells (S. Liu et al., 2020). Among them, Tregs play an immunosuppressive function in tumor immunity by suppressing the activation and proliferation of effector cells, such as monocytes, macrophages, NK cells, and APCs, as well as inducing apoptosis through various mechanisms (Radej, Szewc, & Maciejewski, 2022). LAIR2 was predicted to be a biomarker of T-cell depletion in the TME of cholangiocarcinoma and is a biomarker for immune infiltration assessment in cholangiocarcinoma (Z. Chen et al., 2021). In our study, the abundance of the Treg_LAIR2 subpopulation increased significantly in the Resistant group. Macrophages and CD8+ T cells interact with the Treg_LAIR2 subpopulation via CD86CTLA4 and TNFSF9TNFRSF9 ligand-receptor pairs, respectively, and these immune checkpoints contribute to the immune escape of tumor cells (Etxeberria, Glez-Vaz, Teijeira, & Melero, 2020; Pai et al., 2019).Therefore, we hypothesized that the increased abundance of the CD4+ T cell subpopulation expressing LAIR2 might be associated with drug resistance in prostate cancer.
The abundance of the M2-type macrophage subpopulation also increased significantly during disease progression and participated in the formation of a tumor immunosuppressive microenvironment together with Tregs (C. Liu et al., 2019). In addition, M2_SPP1 and M2_FOLR2 are key TAM subpopulations in the immune microenvironment. Previous studies have confirmed that SPP1 + TAMs have immunosuppressive effects and are associated with the invasive metastasis of tumor cells (Wei et al., 2021). In hepatocellular carcinoma, TAMs expressing FOLR2 colocalize with Tregs and exert immunosuppressive effects (Sharma et al., 2020). Herein, intercellular communication analysis also showed that FOLR2-expressing TAMs communicate with Tregs in the metastatic group, which contributes to drug resistance and metastasis of prostate cancer. Our analysis showed that the TAM subpopulations M2_SPP1 and M2_FOLR2 were enriched in the MPRAD group, suggesting their involvement in the formation of a tumor immunosuppressive microenvironment, thereby contributing to the development of drug resistance and metastasis in prostate cancer.
Tumor growth and metastasis require neovascular support, and endothelial cells are a major part of neovascularization (Lugano, Ramachandran, & Dimberg, 2020).Tumor cells complete hematogenous metastasis within the microvasculature of specific organs through retention, adhesion, and growth into the extravascular parenchymal environment (Sobierajska, Ciszewski, Sacewicz-Hofman, & Niewiarowska, 2020).The new subpopulation, EN-THY1, had the highest abundance in the endothelial cell ecology of the MPRAD group, and the GO and KEGG pathway-based enrichment analysis revealed that this subpopulation had high expression of genes in the local adhesion pathway, the adhesion molecules expressed by endothelial cells could enable tumor cells that have already entered the bloodstream to adhere to endothelial cells, possibly contributing to the colonization of prostate cancer tumor cells via bloodstream metastasis (Zhao & Guan, 2011).In addition, this subpopulation was significantly enriched in genes related to the leukocyte transendothelial migration pathway. This pathway was generally activated in cancer progression (Enarsson, Lundin, Johnsson, Brezicka, & Quiding-Jarbrink, 2007). Activation of the pathway disrupted the tightness and integrity of the endothelial cell junctions, inflammatory cytokines produced by leukocytes contribute to cancer cell extravasation as well (Reymond, d'Agua, & Ridley, 2013).
The RBP1 gene was highly expressed in tumor cells of the PRAD_RBP1 subpopulation, which comprised anti-androgen-treated tumor cells. In addition, tumor cells in a subpopulation of prostate cancer liver metastases also showed high expression of the RBP1 gene. RBP1 increases the proliferation and aggressiveness of the invasive class IV human prostate adenocarcinoma cell line PC-3 (Napoli, 2017). Therefore, we hypothesized that the RBP1 gene contributes to antiandrogenic resistance in prostate cancer and prostate cancer liver metastasis. The PRAD_RORB subpopulation is mainly composed of tumor cells resistant to doxorubicin treatment, and previous studies have shown that RORB is a clock-related gene that is associated with low survival in prostate cancer (Yue et al., 2021). Our analysis also demonstrated high expression of RORB in doxorubicin-resistant tumor cells. Therefore, we hypothesized that RORB is a potential therapeutic target in resistant prostate cancer.
As the disease progresses, the ecological composition of tumor cells becomes progressively more complex. The cell subpopulation PRAD_NME2 showed significantly decreased abundance in the Resistant and MPRAD groups, which led us to speculate that the tumor cell subpopulation PRAD_NME2 is a class of drug therapy-sensitive tumor cells. In addition, the abundance of cell subpopulations with high expression of the NME2 was higher in the EN and Mac ecologies of the primary foci, while their abundance was significantly decreased in both the Resistant and MPRAD groups. We also analyzed intergroup differences in NME2 gene expression, revealing that its expression was significantly lower in prostate cancer resistant primary and metastatic focal tissues compared with that in tumor primary and paracancerous tissues. NME2 is a metastasis suppressor gene (Chang et al., 2015) that is associated with telomere ends and telomerase, reducing telomerase activity within cells (Kar et al., 2012). NME2 has different effects on different types of cancer cells and their invasion or metastasis (Y. F. Liu et al., 2015). The NME2 gene is expected to be a relevant target or biological marker for future prostate cancer drug therapy.
We analyzed the differentiation potential of tumor cell subpopulations, and in general, tumor cell subpopulations in the Resistance group had a higher cell differentiation potential compared with those in the MPRAD group. In addition, we tracked the dynamic changes and differentiation trajectories of tumor cells using trajectory analysis. Both the PRAD_ASCL1 and PRAD_CALML5 subpopulations were terminal subpopulations of tumor cell differentiation, and were the subpopulations with the highest differentiation potentials in the Resistant and MPRAD groups. Previous studies have shown that the stronger the differentiation potential of cancer cells, the stronger the drug resistance (Pattabiraman & Weinberg, 2014). The PRAD_ASCL1 subpopulation, as a subpopulation with high specificity and the highest tumor cell stemness in the Resistant group, might be important for drug resistance in tumor cells. Tumor cells in the PRAD_ASCL1 subpopulation highly express the ASCL1 gene, which is a marker gene for neuroendocrine prostate cancer, one of the most aggressive subtypes of prostate cancer (Dong et al., 2020). To this end, we further investigated the remodeling effect of the PRAD_ASCL1 subpopulation of tumor cells on stromal cells and predicted sensitive drugs for treatment against this subpopulation. Through intercellular communication analysis we found that tumor cells of the PRAD_ASCL1 subpopulation could interact with T cells and macrophages via ICOSLG-ICOS and CD24-SIGLEC10 ligand-receptor pairs, respectively, to construct a tumor immunosuppressive microenvironment (Barkal et al., 2019). In addition, T cells can interact with the PRAD_ASCL1 subpopulation of tumor cells via the CCL5-SDC1/4 ligand-receptor pair. Some in vitro experiments have demonstrated that T cells can promote the migration of pancreatic ductal adenocarcinoma tumor cells via CCL5-SDC1 receptor-ligand interactions. (K. Chen et al., 2022) Therefore, we speculated that CCL5-SDC4 ligand-receptor intercellular interactions between T cells and tumor cells in prostate cancer might also function to promote the migration of resistant tumor cells; however, further experimental validation of our speculation is required. This subpopulation of tumor cells also interacted with endothelial cells via the ligandreceptor pairs PGF-NRP1, PGF-NRP2, PGF-FLT1, and HBEGF-CD9 to promote each other's proliferation. Subsequently, we found that tumor cells in the PRAD_ASCL1 subpopulation were most sensitive to the KRASG12C inhibitor class of drugs according to the drug response prediction analysis. KRAS is the most frequently mutated oncogene in humans (Huang, Guo, Wang, & Fu, 2021), and the hallmark cancers for KRAS mutations are pancreatic, colorectal, lung, and genitourinary cancers (Timar & Kashofer, 2020), in which the gene is involved in multiple tumor-related signaling pathways (Hallin et al., 2020). Previous experiments have validated the therapeutic effects of such drugs in non-small cell lung cancer and colorectal cancer (Hallin et al., 2020). Our analysis predicted that KRASG12C inhibitor class drugs would be expected to be potential agents to treat neuroendocrine prostate cancer.
The PRAD_CALML5 subpopulation, as the terminal subpopulation for tumor cell differentiation, and the subpopulation with the highest differentiation potential of tumor cells in the MPRAD group, is important for the proliferation and migration of tumor cells. Therefore, we used intercellular communication analysis to predict how it creates a microenvironment conducive to tumor cell metastasis. We constructed an extensive regulatory network of intercellular communication between tumor cells and stromal cells, and found that tumor cells of the PRAD_CALML5 subpopulation communicate with M2-type macrophages in the metastasis group via the ligand-receptor pair CD24-SIGLEC10, with T cells via the ligandreceptor pair CCL5-SDC1/4, and with EN cells via the ligand-receptor pair IGF1- INSR for intercellular communication, promoting proliferation resistance and metastasis of tumor cells. In addition, we identified for the first time that CTHRC1-related CAFs can interact with PRAD_CALML5 tumor cells via the TIMP1-CD63 ligand-receptor pair to promote drug resistance and metastasis in prostate cancer (Li, Zhang, Wang, & Jia, 2022).
Overall, we identified, through intercellular communication analysis, key ligand receptors, such as CD24-SIGLEC10 andCCL5-SDC1/4, between tumor cells and stromal cells that affect the development of drug resistance and metastasis in prostate cancer. Prostate cancer tumor cells expressing CD24 interact with macrophage-indicated sialic acid-binding Ig-like lectin 10 (SIGLEC10) receptors, which might contribute to the immune escape function of prostate cancer tumor cells and help build an immunosuppressive microenvironment for prostate cancer resistance and metastasis. CD24 also has potential as a therapeutic target in prostate cancer (Panagiotou, Syrigos, Charpidou, Kotteas, & Vathiotis, 2022). In addition, we speculated that CCL5-SDC1/4 ligand-receptor celltocell interactions between T cells and tumor cells in prostate cancer might function to promote the migration of resistant tumor cells; however, further experimental validation of this speculation is needed.
Although this study reports novel findings, it has some limitations. First, the samples included in this study were relatively small, and the analytical results obtained need to be further validated in a larger sample. Second, although the mechanisms derived in this study are based on a bioinformatic analysis approach, they have not been validated by molecular and cellular experiments. Therefore, we plan to further expand the samples in future studies and use molecular and cellular experiments to validate the findings.
In conclusion, our study provides theoretical support for changes in the abundance and function of different cell subpopulations during the progression of prostate cancer resistance and metastasis, thus identifying potential targets for treatment of prostate cancer resistance and metastasis, suggesting key ligand-receptor interactions that might contribute to disease progression, and providing valuable insights for targeted therapy of prostate cancer.