Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Short Communication
  • Published:

Blockade of the IL-6 trans-signalling/STAT3 axis suppresses cachexia in Kras-induced lung adenocarcinoma

Abstract

Lung cancer is the leading cause of cancer death worldwide, and is frequently associated with the devastating paraneoplastic syndrome of cachexia. The potent immunomodulatory cytokine interleukin (IL)-6 has been linked with the development of lung cancer as well as cachexia; however, the mechanisms by which IL-6 promotes muscle wasting in lung cancer cachexia are ill-defined. In this study, we report that the gp130F/F knock-in mouse model displaying hyperactivation of the latent transcription factor STAT3 via the common IL-6 cytokine family signalling receptor, gp130, develops cachexia during Kras-driven lung carcinogenesis. Specifically, exacerbated weight loss, early mortality and reduced muscle and adipose tissue mass were features of the gp130F/F:KrasG12D model, but not parental KrasG12D mice in which STAT3 was not hyperactivated. Gene expression profiling of muscle tissue in cachectic gp130F/F:KrasG12D mice revealed the upregulation of IL-6 and STAT3-target genes compared with KrasG12D muscle tissue. These cachectic features of gp130F/F:KrasG12D mice were abrogated upon the genetic normalization of STAT3 activation or ablation of IL-6 in gp130F/F:KrasG12D:Stat3−/+ or gp130F/F:KrasG12D:Il6−/− mice, respectively. Furthermore, protein levels of the soluble IL-6 receptor (sIL-6R), which is the central facilitator of IL-6 trans-signalling, were elevated in cachectic muscle from gp130F/F:KrasG12D mice, and the specific blockade of IL-6 trans-signalling, but not classical signalling, with an anti-IL-6R antibody ameliorated cachexia-related characteristics in gp130F/F:KrasG12D mice. Collectively, these preclinical findings identify trans-signalling via STAT3 as the signalling modality by which IL-6 promotes muscle wasting in lung cancer cachexia, and therefore support the clinical evaluation of the IL-6 trans-signalling/STAT3 axis as a therapeutic target in advanced lung cancer patients presenting with cachexia.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Ross PJ, Ashley S, Norton A, Priest K, Waters JS, Eisen T et al. Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers? Br J Cancer 2004; 90: 1905–1911.

    Article  CAS  Google Scholar 

  2. Siegel R, Ma J, Zou Z, Jemal A . Cancer statistics, 2014. CA Cancer J Clin 2014; 64: 9–29.

    Article  Google Scholar 

  3. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011; 12: 489–495.

    Article  Google Scholar 

  4. Del Ferraro C, Grant M, Koczywas M, Dorr-Uyemura LA . Management of anorexia-cachexia in late stage lung cancer patients. J Hosp Palliat Nurs 2012; 14: 397–402.

    Article  Google Scholar 

  5. Ando K, Takahashi F, Kato M, Kaneko N, Doi T, Ohe Y et al. Tocilizumab, a proposed therapy for the cachexia of interleukin6-expressing lung cancer. PLoS One 2014; 9: e102436.

    Article  Google Scholar 

  6. Scott HR, McMillan DC, Crilly A, McArdle CS, Milroy R . The relationship between weight loss and interleukin 6 in non-small-cell lung cancer. Br J Cancer 1996; 73: 1560–1562.

    Article  CAS  Google Scholar 

  7. Songür N, Kuru B, Kalkan F, Ozdilekcan C, Cakmak H, Hizel N . Serum interleukin-6 levels correlate with malnutrition and survival in patients with advanced non-small cell lung cancer. Tumori 2004; 90: 196–200.

    Article  Google Scholar 

  8. Staal-van den Brekel AJ, Dentener M, Schols AM, Buurman WA, Wouters EF . Increased resting energy expenditure and weight loss are related to a systemic inflammatory response in lung cancer patients. J Clin Oncol 1995; 13: 2600–2605.

    Article  CAS  Google Scholar 

  9. Ando K, Takahashi F, Motojima S, Nakashima K, Kaneko N, Hoshi K et al. Possible role for tocilizumab, an anti-interleukin-6 receptor antibody, in treating cancer cachexia. J Clin Oncol 2013; 31: e69–e72.

    Article  Google Scholar 

  10. Bayliss TJ, Smith JT, Schuster M, Dragnev KH, Rigas JR . A humanized anti-IL-6 antibody (ALD518) in non-small cell lung cancer. Expert Opin Biol Ther 2011; 11: 1663–1668.

    Article  CAS  Google Scholar 

  11. Tan BH, Ross J, Kaasa S, Skorpen F, Fearon KC . European Palliative Care Research Collaborative. Identification of possible genetic polymorphisms involved in cancer cachexia: a systematic review. J Genet 2011; 90: 165–177.

    Article  Google Scholar 

  12. Ohe Y, Podack ER, Olsen KJ, Miyahara Y, Miura K, Saito H et al. Interleukin-6 cDNA transfected Lewis lung carcinoma cells show unaltered net tumour growth rate but cause weight loss and shortened survival in syngeneic mice. Br J Cancer 1993; 67: 939–944.

    Article  CAS  Google Scholar 

  13. Baltgalvis KA, Berger FG, Pena MM, Davis JM, Muga SJ, Carson JA . Interleukin-6 and cachexia in ApcMin/+ mice. Am J Physiol Regul Integr Comp Physiol 2008; 294: R393–R401.

    Article  CAS  Google Scholar 

  14. Strassmann G, Fong M, Kenney JS, Jacob CO . Evidence for the involvement of interleukin 6 in experimental cancer cachexia. J Clin Invest 1992; 89: 1681–1684.

    Article  CAS  Google Scholar 

  15. Bonetto A, Aydogdu T, Jin X, Zhang Z, Zhan R, Puzis L et al. JAK/STAT3 pathway inhibition blocks skeletal muscle wasting downstream of IL-6 and in experimental cancer cachexia. Am J Physiol Endocrinol Metab 2012; 303: E410–E421.

    Article  CAS  Google Scholar 

  16. Tsujinaka T, Fujita J, Ebisui C, Yano M, Kominami E, Suzuki K et al. Interleukin 6 receptor antibody inhibits muscle atrophy and modulates proteolytic systems in interleukin 6 transgenic mice. J Clin Invest 1996; 97: 244–249.

    Article  CAS  Google Scholar 

  17. Garbers C, Hermanns HM, Schaper F, Müller-Newen G, Grötzinger J, Rose-John S et al. Plasticity and cross-talk of interleukin 6-type cytokines. Cytokine Growth Factor Rev 2012; 23: 85–97.

    Article  CAS  Google Scholar 

  18. Bonetto A, Aydogdu T, Kunzevitzky N, Guttridge DC, Khuri S, Koniaris LG et al. STAT3 activation in skeletal muscle links muscle wasting and the acute phase response in cancer cachexia. PLoS One 2011; 6: e22538.

    Article  CAS  Google Scholar 

  19. Puppa MJ, Gao S, Narsale AA, Carson JA . Skeletal muscle glycoprotein 130's role in Lewis lung carcinoma-induced cachexia. FASEB J 2014; 28: 998–1009.

    Article  CAS  Google Scholar 

  20. Rose-John S, Scheller J, Elson G, Jones SA . Interleukin-6 biology is coordinated by membrane-bound and soluble receptors: role in inflammation and cancer. J Leukoc Biol 2006; 80: 227–236.

    Article  CAS  Google Scholar 

  21. Brooks GD, McLeod L, Alhayyani S, Miller A, Russell PA, Ferlin W et al. IL6 trans-signaling promotes KRAS-driven lung carcinogenesis. Cancer Res 2016; 76: 866–876.

    Article  CAS  Google Scholar 

  22. Jenkins BJ, Grail D, Nheu T, Najdovska M, Wang B, Waring P et al. Hyperactivation of Stat3 in gp130 mutant mice promotes gastric hyperproliferation and desensitizes TGF-beta signaling. Nat Med 2005; 11: 845–852.

    Article  CAS  Google Scholar 

  23. Ruwanpura SM, McLeod L, Miller A, Jones J, Bozinovski S, Vlahos R et al. Interleukin-6 promotes pulmonary emphysema associated with apoptosis in mice. Am J Respir Cell Mol Biol 2011; 45: 720–730.

    Article  CAS  Google Scholar 

  24. Ruwanpura SM, McLeod L, Miller A, Jones J, Vlahos R, Ramm G et al. Deregulated Stat3 signaling dissociates pulmonary inflammation from emphysema in gp130 mutant mice. Am J Physiol Lung Cell Mol Physiol 2012; 302: L627–L639.

    Article  CAS  Google Scholar 

  25. Yu H, Lee H, Herrmann A, Buettner R, Jove R . Revisiting STAT3 signalling in cancer: new and unexpected biological functions. Nat Rev Cancer 2014; 14: 736–746.

    Article  CAS  Google Scholar 

  26. Lacroix M, Rousseau F, Guilhot F, Malinge P, Magistrelli G, Herren S et al. Novel insights into interleukin 6 (IL-6) cis- and trans-signaling pathways by differentially manipulating the assembly of the IL-6 signaling complex. J Biol Chem 2015; 290: 26943–26953.

    Article  CAS  Google Scholar 

  27. Lissilaa R, Buatois V, Magistrelli G, Williams AS, Jones GW, Herren S et al. Although IL-6 trans-signaling is sufficient to drive local immune responses, classical IL-6 signaling is obligate for the induction of T cell-mediated autoimmunity. J Immunol 2010; 185: 5512–5521.

    Article  CAS  Google Scholar 

  28. Ahrendt S, Decker PA, Alawi EA, Zhu YR, Sanchez-Cespedes M, Yang SC et al. Cigarette smoking is strongly associated with mutation of the K-ras gene in patients with primary adenocarcinoma of the lung. Cancer 2001; 92: 1525–1530.

    Article  CAS  Google Scholar 

  29. Bailey P, Chang DK, Nones K, Johns AL, Patch AM, Gingras MC et al. Genomic analyses identify molecular subtypes of pancreatic cancer. Nature 2016; 531: 47–52.

    Article  CAS  Google Scholar 

  30. Jackson E, Willis N, Mercer K, Bronson RT, Crowley D, Montoya R et al. Analysis of lung tumor initiation and progression using conditional expression of oncogenic K-ras. Genes Dev 2001; 15: 3243–3248.

    Article  CAS  Google Scholar 

  31. Lesina M, Kurkowski M, Ludes K, Rose-John S, Treiber M, Klöppel G et al. Stat3/Socs3 activation by IL-6 transsignaling promotes progression of pancreatic intraepithelial neoplasia and development of pancreatic cancer. Cancer Cell 2011; 19: 456–469.

    Article  CAS  Google Scholar 

  32. Gilabert M, Calvo E, Airoldi A, Hamidi T, Moutardier V, Turrini O et al. Pancreatic cancer-induced cachexia is Jak2-dependent in mice. J Cell Physiol 2014; 229: 1437–1443.

    Article  CAS  Google Scholar 

  33. Angevin E, Tabernero J, Elez E, Cohen SJ, Bahleda R, van Laethem JL et al. A phase I/II, multiple-dose, dose-escalation study of siltuximab, an anti-interleukin-6 monoclonal antibody, in patients with advanced solid tumors. Clin Cancer Res 2014; 20: 2192–2120.

    Article  CAS  Google Scholar 

  34. DuPage M, Dooley AL, Jacks T . Conditional mouse lung cancer models using adenoviral or lentiviral delivery of Cre recombinase. Nat Protoc 2009; 4: 1064–1072.

    Article  CAS  Google Scholar 

  35. Kennedy CL, Najdovski M, Tye H, McLeod L, Yu L, Jarnicki A et al. Differential role of MyD88 and Mal/TIRAP in TLR2-mediated gastric tumourigenesis. Oncogene 2013; 33: 2540–2546.

    Article  Google Scholar 

  36. Tye H, Kennedy C, Najdovska M, McLeod L, McCormack W, Hughes N et al. STAT3-driven upregulation of TLR2 promotes gastric tumorigenesis independent of tumor inflammation. Cancer Cell 2012; 22: 466–478.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by grants awarded by the National Health and Medical Research Council (NHMRC) of Australia and the Lung Cancer Research Foundation, as well as the Operational Infrastructure Support Program by the Victorian Government of Australia. SMR is supported by a NHMRC Post-doctoral Training Fellowship. BJJ is supported by a NHMRC Senior Medical Research Fellowship.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B J Jenkins.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on the Oncogene website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miller, A., McLeod, L., Alhayyani, S. et al. Blockade of the IL-6 trans-signalling/STAT3 axis suppresses cachexia in Kras-induced lung adenocarcinoma. Oncogene 36, 3059–3066 (2017). https://doi.org/10.1038/onc.2016.437

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/onc.2016.437

This article is cited by

Search

Quick links