Red blood cell-tumor cell interactions promote tumor cell progression

A critical step in the metastatic cascade is the survival of circulating tumor cells (CTCs) within the bloodstream. Although interactions between CTCs and various hematopoietic cells have been described, the role of red blood cells (RBCs) remains underexplored. This study investigated the interactions between tumor cells and RBCs from breast and lung cancer patients, revealing significant phenotypic and functional changes in tumor cells, unlike interactions with RBCs from healthy donors. Tumor cell and patient-derived RBC co-cultures increased tumor cell attachment and induced morphological changes. RBC-primed tumor cells showed increased adhesion, disruption of the endothelial barrier, and invasiveness, both in vitro and in vivo. Global proteome changes, including actin remodeling and VASP accumulation at cell edges, promote directional migration. RBCs from patients with metastatic breast cancer also upregulate PAK4, enhancing migration and epithelial-mesenchymal transition, whereas PAK4 inhibition reduces these effects. Clinically, a higher red blood cell distribution width (RDW) in patients with metastasis is associated with increased CTC counts and poor outcomes. This study highlights the previously unrecognized role of RBCs in promoting metastatic behavior in cancer cells and suggests potential therapeutic targets, such as PAK4, to counteract these effects.

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Publication Details

Journal
Journal of Experimental & Clinical Cancer Research
Published
2025-04-29
DOI
https://doi.org/10.1186/s13046-025-03376-w
Citations
5
Primary Topic
Erythrocyte Function and Pathophysiology
Type
article
Field-Weighted Citation Impact
5.82

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article

Red blood cell-tumor cell interactions promote tumor cell progression

Christian Mess, Carmen Abuín, Rafael López‐López, Julian Götze et al.
5 citations
Journal of Experimental & Clinical Cancer Research
Erythrocyte Function and Pathophysiology
5.82
article

Red blood cell-tumor cell interactions promote tumor cell progression

Christian Mess, Carmen Abuín, Rafael López‐López, Julian Götze, Katrin Lamszus, Sabine Windhorst, Thais Pereira‐Veiga, Miriam González-Conde, Clotilde Costa, L. Muinelo-Romay, Klaus Pantel, Celso Yáñez-Gómez, Bente Siebels, Joao Gorgulho, Nadine Heuer‐Olewinski, Alexandra Cortegoso, Martin Reck, Christine Blechner, K. Meißner, Ana B. Dávila‐Ibáñez, Alexander T. Bauer, Pablo Cabezas‐Sainz, Teresa Curiel, Mustafa Abdo, Juan Cueva, Alicia Abalo, Harriet Wikman, Milena Schmidt, Carmela Rodríguez, Luis León‐Mateos, Sven Peine, Sabine Vidal‐y‐Sy, Laura Sánchez‐García, Marta Carmona, Aleksi Pekkarinen, Maider Santos, Patricia Palacios, Ayham Moustafa
article en
5 citations

Abstract

A critical step in the metastatic cascade is the survival of circulating tumor cells (CTCs) within the bloodstream. Although interactions between CTCs and various hematopoietic cells have been described, the role of red blood cells (RBCs) remains underexplored. This study investigated the interactions between tumor cells and RBCs from breast and lung cancer patients, revealing significant phenotypic and functional changes in tumor cells, unlike interactions with RBCs from healthy donors. Tumor cell and patient-derived RBC co-cultures increased tumor cell attachment and induced morphological changes. RBC-primed tumor cells showed increased adhesion, disruption of the endothelial barrier, and invasiveness, both in vitro and in vivo. Global proteome changes, including actin remodeling and VASP accumulation at cell edges, promote directional migration. RBCs from patients with metastatic breast cancer also upregulate PAK4, enhancing migration and epithelial-mesenchymal transition, whereas PAK4 inhibition reduces these effects. Clinically, a higher red blood cell distribution width (RDW) in patients with metastasis is associated with increased CTC counts and poor outcomes. This study highlights the previously unrecognized role of RBCs in promoting metastatic behavior in cancer cells and suggests potential therapeutic targets, such as PAK4, to counteract these effects.

Journal of Experimental & Clinical Cancer ResearchVol. 44(1)
Universität Hamburg (DE), Universidade de Santiago de Compostela (ES), University Medical Center Hamburg-Eppendorf (DE), German Center for Lung Research (DE), LungenClinic Grosshansdorf (DE), Instituto de Investigación Sanitaria de Santiago (ES), Servicio Gallego de Salud (ES), Centro de Investigación Biomédica en Red de Cáncer (ES)
Deutsche Forschungsgemeinschaft, Axencia Galega de Innovación, Instituto de Salud Carlos III
No poverty
Openalex Percentile: Top 4%
Erythrocyte Function and Pathophysiology
5.82
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