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CD93 in regulation of vascular function and tumour progression
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.ORCID iD: 0000-0003-2544-5412 
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

To achieve successful vascular targeting in cancer, a better understanding of the molecular mechanisms that lead to tumour vascular abnormalities is required.  The transmembrane protein CD93 is highly expressed in the vasculature of several tumours including glioblastoma and has emerged as a potential anti-angiogenic target. This thesis work explores the mechanisms through which CD93 contributes to vascular function and facilitates tumour progression. In paper I, we identify that CD93 interacts with the extracellular matrix (ECM) glycoprotein multimerin-2, which stabilizes CD93 at the cell surface and anchors it to the ECM protein fibronectin. CD93 binds to integrinα5β1 and regulates the activity of integrinβ1 and fibronectin fibrillogenesis in vitro. Consistent with this, the tumor vessels of CD93-/- mice bearing gliomas displayed an impaired integrinβ1 activity and fibronectin fibrillogenesis, suggesting that CD93-multimerin-2-fibronectin axis has an important role in tumour angiogenesis. In paper II, we explored the co-regulation of CD93 with other genes associated with glioblastoma vascular abnormalities. Using the publicly available Gliovis database for distinguished gene correlation analysis, we identified multimerin-2, fibronectin and angiopoietin-2 as candidate genes which are likely to be expressed with CD93 in glioblastoma vasculature. The expression of CD93, fibronectin and angiopoietin-2 was associated with high microvascular proliferation. Moreover, the presence of CD93 in a high proportion of the tumor vessels correlated with poor survival, suggesting that targeting CD93 can be beneficial for glioblastoma patients. In paper III, we explored the role of CD93 in the blood brain barrier (BBB) integrity. We demonstrate that CD93 regulates the activity of Rho-GTPases, thus stabilizing the endothelial junction molecules VE-cadherin and claudin-5 and preventing the internalization of VE-cadherin. Consistent with this, CD93-/- mice displayed a compromised BBB and exhibited an increased vascular permeability. In paper IV, we further explored the consequences of endothelial barrier disruption upon CD93-deficiency in cancer. We demonstrate that CD93 binds to VEGFR2 and that the absence of CD93 enhances VEGF-induced VEGFR2 phosphorylation in vitro. Consistent with this, melanoma-bearing CD93-/- mice displayed impaired vascular integrity and an enhanced MMP9 expression, leading to increased intravasation of tumour cells and increased metastatic spread. This phenotype was reversed to the wild-type level by inhibiting the VEGF-VEGFR2 signalling in CD93-/- mice. Taken together, this thesis work reveals a key role of CD93 in regulating vascular maturation and stabilization in health and cancer, and unveils its contribution to tumour progression and metastasis.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2022. , p. 71
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1844
Keywords [en]
CD93, Tumour angiogenesis, Vascular permeability, Endothelial junctions, Cancer, Glioblastoma, Metastasis
National Category
Cell and Molecular Biology Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-473079ISBN: 978-91-513-1513-3 (print)OAI: oai:DiVA.org:uu-473079DiVA, id: diva2:1653328
Public defence
2022-06-10, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjöldsväg 20, Uppsala, 14:10 (English)
Opponent
Supervisors
Available from: 2022-05-19 Created: 2022-04-21 Last updated: 2022-06-15
List of papers
1. CD93 promotes β1 integrin activation and fibronectin fibrillogenesis during tumor angiogenesis
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2018 (English)In: Journal of Clinical Investigation, ISSN 0021-9738, E-ISSN 1558-8238, Vol. 128, no 8, p. 3280-3297Article in journal (Refereed) Published
Abstract [en]

Tumor angiogenesis occurs through regulation of genes that orchestrate endothelial sprouting and vessel maturation, including deposition of a vessel-associated extracellular matrix. CD93 is a transmembrane receptor that is up-regulated in tumor vessels in many cancers, including high-grade glioma. Here, we demonstrate that CD93 regulates integrin-β1-signaling and organization of fibronectin fibrillogenesis during tumor vascularization. In endothelial cells and mouse retina, CD93 was found to be expressed in endothelial filopodia and to promote filopodia formation. The CD93 localization to endothelial filopodia was stabilized by interaction with multimerin-2 (MMRN2), which inhibited its proteolytical cleavage. The CD93-MMRN2 complex was required for activation of integrin-β1, phosphorylation of focal adhesion kinase (FAK) and fibronectin fibrillogenesis in endothelial cells. Consequently, tumor vessels in gliomas implanted orthotopically in CD93-deficient mice showed diminished activation of integrin-β1 and lacked organization of fibronectin into fibrillar structures. These findings demonstrate a key role of CD93 in vascular maturation and organization of the extracellular matrix in tumors, identifying it as a potential target for therapy.

Place, publisher, year, edition, pages
American Society for Clinical Investigation, 2018
Keywords
Brain cancer, Fibronectin, Oncology, Vascular Biology, endothelial cells
National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-350902 (URN)10.1172/JCI97459 (DOI)000440461500015 ()29763414 (PubMedID)
Funder
Swedish Cancer Society, CAN 2014/832Swedish Cancer Society, CAN 2017/502Swedish Cancer Society, CAN 2015/1216Swedish Childhood Cancer Foundation, PR2015-0133Swedish Childhood Cancer Foundation, NCP2015-0075Swedish Research Council, 2016-02495European Commission, 2016-02495
Available from: 2018-05-17 Created: 2018-05-17 Last updated: 2022-06-05Bibliographically approved
2. Multispectral imaging identifies CD93 as a tumor endothelial marker associated with vascular proliferation and poor patient survival in glioblastoma
Open this publication in new window or tab >>Multispectral imaging identifies CD93 as a tumor endothelial marker associated with vascular proliferation and poor patient survival in glioblastoma
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(English)Manuscript (preprint) (Other academic)
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-473076 (URN)
Available from: 2022-04-21 Created: 2022-04-21 Last updated: 2022-04-21
3. CD93 stabilizes endothelial junctions and preserves blood-brain barrier integrity
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(English)Manuscript (preprint) (Other academic)
National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-473074 (URN)
Available from: 2022-04-21 Created: 2022-04-21 Last updated: 2022-04-21
4. CD93 limits VEGFR2 activation and preserves endothelial barrier function in metastatic cancer
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(English)Manuscript (preprint) (Other academic)
National Category
Cancer and Oncology Cell and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-473075 (URN)
Available from: 2022-04-21 Created: 2022-04-21 Last updated: 2022-04-21

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Vemuri, Kalyani

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