Interleukin-6 as an enhancer of anti-angiogenic therapy for ovarian clear cell carcinoma

Sci Rep. 2021 Apr 8;11(1):7689. doi: 10.1038/s41598-021-86913-9.

Abstract

Ovarian clear cell carcinoma (OCCC) is a subtype of epithelial ovarian cancer (EOC) that is associated with elevated interleukin-6 (IL-6) expression, resistance to chemotherapy, and increased mortality. Although bevacizumab (Bev) is a widely used anti-angiogenic agent for EOC, the efficacy of Bev and the role of IL-6 in modulating angiogenesis in OCCC are unknown. We performed tube formation assays using human umbilical vein endothelial cells (HUVEC) cultured in OCCC cell-conditioned medium and using cells directly co-cultured with OCCC cells. We observed that IL-6 inhibition significantly mitigated the ability of Bev to impede tube formation in both cases. Furthermore, IL-6 blockade disrupted the anti-angiogenic efficacy of Bev and its concomitant anti-tumor activity. In addition, IL-6 inhibition resulted in a significant increase in angiopoietin-1 (Ang1) secretion and decreased vascular endothelial growth factor (VEGF) expression. Clinical specimens also exhibited this reciprocal relationship between IL-6 and Ang1 expression. Finally, depletion of Ang1 abrogated the effects of IL-6 inhibition on Bev activity, demonstrating that IL-6 supports the anti-angiogenic activity of Bev by suppressing Ang1 expression and promoting dependence on VEGF for angiogenesis. Altogether, our data suggest that OCCC tumors with high IL-6 levels are candidates for Bev therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Angiopoietin-1 / metabolism
  • Bevacizumab / therapeutic use*
  • Coculture Techniques
  • Culture Media, Conditioned
  • Female
  • Human Umbilical Vein Endothelial Cells
  • Humans
  • Interleukin-6 / therapeutic use*
  • Ovarian Neoplasms / blood supply
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Signal Transduction / drug effects
  • Tumor Cells, Cultured
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • ANGPT1 protein, human
  • Angiogenesis Inhibitors
  • Angiopoietin-1
  • Culture Media, Conditioned
  • Interleukin-6
  • Vascular Endothelial Growth Factor A
  • Bevacizumab