Pathologic Stage. Lymph node Stage
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1 ASC ASC a c Patient ID BMI Age Gleason score Non-obese PBMC (3+3) PBMC (3+3) PBMC (4+4) PBMC (3+4) PBMC (3+3) PBMC (3+4) PBMC (3+4) PBMC N/A N/A PBMC (4+3) PBMC (3+3) PBMC (3+3) PBMC N/A PBMC (4+) PBMC (+4) PBMC (+) PBMC (4+) PBMC (3+4) PBMC (3+4) PBMC (3+) PBMC (4+4) PBMC PBMC (3+3) PBMC (4+3) PBMC (3+3) Obese Patient ID BMI Patient ID BMI Age Gleason score Obese PBMC N/A PBMC (4+3) PBMC N/A PBMC N/A PBMC N/A PBMC 3 31 N/A N/A PBMC (3+4) PBMC (4+) PBMC (4+4) PBMC (4+3) PBMC (3+3) PBMC (+4) PBMC N/A PBMC (3+4) PBMC (4+4) PBMC (+) PBMC (4+4) PBMC N/A PBMC N/A PBMC (4+3) PBMC N/A Clinical Stage Pathologic Stage Lymph node Stage Gleason Score ASC All cells All cells ASC MSC Tumor volume (cc) Age Race Progression Cd34b cells CPC Non-obese P (-) (-) (-) T1c pt2 pn 7 (3+4).48 6 W P (-) (-) (-) T1c pt2 pn 7 (4+3),.32 8 W P (-) (+) (+) T2c pt3a pn 7 (4+3), A P (-) (+) (+) T1c pt2 pn 7 (4+3) W P (-) (-) (+) T2a pt2 pn 6 (3+3).26 8 B P (-) (-) (+) T1c pt3a pn 7 (3+4) B P 37 2 (-) (-) (+) T2c pt3b pn 7 (3+4) W P (-) (-) (-) T2b pt3b pn 7 (4+3) W P (-) (-) (+) T2a pt2 pn 7 (3+4) W P (+) (-) (-) T1c pt2 pn 7 (3+4) W P (-) (+) (+) T2c pt3a pn 8 (4+4) A P (-) (+) (+) T1c pt2 pn 9 (4+) W P (-) (-) (-) T1c pt3a pn 7 (3+4) W P (-) (-) (+) T2b pt3a pn 9 (4+) 1. 8 W P (-) (-) (-) T1c pt2 pn 8 (4+4).34 7 B P (-) N/A (-) T1c pt2 pn 7 (4+3), W Obese P (+) (+) (-) T2a pt2 pn 7 (3+4) W P 3.3 (+) (-) (-) T1c pt2 pn 7 (3+4).44 6 W Biochemical recurrence P (+) (-) (-) T1c pt2 pn 7 (3+4) W P 8 31 (+) (+) (-) T2a pt2 pnx 7 (3+4) A P (+) (-) (+) T3b pt3b pn1 9 (4+) W P (+) (+) (+) T3a pt3a pn 9 (4+) H Biochemical recurrence P (+) (+) (+) T3a pt2 pn 9 (4+) W P (+) N/A (+) T1c pt2 pn 7 (3+4) W P (+) (+) (+) T1c pt2 pnx 7 (3+4).2 61 W P (+) (+) (+) T1c pt2 pnx 7 (3+4).6 1 W P (-) (+) (+) T1c pt2 pnx 7 (3+4) W P (+) (+) (-) T1c pt2 pnx 7 (3+4).9 42 W P (+) (+) (+) T3b pt3b pn1 9 (4+) 6. 3 H Death P (+) (+) (+) T2b pt2 pnx 7 (3+4) W P (+) (+) (-) T1c pt2 pn 7 (3+4).19 4 W P (+) (+) (-) T1c pt2 pn 7 (3+4).3 3 W P (+) (+) (-) T2a pt2 pn1 7 (3+4) 2. 3 B P 31 3 (-) (+) (-) T2a pt2 pn 7 (3+4) B P (+) (+) (+) T2a pt2 pn 7 (3+4) W P (+) (+) (+) T1c pt2 pn 7 (3+4).7 7 B P (+) (+) (-) T2c pt2 pn 7 (3+4) B P N/A N/A N/A T2b pt3a pn 8 (4+4) W Local recurrence P N/A N/A N/A T1c pt3b pn1 8 (4+4) W Biochemical recurrence Supplementary Figure 1 Characteristics of PC patients. (a) Patients who s PBMC were analyzed in Fig. 1a. (b) Flow cytometric gating of cells from a periprostatic (PP) WAT sample identifying CD34bCD4- CD31- ASC, CD34bCD4b leukocytes (LC), CD34dCD31bCD4- C, and CD34bCD31dCD4d CPC. b, bright, d, dim. Data are representative of three independent experiments. (c) Patients who s tissues were analyzed in Fig. 2a-c and Supplementary Fig. 2a-d,f. and expression in epithelium and expression in the stroma is scored as high (+) and low (-). N/A: data not available. pn1: pelvic lymph node metastasis. W: white, B: black, H: hispanic; A: asian.
2 a b Lean, Non-malignant Obese, Non-malignant IB4 IB4 c Lean, low grade PC7 Lean, high grade Obese, low grade PC44 Obese, high grade PC1 PC28 H& d Lean, low grade Lean, high grade PC3 Obese, low grade Obese, high grade PC16 PC16 PC16 PC46 PC43 H1 Normal PC11 A11 Gleason 8, T4NM, Alive B11 Gleason 7, T4NM, Alive e H1 non-malignant, Alive C2 Gleason 9, T3bNM1, Dead F7 Gleason 9, T3bNM, Dead D11 Gleason 8, T3bNM, Dead f Lean, low grade CXCR2 IB4 PC36 Lean, high grade PC43 Obese, low grade PC28 Supplementary Figure 2 The CXCL-CXCR obesity axis. (a-b) IF analysis of non-malignant prostate areas of tumors from lean (a) and obese (b) patients with or antibodies (red) counterstained with or antibodies or IB4 (green). (c) Hematoxylin/eosin (H/) stainings of sections analyzed in Fig. 2a. (d) IF analysis of tumors from additional indicated patients with (red) and (green) antibodies. Insets: H/ staining of the area. (e) IF analysis of indicated cores from Biomax array HPro-Ade96Sur-1s with antibodies (red) and antibodies (green). (f) IF analysis of indicated human prostate tumor sections with CXCR2 antibodies (red) and endothelium-labeling IB4 (green). Arrowheads: endothelium. Arrows: stroma, : epithelium. Nuclei are blue. Scale bar (a-f): 1 µm. Data are representative of three independent experiments in a-d and f.
3 (ng/ml) (ng/ml) ASC ymy ymy Reparixin c d Protein concentra8on (ng/ml) PP ASC Macrophages cxcl1 cxcl8 ab ab CXCR2 ab CXCR2 ab Mouse 1 macrophages Macrophage 1 Human Human& monocytes Monocyte& & DU14 CM ab ab ab CXCR2 ab DU14 CM ab ab Supplementary Figure 3 Chemotaxis toward and. (a) Human PP ASC were subjected to trans-well chamber migration through 8 µm pores toward serum-free medium (-) supplemented (+) with increased indicated concentrations of and / or in the presence of reparixin where indicated. (b) Human ASC and immortalized mouse macrophages were subjected to migration toward serum-free medium (-) supplemented (+) with 1-2 ng/ml of or and neutralizing antibodies (ab) blocking or CXCR2. (c) and concentration in DU14 conditioned medium (CM) measured by LISA. (d) Human ASC, mouse macrophages and primary human PBMC-derived monocytes were subjected to migration toward DU14 CM. Where indicated CM was supplemented with neutralizing ab against,, or CXCR2. Plotted are relative numbers normalized to migration of cells towards 2% FBS set as 1%. Relative cell migration in the absence of CM was < %. p<. vs no-chemokine or no-antibody controls (Student s t-test). In all panels, graphs show mean ± s.e.m. for technical triplicates.
4 BM MSC WAT SVF SSC.1% 7.2% Sca1 CD31 CD4 CD34 SSC % 6.% Rela%ve'migra%on'(%)' " 4" 3" 2" 1" " - + BM HBM"MSCs" MSC SC HPC"SC"WAT" ASC PP ASC HPC"PP"WAT" BM MSC SC ASC PP ASC Supplementary Figure 4 Bone marrow MSC are not subject to the - signaling. (a) A representative flow cytometric analysis of MSC from mouse bone marrow (BM) and WAT stromal/vascular fraction (SVF) showing the expression of on total and CD4-CD31- CD34+Sca1+ stromal cells. Arrows indicate subsequent gating steps. % of total viable cells is indicated. (b) Bone marrow-derived MSC from a cancer-free donor and ASC isolated from PP WAT of a non-obese prostate cancer patient were subjected to trans-well chamber migration toward medium with or without ng/ml. Plotted is relative migrated cells numbers normalized to migration of SC ASC toward 1% FBS set at 1%. Data represent mean ± s.e.m. for technical triplicates; P<.; P<.1 (Student s t-test) versus control (no ).
5 a b Analyte Obese / Lean Analyte Obese / Lean G-CSF 2. otaxin 1.71 GM-CSF - IFN-r - IL-1a.96 IL-1b.2 IL-2 - IL-4 - IL-3 - IL-.8 IL-6.92 IL-7.66 IL IL IL-12p4 1.9 IL-12p7.22 LIF - IL-13.6 LIX.93 IL IL-17 - IP-1.84 (KC) 2.3 MCP-1.19 MIP-1a.48! MIP-1b - MCSF.6 MIP-2.48 MIG.46 RANTS.86 VGF - TNFa - PO.91 xodus-2.76 MCP-.86 MIP-3b.76 MIP-3a.72 TARC.6 IL Fractalkine.88 IL-21 - IL IL IL-28b 1.12 MDC.62 IL IL TIMP IL-2 - IL-33-1! "! CXCR2 " c kda 7 37 β-actin CXCR2 2 Supplementary Figure Mouse chemokine and chemokine receptor analysis. (a) Activation of mouse in obesity / cancer. Plasma samples were collected from mice (n=/group) 11 weeks after subcutaneous ID8 cell grafting in to lean or obese mice. For each cytokine analyzed, presented are ratios of the mean plasma concentrations found for the indicated compared mouse groups. Highlighted are the Luminex panel analytes increased more than 2-fold in plasma of obese animals with tumors compared to lean animals with tumors. (-) analytes were undetectable in circulation. (b) Alignment of mouse and CXCR2 sequences with shrnas. Gene sequence alignment (starting at indicated nucleotide) shows the areas targeted by -sh and /2- sh. (c) Uncropped scans of the Western blotting (performed twice) shown in Fig. a.
6 Relative RM1 cell number (%RFU) No ASC Non-obese SC Non-obese PP Obese SC Obese PP Control + Non-Obese +Non-Obese +Obese +Obese SC WAT PP WAT SC WAT PP WAT RM1 cell increase (fold) no ASC Control ASC -sh ASC /2-sh ASC days days 2 days 4 days 6 days c no ASC RM1 -sh ASC no ASC bnd3 -sh ASC Control ASC /2-sh ASC Control ASC /2-sh ASC Supplementary Figure 6 The effect of ASC on cancer cell growth. (a) Proliferation (assessed by MTT assay) of RM1 cells in control medium (no ASC) or in medium conditioned by ASC isolated from SC and PP WAT of obese and non-obese prostate cancer patients. Data represent mean ± s.e.m. for technical triplicates; P<.; P<.1 (Student s t-test) versus control (no WAT). (b) Proliferation of RM1 cells in direct co-culture with GFP-labeled immortalized mouse ASC transduced with control-sh, -sh or /2-sh. Plotted are numbers of bnd.3 (FITC-) cells collected after the indicated numbers of days. Data represent mean ± s.e.m. for technical triplicates. (c) Proliferation of RM1 and bnd3 (FITC-) cells in direct co-culture with GFP-labeled immortalized mouse ASC (FITC+) transduced with control-sh, -sh or /2- sh. Flow cytometry data post-fixation at day 8 of co-culture are shown. Data are representative of three independent experiments.
7 CXCR2 CXCR2 CXCR2 αsma Percent survival High Low Time (months) Supplementary Figure 7 / signaling and cancer progression. (a) A working model for mechanism of ASC trafficking in cancer. In vivo, ASC express / receptor and possibly CXCR2, expression of which in ASC is increased in cell culture. Obesityinduced secretion of and malignancy-induced secretion of by epithelial cancer cells creates chemokine gradients that enable ASC trafficking to tumors via /2. Upon recruitment of ASC to tumors, αsma expressed downstream of signaling mediates the pro-angiogenic effects of ASC that promote tumor growth. (b) A Kaplan Meier plot showing increased mortality in human prostate cancer patients with high expression of mrna (Z score >2) in the prostate. Based on data from
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