Neutrophils Alter DNA Repair Landscape to Impact Survival and Shape Distinct Therapeutic Phenotypes of Colorectal Cancer

Triet M. Bui, Veronika Butin-Israeli, Hannah L. Wiesolek, Meredith Zhou, Jake F. Rehring, Lisa Wiesmüller, Jennifer D. Wu, Guang Yu Yang, Stephen B. Hanauer, Julien A. Sebag, Ronen Sumagin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background & aims: Tumor-infiltrating neutrophils (polymorphonuclear neutrophils [PMNs]) are a prominent feature of colorectal cancer (CRC), where they can promote cytotoxicity or exacerbate disease outcomes. We recently showed that in acute colon injury, PMNs can increase DNA double-strand break (DSB) burden and promote genomic instability via microRNA-dependent inhibition of homologous recombination (HR) repair. In this study, we aimed to establish whether in inflamed colon, neutrophils shape the DSB-repair responses to impact CRC progression and sensitivity/resistance to DNA-repair targeted therapy. Methods: Human sporadic CRC biopsies, The Cancer Genome Atlas gene expression analyses, tumor xenografts, and murine CRC models, as well as small-molecule inhibition of key DSB-repair factors were leveraged to investigate changes in the DSB-repair landscape and identify unique CRC responses with/without tumor infiltration by PMNs. Results: We reveal that neutrophils exert a functional dualism in cancer cells, driving temporal modulation of the DNA damage landscape and resolution of DSBs. PMNs were found to promote HR deficiency in low-grade CRC by miR-155-dependent downregulation of RAD51, thus attenuating tumor growth. However, neutrophil-mediated genotoxicity due to accumulation of DSBs led to the induction of non-homologous end-joining (NHEJ), allowing for survival and growth of advanced CRC. Our findings identified a PMN-induced HR-deficient CRC phenotype, featuring low RAD51 and low Ku70 levels, rendering it susceptible to synthetic lethality induced by clinically approved PARP1 inhibitor Olaparib. We further identified a distinct PMN-induced HR-deficient CRC phenotype, featuring high Ku70 and heightened NHEJ, which can be therapeutically targeted by specific inhibition of NHEJ. Conclusions: Our work delineates 2 mechanism-based translatable therapeutic interventions in sporadic CRC.

Original languageEnglish (US)
Pages (from-to)225-238.e15
Issue number1
StatePublished - Jul 2021


  • Colon Cancer
  • DSB
  • Ku70
  • MicroRNA
  • Rad51

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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