Journal Article DKFZ-2025-01876

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Coagulation proteases modulate nucleic acid uptake and cGAS-STING-IFN induction in the tumor microenvironment.

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2025
JCI Insight Ann Arbor, Michigan

JCI insight 10(17), e190311 () [10.1172/jci.insight.190311]
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Abstract: Malignancies increase the risk for thrombosis and metastasis dependent on complex interactions of innate immune cells, platelets, and the coagulation system. Immunosuppressive functions of platelets and macrophage-derived coagulation factors in the tumor microenvironment (TME) drive tumor growth. Here, we show that patients with malignancies and tumor-bearing mice have increased levels of coagulation factor (F) X-expressing circulating monocytes engaged in platelet aggregate formation. This interaction and resulting thrombin generation on platelets interferes with monocyte differentiation and antigen uptake of antigen-presenting cells (APCs). Myeloid cell-specific deletion of FX or abrogated FXa signaling via protease activated receptor 2 (PAR2) averts the suppressive activity of platelets on tumor cell debris uptake and promotes the immune stimulatory activity of APCs in the TME. Myeloid cell FXa-PAR2 signaling deficiency specifically enhances activation of the cGAS-STING-IFN-I pathway with a resulting expansion of antigen experienced progenitor exhausted CD8+ T cells. Pharmacological blockade of FXa with direct oral anticoagulants expands T cell priming-competent immune cells in the TME and synergizes with the reactivation of exhausted CD8+ T cells by immune checkpoint inhibitors for improved antitumor responses. These data provide mechanistic insights into the emerging clinical evidence demonstrating the translational potential of FXa inhibition to synergize with immunotherapy.

Keyword(s): Tumor Microenvironment: immunology (MeSH) ; Animals (MeSH) ; Humans (MeSH) ; Mice (MeSH) ; Membrane Proteins: metabolism (MeSH) ; Nucleotidyltransferases: metabolism (MeSH) ; Neoplasms: immunology (MeSH) ; Neoplasms: pathology (MeSH) ; Signal Transduction (MeSH) ; Blood Platelets: metabolism (MeSH) ; Blood Platelets: immunology (MeSH) ; Factor Xa: metabolism (MeSH) ; Factor Xa: genetics (MeSH) ; Female (MeSH) ; Receptor, PAR-2: metabolism (MeSH) ; Receptor, PAR-2: genetics (MeSH) ; CD8-Positive T-Lymphocytes: immunology (MeSH) ; Mice, Inbred C57BL (MeSH) ; Monocytes: metabolism (MeSH) ; Monocytes: immunology (MeSH) ; Antigen-Presenting Cells: immunology (MeSH) ; Male (MeSH) ; Cancer immunotherapy ; Coagulation ; Immunology ; Oncology ; Platelets ; Vascular biology ; Membrane Proteins ; Nucleotidyltransferases ; STING1 protein, human ; cGAS protein, human ; Sting1 protein, mouse ; Factor Xa ; Receptor, PAR-2 ; cGAS protein, mouse

Classification:

Contributing Institute(s):
  1. DKTK Koordinierungsstelle Frankfurt (FM01)
Research Program(s):
  1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2025
Database coverage:
Medline ; Creative Commons Attribution CC BY (No Version) ; DOAJ ; Article Processing Charges ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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 Record created 2025-09-10, last modified 2025-09-14



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