Macrophages: modulators of breast cancer progression.

In many solid tumour types the abundance of tumour associated macrophages (TAMs) is correlated with poor prognosis. Macrophages are recruited through the local expression of chemoattractants such as colony stimulating factor 1 (CSF-1) and macrophage chemoattractant protein 1. Over-expression of both of these factors is correlated with poor prognosis in a variety of tumours. Macrophages also play an important physiological role in the development and function of many tissues ranging from the brain to the mammary gland. Thus we hypothesized that TAMs are recruited to tumours through the expression of potent chemoattractants and in this site their normal trophic functions are subverted to promote tumour progression and metastasis. To test this hypothesis we crossed mice deficient in macrophages owing to being homozygous for a null mutation in the CSF-1 gene with mice pre-disposed to mammary cancer due to the epithelial restricted expression of the polyoma middle T oncoprotein. The absence of macrophages did not change the incidence or growth of the primary tumour but decreased its rate of progression and inhibited metastasis. These data are explicable through the known macrophage functions in matrix remodelling, angiogenesis and stimulation of tumour growth and motility through the synthesis of growth and chemotactic factors. Interestingly, these functions are also normally found in wound healing or pathologically during chronic inflammation. This supports the notion that tumours are 'wounds that never heal' and suggests that chronic inflammation through persistent infection or by other means might be an important cofactor in the genesis and promotion of tumours. Macrophages might therefore be important targets for cancer therapies.