Trends in Cancer
Volume 3, Issue 10, October 2017, Pages 678-685
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Opinion
Imaging Tunneling Membrane Tubes Elucidates Cell Communication in Tumors

https://doi.org/10.1016/j.trecan.2017.08.001Get rights and content

Trends

Direct cell-to-cell communication between cellular conduits called tunneling nanotubes (TNTs) and tumor microtubes (TMs) is an emerging and novel concept in cancer cell biology.

Over the past decade, the field has moved from studies in vitro to the examination of tumors ex vivo and, more recently, in vivo studies in animal models.

Advanced microscopy techniques, including but not limited to confocal imaging, electron microscopy, stimulated emission depletion microscopy, and in vivo laser scanning microscopy, are being harnessed to better characterize the structure of TNTs and TMs at high resolution.

More studies are needed to identify the function and mechanisms of TNTs and to determine the extent to which there is heterogeneity between different cell types.

Intercellular communication is a vital yet underdeveloped aspect of cancer pathobiology. This Opinion article reviews the importance and challenges of microscopic imaging of tunneling nanotubes (TNTs) in the complex tumor microenvironment. The use of advanced microscopy to characterize TNTs in vitro and ex vivo, and related extensions called tumor microtubes (TMs) reported in gliomas in vivo, has propelled this field forward. This topic is important because the identification of TNTs and TMs fills the gap in our knowledge of how cancer cells communicate at long range in vivo, inducing intratumor heterogeneity and resistance to treatment. Here we discuss the concept that TNTs/TMs fill an important niche in the ever-changing microenvironment and the role of advanced microscopic imaging to elucidate that niche.

Section snippets

Intercellular Communication Is Vital to Cancer Pathobiology

Research in cellular oncology has elucidated the importance of intercellular communication networks in cancer and in other diseases. There is untapped potential for targeting modes of communication as a novel strategic approach to treating cancer. Better understanding of how this communication occurs will provide insight to explain at the cellular level why and how tumors are able to evade and evolve to become resistant to many forms of currently used cancer-directed therapies.

Tumors are highly

Knowns and Unknowns about TNTs in Cancer

TNTs are open-ended cellular extensions that connect distant cells. What is known thus far is that they can act as conduits for direct intercellular transfer of important cell cargo such as mitochondria, exosomes, viruses, and miRNAs 12, 13, 14, 15, 16, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42. The differences between TNTs and other actin-based protrusions have been discussed and summarized extensively elsewhere 21, 43, 44, 45, 46.

Technical Challenges of Imaging TNTs in Tumors

With the publication of numerous seminal studies in the field over the past 5 years, a clearer picture has emerged suggesting that TNTs are a universal phenomenon (not tissue or cell-type specific) and that they are exacerbated and upregulated under conditions that favor disease states 11, 19, 22, 24, 36, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59. TNTs, or at least TNT-like structures, can be imaged in human tumor tissue using widely available confocal imaging techniques and software

Horizontal Cell Transfer and Chemoresistance: TNTs Can (Literally) Bridge the Gap

The cellular mechanisms of cancer resistance to chemotherapy remain unclear. Current paradigms state that chemoresistance emerges as a result of mutations in key regulatory genes, with cells passing these genetic mutations to daughter cells through mitotic division and clonal expansion (vertical transmission). However, horizontal (cell-to-cell) transmission of regulatory factors via channels of cellular communication could also be responsible for the development of chemotherapy resistance. This

Biomarkers to Better Identify TNTs and TMs: An Important Next Step

In the current era of molecular oncology, most if not all tumor-based biomarkers in clinical use are assessed by molecular genomic techniques. However, cancer-specific cellular markers, if identified, also could be of use in stratifying tumors for response to therapies and assessing metastatic potential. Can evaluating a patient’s primary tumor for the presence of TNTs or TMs provide such a valid and novel cellular predictive biomarker of drug resistance? Their role in human tumors in vivo has

Concluding Remarks

The direct form of cell-to-cell communication that occurs via TNT and TM conduits is a fast-emerging concept in cancer cell biology. Over the past decade, the field has steadily graduated from studies solely done in vitro to a next-level examination of human- and animal-derived tumors ex vivo and, most recently, in vivo studies in animal models. The study of this field has made it necessary to adapt existing imaging technologies and also to explore ways to harness emerging ones such as

Acknowledgments

The authors thank Michael Franklin for excellent editorial suggestions and critical review of the manuscript. They also thank Guillermo Marques and Mark Sanders for helpful assistance with confocal microscopy performed at the University Imaging Centers at the University of Minnesota. The authors regret that, due to space limitations, many excellent publications in this field could not be cited. They thank all researchers who have dedicated their efforts to advancing research on this topic. This

Glossary

Cytonemes
thin cellular extensions characterized in the wing disc of Drosophila and believed to play a role in morphogen transport. Unlike TNTs/TMs, they do not form tunneled ends to recipient cells.
Filopodia
cytoplasmic actin filament-based projections, or protrusions, that are believed to play an important role in cell sensing and migration. Differences from TNTs include the properties of filopodial adherence to the substratum and lack of an open tunnel at the tip.
Heterotopic
located at a

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