Endogenous Propionibacterium acnes Promotes Ovarian Cancer Progression via Regulating Hedgehog Signalling Pathway

SIMPLE SUMMARY: Epithelial ovarian cancer (EOC) is the most lethal gynaecological malignancy, yet with a still unsatisfactory clinical outcome. Currently, the relationship between intratumor microbiota and the treatment of malignant tumours is a research hotspot, and studies have elucidated their functions on tumour biology. However, there are few studies on the microbial composition of the epithelial benign ovarian tumour or EOC and the potential role of intratumour microbiota in EOC, and its molecular mechanism is still lacking. This study compares the similarities and differences of intratumour microbiota among patients with epithelial benign ovarian tumour and patients with EOC, identifies Propionibacterium acnes is a key strain in facilitating EOC progression, and further ascertains the underlying molecular mechanisms associated with the increased inflammatory response to activate the hedgehog signalling pathway. This could provide insights on improving EOC therapeutics. ABSTRACT: Background: The oncogenesis and progression of epithelial ovarian cancer (EOC) is a complicated process involving several key molecules and factors, yet whether microbiota are present in EOC, and their role in the development of EOC, remains greatly unknown. Methods: In this study, 30 patients were enrolled to compare the similarities and differences of intratumour microbiota among patients with epithelial benign ovarian tumours (EBOTs) and patients with EOC based on the high-throughput sequencing method. Subsequently, we further isolated the specific EOC-related bacteria and defined Propionibacterium acnes as a key strain in facilitating EOC progression. More importantly, we constructed a mouse EOC model to evaluate the effect of the P. acnes strain on EOC using immunohistochemistry, Western blotting, and RT-qPCR. Results: The high-throughput sequencing showed that the intratumour microbiota in EOC tissues had a higher microbial diversity and richness compared to EBOT tissues. The abundance of previously considered pathogens, Actinomycetales, Acinetobacter, Streptococcus, Ochrobacterium, and Pseudomonadaceae Pseudomonas, was increased in the EOC tissues. Meanwhile, we discovered the facilitating role of the P. acnes strain in the progression of EOC, which may be partially associated with the increased inflammatory response to activate the hedgehog (Hh) signalling pathway. This microbial-induced EOC progression mechanism is further confirmed using the inhibitor GANT61. Conclusions: This study profiled the intratumour microbiota of EBOT and EOC tissues and demonstrated that the diversity and composition of the intratumour microbiota were significantly different. Furthermore, through in vivo and in vitro experiments, we confirmed the molecular mechanism of intratumour microbiota promotion of EOC progression in mice, which induces inflammation to activate the Hh signalling pathway. This could provide us clues for improving EOC treatment.