Extracellular DNA promotes colorectal tumor cell survival after cytotoxic chemotherapy

Reginald Anunobi, Brian A. Boone, Nick Cheh, Daolin Tang, Rui Kang, Tara Loux, Michael T. Lotze, Herbert J. Zeh

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: Inflammation promotes the growth and survival of malignant cells. Inflammation within the tumor microenvironment is a result of damage-associated molecular patterns released by dead or dying cells that provide survival signals to the surrounding cells. It has been proposed that extracellular DNA can act as a damage-associated molecular pattern given the association between circulating DNA and autoimmune diseases. Herein, we demonstrate a novel role for genomic extracellular DNA binding to the Toll-like receptor (TLR)-9 on tumor cells in response to cytotoxic insult. Materials and methods: The colorectal tumor cell line HCCT116 was used to study the role of DNA in tumor cell response to chemotherapy. Cell viability was assessed using CCK-8 assay. Cell death mechanisms were assessed by YOYO-1 and lactate dehydrogenase staining for necrosis and TUNEL staining for apoptosis. Autophagy was measured by LC3 punctate formation. TLR9-short hairpin RNA was used to knockdown TLR-9 and determine its role in tumor cell response to DNA. Results: DNA is released from necrotic tumor cells after chemotherapy. Survival after cytotoxic insult is enhanced by the presence of extracellular DNA as a result of inhibition of apoptosis and enhanced autophagy. Knockdown of TLR-9 enhanced apoptosis, diminished autophagy, and decreased survival after cytotoxic insult in the presence or absence of extracellular DNA. Conclusions: DNA in the tumor microenvironment promotes survival through induction of autophagy via TLR-9 signaling. This work has important implications for targeting extracellular DNA, TLR-9, and autophagy during treatment with chemotherapy and enhances our understanding of the role of extracellular DNA in the tumor microenvironment.

Original languageEnglish (US)
Pages (from-to)181-191
Number of pages11
JournalJournal of Surgical Research
StatePublished - Jun 2018
Externally publishedYes


  • Apoptosis
  • Autophagy
  • DAMPs
  • Damage-associated molecular patterns receptors
  • Extracellular DNA
  • TLR-9

ASJC Scopus subject areas

  • Surgery


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