Fukumura, Dai, MD, PhD

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Angiogenesis and Microcirculation in Physiological and Pathophysiological Settings

The long-term goal of my research is to uncover the fundamental nature of vascular biology in both physiological and pathophysiological settings, and to utilize this knowledge for detection and treatment of diseases. Together with outstanding collaborators, I have been developing and utilizing state of the art imaging techniques and animal models which led to the discoveries summarize below.

Role of NO in tumor angiogenesis, lymphangiogenesis, microcirculation and radiation therapy

Nitric oxide (NO) is a highly reactive mediator with a variety of physiological and pathological functions. NO increases and/or maintains tumor blood flow, decreases leukocyte-endothelial interactions, and increases vascular permeability and thus, may facilitate tumor growth. Furthermore, NO mediates angiogenesis and vessel maturation predominantly through endothelial NO synthase. We also found that NO mediates lymph-angiogenesis and metastasis as well as function of lymphatic vessels. We recently uncovered that restoration of perivascular NO gradients improves structure and function of both blood and lymphatic vessels, and response to radiation.

Role of tumor-host interactions in angiogenesis, tumor growth and metastasis

Using genetically engineered mouse and tumor models as well as in vivo imaging techniques, we found for the first time that nontransformed stromal cells –including activated fibroblasts, bone marrow derived cells – are a major inducer of tumor angiogenesis and mediate the formation of abnormal microenvironment. Furthermore, various anti-angiogenic or molecularly targeting treatments result in the activation of host stromal cells leading to treatment resistance. Our recent data indicate that stromal cells in the primary tumor travel with tumor cells and facilitate survival and growth of metastatic tumors. Controlling tumor-host interaction is an promising approach to facilitate tumor treatment. For example,, the blockade of vascular endothelial growth factor signaling can transiently normalize tumor vasculature and potentiate anti-tumor cytotoxic therapies.

Probing tumor microenvironment using nanotechnology

We have been studying the tumor microenvironment and transport properties using nano-probes. We found that relatively large nanoparticles – size of current nanomedicine – can take advantage of enhanced permeability and retention effect for transvascular transport but are unable to penetrate into tumor tissues. We also found superior transvascular transport of rod-shape over spherical nanoparticles. Furthermore, we discovered that neutral charge is the best for interstitial transport. These findings led us to develop multistage nanotherapeutics that shrink upon the entry to the tumor microenvironment in order to facilitate interstitial transport.

Role of obesity in angiogenesis, tumor growth and treatments.

First, we established in vivo system to investigate blood vessel formation during adipogenesis. Using genetic inhibition of PPAR? and pharmacological inhibition of VEGFR2 signaling we found provocative reciprocal regulation of adipogenesis and angiogenesis, suggesting a novel strategy to treat obesity related diseases including cancer. We then established a physiologically based mathematical model and found that leptin pathway plays a key role in maintenance of body mass and its disruption destroys the body weight balance. We are currently studying the underling mechanisms of obesity-induced aggravation of breast cancer through both preclinical studies and clinical trials of breast cancer patients.

Engineering blood vessels

A major limitation of tissue engineering is the lack of functional blood and lymph vessels. First, we established a model to monitor tissue engineered blood vessels in vivo using MPLSM. We found that mesenchymal precursor cells accelerate remodeling of 3-D endothelial cell structure to functional blood vessels, differentiate into peri-vascular cells, and stabilize engineered vessel network for up to a year. Using this tissue engineered blood vessel model,.we then, showed that human ES cell, cord blood and peripheral blood -derived endothelial cells form functional blood vessels in vivo and that human bone marrow derived mesenchymal stem cells serve as perivascular precursor cells, mature and stabilize blood vessels. Detail observation of vessel anastomosis in these tissue-engineered blood vessels revealed a novel mechanism – wrapping-and-tapping of host vessels. More recently, we have established robust protocols deriving endothelial cells and mesenchymal precursor cells from induced pluripotent stem (iPS) cells and successfully generated blood vessels these iPS-derived cells

Selected Publications (from total of 213)

Kodack DP, Askoxylakis V, Ferraro GB, Sheng Q, Badeaux M, Goel S, Qi X, Shankaraiah R, Cao ZA, Ramjiawan RR, Bezwada D, Patel B, Song Y, Costa C, Naxerova K, Wong CSF, Kloepper J, Das R, Tam A, Tanboon J, Duda DG, Miller CR, Siegel MB, Anders CK, Sanders M, Estrada MV, Schlegel R, Arteaga CL, Brachtel E, Huang A, Fukumura D, Engelman JA, Jain RK
The brain microenvironment mediates resistance in luminal breast cancer to PI3K inhibition through HER3 activation.
Sci Transl Med. 2017;9(391):ePub - PMID: 28539475
Martin JD, Fukumura D, Duda DG, Boucher Y, Jain RK
Corrigendum: Reengineering the Tumor Microenvironment to Alleviate Hypoxia and Overcome Cancer Heterogeneity.
Cold Spring Harb Perspect Med. 2016;6(12):ePub - PMID: 27908927 - PMCID: PMC5131752
Rahbari NN, Kedrin D, Incio J, Liu H, Ho WW, Nia HT, Edrich CM, Jung K, Daubriac J, Chen I, Heishi T, Martin JD, Huang Y, Maimon N, Reissfelder C, Weitz J, Boucher Y, Clark JW, Grodzinsky AJ, Duda DG, Jain RK, Fukumura D
Anti-VEGF therapy induces ECM remodeling and mechanical barriers to therapy in colorectal cancer liver metastases.
Sci Transl Med. 2016;8(360):360ra135 - PMID: 27733559 - PMCID: PMC5457741
Martin JD, Fukumura D, Duda DG, Boucher Y, Jain RK
Reengineering the Tumor Microenvironment to Alleviate Hypoxia and Overcome Cancer Heterogeneity.
Cold Spring Harb Perspect Med. 2016;:ePub - PMID: 27663981
Meijer EF, Baish JW, Padera TP, Fukumura D
Measuring Vascular Permeability In Vivo.
Methods Mol Biol. 2016;1458:71-85 - PMID: 27581015 - PMCID: PMC5435480
Incio J, Liu H, Suboj P, Chin SM, Chen IX, Pinter M, Ng MR, Nia HT, Grahovac J, Kao S, Babykutty S, Huang Y, Jung K, Rahbari NN, Han X, Chauhan VP, Martin JD, Kahn J, Huang P, Desphande V, Michaelson J, Michelakos TP, Ferrone CR, Soares R, Boucher Y, Fukumura D, Jain RK
Obesity-induced inflammation and desmoplasia promote pancreatic cancer progression and resistance to chemotherapy.
Cancer Discov. 2016;6(8):852-69 - PMID: 27246539 - PMCID: PMC4972679
Patil MD, Bhaumik J, Babykutty S, Banerjee UC, Fukumura D
Arginine dependence of tumor cells: targeting a chink in cancer's armor.
Oncogene. 2016;35(38):4957-72 - PMID: 27109103 - PMCID: PMC5457742
Kloepper J, Riedemann L, Amoozgar Z, Seano G, Susek K, Yu V, Dalvie N, Amelung RL, Datta M, Song JW, Askoxylakis V, Taylor JW, Lu-Emerson C, Batista A, Kirkpatrick ND, Jung K, Snuderl M, Muzikansky A, Stubenrauch KG, Krieter O, Wakimoto H, Xu L, Munn LL, Duda DG, Fukumura D, Batchelor TT, Jain RK
Ang-2/VEGF bispecific antibody reprograms macrophages and resident microglia to anti-tumor phenotype and prolongs glioblastoma survival.
Proc Natl Acad Sci U S A. 2016;113(16):4476-81 - PMID: 27044098 - PMCID: PMC4843473
Peterson TE, Kirkpatrick ND, Huang Y, Farrar CT, Marijt KA, Kloepper J, Datta M, Amoozgar Z, Seano G, Jung K, Kamoun WS, Vardam T, Snuderl M, Goveia J, Chatterjee S, Batista A, Muzikansky A, Leow CC, Xu L, Batchelor TT, Duda DG, Fukumura D, Jain RK
Dual inhibition of Ang-2 and VEGF receptors normalizes tumor vasculature and prolongs survival in glioblastoma by altering macrophages.
Proc Natl Acad Sci U S A. 2016;113(16):4470-5 - PMID: 27044097 - PMCID: PMC4843449
Incio J, Tam J, Rahbari NN, Suboj P, McManus DT, Chin SM, Vardam T, Batista A, Babykutty S, Jung K, Khachatryan A, Hato T, Ligibel JA, Krop I, Puchner SB, Schlett CL, Hoffmman U, Ancukiewicz M, Shibuya M, Carmeliet P, Soares R, Duda DG, Jain RK, Fukumura D
PlGF/VEGFR-1 signaling promotes macrophage polarization and accelerated tumor progression in obesity.
Clin Cancer Res. 2016;22(12):2993-3004 - PMID: 26861455 - PMCID: PMC4911258
Fukumura D, Incio J, Shankaraiah R, Jain RK
Obesity and cancer: an angiogenic and inflammatory link.
Microcirculation. 2016;23(3):191-206 - PMID: 26808917 - PMCID: PMC4818678
Park KR, Monsky WL, Lee CG, Song CH, Kim DH, Jain RK, Fukumura D
Mast Cells Contribute to Radiation-Induced Vascular Hyperpermeability.
Radiat Res. 2016;185(2):182-189 - PMID: 26771172 - PMCID: PMC4761451
Whitley MJ, Cardona DM, Lazarides AL, Spasojevic I, Ferrer JM, Cahill J, Lee CL, Snuderl M, Blazer DG, Hwang ES, Greenup RA, Mosca PJ, Mito JK, Cuneo KC, Larrier NA, O'Reilly EK, Riedel RF, Eward WC, Strasfeld DB, Fukumura D, Jain RK, Lee WD, Griffith LG, Bawendi MG, Kirsch DG, Brigman BE
A mouse-human phase 1 co-clinical trial of a protease-activated fluorescent probe for imaging cancer.
Sci Transl Med. 2016;8(320):320ra4 - PMID: 26738797 - PMCID: PMC4794335
Singhal PK, Sassi S, Lan L, Au P, Halvorsen SC, Fukumura D, Jain RK, Seed B
Mouse embryonic fibroblasts exhibit extensive developmental and phenotypic diversity.
Proc Natl Acad Sci U S A. 2015;113(1):122-7 - PMID: 26699463 - PMCID: PMC4711836
Incio J, Suboj P, Chin SM, Vardam-Kaur T, Liu H, Hato T, Babykutty S, Chen I, Deshpande V, Jain RK, Fukumura D
Metformin Reduces Desmoplasia in Pancreatic Cancer by Reprogramming Stellate Cells and Tumor-Associated Macrophages.
PLoS One. 2015;10(12):e0141392 - PMID: 26641266 - PMCID: PMC4671732
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