Prostate cancer (PCa) is a hormone-dependent tumor and one of the most prevalent cancers in men worldwide. PCa progression is influenced by its interaction with the surrounding tumor microenvironment, highlighting the role of periprostatic adipose tissue (PPAT), which modulates PCa behavior through the secretion of bioactive molecules (e.g., adipokines). However, the influence of this complex cell communication, particularly under altered metabolic conditions, remains to be fully elucidated. We performed multiomic/bioinformatic approaches integrating transcriptomic, proteomic, and metabolomic data from PPATs and their secretome and circulating/urinary of lipocalin-2 (LCN2) levels using a well-characterized cohort 75 PCa-patients vs. 22 control subjects with benign prostate hyperplasia (BPH). Different prostate cell models normal-like (PNT2) and PCa cells (DU145/LNCaP/22Rv1/PC-3) were used to test the role of the LCN2/SLC22A17 axis in PCa cell via multiple functional (proliferation/apoptosis/migration/invasion/colony-formation/tumorsphere assays), molecular (transcriptomic/phospho-proteomic/targeted inflammatory proteomics), and preclinical (in vivo xenograft) analyses. External validation was performed using TCGA, Grasso, and Taylor cohorts, alongside longitudinal proteomic data from patient-derived xenograft models. A signature of significantly dysregulated adipokines was identified in PPAT of PCa vs. BPH patients. Unsupervised clustering analyses revealed two distinct molecular phenotypes (T1/T2) with unique adipokine fingerprints associated with differential obesity-related comorbidities (BMI/diabetes/dyslipidemia), being LCN2 the only adipokine showing consistent dysregulation at the transcriptomic/proteomic levels. Functional experiments demonstrated that LCN2 and its receptor SLC22A17 exert context- and transformation state-dependent effects i.e., in vitro LCN2 and SLC22A17 overexpression promoting migration capacity in normal-like cells, while suppressing aggressive phenotypes (proliferation/invasion/stemness) in malignant models; these findings being also confirmed on in vivo xenograft models. SLC22A17 expression was progressively lost during PCa progression and associated with significantly poorer survival across multiple independent cohorts. Mechanistically, LCN2 modulated critical oncogenic and inflammatory pathways, including NF-κB, TGF-β, JAK/STAT, and inflammasome-related signaling, and showed obesity-specific associations with arachidonic acid and complement components in the PPAT secretome. These results demonstrate a profound dysregulation of the PPAT-derived adipokine profile in PCa associated with obesity-related comorbidities, and reveal a paradoxical, stage- and context-dependent dual role of the LCN2/SLC22A17 axis as a key modulator of PPAT-PCa microenvironment interactions, with potential implications for inflammation, metabolic signaling, and tumor progression. The fat tissue surrounding the prostate-gland, known as periprostatic adipose-tissue (PPAT), is not simply a passive energy store — it actively communicates with prostate cancer (PCa) cells by releasing signaling molecules called adipokines. Our study shows that this communication is profoundly altered in PCa patients, particularly in those with obesity, diabetes, or high cholesterol. By analyzing PPAT samples from a large group of patients and combining genetic/protein/metabolic data, we identified two distinct groups of PCa patients based on their adipokine profiles, each with different metabolic characteristics. Among all adipokines examined, lipocalin-2 (LCN2) and its receptor SLC22A17 stood out as a patho-physiologically relevant system. Interestingly, rather than simply promoting tumor growth, LCN2 appeared to behave differently depending on the context: in normal prostate cells it stimulated migration, whereas in cancer cells reduced aggressiveness features, a finding confirmed both in laboratory experiments and preclinical models. Moreover, SLC22A17 was progressively lost as the disease advanced, and patients with lower levels of both molecules had worse clinical outcomes. These findings suggest that LCN2/SLC22A17-axis plays a complex, context-dependent role in PCa that is strongly influenced by the metabolic environment shaped by the surrounding PPAT, and that obesity-related changes in PPAT may critically influence how PCa develops and progresses.
Pérez-Gómez et al. (Thu,) studied this question.