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Abstract Breast cancer, particularly the triple-negative subtype, is the primary cause of brain metastasis in women, affecting 10-20% of breast cancer patients. Breast cancer patients who develop brain metastasis have few treatment options and a dismal prognosis with a median survival time of 6-16 months. We demonstrated, for the first time, that EVs derived from brain-seeking breast cancer cells (BrEVs) breach the intact blood-brain barrier (BBB) via transcytosis and cause a significantly increased incidence of breast-to-brain metastasis. Within this context, we are now studying the interactions between BrEVs and the endothelial cells (ECs) of the BBB. BrEVs were isolated by ultracentrifugation, characterized following the latest guidelines published by the International Society of Extracellular Vesicles (MISEV 2018) and tested in vitro using primary human brain ECs and in vivo using our mouse model of breast-to-brain metastasis. ECs were treated with BrEVs and analyzed using antibody-based assays, impedance measurements, genetic engineering and fixed and live cell imaging. The imaging results were analyzed using novel machine learning approaches to detect and describe, for the first time, EV-mediated morphodynamic changes at the brain EC barrier level. In vivo, we administered BrEVs intravenously to our models of breast-to-brain metastasis, followed by the analysis of mouse brains and their cerebral microvessels to examine microscopic structure and protein expression. Our studies show that (1) BrEVs target BBB ECs both in vitro and in vivo, causing significant variations of multiple proteins involved in the intracytoplasmic vesicles' long-recycling loop, (2) BrEVs are responsible for specific EC barrier function and morphodynamic changes and (3) BrEVs mediate, at least in part, their effect (s) through the delivery of specific micro RNAs. Taken together, our studies demonstrate that BrEVs have a significant impact on brain EC endocytic metabolism and morphodynamics, promoting transcytosis and sustaining breast-to-brain metastasis. Our findings increase our understanding of the early events that facilitate brain metastasis and have the potential to identify key regulators of brain metastasis formation. These results also inform and contribute to the development of EV-based therapeutic and diagnostic strategies for brain metastasis. (This work was supported by NIH R21 CA253051-01, the Breast Cancer Research Foundation, NIH T32 5T32HL007917-22 and the Nile Albright Research Foundation. ) Citation Format: Sara Busatto, Golnaz Morad, Marsha A Moses. Breast cancer-derived extracellular vesicles modulate the endocytic metabolism and morphodynamics of the endothelial cells of the blood-brain barrier abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts) ; 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84 (6Suppl): Abstract nr 1500.
Busatto et al. (Fri,) studied this question.