bioRxiv2022
Early lung cancer lesions develop within a unique microenvironment that undergoes constant cyclic stretch from respiration. While tumor stiffening is an established driver of tumor progression, the contribution of stress and strain to lung cancer is unknown. We developed tissue scale finite element models of lung tissue to test how early lesions alter respiration-induced strain. We found that an early tumor, represented as alveolar filling, amplified the strain experienced in the adjacent alveolar walls. Tumor stiffening further increased the amplitude of the strain in the adjacent alveolar walls and extended the strain amplification deeper into the normal lung. In contrast, the strain experienced in the tumor proper was less than the applied strain, although regions of amplification appeared at the tumor edge. Measurements of the alveolar wall thickness in clinical and mouse model samples of lung adenocarcinoma (LUAD) showed wall thickening adjacent to the tumors, consistent with cellular response to strain. Modeling alveolar wall thickening by encircling the tumor with thickened walls moved the strain amplification radially outward, to the next adjacent alveolus. Simulating iterative thickening in response to amplified strain produced tracks of thickened walls. We observed such tracks in early-stage clinical samples. The tracks were populated with invading tumor cells, suggesting that strain amplification in very early lung lesions could guide pro-invasive remodeling of the tumor microenvironment. The simulation results and tumor measurements suggest that cells at the edge of a lung tumor and in surrounding alveolar walls experience increased strain during respiration that could promote tumor progression. Author SummaryLung cancer is the leading cause of cancer-related death in the world. Efforts to identify and treat patients early are hampered by an incomplete understanding of the factors that drive early lesion progression to invasive cancer. We aimed to understand the role of mechanical strain in early lesion progression. The lung is unique in that it undergoes cyclic stretch, which creates strain across the alveolar walls. Computational models have provided fundamental insights into the stretch-strain relationship in the lung. In order to map the strain experienced in the alveolar walls near a tumor, we incorporated a tumor into a tissue scale model of the lung under stretch. We used finite element modeling to apply physiological material behavior to the lung and tumor tissue. Based on reported findings and our measurements, tumor progression was modeled as stiffening of the tumor and thickening of the tumor-adjacent alveolar walls. We found that early tumors amplified the strain in the tumor-adjacent alveolar walls. Strain amplification also arose at the tumor edges. Simulating strain-mediated wall stiffening generated tracks of thickened walls. We experimentally confirmed the presence of tracks of thickened extracellular matrix in clinical samples of LUAD. Our model is the first to interrogate the alterations in strain in and around a tumor during simulated respiration and suggests that lung mechanics and strain amplification play a role in early lung tumorigenesis.