Chronic Exposure to House Dust Mites: A New Risk Factor for Lung Cancer in Never Smokers - ABSTRACT
The incidence of LC in never-smokers (LCINS) has been increasing but the etiology of this cancer type is largely
unknown. We have generated exciting preliminary data showing that exposure to house dust mites (HDM), the
most common indoor aeroallergen worldwide, not only provokes allergic reactions and inflammation in the lungs,
but also induces pro-tumor inflammation and DNA damage, and accelerates lung cancer (LC) development in
three preclinical mouse models of LC at a dose within the range of the annual human HDM exposure. We
identified that HDM genomic DNA is present in the tumors of a high percentage of LCINS patients and that it is
a strong activator of the AIM2 inflammasome and inducer of IL-1β secretion. Based on these new findings, we
hypothesize that long-term exposure to HDM increases the risk of LC development in susceptible hosts (i.e.,
mice and humans genetically predisposed to LC or co-exposed to other lung carcinogens). Our objectives in this
proposal are: 1) to investigate the cellular mechanisms by which chronic HDM exposure changes the lung
microenvironment and makes it conducive to LC development, 2) to determine whether HDM has mutagenic
effects by studying the mutational signatures potentially linked to HDM exposure in mice in vivo and in human
lung organoids in vitro, and 3) to translate these findings to LCINS patients by identifying the composition of the
lung tumor microenvironment (TME) and the mutational signature profiles in a subgroup of patients with signs of
prior exposure to HDM. Our long-term goal is to increase public awareness of the risk that chronic exposure to
HDM may pose for the development of LCINS. Thus, we propose the following three specific aims (SA): in SA-
1, we will test whether HDM exposure changes the cellular composition of the lung TME, in SA-2, we will
determine whether HDM exposure induces somatic mutations in lung epithelial cells, and in SA-3, we will
evaluate whether HDM exposure can be used as a biomarker for diagnosis, prognosis, and targeted therapy in
LCINS patients. The expected outcomes of this work are 1) to identify the cellular mechanisms by which HDM
exposure promotes LC development in susceptible hosts, 2) to demonstrate that chronic exposure to HDM is a
new environmental risk factor for LCINS, 3) to provide strong scientific support for the development of novel
preventive (e.g., HDM avoidance) and therapeutic (e.g., anti-HDM vaccine, anti-IL-1β antibodies, and
NLRP3/AIM2 inhibitors) interventions in LCINS patients chronically exposed to HDM, and 4) to expand the
investigations of exposure to other aeroallergens as potential risk factors in LC.