Schwannomas typically progress slowly and are not considered to be angiogenic tumors. However, our recent review of surgical archival specimen revealed a proangiogenic profile defined by number and size of vessels combined with quantification of VEGF expression and SEMA3F loss [
3]. Furthermore, in a recent preclinical study, we showed that loss of the
Nf2 gene was accompanied by the loss of SEMA3F and that treatment with anti-VEGF therapies resulted in sustained decreases in growth rate and vessel permeability [
4]. These findings ledus to propose that the loss of merlin could contribute to an abnormal tumor vasculature by disrupting the delicate balance of proangiogenic and antiangiogenic factors.
In the current study, we indeed found that merlin regulates expression of class 3 SEMAs through the Rho GTPase Rac1 specifically, but not the other close family members such as cdc42 or Rho A. Rac1 expression levels were found upregulated as well as Rac1 protein translocated to the membrane ruffles in human schwannoma cells lacking wild-type copies of merlin [
26]. Merlin was subsequently found to regulate cell proliferation and contact inhibition dominantly by interfering with the guanine exchange of Ras and Rac and its downstream signaling cascades involving Raf and ERK [
29]. In addition, Rac1 activity has been reported to modulate growth cone collapse induced by SEMA3A [
30–32]. Our findings established a signaling cascade connection whereby Rac1 works downstream of merlin and upstream of SEMA3F (). However, as blocking the expression and activity of Rac1 was able to virtually erase SEMA3F expression, it is likely that the regulation involves multiple steps. Histone deacetylase may represent an intermediate step between Rac1 and SEMA3F because its activity directly correlated with active Rac1 [
33,34] and histone deacetylase inhibition markedly stimulated the activity of SEMA3F [
35].
By reintroducing SEMA3F into merlin-deficient schwannoma cells, we further confirmed the role of SEMA3F as an antiangiogenic factor in our experimental settings. Our data are consistent with the published data that expression of SEMA3F was specifically downregulated in NF2-driven schwannomas [
3] as well as in tumors of the pancreatic and cervical origins [
36] and that reexpressing SEMA3F is able to decrease tumor vascularity and restore pericyte coverage
in vivo [
19,36]. On the basis of this potent angio inhibitory effect, we are the first to show that orthotopic schwannoma tumors overexpressing SEMA3F were smaller in size and the lower tumor burden resulted in extension of overall survival, similar to the effect observed in mice carrying pancreatic tumors overexpressing SEMA3A [
36]. Furthermore, we showed that reexpressing SEMA3F contributed to an effective decrease in permeability. Although much less is known about the blood-nerve barrier, permeability has been shown to play a role in schwannomas and its control might have a direct benefit [
3,4].
In addition to SEMA3F, we also found that TSP2 was highly upregulated in
Nf2-/- schwannoma cells that were reintroduced with wild-type merlin. This up-regulation is consistent with the idea that Rac1 is working upstream because it has been reported that a constitutively active mutant of Rac1 (RacV12) is able to regulate TSP2 expression at the transcription level in endothelial cells [
28]. However, we did not observe any detectable antiangiogenic properties with merlin-deficient schwannoma cells that overexpress TSP2
in vivo (). In general, thrombospondins are antiangiogenic [
37]. However, because TSP1 and TSP2 are composed of multiple functional domains and each has its own receptors, the consequence of TSP expression may not always be simply antiangiogenic. In fact, there is ample evidence that TSP1 is not antiangiogenic and even proangiogenic [
38–41]. In all these studies, it can be concluded that the overall angiogenic outcome initiated by TSPs is largely determined by 1) specific domain interaction with appropriate receptors, (2) absolute concentration of TSPs, and/or (3) the unique microenvironment of the experimental models. Because TSP2 has an equivalent domain structure to TSP1 and the microenvironment of nerve tumors is not completely explored, it is plausible to assume that the domain/receptor interactions between the tumor-secreted TSP2 and the stroma could be complex, and thus, the overall angiogenic outcome is difficult to predict. Moreover, because TSP2 has pleiotropic effects and is involved in processes as disparate as bone growth, homeostasis, and foreign body response [
42], it is also possible that TSP2 is not simply angioinhibitory in the nerve microenvironment. Nevertheless, it is essential to establish a causal correlation between TSP2 and merlin in clinical samples of NF2-related schwannomas so that the precise role of TSP2 can be investigated in the pathogenesis of schwannomas.
Furthermore, there are few data on the regulation and interaction between SEMA3F, RAC1, and TSP2. Our data suggest SEMA3F is upstream of TSP2 because TSP2 is increased with SEMA3F expression, but the reverse is not true. SEMA3F works upstream of RhoA and ROCK because this signaling cascade leads to the activation of cofilin and actin depolymerization in both glioma and endothelial cells [
21]. In addition, RhoA and ROCK are able to suppress TSP1 through Myc, a close member of TSP2 [
43]. Interestingly, Myb, a nuclear transcription factor in the same class of Myc, has been shown to suppress TSP2 specifically [
44]. Therefore, we speculate that SEMA3F works upstream of TSP2, possibly through RhoA, ROCK, and Myb.
In summary, this study revealed that merlin/NF2, a tumor suppressor gene, on top of its antiproliferative function on contact inhibition, also influenced tumor angiogenesis by regulating expression of SEMA3F, a potent angioinhibitory factor, and this regulation worked through Rac1. This study further advanced our knowledge that angiogenesis is essential in benign tumor progression, and by modulating the relative balance of proangiogenic and antiangiogenic components in these tumors, one can successfully control tumor development. This study provides a mechanism for the potential “angiogenic switch” in NF2-driven schwannoma. Benign tumors such as schwannomas progress very slowly, and understanding the mechanism behind the modulation of the proangiogenic and antiangiogenic balance will contribute to improving treatment of these tumors. Although treatment with anti-VEGF therapies has proven successful so far, the long-term treatment of these patients necessitates the identification of new therapeutic regimens. To date, although SEMA3F is well established as an inhibitor of angiogenesis, the regulatory mechanisms of SEMA3F, or other secreted SEMAs that possess potent antiangiogenic properties, are not completely understood. In fact, small molecules that can stimulate SEMA3s expression or activity have not been developed. We strongly believe that more effort should be focused on finding drugs/small molecules that can enhance the SEMA-NRP-plexin signaling event. Modulating angiogenic balance by inhibiting proangiogenesis (blocking VEGF [
4]), or promoting antiangiogenesis (reintroducing SEMA3s, this study), proved to be a successful way to control schwannoma progression and should be considered as a novel approach to treat neurofibromatosis-related tumors similar to malignant tumors [
9].