VHL loss reprograms the immune landscape to promote an inflammatory myeloid microenvironment in renal tumorigenesis

Clear cell renal cell carcinoma (ccRCC) is an aggressive disease characterized by dysregulated hypoxia signaling, metabolic defects, and a complex tumor microenvironment (TME) highly enriched in lymphoid and myeloid immune cells. Loss of the oxygen sensing gene, von Hippel Lindau (VHL), is a critical early event in ccRCC pathogenesis and promotes stabilization of hypoxia inducible factors (HIF) that upregulate pro-growth signaling pathways, including angiogenesis and aerobic glycolysis. However, whether VHL loss in cancer cells impacts the composition, metabolism, or function of immune cells in the TME remains unclear. Using Vhl wildtype (WT) and knockout (KO) in vivo murine kidney cancer models, we found that Vhl KO tumors were less proliferative and more infiltrated by immune cells. Tumor-associated macrophages (TAM) demonstrated enhanced proinflammatory transcriptional signatures from Vhl deficient tumors, and intratumoral myeloid cells residing in the Vhl KO TME showed increased in vivo glucose consumption. Vhl loss did not confer increased in vivo glucose uptake in cancer cells or lymphocytes, or detectable changes in metabolites in the interstitial fluid. Mechanistically, enhanced secretion of the chemokine, CX3CL1, was observed in Vhl KO cancer cells and its cognate receptor, CX3CR1, was significantly elevated on myeloid cells residing in the TME of Vhl deficient tumors. Human ccRCC tumors exhibit high expression of CX3CL1 and CX3CR1 as well as enhanced myeloid metabolism and proinflammatory properties. Here, we identify the importance of cancer cell-specific genetic features to drive environmental reprograming and shape the tumor immune landscape and identify a potential therapeutic target in the treatment of ccRCC.