Activation of M2 macrophage autophagy by rapamycin increases the radiosensitivity of colorectal cancer xenografts

Background: Tumor‑associated macrophages (TAMs) are intimately involved in cancer radiochemotherapy resistance. However, the mechanism by which macrophages affect radiosensitivity through autophagy remains unclear. The purpose of our study was to investigate how activating autophagy in type‑II macrophages (M2) by using rapamycin (RAP) would affect the radiosensitivity of colorectal cancer (CRC) xenografts. Materials and Methods: A nude mouse CRC model was established by injecting LoVo CRC cells. After tumor formation, supernatant from M2 cells (autophagy‑unactivated), autophagy‑activated M2 cells, or autophagy‑downregulated M2 cells was injected peritumorally. All tumor‑bearing mice were irradiated with 8‑Gy X‑rays twice, and the radiosensitivity of CRC xenografts was analyzed in each group. Results: The mass, volume, and microvessel density (MVD) of tumors in the autophagy‑unactivated M2 group significantly increased; however, supernatant from M2 cells that were autophagy‑activated by rapamycin significantly decreased tumor weight, volume, and MVD compared with negative control. Combining bafilomycin A1 (BAF‑A1) with RAP treatment restored the ability of the M2 supernatant to increase tumor mass, volume, and MVD. Immunohistochemical and Western blot results showed that compared with the negative control group, supernatant from M2 cells that were not activated by autophagy downregulated the expression of Livin and Survivin in tumor tissues; activation of M2 autophagy further downregulated the protein levels. Conclusions: Therefore, autophagy‑activated M2 supernatant can downregulate the expression of the antiapoptotic genes Livin and Survivin in CRC xenografts, improving the radiosensitivity of CRC by inducing apoptosis in combination with radiotherapy and inhibiting the growth of transplanted tumors.