Targeting GLP-1R and IL-17A suppresses obesity-induced leukemia in an oncogenic PTPN11 mutation–driven model

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Abstract

Obesity is increasingly implicated in hematopoietic malignancies, yet its role in mutation-driven myeloid leukemias remains unclear. Using UK Biobank data from over 440,000 individuals, we found obesity traits including elevated BMI and waist-to-hip ratio were associated with type 2 diabetes, increased plasma IL-17A levels, reduced glucagon-like peptide 1 receptor (GLP-1R) expression, and heightened risk of myeloid malignancies. Transplantation of protein tyrosine phosphatase nonreceptor type 11 (PTPN11) (Shp2E76K/+) mutant hematopoietic stem/progenitor cells into obese mice demonstrated that metabolic inflammation accelerated leukemogenesis via myeloid cell expansion, lipid metabolic rewiring, IL-17A activation, and accumulation of M2-like tumor-associated macrophages (TAMs), accompanied by T cell exhaustion and impaired antigen presentation. Notably, dual therapy with an anti–IL-17A antibody and a GLP-1R agonist reversed these effects by reducing M2-like TAMs, restoring Ciita-dependent antigen presentation and Tyk2-mediated IFN-γ signaling, reactivating T cell responses, and reducing leukemic burden. These findings establish IL-17A–driven, metabolism-coupled immunosuppression as a mechanistic link between obesity and protein tyrosine phosphatase 2–mutant (SHP2-mutant) myeloid leukemias, highlighting a tractable therapeutic strategy for patients with obesity at high risk for other diseases and their complications.

Authors

Reuben Kapur, Linke Li, Rahul Kanumuri, Kanaka Sai Ram Padam, Baskar Ramdas, Chiranjeevi Pasala, Gabriela Chiosis, Lakshmi Reddy Palam, Ramesh Kumar, Satoshi Koyama, Pradeep Natarajan, Laura S. Haneline, Zhi Yu, Santhosh Kumar Pasupuleti