Platelet-derived extracellular vesicles inhibit ferroptosis and promote distant metastasis of nasopharyngeal carcinoma by upregulating ITGB3

Int J Biol Sci. 2022 Sep 24;18(15):5858-5872. doi: 10.7150/ijbs.76162. eCollection 2022.


Nasopharyngeal carcinoma (NPC) is a malignancy with high metastatic and invasive nature. Distant metastasis contributes substantially to treatment failure and mortality in NPC. Platelets are versatile blood cells and the number of platelets is positively associated with the distant metastasis of tumor cells. However, the role and underlying mechanism of platelets responsible for the metastasis of NPC cells remain unclear. Here we found that the distant metastasis of NPC patients was positively correlated with the expression levels of integrin β3 (ITGB3) in platelet-derived extracellular vesicles (EVs) from NPC patients (P-EVs). We further revealed that EVs transfer occurred from platelets to NPC cells, mediating cell-cell communication and inducing the metastasis of NPC cells by upregulating ITGB3 expression. Mechanistically, P-EVs-upregulated ITGB3 increased SLC7A11 expression by enhancing protein stability and activating the MAPK/ERK/ATF4/Nrf2 axis, which suppressed ferroptosis, thereby facilitating the metastasis of NPC cells. NPC xenografts in mouse models further confirmed that P-EVs inhibited the ferroptosis of circulating NPC cells and promoted the distant metastasis of NPC cells. Thus, these findings elucidate a novel role of platelet-derived EVs in NPC metastasis, which not only improves our understanding of platelet-mediated tumor distant metastasis, but also has important implications in diagnosis and treatment of NPC.

Keywords: ITGB3; extracellular vesicles; ferroptosis; nasopharyngeal carcinoma; platelets.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cell Line, Tumor
  • Extracellular Vesicles* / metabolism
  • Ferroptosis*
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Integrin beta3 / genetics
  • Integrin beta3 / metabolism
  • Mice
  • NF-E2-Related Factor 2 / metabolism
  • Nasopharyngeal Carcinoma / genetics
  • Nasopharyngeal Neoplasms* / metabolism
  • Neoplasm Metastasis / pathology


  • Integrin beta3
  • NF-E2-Related Factor 2
  • ITGB3 protein, human