Reviewer #1 (Public review):
This work regards the role of Aurora Kinase A (AurA) in trained immunity. The authors claim that AurA is essential to the induction of trained immunity. The paper starts with a series of experiments showing the effects of suppressing AurA on beta-glucan-trained immunity. This is followed by an account of how AurA inhibition changes the epigenetic and metabolic reprogramming that are characteristic of trained immunity. The authors then zoom in on specific metabolic and epigenetic processes (regulation of S-adenocylmethionine metabolism & histone methylation). Finally, an inhibitor of AurA is used to reduce beta-glucan's anti-tumour effects in a subcutaneous MC-38 model.
Strengths:
With the exception of my confusion around the methods used for relative gene expression measurements, the experimental methods are generally well-described. I appreciate the authors' broad approach to studying different key aspects of trained immunity (from comprehensive transcriptome/chromatin accessibility measurements to detailed mechanistic experiments). Approaching the hypothesis from many different angles inspires confidence in the results (although not completely - see weaknesses section). Furthermore, the large drug-screening panel is a valuable tool as these drugs are readily available for translational drug-repurposing research.
Weaknesses
(1) The manuscript contains factual inaccuracies such as:<br /> (a) Intro: the claim that trained cells display a shift from OXPHOS to glycolysis based on the paper by Cheng et al. in 2014; this was later shown to be dependent on the dose of stimulation and actually both glycolysis and OXPHOS are generally upregulated in trained cells (pmid 32320649)<br /> (b) Discussion: Trained immunity was first described as such in 2011, not decades ago.
(2) The authors approach their hypothesis from different angles, which inspires a degree of confidence in the results. However, the statistical methods and reporting are underwhelming.<br /> (a) Graphs depict mean +/- SEM, whereas mean +/- SD is almost always more informative.<br /> (b) The use of 1-tailed tests is dubious in this scenario. Furthermore, in many experiments/figures the case could be made that the comparisons should be considered paired (the responses of cells from the same animal are inherently not independent due to their shared genetic background and, up until cell isolation, the same host factors like serum composition/microbiome/systemic inflammation etc).<br /> (c) It could be explained a little more clearly how multiple testing correction was done and why specific tests were chosen in each instance.<br /> (d) Most experiments are done with n = 3, some experiments are done with n = 5. This is not a lot. While I don't think power analyses should be required for simple in vitro experiments, I would be wary of drawing conclusions based on n = 3. It is also not indicated if the data points were acquired in independent experiments. ATAC-seq/RNA-seq was, judging by the figures, done on only 2 mice per group. No power calculations were done for the in vivo tumor model.<br /> (e) Furthermore, the data spread in many experiments (particularly BMDM experiments) is extremely small. I wonder if these are true biological replicates, meaning each point represents BMDMs from a different animal? (disclaimer: I work with human materials where the spread is of course always much larger than in animal experiments, so I might be misjudging this.).
(3) Maybe the authors are reserving this for a separate paper, but it would be fantastic if the authors would report the outcomes of the entire drug screening instead of only a selected few. The field would benefit from this as it would save needless repeat experiments. The list of drugs contains several known inhibitors of training (e.g. mTOR inhibitors) so there must have been more 'hits' than the reported 8 Aurora inhibitors.
(4) Relating to the drug screen and subsequent experiments: it is unclear to me in supplementary figure 1B which concentrations belong to secondary screens #1/#2 - the methods mention 5 µM for the primary screen and "0.2 and 1 µM" for secondary screens, is it in this order or in order of descending concentration?<br /> (a) It is unclear if the drug screen was performed with technical replicates or not - the supplementary figure 1B suggests no replicates and quite a large spread (in some cases lower concentration works better?)
(5) The methods for (presumably) qPCR for measuring gene expression in Figure 1C are missing. Which reference gene was used and is this a suitably stable gene?
(6) From the complete unedited blot image of Figure 1D it appears that the p-Aurora and total Aurora are not from the same gel (discordant number of lanes and positioning). This could be alright if there are no/only slight technical errors, but I find it misleading as it is presented as if the actin (loading control to account for aforementioned technical errors!) counts for the entire figure.
(7) Figure 2: This figure highlights results that are by far not the strongest ones - I think the 'top hits' deserve some more glory. A small explanation on why the highlighted results were selected would have been fitting.
(8) Figure 3 incl supplement: the carbon tracing experiments show more glucose-carbon going into TCA cycle (suggesting upregulated oxidative metabolism), but no mito stress test was performed on the seahorse.
(9) Inconsistent use of an 'alisertib-alone' control in addition to 'medium', 'b-glucan', 'b-glucan + alisertib'. This control would be of great added value in many cases, in my opinion.
(10) Figure 4A: looking at the unedited blot images, the blot for H3K36me3 appears in its original orientation, whereas other images appear horizontally mirrored. Please note, I don't think there is any malicious intent but this is quite sloppy and the authors should explain why/how this happened (are they different gels and the loading sequence was reversed?)
(11) For many figures, for example prominently figure 5, the text describes 'beta-glucan training' whereas the figures actually depict acute stimulation with beta-glucan. While this is partially a semantic issue (technically, the stimulation is 'the training-phase' of the experiment), this could confuse the reader.
(12) Figure 6: Cytokines, especially IL-6 and IL-1β, can be excreted by tumour cells and have pro-tumoral functions. This is not likely in the context of the other results in this case, but since there is flow cytometry data from the tumour material it would have been nice to see also intracellular cytokine staining to pinpoint the source of these cytokines.