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Viúdez-Pareja C, Kreft E, García-Caballero M. Immunomodulatory properties of the lymphatic endothelium in the tumor microenvironment. Front Immunol 2023; 14:1235812. [PMID: 37744339 PMCID: PMC10512957 DOI: 10.3389/fimmu.2023.1235812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
The tumor microenvironment (TME) is an intricate complex and dynamic structure composed of various cell types, including tumor, stromal and immune cells. Within this complex network, lymphatic endothelial cells (LECs) play a crucial role in regulating immune responses and influencing tumor progression and metastatic dissemination to lymph node and distant organs. Interestingly, LECs possess unique immunomodulatory properties that can either promote or inhibit anti-tumor immune responses. In fact, tumor-associated lymphangiogenesis can facilitate tumor cell dissemination and metastasis supporting immunoevasion, but also, different molecular mechanisms involved in LEC-mediated anti-tumor immunity have been already described. In this context, the crosstalk between cancer cells, LECs and immune cells and how this communication can shape the immune landscape in the TME is gaining increased interest in recent years. In this review, we present a comprehensive and updated report about the immunomodulatory properties of the lymphatic endothelium within the TME, with special focus on primary tumors and tumor-draining lymph nodes. Furthermore, we outline emerging research investigating the potential therapeutic strategies targeting the lymphatic endothelium to enhance anti-tumor immune responses. Understanding the intricate mechanisms involved in LEC-mediated immune modulation in the TME opens up new possibilities for the development of innovative approaches to fight cancer.
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Affiliation(s)
- Cristina Viúdez-Pareja
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, Andalucía Tech, University of Málaga, Málaga, Spain
- IBIMA (Biomedical Research Institute of Málaga)-Plataforma BIONAND, Málaga, Spain
| | - Ewa Kreft
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, Andalucía Tech, University of Málaga, Málaga, Spain
- IBIMA (Biomedical Research Institute of Málaga)-Plataforma BIONAND, Málaga, Spain
| | - Melissa García-Caballero
- Department of Molecular Biology and Biochemistry, Faculty of Sciences, Andalucía Tech, University of Málaga, Málaga, Spain
- IBIMA (Biomedical Research Institute of Málaga)-Plataforma BIONAND, Málaga, Spain
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Liao N, Li C, Cao L, Chen Y, Ren C, Chen X, Mok H, Wen L, Li K, Wang Y, Zhang Y, Li Y, Lv J, Cao F, Luo Y, Li H, Wu W, Balch CM, Giuliano AE. Single-cell profile of tumor and immune cells in primary breast cancer, sentinel lymph node, and metastatic lymph node. Breast Cancer 2023; 30:77-87. [PMID: 36129636 DOI: 10.1007/s12282-022-01400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/24/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Little is known about the host-tumor interaction in the lymph-node basin at a single cell level. This study examines single cell sequences in breast cancer nodal metastases of a patient with triple-negative breast cancer. METHODS The primary breast tumor, sentinel lymph node, an adjacent lymph node with metastatic involvement and a clinically normal-appearing lymph node were collected during surgery. Single-cell sequencing was performed on all four specimens. RESULTS 14,016 cells were clustered into 6 cell subpopulations. Cancer cells demonstrated the molecular characteristics of TNBC basal B subtype and highly expressed genes in the MAPK signaling cascade. Tumor-associated macrophages regulated antigen processing and presentation and other immune-related pathways to promote tumor invasion. CD8 + and CD4 + T lymphocytes concentrated more in sentinel lymph node and mainly stratified into two transcriptional states. The immune-cell amount variation among primary tumor, sentinel and normal lymph nodes showed a similar tendency between the sc-RNA-seq profile of TNBC samples and a previous reported bulk RNA-seq profile of a breast cancer cohort, including all four breast cancer subtype samples. DISCUSSION Single-cell sequencing analysis suggested that the sentinel lymph node was the initial meeting site of tumor infiltration and immune response, where partial T lymphocytes perform anti-tumor activity, while other T cells exhibit an exhausted state. We proposed a molecular explanation to the well-established clinical principle that the 5-year and 10-year survival outcomes were noninferior between SLND and ALND.
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Affiliation(s)
- Ning Liao
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China.
| | - Cheukfai Li
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Li Cao
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yanhua Chen
- Berry Oncology Corporation, No.2 Road Donghu, Fuzhou, 350200, China
| | - Chongyang Ren
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Xiaoqing Chen
- Foshan Maternity and Children's Healthcare Hospital, Affiliated to Southern Medical University, Foshan, China
| | - Hsiaopei Mok
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Lingzhu Wen
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Kai Li
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yulei Wang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yuchen Zhang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yingzi Li
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Jiaoyi Lv
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Fangrong Cao
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yuting Luo
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Hongrui Li
- Berry Oncology Corporation, No.2 Road Donghu, Fuzhou, 350200, China
| | - Wendy Wu
- Berry Oncology Corporation, No.2 Road Donghu, Fuzhou, 350200, China.
| | - Charles M Balch
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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One Step Nucleic Acid Amplification (OSNA) Lysate Samples Are Suitable to Establish a Transcriptional Metastatic Signature in Patients with Early Stage Hormone Receptors-Positive Breast Cancer. Cancers (Basel) 2022; 14:cancers14235855. [PMID: 36497336 PMCID: PMC9736102 DOI: 10.3390/cancers14235855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The One Step Nucleic Acid Amplification (OSNA) is being adopted worldwide for sentinel lymph nodes (SLNs) staging in breast cancer (BC). As major disadvantage, OSNA precludes prognostic information based on structural evaluation of SLNs. Our aim is to identify biomarkers related to tumor-microenvironment interplay exploring gene expression data from the OSNA remaining lysate. This study included 32 patients with early stage hormone receptors-positive BC. Remaining OSNA lysates were prepared for targeted RNA-sequencing analysis. Identification of differentially expressed genes (DEGs) was performed by DESeq2 in R and data analysis in STATA. The results show that, in metastatic SLNs, several genes were upregulated: KRT7, VTCN1, CD44, GATA3, ALOX15B, RORC, NECTIN2, LRG1, CD276, FOXM1 and IGF1R. Hierarchical clustering analysis revealed three different clusters. The identified DEGs codify proteins mainly involved in cancer aggressiveness and with impact in immune response. The overexpression of the immune suppressive genes VTCN1 and CD276 may explain that no direct evidence of activation of immune response in metastatic SLNs was found. We show that OSNA results may be improved incorporating microenvironment-related biomarkers that may be useful in the future for prognosis stratification and immunotherapy selection. As OSNA assay is being implemented for SLNs staging in other cancers, this approach could also have a wider utility.
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Li YL, Hung WC. Reprogramming of sentinel lymph node microenvironment during tumor metastasis. J Biomed Sci 2022; 29:84. [PMID: 36266717 PMCID: PMC9583492 DOI: 10.1186/s12929-022-00868-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/15/2022] [Indexed: 11/10/2022] Open
Abstract
Metastasis is a major cause of death in patients with cancer. The two main routes for cancer cell dissemination are the blood and lymphatic systems. The underlying mechanism of hematogenous metastasis has been well characterized in the past few decades. However, our understanding of the molecular basis of lymphatic metastasis remains at a premature stage. Conceptually, cancer cells invade into lymphatic capillary, passively move to collecting lymphatic vessels, migrate into sentinel lymph node (SLN;, the first lymph node to which cancer cells spread from the primary tumor), and enter the blood circulatory system via the subclavian vein. Before arriving, cancer cells release specific soluble factors to modulate the microenvironment in SLN to establish a beachhead for successful colonization. After colonization, cancer cells inhibit anti-tumor immunity by inducing the recruitment of regulatory T cell and myeloid-derived suppressor cells, suppressing the function of dendritic cell and CD8+ T cell, and promoting the release of immunosuppressive cytokines. The development of novel strategies to reverse cancer cell-triggered SLN remodeling may re-activate immunity to reduce beachhead buildup and distant metastasis. In addition to being a microanatomic location for metastasis, the SLN is also an important site for immune modulation. Nanotechnology-based approaches to deliver lymph node-tropic antibodies or drug-conjugated nanoparticles to kill cancer cells on site are a new direction for cancer treatment. Conversely, the induction of stronger immunity by promoting antigen presentation in lymph nodes provides an alternate way to enhance the efficacy of immune checkpoint therapy and cancer vaccine. In this review article, we summarize recent findings on the reprogramming of SLN during lymphatic invasion and discuss the possibility of inhibiting tumor metastasis and eliciting anti-tumor immunity by targeting SLN.
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Affiliation(s)
- Yen-Liang Li
- National Institute of Cancer Research, National Health Research Institutes, Tainan, 704, Taiwan
| | - Wen-Chun Hung
- National Institute of Cancer Research, National Health Research Institutes, Tainan, 704, Taiwan. .,School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
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Ivanović V, Dedović-Tanić N, Milovanović Z, Stojiljković B, Demajo M, Mandušić V. Establishment and Fractionation of Metastatic Axillary Lymph Node Cell Suspension for Determination of Protein Expression Levels of Nuclear cFOS and Cytosolic TGFβ1 from Breast Cancer Patients. Biol Proced Online 2022; 24:6. [PMID: 35658894 PMCID: PMC9166494 DOI: 10.1186/s12575-022-00167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Metastatic Axillary Lymph Node (mALN) status is currently the most important prognostic factor in the management of primary breast cancer (BC). Thus, development of specimens which enable identification of new mALN markers, involved in the progression of the disease, are of considerable interest. The specific aim of this work was to describe the method of establishment of Metastatic Axillary Nodal Cell Suspension and its fractionation, termed Fractionated Nodal Cell Suspension (FNCS), into nuclear and cytosolic extracts to enable determination of protein expression levels of nuclear cFOS and cytosolic Transforming Growth Factor β1 (TGFβ1) in BC patients. Results To standardize the procedure, HeLa cells were successfully fractionated into nuclear/cytosolic extracts with confirmed presence of nuclear cFOS and cytosolic TGFβ1 proteins. Subsequently, the ALN Cell Suspension specimens were obtained and further fractionated from a pilot sample of six ALN tissue pairs, mALN versus autologous normal ALN (nALN), dissected from invasive BC patients. The mALN/nALN results revealed overexpression of both nuclear cFOS and cytosolic TGFβ1 protein levels. However, only the TGFβ1 data exhibited statistically significant overexpression, which was proportional to the respective values of mALN diameter of tumor deposits. Conclusions Detailed protocol for establishment and fractionation of mALN cell suspension specimens, termed FNCS, into nuclear and cytosolic extracts is here described for the first time. This approach might be a convenient ex vivo model for simultaneous analysis of protein, RNA and DNA biomarkers from nuclear/cytosolic extracts of the same mALN tissue sample. It might have potential to enable, in the age of genomics and personalized medicine, an identification of novel mALN biomarkers and thus improve the screening, diagnosis and prognosis of invasive BC.
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López C, Bosch R, Korzynska A, García-Rojo M, Bueno G, García-Fontgivell JF, Martínez González S, Gras Navarro A, Sauras Colón E, Casanova Ribes J, Roszkowiak L, Mata D, Arenas M, Gómez J, Roso A, Berenguer M, Reverté-Villarroya S, Llobera M, Baucells J, Lejeune M. CD68 and CD83 immune populations in non-metastatic axillary lymph nodes are of prognostic value for the survival and relapse of breast cancer patients. Breast Cancer 2022; 29:618-635. [PMID: 35137329 DOI: 10.1007/s12282-022-01336-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The foremost cause of death of breast cancer (BC) patients is metastasis, and the first site to which BC predominantly metastasizes is the axillary lymph node (ALN). Thus, ALN status is a key prognostic indicator at diagnosis. The immune system has an essential role in cancer progression and dissemination, so its evaluation in ALNs could have significant applications. In the present study we aimed to investigate the association of clinical-pathological and immune variables in the primary tumour and non-metastatic ALNs (ALNs-) of a cohort of luminal A and triple-negative BC (TNBC) patients with cancer-specific survival (CSS) and time to progression (TTP). METHODS We analysed the differences in the variables between patients with different outcomes, created univariate and multivariate Cox regression models, validated them by bootstrapping and multiple imputation of missing data techniques, and used Kaplan-Meier survival curves for a 10-years follow-up. RESULTS We found some clinical-pathological variables at diagnosis (tumour diameter, TNBC molecular profile and presence of ALN metastasis), and the levels of several immune markers in the two studied sites, to be associated with worse CSS and TTP. Nevertheless, only CD68 and CD83 in ALNs- were confirmed as independent prognostic factors for TTP. CONCLUSIONS The study identified the importance of macrophage and dendritic cell markers as prognostic factors of relapse for BC. We highlight the importance of studying the immune response in ALNs-, which could be relevant to the prediction of BC patients' outcome.
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Affiliation(s)
- Carlos López
- Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain. .,Universitat Rovira i Virgili (URV) - Campus Terres de l'Ebre, Avinguda Remolins no 13-15, 43500, Tortosa, Spain.
| | - Ramón Bosch
- Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain
| | - Anna Korzynska
- Laboratory of Processing and Analysis of Microscopic Images, Polish Academy of Sciences (IBIB PAN), Nalęcz Institute of Biocybernetics and Biomedical Engineering, Ks. Trojdena 4 St., 02-109, Warsaw, Poland
| | - Marcial García-Rojo
- Department of Pathology, Hospital Universitario Puerta del Mar, Avda. Ana de Viya, 21, 11009, Cádiz, Spain
| | - Gloria Bueno
- VISILAB, Universidad de Castilla-La Mancha, Av. Camilo José Cela, s/n, 13071, Ciudad Real, Spain
| | | | - Salomé Martínez González
- Department of Pathology, Hospital Universitari Joan XXIII, C/Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain
| | - Andrea Gras Navarro
- Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain.,Universitat Rovira i Virgili (URV) - Campus Terres de l'Ebre, Avinguda Remolins no 13-15, 43500, Tortosa, Spain
| | - Esther Sauras Colón
- Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain.
| | - Júlia Casanova Ribes
- Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain
| | - Lukasz Roszkowiak
- Laboratory of Processing and Analysis of Microscopic Images, Polish Academy of Sciences (IBIB PAN), Nalęcz Institute of Biocybernetics and Biomedical Engineering, Ks. Trojdena 4 St., 02-109, Warsaw, Poland
| | - Daniel Mata
- Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain
| | - Meritxell Arenas
- Institut d'Investigació Sanitària Pere Virgili, Radiation Oncology Department, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Junior Gómez
- Institut d'Investigació Sanitària Pere Virgili, Radiation Oncology Department, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Albert Roso
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Marta Berenguer
- Knowledge Management Department, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain
| | - Silvia Reverté-Villarroya
- Universitat Rovira i Virgili (URV) - Campus Terres de l'Ebre, Avinguda Remolins no 13-15, 43500, Tortosa, Spain.,Knowledge Management Department, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain
| | - Montserrat Llobera
- Department of Oncology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain
| | - Jordi Baucells
- Informatics Department, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain
| | - Marylène Lejeune
- Department of Pathology, Oncological Pathology and Bioinformatics Research Group, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500, Tortosa, Spain.,Universitat Rovira i Virgili (URV) - Campus Terres de l'Ebre, Avinguda Remolins no 13-15, 43500, Tortosa, Spain
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Ribeiro C, Gante I, Dias MF, Gomes A, Silva HC. A new application to one-step nucleic acid amplification-discarded sample in breast cancer: Preliminary results. Mol Clin Oncol 2021; 15:216. [PMID: 34476100 DOI: 10.3892/mco.2021.2380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/07/2021] [Indexed: 01/23/2023] Open
Abstract
The one-step nucleic acid amplification (OSNA) assay is a molecular method used for detecting breast cancer (BC) metastasis in sentinel lymph nodes (SLNs). However, this method has a major disadvantage, since it prevents tissue structure analysis, while only one molecular marker can be evaluated, namely cytokeratin 19 mRNA. The aim of the present study was to evaluate whether an OSNA-discarded sample could be suitable for the gene expression analysis of the SLN microenvironment. The remaining intermediate phase of the centrifuged SLN homogenate obtained from the OSNA assay of samples from two patients with BC was used for mRNA extraction. Subsequently, the expression of five genes, namely forkhead box, cluster of differentiation 4 and three control genes, was determined by reverse transcription-quantitative PCR analysis. The results demonstrated that high-quality RNA was extracted. Therefore, this RNA may be used for gene expression analyses to predict novel molecular biomarkers associated with immuno-inflammatory microenvironment.
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Affiliation(s)
- Carolina Ribeiro
- Institute of Medical Genetics/UC Genomics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Inês Gante
- University Clinic of Gynecology, Coimbra Hospital and University Centre (CHUC), 3000-075 Coimbra, Portugal
| | - Margarida Figueiredo Dias
- University Clinic of Gynecology, Coimbra Hospital and University Centre (CHUC), 3000-075 Coimbra, Portugal
| | - Ana Gomes
- Department of Pathology, Coimbra Hospital and University Centre (CHUC), 3000-075 Coimbra, Portugal
| | - Henriqueta Coimbra Silva
- Institute of Medical Genetics/UC Genomics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research-Center of Investigation on Environment, Genetics and Oncobiology (iCBR-CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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Fransen MF, van Hall T, Ossendorp F. Immune Checkpoint Therapy: Tumor Draining Lymph Nodes in the Spotlights. Int J Mol Sci 2021; 22:9401. [PMID: 34502307 PMCID: PMC8431673 DOI: 10.3390/ijms22179401] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/22/2023] Open
Abstract
Tumor-draining lymph nodes play a paradoxical role in cancer. Surgeons often resect these sentinel lymph nodes to determine metastatic spread, thereby enabling prognosis and treatment. However, lymph nodes are vital organs for the orchestration of immune responses, due to the close encounters of dedicated immune cells. In view of the success of immunotherapy, the removal of tumor-draining lymph nodes needs to be re-evaluated and viewed in a different light. Recently, an important role for tumor-draining lymph nodes has been proposed in the immunotherapy of cancer. This new insight can change the use of immune checkpoint therapy, particularly with respect to the use in neoadjuvant settings in which lymph nodes are still operational.
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Affiliation(s)
- Marieke F. Fransen
- Department of Immunology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands;
- Department of Pulmonary Diseases, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Thorbald van Hall
- Department of Medical Oncology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands;
| | - Ferry Ossendorp
- Department of Immunology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands;
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9
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Lamkin DM, Bradshaw KP, Chang J, Epstein M, Gomberg J, Prajapati KP, Soliman VH, Sylviana T, Wong Y, Morizono K, Sloan EK, Cole SW. Physical activity modulates mononuclear phagocytes in mammary tissue and inhibits tumor growth in mice. PeerJ 2021; 9:e10725. [PMID: 33552733 PMCID: PMC7821756 DOI: 10.7717/peerj.10725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022] Open
Abstract
The risk for breast cancer is significantly reduced in persons who engage in greater amounts of physical activity, and greater physical activity before or after diagnosis associates with reduced disease-specific mortality. Previous mechanistic studies indicate that components of innate immunity can mediate an inhibitory effect of physical activity on several types of tumor. However, in breast cancer specifically, the myeloid compartment of innate immunity is thought to exhibit high propensity for an immunosuppressive role that obstructs anti-tumor immunity. Thus, we tested the notion that greater physical activity alters mononuclear phagocytes in mammary tissue when inhibiting nascent tumor in a murine model of breast cancer. To model greater physical activity, we placed an angled running wheel in each mouse's home cage for two weeks before tumor engraftment with EO771 mammary cancer cells that express luciferase for bioluminescent detection. Fully immunocompetent mice and mice with compromised adaptive immunity showed significantly less mammary tumor signal when given access to running wheels, although the effect size was smaller in this latter group. To investigate the role of the myeloid compartment, mononuclear phagocytes were ablated by systemic injection of clodronate liposomes at 24 h before tumor engraftment and again at the time of tumor engraftment, and this treatment reversed the inhibition in wheel running mice. However, clodronate also inhibited mammary tumor signal in sedentary mice, in conjunction with an expected decrease in gene and protein expression of the myeloid antigen, F4/80 (Adgre1), in mammary tissue. Whole transcriptome digital cytometry with CIBERSORTx was used to analyze myeloid cell populations in mammary tissue following voluntary wheel running and clodronate treatment, and this approach found significant changes in macrophage and monocyte populations. In exploratory analyses, whole transcriptome composite scores for monocytic myeloid-derived suppressor cell (M-MDSC), macrophage lactate timer, and inflammation resolution gene expression programs were significantly altered. Altogether, the results support the hypothesis that physical activity inhibits nascent mammary tumor growth by enhancing the anti-tumor potential of mononuclear phagocytes in mammary tissue.
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Affiliation(s)
- Donald M. Lamkin
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States of America
| | - Karen P. Bradshaw
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Department of Neuroscience, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Janice Chang
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Ma’ayan Epstein
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Jack Gomberg
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Krupa P. Prajapati
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Veronica H. Soliman
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Thezia Sylviana
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Yinnie Wong
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Kouki Morizono
- Divison of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
- UCLA AIDS Institute, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
| | - Erica K. Sloan
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States of America
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre-Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Austalia
| | - Steve W. Cole
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States of America
- Divison of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
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López C, Gibert-Ramos A, Bosch R, Korzynska A, García-Rojo M, Bueno G, García-Fontgivell JF, Martínez González S, Fontoura L, Gras Navarro A, Sauras Colón E, Casanova Ribes J, Roszkowiak L, Roso A, Berenguer M, Llobera M, Baucells J, Lejeune M. Differences in the Immune Response of the Nonmetastatic Axillary Lymph Nodes between Triple-Negative and Luminal A Breast Cancer Surrogate Subtypes. THE AMERICAN JOURNAL OF PATHOLOGY 2020; 191:545-554. [PMID: 33309504 DOI: 10.1016/j.ajpath.2020.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/27/2020] [Accepted: 11/19/2020] [Indexed: 01/21/2023]
Abstract
Breast cancer (BC) comprises four immunohistochemical surrogate subtypes of which triple-negative breast cancer (TNBC) has the highest risk of mortality. Axillary lymph nodes (ALNs) are the regions where BC cells first establish before distant metastasis, and the presence of tumor cells in the ALN causes an immune tolerance profile that contrasts with that of the nonmetastatic ALN (ALN-). However, few studies have compared the immune components of the ALNs- in BC subtypes. The present study aimed to determine whether differences between immune populations in the primary tumor and ALNs- were associated with the luminal A or TNBC subtype. We evaluated a retrospective cohort of 144 patients using paraffin-embedded biopsies. The TNBC samples tended to have a higher histologic grade and proliferation index and had higher levels of immune markers compared with luminal A in primary tumors and ALNs-. Two methods for validating the multivariate analysis found that histologic grade, intratumoral S100 dendritic cells, and CD8 T lymphocytes and CD57 natural killer cells in the ALNs- were factors associated with TNBC, whereas CD83 dendritic cells in the ALNs- were associated with the luminal A subtype. In conclusion, we found that intratumoral regions and ALNs- of TNBC contained higher concentrations of markers related to immune tolerance than luminal A. This finding partially explains the worse prognosis of patients with TNBC.
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Affiliation(s)
- Carlos López
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain; Universitat Rovira i Virgili (URV) - Campus Terres de l'Ebre, Tortosa, Spain.
| | - Albert Gibert-Ramos
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain.
| | - Ramón Bosch
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain
| | - Anna Korzynska
- Laboratory of Processing and Analysis of Microscopic Images, Nalęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences (IBIB PAN), Warsaw, Poland
| | - Marcial García-Rojo
- Department of Pathology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Gloria Bueno
- VISILAB, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | | | | | - Laia Fontoura
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain
| | - Andrea Gras Navarro
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain; Universitat Rovira i Virgili (URV) - Campus Terres de l'Ebre, Tortosa, Spain
| | - Esther Sauras Colón
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain
| | - Júlia Casanova Ribes
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain
| | - Lukasz Roszkowiak
- Laboratory of Processing and Analysis of Microscopic Images, Nalęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences (IBIB PAN), Warsaw, Poland
| | - Albert Roso
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Marta Berenguer
- Knowledge Management Department, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain
| | - Montserrat Llobera
- Department of Oncology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain
| | - Jordi Baucells
- Informatics Department, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain
| | - Marylène Lejeune
- Oncological Pathology and Bioinformatics Research Group, Department of Pathology, Hospital de Tortosa Verge de la Cinta, ICS, IISPV, Tortosa, Spain; Universitat Rovira i Virgili (URV) - Campus Terres de l'Ebre, Tortosa, Spain
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Karihtala P, Jääskeläinen A, Roininen N, Jukkola A. Prognostic factors in metastatic breast cancer: a prospective single-centre cohort study in a Finnish University Hospital. BMJ Open 2020; 10:e038798. [PMID: 33046470 PMCID: PMC7552835 DOI: 10.1136/bmjopen-2020-038798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Although novel early breast cancer prognostic factors are being continuously discovered, only rare factors predicting survival in metastatic breast cancer have been validated. The prognostic role of early breast cancer prognostic factors in metastatic disease also remains mostly unclear. DESIGN AND SETTING Prospective cohort study in a Finnish University Hospital. PARTICIPANTS AND OUTCOMES 594 women with early breast cancer were originally followed. Sixty-one of these patients developed distant metastases during the follow-up, and their primary breast cancer properties, such as tumour size, nodal status, oestrogen receptor (ER) and progesterone receptor expression, grade, proliferation rate, histopathological subtype and breast cancer subtype were analysed as potential prognostic factors for metastatic disease. RESULTS In multivariate analysis, the presence of lymph node metastases at the time of early breast cancer surgery (HR, 2.17; 95% CI, 1.09-4.31; p=0.027) and ER status (negative vs positive, HR, 2.16; 95% CI, 1.14-4.10; p=0.018) were significant predictors of survival in metastatic disease. CONCLUSIONS These results confirm ER status as a primary prognostic factor in metastatic breast cancer. Furthermore, it also suggests that the presence of initial lymph node metastases could serve as a prognostic factor in recurrent breast cancer.
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Affiliation(s)
- Peeter Karihtala
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Helsinki, Finland
| | - Anniina Jääskeläinen
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Nelli Roininen
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Arja Jukkola
- Department of Oncology, Tampere University Hospital, Cancer Center, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
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López C, Bosch-Príncep R, Orero G, Fontoura Balagueró L, Korzynska A, García-Rojo M, Bueno G, Fernández-Carrobles MDM, Roszkowiak L, Callau Casanova C, Salvadó-Usach MT, Jaén Martínez J, Gibert-Ramos A, Roso-Llorach A, Gras Navarro A, Berenguer-Poblet M, Llobera M, Gil Garcia J, Tomás B, Gestí V, Laine E, Plancoulaine B, Baucells J, Lejeune M. Peritumoral immune infiltrates in primary tumours are not associated with the presence of axillary lymph node metastasis in breast cancer: a retrospective cohort study. PeerJ 2020; 8:e9779. [PMID: 32953267 PMCID: PMC7474517 DOI: 10.7717/peerj.9779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/30/2020] [Indexed: 11/29/2022] Open
Abstract
Background The axillary lymph nodes (ALNs) in breast cancer patients are the body regions to where tumoral cells most often first disseminate. The tumour immune response is important for breast cancer patient outcome, and some studies have evaluated its involvement in ALN metastasis development. Most studies have focused on the intratumoral immune response, but very few have evaluated the peritumoral immune response. The aim of the present article is to evaluate the immune infiltrates of the peritumoral area and their association with the presence of ALN metastases. Methods The concentration of 11 immune markers in the peritumoral areas was studied in 149 patients diagnosed with invasive breast carcinoma of no special type (half of whom had ALN metastasis at diagnosis) using tissue microarrays, immunohistochemistry and digital image analysis procedures. The differences in the concentration of the immune response of peritumoral areas between patients diagnosed with and without metastasis in their ALNs were evaluated. A multivariate logistic regression model was developed to identify the clinical-pathological variables and the peritumoral immune markers independently associated with having or not having ALN metastases at diagnosis. Results No statistically significant differences were found in the concentrations of the 11 immune markers between patients diagnosed with or without ALN metastases. Patients with metastases in their ALNs had a higher histological grade, more lymphovascular and perineural invasion and larger-diameter tumours. The multivariate analysis, after validation by bootstrap simulation, revealed that only tumour diameter (OR = 1.04; 95% CI [1.00–1.07]; p = 0.026), lymphovascular invasion (OR = 25.42; 95% CI [9.57–67.55]; p < 0.001) and histological grades 2 (OR = 3.84; 95% CI [1.11–13.28]; p = 0.033) and 3 (OR = 5.18; 95% CI [1.40–19.17]; p = 0.014) were associated with the presence of ALN metastases at diagnosis. This study is one of the first to study the association of the peritumoral immune response with ALN metastasis. We did not find any association of peritumoral immune infiltrates with the presence of ALN metastasis. Nevertheless, this does not rule out the possibility that other peritumoral immune populations are associated with ALN metastasis. This matter needs to be examined in greater depth, broadening the types of peritumoral immune cells studied, and including new peritumoral areas, such as the germinal centres of the peritumoral tertiary lymphoid structures found in extensively infiltrated neoplastic lesions.
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Affiliation(s)
- Carlos López
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain.,Campus Terres de l'Ebre, Universitat Rovira Virgili Tarragona, Tortosa, Spain
| | - Ramón Bosch-Príncep
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Guifré Orero
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | | | - Anna Korzynska
- Laboratory of Processing and Analysis of Microscopic Images, Nałęcz Institute of Biocybernetics and Biomedical Engineering, Warsaw, Poland
| | - Marcial García-Rojo
- Department of Pathology, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Gloria Bueno
- VISILAB, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | | | - Lukasz Roszkowiak
- Laboratory of Processing and Analysis of Microscopic Images, Nałęcz Institute of Biocybernetics and Biomedical Engineering, Warsaw, Poland
| | | | - M Teresa Salvadó-Usach
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain.,Campus Terres de l'Ebre, Universitat Rovira Virgili Tarragona, Tortosa, Spain
| | | | - Albert Gibert-Ramos
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Albert Roso-Llorach
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
| | - Andrea Gras Navarro
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Marta Berenguer-Poblet
- Campus Terres de l'Ebre, Universitat Rovira Virgili Tarragona, Tortosa, Spain.,Department of Knowledge Management, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Montse Llobera
- Department of Oncology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Júlia Gil Garcia
- Department of Surgery, Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain
| | - Bárbara Tomás
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Vanessa Gestí
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Eeva Laine
- Department of Knowledge Management, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | | | - Jordi Baucells
- Department of Informatics, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Maryléne Lejeune
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain.,Campus Terres de l'Ebre, Universitat Rovira Virgili Tarragona, Tortosa, Spain
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