1
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Goel RR, Rook AH. Immunobiology and treatment of cutaneous T-cell lymphoma. Expert Rev Clin Immunol 2024; 20:985-996. [PMID: 38450476 DOI: 10.1080/1744666x.2024.2326035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Primary cutaneous T cell lymphomas (CTCL) are a heterogenous group of non-Hodgkin lymphomas derived from skin-homing T cells. These include mycosis fungoides and its leukemic variant Sezary syndrome, as well as the CD30+ lymphoproliferative disorders. AREAS COVERED In this review, we provide a summary of the current literature on CTCL, with a focus on the immunopathogenesis and treatment of mycosis fungoides and Sezary syndrome. EXPERT OPINION Recent advances in immunology have provided new insights into the biology of malignant T cells. This in turn has led to the development of new therapies that modulate the immune system to facilitate tumor clearance or target specific aspects of tumor biology.
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Affiliation(s)
- Rishi R Goel
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Immunology and Immune Health (I3H), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alain H Rook
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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2
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Jiang TT, Kruglov O, Akilov OE. Unleashed monocytic engagement in Sézary syndrome during the combination of anti-CCR4 antibody with type I interferon. Blood Adv 2024; 8:2384-2397. [PMID: 38489234 PMCID: PMC11127216 DOI: 10.1182/bloodadvances.2023010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 01/22/2024] [Accepted: 02/06/2024] [Indexed: 03/17/2024] Open
Abstract
ABSTRACT Sézary syndrome (SS) is an aggressive leukemic expansion of skin-derived malignant CD4+ T cells. Drug monotherapy often results in disease relapse because of the heterogenous nature of malignant CD4+ T cells, but how therapies can be optimally combined remains unclear because of limitations in understanding the disease pathogenesis. We identified immunologic transitions that interlink mycosis fungoides with SS using single-cell transcriptome analysis in parallel with high-throughput T-cell receptor sequencing. Nascent peripheral CD4+ T cells acquired a distinct profile of transcription factors and trafficking receptors that gave rise to antigenically mature Sézary cells. The emergence of malignant CD4+ T cells coincided with the accumulation of dysfunctional monocytes with impaired fragment crystallizable γ-dependent phagocytosis, decreased responsiveness to cytokine stimulation, and limited repertoire of intercellular interactions with Sézary cells. Type I interferon supplementation when combined with a monoclonal antibody targeting the chemokine receptor type 4 (CCR4), unleashed monocyte induced phagocytosis and eradication of Sézary cells in vitro. In turn, coadministration of interferon-α with the US Food and Drug Administration-approved anti-CCR4 antibody, mogamulizumab, in patients with SS induced marked depletion of peripheral malignant CD4+ T cells. Importantly, residual CD4+ T cells after Sézary cell ablation lacked any immunologic shifts. These findings collectively unveil an auxiliary role for augmenting monocytic activity during mogamulizumab therapy in the treatment of SS and underscore the importance of targeted combination therapy in this disease.
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Affiliation(s)
- Tony T. Jiang
- Department of Dermatology, Cutaneous Lymphoma Program, University of Pittsburgh, Pittsburgh, PA
| | - Oleg Kruglov
- Department of Dermatology, Cutaneous Lymphoma Program, University of Pittsburgh, Pittsburgh, PA
| | - Oleg E. Akilov
- Department of Dermatology, Cutaneous Lymphoma Program, University of Pittsburgh, Pittsburgh, PA
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3
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Zhao P, Peng C, Chang X, Cheng W, Yang Y, Shen Y, Sun C, Feng X, Liu C, Wu J. Decreased expression of TIGIT on CD14 + monocytes correlates with clinical features and laboratory parameters of patients with primary Sjögren's syndrome. Clin Rheumatol 2024; 43:297-306. [PMID: 37749409 DOI: 10.1007/s10067-023-06759-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/16/2023] [Accepted: 08/26/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the expression of T-cell immunoglobulin and ITIM domain (TIGIT) in peripheral circulation of primary Sjögren's syndrome (pSS) and its role in the development of pSS. METHODS The expression of TIGIT on T cells, B cells, natural killer (NK) cells, and CD14 + monocytes was detected by flow cytometry in pSS and healthy control (HC). The correlations between expression of TIGIT and clinical features and laboratory parameters of pSS were analyzed. Meanwhile, we analyzed the change in expression of TIGIT before and after treatment, and its role in the prognosis of pSS treatment was evaluated. RESULTS The expression of TIGIT on CD3 + , CD4 + , and CD8 + T cells increased and decreased on CD14 + monocytes in pSS compared to HC; however, there was no significance of B lymphocytes and NK cells. The correlation analysis between the expression of TIGIT on T lymphocytes and CD14 + monocytes and clinical features of pSS showed that the decrease in TIGIT expression on CD14 + monocytes was more closely related to pSS. The expression of TIGIT + CD14 + monocytes negatively correlated with the disease activity of pSS. The expression of TIGIT + CD14 + monocytes of pSS with arthralgia, fatigue, decayed tooth, xerostomia, interstitial lung disease, anti-Ro52 positive, and high IgG decreased compared to that in negative patients. Furthermore, it was significantly lower in active patients than in nonactive patients. After treatment, the expression of TIGIT + CD14 + monocytes tended to increase. CONCLUSION Our study suggested that decreased TIGIT expression on CD14 + monocytes was associated with the clinical manifestations, disease activity, and prognosis of pSS patients. TIGIT + CD14 + monocytes may present as a potential target and a biomarker of the prognosis for immunomodulatory therapy in pSS. Key Points • The expression of TIGIT+CD14+ monocytes significantly decreased in pSS patients compared to HC. • There was a negative correlation between TIGIT+CD14+ monocytes and the disease activity of pSS. • TIGIT+CD14+ monocyte expression was associated with the clinical manifestations, autoantibodies, IgG, and prognosis of pSS patients.
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Affiliation(s)
- Ping Zhao
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, No. 188 Shizi St, Suzhou, 215006, Jiangsu, China
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Cheng Peng
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, No. 188 Shizi St, Suzhou, 215006, Jiangsu, China
| | - Xin Chang
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, No. 188 Shizi St, Suzhou, 215006, Jiangsu, China
- Jiangsu Institute of Clinical Immunology & Jiangsu Key Laboratory of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei Cheng
- Department of Dermatology, The Affiliated Changshu Hospital of Xuzhou Medical University, Suzhou, China
| | - Yanhong Yang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Shen
- Jiangsu Institute of Clinical Immunology & Jiangsu Key Laboratory of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chao Sun
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiuyuan Feng
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, No. 188 Shizi St, Suzhou, 215006, Jiangsu, China
| | - Cuiping Liu
- Jiangsu Institute of Clinical Immunology & Jiangsu Key Laboratory of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Jian Wu
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, No. 188 Shizi St, Suzhou, 215006, Jiangsu, China.
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4
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Ma J, Pang X, Li J, Zhang W, Cui W. The immune checkpoint expression in the tumor immune microenvironment of DLBCL: Clinicopathologic features and prognosis. Front Oncol 2022; 12:1069378. [PMID: 36561512 PMCID: PMC9763555 DOI: 10.3389/fonc.2022.1069378] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background & aims The immune checkpoint recently provides a new strategy for the immunotherapy of malignant tumors. However, the role in the immune microenvironment of DLBCL is not completely clear. Methods We detected the expression of PD-1, LAG-3, TIM-3, and TIGIT on TILs and on tumor cells among 174 DLBCL patients by IHC. Results In TILs, the positive rates of PD-1, LAG-3, TIM-3 and TIGIT were 79.3%, 78.8%, 62.7% and 69.5%, respectively.TIM-3 and TIGIT were expressed in 44.8% and 45.4% of tumor cells. The expression of TIM-3 in TILs was significantly correlated with the Ann-Arbor stage (P=0.039). There was a positive correlation Between PD-1 and LAG-3 or TIM-3 and TIGIT.In addition, LAG-3 expression in TILs was associated with inferior prognosis.Multivariate analysis showed that PS score and R-CHOP therapy were independent risk factors for OS and PFS in patients with DLBCL (P=0.000). Conclusions The expression level of TIM-3 is closely related to the Ann-Arbor stage, which may be expected to be a new index to evaluate the invasiveness of DLBCL. PD-1 was correlated with the expression of LAG-3, and the high expression of LAG-3 and LAG-3/PD-1 predicted the poor prognosis of DLBCL. Therefore, LAG-3 may become a new target of immunotherapy, or be used in combination with PD-1 inhibitors to improve the drug resistance of current patients with DLBCL.
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5
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Giustiniani J, Dobos G, Moins-Teisserenc H, Eustaquio T, Battistella M, Ortonne N, Ram-Wolff C, Bouaziz JD, Marie-Cardine A, Mourah S, Bagot M, Kupper TS, Clark RA, Bensussan A, de Masson A. CCR8 is a new therapeutic target in cutaneous T-cell lymphomas. Blood Adv 2022; 6:3507-3512. [PMID: 35201316 PMCID: PMC9198911 DOI: 10.1182/bloodadvances.2021006512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/13/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jérôme Giustiniani
- INSERM, U955, Henri Mondor Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Université Paris Est Créteil, Créteil, France
| | - Gabor Dobos
- Department of Dermatology, AP-HP, Saint Louis Hospital, Paris, France
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
- Department of Dermatology, Charité Hospital, Berlin, Germany
| | - Hélène Moins-Teisserenc
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, Unité Mixte de Recherche 1160, Paris, France
- Department of Hematology, AP-HP, Saint Louis Hospital, Paris, France
| | | | - Maxime Battistella
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
- Department of Pathology, AP-HP, Saint Louis Hospital, Paris, France
| | - Nicolas Ortonne
- INSERM, U955, Henri Mondor Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Université Paris Est Créteil, Créteil, France
- Department of Pathology, Henri Mondor Hospital, AP-HP, Paris, France
| | | | - Jean-David Bouaziz
- Department of Dermatology, AP-HP, Saint Louis Hospital, Paris, France
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
| | - Anne Marie-Cardine
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
| | - Samia Mourah
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
- Department of Tumor Genomics and Pharmacology, AP-HP, Saint Louis Hospital, Paris, France; and
| | - Martine Bagot
- Department of Dermatology, AP-HP, Saint Louis Hospital, Paris, France
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
| | - Thomas S. Kupper
- Department of Dermatology, Dana Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA
| | - Rachael A. Clark
- Department of Dermatology, Dana Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA
| | - Armand Bensussan
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
| | - Adèle de Masson
- Department of Dermatology, AP-HP, Saint Louis Hospital, Paris, France
- Institut de Recherche Saint-Louis, Université de Paris, Paris, France
- INSERM, UMR 976 “Human Immunology, Pathophysiology and Immunotherapy,” Paris, France
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6
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Wysocka M, Jariwala N, Zhang K, Benoit B, Rook AH. TCF1 and Tox define different subsets of CD4 T cells in patients with Sézary syndrome. Leuk Lymphoma 2022; 63:2715-2718. [DOI: 10.1080/10428194.2022.2081326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maria Wysocka
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Neha Jariwala
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kevin Zhang
- Department of Dermatology, The Ohio State University College of Medicine and Public Health, Columbus, OH, USA
| | - Bernice Benoit
- Department of Pathology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Alain H. Rook
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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7
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Xu B, Liu F, Gao Y, Sun J, Li Y, Lin Y, Liu X, Wen Y, Yi S, Dang J, Tu P, Wang Y. High Expression of IKZF2 in Malignant T Cells Promotes Disease Progression in Cutaneous T Cell Lymphoma. Acta Derm Venereol 2021; 101:adv00613. [PMID: 34853863 PMCID: PMC9472098 DOI: 10.2340/actadv.v101.570] [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] [Indexed: 11/23/2022] Open
Abstract
Cutaneous T cell lymphoma is a generally indolent disease derived from skin-homing mature T cells. However, in advanced stages, cutaneous T cell lymphoma may manifest aggressive clinical behaviour and lead to a poor prognosis. The mechanism of disease progression in cutaneous T cell lymphoma remains unknown. This study, based on a large clinical cohort, found that IKZF2, an essential transcription factor during T cell development and differentiation, showed stage-dependent overexpression in the malignant T cells in mycosis fungoides lesions. IKZF2 is specifically over-expressed in advanced-stage mycosis fungoides lesions, and correlates with poor prognosis. Mechanistically, overexpression of IKZF2 promotes cutaneous T cell lymphoma progression via inhibiting malignant cell apoptosis and may contribute to tumour immune escape by downregulating major histocompatibility complex II molecules and up-regulating the production of anti-inflammatory cytokine interleukin-10 by malignant T cells. These results demonstrate the important role of IKZF2 in high-risk cutaneous T cell lymphoma and pave the way for future targeted therapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Yang Wang
- Department of Dermatology and Venereology, Peking University First Hospital, No.8 Xishiku Street, Xi Cheng District, Beijing 100034, China.
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8
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Immune cell topography predicts response to PD-1 blockade in cutaneous T cell lymphoma. Nat Commun 2021; 12:6726. [PMID: 34795254 PMCID: PMC8602403 DOI: 10.1038/s41467-021-26974-6] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/26/2021] [Indexed: 02/08/2023] Open
Abstract
Cutaneous T cell lymphomas (CTCL) are rare but aggressive cancers without effective treatments. While a subset of patients derive benefit from PD-1 blockade, there is a critically unmet need for predictive biomarkers of response. Herein, we perform CODEX multiplexed tissue imaging and RNA sequencing on 70 tumor regions from 14 advanced CTCL patients enrolled in a pembrolizumab clinical trial (NCT02243579). We find no differences in the frequencies of immune or tumor cells between responders and non-responders. Instead, we identify topographical differences between effector PD-1+ CD4+ T cells, tumor cells, and immunosuppressive Tregs, from which we derive a spatial biomarker, termed the SpatialScore, that correlates strongly with pembrolizumab response in CTCL. The SpatialScore coincides with differences in the functional immune state of the tumor microenvironment, T cell function, and tumor cell-specific chemokine recruitment and is validated using a simplified, clinically accessible tissue imaging platform. Collectively, these results provide a paradigm for investigating the spatial balance of effector and suppressive T cell activity and broadly leveraging this biomarker approach to inform the clinical use of immunotherapies.
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9
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Roccuzzo G, Giordano S, Fava P, Pileri A, Guglielmo A, Tonella L, Sanlorenzo M, Ribero S, Fierro MT, Quaglino P. Immune Check Point Inhibitors in Primary Cutaneous T-Cell Lymphomas: Biologic Rationale, Clinical Results and Future Perspectives. Front Oncol 2021; 11:733770. [PMID: 34485162 PMCID: PMC8415544 DOI: 10.3389/fonc.2021.733770] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Primary cutaneous T-cell lymphomas (PCTCL) are the most common types of cutaneous lymphomas, with Mycosis fungoides as the most frequent subtype. Besides early stages which usually have a good prognosis, advanced stages remain a great therapeutic challenge with low survival rates. To date, none of the currently available therapeutic options have significantly improved the outcomes of advanced cutaneous lymphomas. Recent studies have demonstrated that immune-checkpoint molecules, such as PD-1 and CTLA-4, play part in the proliferation pathways of neoplastic T-cells, as well as in other tumors. Hence, the potential role of immune-checkpoint-inhibitors in treating cutaneous lymphomas has been investigated in the last years. Herein, we outline the current knowledge regarding the role of immune-checkpoint molecules in PCTCL, their signaling pathways, microenvironment and therapeutic inhibition rationale. Moreover, we review the published data on immunotherapies in PCTCL and summarize the currently ongoing clinical trials in this field.
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Affiliation(s)
- Gabriele Roccuzzo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Silvia Giordano
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Paolo Fava
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Alessandro Pileri
- Dermatology-IRCCS Policlinico di Sant'Orsola Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Alba Guglielmo
- Dermatology-IRCCS Policlinico di Sant'Orsola Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Luca Tonella
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Martina Sanlorenzo
- Department of Medicine, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Simone Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Maria Teresa Fierro
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
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10
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Durgin JS, Weiner DM, Wysocka M, Rook AH. The immunopathogenesis and immunotherapy of cutaneous T cell lymphoma: Pathways and targets for immune restoration and tumor eradication. J Am Acad Dermatol 2021; 84:587-595. [PMID: 33352267 PMCID: PMC7897252 DOI: 10.1016/j.jaad.2020.12.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 11/27/2022]
Abstract
Cutaneous T cell lymphomas (CTCLs) are malignancies of skin-trafficking T cells. Patients with advanced CTCL manifest immune dysfunction that predisposes to infection and suppresses the antitumor immune response. Therapies that stimulate immunity have produced superior progression-free survival compared with conventional chemotherapy, reinforcing the importance of addressing the immune deficient state in the care of patients with CTCL. Recent research has better defined the pathogenesis of these immune deficits, explaining the mechanisms of disease progression and revealing potential therapeutic targets. The features of the malignant cell in mycosis fungoides and Sézary syndrome are now significantly better understood, including the T helper 2 cell phenotype, regulatory T cell cytokine production, immune checkpoint molecule expression, chemokine receptors, and interactions with the microenvironment. The updated model of CTCL immunopathogenesis provides understanding into clinical progression and therapeutic response.
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Affiliation(s)
- Joseph S Durgin
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David M Weiner
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maria Wysocka
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alain H Rook
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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11
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Preillon J, Cuende J, Rabolli V, Garnero L, Mercier M, Wald N, Pappalardo A, Denies S, Jamart D, Michaux AC, Pirson R, Pitard V, Bagot M, Prasad S, Houthuys E, Brouwer M, Marillier R, Lambolez F, Marchante JR, Nyawouame F, Carter MJ, Baron-Bodo V, Marie-Cardine A, Cragg M, Déchanet-Merville J, Driessens G, Hoofd C. Restoration of T-cell Effector Function, Depletion of Tregs, and Direct Killing of Tumor Cells: The Multiple Mechanisms of Action of a-TIGIT Antagonist Antibodies. Mol Cancer Ther 2021; 20:121-131. [PMID: 33277440 DOI: 10.1158/1535-7163.mct-20-0464] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/24/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022]
Abstract
TIGIT is an immune checkpoint inhibitor expressed by effector CD4+ and CD8+ T cells, NK cells, and regulatory T cells (Tregs). Inhibition of TIGIT-ligand binding using antagonistic anti-TIGIT mAbs has shown in vitro potential to restore T-cell function and therapeutic efficacy in murine tumor models when combined with an anti-PD(L)-1 antibody. In the current work, we demonstrate broader TIGIT expression than previously reported in healthy donors and patients with cancer with expression on γδ T cells, particularly in CMV-seropositive donors, and on tumor cells from hematologic malignancies. Quantification of TIGIT density revealed tumor-infiltrating Tregs as the population expressing the highest receptor density. Consequently, the therapeutic potential of anti-TIGIT mAbs might be wider than the previously described anti-PD(L)-1-like restoration of αβ T-cell function. CD155 also mediated inhibition of γδ T cells, an immune population not previously described to be sensitive to TIGIT inhibition, which could be fully prevented via use of an antagonistic anti-TIGIT mAb (EOS-448). In PBMCs from patients with cancer, as well as in tumor-infiltrating lymphocytes from mice, the higher TIGIT expression in Tregs correlated with strong antibody-dependent killing and preferential depletion of this highly immunosuppressive population. Accordingly, the ADCC/ADCP-enabling format of the anti-TIGIT mAb had superior antitumor activity, which was dependent upon Fcγ receptor engagement. In addition, the anti-TIGIT mAb was able to induce direct killing of TIGIT-expressing tumor cells both in human patient material and in animal models, providing strong rationale for therapeutic intervention in hematologic malignancies. These findings reveal multiple therapeutic opportunities for anti-TIGIT mAbs in cancer therapeutics.
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MESH Headings
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Neoplasm/immunology
- Antibodies, Neoplasm/pharmacology
- Antibody-Dependent Cell Cytotoxicity/drug effects
- Antigens, CD/metabolism
- Cytotoxicity, Immunologic/drug effects
- Female
- Healthy Volunteers
- Humans
- Immunoglobulin G/metabolism
- Lymphocyte Depletion
- Lymphocytes, Tumor-Infiltrating/drug effects
- Lymphocytes, Tumor-Infiltrating/immunology
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Receptors, Antigen, T-Cell, gamma-delta/metabolism
- Receptors, IgG/metabolism
- Receptors, Immunologic/antagonists & inhibitors
- Receptors, Immunologic/metabolism
- T-Lymphocytes, Regulatory/drug effects
- T-Lymphocytes, Regulatory/immunology
- Mice
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Affiliation(s)
- Julie Preillon
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Julia Cuende
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Virginie Rabolli
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Lucile Garnero
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Marjorie Mercier
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Noémie Wald
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Angela Pappalardo
- ImmunoConcEpT, UMR 5164, Bordeaux University, CNRS, Bordeaux, France
| | - Sofie Denies
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Diane Jamart
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | | | - Romain Pirson
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Vincent Pitard
- ImmunoConcEpT, UMR 5164, Bordeaux University, CNRS, Bordeaux, France
| | - Martine Bagot
- INSERM U976, Université de Paris, Hôpital Saint Louis, Paris, France
| | - Shruthi Prasad
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Erica Houthuys
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Margreet Brouwer
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | - Reece Marillier
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | | | - Joäo R Marchante
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
| | | | - Mathew J Carter
- Antibody & Vaccine Group, Centre for Cancer Immunology, Cancer Sciences Unit, Southampton University Faculty of Medicine, Southampton, United Kingdom
| | | | | | - Mark Cragg
- Antibody & Vaccine Group, Centre for Cancer Immunology, Cancer Sciences Unit, Southampton University Faculty of Medicine, Southampton, United Kingdom
| | | | - Gregory Driessens
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts.
| | - Catherine Hoofd
- iTeos Therapeutics, Gosselies, Belgium and Cambridge, Massachusetts
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12
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Neuwelt A, Al-Juhaishi T, Davila E, Haverkos B. Enhancing antitumor immunity through checkpoint blockade as a therapeutic strategy in T-cell lymphomas. Blood Adv 2020; 4:4256-4266. [PMID: 32898250 PMCID: PMC7479955 DOI: 10.1182/bloodadvances.2020001966] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
The majority of historical therapies for managing T-cell lymphomas (TCLs) have consisted of T-cell-depleting strategies. Unfortunately, these forms of therapies can hamper the ability to mount effective antitumor immune responses. Recently, the use of checkpoint inhibitors has revolutionized the therapy of solid and hematologic malignancies. The development of immunotherapies for the management of TCL has lagged behind other malignancies given 2 central reasons: (1) the competing balance of depleting malignant T cells while simultaneously enhancing an antitumor T-cell response and (2) concern for tumor hyperprogression by blocking inhibitory signals on the surface of the malignant T cell, thereby leading to further proliferation of the malignant cells. These challenges were highlighted with the discovery that programmed cell death protein 1 (PD-1) functions paradoxically as a haploinsufficient tumor suppressor in preclinical TCL models. In contrast, some preclinical and clinical evidence suggests that PD-1/programmed death ligand 1 may become an important therapeutic tool in the management of patients with TCL. Improved understanding of the immune landscape of TCL is necessary in order to identify subsets of patients most likely to benefit from checkpoint-inhibitor therapy. With increased preclinical research focus on the tumor microenvironment, substantial strides are being made in understanding how to harness the power of the immune system to treat TCLs. In this review, designed to be a "call to action," we discuss the challenges and opportunities of using immune-modulating therapies, with a focus on checkpoint inhibitors, for the treatment of patients with TCL.
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Affiliation(s)
- Alexander Neuwelt
- Division of Hematology and Oncology, Richmond Veterans Affairs Medical Center, Richmond, VA
- Division of Hematology and Oncology, Virginia Commonwealth University, Richmond, VA; and
| | - Taha Al-Juhaishi
- Division of Hematology and Oncology, Richmond Veterans Affairs Medical Center, Richmond, VA
- Division of Hematology and Oncology, Virginia Commonwealth University, Richmond, VA; and
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13
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Gene Expression Comparison between Sézary Syndrome and Lymphocytic-Variant Hypereosinophilic Syndrome Refines Biomarkers for Sézary Syndrome. Cells 2020; 9:cells9091992. [PMID: 32872487 PMCID: PMC7563155 DOI: 10.3390/cells9091992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023] Open
Abstract
Sézary syndrome (SS), an aggressive cutaneous T-cell lymphoma (CTCL) with poor prognosis, is characterized by the clinical hallmarks of circulating malignant T cells, erythroderma and lymphadenopathy. However, highly variable clinical skin manifestations and similarities with benign mimickers can lead to significant diagnostic delay and inappropriate therapy that can lead to disease progression and mortality. SS has been the focus of numerous transcriptomic-profiling studies to identify sensitive and specific diagnostic and prognostic biomarkers. Benign inflammatory disease controls (e.g., psoriasis, atopic dermatitis) have served to identify chronic inflammatory phenotypes in gene expression profiles, but provide limited insight into the lymphoproliferative and oncogenic roles of abnormal gene expression in SS. This perspective was recently clarified by a transcriptome meta-analysis comparing SS and lymphocytic-variant hypereosinophilic syndrome, a benign yet often clonal T-cell lymphoproliferation, with clinical features similar to SS. Here we review the rationale for selecting lymphocytic-variant hypereosinophilic syndrome (L-HES) as a disease control for SS, and discuss differentially expressed genes that may distinguish benign from malignant lymphoproliferative phenotypes, including additional context from prior gene expression studies to improve understanding of genes important in SS.
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14
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Bobrowicz M, Fassnacht C, Ignatova D, Chang YT, Dimitriou F, Guenova E. Pathogenesis and Therapy of Primary Cutaneous T-Cell Lymphoma: Collegium Internationale Allergologicum (CIA) Update 2020. Int Arch Allergy Immunol 2020; 181:733-745. [PMID: 32690848 DOI: 10.1159/000509281] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 11/19/2022] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) is a heterogeneous disease group of unknown etiology with a complex immunological background. As CTCL arises from T cells that have a vital role in the antitumor response, their therapy is largely aimed at reversing the immunological mechanisms leading to or manifesting during this malignancy. Early disease stages can be controlled with skin-directed therapy in most CTCL cases. Still, advanced CTCL has a dismal prognosis and warrants systemic therapy. Despite considerable progress in understanding the pathophysiology of the disease and the numerous systemic treatment options available, long-term remission rates with conventional treatments alone are still low. Allogeneic hematopoietic stem cell transplantation is currently the only curative option for advanced CTCL, including mycosis fungoides and Sézary syndrome. The aims of this review is to summarize the recent findings on the immunology of this heterogeneous disease and to present the advances in its clinical management.
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Affiliation(s)
| | - Christina Fassnacht
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Desislava Ignatova
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Yun-Tsan Chang
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Dermatology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Florentia Dimitriou
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland, .,Faculty of Medicine, University of Zurich, Zurich, Switzerland, .,Department of Dermatology, Lausanne University Hospital (CHUV), Lausanne, Switzerland, .,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,
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15
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Yang ZZ, Kim HJ, Wu H, Jalali S, Tang X, Krull JE, Ding W, Novak AJ, Ansell SM. TIGIT Expression Is Associated with T-cell Suppression and Exhaustion and Predicts Clinical Outcome and Anti-PD-1 Response in Follicular Lymphoma. Clin Cancer Res 2020; 26:5217-5231. [PMID: 32631956 DOI: 10.1158/1078-0432.ccr-20-0558] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/01/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE T-cell immunoglobulin and ITIM domain (TIGIT), a member of the immune checkpoint family, is important in normal T-cell biology. However, the phenotypical profile and clinical relevance of TIGIT in follicular lymphoma is largely unknown. EXPERIMENTAL DESIGN Biopsy specimens from a cohort of 82 patients with follicular lymphoma were analyzed using mass cytometry to explore the phenotype and biological and clinical significance of TIGIT+ T cells. RESULTS TIGIT is highly expressed on intratumoral T cells and its expression alters T-cell phenotype in follicular lymphoma. TIGIT is abundantly expressed on Treg cells, resulting in an enhanced suppressive property. TIGIT expression on non-Treg/TFH T cells defines a population that exhibits an exhausted phenotype. Clinically, increased numbers of TIGIT+ T cells are associated with inferior patient outcomes and poor survival. We observe that anti-PD-1 therapy with pembrolizumab alters the phenotype of TIGIT+ T subsets and identifies a role for CD28 expression on TIGIT+ T cells in treatment response. CONCLUSIONS The current study provides a comprehensive analysis of the phenotypic profile of intratumoral TIGIT+ T subsets and their prognostic relevance in follicular lymphoma. Inhibition of TIGIT signaling may be an additional mechanism to prevent T-cell suppression and exhaustion in B-cell lymphoma.
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Affiliation(s)
- Zhi-Zhang Yang
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
| | - Hyo Jin Kim
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Hongyan Wu
- Department of Immunology, Medical College, China Three Gorges University, Yichang, Hubei, China
| | - Shahrzad Jalali
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Xinyi Tang
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jordan E Krull
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Wei Ding
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Anne J Novak
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Stephen M Ansell
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
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16
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Sun Y, Luo J, Chen Y, Cui J, Lei Y, Cui Y, Jiang N, Jiang W, Chen L, Chen Y, Kuang Y, Tang K, Ke Z. Combined evaluation of the expression status of CD155 and TIGIT plays an important role in the prognosis of LUAD (lung adenocarcinoma). Int Immunopharmacol 2020; 80:106198. [PMID: 31954274 DOI: 10.1016/j.intimp.2020.106198] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/13/2019] [Accepted: 01/06/2020] [Indexed: 12/25/2022]
Abstract
The interaction between CD155 and its high-affinity ligand TIGIT is being increasingly investigated in various solid tumors. However, the prognostic significance of CD155 and TIGIT in lung adenocarcinoma (LUAD) remains unclear. In this study, immunohistochemistry was applied in 334 LUAD cases to evaluate the expression of CD155 and TIGIT. Western blotting was conducted in 5 paired primary LUAD and adjacent normal lung tissues. Our results reveal that CD155 and TIGIT are overexpressed in LUAD tissues and that aberrant overexpression is closely correlated with poor clinical outcomes (P < 0.01). The multivariate model also shows that CD155 expression is an independent risk factor for LUAD (RR, 1.34; P = 0.036). Moreover, patients expressing high CD155 and TIGIT simultaneously presented shorter overall survival (OS) (P < 0.01) and progression-free survival (PFS) (P < 0.01). These findings suggest that CD155 and TIGIT can make up a prognosticating tool to predict clinical outcomes, thereby contributing to personalized medical care in LUAD.
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Affiliation(s)
- Yu Sun
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Jiping Luo
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Yangshan Chen
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Ji Cui
- Gastrointestinal Surgery Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Yiyan Lei
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Yongmei Cui
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Neng Jiang
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Wenting Jiang
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Lili Chen
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Yanyang Chen
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Yukun Kuang
- Department of Respiratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Kejing Tang
- Department of Respiratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Zunfu Ke
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China; Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, PR China.
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17
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Moerman-Herzog AM, Acheampong DA, Brooks AG, Blair SM, Hsu PC, Wong HK. Transcriptome analysis of Sézary syndrome and lymphocytic-variant hypereosinophilic syndrome T cells reveals common and divergent genes. Oncotarget 2019; 10:5052-5069. [PMID: 31489115 PMCID: PMC6707948 DOI: 10.18632/oncotarget.27120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/15/2019] [Indexed: 11/25/2022] Open
Abstract
Sézary syndrome (SS) is an aggressive cutaneous T cell lymphoma with pruritic skin inflammation and immune dysfunction, driven by neoplastic, clonal memory T cells in both peripheral blood and skin. To gain insight into abnormal gene expression promoting T cell dysfunction, lymphoproliferation and transformation in SS, we first compared functional transcriptomic profiles of both resting and activated CD4+CD45RO+ T cells from SS patients and normal donors to identified differential expressed genes. Next, a meta-analysis was performed to compare our SS data to public microarray data from a novel benign disease control, lymphocytic-variant hypereosinophilic syndrome (L-HES). L-HES is a rare, clonal lymphoproliferation of abnormal memory T cells that produces similar clinical symptoms as SS, including severe pruritus and eosinophilia. Comparison revealed gene sets specific for either SS (370 genes) or L-HES (519 genes), and a subset of 163 genes that were dysregulated in both SS and L-HES T cells compared to normal donor T cells. Genes confirmed by RT-qPCR included elevated expression of PLS3, TWIST1 and TOX only in SS, while IL17RB mRNA was increased only in L-HES. CDCA7 was increased in both diseases. In an L-HES patient who progressed to peripheral T cell lymphoma, the malignant transformation identified increases in the expression of CDCA7, TIGIT, and TOX, which are highly expressed in SS, suggesting that these genes contribute to neoplastic transformation. In summary, we have identified gene expression biomarkers that implicate a common transformative mechanism and others that are unique to differentiate SS from L-HES.
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Affiliation(s)
- Andrea M Moerman-Herzog
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Daniel A Acheampong
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Joint Graduate Program in Bioinformatics, University of Arkansas at Little Rock and University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Amanda G Brooks
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Suzan M Blair
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ping-Ching Hsu
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Henry K Wong
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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18
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Gaydosik AM, Tabib T, Geskin LJ, Bayan CA, Conway JF, Lafyatis R, Fuschiotti P. Single-Cell Lymphocyte Heterogeneity in Advanced Cutaneous T-cell Lymphoma Skin Tumors. Clin Cancer Res 2019; 25:4443-4454. [PMID: 31010835 DOI: 10.1158/1078-0432.ccr-19-0148] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/21/2019] [Accepted: 04/12/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE The heterogeneity of tumor cells presents a major challenge to cancer diagnosis and therapy. Cutaneous T-cell lymphomas (CTCL) are a group of T lymphocyte malignancies that primarily affect skin. Lack of highly specific markers for malignant lymphocytes prevents early diagnosis, while only limited treatment options are available for patients with advanced stage CTCL. Droplet-based single-cell transcriptome analysis of CTCL skin biopsies opens avenues for dissecting patient-specific T lymphocyte heterogeneity, providing a basis for identifying specific markers for diagnosis and cure of CTCL. EXPERIMENTAL DESIGN Single-cell RNA-sequencing was performed by Droplet-based sequencing (10X Genomics), focusing on 14,056 CD3+ lymphocytes (448 cells from normal and 13,608 cells from CTCL skin samples) from skin biopsies of 5 patients with advanced-stage CTCL and 4 healthy donors. Protein expression of identified genes was validated in advanced stage CTCL skin tumors by immunohistochemistry and confocal immunofluorescence microscopy. RESULTS Our analysis revealed a large inter- and intratumor gene expression heterogeneity in the T lymphocyte subset, as well as a common gene expression signature in highly proliferating lymphocytes that was validated in multiple advanced-stage skin tumors. In addition, we established the immunologic state of reactive lymphocytes and found heterogeneity in effector and exhaustion programs across patient samples. CONCLUSIONS Single-cell analysis of CTCL skin tumor samples reveals patient-specific landscapes of malignant and reactive lymphocytes within the local microenvironment of each tumor, giving an unprecedented view of lymphocyte heterogeneity and identifying tumor-specific molecular signatures, with important implications for diagnosis and personalized disease treatment.
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Affiliation(s)
- Alyxzandria M Gaydosik
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tracy Tabib
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | | | - James F Conway
- Department of Structural Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert Lafyatis
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Patrizia Fuschiotti
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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19
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Anzengruber F, Ignatova D, Schlaepfer T, Chang YT, French LE, Pascolo S, Contassot E, Bobrowicz M, Hoetzenecker W, Guenova E. Divergent LAG-3 versus BTLA, TIGIT, and FCRL3 expression in Sézary syndrome. Leuk Lymphoma 2019; 60:1899-1907. [PMID: 30638415 DOI: 10.1080/10428194.2018.1564827] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In Sézary syndrome (SS) impaired T-cell function and cytokine profile lead to immune evasion. Immune checkpoints non-redundantly regulate immune responses and targeting them is promising. We evaluated the expression of BTLA, CTLA-4, FCRL3, LAG-3, and TIGIT in tumor and non-tumor SS T-cells.Compared to CD4+ T helper cells from ten healthy individuals, tumor cells of eight SS patients had a significant upregulation of BTLA (1.5-fold; p < .0001), FRCL3 (2.2-fold; p < .0028) and TIGIT (2.2-fold; p < .0003) expression. In contrast, we found a reduced expression of LAG-3+ cells in the blood of tumor patients (0.5-fold; p < .0014). Only weak alternations between tumor, non-tumor cells, and healthy controls were observed regarding CTLA-4 (0.5-fold; p < .2022). Our results show a diverse expression pattern of immune-regulatory molecules in SS patients. As these molecules are essential in the regulation of T-cell mediated tumor surveillance and defense, their specific targeting might be of clinical relevance.
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Affiliation(s)
- Florian Anzengruber
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
| | - Desislava Ignatova
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
| | - Tanja Schlaepfer
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
| | - Yun-Tsan Chang
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
| | - Lars E French
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
| | - Steve Pascolo
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
| | - Emmanuel Contassot
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
| | - Malgorzata Bobrowicz
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland.,b Department of Immunology , Medical University of Warsaw , Warsaw , Poland
| | | | - Emmanuella Guenova
- a Department of Dermatology , University Hospital Zurich University of Zurich , Zurich , Switzerland
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