Identification of complement-receptor lymphocytes (B cells) in lymph nodes and tumor infiltrates

Identification of key genes and microRNA regulatory network in development and progression of urothelial bladder carcinoma

Background

Bladder cancer as other cancers contains multiple dynamic alterations in progression. Theoretically, large number of genes participates in cancer progression. In the present study, the interconnections of genesets defined by Gene Set Enrichment Analysis (GSEA) and tumor histopathological stages were characterized. In addition, the outcomes with genesets were discussed in bladder cancer.

Methods

Transcriptome data from 411 tissues of urothelial bladder carcinoma and 19 samples from adjacent tissues were retrieved from The Cancer Genome Atlas (TCGA) database. Single-sample GSEA (ssGSEA), cluster analysis of geneset enrichment scores and genesets as indicators in prognosis were applied to elucidate the correlations between genesets and bladder cancer progression.

Results

Chemical and genetic perturbations (CGP), canonical pathways (CP), CP:BIOCARTA (BioCarta gene sets), CP:KEGG (KEGG gene sets) and CP:REACTOME (Reactome gene sets) in C2 collection, upstream cis-regulatory motifs serum response factor (SRF) in C3 collection, KRAS in C6 collection and C8+ T cells in C7 collection were observed as enriched by ssGSEA. The cluster 2 identified from cluster analysis shows a more immune active microenvironment which tended to increase in stage II and decreased in stage IV indicating the crucial role in bladder cancer progression. miR-450, miR-518s, transcription factor PAX3, KRAS and PTEN were potential markers for outcomes of urothelial bladder carcinoma. Activating tumor immune microenvironment had deteriorated prognosis of patients with bladder cancer.

Conclusions

Our findings demonstrated that activating tumor immune microenvironment is a negative factor for outcomes of urothelial bladder carcinoma. These data provided a potential combination strategy for patients with bladder cancer.

Immune response to sipuleucel-T in prostate cancer

Historically, chemotherapy has remained the most commonly utilized therapy in patients with metastatic cancers. In prostate cancer, chemotherapy has been reserved for patients whose metastatic disease becomes resistant to first line castration or androgen deprivation. While chemotherapy palliates, decreases serum prostate specific antigen and improves survival, it is associated with significant side effects and is only suitable for approximately 60% of patients with castrate-resistant prostate cancer. On that basis, exploration of other therapeutic options such as active secondary hormone therapy, bone targeted treatments and immunotherapy are important. Until recently, immunotherapy has had no role in the treatment of solid malignancies aside from renal cancer and melanoma. The FDA-approved autologous cellular immunotherapy sipuleucel-T has demonstrated efficacy in improving overall survival in patients with metastatic castrate-resistant prostate cancer in randomized clinical trials. The proposed mechanism of action is reliant on activating the patients' own antigen presenting cells (APCs) to prostatic acid phosphatase (PAP) fused with granulocyte-macrophage colony stimulating factor (GM-CSF) and subsequent triggered T-cell response to PAP on the surface of prostate cancer cells in the patients body. Despite significant prolongation of survival in Phase III trials, the challenge to health care providers remains the dissociation between objective changes in serum PSA or on imaging studies after sipleucel-T and survival benefit. On that basis there is an unmet need for markers of outcome and a quest to identify immunologic or clinical surrogates to fill this role. This review focuses on the impact of sipuleucel-T on the immune system, the T and B cells, and their responses to relevant antigens and prostate cancer. Other therapeutic modalities such as chemotherapy, corticosteroids and GM-CSF and host factors can also affect immune response. The optimal timing for immunotherapy, patient selection and best sequencing with other prostate cancer therapies remain to be determined. A better understanding of immune response may help address these issues.

Regulatory dendritic cells in the tumor immunoenvironment

The tumor microenvironment is a pivotal factor in tumorigenesis, and especially in progression, as the pathogenesis of cancer critically depends on the complex interactions between various microenvironmental components. A key component of the tumor immunoenvironment is the infiltration of immune cells, which has been proven to play a dual role in tumor growth and progression. This Janus two-faced function of the tumor immunoenvironment is seen in tumor infiltration by T cells, which correlates with improved patient survival, but also with the homing of multiple subsets of immunoregulatory cells that inhibit the antitumor immune response. Regulatory dendritic cells (regDCs) have recently been shown to be induced by tumor-derived factors and represent a new and potentially important player in supporting tumor progression and suppressing the development of antitumor immune responses. Our recent data reveal that different tumor cell lines produce soluble factors that induce polarization of conventional DCs into regDCs, both in vitro and in vivo. These regDCs can suppress the proliferation of pre-activated T cells and are phenotypically and functionally different from their precursors as well as the classical immature conventional DCs. Understanding the biology of regDCs and the mechanisms of their formation in the tumor immunoenvironment will provide a new therapeutic target for re-polarizing protumorigenic immunoregulatory cells into proimmunogenic effector cells able to induce and support effective antitumor immunity.

The tumor microenvironment: the making of a paradigm

What has been will be again, what has been done will be done again; there is nothing new under the sun

(Ecclesiastes 1:9)

Stephen Paget was the conceptual father of the role played by the Tumor Microenvironment (TME) in tumor progression. The focus of this essay is the developmental phase of the post Paget TME research. Attempts will be made to highlight some of the pioneering work of scientists from the late sixties through the eighties of last century who laid the foundations for the contemporary scientific achievements of TME research but whose ground breaking studies are rarely cited. This review should serve as a small tribute to their great work.

The tumor microenvironment in the post-PAGET era

The research area of tumor microenvironment is considered, at present, to be an important factor in tumorigenesis and especially in tumor progression. The present mini review is focused on three principles characterizing the nature of the tumor microenvironment. We first discuss the regulatory functions of the tumor microenvironment and the complexity of the combinatorial signaling pathways operating in it. We then address the aspect that the tumor microenvironment incorporates both pro and anti malignancy factors and that a balance between these factors regulates tumor progression. Thirdly we provide evidence that the non-tumor cells in the tumor microenvironment and their products may be different from those of their counterparts residing in non-tumor microenvironments. The conclusion of this mini review is that the tumor microenvironment, by exerting regulatory functions and selective pressures drives cancer cells into one of several molecular evolution pathways thereby determining and shaping their malignancy phenotype.

In situ identification of inflammatory cells in malignant, non-lymphoid human tumours

Inflammatory cells (the term is considered to include lymphocytes, plasma cells, macrophages, mast cells and PMN) were identified and quantitated in sections from human carcinomas. Two types of cellular infiltrates are described. In the stroma surrounding the cancer tissue (peritumoural) and, to a lesser degree, also within the malignant tissue (intratumoural), lymphocytes, plasma cells, macrophages and mast cells dominated, whilst numerous polymorph nucleated cells (PMN) and aggregates of macrophages characterized central tumour necroses. The demonstration of both T-lymphocytes and macrophages in and around the cancer tissue supports the view that a local immune reaction is initiated by the tumour, and the consistent finding of IgG, IgA and IgM plasma cells at the borders of the carcinomas, indicates that plasma cells are also part of an immune response at the tumour site. This view is further supported by the demonstration of an increased proportion of IgG containing plasma cells in the stroma of colon tumours, compared with normal mucosa.

Isolation and characterization of lymphocytes and macrophages from solid, malignant human tumours

In mechanically prepared cell suspensions from 17 solid, malignant human tumours, 0.5-5.0% (mean 2.0%) lymphocytes and 1.0-28.0% (mean 7.4+) macrophages were found. Mononuclear cells (MC) were isolated using the Böyum technique. From each biopsy weghing 1-4 g, on average, 1.3 x 10(6) lymphocytes and 0.8 x 10(6) macrophages were recovered. The tumour-infiltrating lymphocytes (TIL) were characterized with regard to T and B markers. The proportion of TIL-forming rosettes with SRBC (T cells) was 43%, which was significantly less than for peripheral blood lymphocytes (PBL) from cancer patients (58%), or normal controls (80%), On average, 15% of the TIL were B cells, whereas 42% had no T- or B-cell markers. Macrophages (TIM) were identified by non-specific esterase staining and phagocytosis. In four cases the tumour cells were also stained with alpha-naphthyl butyrate. Corresponding findings were made on esterase-stained cryostat sections from four tumours. Macrophages were found within and around the tumour tissues, occasionally localized to necrotic areas, but in most cases with no sign of necrosis of the surrounding cells. In some tumour cell suspensions typical clusters of lymphocytes and macrophages were seen. Total lymphocytes and T-cell were markedly reduced inthe peripheral blood of cancer patients, whereas total monocyte counts were within the normal range.

Characterization of lymphocytes isolated from non-lymphoid human malignant tumours

Mononuclear cells (MC) were found in suspensions prepared from twenty-one out of twenty-two solid human neoplasms. In three cases it was calculated that more than 1% of the MC could represent contamination by blood MC. Due to technical difficulties and blood lymphocyte contamination, eight cases were excluded from the study. MC could be separated from thirteen of the remaining fourteen tumours and in one tumour no MC were found. On average, 0.44 X 10(6) MC were obtained from each biopsy weighing 1-5 g. The MC were characterized with regard to markers for T and B lymphocytes. On average 41.0% of the MC were T and 18.2% B cells. There was no significant correlation between MC infiltration and tumour size or spread. In all patients blood MC were also isolated and characterized with regard to T (62.0%) and B lymphocytes (14.3%). The T/B ratio of tumour and blood lymphocytes corresponded in most cases. In two cases a markedly depressed T fraction was found within the tumour, whereas the T lymphocyte portions in the blood of these patients were within the normal range.

Commentary on the immunobiology of bladder cancer

This review is an attempt to integrate the conflicting studies that constitute the literature on immunobiology of bladder cancer and to indicate areas that need further investigation. It is clear that immune reactivity directed at antigens expressed on bladder cancer cells and general host immunologic competence decline with progressive tumor growth. This immunodepression correlates with patient prognosis, even within a given stage of disease. The mechanisms underlying this decline in host immune reactivity are poorly understood. A better understanding of these mechanisms may provide fundamental insight into the host-tumor relationship that possibly could be exploited for preventive, diagnostic and therapeutic purposes.