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Wang Y, Chen-Mayfield TJ, Li Z, Younis MH, Cai W, Hu Q. Harnessing DNA for immunotherapy: Cancer, infectious diseases, and beyond. ADVANCED FUNCTIONAL MATERIALS 2022; 32:2112273. [PMID: 36304724 PMCID: PMC9595111 DOI: 10.1002/adfm.202112273] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Indexed: 05/03/2023]
Abstract
Despite the rapid development of immunotherapy, low response rates, poor therapeutic outcomes and severe side effects still limit their implementation, making the augmentation of immunotherapy an important goal for current research. DNA, which has principally been recognized for its functions of encoding genetic information, has recently attracted research interest due to its emerging role in immune modulation. Inspired by the intrinsic DNA-sensing signaling that triggers the host defense in response to foreign DNA, DNA or nucleic acid-based immune stimulators have been used in the prevention and treatment of various diseases. Besides that, DNA vaccines allow the synthesis of target proteins in host cells, subsequently inducing recognition of these antigens to provoke immune responses. On this basis, researchers have designed numerous vehicles for DNA and nucleic acid delivery to regulate immune systems. Additionally, DNA nanostructures have also been implemented as vaccine delivery systems to elicit strong immune responses against pathogens and diseased cells. This review will introduce the mechanism of harnessing DNA-mediated immunity for the prevention and treatment of diseases, summarize recent progress, and envisage their future applications and challenges.
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Affiliation(s)
- Yixin Wang
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin 53705
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin 53705
| | - Ting-Jing Chen-Mayfield
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin 53705
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin 53705
| | - Zhaoting Li
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin 53705
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin 53705
| | - Muhsin H. Younis
- Department of Radiology and Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin 53705
| | - Weibo Cai
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin 53705
- Department of Radiology and Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin 53705
| | - Quanyin Hu
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin 53705
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin 53705
- Wisconsin Center for NanoBioSystems, University of Wisconsin-Madison, Madison, Wisconsin 53705, USA
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Qin H, Chen Y. Lipid Metabolism and Tumor Antigen Presentation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1316:169-189. [PMID: 33740250 DOI: 10.1007/978-981-33-6785-2_11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tumors always evade immune surveillance and block T cell activation in a poorly immunogenic and immunosuppressive environment. Cancer cells and immune cells exhibit metabolic reprogramming in the tumor microenvironment (TME), which intimately links immune cell function and edits tumor immunology. In addition to glucose metabolism, amino acid and lipid metabolism also provide the materials for biological processes crucial in cancer biology and pathology. Furthermore, lipid metabolism is synergistically or negatively involved in the interactions between tumors and the microenvironment and contributes to the regulation of immune cells. Antigen processing and presentation as the initiation of adaptive immune response play a critical role in antitumor immunity. Therefore, a relationship exists between antigen-presenting cells and lipid metabolism in TME. This chapter introduces the updated understandings of lipid metabolism of tumor antigen-presenting cells and describes new directions in the manipulation of immune responses for cancer treatment.
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Affiliation(s)
- Hong Qin
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Institute for Viral Hepatitis, Centre for Lipid Research, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yaxi Chen
- Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Institute for Viral Hepatitis, Centre for Lipid Research, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
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Osei-Bordom D, Bozward AG, Oo YH. The hepatic microenvironment and regulatory T cells. Cell Immunol 2020; 357:104195. [PMID: 32861844 DOI: 10.1016/j.cellimm.2020.104195] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 12/16/2022]
Abstract
The human liver is regarded as a lymphoid organ that contributes to both local and systemic immune response. Intrahepatic immune cells including regulatory T cells (Tregs) reside in the hepatic microenvironment which is enriched with proinflammatory cytokines, chemokines and metabolites. In addition, the hepatic microenvironment has the unique ability to establish and maintain immune tolerance despite the continuous influx of the gut derived microbial products via the portal vein. Regulatory T cells play a crucial role in maintaining the hepatic tolerogenic state; however, the phenotypic stability, function and survival of Tregs in the inflamed liver microenvironment is still poorly understood. Despite this, Tregs immunotherapy remains as an appealing therapeutic option in autoimmune and immune mediated liver diseases. In order to advance cell therapy, it is important for us to further our understanding of the hepatic microenvironment, with the aim of developing ways to modify the hostile, inflamed environment to one which is more favourable. By doing so, T cell stability and function would be enhanced, resulting in improved clinical outcomes.
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Affiliation(s)
- Daniel Osei-Bordom
- Centre for Liver Research and NIHR BRC, Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom; European Reference Network Centre: Rare Liver, United Kingdom; Queen Elizabeth Hospital, University Hospital of Birmingham NHS Foundation Trust, United Kingdom
| | - Amber G Bozward
- Centre for Liver Research and NIHR BRC, Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom; European Reference Network Centre: Rare Liver, United Kingdom
| | - Ye Htun Oo
- Centre for Liver Research and NIHR BRC, Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom; European Reference Network Centre: Rare Liver, United Kingdom; Queen Elizabeth Hospital, University Hospital of Birmingham NHS Foundation Trust, United Kingdom.
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Iurciuc-Tincu CE, Cretan MS, Purcar V, Popa M, Daraba OM, Atanase LI, Ochiuz L. Drug Delivery System Based on pH-Sensitive Biocompatible Poly(2-vinyl pyridine)-b-poly(ethylene oxide) Nanomicelles Loaded with Curcumin and 5-Fluorouracil. Polymers (Basel) 2020; 12:polym12071450. [PMID: 32605272 PMCID: PMC7408444 DOI: 10.3390/polym12071450] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/15/2022] Open
Abstract
Smart polymeric micelles (PMs) are of practical interest as nanocarriers for the encapsulation and controlled release of hydrophobic drugs. Two hydrophobic drugs, naturally-based curcumin (Cur) and synthetic 5-fluorouracil (5-FU), were loaded into the PMs formed by a well-defined pH-sensitive poly(2-vinyl pyridine)-b-poly(ethylene oxide) (P2VP90-b-PEO398) block copolymer. The influence of the drug loading on the micellar sizes was investigated by dynamic light scattering (DLS) and it appears that the size of the PMs increases from around 60 to 100 nm when Cur is loaded. On the contrary, the loading of the 5-FU has a smaller effect on the micellar sizes. This difference can be attributed to higher molar mass of Cur with respect to 5-FU but also to higher loading efficiency of Cur, 6.4%, compared to that of 5-FU, 5.8%. In vitro drug release was studied at pH 2, 6.8, and 7.4, and it was observed that the pH controls the release of both drugs. At pH 2, where the P2VP sequences from the “frozen-in” micellar core are protonated, the drug release efficiencies exceed 90%. Moreover, it was demonstrated, by in vitro assays, that these PMs are hemocompatible and biocompatible. Furthermore, the PMs protect the Cur against the photo-degradation, whereas the non-ionic PEO corona limits the adsorption of bovine serum albumin (BSA) protein on the surface. This study demonstrates that these pH-sensitive PMs are suitable for practical utilization as human-safe and smart, injectable drug delivery systems.
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Affiliation(s)
- Camelia-Elena Iurciuc-Tincu
- Department of Pharmaceutical Technology, Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, University street, no. 16, 700115 Iaşi, Romania; (C.-E.I.-T.); (M.S.C.); (L.O.)
- Department of Natural and Synthetic Polymers, Faculty of Chemical Engineering and Protection of the Environment, “Gheorghe Asachi” Technical University, 700050 Iaşi, Romania;
| | - Monica Stamate Cretan
- Department of Pharmaceutical Technology, Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, University street, no. 16, 700115 Iaşi, Romania; (C.-E.I.-T.); (M.S.C.); (L.O.)
| | - Violeta Purcar
- National R&D Institute for Chemistry and Petrochemistry—ICECHIM, Splaiul Independentei 202, 6th district, 060021 Bucharest, Romania;
| | - Marcel Popa
- Department of Natural and Synthetic Polymers, Faculty of Chemical Engineering and Protection of the Environment, “Gheorghe Asachi” Technical University, 700050 Iaşi, Romania;
- Academy of Romanian Scientists, Splaiul Independentei Street No. 54, 050085 Bucharest, Romania
| | - Oana Maria Daraba
- Faculty of Dental Medicine, “Apollonia” University of Iasi, Pacurari street, no. 11, 700355 Iași, Romania;
| | - Leonard Ionut Atanase
- Faculty of Dental Medicine, “Apollonia” University of Iasi, Pacurari street, no. 11, 700355 Iași, Romania;
- Correspondence: or
| | - Lacramioara Ochiuz
- Department of Pharmaceutical Technology, Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, University street, no. 16, 700115 Iaşi, Romania; (C.-E.I.-T.); (M.S.C.); (L.O.)
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Han N, Zhang Z, Jv H, Hu J, Ruan M, Zhang C. Culture supernatants of oral cancer cells induce impaired IFN-α production of pDCs partly through the down-regulation of TLR-9 expression. Arch Oral Biol 2018; 93:141-148. [PMID: 29913322 DOI: 10.1016/j.archoralbio.2018.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/29/2018] [Accepted: 06/04/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate whether tumor-derived supernatants down-regulate the immune function of plasmacytoid dendritic cells (pDCs) in oral cancer and the potential molecular mechanisms of this effect. MATERIALS AND METHODS Immunohistochemistry (IHC) and flow cytometry were used to detect tumor-infiltrating and peripheral blood pDCs. MTS and flow cytometry were employed to evaluate the immune response of CD4+ T cells. Real-time PCR and ELISA assays were used to identify TLR-7 and TLR-9 expression, IFN-α production and tumor-secreted soluble cytokines. RESULTS The proportion of pDCs (0.121%±0.043%) was significantly higher in Oral squamous cell carcinoma (OSCC) samples than in normal tissue (0.023%±0.016%) (P = 0.021). TLR9 mRNA was significantly lower in tumor-infiltrating pDCs and positively correlated to low IFN-α production (r = 0.956; P<0.01). The supernatant of oral cancer cells negatively regulated TLR9 mRNA expression and the subsequent IFN-α production of pDCs, which inhibited the immune response of CD4+ T cells. The neutralizing antibodies blocking assay showed that the specific inhibitory effect of pDC functionality was associated with the soluble fraction of the oral cancer environment, which is mainly mediated by IL-10 and TGF-β cooperation. CONCLUSION Tumor-derived supernatants may impair the function of tumor-infiltrating pDCs, which subsequently decreases the immune response of CD4+ T cells in human oral cancer through TGF-β- and IL-10- dependent mechanisms. Careful manipulation of these impaired pDCs may help develop an important alternative immunotherapy for the treatment of oral cancer.
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Affiliation(s)
- Nannan Han
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Reaearch Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China; Department of Oral & Maxillofacial-Head & Neck Oncology, Shanghai Fengcheng Hospital, Fengxian District, Shanghai, 201400, China
| | - Zun Zhang
- Department of Stomatology, Shanghai East Hospital, Tongji University, Shanghai, 200120, China
| | - Houyu Jv
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Reaearch Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China
| | - Jingzhou Hu
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Reaearch Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China.
| | - Min Ruan
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Reaearch Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China; Department of Oral & Maxillofacial-Head & Neck Oncology, Shanghai Fengcheng Hospital, Fengxian District, Shanghai, 201400, China.
| | - Chenping Zhang
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Reaearch Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, 200011, China
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Han N, Zhang Z, Liu S, Ow A, Ruan M, Yang W, Zhang C. Increased tumor-infiltrating plasmacytoid dendritic cells predicts poor prognosis in oral squamous cell carcinoma. Arch Oral Biol 2017; 78:129-134. [PMID: 28242507 DOI: 10.1016/j.archoralbio.2017.02.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 01/15/2017] [Accepted: 02/07/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Accumulating evidence suggests that plasmacytoid dendritic cells (pDC) have a dual role not only in initiating anti-tumor immune responses but also in inducing immune tolerance to facilitate cancer development. The aim of this study was to investigate the distribution and function of tumor-infiltrating pDCs in primary oral squamous cell carcinoma (OSCC) and their relation to patient outcome. METHODS The distribution of pDCs in 10 normal oral mucosa and 60 OSCC tissues was detected by immunohistochemistry. The population of pDCs in six OSCC patients and six healthy donors was evaluated by flow cytometry. The relationship between tumor-infiltrating pDCs and clinicopathological data and patient outcome was analyzed accordingly. The capacity of pDCs to produce cytokines, such as IFN-α, IL-6, IL-8 and TNF-α in response to TLR-9 ligands (CpG-ODN) was measured by ELISA. RESULT PDCs were detected at high levels in 38.3% of the OSCC tissues, primarily in the stroma, but were absent in normal oral mucosa. The frequency of pDCs in OSCC tissue was significantly higher than that observed in normal oral mucosa. However, the distribution and population of circulating pDCs was similar between healthy donors and OSCC patients. Kaplan-Meier analysis revealed a significant association of increasing number of tumor-infiltrating pDCs with lymph node metastasis and overall survival. Multivariate analysis confirmed that high levels of tumor-infiltrating pDCs was an independent prognostic factor. Further cytokine analysis revealed a decreased secretion of IFN-α, IL-6 and TNF-α, which indicated an impaired function of tumor-infiltrating pDCs. CONCLUSIONS The increased number of tumor-infiltrating pDCs correlates with an adverse outcome in primary OSCC patients. This finding is not only suggestive of the contribution of pDCs in the progression of oral cancer but also presents an opportunity and a new target for OSCC immune therapy in oral cancer management.
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Affiliation(s)
- Nannan Han
- Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Zun Zhang
- Department of Stomatology, Shanghai East Hospital, Tongji University, Shanghai 200120, China
| | - Shengwen Liu
- Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Andrew Ow
- Department of Oral and Maxillofacial Surgery, Ng Teng Fong General Hospital, Jurong Health Services, Singapore.
| | - Min Ruan
- Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China.
| | - Wenjun Yang
- Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Chenping Zhang
- Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
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Bazhin AV, Yang Y, D'Haese JG, Werner J, Philippov PP, Karakhanova S. The novel mitochondria-targeted antioxidant SkQ1 modulates angiogenesis and inflammatory micromilieu in a murine orthotopic model of pancreatic cancer. Int J Cancer 2016; 139:130-9. [DOI: 10.1002/ijc.30054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 01/28/2016] [Accepted: 02/03/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Alexandr V. Bazhin
- Department of General; Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich; LMU Munich Germany
| | - Yuhui Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Wuhan China
| | - Jan G. D'Haese
- Department of General; Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich; LMU Munich Germany
| | - Jens Werner
- Department of General; Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich; LMU Munich Germany
| | - Pavel P. Philippov
- Department of Cell Signalling; Belozersky Institute of Physico-Chemical Biology, Moscow State University; Moscow Russia
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Polymeric micelles based on poly(ethylene oxide) and α-carbon substituted poly(ɛ-caprolactone): An in vitro study on the effect of core forming block on polymeric micellar stability, biocompatibility, and immunogenicity. Colloids Surf B Biointerfaces 2015; 132:161-70. [DOI: 10.1016/j.colsurfb.2015.05.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 03/10/2015] [Accepted: 05/08/2015] [Indexed: 12/29/2022]
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Macrophages and dendritic cells as actors in the immune reaction of classical Hodgkin lymphoma. PLoS One 2014; 9:e114345. [PMID: 25470820 PMCID: PMC4255018 DOI: 10.1371/journal.pone.0114345] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 11/06/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The inflammatory infiltrate plays a pivotal role in classical Hodgkin lymphoma (cHL). Here, we focussed on the role of macrophages (MΦ) and dendritic cells (DC). METHODS MΦ and DC infiltration was investigated in 106 cHL specimens using immunohistochemistry and cytokine expression was analyzed in a subset by real-time PCR. Human peripheral blood-derived monocytes, DC, MΦ stimulated with GM-CSF (MΦGM-CSF, pro-inflammatory MΦ-1-model) or M-CSF (MΦM-CSF, immunomodulatory MΦ-2-model) were incubated with cHL cell line (L1236, HDLM2) supernatants (SN). DC maturation or MΦ polarization were investigated by flow cytometry. Furthermore, the impact of DC or MΦ on cHL cell proliferation was analyzed by BrdU/CFSE assay. RESULTS In cHL tissues mature myeloid (m)DC and MΦ predominated. High numbers of CD83+ mDC and low numbers of CD163+ MΦ were associated with improved disease specific survival. In numerous cHL specimens increased levels of both pro- and anti-inflammatory cytokines and of IL13 and GM-CSF were observed compared to reactive lymphadenopathies. Maturation of DC and induction and maintenance of an immunomodulatory MΦ phenotype were promoted by SN derived from cHL cell lines. TNFα neutralization in SN resulted in a significant inhibition of mDC maturation. DC and pro-inflammatory MΦ inhibited the proliferation of cHL cells. CONCLUSION Adopting an immunomodulatory phenotype is a potential mechanism for how MΦ promote immune evasion in cHL. Mature DC, in contrast, might participate in antitumoral immunity.
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Gulubova M, Ivanova K, Ananiev J, Gerenova J, Zdraveski A, Stoyanov H, Vlaykova T. VEGF expression, microvessel density and dendritic cell decrease in thyroid cancer. BIOTECHNOL BIOTEC EQ 2014; 28:508-517. [PMID: 26019537 PMCID: PMC4433839 DOI: 10.1080/13102818.2014.909151] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 11/26/2013] [Indexed: 12/14/2022] Open
Abstract
Thyroid cancer is one of the five most common cancers in the age between 20 and 50 years. Many factors including the potent angiogenic vascular endothelial growth factor (VEGF) and different dendritic cell types are known to be related to thyroid tumourogenesis. The study was performed to address the expression of VEGF and microvessel density in thyroid cancers and to evaluate the effect of VEGF expression in thyroid tumour cells on the dendritic cells. We investigated 65 patients with different types of thyroid carcinomas: papillary (PTC), oncocytic (OTC), follicular (FTC) and anaplastic (ATC), immunohistochemically with antibodies against VEGF, CD1a, CD83, S100 and CD31. Our results suggest that the expression of VEGF is significantly more often in PTC than ATC (92.3% vs. 60.0%, p = 0.025). The microvessel density marked with CD31 in the tumour border of PTC was significantly higher as compared to FTC (p = 0.039), but not to ATC and OTC (p = 0.337 and 0.134). We found that CD1a- and CD83-positive cells were dispersed with variable density and in OC CD31+ vessel numbers were positively correlated with CD83+ dendritic cells in tumour stroma (R = 0.847, p = 0.016). We did not find statistically significant associations of the survival of patients with PTC after the surgical therapy with VEGF expression and MVD. In conclusion we may state that VEGF expression in tumour cells of thyroid cancer can induce neovascularization and suppress dendritic cells.
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Affiliation(s)
- Maya Gulubova
- Department of General and Clinical Pathology, Medical Faculty, Trakia University , Stara Zagora , Bulgaria
| | - Koni Ivanova
- Department of General and Clinical Pathology, Medical Faculty, Trakia University , Stara Zagora , Bulgaria
| | - Julian Ananiev
- Department of General and Clinical Pathology, Medical Faculty, Trakia University , Stara Zagora , Bulgaria
| | - Julieta Gerenova
- Department of Endocrinology, Medical Faculty, Trakia University , Stara Zagora , Bulgaria
| | - Aleksandar Zdraveski
- Department of General Surgery, Medical Faculty, Trakia University , Stara Zagora , Bulgaria
| | - Hristo Stoyanov
- Department of General Surgery, Medical Faculty, Trakia University , Stara Zagora , Bulgaria
| | - Tatyana Vlaykova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University , Stara Zagora , Bulgaria
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Koido S, Homma S, Kan S, Takakura K, Namiki Y, Kobayashi H, Ito Z, Uchiyama K, Kajihara M, Arihiro S, Arakawa H, Okamoto M, Ohkusa T, Gong J, Tajiri H. Induction of antigen-specific cytotoxic T lymphocytes by fusion cells generated from allogeneic plasmacytoid dendritic and tumor cells. Int J Oncol 2014; 45:470-8. [PMID: 24819411 DOI: 10.3892/ijo.2014.2433] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/17/2014] [Indexed: 11/06/2022] Open
Abstract
Previous work has demonstrated that fusion cells generated from autologous monocyte-derived dendritic cells (MoDCs) and whole tumor cells induce efficient antigen-specific cytotoxic T lymphocytes. A major limitation to the use of this strategy is the availability of adequate amounts of autologous tumor cells. Moreover, MoDCs from cancer patients are often defective in their antigen-processing and presentation machinery. In this study, two types of allogeneic cells, a leukemia plasmacytoid dendritic cell (pDC) line (PMDC05) and pancreatic cancer cell lines (PANC-1 or MIA PaCa-2), were fused instead of autologous MoDCs and tumor cells. We created four types of pDC/tumor fusion cells by alternating fusion partners and treating with lipopolysaccharide (LPS): i) PMDC05 fused with PANC-1 (pDC/PANC-1), ii) PMDC05 fused with MIA PaCa-2 (pDC/MIA PaCa-2), iii) LPS-stimulated pDC/PANC-1 (LPS-pDC/PANC-1) and iv) LPS-stimulated pDC/MIA PaCa-2 (LPS-pDC/MIA PaCa-2) and examined their antitumor immune responses. The LPS-pDC/tumor cell fusions were the most active, as demonstrated by their: i) upregulated expression of HLA-DR and CD86 on a per-fusion-cell basis, ii) increased production of IL-12p70, iii) generation of a higher percentage of IFN-γ-producing CD4⁺ and CD8⁺ T cells and iv) augmented induction of MUC1-specific CD8⁺ T cells that lyse target tumor cells. This study provides the first evidence for an in vitro induction of antigen-specific cytotoxic T lymphocytes by LPS-stimulated fusion cells generated from leukemia plasmacytoid DCs and tumor cells and suggests that this strategy has potential applicability to the field of adoptive immunotherapy.
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Affiliation(s)
- Shigeo Koido
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Sadamu Homma
- Department of Oncology, Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Shin Kan
- Department of Oncology, Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Kazuki Takakura
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Yoshihisa Namiki
- Institute of Clinical Medicine and Research, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Hiroko Kobayashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Zensho Ito
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Kan Uchiyama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Mikio Kajihara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Seiji Arihiro
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Hiroshi Arakawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Masato Okamoto
- Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Toshifumi Ohkusa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
| | - Jianlin Gong
- Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Hisao Tajiri
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Chiba 277-8564, Japan
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Narusawa M, Inoue H, Sakamoto C, Matsumura Y, Takahashi A, Inoue T, Watanabe A, Miyamoto S, Miura Y, Hijikata Y, Tanaka Y, Inoue M, Takayama K, Okazaki T, Hasegawa M, Nakanishi Y, Tani K. TLR7 ligand augments GM-CSF-initiated antitumor immunity through activation of plasmacytoid dendritic cells. Cancer Immunol Res 2014; 2:568-80. [PMID: 24830413 DOI: 10.1158/2326-6066.cir-13-0143] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vaccination with irradiated granulocyte macrophage colony-stimulating factor (GM-CSF)-transduced autologous tumor cells (GVAX) has been shown to induce therapeutic antitumor immunity. However, its effectiveness is limited. We therefore attempted to improve the antitumor effect by identifying little-known key pathways in GM-CSF-sensitized dendritic cells (GM-DC) in tumor-draining lymph nodes (TDLN). We initially confirmed that syngeneic mice subcutaneously injected with poorly immunogenic Lewis lung carcinoma (LLC) cells transduced with Sendai virus encoding GM-CSF (LLC/SeV/GM) remarkably rejected the tumor growth. Using cDNA microarrays, we found that expression levels of type I interferon (IFN)-related genes, predominantly expressed in plasmacytoid DCs (pDC), were significantly upregulated in TDLN-derived GM-DCs and focused on pDCs. Indeed, mouse experiments demonstrated that the effective induction of GM-CSF-induced antitumor immunity observed in immunocompetent mice treated with LLC/SeV/GM cells was significantly attenuated when pDC-depleted or IFNα receptor knockout (IFNAR(-/-)) mice were used. Importantly, in both LLC and CT26 colon cancer-bearing mice, the combinational use of imiquimod with autologous GVAX therapy overcame the refractoriness to GVAX monotherapy accompanied by tolerability. Mechanistically, mice treated with the combined vaccination displayed increased expression levels of CD86, CD9, and Siglec-H, which correlate with an antitumor phenotype, in pDCs, but decreased the ratio of CD4(+)CD25(+)FoxP3(+) regulatory T cells in TDLNs. Collectively, these findings indicate that the additional use of imiquimod to activate pDCs with type I IFN production, as a positive regulator of T-cell priming, could enhance the immunologic antitumor effects of GVAX therapy, shedding promising light on the understanding and treatment of GM-CSF-based cancer immunotherapy.
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Affiliation(s)
- Megumi Narusawa
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Hiroyuki Inoue
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, JapanAuthors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, JapanAuthors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Chika Sakamoto
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Yumiko Matsumura
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Atsushi Takahashi
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Tomoko Inoue
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Ayumi Watanabe
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Shohei Miyamoto
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Yoshie Miura
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Yasuki Hijikata
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Yoshihiro Tanaka
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Makoto Inoue
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Koichi Takayama
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Toshihiko Okazaki
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Mamoru Hasegawa
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Yoichi Nakanishi
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
| | - Kenzaburo Tani
- Authors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, JapanAuthors' Affiliations: Department of Molecular Genetics, Medical Institute of Bioregulation; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences; Department of Advanced Cell and Molecular Therapy and Center for Clinical and Translational Research, Kyushu University Hospital, Kyushu University, Fukuoka; and DNAVEC Corporation, Tsukuba, Japan
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Bonaccorsi I, Morandi B, Antsiferova O, Costa G, Oliveri D, Conte R, Pezzino G, Vermiglio G, Anastasi GP, Navarra G, Münz C, Di Carlo E, Mingari MC, Ferlazzo G. Membrane transfer from tumor cells overcomes deficient phagocytic ability of plasmacytoid dendritic cells for the acquisition and presentation of tumor antigens. THE JOURNAL OF IMMUNOLOGY 2013; 192:824-32. [PMID: 24337377 DOI: 10.4049/jimmunol.1301039] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The potential contribution of plasmacytoid dendritic cells (pDCs) in the presentation of tumor cell Ags remains unclear, and some controversies exist with regard to the ability of pDCs to phagocytose cell-derived particulate Ags and cross-present them to MHC class I-restricted T lymphocytes. In this study, we show that human pDCs, although inefficient in the internalization of cell membrane fragments by phagocytosis, can efficiently acquire membrane patches and associated molecules from cancer cells of different histotypes. The transfer of membrane patches to pDCs occurred in a very short time and required cell-to-cell contact. Membrane transfer also included intact HLA complexes, and the acquired Ags could be efficiently recognized on pDCs by tumor-specific CD8(+) T cells. Remarkably, pDCs isolated from human colon cancer tissues displayed a strong surface expression of epithelial cell adhesion molecule, indicating that the exchange of exogenous Ags between pDCs and tumor cells also can occur in vivo. These data demonstrate that pDCs are well suited to acquire membrane patches from contiguous tumor cells by a cell-to-cell contact-dependent mechanism that closely resembles "trogocytosis." This phenomenon may allow pDCs to proficiently present tumor cell-derived Ags, despite limited properties of endophagocytosis.
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Affiliation(s)
- Irene Bonaccorsi
- Laboratory of Immunology and Biotherapy, Department of Human Pathology, University of Messina, 98125 Messina, Italy
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Abstract
Generating an anti-tumor immune response is a multi-step process that is executed by effector T cells that can recognize and kill tumor targets. However, tumors employ multiple strategies to attenuate the effectiveness of T-cell-mediated attack. They achieve this by interfering with nearly every step required for effective immunity, from deregulation of antigen-presenting cells to establishment of a physical barrier at the vasculature that prevents homing of effector tumor-rejecting cells and the suppression of effector lymphocytes through the recruitment and activation of immunosuppressive cells such as myeloid-derived suppressor cells, tolerogenic monocytes, and T regulatory cells. Here, we review the ways in which tumors exert immune suppression and highlight the new therapies that seek to reverse this phenomenon and promote anti-tumor immunity. Understanding anti-tumor immunity, and how it becomes disabled by tumors, will ultimately lead to improved immune therapies and prolonged survival of patients.
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Abstract
Generating an anti-tumor immune response is a multi-step process that is executed by effector T cells that can recognize and kill tumor targets. However, tumors employ multiple strategies to attenuate the effectiveness of T-cell-mediated attack. They achieve this by interfering with nearly every step required for effective immunity, from deregulation of antigen-presenting cells to establishment of a physical barrier at the vasculature that prevents homing of effector tumor-rejecting cells and the suppression of effector lymphocytes through the recruitment and activation of immunosuppressive cells such as myeloid-derived suppressor cells, tolerogenic monocytes, and T regulatory cells. Here, we review the ways in which tumors exert immune suppression and highlight the new therapies that seek to reverse this phenomenon and promote anti-tumor immunity. Understanding anti-tumor immunity, and how it becomes disabled by tumors, will ultimately lead to improved immune therapies and prolonged survival of patients.
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Affiliation(s)
- Greg T Motz
- Ovarian Cancer Research Center, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
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Failli A, Legitimo A, Orsini G, Romanini A, Consolini R. Numerical defect of circulating dendritic cell subsets and defective dendritic cell generation from monocytes of patients with advanced melanoma. Cancer Lett 2013; 337:184-92. [PMID: 23684927 DOI: 10.1016/j.canlet.2013.05.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 04/12/2013] [Accepted: 05/09/2013] [Indexed: 11/15/2022]
Abstract
The behaviour of circulating dendritic cells (DCs) and DC generation from monocytes in melanoma patients during the progression of disease have not been described. We report a significant decrease in the absolute number of total DCs, which mainly affects plasmacytoid DCs in stage IV. Additionally, monocyte-DC generation is less efficient in advanced stages, resulting in DCs that exhibit increased phagocytic capacity, potentially indicating a less mature state. These findings elucidate aspects of basic tumour-mediated immunosuppression, which may have implications for immunotherapeutic approaches, suggesting that the selection of patients for immunotherapy should also be made on the basis of their immune status.
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Affiliation(s)
- Alessandra Failli
- Department of Clinical and Experimental Medicine, Division of Pediatrics, Laboratory of Immunology, University of Pisa, Pisa, Italy
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17
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Plasmacytoid dendritic cells in the tumor microenvironment: immune targets for glioma therapeutics. Neoplasia 2013; 14:757-70. [PMID: 22952428 DOI: 10.1593/neo.12794] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 07/10/2012] [Accepted: 07/11/2012] [Indexed: 01/19/2023] Open
Abstract
Adenovirus-mediated delivery of the immune-stimulatory cytokine Flt3L and the conditionally cytotoxic thymidine kinase (TK) induces tumor regression and long-term survival in preclinical glioma (glioblastoma multiforme [GBM]) models. Flt3L induces expansion and recruitment of plasmacytoid dendritic cells (pDCs) into the brain. Although pDCs can present antigen and produce powerful inflammatory cytokines, that is, interferon α (IFN-α), their role in tumor immunology remains debated. Thus, we studied the role of pDCs and IFN-α in Ad.TK/GCV+ Ad.Flt3L-mediated anti-GBM therapeutic efficacy. Our data indicate that the combined gene therapy induced recruitment of plasmacytoid DCs (pDCs) into the tumor mass; which were capable of in vivo phagocytosis, IFN-α release, and T-cell priming. Thus, we next used either pDCs or an Ad vector encoding IFN-α delivered within the tumor microenvironment. When rats were treated with Ad.TK/GCV in combination with pDCs or Ad-IFN-α, they exhibited 35% and 50% survival, respectively. However, whereas intracranial administration of Ad.TK/GCV + Ad.Flt3L exhibited a high safety profile, Ad-IFN-α led to severe local inflammation, with neurologic and systemic adverse effects. To elucidate whether the efficacy of the immunotherapy was dependent on IFN-α-secreting pDCs, we administered an Ad vector encoding B18R, an IFN-α antagonist, which abrogated the antitumoral effect of Ad.TK/GCV + Ad.Flt3L. Our data suggest that IFN-α release by activated pDCs plays a critical role in the antitumor effect mediated by Ad.TK/GCV + Ad.Flt3L. In summary, taken together, our results demonstrate that pDCs mediate anti-GBM therapeutic efficacy through the production of IFN-α, thus manipulation of pDCs constitutes an attractive new therapeutic target for the treatment of GBM.
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Verbeke H, Struyf S, Laureys G, Van Damme J. The expression and role of CXC chemokines in colorectal cancer. Cytokine Growth Factor Rev 2011; 22:345-58. [PMID: 22000992 DOI: 10.1016/j.cytogfr.2011.09.002] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 09/06/2011] [Indexed: 12/14/2022]
Abstract
Cancer is a life-threatening disease world-wide and colorectal cancer is the second common cause of cancer mortality. The interaction between tumor cells and stromal cells plays a crucial role in tumor initiation and progression and is partially mediated by chemokines. Chemokines predominantly participate in the chemoattraction of leukocytes to inflammatory sites. Nowadays, it is clear that CXC chemokines and their receptors (CXCR) may also modulate tumor behavior by several important mechanisms: regulation of angiogenesis, activation of a tumor-specific immune response by attracting leukocytes, stimulation of tumor cell proliferation and metastasis. Here, we review the expression and complex roles of CXC chemokines (CXCL1 to CXCL16) and their receptors (CXCR1 to CXCR6) in colorectal cancer. Overall, increased expression levels of CXC chemokines correlate with poor prognosis.
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Affiliation(s)
- Hannelien Verbeke
- Laboratory of Molecular Immunology, Rega Institute for Medical Research, University of Leuven (K.U. Leuven), Minderbroedersstraat 10, B-3000 Leuven, Belgium
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Differential immune responses mediated by adenovirus- and lentivirus-transduced DCs in a HER-2/neu overexpressing tumor model. Gene Ther 2011; 18:986-95. [PMID: 21490686 DOI: 10.1038/gt.2011.53] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent investigations have demonstrated that adenoviral and lentiviral vectors encoding HER-2 can be utilized in cancer immunotherapy. However, it is not known whether both viral systems elicit a similar immune response. Here, we compare the immune response in mice induced by dendritic cells (DCs) infected with either recombinant adenovirus or lentivirus encoding rat HER-2 (rHER-2). Both vaccine types yielded similar control of tumor growth, but we found clear differences in their immune responses 10 days after DC immunization. Adenovirus rHER-2-transduced DCs elicited locally and systemically high frequencies of CD4+ and CD8+ T cells, while lentivirus rHER-2-transduced DCs predominantly led to CD4+ T-cell infiltration at the tumor site. Splenocytes from mice immunized with lentivirus rHER-2-transduced DCs secreted higher levels of interferon (IFN)-γ, mainly by CD4+ T cells, following stimulation by RM-1-mHER-2 tumors. In contrast, the adenovirus vaccinated group exhibited CD4+ and CD8+ T cells that both contributed to IFN-γ production. Besides an established cellular immune response, the rHER-2/DC vaccine elicited a significant humoral response that was highest in the adenovirus group. DC subsets and regulatory T cells in the spleen were also differentially modulated in the two vaccine systems. Finally, adoptive transfer of splenocytes from both groups of immunized mice strongly inhibited in vivo tumor growth. Our results suggest that not only the target antigen but also the virus system may determine the nature and magnitude of antitumor immunity by DC vaccination.
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Deepak P, Acharya A. Anti-tumor immunity and mechanism of immunosuppression mediated by tumor cells: role of tumor-derived soluble factors and cytokines. Int Rev Immunol 2010; 29:421-58. [PMID: 20635882 DOI: 10.3109/08830185.2010.483027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The immune system plays a crucial role in the protection against tumor growth and progression. However, the activation of the immune system against the neoplastic cells does not always occur and, therefore, tumor cells are able to grow and progress continually in the host. It has now been realized that tumor cells themselves produce many of the important factors that are responsible for dismounting of effective immune response. These tumor-derived soluble factors invariably subdue the functions of almost every immune cell population. Therefore, we attempted to underline the mechanism of anti-tumor immune response and immunosuppression induced by tumor cells.
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Affiliation(s)
- Praveen Deepak
- Centre of Advance Study in Zoology, Faculty of Science, Banaras Hindu University, Varanasi, UP, India
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21
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Trafficking properties of plasmacytoid dendritic cells in health and disease. Trends Immunol 2010; 31:270-7. [PMID: 20579936 DOI: 10.1016/j.it.2010.05.004] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 05/04/2010] [Accepted: 05/06/2010] [Indexed: 12/29/2022]
Abstract
Plasmacytoid dendritic cells (PDCs) represent a subset of circulating leukocytes characterized by the ability to release high levels of type I interferon (IFN). Under homeostatic conditions PDCs are confined to primary and secondary lymphoid organs. This is consistent with the restricted profile of functional chemotactic receptors expressed by circulating PDCs (i.e. CXCR4 and ChemR23). Accumulation of PDCs in non-lymphoid tissue is, however, observed in certain autoimmune diseases, allergic reactions and tumors. Indeed, PDCs are now considered to be involved in the pathogenesis of diseases characterized by a type I IFN-signature and are considered as a promising target for new intervention strategies. Here, current knowledge of the molecular mechanisms involved in the recruitment of PDCs under homeostatic and pathological conditions are summarized.
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Aspord C, Charles J, Leccia MT, Laurin D, Richard MJ, Chaperot L, Plumas J. A novel cancer vaccine strategy based on HLA-A*0201 matched allogeneic plasmacytoid dendritic cells. PLoS One 2010; 5:e10458. [PMID: 20454561 PMCID: PMC2864288 DOI: 10.1371/journal.pone.0010458] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Accepted: 04/07/2010] [Indexed: 11/26/2022] Open
Abstract
Background The development of effective cancer vaccines still remains a challenge. Despite the crucial role of plasmacytoid dendritic cells (pDCs) in anti-tumor responses, their therapeutic potential has not yet been worked out. We explored the relevance of HLA-A*0201 matched allogeneic pDCs as vectors for immunotherapy. Methods and Findings Stimulation of PBMC from HLA-A*0201+ donors by HLA-A*0201 matched allogeneic pDCs pulsed with tumor-derived peptides triggered high levels of antigen-specific and functional cytotoxic T cell responses (up to 98% tetramer+ CD8 T cells). The pDC vaccine demonstrated strong anti-tumor therapeutic in vivo efficacy as shown by the inhibition of tumor growth in a humanized mouse model. It also elicited highly functional tumor-specific T cells ex-vivo from PBMC and TIL of stage I-IV melanoma patients. Responses against MelA, GP100, tyrosinase and MAGE-3 antigens reached tetramer levels up to 62%, 24%, 85% and 4.3% respectively. pDC vaccine-primed T cells specifically killed patients' own autologous melanoma tumor cells. This semi-allogeneic pDC vaccine was more effective than conventional myeloid DC-based vaccines. Furthermore, the pDC vaccine design endows it with a strong potential for clinical application in cancer treatment. Conclusions These findings highlight HLA-A*0201 matched allogeneic pDCs as potent inducers of tumor immunity and provide a promising immunotherapeutic strategy to fight cancer.
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Affiliation(s)
- Caroline Aspord
- Etablissement Français du Sang Rhone-Alpes, R&D Laboratory, La Tronche, France
- University Joseph Fourier, Grenoble, France
- INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, France
- * E-mail: (CA); (JP)
| | - Julie Charles
- Etablissement Français du Sang Rhone-Alpes, R&D Laboratory, La Tronche, France
- University Joseph Fourier, Grenoble, France
- INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, France
- Centre Hospitalier Universitaire Grenoble, Michallon Hospital, Dermatology, pole pluridisciplinaire de medecine, Grenoble, France
| | - Marie-Therese Leccia
- University Joseph Fourier, Grenoble, France
- INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, France
- Centre Hospitalier Universitaire Grenoble, Michallon Hospital, Dermatology, pole pluridisciplinaire de medecine, Grenoble, France
| | - David Laurin
- Etablissement Français du Sang Rhone-Alpes, R&D Laboratory, La Tronche, France
- University Joseph Fourier, Grenoble, France
- INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, France
| | - Marie-Jeanne Richard
- University Joseph Fourier, Grenoble, France
- INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, France
- Centre Hospitalier Universitaire Grenoble, Michallon Hospital, Cancerology and Biotherapy, Grenoble, France
| | - Laurence Chaperot
- Etablissement Français du Sang Rhone-Alpes, R&D Laboratory, La Tronche, France
- University Joseph Fourier, Grenoble, France
- INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, France
| | - Joel Plumas
- Etablissement Français du Sang Rhone-Alpes, R&D Laboratory, La Tronche, France
- University Joseph Fourier, Grenoble, France
- INSERM, U823, Immunobiology & Immunotherapy of Cancers, La Tronche, France
- * E-mail: (CA); (JP)
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Battaglia A, Buzzonetti A, Martinelli E, Fanelli M, Petrillo M, Ferrandina G, Scambia G, Fattorossi A. Selective changes in the immune profile of tumor-draining lymph nodes after different neoadjuvant chemoradiation regimens for locally advanced cervical cancer. Int J Radiat Oncol Biol Phys 2010; 76:1546-53. [PMID: 20338481 DOI: 10.1016/j.ijrobp.2009.10.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 10/09/2009] [Accepted: 10/14/2009] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess how neoadjuvant chemoradiation regimens modulate the immune system state in tumor-draining lymph nodes (TDLN), in the setting of advanced cervical cancer. METHODS AND MATERIALS Tumor-draining lymph nodes of patients undergoing chemotherapy only (nonirradiated, NI-TDLN) and chemoradiation with lower-dose (39.6 Gy, LD-TDLN) and higher-dose radiation (50 Gy, HD-TDLN) were analyzed by multicolor flow cytometry. RESULTS Enlarging our previous data, LD-TDLN showed features overall indicative of an enhanced antitumor response as compared with NI-TDLN, namely a significant Th1 and Tc1 polarization and a lower amount of the potent CD4(+)Foxp3(+)CD25(high) regulatory T cell (Treg) subset identified by neuropilin-1 expression. Conversely, compared with NI-TDLN, HD-TDLN showed features overall indicative of an impaired antitumor response, namely a significantly inverted CD4/CD8 cell ratio, a higher Nrp1(+)Treg frequency, and a higher frequency of CCR4(+)Treg, a Treg subset facilitated in migrating out from TDLN to suppress the immune response against distant cancer cells. Moreover, the Th1 and Tc1 polarization induced by LD radiation was lost, and there was an unfavorable tolerogenic/immunogenic dendritic cell ratio compared with LD-TDLN. CONCLUSIONS Even minor differences in radiation dose in neoadjuvant regimens for locally advanced cervical cancer are crucial for determining the balance between a tolerogenic and an efficacious antitumor immune response in TDLN. Because most of the anticancer immune response takes place in TDLN, the present findings also emphasize the importance of chemoradiation protocols in the context of immunotherapeutic trials.
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Tel J, Lambeck AJA, Cruz LJ, Tacken PJ, de Vries IJM, Figdor CG. Human plasmacytoid dendritic cells phagocytose, process, and present exogenous particulate antigen. THE JOURNAL OF IMMUNOLOGY 2010; 184:4276-83. [PMID: 20304825 DOI: 10.4049/jimmunol.0903286] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Plasmacytoid dendritic cells (pDCs) play a major role in shaping both innate and adaptive immune responses, mainly via their production of large amounts of type I IFNs. pDCs are considered to primarily present endogenous Ags and are thought not to participate in the uptake and presentation of Ags from the extracellular environment, in contrast to their myeloid counterparts, which efficiently endocytose extracellular particulates. In this study, we show that human pDCs are able to phagocytose and process particulate forms of Ag entrapped in poly(lactic-coglycolic acid) microparticles. Furthermore, pDCs were also able to sense TLR ligands (TLR-Ls) incorporated in these particles, resulting in rapid pDC activation and high IFN-alpha secretion. Combining a tetanus toxoid peptide and TLR-Ls (CpG C and R848) in these microparticles resulted in efficient pDC activation and concomitant Ag-specific T cell stimulation. Moreover, particulate Ag was phagocytosed and presented more efficiently than soluble Ag, indicating that microparticles can be exploited to facilitate efficient delivery of antigenic cargo and immunostimulatory molecules to pDCs. Together, our results show that in addition to their potency to stimulate innate immunity, pDCs can polarize adaptive immune responses against exogenous particulate Ag. These results may have important consequences for the development of new immunotherapeutic strategies exploiting Ag and TLR-Ls encapsulated in microparticles to target APC subsets.
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Affiliation(s)
- Jurjen Tel
- Department of Tumor Immunology, , Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Murakami M, Francavilla C, Torselli I, Corada M, Maddaluno L, Sica A, Matteoli G, Iliev ID, Mantovani A, Rescigno M, Cavallaro U, Dejana E. Inactivation of junctional adhesion molecule-A enhances antitumoral immune response by promoting dendritic cell and T lymphocyte infiltration. Cancer Res 2010; 70:1759-65. [PMID: 20160037 DOI: 10.1158/0008-5472.can-09-1703] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Junctional adhesion molecule-A (JAM-A)-null dendritic cells (DCs) are more motile and effective than their wild-type counterpart in promoting contact hypersensitivity reaction. Here, we show that the growth and aggressiveness of pancreatic islet cell carcinoma induced by SV40 T antigen expression in beta cells (Rip1Tag2 mice) are significantly reduced in JAM-A-null mice. Because these tumor cells do not express JAM-A, we focused on changes in stroma reactivity. In the absence of JAM-A, tumors showed a small but significant reduction in angiogenesis and a marked increase in the immune reaction with enhanced infiltration of DCs (CD11c+ and MHC-II+) and CD4+ and CD8+ lymphocytes. In contrast, phagocyte number was not affected. DC capacity to produce cytokines was not significantly altered, but transmigration through JAM-A-null endothelial cells was increased as compared with JAM-A-positive endothelium. On adoptive transfer, JAM-A(-/-) DCs were recruited to tumors at slightly but significantly higher rate than JAM-A(+/+) DCs. Ablation of CD4+ and CD8+ cells with specific antibodies abrogated the inhibitory effect of JAM-A deletion on tumor growth and angiogenesis. These findings support the idea that, in the Rip1Tag2 tumor model, abrogation of JAM-A reduces cancer development by increasing antitumor immune response.
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Battaglia A, Buzzonetti A, Baranello C, Ferrandina G, Martinelli E, Fanfani F, Scambia G, Fattorossi A. Metastatic tumour cells favour the generation of a tolerogenic milieu in tumour draining lymph node in patients with early cervical cancer. Cancer Immunol Immunother 2009; 58:1363-73. [PMID: 19172271 PMCID: PMC11030623 DOI: 10.1007/s00262-008-0646-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Accepted: 12/15/2008] [Indexed: 12/21/2022]
Abstract
OBJECTIVE We compared the immune system state in metastatic tumour draining lymph nodes (mTDLN) and metastasis free TDLN (mfTDLN) in 53 early stage cervical cancer patients to assess whether the presence of metastatic tumour cells worsen the balance between an efficacious anti-tumour and a tolerogenic microenvironment. METHODS The immune system state was measured by immunophenotypic and functional assessment of suppressor and effector immune cell subsets. RESULTS Compared to mfTDLN, mTDLN were significantly enriched in CD4(+)Foxp3(+) regulatory T cells (Treg), which, in addition, exhibited an activated phenotype (HLA-DR(+) and CD69(+)). Treg in mTDLN were also significantly enriched in neuropilin-1 (Nrp1) expressing cells, a subset particularly potent in dampening T cell responses. mTDLN tended to be enriched in a population of CD8(+)Foxp3(+)T cells (operationally defined as CD8(+)Treg) that showed a suppressor potency similar to Treg under the same experimental conditions. Plasmacytoid dendritic cells (pDC) and myeloid DC (mDC) generally show distinct roles in inducing T cell tolerance and activation, respectively. In line with the excess of suppressor T cells, the ratio pDC to mDC was significantly increased in mTDLN. Immunohistochemical testing showed that metastatic tumour cells produced the vascular endothelial growth factor, a natural ligand for Nrp1 expressed on the cell surface of Nrp1(+)Treg and pDC, and therefore a potential mediator by which tumour cells foster immune privilege in mTDLN. Consistent with the overall tolerogenic profile, mTDLN showed a significant Tc2 polarisation and tended to contain lower numbers of CD45RA(+)CD27(-) effector memory CD8(+)T cells. CONCLUSIONS The increased recruitment of suppressor type cells concomitant with the scarcity of cytotoxic type cells suggests that in mTDLN the presence of tumour cells could tip the balance against anti-tumour immune response facilitating the survival of metastatic tumour cells and possibly contributing to systemic tolerance.
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Reineks EZ, Osei ES, Rosenberg A, Auletta J, Meyerson HJ. CD22 expression on blastic plasmacytoid dendritic cell neoplasms and reactivity of anti-CD22 antibodies to peripheral blood dendritic cells. CYTOMETRY PART B-CLINICAL CYTOMETRY 2009; 76:237-48. [PMID: 19382197 DOI: 10.1002/cyto.b.20469] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We identified CD22 expression on a blastic plasmacytoid dendritic cell (pDC) neoplasm presenting as a leukemia in a child. CD22 expression, as determined by the antibody s-HCL-1, was also noted on the neoplastic cells from three additional patients with blastic pDC tumors identified at our institution. Subsequently we determined that peripheral blood pDCs react with the s-HCL-1 antibody demonstrating that normal pDCs express CD22. Evaluation of five additional anti-CD22 antibodies indicated that staining of pDCs with these reagents was poor except for s-HCL-1. Therefore, the detection of CD22 on pDCs is best demonstrated with the use of this specific antibody clone. All anti-CD22 antibodies stained conventional DCs. We also evaluated the reactivity of the anti-CD22 antibodies with basophils and noted that the pattern of staining was similar to that seen with pDCs. The studies demonstrate that normal DCs and pDC neoplasms express CD22, and highlight clone specific differences in anti-CD22 antibody reactivity patterns on pDCs and basophils.
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Affiliation(s)
- Edmunds Z Reineks
- Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
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Sobolev O, Stern P, Lacy-Hulbert A, Hynes RO. Natural killer cells require selectins for suppression of subcutaneous tumors. Cancer Res 2009; 69:2531-9. [PMID: 19258505 DOI: 10.1158/0008-5472.can-08-3126] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Natural killer (NK) cells recognize and destroy cancer cells through a variety of mechanisms. They may also modulate the adaptive immune response to cancer by interacting with dendritic cells and T cells. Although NK cells play an important role in tumor suppression, little is known about the mechanisms of their recruitment to tumors. Previously it has been shown that subcutaneous tumor growth is enhanced in mice lacking selectins, a family of cell adhesion molecules that mediate the first step of immune cell entry into tissue from the blood. Here we show that NK cell recruitment to tumors is defective in selectin-deficient mice. In vivo NK cell depletion, either pharmacologic or genetic, leads to enhanced subcutaneous tumor growth, similar to the phenotype observed in the selectin-deficient animals. We also show that although NK cells from selectin-deficient mice appear developmentally normal and are functional in in vitro assays, their in vivo function is impaired. This study reveals a role for selectins in NK cell recruitment to tumors and in regulation of effective tumor immunity.
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Affiliation(s)
- Olga Sobolev
- Howard Hughes Medical Institute, David H. Koch Institute for Integrative Cancer Research, Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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Dendritic cell vaccines in melanoma: From promise to proof? Crit Rev Oncol Hematol 2008; 66:118-34. [DOI: 10.1016/j.critrevonc.2007.12.007] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 12/03/2007] [Accepted: 12/13/2007] [Indexed: 02/02/2023] Open
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Abstract
This article describes the multiple escape mechanisms used by tumor cells to avoid T-cell-mediated recognition and destruction. The discussion focuses on escape mechanisms that may result from changes at the level of TA-specific cytotoxic T lymphocytes and tumor cells in the tumor microenvironment. Specifically, we discuss the negative impact of regulatory T cells and T-cell apoptosis on the tumor antigen-specific cytotoxic T lymphocyte response. We also discuss changes in the expression of histocompatibility antigens by tumor cells, which may affect tumor cell-immune cell interactions.
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Affiliation(s)
- Soldano Ferrone
- Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15213-1863, USA.
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Abstract
Studies are revealing that lymphoid neoplasms are characterized by well-defined chromosome translocations and by the accumulation of subsequent molecular alterations involving mainly the cell cycle and/or apoptotic pathways. However, survival of B and T tumor cells is also dependent on the interactions with the accompanying cells that comprise the lymphoma microenvironment. Although non-tumor cells can contribute both positive and negative signals to the lymphoma cells, in this review we present compelling evidence of the essential influence of the tumor microenvironment on the initiation and progression of specific lymphoma types, highlighting some new therapeutic approaches that target the lymphoma microenvironment.
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Affiliation(s)
- B Herreros
- Lymphoma Group, Molecular Pathology Program, Centro Nacional de Investigaciones Oncologicas (CNIO), Madrid, Spain
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