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Moma CA, Barreto IS, Assumpção LVM, Zantut-Wittmann DE. Predominance of CD4+ T cells in metastatic cervical lymph nodes in papillary thyroid carcinoma. Endocr Connect 2024; 13:e240135. [PMID: 38913547 PMCID: PMC11301539 DOI: 10.1530/ec-24-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/24/2024] [Indexed: 06/26/2024]
Abstract
Background Papillary thyroid carcinoma has become increasingly prevalent over the years. Avoiding unnecessary treatments and the risk of complications is essential, as well as understanding the mechanisms of tumor progression and the conditions that indicate a worse prognosis. Assessment of the tumor microenvironment can allow us understand how the immune system organizes itself to contain neoplastic progression. Methods We compared characteristics related to the lymphocytic subpopulations in the thyroid tumor microenvironment and lymph nodes in two groups, with and without lymph node metastatic involvement. Results Of the 400 cases followed up at a thyroid cancer reference service, 32 were selected, of which, 13 cases did not present lymph node metastasis (N0 group) and 19 had lymph node involvement (N1 group). Clinical data were collected, and immunohistochemical reactions were performed for markers CD4, CD8, FoxP3, CD25, and CD20 in lymph nodes and peritumoral infiltrate. We found that the N1 group had larger tumor sizes, higher risk staging, higher frequency of extrathyroidal extension, shorter disease-free times, and higher expression of CD4+ T lymphocytes in lymph nodes; however, there was no difference in the expression of other markers or in the pattern of lymphocyte distribution in the lymph node. Conclusion In cervical lymph nodes, the higher frequency of CD4+ T lymphocytes is related to the presence of metastasis. However, there were no differences in lymphocytic subpopulations in the thyroid tumor microenvironment. The absence of changes in unaffected lymph nodes could not predict any tumor behavior.
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Affiliation(s)
- Camila Aparecida Moma
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Icléia Siqueira Barreto
- Department of Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Ligia Vera Montali Assumpção
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Denise Engelbrecht Zantut-Wittmann
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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Hao Q, Li R, Li H, Rui S, You L, Zhang L, Zhao Y, Li P, Li Y, Kong X, Chen H, Zou X, Liu F, Wang X, Zhou J, Zhang W, Huang L, Shu Y, Liu J, Sun R, Li C, Zhu J, Jiang Y, Wei T, Qian K, Bai B, Hu Y, Peng Y, Dai L, Caulin C, Xu H, Li Z, Park J, Luo H, Ying B. Dynamics of The Γδtcr Repertoires During The Dedifferentiation Process and Pilot Implications for Immunotherapy of Thyroid Cancer. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306364. [PMID: 38286670 PMCID: PMC10987121 DOI: 10.1002/advs.202306364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/29/2023] [Indexed: 01/31/2024]
Abstract
γδ T cells are evolutionarily conserved T lymphocytes that manifest unique antitumor efficacy independent of tumor mutation burden (TMB) and conventional human leukocyte antigen (HLA) recognition. However, the dynamic changes in their T cell receptor (TCR) repertoire during cancer progression and treatment courses remain unclear. Here, a comprehensive characterization of γδTCR repertoires are performed in thyroid cancers with divergent differentiation states through cross-sectional studies. The findings revealed a significant correlation between the differentiation states and TCR repertoire diversity. Notably, highly expanded clones are prominently enriched in γδ T cell compartment of dedifferentiated patients. Moreover, by longitudinal investigations of the γδ T cell response to various antitumor therapies, it is found that the emergence and expansion of the Vδ2neg subset may be potentially associated with favorable clinical outcomes after post-radiotherapeutic immunotherapy. These findings are further validated at single-cell resolution in both advanced thyroid cancer patients and a murine model, underlining the importance of further investigations into the role of γδTCR in cancer immunity and therapeutic strategies.
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Affiliation(s)
- Qing Hao
- Department of Laboratory MedicineWest China Hospital, Sichuan UniversityChengduSichuan610041China
- State Key Laboratory of Biotherapy and Cancer Center, West China HospitalSichuan University and Collaborative Innovation CenterChengduSichuan610041China
| | - Ruicen Li
- Health Promotion CenterWest China Hospital, Sichuan UniversityChengduSichuan610041China
| | - Hancong Li
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Shu Rui
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Liting You
- Department of Laboratory MedicineWest China Hospital, Sichuan UniversityChengduSichuan610041China
| | - Lingyun Zhang
- School of Biomedical SciencesThe Chinese University of Hong KongHong Kong SAR999077China
| | - Yue Zhao
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Peiheng Li
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Yuanmin Li
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Key Laboratory of Transplant Engineering and Immunology, Frontiers Science Center for Disease Related Molecular Network, West China HospitalSichuan UniversityChengdu610041China
| | - Xinagyu Kong
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Haining Chen
- Colorectal Cancer Center, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Xiuhe Zou
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Feng Liu
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Xiaofei Wang
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Juan Zhou
- Department of Laboratory MedicineWest China Hospital, Sichuan UniversityChengduSichuan610041China
| | - Weihan Zhang
- Gastric Cancer Center, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Libing Huang
- Division of Gastrointestinal Surgery, State Key Laboratory of Biotherapy, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Yang Shu
- Gastric Cancer Center, West China HospitalSichuan UniversityChengduSichuan610041China
| | - JiaYe Liu
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Ronghao Sun
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment CenterCancer Hospital of University of Electronic Science and Technology School of MedicineChengdu610041China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment CenterCancer Hospital of University of Electronic Science and Technology School of MedicineChengdu610041China
| | - Jingqiang Zhu
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Yong Jiang
- Division of Pathology, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Tao Wei
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Kun Qian
- State Key Laboratory of Systems Medicine for Cancer, School of Biomedical Engineering, Institute of Medical Robotics and Med‐X Research InstituteShanghai Jiao Tong UniversityShanghai200230China
| | - Bing Bai
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and TechnologyYunnan Key Laboratory of Primate Biomedical ResearchKunmingYunnan650500China
| | - Yiguo Hu
- State Key Laboratory of Biotherapy and Cancer Center, West China HospitalSichuan University and Collaborative Innovation CenterChengduSichuan610041China
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
| | - Yong Peng
- State Key Laboratory of Biotherapy and Cancer Center, West China HospitalSichuan University and Collaborative Innovation CenterChengduSichuan610041China
| | - Lunzhi Dai
- State Key Laboratory of Biotherapy and Cancer Center, West China HospitalSichuan University and Collaborative Innovation CenterChengduSichuan610041China
| | - Carlos Caulin
- Department of Otolaryngology – Head & Neck Surgery and University of Arizona Cancer CenterUniversity of ArizonaTucsonAZ85721USA
| | - Heng Xu
- Department of Laboratory MedicineWest China Hospital, Sichuan UniversityChengduSichuan610041China
- State Key Laboratory of Biotherapy and Cancer Center, West China HospitalSichuan University and Collaborative Innovation CenterChengduSichuan610041China
| | - Zhihui Li
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Jihwan Park
- School of Life SciencesGwangju Institute of Science and Technology (GIST)Gwangju61005Republic of Korea
| | - Han Luo
- Department of Laboratory MedicineWest China Hospital, Sichuan UniversityChengduSichuan610041China
- Division of Thyroid Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Laboratory of Thyroid and Parathyroid DiseaseFrontiers Science Center for Disease‐Related Molecular NetworkChengdu610041China
- Department of General Surgery, West China HospitalSichuan UniversityChengduSichuan610041China
- Sichuan Clinical Research Center for laboratory medicineChengduSichuan610041China
| | - Binwu Ying
- Department of Laboratory MedicineWest China Hospital, Sichuan UniversityChengduSichuan610041China
- Sichuan Clinical Research Center for laboratory medicineChengduSichuan610041China
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Paparodis R, Livadas S, Karvounis E, Bantouna D, Zoupas I, Angelopoulos N, Imam S, Jaume JC. Elevated Preoperative TPO Ab Titers Decrease Risk for DTC in a Linear Fashion: A Retrospective Analysis of 1635 Cases. J Clin Endocrinol Metab 2023; 109:e347-e355. [PMID: 37440589 DOI: 10.1210/clinem/dgad408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023]
Abstract
CONTEXT For some, chronic lymphocytic thyroiditis (Hashimoto thyroiditis) is an important risk factor for differentiated thyroid cancer (DTC). Surgical cohort studies even suggested a potential role for thyroid peroxidase antibodies (TPO-Abs) on that risk. OBJECTIVE Our clinical observations argued against that possibility. We designed the present study to evaluate the relationship of TPO-Abs and DTC in a large patient population. METHODS We recruited individuals who underwent thyroidectomies at 4 different clinical sites (USA: 1 clinic, 2000-2013, and Greece: 3 clinics, 2007-2021). We gathered data on TPO-Abs titers measured with commercially available chemiluminescence immunoassays, and reviewed patients' data including surgical pathology. TPO-Abs of 34 IU/mL or greater was deemed positive (TPO+) and TPO-Abs less than 34 IU/mL was deemed negative (TPO-). Odds ratios (OR) for DTC were calculated with the Fisher exact test and P less than .05 was deemed significant. RESULTS We reviewed data from 8461 consecutive thyroid surgery cases. TPO-Abs titers were available for 1635 individuals: DTC n = 716 (43.8%), benign pathology n = 919 (56.2%), TPO+ n = 540 (33.0%), and TPO- n = 1095 (67.0%). DTC was found at a lower frequency in TPO+ (198/540, 36.7%) compared to TPO- (518/1095, 47.3%) patients, OR 0.64 (0.52-0.80; P < .0001). Rising TPO-Abs titers conferred protection against DTC in a linear fashion: TPO-Abs less than 10 IU/mL: 59.3%, TPO-Abs less than 34 IU/mL: 47.4%, TPO-Abs 34 to 100 IU/mL: 42.6%, TPO-Abs 100 to 500 IU/mL: 32.0%, TPO-Abs greater than 1000 IU/mL: 19.4%; P less than .0001. CONCLUSION Higher TPO-Ab titers appear protective against DTC in our large multicenter cohort of patients who underwent thyroidectomies. Rising preoperative TPO-Abs titers conferred linearly increasing protection against DTC.
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Affiliation(s)
- Rodis Paparodis
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences (formerly Medical College of Ohio), University of Toledo, Toledo, OH 43606, USA
- Private Practice, Patras 26221, Greece
| | - Sarantis Livadas
- Division of Endocrinology, Diabetes and Metabolism, Athens Medical Center, Athens 11527, Greece
| | - Evangelos Karvounis
- Endocrine Surgery Center of Excellence, Euroclinic Hospital, Athens 11521, Greece
| | | | - Ioannis Zoupas
- University of Athens Medical School, Athens 10563, Greece
| | | | - Shahnawaz Imam
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences (formerly Medical College of Ohio), University of Toledo, Toledo, OH 43606, USA
| | - Juan Carlos Jaume
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences (formerly Medical College of Ohio), University of Toledo, Toledo, OH 43606, USA
- Department of Medicine, Edward Hines, Jr. VA Hospital/Loyola University Chicago, Hines, IL 60141, USA
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Banerjee S, Nahar U, Dahiya D, Gupta R, Mukherjee S, Sachdeva N, Sood A, Dey P, Radotra B, Bhansali A. IL-17 A correlates with disease progression in papillary thyroid carcinoma. Diagn Pathol 2023; 18:93. [PMID: 37563607 PMCID: PMC10413719 DOI: 10.1186/s13000-023-01362-4] [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: 02/21/2023] [Accepted: 06/05/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Cancer progression can be promoted by chronic inflammation. Local immune response may be associated with favourable or unfavourable prognosis of Papillary Thyroid Carcinoma (PTC). Regulatory T (Treg) cells and T helper 17 (Th17) cells exert opposing function and their balance may have a vital role in promotion of tumor growth. Treg cells in tumor microenvironment (TME) may promote tumor progression and reduced survival of patients. Whereas, Th17 cells can promote or inhibit tumor progression depending on phenotypic characteristics of tumor. In this study, we aimed to analyse the kind of immune response developed and its prognostic impact in future therapeutics. METHODS Cytometric Bead Array (CBA) analysis of pro and anti-inflammatory cytokines (IFN-gamma, IL-2, IL-6, IL-17 A, TNF-alpha and IL-4, IL-10) was done in 15 PTC irrespective of Lymphocytic Thyroiditis (LT) and 16 Hashimoto's Thyroiditis (HT) cases. Immunohistochemical expression of FoxP3 and IL-17 A was studied in 27 cases of PTC with LT. Whereas, quantitative gene expression of both was analysed in 10 cases. RESULTS All the pro-inflammatory cytokines showed mild elevation in PTC with LT. On IHC, IL-17 A expression was observed in 74% PTC with LT. Whereas, FoxP3 was present in only 40% cases. Also, IL-17 A expression was significantly associated with age group (> 45 years), tumor size ≤ 1 cm and disease progression. CONCLUSIONS Increased expression of cytokines suggested correlation between inflammatory factors and progression of thyroid tumors. Along with this, the balance between IL-17 A and FoxP3 may play an important role in PTC development, prognosis and future management.
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Affiliation(s)
- Sohini Banerjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
| | - Uma Nahar
- Department of Histopathology, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India.
| | - Divya Dahiya
- Department of General Surgery, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
| | - Rijuneeta Gupta
- Department of Otolaryngology (ENT), Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
| | - Soham Mukherjee
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
| | - Ashwani Sood
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Pranab Dey
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
| | - Bishan Radotra
- Department of Histopathology, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research Chandigarh, 160012, Chandigarh, India
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Januś D, Kujdowicz M, Wójcik M, Taczanowska-Niemczuk A, Kiszka-Wiłkojć A, Górecki W, Starzyk JB. Ultrasound evolution of parenchymal changes in the thyroid gland with autoimmune thyroiditis in children prior to the development of papillary thyroid carcinoma - a follow-up study. Front Endocrinol (Lausanne) 2023; 14:1172823. [PMID: 37124746 PMCID: PMC10130420 DOI: 10.3389/fendo.2023.1172823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Background Follicular cell-derived thyroid carcinoma represents the vast majority of paediatric thyroid cancers (TCs). Papillary thyroid carcinoma (PTC) accounts for over 90% of all childhood TC cases, and its incidence in paediatric patients is increasing. The objective of this follow-up study was to present the outcome of ultrasound (US) and laboratory monitoring of paediatric patients with autoimmune thyroiditis (AIT) prior to the development of PTC. Patients and methods This prospective study included 180 children and adolescents (132 females; 73.3%) with a suspicion of thyroid disorder referred to the Outpatient Endocrine Department. The patients were divided into four groups: 1) 28 patients with a mean age of 10.7 [standard deviation (SD), 3.1] y, in whom PTC was detected during the active surveillance of AIT [AIT(+), PTC(+) follow up (F)]; 2) 18 patients with a mean age of 12.8 (SD, 3.4) y, in whom PTC and AIT were detected upon admission (A) [AIT(+), PTC(+) A]; 3) 45 patients with a mean age of 13.0 (SD, 3.4) y, in whom PTC was detected upon admission and AIT was excluded [AIT(-), PTC(+) A]; and 4) an age- and sex-matched control group of 89 patients with AIT and with a mean age of 9.4 (SD, 3.0) y. The analysis included clinical, US, and laboratory assessment results of children on admission (groups 1-4) and during follow-up (groups 1 and 4) in the Paediatric Endocrine Outpatient Department. Results Upon admission of those in group 1, the US evaluation revealed a hypoechogenic thyroid gland in 12 and an irregular normoechogenic gland in 16 patients. US monitoring revealed an increase in thyroid echogenicity and an increased irregularity of the thyroid structure during the follow-up period of all of the patients from group 1. Such changes were not noticed in group 4. PTC was diagnosed at the mean time of 3.6 y (3 mo-9 y) since AIT confirmation in group 1. The mean maximum PTC diameter as per the US was significantly smaller in group 1 than in groups 2 and 3 [13.2 (10.8) mm vs. 22.2 (12.8) and 22.05 (15.4) mm]. Fewer patients in group 1 were referred to 131I than in groups 2 and 3 (71.4% vs. 94.4 and 93.3%). Interestingly, significant differences were observed in the thyroglobulin antibody (TgAb)/thyroid peroxidase antibody (TPOAb) ratio between groups 2 and 3, as opposed to group 4, at the beginning of observation [15.3 (27.6) and 3.5 (8.8] vs. 0.77 (1.9)]. In group 1, after the follow-up, an increase in the TgAb/TPOAb ratio was observed [1.2 (9.8) to 5.2 (13.5)]. There were no significant differences between groups 1-3 in labeling index Ki67, lymph nodes metastasis, extrathyroidal extension, and angioinvasion. There were no associations between thyroid-stimulating hormone, TgAb, and the extent of the disease. Conclusion The use of thyroid US focused on the search for developing tumours in the routine follow-up of patients with AIT may not only help in the early detection of thyroid malignancies that are not clinically apparent but may also influence the invasiveness of oncological therapy and reduce the future side effects of 131I therapy. We propose that the repeat evaluation of TPOAb and TgAb warrants further exploration as a strategy to determine TC susceptibility in paediatric patients with AIT in larger multicentre studies.
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Affiliation(s)
- Dominika Januś
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital in Krakow, Krakow, Poland
| | - Monika Kujdowicz
- Department of Pathomorphology, Jagiellonian University Medical College, Krakow, Poland
- Department of Pathology, University Children Hospital in Krakow, Krakow, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital in Krakow, Krakow, Poland
| | - Anna Taczanowska-Niemczuk
- Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Surgery, University Children Hospital in Krakow, Krakow, Poland
| | - Aleksandra Kiszka-Wiłkojć
- Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Surgery, University Children Hospital in Krakow, Krakow, Poland
| | - Wojciech Górecki
- Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Surgery, University Children Hospital in Krakow, Krakow, Poland
| | - Jerzy B. Starzyk
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital in Krakow, Krakow, Poland
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Banerjee S, Nahar U, Dahiya D, Mukherjee S, Dey P, Gupta R, Radotra B, Sachdeva N, Sood A, Bhadada SK, Bhansali A. Role of cytotoxic T cells and PD-1 immune checkpoint pathway in papillary thyroid carcinoma. Front Endocrinol (Lausanne) 2022; 13:931647. [PMID: 36518249 PMCID: PMC9742369 DOI: 10.3389/fendo.2022.931647] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background Lymphocytic thyroiditis (LT) is frequently seen in the tumor microenvironment (TME) of papillary thyroid carcinomas (PTCs). However, the characteristic of these tumor-infiltrating lymphocytes (TILs) is not well understood. Objective We aim to define the TME of PTC cases by characterizing the TILs. Design This is a cross-sectional observational study. Patients We enrolled 29 PTC (23 having concurrent LT), 14 LT, and 13 hyperplastic nodules with LT (HN) patients from January 2016 to December 2020. Measurements Immunohistochemical (IHC) expression of CD8, FoxP3, PD-1, and PD-L1 was studied in PTC with LT and compared with HN. PD-1 and PD-L1 expression was correlated at the mRNA level by quantitative real-time PCR. Immunophenotyping of TILs was done in FNAC samples of PTC and LT by flow cytometry. Results IHC revealed the presence of CD8+ cytotoxic T lymphocytes (CTLs) and FoxP3+ T regulatory cells (Tregs) in 83% and 52% of PTC with LT cases, respectively. Flow cytometric analysis of the PTC samples revealed a significant abundance of CTL compared with Treg and a higher CTL with lower Treg counts compared with LT. On IHC, PD-1 positivity was noted in 56.5% of PTC with LT cases, while intermediate PD-L1 positivity was found in 70% of the cases. There was a significant upregulation of PD-1 mRNA in PTC with LT. A significant correlation was noted with PD-L1 expression with lymph node metastasis and presence of Treg cells. Conclusions Increased expression of PD-1 and PD-L1 in the TME of PTC may provide a potential molecular mechanism for tumor survival despite the predominance of CTLs, possibly through their inactivation or exhaustion.
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Affiliation(s)
- Sohini Banerjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Dahiya
- Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Soham Mukherjee
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rijuneeta Gupta
- Department of Otolaryngology (ENT), Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bishan Radotra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashwani Sood
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Chen Z, Guo ML, Li YY, Yan K, Li L, Shen F, Guan H, Liu QZ, Xu B, Lian ZX. Immune profiling identifies CD8+ T-cell subset signatures as prognostic markers for recurrence in papillary thyroid cancer. Front Immunol 2022; 13:894919. [PMID: 36420264 PMCID: PMC9676940 DOI: 10.3389/fimmu.2022.894919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Background Thyroid tissue has a special immune microenvironment that is not well characterized. Whether immune cells have a prognostic value in the recurrence of papillary thyroid cancer (PTC) needs further investigation. Methods Multinodular non-toxic goiter (MNG) was taken as normal tissue for the difficulty in obtaining completely normal thyroid tissue (normal thyroid function, no thyroiditis, and no nodules). We compared the composition of mononuclear cells (MNCs) in peripheral blood and thyroid tissues from MNG and PTC patients by high-dimensional flow cytometry profiling and verified the results by multiplex immunohistochemistry. The recurrence rates of PTC patients with different CD8+T cell subset signatures were compared using TCGA database. Results We observed that the immune cell composition of MNG was different from that in peripheral blood. Thyroid tissue contains higher percentages of T cells and NK cells. Moreover, the percentages of memory T cells and Treg cells were higher in thyroid than in peripheral blood and increased in PTC tumors. We further focused on the antitumoral CD8+T cells and found that the expression patterns of PD-1, CD39, and CD103 on CD8+T cells were different between MNG and PTC. Importantly, we found higher percentages of PD-1+CD39+CD103+CD8+T and PD-1+CD39+CD103-CD8+T cells in PTC tumor tissues from recurrent patients than non-recurrent patients. By analyzing PTC data from TCGA database, we found that the expression patterns of these molecules were associated with different pathologic types and genders among PTC patients. Moreover, patients with PD-1hiCD39loCD103hiCD8hi, PD-1hiCD39hiCD103loCD8hi, and PD-1loCD39hiCD103hiCD8hi expression patterns have a higher 10-year recurrence-free survival. Conclusion The immune microenvironment in MNG tissue is distinct from that in peripheral blood and paratumor tissue. More memory CD8+T cells were detected in PTC, and expression patterns of PD-1, CD39, and CD103 on CD8+T cells were significantly different in physiology and gender and associated with the recurrence rate of PTC. These observations indicate that CD8+T cell signatures may be useful prognostic markers for PTC recurrence.
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Affiliation(s)
- Zhen Chen
- Department of Thyroid Surgery, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Meng-Li Guo
- Department of Thyroid Surgery, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Ya-Yi Li
- Department of Thyroid Surgery, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Kai Yan
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Liang Li
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Fei Shen
- Department of Thyroid Surgery, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing-Zhi Liu
- Chronic Disease Laboratory, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
- *Correspondence: Bo Xu, ; Qing-Zhi Liu,
| | - Bo Xu
- Department of Thyroid Surgery, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
- *Correspondence: Bo Xu, ; Qing-Zhi Liu,
| | - Zhe-Xiong Lian
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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Shin E, Koo JS. Cell Component and Function of Tumor Microenvironment in Thyroid Cancer. Int J Mol Sci 2022; 23:ijms232012578. [PMID: 36293435 PMCID: PMC9604510 DOI: 10.3390/ijms232012578] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Thyroid cancer is the most common cancer in the endocrine system. Most thyroid cancers have good prognosis, but some of them are resistant to treatment or show aggressive behavior. Like other tumors, thyroid cancers harbor tumor microenvironment (TME) composed of cancer associated fibroblasts (CAF) and immune cells. Autoimmune lymphocytic thyroiditis can occur in the thyroid, and it may be associated with cancer development. TME is involved in tumor progression through various mechanisms: (1) CAF is involved in tumor progression through cell proliferation and extracellular matrix (ECM) remodeling; and (2) immune cells are involved in tumor progression through cell proliferation, angiogenesis, epithelial mesenchymal transformation (EMT), and immune suppression. These events are activated by various cytokines, chemokines, and metabolites secreted from cells that comprise TME. This review is focused on how CAF and immune cells, two important cell components of thyroid cancer TME, are involved in tumor progression, and will explore their potential as therapeutic targets.
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Affiliation(s)
| | - Ja Seung Koo
- Correspondence: ; Tel.: +82-2-2228-1772; Fax: +82-2-362-0860
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9
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Imam S, Paparodis RD, Rafiqi SI, Ali S, Niaz A, Kanzy A, Tovar YE, Madkhali MA, Elsherif A, Khogeer F, Zahid ZA, Sarwar H, Karim T, Salim N, Jaume JC. Thyroid Cancer Screening Using Tumor-Associated DN T Cells as Immunogenomic Markers. Front Oncol 2022; 12:891002. [PMID: 35692772 PMCID: PMC9186057 DOI: 10.3389/fonc.2022.891002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThyroid nodules are an extremely common entity, and surgery is considered the ultimate diagnostic strategy in those with unclear malignant potential. Unfortunately, strategies aiming to predict the risk of malignancy have inadequate specificity. Our group recently found that the microenvironment of thyroid cancer is characterized by an enhanced immune invasion and activated immune response mediated by double-negative T lymphocytes (DN T) (CD3+CD4-CD8-), which are believed to enable or promote tumorigenesis. In the present work, we try to use the DN T cells’ proportion in thyroid fine-needle aspiration (FNA) material as a predictor of the risk of malignancy.MethodsWe recruited 127 patients and obtained ultrasound-guided FNA samples from subjects with cytology-positive or suspicious for malignancy and from those with benign nodular goiter associated with compressive symptoms (such as dysphagia, shortness of breath, or hoarseness), Hashimoto thyroiditis, and Graves’ disease. Out of 127, we investigated 46 FNA samples of patients who underwent total thyroidectomy and for which postoperative histological diagnosis by the academic pathologists was available. We specifically measured the number of cells expressing CD3+CD4-CD8- (DN T) as a function of total CD3+ cells in FNA samples using flow cytometry. We correlated their FNA DN T-cell proportions with the pathological findings.ResultsThe DN T cells were significantly more abundant in lymphocytic infiltrates of thyroid cancer cases compared to benign nodule controls (p < 0.0001). When the DN T-cell population exceeded a threshold of 9.14%, of total CD3+ cells, the negative likelihood ratio of being cancer-free was 0.034 (96.6% sensitivity, 95% CI, 0.915–1.000, p < 0.0001). DN T cells at <9.14% were not found in any subject with benign disease (specificity 100%). The high specificity of the test is promising, since it abolishes a false-positive diagnosis and in turn unnecessary surgical procedures.ConclusionThe present study proposes DN T cells’ proportion as a preoperative diagnostic signature for thyroid cancer that with integration of RNA transcriptomics can provide a simplified technology based on the PCR assay for the ease of operation.
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Affiliation(s)
- Shahnawaz Imam
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
- *Correspondence: Shahnawaz Imam, ; Juan C. Jaume,
| | - Rodis D. Paparodis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
- Private Practitioner, Patras, Greece
| | - Shafiya Imtiaz Rafiqi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Sophia Ali
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Azra Niaz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Abed Kanzy
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Yara E. Tovar
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Mohammed A. Madkhali
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Ahmed Elsherif
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Feras Khogeer
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Zeeshan A. Zahid
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Haider Sarwar
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
- Windsor University School of Medicine, Cayon St. Kitts West Indies, Saint Kitts and Nevis
| | - Tamanna Karim
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Nancy Salim
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
| | - Juan C. Jaume
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
- Center for Diabetes and Endocrine Research (CeDER), University of Toledo, Toledo, OH, United States
- *Correspondence: Shahnawaz Imam, ; Juan C. Jaume,
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Jarboe T, Tuli NY, Chakraborty S, Maniyar RR, DeSouza N, Xiu-Min Li, Moscatello A, Geliebter J, Tiwari RK. Inflammatory Components of the Thyroid Cancer Microenvironment: An Avenue for Identification of Novel Biomarkers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1350:1-31. [PMID: 34888842 DOI: 10.1007/978-3-030-83282-7_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The incidence of thyroid cancer in the United States is on the rise with an appreciably high disease recurrence rate of 20-30%. Anaplastic thyroid cancer (ATC), although rare in occurrence, is an aggressive form of cancer with limited treatment options and bleak cure rates. This chapter uses discussions of in vitro models that are representative of papillary, anaplastic, and follicular thyroid cancer to evaluate the crosstalk between specific cells of the tumor microenvironment (TME), which serves as a highly heterogeneous realm of signaling cascades and metabolism that are associated with tumorigenesis. The cellular constituents of the TME carry out varying characteristic immunomodulatory functions that are discussed throughout this chapter. The aforementioned cell types include cancer-associated fibroblasts (CAFs), endothelial cells (ECs), and cancer stem cells (CSCs), as well as specific immune cells, including natural killer (NK) cells, dendritic cells (DCs), mast cells, T regulatory (Treg) cells, CD8+ T cells, and tumor-associated macrophages (TAMs). TAM-mediated inflammation is associated with a poor prognosis of thyroid cancer, and the molecular basis of the cellular crosstalk between macrophages and thyroid cancer cells with respect to inducing a metastatic phenotype is not yet known. The dynamic nature of the physiological transition to pathological metastatic phenotypes when establishing the TME encompasses a wide range of characteristics that are further explored within this chapter, including the roles of somatic mutations and epigenetic alterations that drive the genetic heterogeneity of cancer cells, allowing for selective advantages that aid in their proliferation. Induction of these proliferating cells is typically accomplished through inflammatory induction, whereby chronic inflammation sets up a constant physiological state of inflammatory cell recruitment. The secretions of these inflammatory cells can alter the genetic makeup of proliferating cells, which can in turn, promote tumor growth.This chapter also presents an in-depth analysis of molecular interactions within the TME, including secretory cytokines and exosomes. Since the exosomal cargo of a cell is a reflection and fingerprint of the originating parental cells, the profiling of exosomal miRNA derived from thyroid cancer cells and macrophages in the TME may serve as an important step in biomarker discovery. Identification of a distinct set of tumor suppressive miRNAs downregulated in ATC-secreted exosomes indicates their role in the regulation of tumor suppressive genes that may increase the metastatic propensity of ATC. Additionally, the high expression of pro-inflammatory cytokines in studies looking at thyroid cancer and activated macrophage conditioned media suggests the existence of an inflammatory TME in thyroid cancer. New findings are suggestive of the presence of a metastatic niche in ATC tissues that is influenced by thyroid tumor microenvironment secretome-induced epithelial to mesenchymal transition (EMT), mediated by a reciprocal interaction between the pro-inflammatory M1 macrophages and the thyroid cancer cells. Thus, targeting the metastatic thyroid carcinoma microenvironment could offer potential therapeutic benefits and should be explored further in preclinical and translational models of human metastatic thyroid cancer.
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Affiliation(s)
- Tara Jarboe
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | - Neha Y Tuli
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | - Sanjukta Chakraborty
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA.,Weill Cornell Medicine, New York, NY, USA
| | - Rachana R Maniyar
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicole DeSouza
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | - Xiu-Min Li
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | | | - Jan Geliebter
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | - Raj K Tiwari
- Departments of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA.
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11
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Salemme V, Centonze G, Cavallo F, Defilippi P, Conti L. The Crosstalk Between Tumor Cells and the Immune Microenvironment in Breast Cancer: Implications for Immunotherapy. Front Oncol 2021; 11:610303. [PMID: 33777750 PMCID: PMC7991834 DOI: 10.3389/fonc.2021.610303] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/22/2021] [Indexed: 12/12/2022] Open
Abstract
Breast cancer progression is a complex process controlled by genetic and epigenetic factors that coordinate the crosstalk between tumor cells and the components of tumor microenvironment (TME). Among those, the immune cells play a dual role during cancer onset and progression, as they can protect from tumor progression by killing immunogenic neoplastic cells, but in the meanwhile can also shape tumor immunogenicity, contributing to tumor escape. The complex interplay between cancer and the immune TME influences the outcome of immunotherapy and of many other anti-cancer therapies. Herein, we present an updated view of the pro- and anti-tumor activities of the main immune cell populations present in breast TME, such as T and NK cells, myeloid cells, innate lymphoid cells, mast cells and eosinophils, and of the underlying cytokine-, cell–cell contact- and microvesicle-based mechanisms. Moreover, current and novel therapeutic options that can revert the immunosuppressive activity of breast TME will be discussed. To this end, clinical trials assessing the efficacy of CAR-T and CAR-NK cells, cancer vaccination, immunogenic cell death-inducing chemotherapy, DNA methyl transferase and histone deacetylase inhibitors, cytokines or their inhibitors and other immunotherapies in breast cancer patients will be reviewed. The knowledge of the complex interplay that elapses between tumor and immune cells, and of the experimental therapies targeting it, would help to develop new combination treatments able to overcome tumor immune evasion mechanisms and optimize clinical benefit of current immunotherapies.
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Affiliation(s)
- Vincenzo Salemme
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Giorgia Centonze
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Federica Cavallo
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Paola Defilippi
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Laura Conti
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
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12
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Paparodis RD, Bantouna D, Karvounis E, Imam S, Jaume JC. Higher TSH Is Not Associated With Thyroid Cancer Risk in the Presence of Thyroid Autoimmunity. J Clin Endocrinol Metab 2020; 105:5835732. [PMID: 32391913 DOI: 10.1210/clinem/dgaa237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Higher-but-within-normal thyrotropin (thyroid-stimulating hormone, TSH) is associated with higher risk for differentiated thyroid cancer (DTC) in surgical series. Our recent clinical observations suggest that this is not the case in the presence of autoimmune thyroid disease (AITD). We designed the present study to clarify this controversy. METHODS We analyzed our prospectively collected database of patients referred for thyroid surgery at 2 tertiary care referral centers in Greece and the United States. We collected data for preoperative TSH, postoperative pathology, and thyroid peroxidase (TPO) antibodies titers. Subjects were subdivided into 2 groups, those with AITD (i.e., lymphocytic thyroiditis) and non-AITD. We excluded subjects with Graves disease, abnormal TSH (< 0.40 or > 4.50 mIU/mL), or recent use of levothyroxine. We compared the serum TSH among different groups using the Mann-Whitney test. RESULTS A total of 3973 subjects were screened; 1357 met exclusion criteria. After all exclusions, data from 1731 non-AITD subjects and 329 AITD subjects were included in the analysis. AITD subjects had higher TSH than non-AITD subjects (2.09 vs 1.48; P < 0.0001). TSH values were higher in DTC compared with benign histology only in non-AITD subjects (1.65 vs 1.40; P < 0.0001). Progressively higher TSH was associated with higher incidence of DTC only in non-AITD subjects (P < 0.0001). In AITD subjects, TSH was similar between groups with or without DTC (2.02 vs 2.14; P = 0.21). CONCLUSIONS TSH concentrations are not associated with the risk of developing DTC in the presence of thyroid autoimmunity, even though this seems to be the case for all other patients.
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Affiliation(s)
- Rodis D Paparodis
- Private Practice, Patras, Greece
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine and Center for Diabetes and Endocrine Research (CeDER), ProMedica Health System/University of Toledo, Toledo, Ohio
| | - Dimitra Bantouna
- Department of Pathology, University of Patras Hospital, Patras, Greece
| | | | - Shahnawaz Imam
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine and Center for Diabetes and Endocrine Research (CeDER), ProMedica Health System/University of Toledo, Toledo, Ohio
| | - Juan Carlos Jaume
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine and Center for Diabetes and Endocrine Research (CeDER), ProMedica Health System/University of Toledo, Toledo, Ohio
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13
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Hu JQ, Lei BW, Wen D, Ma B, Zhang TT, Lu ZW, Wei WJ, Wang YL, Wang Y, Li DS, Ji QH, Liao T. IL-2 enhanced MHC class I expression in papillary thyroid cancer with Hashimoto's thyroiditis overcomes immune escape in vitro. J Cancer 2020; 11:4250-4260. [PMID: 32368308 PMCID: PMC7196247 DOI: 10.7150/jca.38330] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 04/01/2020] [Indexed: 02/06/2023] Open
Abstract
The impact of Hashimoto's thyroiditis (HT) on the progression of papillary thyroid cancer (PTC) is still unclear. Interleukin-2 (IL-2) is a growth factor and crucial for HT development. This study aimed at investigating the effect of IL-2 on MHC class I expression in PTC cells and immune activation with experimental treatment for PTC using PTC cell lines. We assessed the expression of IL-2, HLA class I, PD-L1, CD3, CD8 and CD16 molecules in paired PTC tissues and HLA-ABC and PD-L1 expression in IL-2 pre-treated K1, TPC-1 and BCPAP cells by immunohistochemistry, qPCR, flow cytometry and Western blotting. The effect of IL-2 on immunogenicity of PTC cells to stimulate activated human T cells was determined for the percentages of activated CD8+ T cells and their cytokine production as well as PD-1 and PD-L1 expression. Compared with non-tumor tissues, we found that IL-2 expression was up-regulated in PTC tissues, particularly in PTC+HT tissues and correlated positively with HLA-class I, CD3 and CD8 expression in PTC+HT tissues. Conversely, PD-L1 expression decreased in PTC+HT tissues. Treatment with IL-2 significantly up-regulated HLA-class I expression, but down-regulated PD-L1 expression in PTC cells. Co-culture with IL-2-pre-treated PTC cells significantly promoted the proliferation of activated CD8+ T cells and their IL-2 secretion, but decreased their PD-1 expression, accompanied by decreased PD-L1 expression in IL-2-treated PTC cells in vitro. In conclusion, IL-2 up-regulated HLA-class I expression and enhanced anti-tumor T cell immunity during the development of PTC and HT. IL-2 may be a promising immunotherapy for PTC.
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Affiliation(s)
- Jia-Qian Hu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Bo-Wen Lei
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Duo Wen
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Ben Ma
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Ting-Ting Zhang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Zhong-Wu Lu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Wen-Jun Wei
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yu-Long Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yu Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Duan-Shu Li
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Qing-Hai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Tian Liao
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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14
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Paparodis RD, Karvounis E, Bantouna D, Chourpiliadis C, Chourpiliadi H, Livadas S, Imam S, Jaume JC. Incidentally Discovered Papillary Thyroid Microcarcinomas Are More Frequently Found in Patients with Chronic Lymphocytic Thyroiditis Than with Multinodular Goiter or Graves' Disease. Thyroid 2020; 30:531-535. [PMID: 31950881 DOI: 10.1089/thy.2019.0347] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Incidental finding of differentiated thyroid microcarcinomas (DTMc) in patients undergoing thyroid surgery for benign indications has become increasingly common. Even though carcinogenesis might relate to the background disease of the gland, the incidence of DTMc in the setting of various thyroid disorders remains unclear. We designed the present study to address this question. Materials and Methods: We reviewed data from two prospectively collected databases of consecutive patients undergoing thyroid surgery in two high-volume tertiary care referral centers, one in the United States (A) and the other one in Greece (B) over 18 years. We collected data on the preoperative surgical indication, fine-needle aspiration (FNA) cytology, and surgical pathology. We excluded subjects operated for thyroid cancer or with high risk for malignancy (FNA suspicious for thyroid cancer, follicular neoplasm, suspicious for follicular neoplasm, follicular lesion of undetermined significance/atypia of undetermined significance, or preoperative features of malignancy) and those with postsurgical pathology consistent with papillary thyroid cancer (PTC) ≥1 cm in largest diameter. We divided our subjects based on pathology data into those with chronic lymphocytic thyroiditis (CLT), Graves' disease (GD), or multinodular goiter (MNG). Results: We reviewed 6096 cases of thyroid surgery (A: 2711, B: 3385). We included 3909 subjects in the analysis. Overall, 569 (14.6%) PTC subjects were identified (A: 221/2003 [11%], B: 348/1906 [18.3%], odds ratios [OR] = 0.56, p < 0.0001). CLT was present in 617 subjects; PTC sonographic was present in 143 subjects (23.2%) (A: 79/404 [19.6%], B: 64/213 [30%], OR = 0.56, p = 0.003). GD was present in 359 subjects; PTC was present in 37 subjects (10.3%) (A: 12/197 [6.1%], B: 25/162 [15.4%], OR = 0.36, p = 0.004). MNG was present in 2933 subjects; PTC was present in 389 subjects (13.3%) (A: 130/1402 [9.3%], B: 259/1531 [16.9%], OR = 0.50, p < 0.0001). The incidence of PTC was significantly higher in CLT compared with MNG (OR = 1.75, p < 0.0001) or GD (OR = 2.25, p < 0.0001) but not in MNG compared with GD (OR = 1.29, p > 0.05). Conclusions: Incidentally discovered PTC are more commonly identified in surgical specimens from subjects with CLT compared with patients with MNG, while patients with GD present with a lower incidence compared with both groups. These data support previously published findings that euthyroid Hashimoto thyroiditis favors carcinogenesis, while GD may have a protective role.
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Affiliation(s)
- Rodis D Paparodis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Center for Diabetes and Endocrine Research (CeDER), University of Toledo and ProMedica Health System, Toledo, Ohio
- Patras Institute of Endocrine Research, Patras, Greece
| | | | - Dimitra Bantouna
- Department of Pathology and Cytology, University of Patras School of Medicine, Patras, Greece
| | | | | | | | - Shahnawaz Imam
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Center for Diabetes and Endocrine Research (CeDER), University of Toledo and ProMedica Health System, Toledo, Ohio
| | - Juan Carlos Jaume
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Center for Diabetes and Endocrine Research (CeDER), University of Toledo and ProMedica Health System, Toledo, Ohio
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15
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Ding J, Wu W, Fang J, Zhao J, Jiang L. Male sex is associated with aggressive behaviour and poor prognosis in Chinese papillary thyroid carcinoma. Sci Rep 2020; 10:4141. [PMID: 32139703 PMCID: PMC7058033 DOI: 10.1038/s41598-020-60199-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/27/2020] [Indexed: 02/07/2023] Open
Abstract
The differences in prognosis of papillary thyroid carcinoma (PTC) by sex have been investigated in several previous studies, but the results have not been consistent. In addition, the impact of sex on the clinical and pathological characteristics, especially on central lymph node metastasis (CLNM), still remains unknown. To the best of our knowledge, the impact of sex on PTC has not been investigated in the Chinese PTC population. Therefore, our study retrospectively analysed the data of 1339 patients who were diagnosed with PTC and had received radical surgery at Ningbo Medical Center, Lihuili Hospital. In addition to cancer-specific death, structural recurrence and risk stratification, prognosis was also estimated by using three conventional prognostic systems: AMES (age, distant metastasis, extent, size), MACIS (distant metastasis, age, completeness of resection, local invasion, size) and the 8th version TNM (tumor, lymph node, metastasis) staging system. The clinical and pathological characteristics and above prognostic indexes were compared between male and female PTC patients. The results showed that there were higher rates of non-microcarcinoma PTC (nM-PTC), CLNM, lateral lymph node metastasis (LLNM), advanced disease and bilateral disease, but there was a lower rate of concurrent Hashimoto's thyroiditis (HT) in male PTC patients than in female PTC patients. Additionally, the rate of intermediate-risk, high-risk or advanced disease was higher in male PTC patients. The above findings indicate that PTC in men is a more aggressive disease and may have a worse prognosis; thus, it should be treated with more caution.
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Affiliation(s)
- Jinhua Ding
- Department of Breast and Thyroid Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, China
- Department of Breast and Thyroid Surgery, Taipei Medical University Ningbo Medical Center, Ningbo, China
| | - Weizhu Wu
- Department of Breast and Thyroid Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, China
- Department of Breast and Thyroid Surgery, Taipei Medical University Ningbo Medical Center, Ningbo, China
| | - Jianjiang Fang
- Department of Emergency, Ningbo Medical Center Lihuili Hospital, Ningbo, China
- Department of Emergency, Taipei Medical University Ningbo Medical Center, Ningbo, China
| | - Jing Zhao
- Department of Breast and Thyroid Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, China
- Department of Breast and Thyroid Surgery, Taipei Medical University Ningbo Medical Center, Ningbo, China
| | - Li Jiang
- Department of General Practice, Ningbo Medical Center Lihuili Hospital, Ningbo, China.
- Department of General Practice, Taipei Medical University Ningbo Medical Center, Ningbo, China.
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16
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Al-Abdallah A, Jahanbani I, Mehdawi H, Ali RH, Al-Brahim N, Mojiminiyi O, Junaid TA. Down-regulation of the human major histocompatibility complex class I chain-related gene A (MICA) and its receptor is mediated by microRNA-146b-5p and is a potential mechanism of immunoediting in papillary thyroid carcinoma. Exp Mol Pathol 2020; 113:104379. [PMID: 31935378 DOI: 10.1016/j.yexmp.2020.104379] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 12/09/2019] [Accepted: 01/11/2020] [Indexed: 12/27/2022]
Abstract
Immune escape is one of the main reasons for the rapid progression of cancer and the poor efficacy of immunotherapy. Papillary thyroid cancer (PTC) is usually accompanied by intra-tumoral lymphocytic infiltration. The mechanisms regulating this tumor associated immune response or its evasion are not well understood. The major histocompatibility complex class I chain-related proteins A (MICA) and its receptor the natural killer group 2 member D (NKG2D) are major executers of the anti-tumor defense. This work aimed to study the expression and regulation of MICA-NKG2D and its association with the lymphocytic infiltration and miRNAs in PTC. Expression of MICA and NKG2D in thyroid tissues, and in cultured primary thyroid cancer cells and lymphocytes transfected with miR-146b-5p inhibitor/mimic was tested by RT-PCR. Results were confirmed by immunofluorescence staining and confocal microscopy. MICA is expressed in malignant and benign thyroid tissues with no association with aggressive behavior. Expression of MICA and NKG2D in PTC is concomitant with the presence of tumor associated lymphocytic response and is regulated by miR-146b-5p. MiR-146b-5p indirectly downregulates NKG2D expression in cancer cells and in lymphocytes. Overexpression of miR-146b-5p in PTC down-regulates MICA expression possibly to reduce the immunogenicity of the tumor cells. Targeting of the MICA-NKG2D axis by miR-146b-5p might be one of the ways adopted by thyroid cancer cells to aid the tumor in evading the immune response. The importance of our findings resides in the potential therapeutic use of MICA, NKG2D and miRNA-146b-5p as targets or modulators to enable the immune response against cancer.
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Affiliation(s)
- Abeer Al-Abdallah
- Pathology Department, Faculty of Medicine, Kuwait University, Kuwait.
| | - Iman Jahanbani
- Pathology Department, Faculty of Medicine, Kuwait University, Kuwait.
| | - Heba Mehdawi
- Pathology Department, Faculty of Medicine, Kuwait University, Kuwait.
| | - Rola H Ali
- Pathology Department, Faculty of Medicine, Kuwait University, Kuwait.
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17
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Menicali E, Guzzetti M, Morelli S, Moretti S, Puxeddu E. Immune Landscape of Thyroid Cancers: New Insights. Front Endocrinol (Lausanne) 2020; 11:637826. [PMID: 33986723 PMCID: PMC8112200 DOI: 10.3389/fendo.2020.637826] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/30/2020] [Indexed: 01/23/2023] Open
Abstract
Immune system plays a key role in cancer prevention as well as in its initiation and progression. During multistep development of tumors, cells must acquire the capability to evade immune destruction. Both in vitro and in vivo studies showed that thyroid tumor cells can avoid immune response by promoting an immunosuppressive microenvironment. The recruitment of immunosuppressive cells such as TAMs (tumor-associated macrophages), TAMCs (tumor-associated mast cells), MDSC (myeloid-derived suppressor cells), TANs (tumor-associated neutrophils) and Tregs (regulatory T cells) and/or the expression of negative immune checkpoints, like PD-L1 (programmed death-ligand 1), CTLA-4 (cytotoxic T-lymphocyte associated protein 4), and/or immunosuppressive enzymes, as IDO1 (indoleamine 2,3-dioxygenase 1), are just some of the mechanisms that thyroid cancer cells exploit to escape immune destruction. Some authors systematically characterized immune cell populations and soluble mediators (chemokines, cytokines, and angiogenic factors) that constitute thyroid cancer microenvironment. Their purpose was to verify immune system involvement in cancer growth and progression, highlighting the differences in immune infiltrate among tumor histotypes. More recently, some authors have provided a more comprehensive view of the relationships between tumor and immune system involved in thyroid carcinogenesis. The Cancer Genome Atlas (TCGA) delivered a large amount of data that allowed to combine information on the inflammatory microenvironment with gene expression data, genetic and clinical-pathological characteristics, and differentiation degree of papillary thyroid carcinoma (PTC). Moreover, using a new sensitive and highly multiplex analysis, the NanoString Technology, it was possible to divide thyroid tumors in two main clusters based on expression of immune-related genes. Starting from these results, the authors performed an immune phenotype analysis that allowed to classify thyroid cancers in hot, cold, or intermediate depending on immune infiltration patterns of the tumor microenvironment. The aim of this review is to provide a comprehensive and updated view of the knowledge on immune landscape of thyroid tumors. Understanding interactions between tumor and microenvironment is crucial to effectively direct immunotherapeutic approaches in the treatment of thyroid cancer, particularly for those not responsive to conventional therapies.
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18
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Ferrari SM, Fallahi P, Galdiero MR, Ruffilli I, Elia G, Ragusa F, Paparo SR, Patrizio A, Mazzi V, Varricchi G, Marone G, Antonelli A. Immune and Inflammatory Cells in Thyroid Cancer Microenvironment. Int J Mol Sci 2019; 20:E4413. [PMID: 31500315 PMCID: PMC6769504 DOI: 10.3390/ijms20184413] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 12/22/2022] Open
Abstract
A hallmark of cancer is the ability of tumor cells to avoid immune destruction. Activated immune cells in tumor microenvironment (TME) secrete proinflammatory cytokines and chemokines which foster the proliferation of tumor cells. Specific antigens expressed by cancer cells are recognized by the main actors of immune response that are involved in their elimination (immunosurveillance). By the recruitment of immunosuppressive cells, decreasing the tumor immunogenicity, or through other immunosuppressive mechanisms, tumors can impair the host immune cells within the TME and escape their surveillance. Within the TME, cells of the innate (e.g., macrophages, mast cells, neutrophils) and the adaptive (e.g., lymphocytes) immune responses are interconnected with epithelial cancer cells, fibroblasts, and endothelial cells via cytokines, chemokines, and adipocytokines. The molecular pattern of cytokines and chemokines has a key role and could explain the involvement of the immune system in tumor initiation and progression. Thyroid cancer-related inflammation is an important target for diagnostic procedures and novel therapeutic strategies. Anticancer immunotherapy, especially immune checkpoint inhibitors, unleashes the immune system and activates cytotoxic lymphocytes to kill cancer cells. A better knowledge of the molecular and immunological characteristics of TME will allow novel and more effective immunotherapeutic strategies in advanced thyroid cancer.
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Affiliation(s)
- Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Poupak Fallahi
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Maria Rosaria Galdiero
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
| | - Ilaria Ruffilli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Giusy Elia
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Francesca Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Sabrina Rosaria Paparo
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Armando Patrizio
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Valeria Mazzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Gilda Varricchi
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
| | - Gianni Marone
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
- Institute of Experimental Endocrinology and Oncology “Gaetano Salvatore” (IEOS), National Research Council (CNR), 80131 Naples, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
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19
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Varricchi G, Loffredo S, Marone G, Modestino L, Fallahi P, Ferrari SM, de Paulis A, Antonelli A, Galdiero MR. The Immune Landscape of Thyroid Cancer in the Context of Immune Checkpoint Inhibition. Int J Mol Sci 2019; 20:E3934. [PMID: 31412566 PMCID: PMC6720642 DOI: 10.3390/ijms20163934] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/01/2019] [Accepted: 08/08/2019] [Indexed: 12/26/2022] Open
Abstract
Immune cells play critical roles in tumor prevention as well as initiation and progression. However, immune-resistant cancer cells can evade the immune system and proceed to form tumors. The normal microenvironment (immune cells, fibroblasts, blood and lymphatic vessels, and interstitial extracellular matrix (ECM)) maintains tissue homeostasis and prevents tumor initiation. Inflammatory mediators, reactive oxygen species, cytokines, and chemokines from an altered microenvironment promote tumor growth. During the last decade, thyroid cancer, the most frequent cancer of the endocrine system, has emerged as the fifth most incident cancer in the United States (USA), and its incidence is steadily growing. Inflammation has long been associated with thyroid cancer, raising critical questions about the role of immune cells in its pathogenesis. A plethora of immune cells and their mediators are present in the thyroid cancer ecosystem. Monoclonal antibodies (mAbs) targeting immune checkpoints, such as mAbs anti-cytotoxic T lymphocyte antigen 4 (anti-CTLA-4) and anti-programmed cell death protein-1/programmed cell death ligand-1 (anti-PD-1/PD-L1), have revolutionized the treatment of many malignancies, but they induce thyroid dysfunction in up to 10% of patients, presumably by enhancing autoimmunity. Combination strategies involving immune checkpoint inhibitors (ICIs) with tyrosine kinase (TK) or serine/threonine protein kinase B-raf (BRAF) inhibitors are showing considerable promise in the treatment of advanced thyroid cancer. This review illustrates how different immune cells contribute to thyroid cancer development and the rationale for the antitumor effects of ICIs in combination with BRAF/TK inhibitors.
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Affiliation(s)
- Gilda Varricchi
- Department of Translational Medical Sciences (DISMET), University of Naples Federico II, 80131 Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, School of Medicine, 80131 Naples, Italy
- WAO Center of Excellence, 80131 Naples, Italy
| | - Stefania Loffredo
- Department of Translational Medical Sciences (DISMET), University of Naples Federico II, 80131 Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, School of Medicine, 80131 Naples, Italy
- WAO Center of Excellence, 80131 Naples, Italy
| | - Giancarlo Marone
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | - Luca Modestino
- Department of Translational Medical Sciences (DISMET), University of Naples Federico II, 80131 Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, School of Medicine, 80131 Naples, Italy
| | - Poupak Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, 56126 Pisa, Italy
| | - Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, 56126 Pisa, Italy
| | - Amato de Paulis
- Department of Translational Medical Sciences (DISMET), University of Naples Federico II, 80131 Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, School of Medicine, 80131 Naples, Italy
- WAO Center of Excellence, 80131 Naples, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, 56126 Pisa, Italy
| | - Maria Rosaria Galdiero
- Department of Translational Medical Sciences (DISMET), University of Naples Federico II, 80131 Naples, Italy.
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, School of Medicine, 80131 Naples, Italy.
- WAO Center of Excellence, 80131 Naples, Italy.
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20
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Means C, Clayburgh DR, Maloney L, Sauer D, Taylor MH, Shindo ML, Coussens LM, Tsujikawa T. Tumor immune microenvironment characteristics of papillary thyroid carcinoma are associated with histopathological aggressiveness and BRAF mutation status. Head Neck 2019; 41:2636-2646. [PMID: 30896061 DOI: 10.1002/hed.25740] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/19/2019] [Accepted: 03/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Papillary thyroid carcinoma (PTC) follows an indolent course; however, up to 30% of patients develop recurrent disease requiring further treatment. Profiling PTC immune complexity may provide new biomarkers for improved risk prediction. METHODS Immune complexity profiles were quantitatively evaluated by multiplex immunohistochemistry (mIHC) in archived tissue sections from 39 patients with PTC, and were assessed for correlations with aggressive histopathological features based on the presence of lymphovascular invasion and/or extrathyroidal extension, and BRAF V600E mutational status. RESULTS mIHC revealed two distinct immune clusters stratifying patients: a lymphoid-inflamed group (higher CD8+ T cells, reduced dendritic and mast cells) and a myeloid/hypo-inflamed group that correlated with aggressive pathological features. BRAF mutation was not associated with aggressive pathological features but did correlate with increased mast cell density. CONCLUSIONS Distinct immune microenvironments exist in PTC correlating with pathological aggressiveness. Immune-based biomarkers associated with possible tumor-immune interactions may be used for risk stratification.
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Affiliation(s)
- Casey Means
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, Oregon.,Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Daniel R Clayburgh
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.,Department of Hematology and Medical Oncology, Oregon Health and Science University, Portland, Oregon.,Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon.,Operative Care Division, Portland Veterans' Affairs Health Care System, Portland, Oregon
| | - Lauren Maloney
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, Oregon
| | - David Sauer
- Department of Pathology, Oregon Health and Science University, Portland, Oregon
| | - Matthew H Taylor
- Department of Hematology and Medical Oncology, Oregon Health and Science University, Portland, Oregon.,Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Maisie L Shindo
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Lisa M Coussens
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, Oregon.,Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Takahiro Tsujikawa
- Department of Cell, Developmental & Cancer Biology, Oregon Health and Science University, Portland, Oregon.,Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.,Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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21
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Januś D, Wójcik M, Taczanowska A, Sołtysiak P, Wędrychowicz A, Roztoczyńska D, Drabik G, Wyrobek Ł, Starzyk JB. Follow-up of parenchymal changes in the thyroid gland with diffuse autoimmune thyroiditis in children prior to the development of papillary thyroid carcinoma. J Endocrinol Invest 2019; 42:261-270. [PMID: 29872995 PMCID: PMC6394764 DOI: 10.1007/s40618-018-0909-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 05/30/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE To present the outcomes of ultrasound (US) follow-ups in children with autoimmune thyroid disease who did not have a thyroid nodule on admission but developed papillary thyroid carcinoma (PTC) and to characterize the parenchymal changes in the thyroid gland prior to the development of PTC. METHODS A retrospective thyroid US scan review of 327 patients diagnosed with AIT was performed. Forty patients (40/327, 12.2%) presented nodular AIT variant with a normoechogenic background. Eleven patients (11/327, 3.4%, 11/40, 27.5%) presenting this variant were diagnosed with PTC (nine females-mean age 15.3 years; two males aged 11 and 13 years). In five of 11 patients, the suspicious nodule that was later confirmed to be PTC was detected on the initial US at presentation. For the remaining six females (6/11) who developed PTC during the follow-up, we retrospectively analysed their US thyroid scans and these patients were selected for analysis in this study. RESULTS On admission, the US evaluation revealed an enlarged normoechogenic thyroid gland in three patients and a hypoechogenic thyroid gland with fibrosis as indicated by irregular, chaotic hyperechogenic layers in three patients. No thyroid nodules were identified. Ultrasound monitoring revealed increasing echogenicity of the thyroid parenchyma during the follow-up. PTC developed in a mean time of 4.6 years (1 9/12-7 4/12 years) since referral to the outpatient thyroid clinic and 2.9 years (6/12-6 9/12) since the last nodule-free US thyroid scan. CONCLUSIONS Sonographic follow-up assessments warrant further exploration as a strategy to determine PTC susceptibility in the paediatric population.
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Affiliation(s)
- D Januś
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Wielicka St. 265, 30-663, Krakow, Poland.
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital, Krakow, Poland.
| | - M Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Wielicka St. 265, 30-663, Krakow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital, Krakow, Poland
| | - A Taczanowska
- Department of Pediatric Surgery, University Children Hospital, Krakow, Poland
- Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - P Sołtysiak
- Department of Pediatric Surgery, University Children Hospital, Krakow, Poland
- Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - A Wędrychowicz
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Wielicka St. 265, 30-663, Krakow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital, Krakow, Poland
| | - D Roztoczyńska
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital, Krakow, Poland
| | - G Drabik
- Department of Clinical Immunology and Transplantation, Institute of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Ł Wyrobek
- Department of Radiology, University Children Hospital, Krakow, Poland
| | - J B Starzyk
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Wielicka St. 265, 30-663, Krakow, Poland
- Department of Pediatric and Adolescent Endocrinology, University Children Hospital, Krakow, Poland
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22
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Imam S, Dar P, Paparodis R, Almotah K, Al-Khudhair A, Hasan SAM, Salim N, Jaume JC. Nature of coexisting thyroid autoimmune disease determines success or failure of tumor immunity in thyroid cancer. J Immunother Cancer 2019; 7:3. [PMID: 30616690 PMCID: PMC6323721 DOI: 10.1186/s40425-018-0483-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/13/2018] [Indexed: 02/08/2023] Open
Abstract
Background Thyroid cancer and thyroid autoimmunity are considered opposite extremes of immune-responses. However, several studies have suggested that thyroid cancer coexists with autoimmune thyroid diseases like Hashimoto Thyroiditis (HT) and Graves disease (GD). We have shown that the risk of developing thyroid cancer is higher in patients with a silent form of autoimmune thyroid disease -Euthyroid Hashimoto Thyroiditis-(EHT). Methods We analyzed data from 2633 consecutive patients with GD, HT, EHT and non-Autoimmune Thyroid Disease (Non-AITD) for the presence of Differentiated Thyroid Cancer (DTC). We further investigated the microenvironment, and cellular mechanism of protection from DTC in GD/EHT by ex-vivo aspirating infiltrates from thyroid samples. We also re-constituted in vitro the in-vivo microenvironment to mimic an in-vivo context. We isolated NK cells and differentiated macrophages into M1 and M2 phenotype from healthy human peripheral blood monocytes. Results DTC was less frequent/aggressive in GD as compared to EHT or Non-AITD. Intra-thyroidal immune-cell profiling revealed differential Natural Killer (NK) cell activity and macrophage polarization in the settings of GD versus EHT. In GD, NK-cells were activated, and macrophages showed M1-like phenotype whereas, in EHT, NK-cells were less active and macrophages displayed M2-like phenotype. Furthermore, in vitro co-cultures of NK-cells with differentiated macrophage subsets revealed that the presence of activated NK (NA) cells favors M1 macrophages, boosts macrophage action and amplifies the innate defense mechanisms. Moreover, co-culture of M2 macrophages with NA, increases the cytotoxicity of NK-cells and favors a pro-inflammatory microenvironment that reverts the anti-inflammatory M2 towards pro-inflammatory M1. Conclusion Surveillance innate immune-cells like Natural Killer (NK) cells and macrophages are complementary to each other in their actions. We discovered here that activated NK-cells in the background of the thyroid autoimmune disease, GD, drive macrophage differentiation to the M1/killer phenotype which in turn is cytotoxic to cancer cells and down regulates the M2/repair phenotype. Understanding the molecular basis of macrophage-NK cell interface in Thyroid Cancer, ETH and GD will open new vistas for immunopathology and therapeutic intervention. Macrophages/innate immunity can be modulated from M2 to M1 phenotype to help treat thyroid cancer as naturally done by GD. Electronic supplementary material The online version of this article (10.1186/s40425-018-0483-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shahnawaz Imam
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA
| | - Pervaiz Dar
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA
| | - Rodis Paparodis
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA
| | - Khalil Almotah
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA
| | - Ahmed Al-Khudhair
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA
| | - Syed Abdul-Moiz Hasan
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA
| | - Nancy Salim
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA
| | - Juan Carlos Jaume
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism and Center for Diabetes and Endocrine Research (CeDER), University of Toledo, College of Medicine and Life Sciences, 3000 Arlington Ave., M.S. 1186, Toledo, OH, 43614, USA.
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23
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Collignon E, Canale A, Al Wardi C, Bizet M, Calonne E, Dedeurwaerder S, Garaud S, Naveaux C, Barham W, Wilson A, Bouchat S, Hubert P, Van Lint C, Yull F, Sotiriou C, Willard-Gallo K, Noel A, Fuks F. Immunity drives TET1 regulation in cancer through NF-κB. SCIENCE ADVANCES 2018; 4:eaap7309. [PMID: 29938218 PMCID: PMC6010319 DOI: 10.1126/sciadv.aap7309] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/09/2018] [Indexed: 05/27/2023]
Abstract
Ten-eleven translocation enzymes (TET1, TET2, and TET3), which induce DNA demethylation and gene regulation by converting 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC), are often down-regulated in cancer. We uncover, in basal-like breast cancer (BLBC), genome-wide 5hmC changes related to TET1 regulation. We further demonstrate that TET1 repression is associated with high expression of immune markers and high infiltration by immune cells. We identify in BLBC tissues an anticorrelation between TET1 expression and the major immunoregulator family nuclear factor κB (NF-κB). In vitro and in mice, TET1 is down-regulated in breast cancer cells upon NF-κB activation through binding of p65 to its consensus sequence in the TET1 promoter. We lastly show that these findings extend to other cancer types, including melanoma, lung, and thyroid cancers. Together, our data suggest a novel mode of regulation for TET1 in cancer and highlight a new paradigm in which the immune system can influence cancer cell epigenetics.
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Affiliation(s)
- Evelyne Collignon
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Annalisa Canale
- Laboratory of Tumor and Development Biology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA)–Cancer, University of Liège, Liège, Belgium
| | - Clémence Al Wardi
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Martin Bizet
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Emilie Calonne
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Sarah Dedeurwaerder
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
| | - Soizic Garaud
- Molecular Immunology Unit, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Céline Naveaux
- Molecular Immunology Unit, Institut Jules Bordet, ULB, Brussels, Belgium
| | - Whitney Barham
- Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA
| | - Andrew Wilson
- Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA
| | - Sophie Bouchat
- Service of Molecular Virology, Department of Molecular Biology, U-CRC, ULB, Gosselies, Belgium
| | - Pascale Hubert
- Laboratory of Experimental Pathology, GIGA-Cancer, University of Liège, Liège, Belgium
| | - Carine Van Lint
- Service of Molecular Virology, Department of Molecular Biology, U-CRC, ULB, Gosselies, Belgium
| | - Fiona Yull
- Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Jules Bordet Institute, ULB, Brussels, Belgium
| | | | - Agnès Noel
- Laboratory of Tumor and Development Biology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA)–Cancer, University of Liège, Liège, Belgium
| | - François Fuks
- Laboratory of Cancer Epigenetics, Faculty of Medicine, ULB (Université libre de Bruxelles)–Cancer Research Center (U-CRC), ULB, Brussels, Belgium
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24
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Latteyer S, Tiedje V, Schilling B, Führer D. Perspectives for immunotherapy in endocrine cancer. Endocr Relat Cancer 2016; 23:R469-84. [PMID: 27485460 DOI: 10.1530/erc-16-0169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 08/02/2016] [Indexed: 12/16/2022]
Abstract
The fight against cancer has seen major breakthroughs in recent years. More than a decade ago, tyrosine kinase inhibitors targeting constitutively activated signaling cascades within the tumor inaugurated a new era of oncological therapy. Recently, immunotherapy with immune checkpoint inhibitors has started to revolutionize the treatment of several malignancies, most notably malignant melanoma, leading to the renaissance and the long-awaited breakthrough of immunooncology. This review provides an overview of the basis of immunotherapy from its initial concepts of anti-tumor immunity and cell-based therapy to the development of immune checkpoint inhibitors and discusses published studies and the perspectives of immunooncology for the treatment of endocrine malignancies.
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Affiliation(s)
- S Latteyer
- Department of Endocrinology and MetabolismUniversity Hospital Essen, University of Duisburg-Essen, Essen, Germany Endocrine Tumour Center at West German Cancer Center (WTZ)Essen, Germany
| | - V Tiedje
- Department of Endocrinology and MetabolismUniversity Hospital Essen, University of Duisburg-Essen, Essen, Germany Endocrine Tumour Center at West German Cancer Center (WTZ)Essen, Germany
| | - B Schilling
- Department of DermatologyVenereology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany German Cancer Consortium (DKTK)Heidelberg, Germany
| | - D Führer
- Department of Endocrinology and MetabolismUniversity Hospital Essen, University of Duisburg-Essen, Essen, Germany Endocrine Tumour Center at West German Cancer Center (WTZ)Essen, Germany
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25
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Jolly LA, Massoll N, Franco AT. Immune Suppression Mediated by Myeloid and Lymphoid Derived Immune Cells in the Tumor Microenvironment Facilitates Progression of Thyroid Cancers Driven by Hras G12V and Pten Loss. ACTA ACUST UNITED AC 2016; 7. [PMID: 27942419 DOI: 10.4172/2155-9899.1000451] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Thyroid cancer is the most common endocrine malignancy and is predicted to be the 4th most commonly diagnosed cancer by 2030. Approximately one-half of follicular thyroid carcinomas (FTC) contain genetic alterations in RAS family members. Furthermore, Cowden's disease, which is characterized by loss of PTEN, predisposes for the development of FTC in humans. We have shown that thyroid specific expression of HrasG12V at endogenous levels and Pten inactivation (HrasG12V/Pten-/-/TPO-cre mice) leads to the development of FTCs that closely recapitulate human disease, with complete penetrance at one year. In patients, FTCs metastasize via the bloodstream to distant sites, frequently the lungs, bones and brain. The first objective of the study was to determine if these mice developed de novo metastasis to relevant sites. Indeed, spontaneous metastasis to the lungs was observed in 56% of HrasG12V/Pten-/-/TPO-cre mice. We next sought to identify the cellular components within the tumor microenvironment (TME) of FTC that contribute to tumor progression and metastasis via FACS analysis. Surprisingly, a large amount of immune infiltrate was observed. HrasG12V/Pten-/-/TPO-Cre thyroid tumors were comprised of 68.5 ± 11.79% CD45+ cells, in stark contrast to wild-type (WT) thyroids which were comprised of 17.6% CD45+ cells. Further, 53.1 ± 10.9% of the CD45+ cells from HrasG12V/Pten-/-/TPO-Cre thyroid tumors were of myeloid-lineage (CD11b+), consisting of macrophages (F4/80+Gr-1-) and myeloid-derived suppressor cells (F4/80-Gr-1+). Further, HrasG12V/Pten-/-/TPO-cre tumors contained Arginase-1 positive cells as determined by immunohistochemical analysis, supporting an immunosuppressive TME in HrasG12V/Pten-/-/TPO-Cre thyroid tumors. We next evaluated whether or not cytotoxic (CD8+) or helper T cells (CD4+) were recruited to HrasG12V/Pten-/-/TPO-Cre tumors. The majority of T cells in these tumors were double positive for CD4 and CD25, markers of immune suppressive regulatory T cells (Treg). Additionally, we identified Foxp3 positive cells by immunohistochemical analysis of tumor sections, indicating a functional suppressive Treg phenotype in vivo. HrasG12V/Pten-/-/TPO-Cre tumor cell lines displayed increased secretion of SDF-1, I-TAC, CCL9/10, and MCP5, cytokines that have been reported to play a direct role in the chemotaxis of immune cells and thus could contribute to the increased recruitment of myeloid and lymphoid derived cells in HrasG12V/Pten-/-/TPO-Cre tumors. These studies are the first to identify and implicate the interaction between tumor cells and immune cells in Ras-driven thyroid cancer progression, which we hope will lead to the development of more effective therapeutic approaches for aggressive forms of thyroid cancer that target the TME.
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Affiliation(s)
- Lee Ann Jolly
- Department of Physiology and Biophysics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nicole Massoll
- Department of Pathology, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aime T Franco
- Department of Physiology and Biophysics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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26
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Galdiero MR, Varricchi G, Marone G. The immune network in thyroid cancer. Oncoimmunology 2016; 5:e1168556. [PMID: 27471646 PMCID: PMC4938375 DOI: 10.1080/2162402x.2016.1168556] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/14/2016] [Accepted: 03/14/2016] [Indexed: 01/17/2023] Open
Abstract
The immune system plays critical roles in tumor prevention, but also in its initiation and progression. Tumors are subjected to immunosurveillance, but cancer cells generate an immunosuppressive microenvironment that favors their escape from immune-mediated elimination. During chronic inflammation, immune cells can contribute to the formation and progression of tumors by producing mitogenic, prosurvival, proangiogenic and lymphangiogenic factors. Thyroid cancer is the most frequent type of endocrine neoplasia and is the most rapidly increasing cancer in the US. In this review, we discuss recent findings on how different immune cells and mediators can contribute to thyroid cancer development and progression.
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Affiliation(s)
- Maria Rosaria Galdiero
- Department of Translational Medical Sciences (DiSMeT), School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gilda Varricchi
- Department of Translational Medical Sciences (DiSMeT), School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gianni Marone
- Department of Translational Medical Sciences (DiSMeT), School of Medicine, University of Naples Federico II, Naples, Italy
- Institute of Experimental Endocrinology and Oncology “Gaetano Salvatore” (IEOS), National Research Council (CNR), Naples, Italy
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27
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Abstract
PURPOSE OF REVIEW Anaplastic thyroid cancer (ATC) is a rare malignancy of the thyroid with a high mortality rate. Conventional therapy has not been effective. Several biological agents are being investigated. The purpose of the review is to highlight the current standards for treatment and review new targets for treating ATC. RECENT FINDINGS Retrospective studies have led to formulation of guidelines for management, including those by the American Thyroid Association. An expansion in the understanding of the genetic mutations has led to several newer biological agents being tested to treat ATC. Aurora kinase inhibitors, PPAR γ agonists, and vascular targeting agents are some of the latest therapeutic agents that have shown promise and could become standard of therapy with further supporting research. SUMMARY Further well coordinated preclinical and clinical research is needed to support the emerging treatments for ATC.
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Affiliation(s)
- Rohit Ranganath
- aMemorial Sloan Kettering Cancer Center, New York bMercy Catholic Medical Center, Philadelphia, USA
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28
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Paparodis R, Jaume JC. Response to: "Oh, no--equations! Reanalysis of the data reveal even stronger associations between Hashimoto's thyroiditis and differentiated thyroid cancer". Thyroid 2015; 25:142. [PMID: 25375759 DOI: 10.1089/thy.2014.0493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Rodis Paparodis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Life Sciences, University of Toledo , Toledo, Ohio
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29
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Ehlers M, Schott M. Hashimoto's thyroiditis and papillary thyroid cancer: are they immunologically linked? Trends Endocrinol Metab 2014; 25:656-64. [PMID: 25306886 DOI: 10.1016/j.tem.2014.09.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 08/27/2014] [Accepted: 09/05/2014] [Indexed: 01/14/2023]
Abstract
Hashimoto's thyroiditis (HT) is the most common autoimmune disease in humans frequently leading to hypothyroidism. HT is characterized by a cellular immune response with lymphatic infiltration of the thyroid gland by T and B cells, as well as by a humoral immune response leading to specific antibody production. The synchronous appearance of HT and papillary thyroid cancer (PTC) indicates an immunological link between the two entities. Three different pathomechanisms may be postulated, including preexisting autoimmunity leading to malignancy due to inflammation, immunity towards preexisiting tumor cells leading to specific autoimmunity, and immune tolerance leading to malignancy despite (auto)immunity. In this article we review data describing these potential mechanisms that might lead to the synchronous appearance of HT and PTC.
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Affiliation(s)
- Margret Ehlers
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany.
| | - Matthias Schott
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany.
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30
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Hsu KT, Yu XM, Audhya AW, Jaume JC, Lloyd RV, Miyamoto S, Prolla TA, Chen H. Novel approaches in anaplastic thyroid cancer therapy. Oncologist 2014; 19:1148-55. [PMID: 25260367 PMCID: PMC4221369 DOI: 10.1634/theoncologist.2014-0182] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/18/2014] [Indexed: 11/17/2022] Open
Abstract
Anaplastic thyroid cancer (ATC), accounting for less than 2% of all thyroid cancer, is responsible for the majority of death from all thyroid malignancies and has a median survival of 6 months. The resistance of ATC to conventional thyroid cancer therapies, including radioiodine and thyroid-stimulating hormone suppression, contributes to the very poor prognosis of this malignancy. This review will cover several cellular signaling pathways and mechanisms, including RET/PTC, RAS, BRAF, Notch, p53, and histone deacetylase, which are identified to play roles in the transformation and dedifferentiation process, and therapies that target these pathways. Lastly, novel approaches and agents involving the Notch1 pathway, nuclear factor κB, Trk-fused gene, cancer stem-like cells, mitochondrial mutation, and tumor immune microenvironment are discussed. With a better understanding of the biological process and treatment modality, the hope is to improve ATC outcome in the future.
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Affiliation(s)
- Kun-Tai Hsu
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Xiao-Min Yu
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Anjon W Audhya
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Juan C Jaume
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ricardo V Lloyd
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Shigeki Miyamoto
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Tomas A Prolla
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Herbert Chen
- Endocrine Surgery Research Laboratories, Department of Surgery, Department of Biomolecular Chemistry, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Department of Pathology and Laboratory Medicine, Department of Oncology, Department of Genetics and Medical Genetics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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31
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Paparodis R, Imam S, Todorova-Koteva K, Staii A, Jaume JC. Hashimoto's thyroiditis pathology and risk for thyroid cancer. Thyroid 2014; 24:1107-14. [PMID: 24708347 PMCID: PMC4080848 DOI: 10.1089/thy.2013.0588] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Hashimoto's thyroiditis (HT) has been found to coexist with differentiated thyroid cancer (DTC) in surgical specimens, but an association between the two conditions has been discounted by the medical literature. Therefore, we performed this study to determine any potential relationship between HT and the risk of developing DTC. METHODS We collected data for thyrotropin (TSH), thyroxine (T4), thyroid peroxidase antibody (TPO-Ab) titers, surgical pathology, and weight-based levothyroxine (LT4) replacement dose for patients who were referred for thyroid surgery. Patients with HT at final pathology were studied further. To estimate thyroid function, patients with preoperative hypothyroid HT (Hypo-HT) were divided into three equal groups based on their LT4 replacement: LT4-Low (<0.90 μg/kg), LT4-Mid (0.90-1.43 μg/kg), and LT4-High (>1.43 μg/kg). A group of preoperatively euthyroid (Euth-HT) patients but with HT by pathology was also studied. All subjects were also grouped based on their TPO-Ab titer in TPO-high (titer >1:1000) or TPO-low/negative (titer <1:1000 or undetectable) groups. The relationship of HT and DTC was studied extensively. RESULTS Of 2811 subjects, 582 had HT on surgical pathology, 365 of whom were Euth-HT preoperatively. DTC was present in 47.9% of the Euth-HT, in 59.7% of LT4-Low, 29.8% of LT4-Mid, and 27.9% of LT4-High groups. The relative risk (RR) for DTC was significantly elevated for the Euth-HT and LT4-Low groups (p<0.001), but not for the LT4-Mid or LT4-High replacement dose groups. TPO-low/negative status conferred an increased RR in the Euth-HT and LT4-Low replacement dose groups (p<0.001 both), while TPO-high status decreased it in Euth-HT group (p<0.05) and made it nonsignificant in the LT4-Low group. CONCLUSIONS HT pathology increases the risk for DTC only in euthyroid subjects and those with partially functional thyroid glands (LT4-Low) but not in fully hypothyroid HT (LT4-Mid and LT4-High). High TPO-Ab titers appear to protect against DTC in patients with HT.
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Affiliation(s)
- Rodis Paparodis
- Endocrine Autoimmunity Unit, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Shahnawaz Imam
- Endocrine Autoimmunity Unit, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kristina Todorova-Koteva
- Endocrine Autoimmunity Unit, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anca Staii
- Endocrine Autoimmunity Unit, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Juan Carlos Jaume
- Endocrine Autoimmunity Unit, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Veterans Affairs Medical Center, Madison Wisconsin
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32
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Abstract
Immune responses by innate and adaptive immune cells are crucial for the suppression of carcinogenesis and tumor spread. Effector T cells such as, cytotoxic CD8(+) T (CTL), natural killer (NK), and NK T cells (NKT cells) prevent tumor growth by their ability to induce apoptosis in cancer cells. To circumvent anti-tumor immunity, tumors commonly attract regulatory T cells (Treg), which suppress the function of CTL and NKT cells in a contact- and cytokine-dependent manner. Recent findings in patients with thyroid cancer have suggested that an imbalance between immune suppressive and anti-tumor cells occurs during thyroid carcinogenesis. However, the composition and regulation of immune responses in thyroid cancer are still elusive and a comprehensive immune profile of thyroid cancer is missing. In this issue of Endocrine-Related Cancer, Imam et al. compare immune profiles between patients with papillary thyroid carcinoma and autoimmune thyroiditis. Their data suggest that an imbalance between immunosuppressive Treg cells and effector T cells occurs during papillary thyroid carcinogenesis. Their study identified double-negative T cells as a novel key factor involved in this process. Future research is required to recapitulate these findings, to elucidate the mechanisms by which the immune response is regulated and to evaluate if this process might be used for the therapeutical management of thyroid cancer.
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Affiliation(s)
- Frank Weber
- Department of General-Visceral- and Transplantations Surgery, Division of Endocrine Surgery, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45130 Essen, Germany
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