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Di Blasi D, Boldanova T, Mori L, Terracciano L, Heim MH, De Libero G. Unique T-Cell Populations Define Immune-Inflamed Hepatocellular Carcinoma. Cell Mol Gastroenterol Hepatol 2019; 9:195-218. [PMID: 31445190 PMCID: PMC6957799 DOI: 10.1016/j.jcmgh.2019.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS The characterization of T cells infiltrating hepatocellular carcinoma (HCC) provides information on cancer immunity and also on selection of patients with precise indication of immunotherapy. The aim of the study was to characterize T-cell populations within tumor tissue and compare them with non-neoplastic liver tissue as well as circulating cells of the same patients. METHODS The presence of unique cell populations was investigated in 36 HCC patients by multidimensional flow cytometry followed by t-distributed stochastic neighbor embedding analysis. Functional activity of tumor-infiltrating T cells was determined after activation by phorbol 12-myristate 13-acetate and ionomycin. RESULTS Within the tumor there were more cells expressing CD137 and ICOS than in non-neoplastic liver tissue, possibly after recent antigenic activation. These cells contained several populations, including the following: (1) functionally impaired, proliferating CD4+ cells co-expressing Inducible T-cell costimulator (ICOS) and T cell immunoreceptor with Ig and ITIM domains (TIGIT); (2) functionally active CD8+ cells co-expressing CD38 and Programmed cell-death protein 1 (PD1); and (3) CD4-CD8 double-negative T-cell receptor αβ and γδ cells (both non-major histocompatibility complex-restricted T cells). When the identified clusters were compared with histologic classification performed on the same samples, an accumulation of activated T cells was observed in immune-inflamed HCC. The same analyses performed in 7 patients receiving nivolumab treatment showed a remarkable reduction in the functionally impaired CD4+ cells, which returned to almost normal activity over time. CONCLUSIONS Unique populations of activated T cells are present in HCC tissue, whose antigen specificity remains to be investigated. Some of these cell populations are functionally impaired and nivolumab treatment restores their responsiveness. The finding of ongoing immune response within the tumor shows which lymphocyte populations are impaired within the HCC and identifies the patients who might take benefit from immunotherapy.
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Affiliation(s)
- Daniela Di Blasi
- Experimental Immunology, Department of Biomedicine, University of Basel, Switzerland,Hepatology Laboratory, Department of Biomedicine, University of Basel, Switzerland
| | - Tujana Boldanova
- Hepatology Laboratory, Department of Biomedicine, University of Basel, Switzerland,Division of Gastroenterology and Hepatology, University Hospital Basel, Basel, Switzerland
| | - Lucia Mori
- Experimental Immunology, Department of Biomedicine, University of Basel, Switzerland
| | - Luigi Terracciano
- Institute of Pathology, Division of Molecular Pathology, University Hospital Basel, Basel, Switzerland
| | - Markus H. Heim
- Hepatology Laboratory, Department of Biomedicine, University of Basel, Switzerland,Division of Gastroenterology and Hepatology, University Hospital Basel, Basel, Switzerland,Correspondence Address correspondence to: Gennaro De Libero, MD, or Markus H. Heim, MD, Department of Biomedicine, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland. fax: +41 61 265 23 50.
| | - Gennaro De Libero
- Experimental Immunology, Department of Biomedicine, University of Basel, Switzerland,Correspondence Address correspondence to: Gennaro De Libero, MD, or Markus H. Heim, MD, Department of Biomedicine, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland. fax: +41 61 265 23 50.
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