1
|
Gkountana GV, Wang L, Giacomini M, Hyytiäinen A, Juurikka K, Salo T, Al-Samadi A. IDO1 correlates with the immune landscape of head and neck squamous cell carcinoma: a study based on bioinformatics analyses. FRONTIERS IN ORAL HEALTH 2024; 5:1335648. [PMID: 38736462 PMCID: PMC11082366 DOI: 10.3389/froh.2024.1335648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
Background Head and neck squamous cell carcinoma (HNSCCs) is a common cancer type with a high mortality rate and poor prognosis. Recent studies have focused on the role of immune checkpoints in HNSCC progression and in their potential use as prognostic markers and immunotherapeutic candidates. Some immune checkpoints, such as PD-1 and PD-L1, have been studied thoroughly in HNSCC. Other molecules, such as indoleamine 2,3-dioxygenase 1 (IDO1), have been investigated minimally. Methods IDO1 expression, prognostic potential, and association with the immune profile of HNSCC were explored using online databases, including GEPIA, UALCAN, TIMER2.0, cBioPortal, and LinkedOmics, which utilize TCGA datasets and are freely available for use. For validation purposes, seven pairs of primary and metastatic HNSCC were immunostained for IDO1. Results Our analysis revealed significantly higher expression of IDO1 in HNSCC, especially in HPV+ SCCs compared with healthy control tissue. However, IDO1 expression showed weak to no prognostic potential for overall and disease-free survival in HNSCC. IDO1 expression in HNSCC was positively correlated with several immune-related molecules, including most of the immune checkpoints. Additionally, GO enrichment analysis revealed that several immune-related pathways are positively correlated with IDO1 expression in HNSCC, such as response to type I interferon and lymphocyte-mediated immunity pathways. Finally, IDO1 expression positively correlated with infiltration of most of the immune cells in HNSCC, such as CD4+ T cells, CD8+ T cells, M1 and M2 macrophages, dendritic cells, and B cells. Conclusion IDO1 expression is closely correlated with the immune profile of the HNSCC. This observation should be explored further to elucidate the potential of targeting IDO1 as a novel immunotherapeutic approach for HNSCC.
Collapse
Affiliation(s)
- Georgia Vasiliki Gkountana
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program (TRIMM), Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Lezhou Wang
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Martina Giacomini
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Aini Hyytiäinen
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program (TRIMM), Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Krista Juurikka
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program (TRIMM), Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program (TRIMM), Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Institute of Dentistry, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
2
|
Struckmeier AK, Radermacher A, Fehrenz M, Bellin T, Alansary D, Wartenberg P, Boehm U, Wagner M, Scheller A, Hess J, Moratin J, Freudlsperger C, Hoffmann J, Thurner L, Roemer K, Freier K, Horn D. IDO1 is highly expressed in macrophages of patients in advanced tumour stages of oral squamous cell carcinoma. J Cancer Res Clin Oncol 2023; 149:3623-3635. [PMID: 35963900 PMCID: PMC10314853 DOI: 10.1007/s00432-022-04277-7] [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: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Strategies for Indolamine-2,3-dioxygenase 1 (IDO1) inhibition in cancer immunotherapy once produced encouraging results, but failed in clinical trials. Recent evidence indicates that immune cells in the tumour microenvironment, especially macrophages, contribute to immune dysregulation and therefore might play a critical role in drug resistance. METHODS In this study, we investigated the significance of IDO1 expressing immune cells in primary tumours and corresponding lymph node metastases (LNMs) in oral squamous cell carcinoma (OSCC) by immunohistochemistry. The link between IDO1 and macrophages was investigated by flow cytometry in tumour tissue, healthy adjacent tissue and peripheral blood mononuclear cells (PBMCs). IDO1 activity (measured as Kynurenine/Tryptophan ratio) was assessed by ELISAs. RESULTS High IDO1 expression in tumour-infiltrating immune cells was significantly correlated with advanced stages [Spearman's rank correlation (SRC), p = 0.027] and reduced progression-free survival (multivariate Cox regression, p = 0.034). IDO1 was significantly higher expressed in PBMCs of patients in advanced stages than in healthy controls (ANOVA, p < 0.05) and IDO1+ macrophages were more abundant in intratumoural areas than peritumoural (t test, p < 0.001). IDO1 expression in PBMCs was significantly correlated with IDO1 activity in serum (SRC, p < 0.05). IDO1 activity was significantly higher in patients with LNMs (t test, p < 0.01). CONCLUSION All in all, IDO1 expressing immune cells, especially macrophages, are more abundant in advanced stages of OSCC and are associated with reduced progression-free survival. Further investigations are needed to explore their role in local and systemic immune response. The IDO1 activity might be a suitable biomarker of metastasis in OSCC patients.
Collapse
Affiliation(s)
- Ann-Kristin Struckmeier
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Saar, Germany.
| | - Anne Radermacher
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Saar, Germany
| | - Michael Fehrenz
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Saar, Germany
| | - Tamara Bellin
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Saar, Germany
| | - Dalia Alansary
- Institute of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, Homburg, Saar, Germany
| | - Philipp Wartenberg
- Department of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Saar, Germany
| | - Ulrich Boehm
- Department of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Saar, Germany
| | - Mathias Wagner
- Department of Pathology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Anja Scheller
- Department of Molecular Physiology, Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University, Homburg, Saar, Germany
| | - Jochen Hess
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julius Moratin
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Lorenz Thurner
- Department of Internal Medicine 1 (Oncology, Hematology, Clinical Immunology, and Rheumatology), Saarland University Medical Center, Homburg, Saar, Germany
| | - Klaus Roemer
- José Carreras Center for Immuno and Gene Therapy, Saarland University, Homburg, Saar, Germany
| | - Kolja Freier
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Saar, Germany
| | - Dominik Horn
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str. 100, 66421, Homburg, Saar, Germany
| |
Collapse
|
3
|
Economopoulou P, Kladi-Skandali A, Strati A, Koytsodontis G, Kirodimos E, Giotakis E, Maragoudakis P, Gagari E, Maratou E, Dimitriadis G, Kotsantis I, Vagia E, Anastasiou M, Gkotzamanidou M, Kavourakis G, Lianidou E, Psyrri A. Prognostic impact of indoleamine 2,3-dioxygenase 1 (IDO1) mRNA expression on circulating tumour cells of patients with head and neck squamous cell carcinoma. ESMO Open 2021; 5:e000646. [PMID: 32414944 PMCID: PMC7232623 DOI: 10.1136/esmoopen-2019-000646] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 01/07/2023] Open
Abstract
Background We sought to determine the prognostic role of indoleamine 2,3-dioxygenase 1 (IDO1) by evaluating IDO1 expression in circulating tumour cells (CTCs) at baseline and after completion of chemoradiotherapy in patients with locally advanced (LA) head and neck squamous cell carcinoma (HNSCC) treated with curative intent. Methods In a prospective cohort of 113 patients with LA HNSCC, we evaluated expression of IDO1 in the EpCAM+ CTC fraction at baseline and after cisplatin chemoradiation. The prognostic value of combined programmed cell death ligand-1 (PDL-1) and IDO1 expression was assessed. Results IDO1 was significantly overexpressed at baseline compared with the post-treatment counterparts (p=0.007). IDO1 messenger RNA (mRNA) expression at baseline was associated with better survival in terms of progression-free survival (PFS) (HR=0.19, p=0.017). Post-treatment IDO1 mRNA levels were correlated with unfavourable prognosis in terms of overall survival (OS) (HR=3.27, p=0.008). Patients with combined decreased expression levels of PDL-1 and IDO1 after treatment exhibited superior PFS (p=0.043) and OS (p=0.021). Conclusions Our results strongly suggest that IDO1 mRNA expression is an independent prognostic factor for clinical outcome. Our study provides useful information for future trials combining chemoradiation with immune checkpoint inhibitors and IDO1 inhibitors.
Collapse
Affiliation(s)
- Panagiota Economopoulou
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athina Kladi-Skandali
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Areti Strati
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - George Koytsodontis
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Efthymios Kirodimos
- Department of Otolaryngology-Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Giotakis
- Department of Otorhinolaryngology, Facial Plastic and Reconstructive Surgery, Städtisches Klinikum, Karlsruhe, Germany
| | - Pavlos Maragoudakis
- Second Otolaryngology Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Gagari
- Oral Medicine Clinics, A. Syggros Hospital of Dermatologic and Venereal Diseases, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Maratou
- Hellenic National Center for the Research, Prevention and Treatment of Diabetes Mellitus and its Complications (H.N.D.C), Athens, Greece
| | - George Dimitriadis
- Second Department of Internal Medicine and Research Institute, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Ioannis Kotsantis
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elena Vagia
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anastasiou
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Gkotzamanidou
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Kavourakis
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evi Lianidou
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Amanda Psyrri
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| |
Collapse
|
4
|
Lin DJ, Ng JCK, Huang L, Robinson M, O'Hara J, Wilson JA, Mellor AL. The immunotherapeutic role of indoleamine 2,3-dioxygenase in head and neck squamous cell carcinoma: A systematic review. Clin Otolaryngol 2021; 46:919-934. [PMID: 34053179 PMCID: PMC8600953 DOI: 10.1111/coa.13794] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/31/2021] [Accepted: 04/24/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Novel cancer immunotherapy seeks to harness the body's own immune system and tip the balance in favour of antitumour activity. The intracellular enzyme indoleamine 2,3-dioxygenase (IDO) is a critical regulator of the tumour microenvironment (TME) via tryptophan metabolism. The potential immunotherapeutic role of IDO in head and neck squamous cell carcinoma (HNSCC) requires further exploration. We aim to assess the evidence on IDO in HNSCC. METHODS A systematic review of literature and clinical trials databases. RESULTS We included 40 studies: seven involved cell lines: eight assessed tumour immunohistochemistry: ten measured IDO gene transcription: 15 reported on clinical trials. Increased cell line IDO expression was postulated to adversely affect tumour metabolism and apoptosis. Immunohistochemical IDO expression correlated with worse survival. Gene transcription studies associated IDO with positive PD-L1 and human papillomavirus (HPV) status. Phase I/II clinical trials showed (a) overall response (34%-55%) and disease control rates (62%-70%) for IDO1 inhibitor in combination with a PD-1 inhibitor, (b) similar safety profiles when both are used in combination therapy compared to each as monotherapies and (c) IDO gene expression as a predictive biomarker for response to PD-L1 therapy. CONCLUSIONS IDO expression is increased in the TME of HNSCC, which correlates with poor prognosis. However, the exact mechanism of IDO-driven immune modulation in the TME is an enigma. Future translational studies should map IDO activity during HNSCC treatment and elucidate its precise role in the TME, such research will underpin the development of clinical trials establishing the efficacy of IDO inhibitors in HNSCC.
Collapse
Affiliation(s)
- Daniel J Lin
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,ENT Department, Freeman Hospital, High Heaton, Newcastle upon Tyne, UK
| | - James C K Ng
- ENT Department, Freeman Hospital, High Heaton, Newcastle upon Tyne, UK
| | - Lei Huang
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Max Robinson
- Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | - James O'Hara
- ENT Department, Freeman Hospital, High Heaton, Newcastle upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Janet A Wilson
- ENT Department, Freeman Hospital, High Heaton, Newcastle upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew L Mellor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
5
|
Riess C, Schneider B, Kehnscherper H, Gesche J, Irmscher N, Shokraie F, Classen CF, Wirthgen E, Domanska G, Zimpfer A, Strüder D, Junghanss C, Maletzki C. Activation of the Kynurenine Pathway in Human Malignancies Can Be Suppressed by the Cyclin-Dependent Kinase Inhibitor Dinaciclib. Front Immunol 2020; 11:55. [PMID: 32117235 PMCID: PMC7034242 DOI: 10.3389/fimmu.2020.00055] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/09/2020] [Indexed: 01/08/2023] Open
Abstract
Indoleamine 2,3-dioxygenase (IDO) and tryptophan 2,3-dioxygenase (TDO2) are the key enzymes of tryptophan (TRP) metabolism in the kynurenine pathway (KP). Both enzymes function as indicators of immunosuppression and poor survival in cancer patients. Direct or indirect targeting of either of these substances seems thus reasonable to improve therapy options for patients. In this study, glioblastoma multiforme (GBM) as well as head and neck squamous cell carcinomas (HNSCC) were examined because of their different mechanisms of spontaneous and treatment-induced immune escape. Effects on gene expression and protein levels were examined. Accompanying assessment of TRP metabolites from treated GBM cell culture supernatants was conducted. Our results show a heterogeneous and inversely correlated expression profile of TRP-metabolizing genes among GBM and HNSCC cells, with low, but inducible IDO1 expression upon IFNγ treatment. TDO2 expression was higher in GBM cells, while genes encoding kynurenine aminotransferases were mainly confined to HNSCC cells. These data indicate that the KP is active in both entities, with however different enzymes involved in TRP catabolism. Upon treatment with Temozolomide, the standard of care for GBM patients, IDO1 was upregulated. Comparable, although less pronounced effects were seen in HNSCC upon Cetuximab and conventional drugs (i.e., 5-fluorouracil, Gemcitabine). Here, IDO1 and additional genes of the KP (KYAT1, KYAT2, and KMO) were induced. Vice versa, the novel yet experimental cyclin-dependent kinase inhibitor Dinaciclib suppressed KP in both entities. Our comprehensive data imply inhibition of the TRP catabolism by Dinaciclib, while conventional chemotherapeutics tend to activate this pathway. These data point to limitations of conventional therapy and highlight the potential of targeted therapies to interfere with the cells' metabolism more than anticipated.
Collapse
Affiliation(s)
- Christin Riess
- University Children's Hospital, Rostock University Medical Centre, Rostock, Germany.,Institute for Medical Microbiology, Virology, and Hygiene, Rostock University Medical Centre, Rostock, Germany.,Medical Clinic III - Hematology, Oncology, Palliative Care, Department of Internal Medicine, Rostock University Medical Center, Rostock, Germany
| | - Björn Schneider
- Institute of Pathology, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Hanna Kehnscherper
- Medical Clinic III - Hematology, Oncology, Palliative Care, Department of Internal Medicine, Rostock University Medical Center, Rostock, Germany
| | - Julia Gesche
- Medical Clinic III - Hematology, Oncology, Palliative Care, Department of Internal Medicine, Rostock University Medical Center, Rostock, Germany
| | - Nina Irmscher
- Medical Clinic III - Hematology, Oncology, Palliative Care, Department of Internal Medicine, Rostock University Medical Center, Rostock, Germany
| | - Fatemeh Shokraie
- University Children's Hospital, Rostock University Medical Centre, Rostock, Germany
| | | | - Elisa Wirthgen
- University Children's Hospital, Rostock University Medical Centre, Rostock, Germany
| | - Grazyna Domanska
- Institute of Immunology and Transfusion Medicine, University of Greifswald, Greifswald, Germany
| | - Annette Zimpfer
- Institute of Pathology, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Daniel Strüder
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", Rostock University Medical Center, Rostock, Germany
| | - Christian Junghanss
- Medical Clinic III - Hematology, Oncology, Palliative Care, Department of Internal Medicine, Rostock University Medical Center, Rostock, Germany
| | - Claudia Maletzki
- Medical Clinic III - Hematology, Oncology, Palliative Care, Department of Internal Medicine, Rostock University Medical Center, Rostock, Germany
| |
Collapse
|
6
|
Budach V, Tinhofer I. Novel prognostic clinical factors and biomarkers for outcome prediction in head and neck cancer: a systematic review. Lancet Oncol 2019; 20:e313-e326. [DOI: 10.1016/s1470-2045(19)30177-9] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 01/16/2023]
|
7
|
Jia YQ, Yang B, Wen LL, Mu WX, Wang Z, Cheng B. Prognostic value of immune checkpoint molecules in head and neck cancer: a meta-analysis. Aging (Albany NY) 2019; 11:501-522. [PMID: 30668545 PMCID: PMC6366990 DOI: 10.18632/aging.101756] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/01/2019] [Indexed: 04/13/2023]
Abstract
Immune checkpoint molecules are important targets in cancer immunotherapy, but their association with prognosis in patients with head and neck cancer is controversial. In this meta-analysis, we searched for 12 immune checkpoint molecules in the PubMed, Embase and Cochrane Library databases and retrieved 52 studies with 7127 participants. Among the molecules included in the search, indoleamine 2, 3-dioxygenase (IDO), programmed death ligand 1 (PD-L1), and programmed death 1 (PD-1) met the inclusion criteria for further analysis. Higher expression of IDO was associated with poorer overall survival in head and neck cancer patients (P = 0.011), but higher expression of PD-L1 correlated with better overall survival specifically in nasopharyngeal carcinoma patients (P = 0.01). In a sensitivity analysis, higher PD-L1 expression correlated with better progression-free survival (P = 0.043), and was associated with better overall survival in Caucasian subjects (P = 0.02), nasopharyngeal carcinoma patients (P = 0.015), and studies with small sample sizes (P = 0.001). PD-1 had no prognostic significance. There was no publication bias affecting the results. Thus, among the immune checkpoint molecules, IDO and PD-L1 are potential prognostic predictors in head and neck cancer.
Collapse
Affiliation(s)
- Yi-Qun Jia
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, China
- Equal contribution
| | - Bo Yang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, China
- Equal contribution
| | - Li-Ling Wen
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, China
| | - Wen-Xin Mu
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, China
| | - Zhi Wang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, China
| | - Bin Cheng
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, China
| |
Collapse
|
8
|
Acovic A, Gazdic M, Jovicic N, Harrell CR, Fellabaum C, Arsenijevic N, Volarevic V. Role of indoleamine 2,3-dioxygenase in pathology of the gastrointestinal tract. Therap Adv Gastroenterol 2018; 11:1756284818815334. [PMID: 30574192 PMCID: PMC6295700 DOI: 10.1177/1756284818815334] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/31/2018] [Indexed: 02/04/2023] Open
Abstract
Indoleamine 2,3-dioxygenase (IDO) has the most important role in modulation of tryptophan-dependent effects in the gastrointestinal tract, including modulation of intestinal immune response. An increased IDO activity maintains immune tolerance and attenuates ongoing inflammation but allows immune escape and uncontrolled growth of gastrointestinal tumors. Accordingly, IDO represents a novel therapeutic target for the treatment of inflammatory and malignant diseases of the gastrointestinal tract. In this review article, we summarize current knowledge about molecular and cellular mechanisms that are involved in IDO-dependent effects. We provide a brief outline of experimental and clinical studies that increased our understanding of how enhanced IDO activity: controls host-microbiota interactions in the gut; regulates detrimental immune response in inflammatory disorders of the gastrointestinal system; and allows immune escape and uncontrolled growth of gastrointestinal tumors. Additionally, we present future perspectives regarding modulation of IDO activity in the gut as possible new therapeutic approaches for the treatment of inflammatory and malignant diseases of the gastrointestinal system.
Collapse
Affiliation(s)
- Aleksandar Acovic
- Center for Molecular Medicine and Stem Cell Research, Department of Microbiology and Immunology, Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
| | - Marina Gazdic
- Center for Molecular Medicine and Stem Cell Research, Department of Microbiology and Immunology, Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
| | - Nemanja Jovicic
- Center for Molecular Medicine and Stem Cell Research, Department of Microbiology and Immunology, Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
| | | | - Crissy Fellabaum
- Regenerative Processing Plant-RPP, LLC, Palm Harbor, Florida, USA
| | - Nebojsa Arsenijevic
- Center for Molecular Medicine and Stem Cell Research, Department of Microbiology and Immunology, Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
| | | |
Collapse
|
9
|
Sieviläinen M, Almahmoudi R, Al-Samadi A, Salo T, Pirinen M, Almangush A. The prognostic value of immune checkpoints in oral squamous cell carcinoma. Oral Dis 2018; 25:1435-1445. [PMID: 30315712 DOI: 10.1111/odi.12991] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite the importance of immune checkpoints in immunotherapy, the prognostic value of these molecules remains controversial in oral squamous cell carcinoma (OSCC). We performed a systematic review to investigate the prognostic significance of the immune checkpoints in OSCC. MATERIALS A systematic search was conducted in Ovid Medline, Scopus and Cochrane libraries, and all studies that evaluated the prognostic significance of immune checkpoints in OSCC were systematically retrieved. RESULTS Twelve immune checkpoints/modulators were studied for their prognostic values in OSCC patients between 1985 and 2017. Seven immune checkpoints (FKBP51, B7-H4, B7-H6, ALHD1, PD-L1, B7-H3 and IDO1) were reported to be associated with poor patients' survival in at least one study, and five (CTLA-4, TLT-2, VISTA, PD-L2 and PD-1) did not have a significant prognostic value. PD-L1 results were controversial as it was reported to be associated with both better and worse patients' survival. CONCLUSIONS Even though immune checkpoint markers had high expectation for OSCC prognostication, our systematic review revealed that the majority of them had been studied only once. The other molecules, which had been studied more than once, had controversial findings, except B7-H3.
Collapse
Affiliation(s)
- Meri Sieviläinen
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland
| | - Rabeia Almahmoudi
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Medical Research Centre, Oulu University Hospital, Oulu, Finland.,Department of Diagnostics and Oral Medicine, Medical Faculty, Research Group of Cancer Research and Translational Medicine, University of Oulu, Oulu, Finland
| | - Matti Pirinen
- Institute for Molecular Medicine Finland FIMM, Helsinki Institute of Life Science HiLIFE, University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Alhadi Almangush
- Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland.,Department of Pathology, University of Helsinki, Helsinki, Finland.,Institute of Dentistry, University of Misurata, Misurata, Libya
| |
Collapse
|
10
|
Sieviläinen M, Passador-Santos F, Almahmoudi R, Christopher S, Siponen M, Toppila-Salmi S, Salo T, Al-Samadi A. Immune checkpoints indoleamine 2,3-dioxygenase 1 and programmed death-ligand 1 in oral mucosal dysplasia. J Oral Pathol Med 2018; 47:773-780. [DOI: 10.1111/jop.12737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Meri Sieviläinen
- Department of Oral and Maxillofacial Diseases; Clinicum; University of Helsinki; Helsinki Finland
| | | | - Rabeia Almahmoudi
- Department of Oral and Maxillofacial Diseases; Clinicum; University of Helsinki; Helsinki Finland
| | - Solomon Christopher
- Department of Mathematics and Statistics; University of Helsinki; Helsinki Finland
| | - Maria Siponen
- Department of Oral and Maxillofacial Diseases; Kuopio University Hospital; Kuopio Finland
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Sanna Toppila-Salmi
- Department of Allergy; Helsinki University Hospital; University of Helsinki; Helsinki Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases; Clinicum; University of Helsinki; Helsinki Finland
- Medical Research Centre; Oulu University Hospital; Oulu Finland
- Department of Diagnostics and Oral Medicine; Research Group of Cancer Research and Translational Medicine; Medical Faculty; University of Oulu; Oulu Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases; Clinicum; University of Helsinki; Helsinki Finland
| |
Collapse
|