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van Eijck CWF, Real FX, Malats N, Vadgama D, van den Bosch TPP, Doukas M, van Eijck CHJ, Mustafa DAM. GATA6 identifies an immune-enriched phenotype linked to favorable outcomes in patients with pancreatic cancer undergoing upfront surgery. Cell Rep Med 2024; 5:101557. [PMID: 38733987 PMCID: PMC11148804 DOI: 10.1016/j.xcrm.2024.101557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/14/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024]
Abstract
This study underscores GATA6's role in distinguishing classical and basal-like pancreatic ductal adenocarcinoma (PDAC) phenotypes. Retrospective studies associate GATA6 immunohistochemistry (IHC) expression with survival outcomes, warranting prospective validation. In a prospective treatment-naive cohort of patients with resected PDAC, GATA6 IHC proves a prognostic discriminator, associating high GATA6 expression with extended survival and the classical PDAC phenotype. However, GATA6's prognostic significance is numerically lower after gemcitabine-based neoadjuvant chemoradiotherapy compared to its significance in patients treated with upfront surgery. Furthermore, GATA6 is implicated in immunomodulation, although a comprehensive investigation of its immunological role is lacking. Treatment-naive PDAC tumors with varying GATA6 expression yield distinct immunological landscapes. Tumors highly expressing GATA6 show reduced infiltration of immunosuppressive regulatory T cells and M2 macrophages but increased infiltration of immune-stimulating, antigen-presenting, and activated T cells. Our findings caution against solely relying on GATA6 for molecular subtyping in clinical trials and open avenues for exploring immune-based combination therapies.
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Affiliation(s)
- Casper W F van Eijck
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre, Madrid, Spain.
| | - Francisco X Real
- Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre, Madrid, Spain; Centro de Investigación Biomédica en Red-Cáncer, Madrid, Spain; Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre, Madrid, Spain; Centro de Investigación Biomédica en Red-Cáncer, Madrid, Spain
| | - Disha Vadgama
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Thierry P P van den Bosch
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Michail Doukas
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Casper H J van Eijck
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre, Madrid, Spain
| | - Dana A M Mustafa
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre, Rotterdam, the Netherlands; The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Centre, Rotterdam, the Netherlands.
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2
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van Eijck CWF, Mustafa DAM, Vadgama D, de Miranda NFCC, Groot Koerkamp B, van Tienhoven G, van der Burg SH, Malats N, van Eijck CHJ. Enhanced antitumour immunity following neoadjuvant chemoradiotherapy mediates a favourable prognosis in women with resected pancreatic cancer. Gut 2024; 73:311-324. [PMID: 37709493 PMCID: PMC10850691 DOI: 10.1136/gutjnl-2023-330480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/01/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND This study investigates sex disparities in clinical outcomes and tumour immune profiles in patients with pancreatic ductal adenocarcinoma (PDAC) who underwent upfront resection or resection preceded by gemcitabine-based neoadjuvant chemoradiotherapy (nCRT). METHODS Patients originated from the PREOPANC randomised controlled trial. Upfront surgery was performed in 82 patients, and 66 received nCRT before resection. The impact of sex on overall survival (OS) was investigated using Cox proportional hazards models. The immunological landscape within the tumour microenvironment (TME) was mapped using transcriptomic and spatial proteomic profiling. RESULTS The 5-year OS rate differed between the sexes following resection preceded by nCRT, with 43% for women compared with 22% for men. In multivariate analysis, the female sex was a favourable independent prognostic factor for OS only in the nCRT group (HR 0.19; 95% CI 0.07 to 0.52). Multivariate heterogeneous treatment effects analysis revealed a significant interaction between sex and treatment, implying increased nCRT efficacy among women with resected PDAC. The TME of women contained fewer protumoural CD163+MRC1+M2 macrophages than that of men after nCRT, as indicated by transcriptomic and validated using spatial proteomic profiling. CONCLUSION PDAC tumours of women are more sensitive to gemcitabine-based nCRT, resulting in longer OS after resection compared with men. This may be due to enhanced immunity impeding the infiltration of protumoral M2 macrophages into the TME. Our findings highlight the importance of considering sex disparities and mitigating immunosuppressive macrophage polarisation for personalised PDAC treatment.
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Affiliation(s)
- Casper W F van Eijck
- Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre, and CIBERONC, Madrid, Spain
| | - Dana A M Mustafa
- Department of Pathology, Tumour-Immuno Pathology Laboratory, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Disha Vadgama
- Department of Pathology, Tumour-Immuno Pathology Laboratory, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Bas Groot Koerkamp
- Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Sjoerd H van der Burg
- Department of Medical Oncology, Oncode Institute, Leiden University Medical Center, Leiden, The Netherlands
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre, and CIBERONC, Madrid, Spain
| | - Casper H J van Eijck
- Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre, and CIBERONC, Madrid, Spain
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de Koning W, Feenstra FF, Calkoen FGJ, van der Lugt J, Kester LA, Mustafa DAM. Characterizing the tumor immune microenvironment of ependymomas using targeted gene expression profiles and RNA sequencing. Cancer Immunol Immunother 2023; 72:2659-2670. [PMID: 37072536 PMCID: PMC10361846 DOI: 10.1007/s00262-023-03450-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/07/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Defining the tumor immune microenvironment (TIME) of patients using transcriptome analysis is gaining more popularity. Here, we examined and discussed the pros and cons of using RNA sequencing for fresh frozen samples and targeted gene expression immune profiles (NanoString) for formalin-fixed, paraffin-embedded (FFPE) samples to characterize the TIME of ependymoma samples. RESULTS Our results showed a stable expression of the 40 housekeeping genes throughout all samples. The Pearson correlation of the endogenous genes was high. To define the TIME, we first checked the expression of the PTPRC gene, known as CD45, and found it was above the detection limit in all samples by both techniques. T cells were identified consistently using the two types of data. In addition, both techniques showed that the immune landscape was heterogeneous in the 6 ependymoma samples used for this study. CONCLUSIONS The low-abundant genes were detected in higher quantities using the NanoString technique, even when FFPE samples were used. RNA sequencing is better suited for biomarker discovery, fusion gene detection, and getting a broader overview of the TIME. The technique that was used to measure the samples had a considerable effect on the type of immune cells that were identified. The limited number of tumor-infiltrating immune cells compared to the high density of tumor cells in ependymoma can limit the sensitivity of RNA expression techniques regarding the identification of the infiltrating immune cells.
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Affiliation(s)
- W. de Koning
- Tumor Immuno-Pathology Laboratory, Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Clinical Bioinformatics Unit, Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - F. F. Feenstra
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - F. G. J. Calkoen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - J. van der Lugt
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - L. A. Kester
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - D. A. M. Mustafa
- Tumor Immuno-Pathology Laboratory, Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Najjary S, Kros JM, de Koning W, Vadgama D, Lila K, Wolf J, Mustafa DAM. Tumor lineage-specific immune response in brain metastatic disease: opportunities for targeted immunotherapy regimen? Acta Neuropathol Commun 2023; 11:64. [PMID: 37061716 PMCID: PMC10105417 DOI: 10.1186/s40478-023-01542-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/05/2023] [Indexed: 04/17/2023] Open
Abstract
Metastases in the brain are the most severe and devastating complication of cancer. The incidence of brain metastasis is increasing. Therefore, the need of finding specific druggable targets for brain metastasis is demanding. The aim of this study was to compare the brain (immune) response to brain metastases of the most common tumor lineages, viz., lung adenocarcinoma and breast cancer. Targeted gene expression profiles of 11 brain metastasis of lung adenocarcinoma (BM-LUAD) were compared to 11 brain metastasis of breast cancer (BCBM) using NanoString nCounter PanCancer IO 360™ Panel. The most promising results were validated spatially using the novel GeoMx™ Digital Spatial Profiler (DSP) Technology. Additionally, Immune cell profiles and expression of drug targets were validated by multiplex immunohistochemistry. We found a more active immune response in BM-LUAD as compared to BCBM. In the BM-LUAD, 138 genes were upregulated as compared to BCBM (adj. p ≤ 0.05). Conversely, in BCBM 28 genes were upregulated (adj. p ≤ 0.05). Additionally, genes related to CD45 + cells, T cells, and cytotoxic T cells showed to be expressed higher in BM-LUAD compared to BCBM (adj. p = 0.01, adj. p = 0.023, adj. p = 0.023, respectively). The spatial quantification of the immune cells using the GeoMx DSP technique revealed the significantly higher quantification of CD14 and CD163 in tumor regions of BM-LUAD as compared to BCBM. Importantly, the immune checkpoint VISTA and IDO1 were identified as highly expressed in the BM-LUAD. Multiplex immunohistochemistry confirmed the finding and showed that VISTA is expressed mainly in BM-LUAD tumor cells, CD3 + cells, and to fewer levels in some microglial cells in BM-LUAD. This is the first report on differences in the brain immune response between metastatic tumors of different lineages. We found a far more extensive infiltration of immune cells in BM-LUAD as compared to BCBM. In addition, we found higher expression of VISTA and IDO1 in BM-LUAD. Taken together, targeted immune therapy should be considered to treat patients with BM-LUAD.
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Affiliation(s)
- Shiva Najjary
- Department of Pathology and Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Johan M Kros
- Department of Pathology and Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Willem de Koning
- Department of Pathology and Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Disha Vadgama
- Department of Pathology and Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Karishma Lila
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Janina Wolf
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Center, Rotterdam, The Netherlands
- Institute of Tissue Medicine and Pathology, University of Bern, Murtenstrasse 31, 3008, Bern, Switzerland
| | - Dana A M Mustafa
- Department of Pathology and Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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van Eijck CWF, de Koning W, van der Sijde F, Moskie M, Groot Koerkamp B, Homs MYV, van der Burg SH, van Eijck CHJ, Mustafa DAM. A multigene circulating biomarker to predict the lack of FOLFIRINOX response after a single cycle in patients with pancreatic ductal adenocarcinoma. Eur J Cancer 2023; 181:119-134. [PMID: 36652890 DOI: 10.1016/j.ejca.2022.12.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION 5-fluorouracil, folinic acid, irinotecan and oxaliplatin (FOLFIRINOX) is promising in treating patients with pancreatic ductal adenocarcinoma. However, many patients and physicians are reluctant to start FOLFIRINOX due to its high toxicity and limited clinical response rates. In this study, we investigated the effect of a single FOLFIRINOX cycle, in combination with a granulocyte colony-stimulating factor, on the blood immune transcriptome of patients with pancreatic ductal adenocarcinoma. We aimed to identify an early circulating biomarker to predict the lack of FOLFIRINOX response. METHODS Blood samples of 68 patients from all disease stages, who received at least four FOLFIRINOX cycles, were collected at baseline and after the first cycle. The response to treatment was radiologically evaluated following the Response Evaluation Criteria in Solid Tumours criteria 1.1. Targeted immune-gene expression profiling (GEP) was performed using NanoString technologies. To predict the lack of FOLFIRINOX response, we developed a FOLFIRINOX delta GEP (FFX-ΔGEP) score. RESULTS A single FOLFIRINOX cycle significantly altered 395 genes, correlating to 30 significant alterations in relative immune cell abundances and pathway activities. The eight-gene (BID, FOXP3, KIR3DL1, MAF, PDGFRB, RRAD, SIGLEC1 and TGFB2) FFX-ΔGEP score predicted the lack of FOLFIRINOX response with a leave-one-out cross-validated area under the curve (95% confidence interval) of 0.87 (0.60-0.98), thereby outperforming the predictiveness of absolute and proportional Δcarbohydrate antigen19-9 values. CONCLUSIONS A single FOLFIRINOX cycle, combined with granulocyte colony-stimulating factor, alters the peripheral immune transcriptome indisputably. Our novel FFX-ΔGEP is, to our knowledge, the first multigene early circulating biomarker that predicts the lack of FOLFIRINOX response after one cycle. Validation in a larger independent patient cohort is crucial before clinical implementation.
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Affiliation(s)
- Casper W F van Eijck
- Department of Surgery, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pathology Unit of Tumour Immuno-Pathology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
| | - Willem de Koning
- Department of Pathology Unit of Tumour Immuno-Pathology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pathology Unit of Clinical Bioinformatics, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
| | - Fleur van der Sijde
- Department of Surgery, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pathology Unit of Tumour Immuno-Pathology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
| | - Miranda Moskie
- Department of Surgery, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
| | - Marjolein Y V Homs
- Department of Medical Oncology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
| | - Sjoerd H van der Burg
- Department of Medical Oncology, Oncode Institute, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.
| | - Casper H J van Eijck
- Department of Surgery, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pathology Unit of Tumour Immuno-Pathology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
| | - Dana A M Mustafa
- Department of Pathology Unit of Tumour Immuno-Pathology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands.
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Aziz HM, Saida L, de Koning W, Stubbs AP, Li Y, Sideras K, Palacios E, Feliu J, Mendiola M, van Eijck CHJ, Mustafa DAM. Spatial genomics reveals a high number and specific location of B cells in the pancreatic ductal adenocarcinoma microenvironment of long-term survivors. Front Immunol 2023; 13:995715. [PMID: 36685537 PMCID: PMC9846531 DOI: 10.3389/fimmu.2022.995715] [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: 07/16/2022] [Accepted: 11/04/2022] [Indexed: 01/06/2023] Open
Abstract
Background and aim Only 10% of pancreatic ductal adenocarcinoma (PDAC) patients survive longer than five years. Factors underlining long-term survivorship in PDAC are not well understood. Therefore, we aimed to identify the key players in the tumor immune microenvironment (TIME) associated with long-term survivorship in PDAC patients. Methods The immune-related gene expression profiles of resected PDAC tumors of patients who survived and remained recurrence-free of disease for ≥36 months (long-term survivors, n=10) were compared to patients who had survived ≤6 months (short-term survivors, n=10) due to tumor recurrence. Validation was performed by the spatial protein expression profile of immune cells using the GeoMx™ Digital Spatial Profiler. An independent cohort of samples consisting of 12 long-term survivors and 10 short-term survivors, was used for additional validation. The independent validation was performed by combining qualitative immunohistochemistry and quantitative protein expression profiling. Results B cells were found to be significantly increased in the TIME of long-term survivors by gene expression profiling (p=0.018). The high tumor infiltration of B cells was confirmed by spatial protein profiling in the discovery and the validation cohorts (p=0.002 and p=0.01, respectively). The higher number of infiltrated B cells was found mainly in the stromal compartments of PDAC samples and was exclusively found within tumor cells in long-term survivors. Conclusion This is the first comprehensive study that connects the immune landscape of gene expression profiles and protein spatial infiltration with the survivorship of PDAC patients. We found a higher number and a specific location of B cells in TIME of long-term survivors which emphasizes the importance of B cells and B cell-based therapy for future personalized immunotherapy in PDAC patients.
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Affiliation(s)
- Hosein M. Aziz
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Lawlaw Saida
- Department of Pathology & Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Willem de Koning
- Department of Pathology & Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Rotterdam, Netherlands,Department of Pathology & Clinical Bioinformatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Andrew P. Stubbs
- Department of Pathology & Clinical Bioinformatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Yunlei Li
- Department of Pathology & Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Rotterdam, Netherlands,Department of Pathology & Clinical Bioinformatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Kostandinos Sideras
- Divisions of Medical Oncology and Hematology, Mayo Clinic, Rochester, MN, United States
| | - Elena Palacios
- Department of Pathology, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Jaime Feliu
- Department of Medical Oncology, La Paz University Hospital, IdiPAZ, Madrid, Spain,Cátedra UAM-ANGEM, Madrid, Spain,Centro de Investigación Biomédica en red de Cáncer, CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Mendiola
- Centro de Investigación Biomédica en red de Cáncer, CIBERONC, Instituto de Salud Carlos III, Madrid, Spain,Molecular Pathology and therapeutic Targets Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Casper H. J. van Eijck
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands,Department of Pathology & Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Dana A. M. Mustafa
- Department of Pathology & Clinical Bioinformatics, The Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center, Rotterdam, Netherlands,*Correspondence: Dana A. M. Mustafa,
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Broekhuizen M, Hitzerd E, van den Bosch TPP, Dumas J, Verdijk RM, van Rijn BB, Danser AHJ, van Eijck CHJ, Reiss IKM, Mustafa DAM. The Placental Innate Immune System Is Altered in Early-Onset Preeclampsia, but Not in Late-Onset Preeclampsia. Front Immunol 2022; 12:780043. [PMID: 34992598 PMCID: PMC8724430 DOI: 10.3389/fimmu.2021.780043] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/29/2021] [Indexed: 12/18/2022] Open
Abstract
Preeclampsia is a severe placenta-related pregnancy disorder that is generally divided into two subtypes named early-onset preeclampsia (onset <34 weeks of gestation), and late-onset preeclampsia (onset ≥34 weeks of gestation), with distinct pathophysiological origins. Both forms of preeclampsia have been associated with maternal systemic inflammation. However, alterations in the placental immune system have been less well characterized. Here, we studied immunological alterations in early- and late-onset preeclampsia placentas using a targeted expression profile approach. RNA was extracted from snap-frozen placenta samples (healthy n=13, early-onset preeclampsia n=13, and late-onset preeclampsia n=6). The expression of 730 immune-related genes from the Pan Cancer Immune Profiling Panel was measured, and the data were analyzed in the advanced analysis module of nSolver software (NanoString Technology). The results showed that early-onset preeclampsia placentas displayed reduced expression of complement, and toll-like receptor (TLR) associated genes, specifically TLR1 and TLR4. Mast cells and M2 macrophages were also decreased in early-onset preeclampsia compared to healthy placentas. The findings were confirmed by an immunohistochemistry approach using 20 healthy, 19 early-onset preeclampsia, and 10 late-onset preeclampsia placentas. We conclude that the placental innate immune system is altered in early-onset preeclampsia compared to uncomplicated pregnancies. The absence of these alterations in late-onset preeclampsia placentas indicates dissimilar immunological profiles. The study revealed distinct pathophysiological processes in early-onset and late-onset preeclampsia placentas and imply that a tailored treatment to each subtype is desirable.
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Affiliation(s)
- Michelle Broekhuizen
- Division of Neonatology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands.,Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands.,Division of Experimental Cardiology, Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Emilie Hitzerd
- Division of Neonatology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands.,Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Jasper Dumas
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands.,The Tumor Immuno-Pathology (TIP) Laboratory, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Robert M Verdijk
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bas B van Rijn
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - A H Jan Danser
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Casper H J van Eijck
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Irwin K M Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Dana A M Mustafa
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands.,The Tumor Immuno-Pathology (TIP) Laboratory, Erasmus University Medical Center, Rotterdam, Netherlands
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de Geus V, Ewing-Graham PC, de Koning W, de Koning MNC, van den Bosch TPP, Nigg AL, van Eijck CHJ, Jozwiak M, van Beekhuizen HJ, Mustafa DAM. Identifying Molecular Changes in Early Cervical Cancer Samples of Patients That Developed Metastasis. Front Oncol 2022; 11:715077. [PMID: 35087740 PMCID: PMC8787153 DOI: 10.3389/fonc.2021.715077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Cervical cancer is one of the most common cancers in women worldwide. Patients diagnosed with early-stage cervical cancer have a good prognosis, however, 10-20% suffer from local or distant recurrent disease after primary treatment. Treatment options for recurrent cervical cancer are limited. Therefore, it is crucial to identify factors that can predict patients with an increased risk of recurrence to optimize treatment to prevent the recurrence of cervical cancer. We aimed to identify biomarkers in early-stage primary cervical cancer which recurred after surgery. Formalin-Fixed, Paraffin-Embedded surgical specimens of 34 patients with early-stage cervical cancer (FIGO 2009 stage 1B1) and 7 healthy controls were analyzed. Targeted gene expression profiling using the PanCancer IO 360 panel of NanoString Technology was performed. The findings were confirmed by performing immunohistochemistry stainings. Various genes, namely GLS, CD36, WNT5a, HRAS, DDB2, PIK3R2, and CDH2 were found to be differentially highly expressed in primary cervical cancer samples of patients who developed distant recurrence. In addition, The relative infiltration score of CD8+ T cells, CD80+CD86+ macrophages, CD163+MRC1+ macrophages, and FOXP3+IL2RA+ regulatory T cells were significantly higher in this group of samples. In contrast, no significant differences in gene expression and relative immune infiltration were found in samples of patients who developed local recurrence. The infiltration of CD8 and FOXP3 cells were validated by immunohistochemistry using all samples included in the study. We identified molecular alterations in primary cervical cancer samples from patients who developed recurrent disease. These findings can be utilized towards developing a molecular signature for the early detection of patients with a high risk to develop metastasis.
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Affiliation(s)
- Vera de Geus
- Department of Gynaecologic Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.,Department of Pathology, Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | | | - Willem de Koning
- Department of Pathology, Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Pathology, Clinical Bioinformatics Unit, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Maurits N C de Koning
- Department of Research & Development Services, Delft Diagnostic Laboratory (DDL) Diagnostic Laboratory, Rijswijk, Netherlands
| | | | - Alex L Nigg
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Casper H J van Eijck
- Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Marta Jozwiak
- Department of Gynaecologic Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | | | - Dana A M Mustafa
- Department of Pathology, Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
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