1
|
Muñoz Perez N, Pensabene JM, Galbo PM, Sadeghipour N, Xiu J, Moziak K, Yazejian RM, Welch RL, Bell WR, Sengupta S, Aulakh S, Eberhart CG, Loeb DM, Eskandar E, Zheng D, Zang X, Martin AM. VISTA Emerges as a Promising Target against Immune Evasion Mechanisms in Medulloblastoma. Cancers (Basel) 2024; 16:2629. [PMID: 39123357 PMCID: PMC11312086 DOI: 10.3390/cancers16152629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/12/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Relapsed medulloblastoma (MB) poses a significant therapeutic challenge due to its highly immunosuppressive tumor microenvironment. Immune checkpoint inhibitors (ICIs) have struggled to mitigate this challenge, largely due to low T-cell infiltration and minimal PD-L1 expression. Identifying the mechanisms driving low T-cell infiltration is crucial for developing more effective immunotherapies. METHODS We utilize a syngeneic mouse model to investigate the tumor immune microenvironment of MB and compare our findings to transcriptomic and proteomic data from human MB. RESULTS Flow cytometry reveals a notable presence of CD45hi/CD11bhi macrophage-like and CD45int/CD11bint microglia-like tumor-associated macrophages (TAMs), alongside regulatory T-cells (Tregs), expressing high levels of the inhibitory checkpoint molecule VISTA. Compared to sham control mice, the CD45hi/CD11bhi compartment significantly expands in tumor-bearing mice and exhibits a myeloid-specific signature composed of VISTA, CD80, PD-L1, CTLA-4, MHCII, CD40, and CD68. These findings are corroborated by proteomic and transcriptomic analyses of human MB samples. Immunohistochemistry highlights an abundance of VISTA-expressing myeloid cells clustering at the tumor-cerebellar border, while T-cells are scarce and express FOXP3. Additionally, tumor cells exhibit immunosuppressive properties, inhibiting CD4 T-cell proliferation in vitro. Identification of VISTA's binding partner, VSIG8, on tumor cells, and its correlation with increased VISTA expression in human transcriptomic analyses suggests a potential therapeutic target. CONCLUSIONS This study underscores the multifaceted mechanisms of immune evasion in MB and highlights the therapeutic potential of targeting the VISTA-VSIG axis to enhance anti-tumor responses.
Collapse
Affiliation(s)
- Natalia Muñoz Perez
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Juliana M. Pensabene
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Phillip M. Galbo
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | | | - Joanne Xiu
- Caris Life Sciences, Phoenix, AZ 85040, USA; (N.S.); (J.X.)
| | - Kirsten Moziak
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Rita M. Yazejian
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Rachel L. Welch
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - W. Robert Bell
- Department of Clinical Pathology & Laboratory Medicine, School of Medicine, Indiana University, 340 West 10th Street Fairbanks Hall, Indianapolis, IN 46202, USA;
| | - Soma Sengupta
- Department of Neurology & Neurosurgery, University of North Carolina at Chapel Hill, 170 Manning Drive, Chapel Hill, NC 27599, USA;
| | - Sonikpreet Aulakh
- Department of Internal Medicine, West Virginia University, 64 Medical Center Drive, Morgantown, WV 26506, USA;
| | - Charles G. Eberhart
- Department of Pathology, Johns Hopkins School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, USA;
| | - David M. Loeb
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Emad Eskandar
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Deyou Zheng
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Xingxing Zang
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| | - Allison M. Martin
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; (J.M.P.); (P.M.G.J.); (K.M.); (R.M.Y.); (R.L.W.); (D.M.L.); (E.E.); (D.Z.); (X.Z.)
| |
Collapse
|
2
|
Olbromski M, Mrozowska M, Piotrowska A, Smolarz B, Romanowicz H. The VISTA/VSIG3/PSGL-1 axis: crosstalk between immune effector cells and cancer cells in invasive ductal breast carcinoma. Cancer Immunol Immunother 2024; 73:136. [PMID: 38833004 PMCID: PMC11150347 DOI: 10.1007/s00262-024-03701-w] [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: 03/11/2024] [Accepted: 04/09/2024] [Indexed: 06/06/2024]
Abstract
A checkpoint protein called the V-domain Ig suppressor of T cell activation (VISTA) is important for controlling immune responses. Immune cells that interact with VISTA have molecules, or receptors, known as VISTA receptors. Immune system activity can be modified by the interaction between VISTA and its receptors. Since targeting VISTA or its receptors may be beneficial in certain conditions, VISTA has been studied in relation to immunotherapy for cancer and autoimmune illnesses. The purpose of this study was to examine the expression levels and interactions between VISTA and its receptors, VSIG3 and PSGL-1, in breast cancer tissues. IHC analysis revealed higher levels of proteins within the VISTA/VSIG3/PSGL-1 axis in cancer tissues than in the reference samples (mastopathies). VISTA was found in breast cancer cells and intratumoral immune cells, with membranous and cytoplasmic staining patterns. VISTA was also linked with pathological grade and VSIG3 and PSGL-1 levels. Furthermore, we discovered that the knockdown of one axis member boosted the expression of the other partners. This highlights the significance of VISTA/VSIG3/PSGL-1 in tumor stroma and microenvironment remodeling. Our findings indicate the importance of the VISTA/VSIG3/PSGL-1 axis in the molecular biology of cancer cells and the immune microenvironment.
Collapse
Affiliation(s)
- Mateusz Olbromski
- Department of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Chalubinskiego 6a, 50-368, Wroclaw, Poland.
| | - Monika Mrozowska
- Department of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Chalubinskiego 6a, 50-368, Wroclaw, Poland
| | - Aleksandra Piotrowska
- Department of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Chalubinskiego 6a, 50-368, Wroclaw, Poland
| | - Beata Smolarz
- Department of Pathology, Polish Mother's Memorial Hospital Research Institute, 93-338, Lodz, Poland
| | - Hanna Romanowicz
- Department of Pathology, Polish Mother's Memorial Hospital Research Institute, 93-338, Lodz, Poland
| |
Collapse
|
3
|
Tinca AC, Szoke AR, Lazar BA, Szász EA, Tomuț AN, Sabău AH, Cocuz IG, Cotoi TC, Niculescu R, Chiorean DM, Ungureanu IA, Turdean SG, Cotoi OS. H-VISTA Immunohistochemistry Score Is Associated with Advanced Stages in Cutaneous and Ocular Melanoma. Int J Mol Sci 2024; 25:4335. [PMID: 38673920 PMCID: PMC11049914 DOI: 10.3390/ijms25084335] [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: 03/13/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Melanoma represents a public health issue. One of the biggest goals of current research is to develop new therapeutic options for patients affected by this aggressive tumor. We conducted a retrospective study including 105 patients diagnosed with cutaneous and ocular melanoma, with stages varying from pT1a to pT4b and pT4e, respectively, and we performed immunohistochemistry reactions with the new potential prognostic marker, VISTA (V-domain Ig suppressor of T cell activation). We quantified the expression by applying the H-score adapted for VISTA and divided the patients, based on the median value, into groups that presented high, low, and negative expression. Therefore, we obtained 65 cases with positive expression for cutaneous melanoma and 8 cases with positive expression for ocular melanoma. Forty-one cases presented high expression in cutaneous melanoma and three cases presented high expression in ocular melanoma. In cutaneous melanoma, analytic statistics showed that VISTA expression was associated with a high Breslow index, high mitotic count, high Ki67 expression, and advanced clinicopathological stage. The majority of ocular melanoma cases demonstrating a positive reaction were classified as stage pT3, whereas earlier stages showed a negative reaction. Our findings underscore a significant correlation between VISTA expression and key prognostic factors in melanoma. Looking ahead, the prospect of future randomized studies holds promise in corroborating the clinical relevance of our findings. By further elucidating the intricate relationship between VISTA expression and melanoma progression, new treatment strategies could be found, improving patient outcomes in this challenging neoplasm.
Collapse
Affiliation(s)
- Andreea Cătălina Tinca
- Doctoral School of Medicine and Pharmacy, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.C.T.); (A.H.S.); (R.N.); (D.M.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Andreea Raluca Szoke
- Doctoral School of Medicine and Pharmacy, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.C.T.); (A.H.S.); (R.N.); (D.M.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Bianca Andreea Lazar
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
| | - Emőke Andrea Szász
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Faculty of Medicine, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.N.T.); (I.A.U.)
| | - Alexandru Nicușor Tomuț
- Faculty of Medicine, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.N.T.); (I.A.U.)
| | - Adrian Horațiu Sabău
- Doctoral School of Medicine and Pharmacy, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.C.T.); (A.H.S.); (R.N.); (D.M.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Iuliu-Gabriel Cocuz
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Titiana-Cornelia Cotoi
- Faculty of Pharmacy, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania;
| | - Raluca Niculescu
- Doctoral School of Medicine and Pharmacy, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.C.T.); (A.H.S.); (R.N.); (D.M.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Diana Maria Chiorean
- Doctoral School of Medicine and Pharmacy, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.C.T.); (A.H.S.); (R.N.); (D.M.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
| | - Ioana Ancuța Ungureanu
- Faculty of Medicine, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.N.T.); (I.A.U.)
| | - Sabin Gligore Turdean
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Faculty of Medicine, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania; (A.N.T.); (I.A.U.)
| | - Ovidiu Simion Cotoi
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (B.A.L.); (E.A.S.); (I.-G.C.); (S.G.T.); (O.S.C.)
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| |
Collapse
|
4
|
Li S, Wang G, Ren Y, Liu X, Wang Y, Li J, Liu H, Yang J, Xing J, Zhang Y, He C, Xu S, Hou X, Li N. Expression and function of VISTA on myeloid cells. Biochem Pharmacol 2024; 222:116100. [PMID: 38428824 DOI: 10.1016/j.bcp.2024.116100] [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: 10/23/2023] [Revised: 02/04/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024]
Abstract
V-domain containing Ig Suppressor of T cell Activation (VISTA) is predominantly expressed on myeloid cells and functions as a ligand/receptor/soluble molecule. In inflammatory responses and immune responses, VISTA regulates multiple functions of myeloid cells, such as chemotaxis, phagocytosis, T cell activation. Since inflammation and immune responses are critical in many diseases, VISTA is a promising therapeutic target. In this review, we will describe the expression and function of VISTA on different myeloid cells, including neutrophils, monocytes, macrophages, dendritic cells (DCs), myeloid-derived suppressor cells (MDSCs). In addition, we will discuss whether the functions of VISTA on these cells impact the disease processing.
Collapse
Affiliation(s)
- Siyu Li
- Health Science Center, Ningbo University, Ningbo, China.
| | - Geng Wang
- Health Science Center, Ningbo University, Ningbo, China.
| | - Yan Ren
- Health Science Center, Ningbo University, Ningbo, China.
| | - Xinyue Liu
- Health Science Center, Ningbo University, Ningbo, China.
| | - Yixuan Wang
- Health Science Center, Ningbo University, Ningbo, China.
| | - Jianing Li
- Health Science Center, Ningbo University, Ningbo, China.
| | - Hua Liu
- Health Science Center, Ningbo University, Ningbo, China.
| | - Jiaqiang Yang
- Health Science Center, Ningbo University, Ningbo, China.
| | - Jingjun Xing
- Health Science Center, Ningbo University, Ningbo, China.
| | - Yanru Zhang
- Health Science Center, Ningbo University, Ningbo, China.
| | - Canxia He
- Health Science Center, Ningbo University, Ningbo, China.
| | - Suling Xu
- Department of Dermatology, the First Affiliated Hospital of Ningbo University, Ningbo, China.
| | - Xin Hou
- Health Science Center, Ningbo University, Ningbo, China.
| | - Na Li
- Health Science Center, Ningbo University, Ningbo, China; Department of Dermatology, the First Affiliated Hospital of Ningbo University, Ningbo, China.
| |
Collapse
|
5
|
Chen Y, Sun J, Liu J, Wei Y, Wang X, Fang H, Du H, Huang J, Li Q, Ren G, Wang X, Li H. Aldehyde dehydrogenase 2-mediated aldehyde metabolism promotes tumor immune evasion by regulating the NOD/VISTA axis. J Immunother Cancer 2023; 11:e007487. [PMID: 38088186 PMCID: PMC10711917 DOI: 10.1136/jitc-2023-007487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Aldehyde dehydrogenase 2 (ALDH2) is a crucial enzyme involved in endogenous aldehyde detoxification and has been implicated in tumor progression. However, its role in tumor immune evasion remains unclear. METHODS Here, we analyzed the relationship between ALDH2 expression and antitumor immune features in multiple cancers. ALDH2 knockout tumor cells were then established using CRISPR/Cas9 system. In immunocompetent breast cancer EMT6 and melanoma B16-F10 mouse models, we investigated the impact of ALDH2 blockade on cytotoxic T lymphocyte function and tumor immune microenvironment by flow cytometry, mass cytometry, Luminex liquid suspension chip detection, and immunohistochemistry. Furthermore, RNA sequencing, flow cytometry, western blot, chromatin immunoprecipitation assay, and luciferase reporter assays were employed to explore the detailed mechanism of ALDH2 involved in tumor immune evasion. Lastly, the synergistic therapeutic efficacy of blocking ALDH2 by genetic depletion or its inhibitor disulfiram in combination with immune checkpoint blockade (ICB) was investigated in mouse models. RESULTS In our study, we uncovered a positive correlation between the expression level of ALDH2 and T-cell dysfunction in multiple cancers. Furthermore, blocking ALDH2 significantly suppressed tumor growth by enhancing cytotoxic activity of CD8+ T cells and reshaping the immune landscape and cytokine milieu of tumors in vivo. Mechanistically, inhibiting ALDH2-mediated metabolism of aldehyde downregulated the expression of V-domain Ig suppressor of T-cell activation (VISTA) via inactivating the nucleotide oligomerization domain (NOD)/nuclear factor kappa-B (NF-κB) signaling pathway. As a result, the cytotoxic function of CD8+ T cells was revitalized. Importantly, ALDH2 blockade markedly reinforced the efficacy of ICB treatment. CONCLUSIONS Our data delineate that ALDH2-mediated aldehyde metabolism drives tumor immune evasion by activating the NOD/NF-κB/VISTA axis. Targeting ALDH2 provides an effective combinatorial therapeutic strategy for immunotherapy.
Collapse
Affiliation(s)
- Yuru Chen
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiazheng Sun
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiazhou Liu
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuxian Wei
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoyu Wang
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huiying Fang
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Breast Disease, Chongqing University Cancer Hospital, Chongqing, China
| | - Huimin Du
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Huang
- Department of Respiratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qin Li
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guosheng Ren
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoyi Wang
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongzhong Li
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
6
|
Lamas NJ, Lassalle S, Martel A, Nahon-Estève S, Macocco A, Zahaf K, Lalvee S, Fayada J, Lespinet-Fabre V, Bordone O, Pedeutour F, Baillif S, Hofman P. Characterisation of the protein expression of the emerging immunotherapy targets VISTA, LAG-3 and PRAME in primary uveal melanoma: insights from a southern French patient cohort. Pathology 2023; 55:929-944. [PMID: 37863710 DOI: 10.1016/j.pathol.2023.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 07/02/2023] [Accepted: 08/04/2023] [Indexed: 10/22/2023]
Abstract
Uveal melanoma (UM) is the most common intraocular tumour in adults, with dismal prognosis once metastases develop, since therapeutic options for the metastatic disease are ineffective. Over the past decade, novel cancer therapies based on immunotherapy have changed the landscape of treatment of different forms of cancer leading to many hopes of improvement in patient overall survival (OS). VISTA, LAG-3 and PRAME are novel promising targets of immunotherapy that have recently gained attention in different solid tumours, but whose relevance in UM remained to be comprehensively evaluated until now. Here, we studied the protein expression of VISTA, LAG-3 and PRAME using immunohistochemistry in representative whole tissue sections from primary UM cases in a cohort of 30 patients from a single centre (Nice University Hospital, Nice, France). The expression of each of these markers was correlated with different clinical and pathological parameters, including onset of metastases and OS. We demonstrated the protein expression of VISTA and LAG-3 in small lymphocytes infiltrating the tumour, while no expression of the proteins was detected in UM cells. For PRAME, nuclear expression was observed in UM cells, but no expression in tumour infiltrating immune cells was identified. Increased levels of VISTA expression in tumour infiltrating lymphocytes (TILs) were associated with nuclear BAP1 expression and better prognosis. Higher levels of LAG-3 in TILs were associated with higher levels of CD8-positive TILs. PRAME nuclear positivity in melanoma cells was associated with epithelioid cell dominant (>90%) UM histological subtype, higher mitotic numbers and a higher percentage of chromosome 8q gain. This study proposes VISTA as a novel relevant immune checkpoint molecule in primary UM and contributes to confirm LAG-3 and PRAME as potentially important immunotherapy targets in the treatment of UM patients, helping to expand the number of immunotherapy candidate molecules that are relevant to modulate in this aggressive cancer.
Collapse
Affiliation(s)
- Nuno Jorge Lamas
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France; Anatomic Pathology Service, Pathology Department, Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Largo Professor Abel Salazar, Porto, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Sandra Lassalle
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France; IRCAN Team 4, Inserm U1081/CNRS 7284, Centre de Lutte contre le Cancer Antoine Lacassagne, Nice, France; FHU OncoAge, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Arnaud Martel
- Université Côte d'Azur, Department of Ophthalmology, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Sacha Nahon-Estève
- Université Côte d'Azur, Department of Ophthalmology, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Adam Macocco
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Katia Zahaf
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Salome Lalvee
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Julien Fayada
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Virginie Lespinet-Fabre
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France; IRCAN Team 4, Inserm U1081/CNRS 7284, Centre de Lutte contre le Cancer Antoine Lacassagne, Nice, France; FHU OncoAge, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Olivier Bordone
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France; IRCAN Team 4, Inserm U1081/CNRS 7284, Centre de Lutte contre le Cancer Antoine Lacassagne, Nice, France; FHU OncoAge, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Florence Pedeutour
- Laboratory of Solid Tumour Genetics, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Stéphanie Baillif
- Université Côte d'Azur, Department of Ophthalmology, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Paul Hofman
- Université Côte d'Azur, Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, Pasteur Hospital, Centre Hospitalier Universitaire de Nice, Nice, France; IRCAN Team 4, Inserm U1081/CNRS 7284, Centre de Lutte contre le Cancer Antoine Lacassagne, Nice, France; FHU OncoAge, Centre Hospitalier Universitaire de Nice, Nice, France.
| |
Collapse
|
7
|
Liu J, Lin WP, Xiao Y, Yang QC, Bushabu Fidele N, Yu HJ, Sun ZJ. VISTA blockade alleviates immunosuppression of MDSCs in oral squamous cell carcinoma. Int Immunopharmacol 2023; 125:111128. [PMID: 37907049 DOI: 10.1016/j.intimp.2023.111128] [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: 07/06/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/02/2023]
Abstract
V-domain Ig suppressor of T-cell activation (VISTA) is a novel immune checkpoint regulator that can inhibit T cell-mediated antitumor immunity. Although the use of anti-VISTA monoclonal antibody has demonstrated encouraging outcomes in the therapy of various malignancies, its specific impact and underlying mechanisms in oral squamous cell carcinoma (OSCC) remain to be explored. In this work, we analyzed human OSCC tissue microarrays, human peripheral blood mononuclear cells, and immunocompetent transgenic mouse models to investigate the relationship between high VISTA expression and markers of myeloid-derived immunosuppressive cells (MDSCs; CD11b, CD33, Arginase-1), tumor-associated macrophages (CD68, CD163, CD206), and T cell function (CD8, PD-L1, Granzyme B). In OSCC, we discovered that VISTA was highly expressed and stably expressed in MDSCs. Furthermore, we established a mouse OSCC orthotopic xenograft tumor model to investigate the impact of VISTA blockade on the tumor microenvironment. We found that VISTA blockade reduces the immunosuppressive microenvironment and delays tumor growth. This is achieved by suppressing the quantity and function of MDSCs while boosting the function of tumor-infiltrating T cells. Our research indicated that VISTA expressed by MDSCs has a crucial function in the progression of OSCC and that VISTA blockade therapy is a promising immune checkpoint blockade therapy.
Collapse
Affiliation(s)
- Jie Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan 430079, PR China
| | - Wen-Ping Lin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan 430079, PR China
| | - Yao Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan 430079, PR China
| | - Qi-Chao Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan 430079, PR China
| | - Nyimi Bushabu Fidele
- The National Key Laboratory of Basic Science of Stomatology of Kinshasa University, School of Dental Medicine, University of Kinshasa, Kinshasa B.P. 834 KIN XI, Democratic Republic of Congo
| | - Hai-Jun Yu
- Department of Radiation and Medical Oncology, Hubei Province Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan 430071, PR China.
| | - Zhi-Jun Sun
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan 430079, PR China; Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, PR China.
| |
Collapse
|
8
|
Shekari N, Shanehbandi D, Kazemi T, Zarredar H, Baradaran B, Jalali SA. VISTA and its ligands: the next generation of promising therapeutic targets in immunotherapy. Cancer Cell Int 2023; 23:265. [PMID: 37936192 PMCID: PMC10631023 DOI: 10.1186/s12935-023-03116-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023] Open
Abstract
V-domain immunoglobulin suppressor of T cell activation (VISTA) is a novel negative checkpoint receptor (NCR) primarily involved in maintaining immune tolerance. It has a role in the pathogenesis of autoimmune disorders and cancer and has shown promising results as a therapeutic target. However, there is still some ambiguity regarding the ligands of VISTA and their interactions with each other. While V-Set and Immunoglobulin domain containing 3 (VSIG-3) and P-selectin glycoprotein ligand-1(PSGL-1) have been extensively studied as ligands for VISTA, the others have received less attention. It seems that investigating VISTA ligands, reviewing their functions and roles, as well as outcomes related to their interactions, may allow an understanding of their full functionality and effects within the cell or the microenvironment. It could also help discover alternative approaches to target the VISTA pathway without causing related side effects. In this regard, we summarize current evidence about VISTA, its related ligands, their interactions and effects, as well as their preclinical and clinical targeting agents.
Collapse
Affiliation(s)
- Najibeh Shekari
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dariush Shanehbandi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Kazemi
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Habib Zarredar
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Seyed Amir Jalali
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
9
|
Noelle RJ, Lines JL, Lewis LD, Martell RE, Guillaudeux T, Lee SW, Mahoney KM, Vesely MD, Boyd-Kirkup J, Nambiar DK, Scott AM. Clinical and research updates on the VISTA immune checkpoint: immuno-oncology themes and highlights. Front Oncol 2023; 13:1225081. [PMID: 37795437 PMCID: PMC10547146 DOI: 10.3389/fonc.2023.1225081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/21/2023] [Indexed: 10/06/2023] Open
Abstract
Immune checkpoints limit the activation of the immune system and serve an important homeostatic function but can also restrict immune responses against tumors. Inhibition of specific immune checkpoint proteins such as the B7:CD28 family members programmed cell death protein-1 (PD-1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) has transformed the treatment of various cancers by promoting the anti-tumor activation of immune cells. In contrast to these effects, the V-domain immunoglobulin suppressor of T-cell activation (VISTA) regulates the steady state of the resting immune system and promotes homeostasis by mechanisms distinct from PD-1 and CTLA-4. The effects of VISTA blockade have been shown to include a decrease in myeloid suppression coupled with proinflammatory changes by mechanisms that are separate and distinct from other immune checkpoint proteins; in some preclinical studies these immune effects appear synergistic. Given the potential benefits of VISTA blockade in the context of cancer therapy, the second Annual VISTA Symposium was convened virtually on September 23, 2022, to review new research from investigators and immuno-oncology experts. Discussions in the meeting extended the knowledge of VISTA biology and the effects of VISTA inhibition, particularly on cells of the myeloid lineage and resting T cells, as three candidate anti-VISTA antibodies are in, or nearing, clinical development.
Collapse
Affiliation(s)
- Randolph J. Noelle
- ImmuNext Inc., Lebanon, NH, United States
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - J. Louise Lines
- Department of Microbiology and Immunology, Dartmouth Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Lionel D. Lewis
- Section of Clinical Pharmacology, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth Cancer Center, Hanover, NH, United States
| | - Robert E. Martell
- Curis, Inc., Lexington, MA, United States
- Division of Hematology/Oncology, Tufts Medical Center, Boston, MA, United States
| | | | - Sam W. Lee
- Yale University School of Medicine, New Haven, CT, United States
| | - Kathleen M. Mahoney
- Department of Medical, Division of Medical Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - Matthew D. Vesely
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | | | - Dhanya K. Nambiar
- Department of Radiation Oncology, Stanford School of Medicine, Stanford, CA, United States
| | - Andrew M. Scott
- Olivia Newton-John Cancer Research Institute and School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia
- Department of Molecular Imaging and Therapy, Austin Health and Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
10
|
Tinca AC, Raicea A, Szőke AR, Cocuz IG, Şincu MC, Niculescu R, Sabău AH, Popelea MC, Fruntelată RF, Cotoi OS. Morphological aspects and therapeutic options in melanoma: a narrative review of the past decade. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:135-141. [PMID: 37518869 PMCID: PMC10520381 DOI: 10.47162/rjme.64.2.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
Melanoma is a malignant cancer of the skin, the incidence of which has been increasing year by year. This neoplasm has high aggressivity as well as the potential for invasion and metastases. Multiple factors related to the proliferation of this type of tumor have been identified, such as exposure to ultraviolet (UV) radiation and specific genetic backgrounds. From a histological and cytological point of view, the most common cells that are found in melanoma are epithelioid or spindle cells. To confirm the diagnosis and the melanocytic origin of the tumor, specific and sensitive markers are used. Also, observation of the behavior of this cancer, including its proliferative properties, has led to the development of multiple therapies, each of which is characteristic of the pathological stage at the time of diagnosis. While surgery is the most important therapeutic and curative option in cases of melanoma in situ, chemotherapy has been the main treatment for advanced stages of melanoma for many years. However, recently, targeted therapy and immunotherapy have changed the approach to treatment. At present, multiple studies are attempting to obtain further data about the tumor microenvironment and investigating how targeting particular molecules can change the prognosis of patients.
Collapse
|
11
|
Li N, Yang S, Ren Y, Tai R, Liu H, Wang Y, Li J, Wang F, Xing J, Zhang Y, Zhu X, Xu S, Hou X, Wang G. Chemotherapy induces immune checkpoint VISTA expression in tumor cells via HIF-2alpha. Biochem Pharmacol 2023; 210:115492. [PMID: 36898416 DOI: 10.1016/j.bcp.2023.115492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/19/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023]
Abstract
Tumor cells can evade the innate and adaptive immune systems, which play important roles in tumor recurrence and metastasis. Malignant tumors that recur after chemotherapy are more aggressiveciscis, suggesting an increased ability of the surviving tumor cells to evade innate and adaptive immunity. Therefore, in order to reduce patient mortality, it is important to discover the mechanisms by which tumor cells develop resistance to chemotherapeutics. In the present study we focused on the tumor cells that survived chemotherapy. We found that chemotherapy could promote the expression of VISTA in tumor cells, and that this change was mediated by HIF-2α. In addition, VISTA overexpression on melanoma cells promoted immune evasion, and the application of the VISTA-blocking antibody 13F3 enhanced the therapeutic effect of carboplatin. These results offer an insight into the immune evasion of chemotherapy-resistant tumors, and provide a theoretical basis for the combined application of chemotherapy drugs and VISTA inhibitors to treat tumors.
Collapse
Affiliation(s)
- Na Li
- Department of Dermatology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China; School of Medicine, Ningbo University, Ningbo, China
| | - Shanru Yang
- Department of Histology and Embryology, Harbin Medical University, Harbin, China; Department of Pathology, the First Hospital of Lanzhou University, Lanzhou, China
| | - Yan Ren
- School of Medicine, Ningbo University, Ningbo, China
| | - Risheng Tai
- Department of Histology and Embryology, Harbin Medical University, Harbin, China; The First Psychiatric Hospital of Harbin, Heilongjiang, China
| | - Hua Liu
- School of Medicine, Ningbo University, Ningbo, China
| | - Yixuan Wang
- School of Medicine, Ningbo University, Ningbo, China
| | - Jianing Li
- School of Medicine, Ningbo University, Ningbo, China
| | - Fuyan Wang
- School of Medicine, Ningbo University, Ningbo, China
| | - Jingjun Xing
- School of Medicine, Ningbo University, Ningbo, China
| | - Yanru Zhang
- School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoxia Zhu
- Department of Dermatology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
| | - Suling Xu
- Department of Dermatology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
| | - Xin Hou
- School of Medicine, Ningbo University, Ningbo, China.
| | - Geng Wang
- School of Medicine, Ningbo University, Ningbo, China.
| |
Collapse
|
12
|
Benito-Lopez JJ, Marroquin-Muciño M, Perez-Medina M, Chavez-Dominguez R, Aguilar-Cazares D, Galicia-Velasco M, Lopez-Gonzalez JS. Partners in crime: The feedback loop between metabolic reprogramming and immune checkpoints in the tumor microenvironment. Front Oncol 2023; 12:1101503. [PMID: 36713558 PMCID: PMC9879362 DOI: 10.3389/fonc.2022.1101503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/22/2022] [Indexed: 01/15/2023] Open
Abstract
The tumor microenvironment (TME) is a complex and constantly changing cellular system composed of heterogeneous populations of tumor cells and non-transformed stromal cells, such as stem cells, fibroblasts, endothelial cells, pericytes, adipocytes, and innate and adaptive immune cells. Tumor, stromal, and immune cells consume available nutrients to sustain their proliferation and effector functions and, as a result of their metabolism, produce a wide array of by-products that gradually alter the composition of the milieu. The resulting depletion of essential nutrients and enrichment of by-products work together with other features of the hostile TME to inhibit the antitumor functions of immune cells and skew their phenotype to promote tumor progression. This review briefly describes the participation of the innate and adaptive immune cells in recognizing and eliminating tumor cells and how the gradual metabolic changes in the TME alter their antitumor functions. In addition, we discuss the overexpression of the immune checkpoints and their ligands as a result of nutrient deprivation and by-products accumulation, as well as the amplification of the metabolic alterations induced by the immune checkpoints, which creates an immunosuppressive feedback loop in the TME. Finally, the combination of metabolic and immune checkpoint inhibitors as a potential strategy to treat cancer and enhance the outcome of patients is highlighted.
Collapse
Affiliation(s)
- Jesus J Benito-Lopez
- Laboratorio de Investigacion en Cancer Pulmonar, Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
- Posgrado en Ciencias Biologicas, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Mario Marroquin-Muciño
- Laboratorio de Investigacion en Cancer Pulmonar, Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
- Laboratorio de Quimioterapia Experimental, Departamento de Bioquimica, Escuela Nacional de Ciencias Biologicas, Instituto Politecnico Nacional, Mexico City, Mexico
| | - Mario Perez-Medina
- Laboratorio de Investigacion en Cancer Pulmonar, Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
- Laboratorio de Quimioterapia Experimental, Departamento de Bioquimica, Escuela Nacional de Ciencias Biologicas, Instituto Politecnico Nacional, Mexico City, Mexico
| | - Rodolfo Chavez-Dominguez
- Laboratorio de Investigacion en Cancer Pulmonar, Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
- Posgrado en Ciencias Biologicas, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Dolores Aguilar-Cazares
- Laboratorio de Investigacion en Cancer Pulmonar, Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - Miriam Galicia-Velasco
- Laboratorio de Investigacion en Cancer Pulmonar, Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| | - Jose S Lopez-Gonzalez
- Laboratorio de Investigacion en Cancer Pulmonar, Departamento de Enfermedades Cronico-Degenerativas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico
| |
Collapse
|
13
|
Combined Vaccination with B Cell Peptides Targeting Her-2/neu and Immune Checkpoints as Emerging Treatment Option in Cancer. Cancers (Basel) 2022; 14:cancers14225678. [PMID: 36428769 PMCID: PMC9688220 DOI: 10.3390/cancers14225678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/22/2022] Open
Abstract
The application of monoclonal antibodies (mAbs), targeting tumor-associated (TAAs) or tumor-specific antigens or immune checkpoints (ICs), has shown tremendous success in cancer therapy. However, the application of mAbs suffers from a series of limitations, including the necessity of frequent administration, the limited duration of clinical response and the emergence of frequently pronounced immune-related adverse events. However, the introduction of mAbs has also resulted in a multitude of novel developments for the treatment of cancers, including vaccinations against various tumor cell-associated epitopes. Here, we reviewed recent clinical trials involving combination therapies with mAbs targeting the PD-1/PD-L1 axis and Her-2/neu, which was chosen as a paradigm for a clinically highly relevant TAA. Our recent findings from murine immunizations against the PD-1 pathway and Her-2/neu with peptides representing the mimotopes/B cell peptides of therapeutic antibodies targeting these molecules are an important focus of the present review. Moreover, concerns regarding the safety of vaccination approaches targeting PD-1, in the context of the continuing immune response, as a result of induced immunological memory, are also addressed. Hence, we describe a new frontier of cancer treatment by active immunization using combined mimotopes/B cell peptides aimed at various targets relevant to cancer biology.
Collapse
|
14
|
Pęksa R, Kunc M, Czapiewski P, Piątek M, Hać S, Radecka B, Biernat W. Tumor Budding Is an Independent Prognostic Factor in Pancreatic Adenocarcinoma and It Positively Correlates with PD-L1 Expression on Tumor Cells. Biomedicines 2022; 10:biomedicines10071761. [PMID: 35885065 PMCID: PMC9312915 DOI: 10.3390/biomedicines10071761] [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: 06/21/2022] [Revised: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Abstract
Pancreatic adenocarcinoma is one of the leading causes of cancer-related death in developed countries. Only 15% of patients are candidates for radical surgery, and adequate prognostication may guide proper postsurgical management. We aimed to retrospectively assess the prognostic significance of the immunohistochemical expression of immune checkpoint receptors (PD-L1 and VISTA), markers of systemic inflammation, thrombosis in the tumor area, and the tumor budding in the group of 107 patients diagnosed with pancreatic adenocarcinoma in a single center. The high expression of PD-L1 on tumor cells (TCs) was associated with worse overall survival (OS, p = 0.041, log-rank). On the contrary, high PD-L1 or VISTA on tumor-associated immune cells (TAICs) was correlated with better OS (p = 0.006 and p = 0.008, respectively, log-rank). The joint status of PD-L1 on TCs and TAICs stratified patients into three prognostic groups. The cases with high-grade budding were characterized by higher PD-L1 expression on TCs (p = 0.008) and elevated systemic inflammatory markers. Moreover, budding was identified as the independent prognostic factor in multivariate Cox regression analysis (HR = 2.87; 95% CI = 1.75−4.68; p < 0.001). To conclude, the pattern of PD-L1 and VISTA expression was associated with survival in univariate analysis. Tumor budding accurately predicts outcomes in pancreatic cancer and should be incorporated into routine histopathological practice.
Collapse
Affiliation(s)
- Rafał Pęksa
- Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.K.); (W.B.)
- Correspondence: ; Tel.: +48-58-349-3750
| | - Michał Kunc
- Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.K.); (W.B.)
| | - Piotr Czapiewski
- Department of Pathology, Dessau Medical Centre, Auenweg 38, 06847 Dessau-Roßlau, Germany;
- Department of Pathology, Medical Faculty, Otto-von-Guericke University Magdeburg, Leipzigerstr. 44, 39120 Magdeburg, Germany
| | - Michał Piątek
- Department of Oncology with Daily Unit, Tadeusz Koszarowski Cancer Center in Opole, Katowicka 66a, 45-061 Opole, Poland; (M.P.); (B.R.)
| | - Stanisław Hać
- Department of General Endocrine and Transplant Surgery, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Barbara Radecka
- Department of Oncology with Daily Unit, Tadeusz Koszarowski Cancer Center in Opole, Katowicka 66a, 45-061 Opole, Poland; (M.P.); (B.R.)
- Department of Oncology, Institute of Medical Sciences, University of Opole, 45-062 Opole, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.K.); (W.B.)
| |
Collapse
|
15
|
Tang XY, Xiong YL, Shi XG, Zhao YB, Shi AP, Zheng KF, Liu YJ, Jiang T, Ma N, Zhao JB. IGSF11 and VISTA: a pair of promising immune checkpoints in tumor immunotherapy. Biomark Res 2022; 10:49. [PMID: 35831836 PMCID: PMC9277907 DOI: 10.1186/s40364-022-00394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/22/2022] [Indexed: 11/20/2022] Open
Abstract
Immunotherapy has become the major treatment for tumors in clinical practice, but some intractable problems such as the low response rate and high rates of immune-related adverse events still hinder the progress of tumor immunotherapy. Hence, it is essential to explore additional immunotherapy treatment targets. In this review, we focus on the structure, expression and expression-related mechanisms, interactions, biological functions and the progress in preclinical/clinical research of IGSF11 and VISTA in tumors. We cover the progress in recent research with this pair of immune checkpoints in tumor immune regulation, proliferation, immune resistance and predictive prognosis. Both IGSF11 and VISTA are highly expressed in tumors and are modulated by various factors. They co-participate in the functional regulation of immune cells and the inhibition of cytokine production. Besides, in the downregulation of IGSF11 and VISTA, both inhibit the growth of some tumors. Preclinical and clinical trials all emphasize the predictive role of IGSF11 and VISTA in the prognosis of tumors, and that the predictive role of the same gene varies from tumor to tumor. At present, further research is proving the enormous potential of IGSF11 and VISTA in tumors, and especially the role of VISTA in tumor immune resistance. This may prove to be a breakthrough to solve the current clinical immune resistance, and most importantly, since research has focused on VISTA but less on IGSF11, IGSF11 may be the next candidate for tumor immunotherapy.
Collapse
Affiliation(s)
- Xi-Yang Tang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Yan-Lu Xiong
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Xian-Gui Shi
- College of Basic Medicine, Air Force Medical University, Xi'an, 710032, Shaanxi, China
| | - Ya-Bo Zhao
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - An-Ping Shi
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Kai-Fu Zheng
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Yu-Jian Liu
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Tao Jiang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China.
| | - Nan Ma
- Department of Ophthalmology, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, 710038, Xi'an, China.
| | - Jin-Bo Zhao
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, 569 Xinsi Road, Xi'an, 710038, Shaanxi, China.
| |
Collapse
|
16
|
Zong L, Gu Y, Zhou Y, Kong Y, Mo S, Yu S, Xiang Y, Chen J. Expression of B7 family checkpoint proteins in cervical cancer. Mod Pathol 2022; 35:786-793. [PMID: 34848831 DOI: 10.1038/s41379-021-00979-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 11/09/2022]
Abstract
The role of programmed cell death-ligand 1 (PD-L1) in cervical cancer has been widely investigated; however, the influences of other inhibitory B7 family members are poorly understood. We investigated the expression of PD-L1, B7 homolog 3 (B7-H3), B7-H4, and V-domain Ig suppressor of T-cell activation (VISTA) and their association with the clinicopathological features and outcomes of a large cohort of 673 patients with squamous cell carcinoma or adenocarcinoma of the uterine cervix. The positivity rates for PD-L1 (combined positive score ≥1), B7-H3 in tumor cells (TCs), B7-H4 (exclusively in TCs), VISTA in immune cells (ICs), and VISTA in TCs were 57.9%, 62.8%, 44.8%, 92.6%, and 4.8%, respectively, in 606 primary cervical cancer samples. Co-expression of PD-L1 with B7-H3 in TCs and with B7-H4 and VISTA in ICs was observed in 38.8%, 25.4%, and 57.9% of samples, respectively. B7-H3 in TCs and B7-H4 and VISTA in ICs were observed in 58.1%, 46.6%, and 83.1% of PD-L1-negative samples, respectively. These proteins were observed more frequently in squamous cell carcinomas and in moderately to poorly differentiated carcinomas. VISTA (in ICs) and B7-H4 were more frequent in primary tumors than in recurrent counterparts and correlated with improved survival; in contrast, B7-H3 positivity in TCs was less frequent in primary tumors and correlated with short disease-specific survival. Co-expression of B7-H4 and VISTA in ICs was an independent predictor of favorable outcomes overall and among patients with PD-L1-negative tumors. These data indicate that B7 family proteins exhibit differing expression patterns, distributions, and prognostic implications in cervical cancer. Furthermore, the co-expression of PD-L1 with other checkpoint proteins suggests that PD-1/PD-L1 blockade combined with modulating other immune checkpoints may present a novel therapeutic approach for cervical cancer. Future studies are needed to validate prognostic values of B7 family proteins and explore their biological roles in this malignancy.
Collapse
Affiliation(s)
- Liju Zong
- Department of Gynecologic Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Yu Gu
- Department of Gynecologic Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Yuncan Zhou
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yujia Kong
- Department of Gynecologic Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Shengwei Mo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shuangni Yu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yang Xiang
- Department of Gynecologic Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. .,National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China.
| | - Jie Chen
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| |
Collapse
|
17
|
Long L, Zhang L, Yang Y, Zhou Y, Chen H. Different clinical significance of novel B7 family checkpoints VISTA and HHLA2 in human lung adenocarcinoma. Immunotherapy 2022; 14:419-431. [PMID: 35187955 DOI: 10.2217/imt-2021-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Background: VISTA and HHLA2 are two recently identified members of the B7 homologue family of immune-regulatory molecules. But the expression patterns and clinical significance of VISTA and HHLA2 in lung adenocarcinoma (LUAD) remain largely unknown. Methods: Immunohistochemistry was performed to examine the expression of VISTA, HHLA2, PD-L1 and CD8+ tumor-infiltrating lymphocytes in 74 cases of LUAD. The expression of VISTA, HHLA2, PD-L1, CD68 and CD8 proteins was detected by multiplex immunofluorescence staining in the LUAD tissues. Results: High expression of VISTA and HHLA2 was observed in LUAD compared with noncancerous tissues. High VISTA expression in immune cells predicted a high mortality rate and worse survival. Conclusion: VISTA and HHLA2 are potential immunotherapeutic targets that possess different prognostic significance in LUAD.
Collapse
Affiliation(s)
- Long Long
- Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, P.R. China.,Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, P.R. China
| | - Li Zhang
- Department of Pathology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, P.R. China
| | - Yuhan Yang
- Department of Pathology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, P.R. China
| | - Yunfeng Zhou
- Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, P.R. China
| | - Honglei Chen
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, P.R. China.,Department of Pathology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, P.R. China
| |
Collapse
|
18
|
Analysis of the immune checkpoint V-domain Ig-containing suppressor of T-cell activation (VISTA) in endometrial cancer. Mod Pathol 2022; 35:266-273. [PMID: 34493823 DOI: 10.1038/s41379-021-00901-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 11/08/2022]
Abstract
V-domain Ig-containing suppressor of T-cell activation (VISTA) is a novel immune checkpoint protein and a potential immunotherapeutic target. However, its expression in endometrial cancer has not been clearly defined. This study aimed to investigate VISTA expression and determine its associations with clinicopathological features, molecular subtypes, programmed cell death-ligand 1 (PD-L1) expression, CD8+ T-cell count, and survival in a cohort of 839 patients with endometrial cancer. Using direct sequencing of the polymerase epsilon (POLE) exonuclease domain and immunohistochemistry for mismatch repair (MMR) proteins and p53, we stratified endometrial cancers into four molecular subtypes: POLE ultramutated, MMR-deficient, p53-mutant, and nonspecific molecular profile (NSMP). PD-L1, CD8, and VISTA were detected via immunohistochemistry. VISTA was expressed in the immune cells of 76.6% (643/839) of the samples and in the tumor cells of 6.8% (57/839). VISTA positivity in the immune cells was frequent in tumors staged I-III, those with positive PD-L1 or high CD8+ T-cell density, and those representing POLE ultramutated and MMR-deficient subtypes. Furthermore, VISTA positivity in tumor cells was more frequent in clear cell carcinoma samples. VISTA in immune cells was associated with improved survival in the entire cohort as well as in the endometrioid histology, stage I, PD-L1-negative, MMR-deficient, MMR-proficient, and high and low number of CD8+ T-cell-infiltrated tumor subgroups. VISTA in immune cells was a prognostic factor overall, as well as in patients with endometrioid histology, independent of molecular subtype or CD8+ T-cell density. The data produced by this study, which was the largest to focus on VISTA expression in patients with endometrial cancer to date, suggest that VISTA is a predictor of improved survival.
Collapse
|
19
|
Alanazi FE, As Sobeai HM, Alhazzani K, Al-Dhfyan A, Alshammari MA, Alotaibi M, Al-hosaini K, Korashy HM, Alhoshani A. Metformin attenuates V-domain Ig suppressor of T-cell activation through the aryl hydrocarbon receptor pathway in Melanoma: In Vivo and In Vitro Studies. Saudi Pharm J 2022; 30:138-149. [PMID: 35528855 PMCID: PMC9072704 DOI: 10.1016/j.jsps.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/27/2021] [Indexed: 11/06/2022] Open
Abstract
Melanoma is an aggressive skin cancer with a high rate of metastasis to other organs. Recent studies specified the overexpression of V-domain Ig suppressor of T-cell activation (VISTA) and Aryl Hydrocarbon Receptor (AHR) in melanoma. Metformin shows anti-tumor activities in several cancer types. However, the mechanism is unclear. This study aims to investigate the inhibitory effect of metformin on VISTA via AHR in melanoma cells (CHL-1, B16) and animal models. VISTA and AHR levels were assessed by qPCR, Western blot, immunofluorescence microscope, flow cytometry, and immunohistochemistry. Here, metformin significantly decreased VISTA and AHR levels in vitro and in vivo. Furthermore, metformin inhibited all AHR-regulated genes. VISTA levels were dramatically inhibited by AHR modulations using shRNA and αNF, confirming the central role of AHR in VISTA. Finally, melanoma cells were xenografted in C57BL/6 and nude mice. Metformin significantly reduced the tumor volume and growth rate. Likewise, VISTA and AHR-regulated protein levels were suppressed in both models. These findings demonstrate for the first time that VISTA is suppressed by metformin and identified a new regulatory mechanism through AHR. The data suggest that metformin could be a new potential therapeutic strategy to treat melanoma patients combined with targeted immune checkpoint inhibitors.
Collapse
Affiliation(s)
- Fawaz E. Alanazi
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
- Pharmacy Services Department, Security Forces Hospital Program, P.O. Box 3643, Riyadh 11481, Saudi Arabia
| | - Homood M. As Sobeai
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Khalid Alhazzani
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Abdullah Al-Dhfyan
- Stem Cell & Tissue Re-Engineering, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Musaad A Alshammari
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Moureq Alotaibi
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Khaled Al-hosaini
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Hesham M. Korashy
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha 2713, Qatar
| | - Ali Alhoshani
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| |
Collapse
|