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Zhang Y, Guo F, Wang Y. Hypoxic tumor microenvironment: Destroyer of natural killer cell function. Chin J Cancer Res 2024; 36:138-150. [PMID: 38751439 PMCID: PMC11090795 DOI: 10.21147/j.issn.1000-9604.2024.02.04] [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: 01/19/2024] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
In recent years, immunotherapy has made remarkable progress in treating certain tumors and hematological malignancies. However, the efficacy of natural killer (NK) cells, which are an important subset of innate lymphocytes used in anticancer immunotherapy, remains limited. Hypoxia, a critical characteristic of the tumor microenvironment (TME), is involved in tumor development and resistance to radiotherapy, chemotherapy, and immunotherapy. Moreover, hypoxia contributes to the impairment of NK cell function and may be a significant factor that limits their therapeutic effects. Targeted hypoxia therapy has emerged as a promising research area for enhancing the efficacy of NK cell therapy. Therefore, understanding how the hypoxic TME influences NK cell function is crucial for improving antitumor treatment outcomes.
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Affiliation(s)
- Yongfei Zhang
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, China
| | - Feifei Guo
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, China
| | - Yufeng Wang
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, China
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Tong L, Jiménez-Cortegana C, Tay AH, Wickström S, Galluzzi L, Lundqvist A. NK cells and solid tumors: therapeutic potential and persisting obstacles. Mol Cancer 2022; 21:206. [PMID: 36319998 PMCID: PMC9623927 DOI: 10.1186/s12943-022-01672-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/10/2022] [Accepted: 09/24/2022] [Indexed: 11/05/2022] Open
Abstract
Natural killer (NK) cells, which are innate lymphocytes endowed with potent cytotoxic activity, have recently attracted attention as potential anticancer therapeutics. While NK cells mediate encouraging responses in patients with leukemia, the therapeutic effects of NK cell infusion in patients with solid tumors are limited. Preclinical and clinical data suggest that the efficacy of NK cell infusion against solid malignancies is hampered by several factors including inadequate tumor infiltration and persistence/activation in the tumor microenvironment (TME). A number of metabolic features of the TME including hypoxia as well as elevated levels of adenosine, reactive oxygen species, and prostaglandins negatively affect NK cell activity. Moreover, cancer-associated fibroblasts, tumor-associated macrophages, myeloid-derived suppressor cells, and regulatory T cells actively suppress NK cell-dependent anticancer immunity. Here, we review the metabolic and cellular barriers that inhibit NK cells in solid neoplasms as we discuss potential strategies to circumvent such obstacles towards superior therapeutic activity.
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Affiliation(s)
- Le Tong
- grid.4714.60000 0004 1937 0626Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - Carlos Jiménez-Cortegana
- grid.5386.8000000041936877XDepartment of Radiation Oncology, Weill Cornell Medical College, New York, NY USA ,grid.9224.d0000 0001 2168 1229Department of Medical Biochemistry, Molecular Biology and Immunology, Faculty of Medicine, University of Seville, Seville, Spain
| | - Apple H.M. Tay
- grid.4714.60000 0004 1937 0626Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden ,grid.59025.3b0000 0001 2224 0361Department of Biological Science, Nanyang Technological University, Singapore, Singapore
| | - Stina Wickström
- grid.4714.60000 0004 1937 0626Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - Lorenzo Galluzzi
- grid.5386.8000000041936877XDepartment of Radiation Oncology, Weill Cornell Medical College, New York, NY USA ,grid.5386.8000000041936877XSandra and Edward Meyer Cancer Center, New York, NY USA ,grid.5386.8000000041936877XCaryl and Israel Englander Institute for Precision Medicine, New York, NY USA
| | - Andreas Lundqvist
- grid.4714.60000 0004 1937 0626Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
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Valenzuela PL, Saco-Ledo G, Santos-Lozano A, Morales JS, Castillo-García A, Simpson RJ, Lucia A, Fiuza-Luces C. Exercise Training and Natural Killer Cells in Cancer Survivors: Current Evidence and Research Gaps Based on a Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:36. [PMID: 35244811 PMCID: PMC8897541 DOI: 10.1186/s40798-022-00419-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/13/2022] [Indexed: 12/25/2022]
Abstract
Background Exercise training can positively impact the immune system and particularly natural killer (NK) cells, at least in healthy people. This effect would be of relevance in the context of cancer given the prominent role of these cells in antitumor immunity. In this systematic review and meta-analysis, we aimed to summarize current evidence on the effects of exercise training on the levels and function of NK cells in cancer survivors (i.e., from the time of diagnosis until the end of life). Methods Relevant articles were searched in PubMed, Scopus, Web of Science and Cochrane Central Register of Controlled Trials (until January 11, 2022). Randomized controlled trials (RCT) of exercise training (i.e., non-acute) interventions vs usual care conducted in cancer survivors and assessing NK number and/or cytotoxic activity (NKCA) before and upon completion of the intervention were included. Methodological quality of the studies was assessed with the PEDro scale, and results were meta-analyzed using a random effects (Dersimoian and Laird) model. Results Thirteen RCT including 459 participants (mean age ranging 11–63 years) met the inclusion criteria. Methodological quality of the studies was overall fair (median PEDro score = 5 out of 10). There was heterogeneity across studies regarding cancer types (breast cancer, non-small cell lung cancer and other solid tumors), treatment (e.g., receiving vs having received chemotherapy), exercise modes (aerobic or resistance exercise, Tai Chi, Yoga) and duration (2–24 weeks). No consistent effects were observed for NK number in blood (mean difference [MD]: 1.47, 95% confidence interval [CI] − 0.35 to 3.29, p = 0.113) or NKCA as assessed in vitro (MD: − 0.02, 95%CI − 0.17 to 0.14, p = 0.834). However, mixed results existed across studies, and some could not be meta-analyzed due to lack of information or methodological heterogeneity. Conclusions Current evidence does not support a significant effect of exercise training intervention on NK cells in blood or on their ‘static response’ (as assessed in vitro) in cancer survivors. Several methodological issues and research gaps are highlighted in this review, which should be considered in future studies to draw definite conclusions on this topic. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00419-w.
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Affiliation(s)
- Pedro L Valenzuela
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Sanitaria Hospital, '12 de Octubre' ('imas12'), Centro de Actividades Ambulatorias (CAA), 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain
| | - Gonzalo Saco-Ledo
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Sanitaria Hospital, '12 de Octubre' ('imas12'), Centro de Actividades Ambulatorias (CAA), 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Sanitaria Hospital, '12 de Octubre' ('imas12'), Centro de Actividades Ambulatorias (CAA), 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain.,I+HeALTH, Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | | | - Richard J Simpson
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, USA.,Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Immunobiology, The University of Arizona, Tucson, AZ, USA
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Sanitaria Hospital, '12 de Octubre' ('imas12'), Centro de Actividades Ambulatorias (CAA), 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain
| | - Carmen Fiuza-Luces
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Sanitaria Hospital, '12 de Octubre' ('imas12'), Centro de Actividades Ambulatorias (CAA), 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain.
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Coletta AM, Agha NH, Baker FL, Niemiro GM, Mylabathula PL, Brewster AM, Bevers TB, Fuentes-Mattei E, Basen-Engquist K, Gilchrist SC, Simpson RJ. The impact of high-intensity interval exercise training on NK-cell function and circulating myokines for breast cancer prevention among women at high risk for breast cancer. Breast Cancer Res Treat 2021; 187:407-416. [PMID: 33555464 PMCID: PMC8189992 DOI: 10.1007/s10549-021-06111-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/21/2021] [Indexed: 12/31/2022]
Abstract
Purpose Preclinical evidence suggests that natural killer cell (NK-cell) function and myokines facilitate the protective effects of exercise for breast cancer prevention. Since higher-intensity exercise acutely promotes greater mobilization and larger changes in NK-cell cytotoxicity than lower-intensity, high-intensity interval training (HIIT) might offer increased immune protection compared to moderate-intensity continuous-training (MICT). This study compared a 12-week HIIT program to a 12-week MICT program and usual care on changes in resting NK-cell function and circulating myokines among women at high risk for breast cancer. Methods Thirty-three women were randomized to HIIT, MICT, or usual care, for a supervised exercise intervention. Blood was collected at baseline and end-of-study. The cytotoxic activity of CD3−/CD56+ NK-cells against the K562 target cell line in vitro was determined by flow cytometry. Circulating myokines (IL-15, IL-6, irisin, OSM, osteonectin, IL-7) were assessed with luminex multiplex assays and ELISA. One-way ANOVA and paired sample t-tests assessed between- and within-group differences, respectively. Pearson correlation coefficients determined relationships between baseline fitness and change variables. Results Significant differences were not observed between groups for change in NK-cell function or circulating myokines (p > 0.05). Significant correlations were only observed for baseline peak aerobic capacity (ml/kg/min) and change in NK-cell-specific lysis (r = − 0.43, p = 0.02) and hemacytotoxicity for the total sample (r = − 0.46, p = 0.01). Conclusion Our findings suggest that exercise intensity may not significantly impact change in resting NK-cell function and circulating myokines among women at high risk for breast cancer. Structured exercise training may have a larger impact on NK-cell function in those with lower levels of cardiorespiratory fitness. Clinical trial registration: NCT02923401; Registered on October 4, 2016
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Affiliation(s)
- Adriana M Coletta
- Department of Health and Kinesiology, The University of Utah, Salt Lake City, UT, USA. .,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT, USA. .,Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Research South Building Room 4747, Salt Lake City, UT, 84112, USA.
| | - Nadia H Agha
- Department of Health and Human Performance, The University of Houston, Houston, TX, USA
| | - Forrest L Baker
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA
| | - Grace M Niemiro
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA
| | - Preteesh L Mylabathula
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA
| | - Abenaa M Brewster
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Therese B Bevers
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Enrique Fuentes-Mattei
- Department of Radiation Oncology Clinical Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard J Simpson
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Immunobiology, The University of Arizona, Tucson, AZ, USA.,The University of Arizona Cancer Center, Tucson, AZ, USA
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Tailored Exercise during Hematopoietic Stem Cell Transplantation Hospitalization in Children with Cancer: A Prospective Cohort Study. Cancers (Basel) 2020; 12:cancers12103020. [PMID: 33080908 PMCID: PMC7650695 DOI: 10.3390/cancers12103020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 02/08/2023] Open
Abstract
We assessed the clinical effects of a supervised exercise (aerobic + resistance) intervention performed during inpatient hospitalization for pediatric hematopoietic stem cell transplantation (HSCT). Patients were placed in an exercise (n = 65 (47 and 18 with allogeneic (allo-) and autologous (auto-) HSCT, respectively)) or a control (n = 53 (39 and 14)) group. Exercise interventions were performed in isolated hospital patient rooms. Patients were followed-up from the beginning of the conditioning phase up to 6 years. We assessed survival, risk of graft-versus-host disease (GvHD) or graft failure (primary outcomes), and engraftment kinetics, supportive care, toxicity profile, and immune reconstitution for auto-HSCT and allo-HSCT. The exercise intervention was safe and did not affect the risk of mortality, acute/chronic GvHD, or graft failure (all p > 0.05). No between-group differences (p > 0.05) were found for the remainder of clinical endpoints, except for a reduced number of total and viral infections in the exercise group after allo-HSCT (unadjusted p = 0.005 for both total and viral infections, and adjusted p = 0.023 and 0.083, respectively). In conclusion, exercise performed during inpatient hospitalization for pediatric HSCT is safe and well tolerated during both auto and allo-HSCT and tends to decrease the risk of infection after allo-HSCT. These findings provide additional support to the notion that a multidisciplinary approach (i.e., including the work of exercise specialists) is suitable in the management of children undergoing HSCT. Further studies are needed to determine whether applying a different training stimulus (notably, higher exercise intensities) exerts positive effects on HSCT prognosis in these patients.
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