Interaktionen von dendritischen Zellen und Effektorzellen der frühen antitumoralen Immunabwehr

In den letzten Jahren ergaben sich vermehrt Hinweise, dass dendritische Zellen (DCs) zu einer Stimulation von Natürlichen „Killer“ (NK)-Zellen in der Lage sind, die als zytotoxische Effektorzellen des angeborenen Immunsystems Tumorzellen eliminieren. Aus diesem Grund bestand ein wesentliches Ziel dieser Arbeit in der Analyse der Wechselwirkungen zwischen nativen DCs und NK-Zellen. Dazu wurden slanDCs verwendet, welche die größte DC-Subpopulation des Blutes repräsentieren. Zunächst wurde evaluiert, ob slanDCs eine effiziente Aktivierung von NK-Zellen bewirken. Als ein Ergebnis zeigte sich, dass Lipopolysaccharid (LPS)-stimulierte slanDCs sowohl zu einer verstärkten Expression des Aktivierungsmarkers CD69 auf der Oberfläche von NK-Zellen als auch zur Induktion der NK-Zell-Proliferation führen. Darüber hinaus wurde erstmals die slanDC-abhängige Erhöhung der Expression von aktivierenden Rezeptoren (NKp46, NKp44, NKp30) und Korezeptoren (2B4, DNAM-1) auf NK-Zellen demonstriert, welche essentiell für die NK-Zell-vermittelte Erkennung und Lyse von Tumorzellen sind. In weiteren Untersuchungen induzierten LPS-aktivierte slanDCs eine erhebliche Produktion von Interferon (IFN)-gamma in NK-Zellen, welches proliferationshemmend auf Tumorzellen und aktivierend auf T-Lymphozyten wirkt. Funktionelle Analysen ergaben, dass aktivierte slanDCs das zytotoxische Potential von NK-Zellen gegenüber der Tumorzelllinie K-562 deutlich verstärken. Untersuchungen der zugrunde liegenden Mechanismen zeigten die herausragende Bedeutung von IL-12, das sowohl die Steigerung der IFN-gamma-Sekretion als auch die Zunahme der zytolytischen Aktivität von NK-Zellen induzierte. Darüber hinaus konnte erstmals gezeigt werden, dass LPS-aktivierte slanDCs eine Zytotoxizität von NK-Zellen gegenüber frisch etablierten Blasten von Patienten mit akuter myeloischer Leukämie induzieren. In weiteren Untersuchungen wurde evaluiert, ob NK-Zellen ihrerseits die immunstimulatorischen Eigenschaften von slanDCs beeinflussen. Die Analysen zeigten erstmals, dass unstimulierte NK-Zellen die Expression von MHC-Klasse II-Molekülen, kostimulatorischen Molekülen und Adhäsionsmolekülen auf slanDCs deutlich erhöhen und somit ihre Fähigkeit zur Aktivierung von CD8+ T-Lymphozyten sowie CD4+ T-Helferzellen fördern. NK-Zellen führen ebenfalls zu einer deutlichen Verstärkung der Produktion von IL-12 durch LPS-stimulierte slanDCs. Darüber hinaus zeigte sich, dass NK-Zellen die Sekretion des immunsuppressiven Zytokins IL-10 durch LPS-stimulierte slanDCs reduzieren. In weiteren Analysen wurde demonstriert, dass die Interaktionen mit NK Zellen die Fähigkeit von LPS-aktivierten slanDCs zur Programmierung naiver CD4+ T-Lymphozyten in IFN-gamma-produzierende T-Helfer-1-Zellen deutlich verstärken. Diese Ergebnisse zeigten deutlich, dass stimulierte slanDCs und NK-Zellen in der Lage sind, sich wechselseitig zu aktivieren. NKT-Zellen repräsentieren eine weitere bedeutende Effektorzellpopulation der frühen antitumoralen Immunabwehr, die durch Sekretion von Zytokinen und ein ausgeprägtes zytolytisches Potential zur Elimination von Tumorzellen beiträgt. Deshalb wurden im Rahmen dieser Arbeit erstmals die Wechselwirkungen zwischen slanDCs und NKT-Zellen analysiert. Dabei verstärkten LPS-stimulierte slanDCs die Expression des Aktivierungsmarkers CD69 auf NKT-Zellen. Darüber hinaus induzierten LPS-aktivierte slanDCs eine deutliche IFN-gamma-Produktion in NKT-Zellen, wobei erneut die zentrale Rolle von IL-12 gezeigt wurde. Diese Ergebnisse demonstrierten, dass stimulierte slanDCs zu einer effektiven Aktivierung von NKT Zellen in der Lage sind. In abschließenden Untersuchungen wurde die Wirkung von NKT-Zellen auf slanDCs evaluiert. Dabei verstärkten NKT-Zellen die Maturierung von slanDCs erheblich und führten zu einer signifikanten Steigerung der IL-12-Produktion sowie zu einer Reduktion der IL-10-Freisetzung in Abhängigkeit von IFN-gamma. Die gewonnenen Daten demonstrierten, dass NKT-Zellen und slanDCs zu einer gegenseitigen Aktivierung befähigt sind. Die im Rahmen dieser Dissertation gewonnenen Erkenntnisse zu den Interaktionen von slanDCs und NK- bzw. NKT-Zellen können einen wesentlichen Beitrag zum Verständnis der Immunabwehr von Tumoren leisten und die Konzeption neuer antitumoraler Therapiestrategien unterstützen

Tumor-associated human dendritic cell subsets: Phenotype, functional orientation, and clinical relevance

DCs play a pivotal role in orchestrating innate and adaptive antitumor immunity. Activated DCs can produce large amounts of various proinflammatory cytokines, initiate T-cell responses, and exhibit direct cytotoxicity against tumor cells. They also efficiently enhance the antitumoral properties of NK cells and T lymphocytes. Based on these capabilities, immunogenic DCs promote tumor elimination and are associated with improved survival of patients. Furthermore, they can essentially contribute to the clinical efficacy of immunotherapeutic strategies for cancer patients. However, depending on their intrinsic properties and the tumor microenvironment, DCs can be rendered dysfunctional and mediate tolerance by producing immunosuppressive cytokines and activating Treg cells. Such tolerogenic DCs can foster tumor progression and are linked to poor prognosis of patients. Here, we focus on recent studies exploring the phenotype, functional orientation, and clinical relevance of tumor-infiltrating conventional DC1, conventional DC2, plasmacytoid DCs, and monocyte-derived DCs in translational and clinical settings. In addition, recent findings demonstrating the influence of DCs on the efficacy of immunotherapeutic strategies are summarized

Repeated lipoprotein apheresis and immune response: Effects on different immune cell populations

BACKGROUND Atherosclerosis is considered a chronic inflammation of arterial vessels with the involvement of several immune cells causing severe cardiovascular diseases. Lipoprotein apheresis (LA) improves cardiovascular conditions of patients with severely disturbed lipid metabolism. In this context, little is known about the impact of LA on various immune cell populations, especially over time. METHODS Immune cells of 18 LA-naïve patients starting weekly LA treatment were analyzed before and after four apheresis cycles over the course of 24 weeks by flow cytometry. RESULTS AND CONCLUSIONS An acute lowering effect of LA on T cell and natural killer (NK) cell subpopulations expressing CD69 was observed. The non-classical and intermediate monocyte subsets as well as HLA-DR$^{+}$ 6-sulfo LacNAc$^{+}$ monocytes were significantly reduced during the apheresis procedure. We conclude that LA has the capacity to alter various immune cell subsets. However, LA has mainly short-term effects than long-term consequences on proportions of immune cells

Repeated lipoprotein apheresis and immune response: Effects on different immune cell populations

Background: Atherosclerosis is considered a chronic inflammation of arterial vessels with the involvement of several immune cells causing severe cardiovascular diseases. Lipoprotein apheresis (LA) improves cardiovascular conditions of patients with severely disturbed lipid metabolism. In this context, little is known about the impact of LA on various immune cell populations, especially over time. Methods: Immune cells of 18 LA-naïve patients starting weekly LA treatment were analyzed before and after four apheresis cycles over the course of 24 weeks by flow cytometry. Results and Conclusions: An acute lowering effect of LA on T cell and natural killer (NK) cell subpopulations expressing CD69 was observed. The nonclassical and intermediate monocyte subsets as well as HLA-DR+ 6-sulfo LacNAc+ monocytes were significantly reduced during the apheresis procedure. We conclude that LA has the capacity to alter various immune cell subsets. However, LA has mainly short-term effects than long-term consequences on proportions of immune cells

Dendritic Cell-Based Immunotherapy for Prostate Cancer

Dendritic cells (DCs) are professional antigen-presenting cells (APCs), which display an extraordinary capacity to induce, sustain, and regulate T-cell responses providing the opportunity of DC-based cancer vaccination strategies. Thus, clinical trials enrolling prostate cancer patients were conducted, which were based on the administration of DCs loaded with tumor-associated antigens. These clinical trials revealed that DC-based immunotherapeutic strategies represent safe and feasible concepts for the induction of immunological and clinical responses in prostate cancer patients. In this context, the administration of the vaccine sipuleucel-T consisting of autologous peripheral blood mononuclear cells including APCs, which were pre-exposed in vitro to the fusion protein PA2024, resulted in a prolonged overall survival among patients with metastatic castration-resistent prostate cancer. In April 2010, sipuleucel-T was approved by the United States Food and Drug Administration for prostate cancer therapy

The Evolving Landscape of Biomarkers for Anti-PD-1 or Anti-PD-L1 Therapy

The administration of antibodies blocking the immune checkpoint molecules programmed cell death protein 1 (PD-1) or programmed cell death 1 ligand 1 (PD-L1) has evolved as a very promising treatment option for cancer patients. PD-1/PD-L1 inhibition has significantly enhanced expansion, cytokine secretion, and cytotoxic activity of CD4+ and CD8+ T lymphocytes, resulting in enhanced antitumor responses. Anti-PD-1 or anti-PD-L1 therapy has induced tumor regression and improved clinical outcome in patients with different tumor entities, including melanoma, non-small-cell lung cancer, and renal cell carcinoma. These findings led to the approval of various anti-PD-1 or anti-PD-L1 antibodies for the treatment of tumor patients. However, the majority of patients have failed to respond to this treatment modality. Comprehensive immune monitoring of clinical trials led to the identification of potential biomarkers distinguishing between responders and non-responders, the discovery of modes of treatment resistance, and the design of improved immunotherapeutic strategies. In this review article, we summarize the evolving landscape of biomarkers for anti-PD-1 or anti-PD-L1 therapy

Type I conventional dendritic cells and CD8+ T cells predict favorable clinical outcome of head and neck squamous cell carcinoma patients

Head and neck squamous cell carcinoma (HNSCC) is one of the most common tumor entities worldwide, with human papillomavirus (HPV) infection contributing to cancer development. Conventional therapies achieve only limited efficiency, especially in recurrent or metastatic HNSCC. As the immune landscape decisively impacts the survival of patients and treatment efficacy, this study comprehensively investigated the immunological tumor microenvironment (TME) and its association with patient outcome, with special focus on several dendritic cell (DC) and T lymphocyte subpopulations. Therefore, formalin-fixed paraffin-embedded tumor samples of 56 HNSCC patients, who have undergone resection and adjuvant radiotherapy, were analyzed by multiplex immunohistochemistry focusing on the detailed phenotypic characterization and spatial distribution of DCs, CD8+ T cells, and T-helper cell subsets in different tumor compartments. Immune cell densities and proportions were correlated with clinical characteristics of the whole HNSCC cohort and different HPV- or hypoxia-associated subcohorts. Tumor stroma was highly infiltrated by plasmacytoid DCs and T lymphocytes. Among the T-helper cells and CD8+ T cells, stromal regulatory T cells and intraepithelial exhausted CD8+ T cells expressing programmed cell death protein-1 (PD-1+) and/or lymphocyte-activation gene-3 (LAG-3+) were the predominant phenotypes, indicating an immunosuppressive TME. HPV-associated tumors showed significantly higher infiltration of type I and type II conventional DCs (cDC1, cDC2) as well as several CD8+ T cell phenotypes including exhausted, activated, and proliferating T cells. On the contrary, tumors with hypoxia-associated gene signatures exhibited reduced infiltration for these immune cells. By multivariate Cox regression, immune-related prognostic factors were identified. Patient clusters defined by high infiltration of DCs and T lymphocytes combined with HPV positivity or low hypoxia showed significantly prolonged survival. Thereby, cDC1 and CD8+ T cells emerged as independent prognostic factors for local and distant recurrence. These results might contribute to the implementation of an immune cell infiltration score predicting HNSCC patients’ survival and such patient stratification might improve the design of future individualized radiochemo-(immuno)therapies

Phagosomal signalling of the C-type lectin receptor Dectin-1 is terminated by intramembrane proteolysis

Sensing of pathogens by pattern recognition receptors (PRR) is critical to initiate protective host defence reactions. However, activation of the immune system has to be carefully titrated to avoid tissue damage necessitating mechanisms to control and terminate PRR signalling. Dectin-1 is a PRR for fungal β-glucans on immune cells that is rapidly internalised after ligand-binding. Here, we demonstrate that pathogen recognition by the Dectin-1a isoform results in the formation of a stable receptor fragment devoid of the ligand binding domain. This fragment persists in phagosomal membranes and contributes to signal transduction which is terminated by the intramembrane proteases Signal Peptide Peptidase-like (SPPL) 2a and 2b. Consequently, immune cells lacking SPPL2b demonstrate increased anti-fungal ROS production, killing capacity and cytokine responses. The identified mechanism allows to uncouple the PRR signalling response from delivery of the pathogen to degradative compartments and identifies intramembrane proteases as part of a regulatory circuit to control anti-fungal immune responses

Phagosomal signalling of the C-type lectin receptor Dectin-1 is terminated by intramembrane proteolysis

Dectin-1 is a critical component of the innate sensing repertoire which is involved in pattern based recognition of fungal pathogens. Here the authors show that intramembrane proteolysis is involved in the regulation of the antifungal host response by termination of the phagosomal signalling of Dectin-1. Sensing of pathogens by pattern recognition receptors (PRR) is critical to initiate protective host defence reactions. However, activation of the immune system has to be carefully titrated to avoid tissue damage necessitating mechanisms to control and terminate PRR signalling. Dectin-1 is a PRR for fungal beta-glucans on immune cells that is rapidly internalised after ligand-binding. Here, we demonstrate that pathogen recognition by the Dectin-1a isoform results in the formation of a stable receptor fragment devoid of the ligand binding domain. This fragment persists in phagosomal membranes and contributes to signal transduction which is terminated by the intramembrane proteases Signal Peptide Peptidase-like (SPPL) 2a and 2b. Consequently, immune cells lacking SPPL2b demonstrate increased anti-fungal ROS production, killing capacity and cytokine responses. The identified mechanism allows to uncouple the PRR signalling response from delivery of the pathogen to degradative compartments and identifies intramembrane proteases as part of a regulatory circuit to control anti-fungal immune responses

Perturbations of mesenchymal stromal cells after allogeneic hematopoietic cell transplantation predispose for bone marrow graft- versus-host-disease

Functional impairment of the bone marrow (BM) niche has been suggested as a major reason for prolonged cytopenia and secondary graft failure after allogeneic hematopoietic cell transplantation (alloHCT). Because mesenchymal stromal cells (MSCs) serve as multipotent progenitors for several niche components in the BM, they might play a key role in this process. We used collagenase digested trephine biopsies to directly quantify MSCs in 73 patients before (n = 18) and/or after alloHCT (n = 65). For the first time, we demonstrate that acute graft-versus-host disease (aGvHD, n = 39) is associated with a significant decrease in MSC numbers. MSC reduction can be observed even before the clinical onset of aGvHD (n = 10). Assessing MSCs instantly after biopsy collection revealed phenotypic and functional differences depending on the occurrence of aGvHD. These differences vanished during ex vivo expansion. The MSC endotypes observed revealed an enhanced population of donor-derived classical dendritic cells type 1 and alloreactive T cells as the causing agent for compartmental inflammation and MSC damage before clinical onset of aGvHD was ascertained. In conclusion, MSCs endotypes may constitute a predisposing conductor of alloreactivity after alloHCT preceding the clinical diagnosis of aGvHD