Beyer Marc, Kochanek Matthias, Darabi Kamruz, Popov Alexey, Jensen Markus, Endl Elmar, Knolle Percy A, Thomas Roman K, von Bergwelt-Baildon Michael, Debey Svenja, Hallek Michael, Schultze Joachim L
Molecular Tumor Biology and Tumor Immunology Clinic I for Internal Medicine, University of Cologne, Joseph-Stelzmann Str 9/Haus 16, 50931 Cologne, Germany.
Blood. 2005 Sep 15;106(6):2018-25. doi: 10.1182/blood-2005-02-0642. Epub 2005 May 24.
Globally suppressed T-cell function has been described in many patients with cancer to be a major hurdle for the development of clinically efficient cancer immunotherapy. Inhibition of antitumor immune responses has been mainly linked to inhibitory factors present in cancer patients. More recently, increased frequencies of CD4+CD25hi regulatory T cells (Treg cells) have been described as an additional mechanism reducing immunity. We assessed 73 patients with B-cell chronic lymphocytic leukemia (CLL) and 42 healthy controls and demonstrated significantly increased frequencies of cytotoxic T lymphocyte-associated protein 4 (CTLA4+)-, Forkhead box P3 (FOXP3+)-, glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR+)-, CD62L+-, transforming growth factor beta1 (TGF-beta1+)-, interleukin 10 (IL-10+)-Treg cells in patients with CLL, with highest frequencies in untreated or progressing patients presenting with extended disease. Most surprisingly, in the majority of patients with CLL treated with fludarabine-containing therapy regimens the inhibitory function of Treg cells was decreased or even abrogated. In addition, frequencies of Treg cells were significantly decreased after therapy with fludarabine. In light of similar findings for cyclophosphamide the combination of fludarabine and cyclophosphamide might be further exploited in strategies reducing immunosuppression prior to cancer immunotherapy.
全球范围内,许多癌症患者的T细胞功能受到抑制,这被认为是临床有效癌症免疫治疗发展的主要障碍。抗肿瘤免疫反应的抑制主要与癌症患者体内存在的抑制因子有关。最近,CD4+CD25hi调节性T细胞(Treg细胞)频率增加被描述为另一种降低免疫力的机制。我们评估了73例B细胞慢性淋巴细胞白血病(CLL)患者和42例健康对照,结果显示CLL患者中细胞毒性T淋巴细胞相关蛋白4(CTLA4+)、叉头框P3(FOXP3+)、糖皮质激素诱导的肿瘤坏死因子受体相关蛋白(GITR+)、CD62L+、转化生长因子β1(TGF-β1+)、白细胞介素10(IL-10+)-Treg细胞的频率显著增加,在未治疗或病情进展且疾病范围扩大的患者中频率最高。最令人惊讶的是,在大多数接受含氟达拉滨治疗方案的CLL患者中,Treg细胞的抑制功能降低甚至消除。此外,氟达拉滨治疗后Treg细胞频率显著降低。鉴于环磷酰胺也有类似的发现,氟达拉滨和环磷酰胺的联合应用可能在癌症免疫治疗前降低免疫抑制的策略中得到进一步应用。
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