Division of Hepatology and Gene Therapy, Center for Applied Medical Research, University of Navarra, Pamplona, 31008 Navarra, Spain.
J Immunol. 2011 Jan 15;186(2):807-15. doi: 10.4049/jimmunol.1001483. Epub 2010 Dec 8.
IL-12 is a potent immunostimulatory cytokine, but its impact as an antitumor drug in clinical practice is limited. Upsurge of regulatory T cells (Treg) in the tumor milieu has been proposed to limit the efficacy of the treatment. In this paper, two drugs (cyclophosphamide [CPA] and anti-CD25 mAb) widely used to eliminate Treg were used in an attempt to enhance the antitumor effect of IL-12 gene therapy. Both anti-CD25 and CPA combined with IL-12 were able to deplete intratumoral Treg and myeloid-derived suppressor cells (MDSC), but only IL-12 plus CPA achieved significant antitumor activity in mice with large established s.c. colon carcinoma. This therapeutic effect was associated with the emergence of a heterogeneous population of myeloid cells within the tumor, termed inflammatory myeloid cells (IMC), composed of Ly6C(high)Ly6G(low) inflammatory monocytes and Ly6G(high)Ly6C(+) neutrophils. IMC showed a distinctive pattern of cytokine/chemokine production, and in contrast to MDSC, they did not induce conversion of naive CD4(+) T cells into Treg. The appearance of IMC coincided with intense tumor infiltration by effector T cells, which was abrogated by elimination of IMC by anti-Gr1 mAb, a maneuver that abolished the antitumor effect of the therapy. Therefore, the combination of IL-12 and CPA eliminates intratumoral Treg and MDSC, while it induces the appearance of IMC within the tumor microenvironment. The latter effect is essential to facilitate effector T cell infiltration and subsequent tumor elimination.
白细胞介素 12(IL-12)是一种有效的免疫刺激细胞因子,但在临床实践中作为抗肿瘤药物的效果有限。肿瘤微环境中调节性 T 细胞(Treg)的增加被认为限制了治疗的疗效。在本文中,我们使用两种广泛用于消除 Treg 的药物(环磷酰胺[CPA]和抗-CD25 mAb)来尝试增强 IL-12 基因治疗的抗肿瘤作用。抗-CD25 和 CPA 联合使用均可耗尽肿瘤内的 Treg 和髓源抑制细胞(MDSC),但只有 IL-12 联合 CPA 才能在皮下建立的大型结肠癌细胞癌小鼠中实现显著的抗肿瘤活性。这种治疗效果与肿瘤内出现异质髓样细胞有关,称为炎症性髓样细胞(IMC),由 Ly6C(高)Ly6G(低)炎症单核细胞和 Ly6G(高)Ly6C(+)中性粒细胞组成。IMC 表现出独特的细胞因子/趋化因子产生模式,与 MDSC 不同,它们不会诱导幼稚 CD4(+)T 细胞转化为 Treg。IMC 的出现与效应 T 细胞在肿瘤中的强烈浸润相一致,而通过抗-Gr1 mAb 消除 IMC 则会消除这种浸润,从而消除治疗的抗肿瘤作用。因此,IL-12 和 CPA 的联合使用可消除肿瘤内的 Treg 和 MDSC,同时诱导肿瘤微环境中 IMC 的出现。后一种效应对于促进效应 T 细胞浸润和随后的肿瘤消除是必不可少的。