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射频消融肝癌增强肿瘤相关抗原特异性 T 细胞反应。

Enhancement of tumor-associated antigen-specific T cell responses by radiofrequency ablation of hepatocellular carcinoma.

机构信息

Department of Gastroenterology, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.

出版信息

Hepatology. 2013 Apr;57(4):1448-57. doi: 10.1002/hep.26153.

Abstract

UNLABELLED

Radiofrequency ablation (RFA) is one of the treatments for hepatocellular carcinoma (HCC) and is known to enhance host immune response. However, the epitopes to which enhanced immune responses occur, the impact on patient prognosis, and the functions and phenotype of T cells induced are still unclear. To address these issues, we analyzed immune responses before and after RFA in 69 HCC patients using 11 tumor-associated antigen (TAA)-derived peptides that we identified to be appropriate to analyze HCC-specific immune responses. The immune responses were analyzed using enzyme-linked immunospot (ELISPOT) assay and tetramer assays using peripheral blood mononuclear cells. An increase in the number of TAA-specific T cells detected by interferon-γ ELISPOT assays occurred in 62.3% of patients after RFA. The antigens and their epitope to which enhanced T cell responses occur were diverse, and some of them were newly induced. The number of TAA-specific T cells after RFA was associated with the prevention of HCC recurrence, and it was clarified to be predictive of HCC recurrence after RFA by univariate and multivariate analyses. The number of TAA-specific T cells after RFA was inversely correlated with the frequency of CD14+ HLA-DR(-/low) myeloid-derived suppressor cells (MDSCs). The modification of T cell phenotype was observed after RFA. The number of TAA-specific T cells at 24 weeks after RFA was decreased.

CONCLUSION

Although RFA can enhance various TAA-specific T cell responses and the T cells induced contribute to the HCC recurrence-free survival of patients, besides immunosuppression by MDSCs, the memory phenotype and lifetime of TAA-specific T cells are not sufficient to prevent HCC recurrence completely. Additional treatments by vaccine or immunomodulatory drugs might be useful to improve the immunological effect of RFA.

摘要

目的

射频消融(RFA)是治疗肝细胞癌(HCC)的方法之一,已知其可增强宿主的免疫反应。然而,增强免疫反应的表位、对患者预后的影响以及诱导的 T 细胞的功能和表型仍不清楚。为了解决这些问题,我们使用 11 种肿瘤相关抗原(TAA)衍生肽分析了 69 例 HCC 患者 RFA 前后的免疫反应,这些肽被认为适合分析 HCC 特异性免疫反应。使用酶联免疫斑点(ELISPOT)分析和外周血单个核细胞的四聚体分析来分析免疫反应。RFA 后,62.3%的患者 IFN-γ ELISPOT 检测到 TAA 特异性 T 细胞数量增加。增强 T 细胞反应的抗原及其表位多种多样,其中一些是新诱导的。RFA 后 TAA 特异性 T 细胞的数量与预防 HCC 复发有关,通过单因素和多因素分析证实其可预测 RFA 后 HCC 复发。RFA 后 TAA 特异性 T 细胞的数量与 CD14+HLA-DR(-/低)髓系来源抑制细胞(MDSCs)的频率呈负相关。RFA 后观察到 T 细胞表型的修饰。RFA 后 24 周时 TAA 特异性 T 细胞的数量减少。

结论

尽管 RFA 可以增强各种 TAA 特异性 T 细胞反应,并且诱导的 T 细胞有助于 HCC 无复发生存,但除了 MDSCs 的免疫抑制作用外,TAA 特异性 T 细胞的记忆表型和寿命不足以完全预防 HCC 复发。疫苗或免疫调节药物的额外治疗可能有助于提高 RFA 的免疫效果。

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