Krönig Holger, Kremmler Lukas, Haller Bernhard, Englert Carsten, Peschel Christian, Andreesen Reinhard, Blank Christian U
Department of Hematology and Medical Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
Eur J Haematol. 2014 Mar;92(3):195-203. doi: 10.1111/ejh.12228. Epub 2013 Nov 26.
While current treatment for acute myeloid leukemia is characterized by high response rates, patients' long-term outcome is still disappointing, due to frequent relapse and ineligibility of the often elderly patients for stem cell transplantation approaches. Considerable efforts have, thus, been made to incorporate immunotherapeutic approaches in the acute myeloid leukemia (AML) consolidation, with so far disappointing clinical benefit. The B7 family ligand programmed-death receptor-ligand 1 (PD-L1, B7-H1, CD274) has been recently described (with conflicting results) to be expressed on AML blast cells, and interaction with its receptor on T cells, programmed death receptor-1 (PD-1, CD279), has been shown to suppress T-cell functions and to allow survival of dormant AML cells in animal models.
In this work, we analyzed freshly isolated myeloid precursor cells from healthy donors and from AML patients for PD-L1 expression with or without interferon-γ exposure at different time points during their treatment.
While without IFN exposure, only minor differences were observed, we found IFN-γ-induced PD-L1 expression most prominent after initial treatment and independent of treatment outcome.
Our observations support the recently suggested PD-L1-mediated adaptive immune resistance and argue for a targeting of the PD-L1/PD-1 pathway during the consolidation phase of AML treatment.
虽然目前急性髓系白血病的治疗具有较高的缓解率,但由于频繁复发以及老年患者往往不符合干细胞移植治疗的条件,患者的长期预后仍然令人失望。因此,人们付出了巨大努力将免疫治疗方法纳入急性髓系白血病(AML)的巩固治疗中,但迄今为止临床获益令人失望。B7家族配体程序性死亡受体配体1(PD-L1,B7-H1,CD274)最近被报道(结果相互矛盾)在AML原始细胞上表达,并且在动物模型中已表明其与T细胞上的受体程序性死亡受体1(PD-1,CD279)相互作用可抑制T细胞功能并使休眠的AML细胞存活。
在这项研究中,我们分析了来自健康供体和AML患者的新鲜分离的髓系前体细胞在治疗期间不同时间点有无γ干扰素暴露情况下的PD-L1表达。
在未暴露于IFN的情况下,仅观察到微小差异,但我们发现γ干扰素诱导的PD-L1表达在初始治疗后最为显著,且与治疗结果无关。
我们的观察结果支持最近提出的PD-L1介导的适应性免疫抵抗,并主张在AML治疗的巩固阶段靶向PD-L1/PD-1通路。