Di Gennaro P, Gerlini G, Urso C, Sestini S, Brandani P, Pimpinelli N, Borgognoni L
Plastic and Reconstructive Surgery Unit - Regional Melanoma Referral Center - Tuscan Tumour Institute (ITT), Santa Maria Annunziata Hospital, Via Antella, 58-50012, Bagno a Ripoli, Florence, Italy.
Department of Anatomic Pathology - Dermatopathology Section, Santa Maria Annunziata Hospital, Florence, Italy.
Clin Exp Metastasis. 2016 Dec;33(8):787-798. doi: 10.1007/s10585-016-9814-x. Epub 2016 Jul 30.
Electrochemotherapy (ECT) represents an effective local treatment for skin unresectable melanoma metastases with high overall objective response rate. ECT is based on the combination of anti-neoplastic drugs administration and cancer cells electroporation. Whether ECT can also activate the immune system is a matter of debate, however a significant recruitment of dendritic cells in melanoma treated metastases has been described. Herein we investigated immediate and late effects of ECT treatment on T cell subsets in ECT-treated lesions by fluorescent immunohistochemistry. Biopsies from melanoma patients (n = 10) were taken before ECT (t0), at d1 and d14 from treatment. At t0, CD3CD4 T cells were the most represented T cells, well detected in the perilesional dermis, particularly at tumour margin, while CD3CD8 T cells were less represented. CD4FOXP3 T regulatory (Treg) cells were present in the perilesional dermis and within the lesion. ECT induced a significant decrease of CD4FOXP3 Treg cells percentage in the perilesional dermis, observed at d1 and at d14 (p < 0.001). CD3CD8 T cells frequency significantly increased at d14 from treatment in the perilesional dermis (p < 0.001). Furthermore calreticulin translocation to the plasma membrane, a hallmark of immunogenic cell death, was observed in metastatic cells after ECT. The data reported here confirm that ECT induces a local response, with a lymphoid infiltrate characterized by CD4FOXP3 Treg cells decrease and CD3CD8 T cells recruitment in the treated lesions. These results might contribute to design novel combinational therapeutic approaches with ECT and immunotherapy in order to generate a systemic long-lasting anti-melanoma immunity.
电化学疗法(ECT)是一种有效的局部治疗方法,用于治疗无法切除的皮肤黑色素瘤转移灶,总体客观缓解率较高。ECT基于抗肿瘤药物给药与癌细胞电穿孔的联合应用。ECT是否也能激活免疫系统仍存在争议,然而,已有研究描述了在接受ECT治疗的黑色素瘤转移灶中树突状细胞的显著募集。在此,我们通过荧光免疫组织化学研究了ECT治疗对ECT治疗病灶中T细胞亚群的即时和晚期影响。在ECT治疗前(t0)、治疗后第1天(d1)和第14天(d14)采集黑色素瘤患者(n = 10)的活检样本。在t0时,CD3CD4 T细胞是最主要的T细胞,在病灶周围真皮中检测到,尤其是在肿瘤边缘,而CD3CD8 T细胞数量较少。CD4FOXP3 T调节(Treg)细胞存在于病灶周围真皮和病灶内。ECT导致病灶周围真皮中CD4FOXP3 Treg细胞百分比显著降低,在d1和d14时观察到(p < 0.001)。治疗后第14天,病灶周围真皮中CD3CD8 T细胞频率显著增加(p < 0.001)。此外,在ECT治疗后的转移细胞中观察到钙网蛋白易位至质膜,这是免疫原性细胞死亡的一个标志。此处报道的数据证实,ECT诱导局部反应,在治疗病灶中以CD4FOXP3 Treg细胞减少和CD3CD8 T细胞募集为特征的淋巴细胞浸润。这些结果可能有助于设计ECT与免疫疗法的新型联合治疗方法,以产生全身性的持久抗黑色素瘤免疫。