Department of Laboratory Medicine-Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands.
Biol Blood Marrow Transplant. 2018 Apr;24(4):666-677. doi: 10.1016/j.bbmt.2017.11.027. Epub 2017 Dec 26.
Allogeneic stem cell transplantation (allo-SCT) can be a curative treatment for patients with a hematologic malignancy due to alloreactive T cell responses recognizing minor histocompatibility antigens (MiHA). Yet tumor immune escape mechanisms can cause failure of T cell immunity, leading to relapse. Tumor cells display low expression of costimulatory molecules and can up-regulate coinhibitory molecules that inhibit T cell functionality on ligation with their counter-receptors on the tumor-reactive T cells. The aim of this explorative study was to evaluate immune checkpoint expression profiles on T cell subsets and on cytomegalovirus (CMV)- and/or MiHA-reactive CD8 T cells of allo-SCT recipients using a 13-color flow cytometry panel, and to correlate these expression patterns to clinical outcomes. MiHA-reactive CD8 T cells exhibited an early differentiated CD27/CD28 phenotype with low KLRG-1 and CD57 expression. These T cells also displayed increased expression of PD-1, TIM-3, and TIGIT compared with total effector memory T cells and CMV-specific CD8 T cells in healthy donors and allo-SCT recipients. Remarkably, high coexpression of PD-1, TIGIT, and KLRG-1 on MiHA-reactive CD8 T cells was associated with relapse after allo-SCT. Taken together, these findings indicate that MiHA-specific CD8 T cells of relapsed patients have a distinctive coinhibitory expression signature compared with patients who stay in remission. This phenotype may serve as a potential monitoring tool in patients. Moreover, these findings suggest that PD-1 and TIGIT play important roles in regulating T cell-mediated tumor control, providing a rationale for immunotherapy with blocking antibodies to treat relapse after allo-SCT.
同种异体干细胞移植(allo-SCT)可以通过识别次要组织相容性抗原(MiHA)的同种反应性 T 细胞反应为血液恶性肿瘤患者提供治愈性治疗。然而,肿瘤免疫逃逸机制可能导致 T 细胞免疫失效,从而导致复发。肿瘤细胞显示出低水平的共刺激分子表达,并可上调抑制性共抑制分子,这些分子在与肿瘤反应性 T 细胞上的对应受体结合时抑制 T 细胞功能。本探索性研究的目的是使用 13 色流式细胞术面板评估 allo-SCT 受者 T 细胞亚群和细胞巨化病毒(CMV)和/或 MiHA 反应性 CD8 T 细胞上的免疫检查点表达谱,并将这些表达模式与临床结果相关联。MiHA 反应性 CD8 T 细胞表现出早期分化的 CD27/CD28 表型,低表达 KLRG-1 和 CD57。与健康供体和 allo-SCT 受者中的总效应记忆 T 细胞和 CMV 特异性 CD8 T 细胞相比,这些 T 细胞还显示出 PD-1、TIM-3 和 TIGIT 的表达增加。值得注意的是,MiHA 反应性 CD8 T 细胞上 PD-1、TIGIT 和 KLRG-1 的高共表达与 allo-SCT 后复发相关。总之,这些发现表明与缓解期患者相比,复发患者的 MiHA 特异性 CD8 T 细胞具有独特的共抑制表达特征。这种表型可以作为患者监测的潜在工具。此外,这些发现表明 PD-1 和 TIGIT 在调节 T 细胞介导的肿瘤控制中起重要作用,为用阻断抗体进行免疫治疗以治疗 allo-SCT 后复发提供了依据。