Department of Urology, Peking University First Hospital and Institute of Urology, Peking University, Beijing, China.
National Research Center for Genitourinary Oncology, Beijing, China.
Prostate. 2019 Jun;79(9):1018-1031. doi: 10.1002/pros.23810. Epub 2019 Apr 24.
Chemotherapy with Docetaxel (Doc) is efficient in a subset of prostate cancer (PCa) cases; however, most patients ultimately develop resistance to Docetaxel. The tumor immune microenvironment and secreted cytokines play a substantial role in development of resistance to chemotherapy. Our previous study has demonstrated that CD4+ T cells in prostate tumor microenvironment contribute to PCa progression; meanwhile, we found increased CD4+ T-cell infiltration in tumor area after Doc treatment; however, their effects on PCa chemosensitivity remain unclear. Here, we aim to explore the role and mechanisms of CD4+ T cells in PCa chemotherapy sensitivity.
CD4+ T-cell infiltration in Doc-treated paraffin-embedded specimens from transurethral resection of prostate, radical prostatectomy, or bone metastasis was detected by immunohistochemistry. The castration-resistant PCa cell lines-C4-2 and CWR22RV1, and CD4+ T-cell lines-HH and Molt-3 were used in the coculture system. After coculture with the lymphocytes, PCa cell chemosensitivity was detected by cell counting kit-8, terminal deoxynucleotidyl transferase dUTP nick-end labeling assays, and Western blot analysis. Various cell cytokines were determined by cytokine arrays and reverse-transcription polymerase chain reaction. The recombinant human C-C motif chemokine ligand 5 (CCL5) was added to PCa cells for further confirming its effects and anti-CCL5 antibody was used for neutralization. S3I-201, a signal transducer and activator of transcription 3 (STAT3) inhibitor, was added to the coculture system to detect STAT3 role in chemosensitivity. Tumor xenografts in nude mice were used for confirming effects of CD4+ T cells in vivo study.
We found more infiltrated CD4+ T cells in human PCa lesions than in the adjacent noncancerous tissues after Doc treatment. In vitro cell line study confirmed that CD4+ T cells increase the PCa Doc resistance. Quantative polymerase chain reaction and cytokine arrays indicated that after coculture with PCa, CD4+ T cells could secrete large amounts of CCL5. Moreover, CCL5 stimulation enhanced PCa resistance to Doc, and anti-CCL5 antibody could partly reverse this process. We found that CD4+ T cells could activate P-STAT3 signaling via secreting CCL5 and adding a STAT3 inhibitor can reverse the chemoresistance. In vivo mouse model with xenografted 22RV1 cells and CD4+ T cells also confirmed the in vitro results.
Together, our results indicate that infiltrating CD4+ T cells could promote PCa chemotherapy resistance via modulation of the CCL5/STAT3 signaling pathway.
多西紫杉醇(Doc)化疗在前列腺癌(PCa)病例亚组中有效;然而,大多数患者最终对多西紫杉醇产生耐药性。肿瘤免疫微环境和分泌的细胞因子在化疗耐药性的发展中起着重要作用。我们之前的研究表明,前列腺肿瘤微环境中的 CD4+T 细胞有助于 PCa 的进展;同时,我们发现 Doc 治疗后肿瘤区域的 CD4+T 细胞浸润增加;然而,它们对 PCa 化疗敏感性的影响尚不清楚。在这里,我们旨在探索 CD4+T 细胞在 PCa 化疗敏感性中的作用和机制。
通过免疫组织化学检测经尿道前列腺切除术、根治性前列腺切除术或骨转移的 Doc 处理的石蜡包埋标本中的 CD4+T 细胞浸润。使用共培养系统中的去势抵抗性 PCa 细胞系-C4-2 和 CWR22RV1 以及 CD4+T 细胞系-HH 和 Molt-3。与淋巴细胞共培养后,通过细胞计数试剂盒-8、末端脱氧核苷酸转移酶 dUTP 缺口末端标记测定和 Western blot 分析检测 PCa 细胞的化疗敏感性。通过细胞因子阵列和逆转录聚合酶链反应测定各种细胞因子。向 PCa 细胞中添加重组人 C-C 基序趋化因子配体 5(CCL5)以进一步确认其作用,并使用抗 CCL5 抗体进行中和。在共培养系统中添加信号转导和转录激活因子 3(STAT3)抑制剂 S3I-201,以检测 STAT3 在化疗敏感性中的作用。使用裸鼠肿瘤异种移植进行体内研究以确认 CD4+T 细胞的作用。
我们发现,在 Doc 治疗后,人前列腺癌病变中的浸润性 CD4+T 细胞比相邻的非癌组织多。体外细胞系研究证实,CD4+T 细胞增加了 PCa 对 Doc 的耐药性。定量聚合酶链反应和细胞因子阵列表明,与 PCa 共培养后,CD4+T 细胞可大量分泌 CCL5。此外,CCL5 刺激增强了 PCa 对 Doc 的耐药性,而抗 CCL5 抗体可部分逆转这一过程。我们发现,CD4+T 细胞可以通过分泌 CCL5激活 P-STAT3 信号,添加 STAT3 抑制剂可以逆转耐药性。带有 22RV1 细胞和 CD4+T 细胞的异种移植小鼠模型也证实了体外结果。
综上所述,我们的结果表明,浸润性 CD4+T 细胞可通过调节 CCL5/STAT3 信号通路促进 PCa 化疗耐药性。