Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA.
Department of Dermatology and Internal Medicine, University of California, Davis, Sacramento, California, USA.
JCI Insight. 2019 Jun 18;5(14):127729. doi: 10.1172/jci.insight.127729.
NK cell exhaustion (NCE) due to sustained proliferation results in impaired NK cell function with loss of cytokine production and lytic activity. Using murine models of chronic NK cell stimulation, we have identified a phenotypic signature of NCE characterized by up-regulation of the terminal differentiation marker KLRG1 and by down-regulation of eomesodermin and the activating receptor NKG2D. Chronic stimulation of mice lacking NKG2D resulted in minimized NCE compared to control mice, thus identifying NKG2D as a crucial mediator of NCE. NKG2D internalization and downregulations on NK cells has been previously observed in the presence of tumor cells with high expression of NKG2D ligands (NKG2DL) due to the activation of the DNA damage repair pathways. Interestingly, our study revealed that during NK cell activation there is an increase of MULT1, and NKG2DL, that correlates with an induction of DNA damage. Treatment with the ATM DNA damage repair pathway inhibitor KU55933 (KU) during activation reduced NCE by improving expression of activation markers and genes involved in cell survival, by sustaining NKG2D expression and by preserving cell functionality. Importantly, NK cells expanded ex vivo in the presence of KU displayed increased anti-tumor efficacy in both NKG2D-dependent and -independent mouse models. Collectively, these data demonstrate that NCE is caused by DNA damage and regulated, at least in part, by NKG2D. Further, the prevention of NCE is a promising strategy to improve NK cell-based immunotherapy.
自然杀伤 (NK) 细胞耗竭 (NCE) 是由于持续增殖导致 NK 细胞功能受损,表现为细胞因子产生和裂解活性丧失。通过慢性 NK 细胞刺激的小鼠模型,我们确定了 NCE 的表型特征,其特征在于终末分化标记物 KLRG1 的上调以及 eomesodermin 和激活受体 NKG2D 的下调。与对照小鼠相比,缺乏 NKG2D 的小鼠慢性刺激导致 NCE 最小化,从而鉴定出 NKG2D 是 NCE 的关键介质。由于 DNA 损伤修复途径的激活,先前已经在高表达 NKG2D 配体 (NKG2DL) 的肿瘤细胞存在的情况下观察到 NK 细胞上的 NKG2D 内化和下调。有趣的是,我们的研究表明,在 NK 细胞激活期间,MULT1 和 NKG2DL 的表达增加,这与 DNA 损伤的诱导相关。在激活过程中用 ATM DNA 损伤修复途径抑制剂 KU55933 (KU) 处理可通过改善激活标记物和参与细胞存活的基因的表达、维持 NKG2D 表达和保持细胞功能来减少 NCE。重要的是,在 KU 存在下体外扩增的 NK 细胞在 NKG2D 依赖性和非依赖性小鼠模型中均显示出增强的抗肿瘤功效。总之,这些数据表明 NCE 是由 DNA 损伤引起的,并至少部分受到 NKG2D 的调节。此外,预防 NCE 是提高基于 NK 细胞的免疫疗法的有前途的策略。
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