National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China.
Key Laboratory of Molecular Biophysics of Ministry of Education, Center for Human Genome Research, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China.
Theranostics. 2019 May 31;9(14):4115-4129. doi: 10.7150/thno.35131. eCollection 2019.
Galunisertib (Gal) is a transforming growth factor (TGF-β) blockade which is being investigated as a potential tumor immunotherapy candidate drug in clinical trials. However, primary or acquired resistance is often found in the recruited cancer patients, which limits its clinical application. Tumor immune microenvironment can be regulated by intestinal microbiota, leading to different therapeutic outcomes. It is hypothesized that manipulation of cancer patients' intestinal microbiome in the early stage of therapy may be a promising strategy to improve the therapeutic efficacy of Gal. : 4T1 and H22 subcutaneous tumor bearing mice were used to evaluate the therapeutic effect. strain Nissle 1917 (EcN), a widely used probiotic bacteria, was orally delivered to the tumor bearing mice daily along with Gal treatment. Antitumor effect of the combination therapy was evaluated by tumor volume, histological staining of tumor tissues. Furthermore, flow cytometry was performed to analyze the alteration of immune microenvironment in tumor bed after treatment. The suppressing effect of the combination therapy on tumor invasiveness and metastasis was evaluated in both mice and zebrafish xenografts models. Fecal sample 16S rRNA gene sequencing was conducted to analyze changes of intestinal microbial diversity. The effect of intestinal microbiota on tumor suppression after receiving EcN was further tested by fecal transplant. : The therapeutic outcomes in tumor growth inhibition and metastasis suppression of Gal were significantly potentiated by EcN, resulting from the strengthened antitumor immunity. EcN was able to relieve the immunosuppressive tumor microenvironment, which was evidenced by enhanced tumor-specific effector T cells infiltration and dendritic cells activation. Intestinal microbiota was modulated by EcN, illustrated by a shift of gut microbiome toward certain beneficial bacteria. : These results suggested that Gal combined with EcN might be a novel therapeutic approach with great potential of clinical implications for cancer prevention or treatment.
加鲁纳替布(Gal)是一种转化生长因子(TGF-β)阻断剂,目前正在临床试验中作为一种潜在的肿瘤免疫治疗候选药物进行研究。然而,招募的癌症患者中经常会出现原发性或获得性耐药,这限制了其临床应用。肿瘤免疫微环境可受肠道微生物群调节,从而导致不同的治疗结果。据推测,在治疗的早期阶段对癌症患者的肠道微生物群进行操作可能是提高 Gal 治疗效果的一种有前途的策略。
在 4T1 和 H22 皮下荷瘤小鼠中评估了治疗效果。每天用加鲁纳替布(Gal)治疗的同时,用口服方式给予肿瘤荷瘤小鼠广泛使用的益生菌细菌菌株 Nissle 1917(EcN)。通过肿瘤体积、肿瘤组织的组织学染色来评估联合治疗的抗肿瘤效果。此外,还进行了流式细胞术分析治疗后肿瘤床中免疫微环境的变化。在小鼠和斑马鱼异种移植模型中评估了联合治疗对肿瘤侵袭和转移的抑制作用。进行粪便样本 16S rRNA 基因测序分析肠道微生物多样性的变化。通过粪便移植进一步测试了肠道微生物群对接受 EcN 后抑制肿瘤的影响。
Gal 的肿瘤生长抑制和转移抑制治疗效果显著增强,这得益于 EcN 增强的抗肿瘤免疫。EcN 能够缓解免疫抑制性肿瘤微环境,这表现为增强了肿瘤特异性效应 T 细胞浸润和树突状细胞激活。肠道微生物群被 EcN 调节,表现为肠道微生物群向某些有益细菌转移。
这些结果表明,Gal 联合 EcN 可能是一种具有很大临床应用潜力的新型治疗方法,可用于癌症的预防或治疗。