Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
JCI Insight. 2020 Jul 23;5(14):137088. doi: 10.1172/jci.insight.137088.
Pancreatic ductal adenocarcinoma (PDA) is a lethal malignancy that has no effective treatment. The tumor microenvironment (TME) of PDA employs a multitude of immune derangement strategies to protect PDA from immune elimination. Tumor-associated macrophages (TAMs) have been implicated in the pathogenesis of immune suppression of the PDA TME; however, its underlying mechanisms remained largely unknown. Using primary patient samples, our studies showed that, in comparison with macrophages isolated from normal pancreatic tissues, the phagocytosis activity of the PDA TAMs was significantly reduced. We found that the expression of homeobox protein VentX, a master regulator of macrophage plasticity, was significantly decreased in the PDA TAMs. We demonstrated that VentX was required for phagocytosis and that restoration of VentX expression in PDA TAMs promoted phagocytosis through the regulation of the signaling cascades involved in the process. Using an ex vivo culture model of primary human PDA, we showed that VentX-modulated TAMs transformed the PDA TME from a protumor milieu to an antitumor microenvironment by rectifying differentiation, proliferation, and activation of PDA-infiltrating immune cells. Using NSG-PDX models of primary human PDAs, we showed that VentX-modulated TAMs exerted strong inhibition on PDA tumorigenesis in vivo. Taken together, our data revealed a central mechanism underlying immune evasion of PDA and a potential novel venue to improve PDA prognosis.
胰腺导管腺癌 (PDA) 是一种致命的恶性肿瘤,目前尚无有效的治疗方法。PDA 的肿瘤微环境 (TME) 采用多种免疫失调策略来保护 PDA 免受免疫消除。肿瘤相关巨噬细胞 (TAMs) 被认为参与了 PDA TME 的免疫抑制发病机制;然而,其潜在机制在很大程度上仍不清楚。使用原发性患者样本,我们的研究表明,与从正常胰腺组织中分离出的巨噬细胞相比,PDA TAMs 的吞噬活性显著降低。我们发现,转录因子 VentX 的表达明显降低,VentX 是巨噬细胞可塑性的主要调节因子。我们证明 VentX 是吞噬作用所必需的,并且在 PDA TAMs 中恢复 VentX 表达通过调节参与该过程的信号级联反应来促进吞噬作用。使用原发性人 PDA 的体外培养模型,我们表明 VentX 调节的 TAMs 通过纠正 PDA 浸润免疫细胞的分化、增殖和激活,将 PDA TME 从促肿瘤环境转变为抗肿瘤微环境。使用原发性人 PDAs 的 NSG-PDX 模型,我们表明 VentX 调节的 TAMs 在体内对 PDA 肿瘤发生具有强烈的抑制作用。总之,我们的数据揭示了 PDA 免疫逃逸的核心机制,并为改善 PDA 预后提供了一个潜在的新途径。