Key Laboratory of Cell Proliferation and Differentiation of the Ministry of Education, School of Life Sciences, Peking University, Beijing, 100871, China.
Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China.
Cell Res. 2020 Nov;30(11):966-979. doi: 10.1038/s41422-020-00395-4. Epub 2020 Aug 24.
CD8 T cell-mediated cancer clearance is often suppressed by the interaction between inhibitory molecules like PD-1 and PD-L1, an interaction acts like brakes to prevent T cell overreaction under normal conditions but is exploited by tumor cells to escape the immune surveillance. Immune checkpoint inhibitors have revolutionized cancer therapeutics by removing such brakes. Unfortunately, only a minority of cancer patients respond to immunotherapies presumably due to inadequate immunity. Antitumor immunity depends on the activation of the cGAS-STING pathway, as STING-deficient mice fail to stimulate tumor-infiltrating dendritic cells (DCs) to activate CD8 T cells. STING agonists also enhance natural killer (NK) cells to mediate the clearance of CD8 T cell-resistant tumors. Therefore STING agonists have been intensively sought after. We previously discovered that manganese (Mn) is indispensable for the host defense against cytosolic dsDNA by activating cGAS-STING. Here we report that Mn is also essential in innate immune sensing of tumors and enhances adaptive immune responses against tumors. Mn-insufficient mice had significantly enhanced tumor growth and metastasis, with greatly reduced tumor-infiltrating CD8 T cells. Mechanically, Mn promoted DC and macrophage maturation and tumor-specific antigen presentation, augmented CD8 T cell differentiation, activation and NK cell activation, and increased memory CD8 T cells. Combining Mn with immune checkpoint inhibition synergistically boosted antitumor efficacies and reduced the anti-PD-1 antibody dosage required in mice. Importantly, a completed phase 1 clinical trial with the combined regimen of Mn and anti-PD-1 antibody showed promising efficacy, exhibiting type I IFN induction, manageable safety and revived responses to immunotherapy in most patients with advanced metastatic solid tumors. We propose that this combination strategy warrants further clinical translation.
CD8 T 细胞介导的癌症清除通常受到抑制性分子(如 PD-1 和 PD-L1)之间相互作用的抑制,这种相互作用就像刹车一样,可防止 T 细胞在正常情况下过度反应,但肿瘤细胞会利用这种相互作用逃避免疫监视。免疫检查点抑制剂通过去除这种刹车,彻底改变了癌症治疗方法。不幸的是,只有少数癌症患者对免疫疗法有反应,这可能是由于免疫力不足。抗肿瘤免疫依赖于 cGAS-STING 途径的激活,因为缺乏 STING 的小鼠无法刺激肿瘤浸润树突状细胞(DC)激活 CD8 T 细胞。STING 激动剂还增强自然杀伤(NK)细胞来介导 CD8 T 细胞耐药肿瘤的清除。因此,STING 激动剂受到了广泛关注。我们之前发现,锰(Mn)通过激活 cGAS-STING 对于宿主防御细胞质 dsDNA 是必不可少的。在这里,我们报告 Mn 对于肿瘤的先天免疫感应也是必不可少的,并增强了对肿瘤的适应性免疫反应。Mn 不足的小鼠肿瘤生长和转移明显增强,肿瘤浸润的 CD8 T 细胞大大减少。机制上,Mn 促进 DC 和巨噬细胞成熟和肿瘤特异性抗原呈递,增强 CD8 T 细胞分化、激活和 NK 细胞激活,并增加记忆 CD8 T 细胞。Mn 与免疫检查点抑制联合使用可协同提高抗肿瘤疗效,并减少小鼠中抗 PD-1 抗体的用量。重要的是,一项 Mn 与抗 PD-1 抗体联合治疗的 I 期临床试验显示出良好的疗效,表现出 I 型 IFN 诱导、可管理的安全性,并使大多数晚期转移性实体瘤患者的免疫治疗反应得到恢复。我们提出,这种联合策略值得进一步临床转化。
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