Rohrbacher Lisa, Brauchle Bettina, Ogrinc Wagner Ana, von Bergwelt-Baildon Michael, Bücklein Veit L, Subklewe Marion
Laboratory for Translational Cancer Immunology, Gene Center, Ludwig-Maximilians-Universität München, Munich, Germany.
Department of Internal Medicine III, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
Front Immunol. 2021 Mar 15;12:608625. doi: 10.3389/fimmu.2021.608625. eCollection 2021.
B-cell receptors, multiple receptor tyrosine kinases, and downstream effectors are constitutively active in chronic lymphocytic leukemia (CLL) B cells. Activation of these pathways results in resistance to apoptosis and enhanced survival of the leukemic cells. Idelalisib is a highly selective inhibitor of the PI3K p110∂ isoform and is approved for the treatment of CLL in patients with relapsed/refractory disease or in those harboring 17p deletions or tp53 mutations. Despite the initial excitement centered around high response rates in clinical trials of idelalisib, its therapeutic success has been hindered by the incidence of severe opportunistic infections. To examine the potential contribution of idelalisib to the increased risk of infection, we investigated the effects of idelalisib on the immune cell compartments of healthy donors (HDs) and CLL patients. PI3K∂ blockade by idelalisib reduced the expression levels of inhibitory checkpoint molecules in T cells isolated from both HDs and CLL patients. In addition, the presence of idelalisib in cultures significantly decreased T-cell-mediated cytotoxicity and granzyme B secretion, as well as cytokine secretion levels in both cohorts. Furthermore, idelalisib reduced the proliferation and cytotoxicity of HD NK cells. Collectively, our data demonstrate that both human T and NK cells are highly sensitive to PI3K∂ inhibition. Idelalisib interfered with the functions of T and NK cell cells from both HDs and CLL patients. Therefore, idelalisib might contribute to an increased risk of infections regardless of the underlying B-cell malignancy.
B细胞受体、多种受体酪氨酸激酶和下游效应分子在慢性淋巴细胞白血病(CLL)B细胞中持续激活。这些信号通路的激活导致白血病细胞对凋亡产生抗性并增强其存活能力。idelalisib是一种高度选择性的PI3K p110∂亚型抑制剂,已被批准用于治疗复发/难治性疾病患者或携带17p缺失或tp53突变的CLL患者。尽管最初围绕idelalisib临床试验中的高缓解率而兴奋不已,但其治疗成功却因严重机会性感染的发生率而受到阻碍。为了研究idelalisib对感染风险增加的潜在影响,我们调查了idelalisib对健康供体(HD)和CLL患者免疫细胞亚群的影响。idelalisib对PI3K∂的阻断降低了从HD和CLL患者分离的T细胞中抑制性检查点分子的表达水平。此外,培养物中idelalisib的存在显著降低了两个队列中T细胞介导的细胞毒性和颗粒酶B分泌以及细胞因子分泌水平。此外,idelalisib降低了HD NK细胞的增殖和细胞毒性。总体而言,我们的数据表明,人类T细胞和NK细胞对PI3K∂抑制高度敏感。idelalisib干扰了HD和CLL患者T细胞和NK细胞的功能。因此,无论潜在的B细胞恶性肿瘤如何,idelalisib都可能导致感染风险增加。