肝纤维化通过 GOLM1 介导的 PD-L1 上调促进肝癌中的免疫逃逸。

Liver fibrosis promotes immune escape in hepatocellular carcinoma via GOLM1-mediated PD-L1 upregulation.

机构信息

National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi Province, China.

Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250023, Shandong Province, China; Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250023, Shandong Province, China.

出版信息

Cancer Lett. 2021 Aug 10;513:14-25. doi: 10.1016/j.canlet.2021.05.007. Epub 2021 May 14.

Abstract

Immune checkpoint blockade is considered a breakthrough in cancer treatment. However, with the low response rates and therapeutic resistance of patients with hepatocellular carcinoma (HCC), the challenges facing the application of this treatment are tremendous. Liver fibrosis is a key driver of tumor immune escape, the underlying mechanism has never been clarified. This study sought to explore the role of liver fibrosis in regulating tumor-infiltrating lymphocytes (TILs) and inducing tumor immunosuppression. Ninety-nine fixed HCC tissue samples were used to analyze the association between liver fibrosis and immune escape using immunohistochemistry. In HCC patients, low FIB-4 values and high CD8 T cell infiltration were correlated with prolonged survival. Elevated expression of immune checkpoints and attenuated antitumor immunity were observed in CCl-induced mice liver fibrosis models and human fibrotic livers compared to control group. GOLM1 levels were increased in livers of patients with fibrosis and mice in response to CCl-induced liver fibrosis. CD8 T cell infiltrations were significantly decreased and PD-L1 expression was significantly increased in tumor tissues from hepatocyte-specific GOLM1 transgenic mice (Alb/GOLM1 mice) inducing chemical carcinogenesis compared to their corresponding control WT mice. GOLM1 induced PD-L1 expression via EGFR pathway activation. EGFR inhibitors, especially together with anti-PD-L1 therapy, improved the efficacy of immunotherapy in HCC. These findings illustrate the importance of liver fibrosis-induced immunosuppression as a tumor-promoting mechanism. GOLM1, which is highly upregulated in the fibrotic liver, regulates tumor microenvironmental immune escape via the EGFR/PD-L1 signaling pathway. EGFR blockade may bolster the efficacy of immune checkpoint inhibitors for HCC treatment.

摘要

免疫检查点阻断被认为是癌症治疗的突破。然而,由于肝细胞癌 (HCC) 患者的低反应率和治疗耐药性,这种治疗方法面临着巨大的挑战。肝纤维化是肿瘤免疫逃逸的关键驱动因素,但潜在机制尚未得到阐明。本研究旨在探讨肝纤维化在调节肿瘤浸润淋巴细胞 (TIL) 和诱导肿瘤免疫抑制中的作用。使用免疫组织化学分析 99 例固定 HCC 组织样本,研究肝纤维化与免疫逃逸之间的关系。在 HCC 患者中,低 FIB-4 值和高 CD8 T 细胞浸润与延长的生存时间相关。与对照组相比,在 CCl 诱导的小鼠肝纤维化模型和人类纤维化肝脏中,观察到免疫检查点的上调和抗肿瘤免疫的减弱。与对照组相比,在纤维化患者和 CCl 诱导的肝纤维化小鼠的肝脏中,GOLM1 水平升高。与相应的 WT 对照小鼠相比,在化学致癌诱导的肝细胞特异性 GOLM1 转基因小鼠 (Alb/GOLM1 小鼠) 的肿瘤组织中,CD8 T 细胞浸润显著减少,PD-L1 表达显著增加。GOLM1 通过 EGFR 途径激活诱导 PD-L1 表达。EGFR 抑制剂,特别是与抗 PD-L1 治疗联合使用,可提高 HCC 免疫治疗的疗效。这些发现说明了肝纤维化诱导的免疫抑制作为肿瘤促进机制的重要性。在纤维化的肝脏中高度上调的 GOLM1 通过 EGFR/PD-L1 信号通路调节肿瘤微环境中的免疫逃逸。EGFR 阻断可能增强免疫检查点抑制剂治疗 HCC 的疗效。

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