Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, Frankfurt/Main, Germany.
Frankfurt Cancer Institute, Goethe University Frankfurt, Frankfurt/Main, Germany.
Gut. 2023 Sep;72(9):1774-1782. doi: 10.1136/gutjnl-2022-327909. Epub 2023 Jan 27.
OBJECTIVE: Investigating the effect of ferroptosis in the tumour microenvironment to identify combinatory therapy for liver cancer treatment. DESIGN: Glutathione peroxidase 4 (GPx4), which is considered the master regulator of ferroptosis, was genetically altered in murine models for hepatocellular carcinoma (HCC) and colorectal cancer (CRC) to analyse the effect of ferroptosis on tumour cells and the immune tumour microenvironment. The findings served as foundation for the identification of additional targets for combine therapy with ferroptotic inducer in the treatment of HCC and liver metastasis. RESULTS: Surprisingly, hepatocyte-restricted GPx4 loss does not suppress hepatocellular tumourigenesis. Instead, GPx4-associated ferroptotic hepatocyte death causes a tumour suppressive immune response characterised by a CXCL10-dependent infiltration of cytotoxic CD8 T cells that is counterbalanced by PD-L1 upregulation on tumour cells as well as by a marked HMGB1-mediated myeloid derived suppressor cell (MDSC) infiltration. Blocking PD-1 or HMGB1 unleashes T cell activation and prolongs survival of mice with -deficient liver tumours. A triple combination of the ferroptosis inducing natural compound withaferin A, the CXCR2 inhibitor SB225002 and α-PD-1 greatly improves survival of wild-type mice with liver tumours. In contrast, the same combination does not affect tumour growth of subcutaneously grown CRC organoids, while it decreases their metastatic growth in liver. CONCLUSION: Our data highlight a context-specific ferroptosis-induced immune response that could be therapeutically exploited for the treatment of primary liver tumours and liver metastases.
目的:研究肿瘤微环境中的铁死亡对肝癌治疗联合治疗的影响。
设计:谷胱甘肽过氧化物酶 4(GPx4)被认为是铁死亡的主要调节因子,在肝癌(HCC)和结直肠癌(CRC)的小鼠模型中进行了基因改变,以分析铁死亡对肿瘤细胞和免疫肿瘤微环境的影响。这些发现为鉴定 HCC 和肝转移联合治疗中与铁死亡诱导剂联合治疗的其他靶点奠定了基础。
结果:令人惊讶的是,肝细胞特异性 GPx4 缺失不会抑制肝细胞肿瘤发生。相反,与 GPx4 相关的铁死亡诱导的肝细胞死亡导致肿瘤抑制性免疫反应,其特征是 CXCL10 依赖性细胞毒性 CD8 T 细胞浸润,而肿瘤细胞上 PD-L1 的上调以及 HMGB1 介导的髓样来源抑制细胞(MDSC)浸润则起到平衡作用。阻断 PD-1 或 HMGB1 可释放 T 细胞激活,并延长缺乏 -的肝肿瘤小鼠的存活时间。铁死亡诱导天然化合物 withaferin A、CXCR2 抑制剂 SB225002 和 α-PD-1 的三重组合极大地提高了野生型荷瘤小鼠的存活率。相比之下,相同的组合不会影响皮下生长的 CRC 类器官的肿瘤生长,但会降低它们在肝脏中的转移生长。
结论:我们的数据强调了一种特定于背景的铁死亡诱导的免疫反应,可用于治疗原发性肝肿瘤和肝转移。
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