Liu Yao, Xun Zhenzhen, Ma Kun, Liang Shuhang, Li Xianying, Zhou Shuo, Sun Linmao, Liu Yufeng, Du Yanhua, Guo Xinyu, Cui Tianming, Zhou Huanran, Wang Jizhou, Yin Dalong, Song Ruipeng, Zhang Shugeng, Cai Wei, Meng Fanzheng, Guo Hongrui, Zhang Bo, Yang Di, Bao Rujuan, Hu Qingsong, Wang Jiabei, Ye Youqiong, Liu Lianxin
Department of Hepatobiliary Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Anhui Provincial Clinical Research Center for Hepatobiliary Diseases, Hefei 230001, China.
Shanghai Institute of Immunology, State Key Laboratory of Oncogenes and Related Genes, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
J Hepatol. 2023 Apr;78(4):770-782. doi: 10.1016/j.jhep.2023.01.011. Epub 2023 Jan 26.
BACKGROUND & AIMS: The tumour microenvironment (TME) is a crucial mediator of cancer progression and therapeutic outcome. The TME subtype correlates with patient response to immunotherapy in multiple cancers. Most previous studies have focused on the role of different cellular components in the TME associated with immunotherapy efficacy. However, the specific structure of the TME and its role in immunotherapy efficacy remain largely unknown. METHODS: We combined spatial transcriptomics with single-cell RNA-sequencing and multiplexed immunofluorescence to identify the specific spatial structures in the TME that determine the efficacy of immunotherapy in patients with hepatocellular carcinoma (HCC) receiving anti-PD-1 treatment. RESULTS: We identified a tumour immune barrier (TIB) structure, a spatial niche composed of SPP1 macrophages and cancer-associated fibroblasts (CAFs) located near the tumour boundary, which is associated with the efficacy of immune checkpoint blockade. Furthermore, we dissected ligand‒receptor networks among malignant cells, SPP1 macrophages, and CAFs; that is, the hypoxic microenvironment promotes SPP1 expression, and SPP1 macrophages interact with CAFs to stimulate extracellular matrix remodelling and promote TIB structure formation, thereby limiting immune infiltration in the tumour core. Preclinically, the blockade of SPP1 or macrophage-specific deletion of Spp1 in mice led to enhanced efficacy of anti-PD-1 treatment in mouse liver cancer, accompanied by reduced CAF infiltration and increased cytotoxic T-cell infiltration. CONCLUSIONS: We identified that the TIB structure formed by the interaction of SPP1 macrophages and CAFs is related to immunotherapy efficacy. Therefore, disruption of the TIB structure by blocking SPP1 may be considered a relevant therapeutic approach to enhance the therapeutic effect of immune checkpoint blockade in HCC. IMPACT AND IMPLICATIONS: Only a limited number of patients with hepatocellular carcinoma (HCC) benefit from tumour immunotherapy, which significantly hinders its application. Herein, we used multiomics to identify the spatial structure of the tumour immune barrier (TIB), which is formed by the interaction of SPP1+ macrophages and cancer-associated fibroblasts in the HCC microenvironment. This structure constrains immunotherapy efficacy by limiting immune cell infiltration into malignant regions. Preclinically, we revealed that blocking SPP1 or macrophage-specific deletion of Spp1 in mice could destroy the TIB structure and sensitize HCC cells to immunotherapy. These results provide the first key steps towards finding more effective therapies for HCC and have implications for physicians, scientists, and drug developers in the field of HCC.
背景与目的:肿瘤微环境(TME)是癌症进展和治疗结果的关键调节因子。TME亚型与多种癌症患者对免疫治疗的反应相关。以往大多数研究都集中在TME中不同细胞成分在免疫治疗疗效方面的作用。然而,TME的具体结构及其在免疫治疗疗效中的作用在很大程度上仍不清楚。 方法:我们将空间转录组学与单细胞RNA测序和多重免疫荧光相结合,以确定TME中决定接受抗PD-1治疗的肝细胞癌(HCC)患者免疫治疗疗效的特定空间结构。 结果:我们确定了一种肿瘤免疫屏障(TIB)结构,这是一种由位于肿瘤边界附近的SPP1巨噬细胞和癌症相关成纤维细胞(CAF)组成的空间生态位,它与免疫检查点阻断的疗效相关。此外,我们剖析了恶性细胞、SPP1巨噬细胞和CAF之间的配体-受体网络;也就是说,缺氧微环境促进SPP1表达,SPP1巨噬细胞与CAF相互作用以刺激细胞外基质重塑并促进TIB结构形成,从而限制肿瘤核心中的免疫浸润。在临床前研究中,阻断小鼠体内的SPP1或巨噬细胞特异性缺失Spp1可提高抗PD-1治疗对小鼠肝癌的疗效,同时减少CAF浸润并增加细胞毒性T细胞浸润。 结论:我们确定由SPP1巨噬细胞和CAF相互作用形成的TIB结构与免疫治疗疗效相关。因此,通过阻断SPP1破坏TIB结构可能被认为是增强HCC免疫检查点阻断治疗效果的一种相关治疗方法。 影响与意义:只有少数肝细胞癌(HCC)患者能从肿瘤免疫治疗中获益,这严重阻碍了其应用。在此,我们使用多组学方法确定了肿瘤免疫屏障(TIB)的空间结构,它由HCC微环境中的SPP1 +巨噬细胞和癌症相关成纤维细胞相互作用形成。这种结构通过限制免疫细胞浸润到恶性区域来限制免疫治疗疗效。在临床前研究中,我们发现阻断小鼠体内的SPP1或巨噬细胞特异性缺失Spp1可以破坏TIB结构并使HCC细胞对免疫治疗敏感。这些结果为寻找更有效的HCC治疗方法迈出了关键的第一步,对HCC领域的医生、科学家和药物开发者具有重要意义。
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