Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV.
WVU Cancer Institute, West Virginia University, Morgantown, WV.
J Immunol. 2023 Nov 15;211(10):1589-1604. doi: 10.4049/jimmunol.2300326.
GM-CSF has been employed as an adjuvant to cancer immunotherapy with mixed results based on dosage. We previously showed that GM-CSF regulated tumor angiogenesis by stimulating soluble vascular endothelial growth factor (VEGF) receptor-1 from monocytes/macrophages in a dose-dependent manner that neutralized free VEGF, and intratumoral injections of high-dose GM-CSF ablated blood vessels and worsened hypoxia in orthotopic polyoma middle T Ag (PyMT) triple-negative breast cancer (TNBC). In this study, we assessed both immunoregulatory and oxygen-regulatory components of low-dose versus high-dose GM-CSF to compare effects on tumor oxygen, vasculature, and antitumor immunity. We performed intratumoral injections of low-dose GM-CSF or saline controls for 3 wk in FVB/N PyMT TNBC. Low-dose GM-CSF uniquely reduced tumor hypoxia and normalized tumor vasculature by increasing NG2+ pericyte coverage on CD31+ endothelial cells. Priming of "cold," anti-PD1-resistant PyMT tumors with low-dose GM-CSF (hypoxia reduced) sensitized tumors to anti-PD1, whereas high-dose GM-CSF (hypoxia exacerbated) did not. Low-dose GM-CSF reduced hypoxic and inflammatory tumor-associated macrophage (TAM) transcriptional profiles; however, no phenotypic modulation of TAMs or tumor-infiltrating lymphocytes were observed by flow cytometry. In contrast, high-dose GM-CSF priming increased infiltration of TAMs lacking the MHC class IIhi phenotype or immunostimulatory marker expression, indicating an immunosuppressive phenotype under hypoxia. However, in anti-PD1 (programmed cell death 1)-susceptible BALB/c 4T1 tumors (considered hot versus PyMT), high-dose GM-CSF increased MHC class IIhi TAMs and immunostimulatory molecules, suggesting disparate effects of high-dose GM-CSF across PyMT versus 4T1 TNBC models. Our data demonstrate a (to our knowledge) novel role for low-dose GM-CSF in reducing tumor hypoxia for synergy with anti-PD1 and highlight why dosage and setting of GM-CSF in cancer immunotherapy regimens require careful consideration.
GM-CSF 已被用作癌症免疫治疗的佐剂,但基于剂量的不同,其结果也有所不同。我们之前的研究表明,GM-CSF 通过刺激单核细胞/巨噬细胞中可溶性血管内皮生长因子(VEGF)受体-1 来调节肿瘤血管生成,这种方式具有剂量依赖性,可以中和游离的 VEGF,并且肿瘤内注射高剂量的 GM-CSF 可消除血管并加重原位多瘤病毒中 T 抗原(PyMT)三阴性乳腺癌(TNBC)的缺氧。在这项研究中,我们评估了低剂量与高剂量 GM-CSF 的免疫调节和氧调节成分,以比较它们对肿瘤氧、血管和抗肿瘤免疫的影响。我们在 FVB/N PyMT TNBC 中进行了为期 3 周的肿瘤内注射低剂量 GM-CSF 或生理盐水对照。低剂量 GM-CSF 独特地通过增加 CD31+内皮细胞上的 NG2+周细胞覆盖来减少肿瘤缺氧并使肿瘤血管正常化。用低剂量 GM-CSF(减少缺氧)对“冷”、抗 PD1 耐药的 PyMT 肿瘤进行预处理可使肿瘤对抗 PD1 敏感,而高剂量 GM-CSF(加剧缺氧)则不能。低剂量 GM-CSF 降低了缺氧和炎症性肿瘤相关巨噬细胞(TAM)的转录谱;然而,通过流式细胞术观察到 TAM 或肿瘤浸润淋巴细胞没有表型调节。相比之下,高剂量 GM-CSF 引发的 TAM 浸润缺乏 MHC 类 IIhi 表型或免疫刺激标志物表达,表明在缺氧下存在免疫抑制表型。然而,在抗 PD1(程序性细胞死亡 1)敏感的 BALB/c 4T1 肿瘤(被认为是热肿瘤,而 PyMT 是冷肿瘤)中,高剂量 GM-CSF 增加了 MHC 类 IIhi TAM 和免疫刺激分子,这表明高剂量 GM-CSF 在 PyMT 与 4T1 TNBC 模型中的作用不同。我们的数据证明了低剂量 GM-CSF 在减少肿瘤缺氧以与抗 PD1 协同作用方面具有(据我们所知)新的作用,并强调了 GM-CSF 在癌症免疫治疗方案中的剂量和设置为何需要仔细考虑。
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