维生素 D 与光动力疗法联合增强了鳞状细胞皮肤癌小鼠模型的免疫反应。

Combination of vitamin D and photodynamic therapy enhances immune responses in murine models of squamous cell skin cancer.

机构信息

Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, 9500 Euclid Avenue, Cleveland, OH 44195, USA; Dermatology and Plastic Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA; Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

出版信息

Photodiagnosis Photodyn Ther. 2024 Feb;45:103983. doi: 10.1016/j.pdpdt.2024.103983. Epub 2024 Jan 27.

Abstract

Improved treatment outcomes for non-melanoma skin cancers can be achieved if Vitamin D (Vit D) is used as a neoadjuvant prior to photodynamic therapy (PDT). However, the mechanisms for this effect are unclear. Vit D elevates protoporphyrin (PpIX) levels within tumor cells, but also exerts immune-modulatory effects. Here, two murine models, UVB-induced actinic keratoses (AK) and human squamous cell carcinoma (A431) xenografts, were used to analyze the time course of local and systemic immune responses after PDT ± Vit D. Fluorescence immunohistochemistry of tissues and flow analysis (FACS) of blood were employed. In tissue, damage-associated molecular patterns (DAMPs) were increased, and infiltration of neutrophils (Ly6G+), macrophages (F4/80+), and dendritic cells (CD11c+) were observed. In most cases, Vit D alone or PDT alone increased cell recruitment, but Vit D + PDT showed even greater recruitment effects. Similarly for T cells, increased infiltration of total (CD3+), cytotoxic (CD8+) and regulatory (FoxP3+) T-cells was observed after Vit D or PDT, but the increase was even greater with the combination. FACS analysis revealed a variety of interesting changes in circulating immune cell levels. In particular, neutrophils decreased in the blood after Vit D, consistent with migration of neutrophils into AK lesions. Levels of cells expressing the PD-1+ checkpoint receptor were reduced in AKs following Vit D, potentially counteracting PD-1+ elevations seen after PDT alone. In summary, Vit D and ALA-PDT, two treatments with individual immunogenic effects, may be advantageous in combination to improve treatment efficacy and management of AK in the dermatology clinic.

摘要

如果在光动力疗法(PDT)之前使用维生素 D(Vit D)作为新辅助药物,非黑素瘤皮肤癌的治疗效果可以得到改善。然而,这种效果的机制尚不清楚。Vit D 会提高肿瘤细胞内原卟啉(PpIX)的水平,但也具有免疫调节作用。在这里,我们使用了两种小鼠模型,即 UVB 诱导的光化性角化病(AK)和人鳞状细胞癌(A431)异种移植物,来分析 PDT ± Vit D 后局部和全身免疫反应的时间过程。我们采用荧光免疫组织化学和血液流式分析(FACS)进行分析。在组织中,观察到损伤相关分子模式(DAMPs)增加,以及中性粒细胞(Ly6G+)、巨噬细胞(F4/80+)和树突状细胞(CD11c+)的浸润。在大多数情况下,Vit D 单独或 PDT 单独增加细胞募集,但 Vit D + PDT 显示出更大的募集效果。同样,对于 T 细胞,观察到 Vit D 或 PDT 后总(CD3+)、细胞毒性(CD8+)和调节(FoxP3+)T 细胞的浸润增加,但联合使用时增加更为明显。FACS 分析揭示了循环免疫细胞水平的各种有趣变化。特别是,在 Vit D 后,血液中的中性粒细胞减少,这与中性粒细胞向 AK 病变的迁移一致。在 Vit D 后,AK 中表达 PD-1+检查点受体的细胞水平降低,这可能抵消了单独 PDT 后 PD-1+的升高。总之,Vit D 和 ALA-PDT 这两种具有单独免疫原性作用的治疗方法联合使用可能有利于提高 AK 的治疗效果和管理。

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