Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Nature. 2024 Jun;630(8018):968-975. doi: 10.1038/s41586-024-07529-3. Epub 2024 Jun 12.
Obesity is a leading risk factor for progression and metastasis of many cancers, yet can in some cases enhance survival and responses to immune checkpoint blockade therapies, including anti-PD-1, which targets PD-1 (encoded by PDCD1), an inhibitory receptor expressed on immune cells. Although obesity promotes chronic inflammation, the role of the immune system in the obesity-cancer connection and immunotherapy remains unclear. It has been shown that in addition to T cells, macrophages can express PD-1. Here we found that obesity selectively induced PD-1 expression on tumour-associated macrophages (TAMs). Type I inflammatory cytokines and molecules linked to obesity, including interferon-γ, tumour necrosis factor, leptin, insulin and palmitate, induced macrophage PD-1 expression in an mTORC1- and glycolysis-dependent manner. PD-1 then provided negative feedback to TAMs that suppressed glycolysis, phagocytosis and T cell stimulatory potential. Conversely, PD-1 blockade increased the level of macrophage glycolysis, which was essential for PD-1 inhibition to augment TAM expression of CD86 and major histocompatibility complex I and II molecules and ability to activate T cells. Myeloid-specific PD-1 deficiency slowed tumour growth, enhanced TAM glycolysis and antigen-presentation capability, and led to increased CD8 T cell activity with a reduced level of markers of exhaustion. These findings show that obesity-associated metabolic signalling and inflammatory cues cause TAMs to induce PD-1 expression, which then drives a TAM-specific feedback mechanism that impairs tumour immune surveillance. This may contribute to increased cancer risk yet improved response to PD-1 immunotherapy in obesity.
肥胖是许多癌症进展和转移的主要风险因素,但在某些情况下可以提高存活率并增强对免疫检查点阻断疗法的反应,包括抗 PD-1,它靶向 PD-1(由 PDCD1 编码),这是一种在免疫细胞上表达的抑制受体。尽管肥胖会促进慢性炎症,但免疫系统在肥胖与癌症的联系和免疫治疗中的作用仍不清楚。已经表明,除了 T 细胞,巨噬细胞也可以表达 PD-1。在这里,我们发现肥胖选择性地诱导肿瘤相关巨噬细胞(TAMs)上的 PD-1 表达。I 型炎症细胞因子和与肥胖相关的分子,包括干扰素-γ、肿瘤坏死因子、瘦素、胰岛素和棕榈酸,以 mTORC1 和糖酵解依赖的方式诱导巨噬细胞 PD-1 表达。PD-1 然后为 TAMs 提供负反馈,抑制糖酵解、吞噬作用和 T 细胞刺激潜力。相反,PD-1 阻断增加了巨噬细胞糖酵解的水平,这对于 PD-1 抑制增强 TAM 表达 CD86 和主要组织相容性复合体 I 和 II 分子以及激活 T 细胞的能力至关重要。髓样细胞特异性 PD-1 缺失可减缓肿瘤生长,增强 TAM 糖酵解和抗原呈递能力,并导致 CD8 T 细胞活性增加,同时降低衰竭标志物的水平。这些发现表明,肥胖相关的代谢信号和炎症提示导致 TAMs 诱导 PD-1 表达,然后驱动 TAM 特异性反馈机制,损害肿瘤免疫监测。这可能导致癌症风险增加,但肥胖患者对 PD-1 免疫治疗的反应改善。
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