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在食管鳞状细胞癌中,具有不同新辅助免疫治疗加化疗反应的癌症相关成纤维细胞的功能异质性。

Functional heterogeneity of cancer-associated fibroblasts with distinct neoadjuvant immunotherapy plus chemotherapy response in esophageal squamous cell carcinoma.

作者信息

Jiang Jun, Xu Chao, Han Donghui, Lu Yuan, Yang Fa, Wang Jiawei, Yan Xiaolong, Mu Xiaorong, Zhang Jipeng, Jia Chenghui, Xu Xinyao, Liu Kui, Liu Zhenhua, Gong Li, Wan Yi, Lu Qiang

机构信息

Department of Health Service, Base of Health Service, Air Force Medical University, Xi'an, China.

Department of Urology, Xijing Hospital, Air Force Medical University, Xi'an, China.

出版信息

Biomark Res. 2024 Sep 27;12(1):113. doi: 10.1186/s40364-024-00656-z.

Abstract

Novel neoadjuvant immunotherapy combined with chemotherapy (neoICT) has improved outcomes for patients with esophageal squamous-cell carcinoma (ESCC), but challenges persist in low response rates and therapy resistance. Little is known about the intra-tumoral heterogeneity in the ESCC tumor microenvironment (TME) that underlies differential responses to neoadjuvant therapy. We applied single-cell RNA sequencing (scRNA-seq) profiling and multiplexed immunofluorescence staining to thoroughly decipher the TME in ESCC specimens from a neoadjuvant anti-PD1 combination therapy clinical trial. The cancer-associated fibroblasts (CAFs) population showed the significant alteration in abundance following neoadjuvant therapy. Specifically, IL6 + CCL2 + immunomodulatory CAFs and a novel CD248 + mechanoresponsive CAFs subset exhibited increasing infiltration. Mechanistically, CD248 + mechanoresponsive CAFs approached and lined the tumor nest to physically block the infiltration of CD8 + T cells and drug delivery, while IL6 + CCL2 + immunomodulatory CAFs induced therapeutic resistance with distinct IL-6 expression. Among patients treated with neoICT, we observed prominent CAF-T cell interactions. In particular, the NECTIN2-TIGIT ligand-receptor pair was enriched in treated samples, and TIGIT was identified as the major inhibitory checkpoint of T cells. Our findings demonstrate distinct alterations in TME constituent responses to neoadjuvant immunotherapy and identify functional phenotypes of CAFs associated with unfavorable therapeutic responses in patients. This provides potential targets to enhance responses to neoadjuvant therapy in ESCC.

摘要

新型新辅助免疫疗法联合化疗(neoICT)改善了食管鳞状细胞癌(ESCC)患者的预后,但低反应率和治疗耐药性问题依然存在。对于新辅助治疗反应差异背后的ESCC肿瘤微环境(TME)中的肿瘤内异质性,我们知之甚少。我们应用单细胞RNA测序(scRNA-seq)分析和多重免疫荧光染色,以彻底解析来自一项新辅助抗PD1联合治疗临床试验的ESCC标本中的TME。新辅助治疗后,癌症相关成纤维细胞(CAF)群体的丰度出现了显著变化。具体而言,IL6+CCL2+免疫调节性CAF和一个新的CD248+机械反应性CAF亚群的浸润增加。从机制上讲,CD248+机械反应性CAF靠近并排列在肿瘤巢周围,以物理方式阻断CD8+T细胞的浸润和药物递送,而IL6+CCL2+免疫调节性CAF通过独特的IL-6表达诱导治疗耐药性。在接受neoICT治疗的患者中,我们观察到显著的CAF-T细胞相互作用。特别是,NECTIN2-TIGIT配体-受体对在治疗后的样本中富集,并且TIGIT被确定为T细胞的主要抑制性检查点。我们的研究结果表明,TME成分对新辅助免疫疗法的反应存在明显改变,并确定了与患者不良治疗反应相关的CAF功能表型。这为增强ESCC对新辅助治疗的反应提供了潜在靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21ea/11437904/a5a045094703/40364_2024_656_Fig1_HTML.jpg

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