髓系衍生的抑制性细胞与肿瘤免疫耐受关系的研究进展

髓系衍生的抑制性细胞(myeloid-derived suppressor cells,MDSCs),是在肿瘤等病理因素的作用下髓系细胞发生分化障碍所产生的不同阶段髓系祖细胞的集合,具有广谱而强大的免疫抑制功能,是免疫系统的重要负性调节组件之一.研究表明:肿瘤微环境中的多种细胞因子或生长因子可通过激活相应的信号通路促进MDSCs扩增及活化,MDSCs进而通过多种机制抑制包括T细胞在内的多种免疫细胞的功能而促进肿瘤个体免疫耐受的发生.临床研究表明:肿瘤患者体内MDSCs的水平与肿瘤临床病程进展密切相关,基于MDSCs的免疫治疗也有望成为肿瘤免疫治疗的新策略.本文主要介绍了肿瘤中MDSCs的表型鉴定、扩增及活化机制、发挥免疫抑制作用的途径及机制、肿瘤中MDSCs的临床意义以及本领域需要解决的问题,以期对MDSCs在肿瘤免疫耐受中的作用进展提供参考.     

髓源性抑制细胞研究进展

髓源性抑制细胞(myeloid-derived suppressor cells, MDSCs)是一群表型异常、具有免疫抑制功能的髓系来源细胞。在进展期肿瘤、败血症、慢性感染等病理环境中,MDSCs大量扩增并通过多种途径抑制T淋巴细胞等免疫细胞的增殖、活化和迁移,MDSCs的数量与疾病进程和患者转归密切相关。通过单细胞测序、质谱流式等新技术,研究人员发现MDSCs和正常髓系细胞在表型标记分子、基因表达、能量代谢和调控通路上存在明显差异。特别是在肿瘤领域,MDSCs靶向治疗研究也取得了丰硕的成果。本文以MDSCs研究里程碑为起点,以MDSCs靶向治疗机制及其在感染性疾病中的作用为重点,对MDSCs新近研究成果进行综述。     

髓源性抑制细胞对炎症性肠病的免疫调节作用及靶向免疫治疗研究

髓源性抑制细胞(myeloid-derived suppressor cells, MDSCs)是机体在缺氧、炎症、感染和癌症等病理条件下,髓系细胞分化受阻的一组异质性未成熟细胞,具有强大的免疫抑制功能。在小鼠和人类中研究表明,MDSCs在炎症肠病(inflammatory bowel disease, IBD)中激活和扩增,通过抑制炎症反应改善IBD的疾病进展,或通过促炎反应加速IBD的发生、发展。因此,了解MDSCs的生物学特性及其在IBD肠道炎症微环境中的调节作用,对靶向MDSCs的免疫治疗至关重要。现就MDSCs在IBD炎症条件下的不同生理作用,包括其促炎或免疫抑制作用以及目前基于MDSCs的免疫治疗策略作一概述,旨在为临床更全面的靶向MDSCs免疫治疗提供理论依据。     

MDSCs在恶性肿瘤中的生物学作用及其研究进展

髓源抑制性细胞(myeloid-derived suppressor cells,MDSCs)是一群以骨髓祖细胞和未分化成熟的粒细胞、树突状细胞、巨噬细胞为代表的异质髓细胞,表达的抗原标志多样且不同于成熟髓细胞。当机体处于癌症、炎症、感染等状态时,MDSCs首先从骨髓被募集到外周并在外周被活化,一系列肿瘤来源的慢性炎症相关的因子是介导MDSCs的募集和活化的关键。MDSCs有多种方法抑制机体的获得性和天然抗肿瘤免疫,来帮助肿瘤细胞逃避机体的免疫监视和攻击,促进肿瘤发展。近年来,越来越多的研究者开始关注MDSCs与恶性肿瘤的相关性而且靶向MDSCs的肿瘤免疫治疗也见于报道。本文旨在对MDSCs在恶性肿瘤中的生物学作用及研究进展作一简要综述。     

基于髓源性抑制细胞的食药用菌多糖抗肿瘤免疫作用机制

髓源性抑制细胞(myeloid-derived suppressor cells,MDSCs)是一种异质性的免疫调节细胞。在癌症机体中,MDSCs是主要的免疫抑制细胞,通过多种途径诱导T淋巴细胞衰竭和凋亡,促进肿瘤细胞逃逸,从而导致肿瘤不受控制地生长,是癌症治疗的主要障碍。目前,MDSCs是癌症药物研究的热点和关键靶点。近年来,研究报道显示多糖可下调MDSCs在癌症患者及肿瘤实验动物体内数量和比例,并诱导免疫抑制功能丧失。食药用菌多糖是天然多糖的主要来源,可以通过多种途径激活肿瘤免疫应答,其抑制MDSCs功能的研究报道逐年增多,目前研究主要集中在香菇多糖、灵芝多糖等部分种类。因此,本文简要描述髓源性抑制细胞在癌症中的免疫抑制功能,然后详细地综述食药用菌多糖对髓源性抑制细胞作用的研究进展,以期为食药用菌多糖在肿瘤免疫药物开发及辅助增强(如免疫检查点抑制剂)等免疫治疗提供新思路。     

髓源性抑制细胞在肿瘤免疫中的作用

近来研究发现,一类被称为髓源性抑制细胞(Myeloid-derived suppressor cells,MDSCs)的细胞群,参与了肿瘤的免疫逃逸、免疫耐受、免疫抑制等病理过程,促进肿瘤的发生和生长。这群细胞主要分布在血液、脾、淋巴结、骨髓及肿瘤微环境等部位,通过复杂的分子途径,对机体的抗肿瘤免疫起抑制作用。本文就MDSCs在这方面作用的研究进展作一综述。     

调节性T细胞与胶质瘤的免疫治疗

调节性T细胞（regulatory T cell,Treg）是一群具有抑制其它免疫细胞功能的起负性调控的细胞群. Treg细胞能抑制多种免疫细胞,如CD4+T和CD8+T淋巴细胞、NK细胞、B淋巴细胞以及树突状细胞的活化和增殖,是体内维持免疫系统稳定,防止出现自身免疫性疾病重要因素.最新研究表明,Treg细胞在肿瘤免疫逃逸中也发挥重要作用. 肿瘤细胞通过扩增或招募Treg细胞,抑制机体对肿瘤的免疫作用,由此可知,Treg细胞在肿瘤的发生和发展过程中发挥重要作用. 因此,抑制Treg细胞的活性和数量是包括胶质瘤在内的肿瘤免疫治疗有效的方式.     

免疫细胞与肿瘤微环境

肿瘤细胞和免疫细胞间的相互作用一直是肿瘤生物学关注的热点.流行病学与临床研究均表明,炎症反应与肿瘤的发生发展存在密切关联,但是其中的分子作用机理和遗传学机制尚未完全阐明.研究显示,T淋巴细胞、巨噬细胞、树突状细胞、巨大细胞等多种免疫细胞会浸润到肿瘤微环境中,协同调控肿瘤生长、免疫逃逸和侵袭转移.本文就近年对肿瘤微环境中免疫细胞功能研究的进展进行综述.正确认识这些免疫细胞在肿瘤发生发展中的作用,对于发展更优的肿瘤免疫治疗手段具有十分重要意义.     

CD4+T细胞在肿瘤免疫治疗中的作用

近年来,人们对CD4 T细胞在肿瘤免疫治疗中的作用给予了极大的关注,CD4 T细胞不仅可通过IFN-γ依赖性等机制直接杀伤肿瘤细胞,而且在CD8 T细胞的激活、记忆性的细胞毒性T细胞(CTL)应答的产生、维持以及促进其存活等过程中发挥着重要作用,同时激活CD4 T细胞和CD8 T细胞是免疫治疗的理想策略;另外,CD4 CD25 调节性T细胞(Treg细胞)可能被肿瘤表达的自身抗原所诱导,与肿瘤免疫耐受的维持和抗肿瘤应答的下调有关,被认为是免疫治疗失败的主要原因,抑制该细胞亚群可增强治疗性肿瘤疫苗的临床效果.现就CD4 T细胞在肿瘤免疫治疗中的作用的研究进展作一综述.     

A paradoxical role for myeloid-derived suppressor cells in sepsis and trauma

Myeloid-derived suppressor cells (MDSCs) are a heterogenous population of immature myeloid cells whose numbers dramatically increase in chronic and acute inflammatory diseases, including cancer, autoimmune disease, trauma, burns and sepsis. Studied originally in cancer, these cells are potently immunosuppressive, particularly in their ability to suppress antigen-specific CD8(+) and CD4(+) T-cell activation through multiple mechanisms, including depletion of extracellular arginine, nitrosylation of regulatory proteins, and secretion of interleukin 10, prostaglandins and other immunosuppressive mediators. However, additional properties of these cells, including increased reactive oxygen species and inflammatory cytokine production, as well as their universal expansion in nearly all inflammatory conditions, suggest that MDSCs may be more of a normal component of the inflammatory response ("emergency myelopoiesis") than simply a pathological response to a growing tumor. Recent evocative data even suggest that the expansion of MDSCs in acute inflammatory processes, such as burns and sepsis, plays a beneficial role in the host by increasing immune surveillance and innate immune responses. Although clinical efforts are currently underway to suppress MDSC numbers and function in cancer to improve antineoplastic responses, such approaches may not be desirable or beneficial in other clinical conditions in which immune surveillance and antimicrobial activities are required.     

Signaling pathways involved in MDSC regulation

The immune system has evolved mechanisms to protect the host from the deleterious effects of inflammation. The generation of immune suppressive cells like myeloid derived suppressor cells (MDSCs) that can counteract T cell responses represents one such strategy. There is an accumulation of immature myeloid cells or MDSCs in bone marrow (BM) and lymphoid organs under pathological conditions such as cancer. MDSCs represent a population of heterogeneous myeloid cells comprising of macrophages, granulocytes and dendritic cells that are at early stages of development. Although, the precise signaling pathways and molecular mechanisms that lead to MDSC generation and expansion in cancer remains to be elucidated. It is widely believed that perturbation of signaling pathways involved during normal hematopoietic and myeloid development under pathological conditions such as tumorogenesis contributes to the development of suppressive myeloid cells. In this review we discuss the role played by key signaling pathways such as PI3K, Ras, Jak/Stat and TGFb during myeloid development and how their deregulation under pathological conditions can lead to the generation of suppressive myeloid cells or MDSCs. Targeting these pathways should help in elucidating mechanisms that lead to the expansion of MDSCs in cancer and point to methods for eliminating these cells from the tumor microenvironment.     

The downregulation of type I IFN signaling in G-MDSCs under tumor conditions promotes their development towards an immunosuppressive phenotype

Tumors modify myeloid cell differentiation and induce an immunosuppressive microenvironment. Granulocytic myeloid-derived suppressor cells (G-MDSCs), the main subgroup of myeloid-derived suppressor cells (MDSCs), are immature myeloid cells (IMCs) with immunosuppressive activity and exist in tumor-bearing hosts. The reason why these cells diverge from a normal differentiation pathway and are shaped into immunosuppressive cells remains unclear. Here, we reported that the increase of granulocyte colony-stimulating factor (G-CSF) in mouse serum with tumor progression encouraged G-MDSCs to obtain immunosuppressive traits in peripheral blood through the PI3K-Akt/mTOR pathway. Importantly, we found that downregulation of type I interferon (IFN-I) signaling in G-MDSCs was a prerequisite for their immunosuppressive effects. Suppressor of cytokine signaling (SOCS1), the action of which is dependent on IFN-I signaling, inhibited the activation of the PI3K-Akt/mTOR pathway by directly interacting with Akt, indicating that the differentiation of immunosuppressive G-MDSCs involves a transition from immune activation to immune tolerance. Our study suggests that increasing IFN-I signaling in G-MDSCs may be a strategy for reprograming immunosuppressive myelopoiesis and slowing tumor progression.Subject terms: Cancer, Immune evasion     

Myeloid Derived Suppressor Cells (MDSCs) Are Increased and Exert Immunosuppressive Activity Together with Polymorphonuclear Leukocytes (PMNs) in Chronic Myeloid Leukemia Patients

Tumor immune tolerance can derive from the recruitment of suppressor cell population, including myeloid derived suppressor cells (MDSCs), able to inhibit T cells activity. We identified a significantly expanded MDSCs population in chronic myeloid leukemia (CML) patients at diagnosis that decreased to normal levels after imatinib therapy. In addition, expression of arginase 1 (Arg1) that depletes microenvironment of arginine, an essential aminoacid for T cell function, resulted in an increase in patients at diagnosis. Purified CML CD11b+CD33+CD14-HLADR- cells markedly suppressed normal donor T cell proliferation in vitro. Comparing CML Gr-MDSCs to autologous polymorphonuclear leukocytes (PMNs) we observed a higher Arg1 expression and activity in PMNs, together with an inhibitory effect on T cells in vitro. Our data indicate that CML cells create an immuno-tolerant environment associated to MDSCs expansion with immunosuppressive capacity mediated by Arg1. In addition, we demonstrated for the first time also an immunosuppressive activity of CML PMNs, suggesting a strong potential immune escape mechanism created by CML cells, which control the anti-tumor reactive T cells. MDSCs should be monitored in imatinib discontinuation trials to understand their importance in relapsing patients.     

Chronic intake of high fish oil diet induces myeloid-derived suppressor cells to promote tumor growth

Omega-3 polyunsaturated fatty acids enriched fish oil exerts beneficial anti-inflammatory effects in animal models with acute and chronic inflammatory diseases. Myeloid-derived suppressor cells (MDSCs), comprised of myeloid progenitors and precursors of myeloid cells, play vital roles in cancer. How fish oil affects the generation of MDSCs and the tumor development remains largely unexplored. Here, we show that dietary intake of high fish oil diet suppresses CD8⁺ T cells activation and proliferation in vivo via elevated levels of MDSCs. Mechanistically, high fish oil diet induces the expression of immunosuppressive cytokine IL-10 and promotes myelopoiesis in the spleen as well as other peripheral tissues. The immature myeloid cells in the spleen exhibit morphological and functional characteristics of MDSCs with the capability to downregulate CD8⁺ T cells activation. Depletion of MDSCs using anti-Gr-1 antibody decreases the growth of subcutaneously transferred B16 melanoma in mice on high fish oil diet. Interestingly, diet-induced production of MDSCs is not solely dependent of the spleen, as splenectomy has no effect on the tumor progress. Our data show that the liver functions as an alternative extramedullary hematopoiesis organ to support MDSCs differentiation and maintain tumor growth. Taken together, our study provides a novel insight into the physiological effects of fish oil and points to MDSCs as a possible mediator linking dietary fish oil intake and immunosuppression in cancer immunosurveillance.     

Metabolic reprogramming of myeloid-derived suppressor cells in the context of organ transplantation

Myeloid-derived suppressor cells (MDSCs) are naturally occurring leukocytes that develop from immature myeloid cells under inflammatory conditions that were discovered initially in the context of tumor immunity. Because of their robust immune inhibitory activities, there has been growing interest in MDSC-based cellular therapies for transplant tolerance induction. Indeed, various pre-clinical studies have introduced in vivo expansion or adoptive transfer of MDSC as a promising therapeutic strategy leading to a profound extension of allograft survival due to suppression of alloreactive T cells. However, several limitations of cellular therapies using MDSCs remain to be addressed, including their heterogeneous nature and limited expansion capacity. Metabolic reprogramming plays a crucial role for differentiation, proliferation and effector function of immune cells. Notably, recent reports have focused on a distinct metabolic phenotype underlying the differentiation of MDSCs in an inflammatory microenvironment representing a regulatory target. A better understanding of the metabolic reprogramming of MDSCs may thus provide novel insights for MDSC-based treatment approaches in transplantation. In this review, we will summarize recent, interdisciplinary findings on MDSCs metabolic reprogramming, dissect the underlying molecular mechanisms and discuss the relevance for potential treatment approaches in solid-organ transplantation.     

Cancer chemotherapy: not only a direct cytotoxic effect, but also an adjuvant for antitumor immunity

Treatment of metastatic cancer mainly relies on chemotherapy. Chemotherapeutic agents kill tumor cells by direct cytotoxicity, thus leading to tumor regression. However, emerging data focus on another side of cancer chemotherapy: its antitumor immunity effect. Although cancer chemotherapy was usually considered as immunosuppressive, some chemotherapeutic agents have recently been shown to activate an anticancer immune response, which is involved in the curative effect of these treatments. Cancer development often leads to the occurrence of an immune tolerance that prevents cancer rejection by the immune system and hinders efficacy of immunotherapy. Cancer cells induce proliferation and local accumulation of immunosuppressive cells such as regulatory T cells and immature myeloid cells, and prevent the maturation of dendritic cells and their capacity to present tumor antigens to T lymphocytes. Many anticancer cytotoxic agents interfere with the molecular and cellular mechanisms leading to tumor-induced tolerance. They can restore an efficient immune response that contributes to the therapeutic effects of chemotherapy. These findings open a novel field of investigations for future clinical trial design, taking into account the immunostimulatory capacity of chemotherapeutic agents, and using them in combined chemo-immunotherapy strategies when tumor-induced tolerance is overcome.     

Contribution of myeloid-derived suppressor cells to tumor-induced immune suppression, angiogenesis, invasion and metastasis

Growing evidence suggests that myeloid-derived suppressor cells (MDSCs), which have been named "immature myeloid cells" or "myeloid suppressor cells" (MSCs), play a critical role during the progression of cancer in tumor-bearing mice and cancer patients. As their name implies, these cells are derived from bone marrow and have a tremendous potential to suppress immune responses. Recent studies indicated that these cells also have a crucial role in tumor progression. MDSCs can directly incorporate into tumor endothelium.They secret many pro-angiogenic factors as well. In addition, they play an essential role in cancer invasion and metastasis through inducing the production of matrix metalloproteinases (MMPs), chemoattractants and creating a pre-metastatic environment. Increasing evidence supports the idea that cancer stem cells (CSCs) are responsible for tumorigenesis, resistance to therapies, invasion and metastasis.Here, we hypothesize that CSCs may "hijack" MDSCs for use as alternative niche cells, leading to the maintenance of stemness and enhanced chemo- and radio-therapy resistance. The countermeasure that directly targets to MDSCs may be useful for against angiogenesis and preventing cancer from invasion and metastasis. Therefore, the study of MDSCs is important to understand tumor progression and to enhance the therapeutic efficacy against cancer.     

Myeloid-derived suppressor cells regulate the immunosuppressive functions of PD-1−PD-L1+ Bregs through PD-L1/PI3K/AKT/NF-κB axis in breast cancer

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of myeloid cells that are closely related to tumor immune escape, but the mechanism by which MDSCs regulate B cells has not been elucidated. Our previous studies revealed that breast cancer-derived MDSCs could induce a group of PD-1⁻PD-L1⁺ Bregs with immunosuppressive functions. Here, we reported that blocking PD-1/PD-L1 interaction between MDSCs and B cells could reverse the immunosuppressive functions of PD-1⁻PD-L1⁺ Bregs. The activation of PI3K/AKT/NF-κB signaling pathway is essential for PD-1⁻PD-L1⁺ Bregs to exert immunosuppressive effects. MDSCs activated the PI3K/AKT/NF-κB pathway in B cells via the PD-1/PD-L1 axis. Furthermore, inhibition of PD-1/PD-L1 or PI3K/AKT signaling suppressed both tumor growth and the immunosuppressive functions of PD-1⁻PD-L1⁺ Bregs. Dual suppression of PD-1/PD-L1 and PI3K/AKT exerted better antitumor effect. Finally, MDSCs and PD-1⁻PD-L1⁺ Bregs were colocalized in breast cancer tissues and PD-1⁻PD-L1⁺ Bregs were positively correlated with poor prognosis. Thus, MDSC-educated PD-1⁻PD-L1⁺ Bregs and their regulatory mechanisms could contribute to the immunosuppressive tumor microenvironment. Our study proposes a novel mechanism for MDSC-mediated regulation of B cell immunity, which might shed new light on tumor immunotherapy.⁺Subject terms: Breast cancer, Cancer microenvironment     

Circulating myeloid-derived suppressor cells: An independent prognostic factor in patients with breast cancer

Evading immune destruction is a hallmark of cancer. Myeloid-derived suppressor cells (MDSCs), a heterogeneous population of myeloid immune cells, are thought to foster the establishment of an immunosuppressive tumor microenvironment, but it remains unclear how. This study aims to determine the levels of circulating MDSCs and their subpopulations and test their immunosuppressive functions in patients with breast cancer (BC). We analyzed the fractions of MDSCs in freshly isolated peripheral blood mononuclear cells of patients with BC and healthy donors using flow cytometry. Circulating MDSCs were further phenotyped using fluorescently labeled antihuman monoclonal antibodies. Coculture experiments revealed the effects of MDSCs on CD3⁺ T cell response. Moreover, we correlated circulating MDSC levels with clinicopathological features of patients with BC. We show that the fraction of HLA-DR ^– CD33 ⁺ MDSCs in peripheral blood is about 10-fold higher in patients with BC than in healthy control individuals. The levels of all MDSC subpopulations, including monocytic and granulocytic MDSCs, are significantly elevated. Coculture experiments of purified HLA-DR ^– CD33 ⁺ MDSCs and CD3 ⁺ T cells demonstrate that T cell proliferation is more effectively inhibited by BC patient-derived MDSCs than by healthy control MDSCs. Moreover, increased circulating MDSC levels robustly associate with advanced BC stage and positive lymph node status. By being more abundant and more effective T cell suppressors, BC patient-derived circulating MDSCs exert a dual immunosuppressive effect. Our findings pave the way to develop novel diagnostic and immunotherapeutic strategies, aimed at detecting and inhibiting MDSCs in patients with BC.