Signaling defects in T lymphocytes of patients with malignancy

In patients with cancer, alterations in the expression of T-cell receptor-associated molecules in tumor-infiltrating lymphocytes (TIL) as well as in circulating lymphocytes have been reported. By quantitative flow cytometry analysis, decreased or absent expression of the ζ chain in CD4⁺ or CD8⁺ T cells as well as in natural killer (NK) cells was demonstrated in patients with malignancies. Changes in the expression of ζ are biologically significant, because the absence or low expression of this signaling molecule in TIL of patients with stage III or IV head and neck cancer predicts a significantly shorter 5-year survival than that of patients with normal ζ expression in TIL. Preliminary evidence indicates that expression of ζ in TIL may not only influence survival but also predicts a favorable response to biologic therapies. Patients with cancer also show significantly greater spontaneous ex vivo apoptosis in peripheral blood mononuclear cells (PBMC) compared to normal controls, as measured by a terminal deoxynucleotide transferase-mediated dUTP nick end labeling (TUNEL) assay. While no correlation could be established between the proportions of cells with low ζ chain expression and those that spontaneously apoptose ex vivo, the ζ chain has been shown to be cleaved by caspases in T cells coincubated with tumor cells or with T cells exposed to CH-11 antibody, which induces apoptosis upon crosslinking Fas on the cell surface. The results suggest that low/absent ζ chain expression and lymphocyte apoptosis may be manifestations of negative effects of the tumor on the host immune system. Received: 20 March 1999 / Accepted: 3 May 1999