Expression of PD-L1, PD-L2, PD-1 and CTLA4 in myelodysplastic syndromes is enhanced by treatment with hypomethylating agents.

Expression of PD-L1, PD-L2, PD-1 and CTLA4 in myelodysplastic syndromes is enhanced by treatment with hypomethylating agents.
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DOI:
10.1038/leu.2013.355
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发表时间:
2014-06
期刊:
影响因子:
11.4
通讯作者:
--
中科院分区:
医学1区
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--
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免疫检查点阻断正在成为一种新的抗癌治疗形式。我们研究了骨髓增生异常综合征(MDS)、慢性粒单核细胞白血病(CMML)和急性髓系白血病(AML)患者(N = 124)的CD34 +细胞中程序性死亡配体1(PD - L1)、程序性死亡配体2(PD - L2)、程序性死亡受体1(PD - 1)和细胞毒性T淋巴细胞相关蛋白4(CTLA4)信使核糖核酸(mRNA)的表达情况。在患者中分别观察到异常上调(≥2倍)的比例为34%、14%、15%和8%。在周围血单个核细胞(PBMNC,N = 61)中也观察到这4种基因表达增加。与AML相比,MDS(p = 0.018)和CMML(p = 0.0128)患者的PBMNC中PD - L1的相对表达显著更高。通过免疫组织化学(IHC)分析,在MDS的CD34 +细胞中观察到PD - L1蛋白表达,而基质/非原始细胞区室的PD - 1呈阳性。在一组接受表观遗传治疗的患者中,PD - L1、PD - L2、PD - 1和CTLA4的表达上调。与治疗有反应的患者相比,对治疗耐药的患者基因表达的相对增加幅度更高。用地西他滨治疗白血病细胞导致上述基因呈剂量依赖性上调。接触地西他滨导致白血病细胞系和人类样本中PD - 1部分去甲基化。这项研究表明PD - 1信号通路可能参与MDS的发病机制以及对去甲基化药物(HMAs)的耐药机制。阻断该通路可能是MDS和AML的一种潜在治疗方法。
Blockade of immune checkpoints is emerging as new form of anticancer therapy. We studied the expression of PD-L1, PD-L2, PD-1 and CTLA4 mRNA expression in CD34+ cells from MDS, CMML and AML patients (N=124). Aberrant up-regulation (≥2 fold) was observed in 34%, 14%, 15% and 8% of the patients respectively. Increased expression of these 4 genes was also observed in PBMNC (N=61). The relative expression of PD-L1 from PBMNC was significantly higher in MDS (p=0.018) and CMML (p=0.0128) compared to AML. By immunohistochemical (IHC) analysis, PD-L1 protein expression was observed in MDS CD34+ cells, whereas stroma/non-blast cellular compartment was positive for PD-1. In a cohort of patients treated with epigenetic therapy, PD-L1, PD-L2, PD-1 and CTLA4 expression was upregulated. Patients resistant to therapy had relative higher increments in gene expression compared to patients that achieved response. Treatment of leukemia cells with decitabine resulted in a dose dependent up-regulation of above genes. Exposure to decitabine resulted in partial demethylation of PD-1 in leukemia cell lines and human samples. This study suggests PD-1 signaling may be involved in MDS pathogenesis and resistance mechanisms to HMAs. Blockade of this pathway can be a potential therapy in MDS and AML.
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