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Pathogenesis of the cART unresponsive Kaposi’s sarcoma tumor niche

cART 无反应卡波西肉瘤肿瘤微环境的发病机制

基本信息

批准号：
10245125
负责人：
MICHAEL Shannon MCGRATH
金额：
$ 56.7万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-18 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10245125
关键词：
Acquired Immunodeficiency Syndrome Address Africa South of the Sahara Anti-Retroviral Agents B-Cell Activation B-Lymphocytes Bar Codes Biocompatible Materials Bioinformatics Biological Assay Biopsy CD3 Antigens CD8B1 gene Case Study Categories Cell Count Cell Line Cells Clinical Clinical Trials Complex Complex Mixtures Cytokine Signaling DNA Data Data Set Development Diagnosis Disease Disease remission Elements Ensure Environment Evaluation Future Gene Expression Gene Expression Profiling Genes Genotype Growth Factor HIV Histologic Human Human Herpesvirus 8 Imaging technology Immune Immune system Immunohistochemistry Immunologic Factors Immunologics In Vitro Individual Infection Infiltration Inflammatory Kaposi Sarcoma Lytic Virus MS4A1 gene Machine Learning Malignant Neoplasms Nature Outcome Participant Pathogenesis Pathology Pathway interactions Patients Pattern Phenotype Phylogenetic Analysis Physical environment Plasma Play Population Population Sizes Process RNA Rest Risk Role Serous Statistical Data Interpretation Structure T-Lymphocyte Technology Testing Tissue Banks Tissue Microarray Tissues Tropism Tumor Tissue Tumor-infiltrating immune cells United States Up-Regulation Viral Viral Genes Viral Load result Viral Proteins Virus Virus Diseases antiretroviral therapy base chemotherapy clinically relevant cohort combinatorial complex data cytokine deep sequencing detection assay experience experimental study immunoregulation in vivo innovation macrophage mortality novel recruit single molecule real time sequencing therapy resistant transcriptome transcriptome sequencing tumor tumor microenvironment tumor progression

项目摘要

Abstract Kaposi's Sarcoma (KS) is the most common AIDS-defining cancer. Combined anti-retroviral therapy (cART) has greatly reduced KS-associated mortality among AIDS patients; however, a serous clinical problem exists in that up to 50% of HIV+KS+ patients in the United States and 61% in Sub-Saharan Africa never achieve complete remission even with chemotherapy and a reduction in HIV viral loads. No definitive study has identified if there are tumor-associated features or mechanisms are associated with cART-progressive KS (progressors) vs. the responder (responders) phenotype. Our study utilizes a robust pre-cART KS tissue collection (n = 224) from the ACSR that originated from the Antiretrovirals for Kaposi's Sarcoma (ARKS) clinical trial. 36% of ARKS participants experienced continued progression of KS despite a reduction in viral loads and restored T-cell counts, in contrast to the rest of the cohort who experienced a reduction or elimination of tumors by the 1-year trial endpoint. This application poses several hypotheses concerning the progressor phenotype: 1) prior to the initiation of cART, an increase in HIV and/or KSHV-infected immune cells enhances a stimulatory immunological profile in the progressor phenotype, 2) there are significant differences in the upregulation of KSHV lytic and immunomodulation genes, which stimulate increased immune cell recruitment into the pre-cART tumor microenvironment and promote tumor progression through cytokine-signaling inflammatory processes enhanced in part by the cART-revitalized immune system, 3) the highly inflammatory nature of KS tumors, comprising a complex mixture of immune cells with which to interact, selects for unique and/or elusive HIV genotypes, distinct from plasma HIV, that promote stimulatory processes to continue in the progressor phenotype. Our Specific Aims address these hypotheses using a combination of advanced immunohistochemistry, virus specific cellular localization (DNA and RNAscope), high-throughput gene expression analysis (RNAseq), and a novel deep sequencing approach applied to HIV. Innovations include the unprecedented amount pre-cART KS tumor material available for the study, advanced imagining technologies, in vivo KS tumors gene expression studies, the use of the newer PacBio SMRT sequencing approach applied to HIV, and machine-learning approaches that can define non-linear associations in complex data sets. This project will define the largest well-characterized set of combinatorial features related to cART-associated KS outcomes derived directly from KS-associated biomaterial. Identifying clinically relevant immune factors in the tumor niche pre-cART will pave the way for the development of future mechanistic studies on the functions of both viral and cellular genes that are involved in cART resistant tumor progression.

摘要