Immunotherapy plays an increasing role in systemic therapy for hepatocellular carcinoma(HCC),however, it's observed that monotherapy cannot achieve a high response rate in clinic. In order to offer a novel and comprehensive immunotherapeutic strategy for HCC, the present study set the components involved in the HCC immunosuppressive microenvironment as the objects(immune cells, immunosuppressive cytokines and immune checkpoint molecules) and reviewed their origin, morphological and functional characteristics, and the emphasis had been put on the mechanisms of the immune tolerance.
ZHANG Feng, YIN Xin.
Research progress on the mechanisms of immune tolerance in hepatocellular carcinoma[J]. Fudan University Journal of Medical Sciences, 2020, 47(02): 280-287 https://doi.org/10.3969/j.issn.1672-8467.2020.02.023
[1] FORNER A,REIG M,BRUIX J.Hepatocellular carcinoma[J].Lancet,2018,391(10127):1301-1314.
[2] MARQUARDT JU,ANDERSEN,THORGEIRSSON SS.Functional and genetic deconstruction of the cellular origin in liver cancer[J].Nat Rev Cancer,2015,15(11):653-667.
[3] SCHULZE K,NAULT JC,VILLANUEVA A.Genetic profiling of hepatocellular carcinoma using next-generation sequencing[J].J Hepatol,2016,65(5):1031-1042.
[4] OSAKI Y,NISHIKAWA H.Treatment for hepatocellular carcinoma in Japan over the last three decades:Our experience and published work review[J].Hepatol Res,2015,45(1):59-74.
[5] SAKAGUCHI S,SAKAGUCHI N,ASANO M,et al.Immunologic self-Tolerance maintained by activated T cells expressing IL-2 receptor alpha-Chains(CD25) breakdown of a single mechanism of self-tolerance causes various autoimmune diseases[J].J Immunol,2011,186(7):1151-1164.
[6] HORI S,NOMURA T,SAKAGUCHI S.Control of regulatory T cell development by the transcription factor Foxp3[J].Science,2003,299(5609):1057-1061.
[7] TANAKA A,SAKAGUCHI S.Regulatory T cells in cancer immunotherapy[J].Cell Res,2017,27(1):109-118.
[8] CHAUDHARY B,ELKORD E.Regulatory T Cells in the tumor microenvironment and cancer progression:role and therapeutic targeting[J].Vaccines(Basel),2016,4(3):E28.
[9] CARIANI E,MISSALE G.Immune landscape of hepatocellular carcinoma microenvironment:implications for prognosis and therapeutic applications[J].Liver Int,2019,39(9):1608-1621.
[10] GAO Q,QIU SJ,FAN J,et al.Intratumoral balance of regulatory and cytotoxic T cells is associated with prognosis of hepatocellular carcinoma after resection[J].J Clin Oncol,2007,25(18):2586-2593.
[11] ZHENG C,ZHENG L,YOO JK,et al.Landscape of infiltrating t cells in liver cancer revealed by single-cell sequencing[J].Cell,2017,169(7):1342-1356,e1316.
[12] SPRINZL MF,GALLE PR.Immune control in hepatocellular carcinoma development and progression:role of stromal cells[J].Semin Liver Dis,2014,34(4):376-388.
[13] CHEN X,DU Y,HUANG Z.CD4+ CD25+ Treg derived from hepatocellular carcinoma mice inhibits tumor immunity[J].Immunol Lett,2012,148(1):83-89.
[14] KALATHIL S,LUGADE AA,MILLER A,et al.Higher frequencies of GARP(+)CTLA-4(+)Foxp3(+) T regulatory cells and myeloid-derived suppressor cells in hepatocellular carcinoma patients are associated with impaired T-cell functionality[J].Cancer Res,2013,73(8):2435-2444.
[15] CAI XY,NI XC,YI Y,et al.Overexpression of CD39 in hepatocellular carcinoma is an independent indicator of poor outcome after radical resection[J].Medicine,2016,95(40):e4989.
[16] KORANGY F,HÖCHST B,MANNS MP,et al.Immunotherapy of hepatocellular carcinoma[J]. Exp Rev Gastroenterol Hepatol,2010,4(3):345-353.
[17] VEGLIA F,PEREGO M,GABRILOVICH D.Myeloid-derived suppressor cells coming of age[J].Nat Immunol,2018,19(2):108-119.
[18] LI X,YAO W,YUAN Y,et al.Targeting of tumour-infiltrating macrophages via CCL2/CCR2 signalling as a therapeutic strategy against hepatocellular carcinoma[J].Gut,2017,66(1):157-167.
[19] GAO XH,TIAN L,WU J,et al.Circulating CD14 HLA-DR myeloid-derived suppressor cells predicted early recurrence of hepatocellular carcinoma after surgery[J].Hepatol Res,2017,47(10):1061-1071.
[20] MIZUKOSHI E,YAMASHITA T,ARAI K,et al.Myeloid-derived suppressor cells correlate with patient outcomes in hepatic arterial infusion chemotherapy for hepatocellular carcinoma[J].Cancer Immunol Immunother,2016,65(6):715-725.
[21] DRAGHICIU O,LUBBERS J,NIJMAN HW,et al.Myeloid derived suppressor cells-An overview of combat strategies to increase immunotherapy efficacy[J].Oncoimmunology,2015,4(1):e954829.
[22] LU T,GABRILOVICH DI.Molecular pathways:tumor-infiltrating myeloid cells and reactive oxygen species in regulation of tumor microenvironment[J].Clin Cancer Res,2012,18(18):4877-4882.
[23] KONDO Y,SHIMOSEGAWA T.Significant roles of regulatory T cells and myeloid derived suppressor cells in hepatitis B virus persistent infection and hepatitis B virus-related HCCs[J].Int J Mol Sci,2015,16(2):3307-3322.
[24] ILKOVITCH D,LOPEZ DM.The liver is a site for tumor-induced myeloid-derived suppressor cell accumulation and immunosuppression[J].Cancer Res,2009,69(13):5514-5521.
[25] HOECHST B,VOIGTLAENDER T,ORMANDY L,et al.Myeloid derived suppressor cells inhibit natural killer cells in patients with hepatocellular carcinoma via the NKp30 Receptor[J].Hepatology,2009,50(3):799-807.
[26] DOU L,ONO Y,CHEN YF,et al.Hepatic dendritic cells,the tolerogenic liver environment,and liver disease[J].Semin liver Dis,2018,38(2):170-180.
[27] REIZIS B,BUNIN A,GHOSH HS,et al.Plasmacytoid dendritic cells:recent progress and open questions[J].Ann Rev Immunol,2011,29:163-183.
[28] GUILLIAMS M,GINHOUX F,JAKUBZICK C,et al.Dendritic cells,monocytes and macrophages:a unified nomenclature based on ontogeny[J].Nat Rev Immunol,2014,14(8):571-578.
[29] SCHLITZER A,SIVAKAMASUNDARI V,CHEN JM,et al.Identification of cDC1-and cDC2-committed DC progenitors reveals early lineage priming at the common DC progenitor stage in the bone marrow[J].Nat Immunol,2015,16(7):718-728.
[30] MILDNER A,JUNG S.Development and function of dendritic cell subsets[J].Immunity,2014,40(5):642-656.
[31] MURPHY TL,GRAJALES-REYES GE,WU XD,et al.Transcriptional control of dendritic cell development[J].Ann Rev Immunol,2016,34:93-119.
[32] SEGURA E,TOUZOT M,BOHINEUST A,et al.Human inflammatory dendritic cells induce th17 cell differentiation[J].Immunity,2013,38(2):336-348.
[33] CONEJO-GARCIA JR,RUTKOWSKI MR,CUBILLOS-RUIZ JR.State-of-the-art of regulatory dendritic cells in cancer[J].Pharmacol Ther,2016,164:97-104.
[34] GENTLES AJ,NEWMAN AM,LIU CL,et al.The prognostic landscape of genes and infiltrating immune cells across human cancers[J].Nat Med,2015,21(8):938-945.
[35] ZHONG M,ZHONG C,CUI W,et al.Induction of tolerogenic dendritic cells by activated TGF-β/Akt/Smad2 signaling in RIG-I-deficient stemness-high human liver cancer cells[J]. BMC Cancer,2019,19(1):439.
[36] MIZUKOSHI E,KANEKO S.Immune cell therapy for hepatocellular carcinoma[J].J Hematol Oncol,2019,12(1):52.
[37] OUYANG FZ,WU RQ,WEI Y,et al.Dendritic cell-elicited B-cell activation fosters immune privilege via IL-10 signals in hepatocellular carcinoma[J].Nat Commun,2016,7:13453.
[38] PEDROZA-GONZALEZ A,ZHOU GY,VARGAS-MENDEZ E,et al.Tumor-infiltrating plasmacytoid dendritic cells promote immunosuppression by Tr1 cells in human liver tumors[J].Oncoimmunology,2015,4(6):e1008335.
[39] SONG S,YUAN P,WU H,et al.Dendritic cells with an increased PD-L1 by TGF-β induce T cell anergy for the cytotoxicity of hepatocellular carcinoma cells[J].Int Immunopharmacol,2014,20(1):117-123.
[40] ZHOU G,SPRENGERS D,BOOR PPC,et al.Antibodies Against immune checkpoint molecules restore functions of tumor-infiltrating t cells in hepatocellular carcinomas[J]. Gastroenterology,2017,153(4):1107-1119,e1110.
[41] CHENG JT,DENG YN,YI HM,et al.Hepatic carcinoma-associated fibroblasts induce IDO-producing regulatory dendritic cells through IL-6-mediated STAT3 activation[J]. Oncogenesis,2016,5:e198.
[42] LIU Y,CAO XT.The origin and function of tumor-associated macrophages[J].Cell Mol Immunol,2015,12(1):1-4.
[43] CAPECE D,FISCHIETTI M,VERZELLA D,et al.The inflammatory microenvironment in hepatocellular carcinoma:a pivotal role for tumor-associated macrophages[J].Biomed Res Int,2013,2013:187204.
[44] TAKAI H,ASHIHARA M,ISHIGURO T,et al.Involvement of glypican-3 in the recruitment of M2-polarized tumor-associated macrophages in hepatocellular carcinoma[J].Cancer Biol Ther,2009,8(24):2329-2338.
[45] YEUNG OW,LO CM,LING CC,et al.Alternatively activated(M2) macrophages promote tumour growth and invasiveness in hepatocellular carcinoma[J].J Hepatol,2015,62(3):607-616.
[46] DONG PP,MA LJ,LIU LZ,et al.CD86(+)/CD206(+),diametrically polarized tumor-associated macrophages,predict hepatocellular carcinoma patient prognosis[J].Int J Mol Sci,2016,17(3):320.
[47] KUANG DM,ZHAO QY,PENG C,et al.Activated monocytes in peritumoral stroma of hepatocellular carcinoma foster immune privilege and disease progression through PD-L1[J].J Exp Med,2009,206(6):1327-1337.
[48] GORDON SR,AUTE RLM,DULKEN BW,et al.PD-1 expression by tumour-associated macrophages inhibits phagocytosis and tumour immunity[J].Nature,2017,545(7655):495-499.
[49] ZHOU J,DING T,PAN W,et al.Increased intratumoral regulatory T cells are related to intratumoral macrophages and poor prognosis in hepatocellular carcinoma patients[J]. Int J Cancer,2009,125(7):1640-1648.
[50] LI TJ,YANG Y,HUA XF,et al.Hepatocellular carcinoma-associated fibroblasts trigger NK cell dysfunction via PGE2 and IDO[J].Cancer Lett,2012,318(2):154-161.
[51] DENG Y,CHENG J,FU B,et al.Hepatic carcinoma-associated fibroblasts enhance immune suppression by facilitating the generation of myeloid-derived suppressor cells[J]. Oncogene,2017,36(8):1090-1101.
[52] CHENG Y,LI H,DENG Y,et al.Cancer-associated fibroblasts induce PDL1+ neutrophils through the IL6-STAT3 pathway that foster immune suppression in hepatocellular carcinoma[J].Cell Death Dis,2018,9(4):422.
[53] ZHAO W,ZHANG L,XU Y,et al.Hepatic stellate cells promote tumor progression by enhancement of immunosuppressive cells in an orthotopic liver tumor mouse model[J]. Lab Invest,2014,94(2):182-191.
[54] XU YP,ZHAO WX,XU JF,et al.Activated hepatic stellate cells promote liver cancer by induction of myeloid-derived suppressor cells through cyclooxygenase-2[J].Oncotarget,2016,7(8):8866-8878.
[55] CHEN YC,HUANG YH,REIBERGER T,et al.Differential Effects of sorafenib on liver versus tumor fibrosis mediated by stromal-derived factor 1 Alpha/C-X-C receptor type 4 axis and myeloid differentiation antigen-positive myeloid cell infiltration in mice[J].Hepatology,2014,59(4):1435-1447.
[56] DAVID CJ,MASSAGUÉ J.Contextual determinants of TGFβ action in development,immunity and cancer[J].Nat Rev Mol Cell Biol,2018,19(7):419-435.
[57] HAMMERICH L,TACKE F.Interleukins in chronic liver disease:lessons learned from experimental mouse models[J].Clin Exp Gastroenterol,2014,7:297-306.
[58] RAI V,ABDO J,ALSUWAIDAN AN,et al.Cellular and molecular targets for the immunotherapy of hepatocellular carcinoma[J].Mol Cell Biochem,2017,437(1-2):13-36.
[59] MUNN DH,MELLOR AL.IDO in the tumor microenvironment:inflammation,counter-regulation,and tolerance[J].Trends Immunol,2016,37(3):193-207.
[60] HAN YM,CHEN ZB,YANG Y,et al.Human CD14(+)CTLA-4(+) regulatory dendritic cells suppress T-cell response by cytotoxic T-lymphocyte antigen-4-dependent IL-10 and Indoleamine-2,3-dioxygenase production in hepatocellular carcinoma[J].Hepatology,2014,59(2):567-579.
[61] ASGHAR K,FAROOQ A,ZULFIQAR B,et al.Indoleamine 2,3-dioxygenase:As a potential prognostic marker and immunotherapeutic target for hepatocellular carcinoma[J].World K Gastroenterol,2017,23(13):2286-2293.
[62] HOECHST B,ORMANDY LA,BALLMAIER M,et al.A new population of myeloid-derived suppressor cells in hepatocellular carcinoma patients induces CD4(+)CD25(+)Foxp3(+) T cells[J].Gastroenterology,2008,135(1):234-243.
[63] KANG FB,WANG L,LI D,et al.Hepatocellular carcinomas promote tumor-associated macrophage M2-polarization via increased B7-H3 expression[J].Oncol Rep,2015,33(1):274-282.
[64] ZAREK PE,HUANG CT,LUTZ ER,et al.A2A receptor signaling promotes peripheral tolerance by inducing T-cell anergy and the generation of adaptive regulatory T cells[J]. Blood,2008,111(1):251-259.
[65] ZAROUR HM.Reversing T-cell dysfunction and exhaustion in cancer[J].Clin Cancer Res,2016,22(8):1856-1864.
[66] DYCK L,MILLS KHG.Immune checkpoints and their inhibition in cancer and infectious diseases[J].Eur J Immunol,2017,47(5):765-779.
[67] HATO T,GOYAL L,GRETEN TF,et al.Immune checkpoint blockade in hepatocellular carcinoma:current progress and future directions[J].Hepatology,2014,60(5):1776-1782.
[68] IHLING C,NAUGHTON B,ZHANG Y,et al.Observationalstudy of PD-L1,TGF-β,and immune cell infiltrates in hepatocellular carcinoma[J].Front Med,2019,6:15.
[69] EL-KHOUEIRY AB,SANGRO B,YAU T,et al.Nivolumab in patients with advanced hepatocellular carcinoma(CheckMate 040):an open-label,non-comparative,phase 1/2 dose escalation and expansion trial[J].Lancet,2017,389(10088):2492-2502.
[70] EL-DIKA I,KHALIL DN,ABOU-ALFA GK.Immune checkpoint inhibitors for hepatocellular carcinoma[J].Cancer,2019,125(19):3312-3319.
[71] ZHU AX,FINN RS,EDELINE J,et al.Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenibofNOTE-224):a non-randomised,open-label phase 2 trial[J].Lancet Oncol,2018,19(7):940-952.
[72] KUDO M.Immuno-Oncology in Hepatocellular Carcinoma:2017 Update[J].Oncology,2017,93(Suppl 1):147-159.
[73] RAMAGOPAL UA,LIU WF,GARRETT-THOMSON SC,et al.Structural basis for cancer immunotherapy by the first-in-class checkpoint inhibitor ipilimumab[J].Proc Natl Acad Sci U S A,2017,114(21):E4223-E4232.
[74] CHEN X,DU Y,HU QQ,et al.Tumor-derived CD4+ CD25+ regulatory T cells inhibit dendritic cells function by CTLA-4[J].Pathol Res Prac,2017,213(3):245-249.
[75] MIZUKOSHI E,NAKAMOTO Y,ARAI K,et al.Comparative analysis of various tumor-associated antigen-specific t-cell responses in patients with hepatocellular carcinoma[J]. Hepatology,2011,53(4):1206-1216.
[76] LI H,WU K,TAO KX,et al.Tim-3/galectin-9 signaling pathway mediates T-cell dysfunction and predicts poor prognosis in patients with hepatitis B virus-associated hepatocellular carcinoma[J].Hepatology,2012,56(4):1342-1351.
[77] YAN WJ,LIU X,MA HX,et al.Tim-3 fosters HCC development by enhancing TGF-beta-mediated alternative activation of macrophages[J].Gut,2015,64(10):1593-1604.
[78] LI FJ,ZHANG Y,JIN GX,et al.Expression of LAG-3 is coincident with the impaired effector function of HBV-specific CD8(+) T cell in HCC patients[J].Immunol Lett,2013,150(1-2):116-122.
[79] MATSUDA Y,YAMAGIWA Y,FUKUSHIMA K,et al.Expression of galectin-3 involved in prognosis of patients with hepatocellular carcinoma[J].Hepatol Res,2008,38(11):1098-1111.
[80] HOKUTO D,SHO M,YAMATO I,et al.Clinical impact of herpesvirus entry mediator expression in human hepatocellular carcinoma[J].Eur J Cancer,2015,51(2):157-165.