外泌体在卵巢癌诊疗中的研究进展

卵巢癌是妇科常见的恶性肿瘤,具有发病率高、5年生存率低、早期不易发现、易转移反复等特点,严重威胁妇女健康.外泌体是多囊泡体与细胞膜融合后释放到细胞外直径为30~100 nm的囊泡样小体,其在肿瘤发生发展、早期诊断、化疗药物选择及治疗中的潜在价值引起了广泛关注,本文主要对外泌体在卵巢癌诊疗中的研究进展做以综述.     

Role of exosomes in cellular communication between tumor cells and the tumor microenvironment

Exosomes are nanovesicles secreted by almost all types of cells. They contain RNAs, microRNAs, proteins and other bioactive substances, and can be used as carriers and for communication between cells. They regulate numerous biological processes, such as tumor development, cell proliferation and resistance to chemotherapy. Exosome-mediated communication between tumor cells and the tumor microenvironment (TME) is crucial in the initiation and progression of tumor development. The present review aims to summarize the role of exosomes in mediating the communication between tumor cells and the TME and to suggest the potential use of exosomes as targets for the development of novel therapeutic strategies against cancer.     

Exosomes: Mediators in microenvironment of colorectal cancer

Tumor microenvironment, the soil where tumor thrives, plays a critical role in the development and progression of colorectal cancer (CRC). Various cell signaling molecules in the environment promote tumor angiogenesis, immune tolerance and facilitate immune escape. Exosomes, as messengers between tumor and host cells, are considered key mediators involved in the tumor-accelerating environment. However, the exosome-mediated communication networks in the CRC microenvironment are still largely unclear. In this review, we summarized the relationship between TME and CRC based on recent literature. Then, we revealed the unique impacts and signal molecules of exosomes on account of their regulatory role in the flora, hypoxia, inflammatory and immunological microenvironment of CRC. Finally, we summarized the therapeutically effective of exosomes in CRC microenvironment and discussed their current status and prospects, aiming to provide new molecular targets and a theoretical basis for the CRC treatment.     

Role of the tumor immune microenvironment in tumor immunotherapy

Tumor immunotherapy is considered to be a novel and promising therapy for tumors and it has recently become a hot research topic. The clinical success of tumor immunotherapy has been notable, but it has been less than totally satisfactory because tumor immunotherapy has performed poorly in numerous patients although it has shown appreciable efficacy in some patients. A minority of patients demonstrate durable responses but the majority of patients do not respond to tumor immunotherapy as the tumor immune microenvironment is different in different patients for different tumor types. The success of tumor immunotherapy may be affected by the heterogeneity of the tumor immune microenvironment and its components, as these vary widely during neoplastic progression. The deepening of research and the development of technology have improved our understanding of the complexity and heterogeneity of the tumor immune microenvironment and its components, and their effects on response to tumor immunotherapy. Therefore, investigating the tumor immune microenvironment and its components and elucidating their association with tumor immunotherapy should improve the ability to study, predict and guide immunotherapeutic responsiveness, and uncover new therapeutic targets.     

Targeting the tumour microenvironment in ovarian cancer

The study of cancer initiation, growth, and metastasis has traditionally been focused on cancer cells, and the view that they proliferate due to uncontrolled growth signalling owing to genetic derangements. However, uncontrolled growth in tumours cannot be explained solely by aberrations in cancer cells themselves. To fully understand the biological behaviour of tumours, it is essential to understand the microenvironment in which cancer cells exist, and how they manipulate the surrounding stroma to promote the malignant phenotype.Ovarian cancer is the leading cause of death from gynaecologic cancer worldwide. The majority of patients will have objective responses to standard tumour debulking surgery and platinum-taxane doublet chemotherapy, but most will experience disease recurrence and chemotherapy resistance. As such, a great deal of effort has been put forth to develop therapies that target the tumour microenvironment in ovarian cancer. Herein, we review the key components of the tumour microenvironment as they pertain to this disease, outline targeting opportunities and supporting evidence thus far, and discuss resistance to therapy.     

肿瘤微环境中外泌体功能研究进展

细胞外囊泡是一种十分重要的细胞间通讯的方式,尤其是外泌体在生理、病理过程中的调控作用越来越受到研究人员的关注。而在肿瘤微环境中,肿瘤细胞、免疫细胞、基质细胞都是外泌体的主要来源,外泌体中包裹的大量生物活性分子,对下游靶细胞的表型分化、生理功能、代谢状态有着重要的作用。探究肿瘤微环境中外泌体的调控作用,对进一步认识肿瘤发生、进展、转移、耐药、免疫逃逸等过程有着十分重要的意义,并且可作为肿瘤患者早期诊断和预后评价的重要指标。本文将主要介绍外泌体在肿瘤微环境中的作用。     

Immune cell infiltration as an indicator of the immune microenvironment of pancreatic cancer

Background:

The host immune reaction is represented by immune/inflammatory cell infiltrates. Here we systematically analysed tumour-infiltrating immune/inflammatory cells in pancreatic ductal carcinoma (PDC) and evaluated their clinicopathological impact.

Methods:

Using immunohistochemistry, we examined tumour-infiltrating CD68⁺ pan-macrophages, HLA-DR⁺CD68⁺ M1 macrophages (M1), CD163⁺ or CD204⁺ M2 macrophages (M2), CD66b⁺ neutrophils (Neu), CD4⁺ T cells (CD4⁺T), CD8⁺ T cells (CD8⁺T), and FOXP3⁺CD4⁺ regulatory T cells (Treg) in 212 cases of PDC, and conducted correlation and survival analyses using the Kaplan–Meier method and Cox proportional hazards model.

Results:

Higher levels of tumour-infiltrating pan-macrophages, M2, Neu, or the ratio of Tregs to CD4⁺T (%Treg) were significantly associated with shorter survival, whereas higher levels of tumour-infiltrating CD4⁺T, CD8⁺T, or the ratio of M1 to pan-macrophages (%M1) were significantly associated with longer survival. Survival analysis of pairs of these variables revealed that some of the resulting patient groups had exclusively longer survival. We then connected the apparently related factors, and two significant variables emerged: tumour-infiltrating CD4⁺T^high/CD8⁺T^high/%Treg^low and tumour-infiltrating %M1^high/M2^low. Multivariate survival analysis revealed that these variables were significantly correlated with longer survival and had a higher hazard ratio.

Conclusion:

Tumour-infiltrating CD4⁺T^high/CD8⁺T^high/%Treg^low and %M1^high/M2^low are independent prognosticators useful for evaluating the immune microenvironment of PDC.     

免疫微环境促进肿瘤发生发展的机制研究进展

机体免疫有宿主保护和肿瘤促进双重作用免疫微环境对肿瘤的促进作用知之甚少。研究发现本文讨论免疫微环境可直接或间接地影响肿瘤的发生发展,其机制。其机制包括促进肿瘤血管生成、改变肿瘤的生物学特性、筛选适应微环境的肿瘤细胞存活或建立适宜的肿瘤微环境促进肿瘤进展,甚至可以调节肿瘤干细胞活性。基于免疫微环境在肿瘤发生发展中的重要作用,免疫治疗成为一种重要的抗肿瘤治疗手段,而探索免疫治疗和细胞毒药物或分子靶向药物联合的多模式治疗可能是未来肿瘤免疫治疗的方向。     

卵巢癌肿瘤微环境中长链非编码RNA的研究进展

卵巢癌是死亡率最高的妇科恶性肿瘤,其微环境是由多种细胞和非细胞成分共同组成的。肿瘤细胞和微环境的相互作用影响肿瘤的进展。因此,寻找新的肿瘤标志物及治疗靶点有着重要意义。长链非编码RNA（long non-coding RNA,lncRNA）是长度超过200个核苷酸的非编码RNA,在多种肿瘤的发生、发展和耐药中发挥着重要的作用。在本篇综述中,研究证明lncRNA在卵巢癌肿瘤微环境中细胞成分和非细胞成分交流的过程中发挥重要作用。此外,本文总结了以lncRNA作为靶向卵巢癌肿瘤微环境或细胞成分潜在靶点的治疗方式。     

Nanobiotherapeutic strategies to target immune microenvironment of triple-negative breast cancer

Triple-negative breast cancer (TNBC) is the subtype with the least favourable outcomes in breast cancer. Besides chemotherapy, there is a chronic lack of other effective treatments. Advances in omic technologies have liberated us from the ambiguity of TNBC heterogeneity in terms of cancer cell and immune microenvironment in recent years. This new understanding of TNBC pathology has already led to the exploitation of novel nanoparticulate systems, including tumor vaccines, oncolytic viruses, and antibody derivatives. The revolutionary ideas in the therapeutic landscape provide new opportunities for TNBC patients. Translating these experimental medicines into clinical benefit is both appreciated and challenging. In this review, we describe the prospective nanobiotherapy of TNBC that has been developed to overcome clinical obstacles, and provide our vision for this booming field at the overlap of cancer biotherapy and nanomaterial design.     

miR-214、miR-503在上皮性卵巢癌组织及血清外泌小体中表达的研究

目的 检测正常卵巢、化疗敏感上皮性卵巢癌(EOC)及化疗耐药EOC组织及血清外泌小体中p53相关miR-214、miR-503的表达差异,初探p53相关miRNA与EOC耐药的关系.方法 采用免疫荧光法检测正常卵巢、化疗敏感EOC及化疗耐药EOC组织中p53的表达;RT-PCR法检测血清外泌小体及上述3种组织中p53相关miR-214、miR-503表达的差异.结果 免疫荧光法发现,与正常组织相比,p53在EOC组织中荧光较弱,其中化疗耐药EOC组织与化疗敏感EOC组织间比较差异无统计学意义(P﹥0.05).与敏感组相比,耐药组血清外泌小体中miR-214上调3倍,miR-503下调3倍,与组织中变化一致.结论 p53相关miR-214及miR-503由外泌小体携带进入血液循环,并可能在EOC化疗耐药中发挥重要作用.     

Hospicells derived from ovarian cancer stroma inhibit T‐cell immune responses

With metastatic disease at diagnosis for 70% of patients, ovarian cancer represents the most lethal gynecological malignancy. Ovarian carcinomas are aggressive malignancies that can evade immune surveillance and frequently develop into metastases. The tumor microenvironment is decisive for preventing immune attack but, in the case of ovarian carcinoma, the mechanisms are unclear. We recently isolated a novel type of stromal cell from the ascitis of patients with ovarian carcinoma that interacts with epithelial ovarian cancers conferring them chemoresistance. These cells, called Hospicells, have the cell surface markers CD9, CD10, CD29, CD146 and CD166. Here, we investigated whether Hospicells also have immunomodulatory functions that might interfere with immunity to cancer. We report that Hospicells inhibit the proliferation of human CD4⁺, CD8⁺ and Vγ9Vδ2 T cells in vitro and the production of cytokines by these immune cells. The immunosuppression of CD4⁺ T cells is independent of direct contact with the Hospicells and is mainly due to nitric oxide produced by the inducible nitric oxide synthase and to products of the tryptophan degradation by indoleamine 2,3‐dioxygenase. We proposed that Hospicells in the microenvironment of the tumor mediate immunosuppression of T cells and thus allow ovarian cancers to evade immune surveillance. Targeting of Hospicells could be an alternative to strong chemotherapy through the recovery of immune responses against tumor cells.     

A distinct pre-existing inflammatory tumour microenvironment is associated with chemotherapy resistance in high-grade serous epithelial ovarian cancer

Background:

Chemotherapy resistance is a major determinant of poor overall survival rates in high-grade serous ovarian cancer (HGSC). We have previously shown that gene expression alterations affecting the NF-κB pathway characterise chemotherapy resistance in HGSC, suggesting that the regulation of an immune response may be associated with this phenotype.

Methods:

Given that intrinsic drug resistance pre-exists and is governed by both tumour and host factors, the current study was performed to examine the cross-talk between tumour inflammatory microenvironment and cancer cells, and their roles in mediating differential chemotherapy response in HGSC patients. Expression profiling of a panel of 184 inflammation-related genes was performed in 15 chemoresistant and 19 chemosensitive HGSC tumours using the NanoString nCounter platform.

Results:

A total of 11 significantly differentially expressed genes were found to distinguish the two groups. As STAT1 was the most significantly differentially expressed gene (P=0.003), we validated the expression of STAT1 protein by immunohistochemistry using an independent cohort of 183 (52 resistant and 131 sensitive) HGSC cases on a primary tumour tissue microarray. Relative expression levels were subjected to Kaplan–Meier survival analysis and Cox proportional hazard regression models.

Conclusions:

This study confirms that higher STAT1 expression is significantly associated with increased progression-free survival and that this protein together with other mediators of tumour–host microenvironment can be applied as a novel response predictive biomarker in HGSC. Furthermore, an overall underactive immune microenvironment suggests that the pre-existing state of the tumour immune microenvironment could determine response to chemotherapy in HGSC.     

Metabolic-associated signature and hub genes associated with immune microenvironment and prognosis in bladder cancer

The relationship between metabolism and immune microenvironment remains to be studied in bladder cancer (BCa). We aimed to construct a metabolic-associated signature for prognostic prediction and investigate its relationship with the immune microenvironment in BCa. The RNA expression of metabolism associated genes was obtained from a combined data set including The Cancer Genome Atlas, GSE48075, and GSE13507 to divide BCa patients into different clusters. A metabolic-associated signature was constructed using the differentially expressed genes between clusters in the combined data set and validated in the IMvigor210 trial and our center. The composition of tumor-infiltrating immune cells (TIICs) was evaluated using the single-sample Gene Set Variation Analysis. BCa patients in Cluster A or high-risk level were associated with advanced clinicopathological features and poor survival outcomes. The percentage of high-risk patients was significantly lower in patients responding to anti-PD-L1 treatment. Compared with low-risk patients, the IC50 values of cisplatin and gemcitabine were significantly lower in high-risk patients. Thiosulfate transferase (TST) and S100A16 were significantly associated with clinicopathological features and prognosis. Downregulation of TST promoted BCa cell invasion, migration, and epithelial-to-mesenchymal transition, which are inhibited by downregulation of S100A16. CD8 + T cells, neutrophils, and dendritic cells had higher infiltration in the TST low-level and the S100A16 high-level. Furthermore, loss of function TST and S100A16 significantly affected the expression of PD-L1 and CD47. The metabolic-associated signature can stratify BCa patients into distinct risk levels with different immunotherapeutic susceptibility and survival outcomes. Metabolism disorder promoted the dysregulation of immune microenvironment, thus contributing to immunosuppression.     

腹水中exosomes的分离和鉴定

目的:从卵巢癌患者腹水中分离exosomes,鉴定其来源及分子表型。方法:用多步离心和超滤等方法从腹水中分离exosomes,分别用免疫电镜和Westernblot检测Hsc73、MHCⅠ类和MHCⅡ类分子的表达。腹水中分离的卵巢癌细胞为阳性对照。结果:从卵巢癌患者腹水中分离的exosomes,其形态为圆形或椭圆形小囊泡,直径约30~90nm;经免疫电镜检测,exosomes有Hsc73和MHCⅠ类分子的金颗粒附着,而MHCⅡ类分子为阴性表达。经Westernblot证实,exosomes表达Hsc73和MHCⅠ类分子,但MHCⅡ类分子表达阴性。结论:经过多步离心、超滤等方法从卵巢癌患者腹水中分离的exosomes来源于卵巢癌细胞,为卵巢癌免疫治疗奠定了基础。     

精准肿瘤医学之实践：靶向肿瘤免疫微环境

近年来,肿瘤免疫治疗技术的发展为拓宽精准肿瘤医学领域做出了巨大贡献。免疫微环境是影响免疫治疗效果的重 要因素,其在肿瘤进展和动员抗肿瘤免疫方面都有不可忽视的作用。针对肿瘤免疫微环境的免疫性放疗、免疫检查点抑制剂、肿 瘤疫苗和免疫细胞治疗等手段已在临床研究中取得了很多成果,但其临床疗效仍有待提高。本文在介绍肿瘤免疫微环境的组成 和特征的基础上,从临床应用的角度阐述针对目前靶向肿瘤免疫微环境的治疗手段可行的优化策略。     

Tumor immune microenvironment and immune checkpoint inhibitors in esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma (ESCC) is the main prevalent histological type of esophageal cancer, predominantly constituting 90% of cases worldwide. Despite the development of multidisciplinary therapeutic approaches, its prognosis remains unfavorable. Recently, the development of monoclonal antibodies inhibiting programmed death 1 (PD‐1) or programmed death‐ligand 1 (PD‐L1) has led to marked therapeutic responses among multiple malignancies including ESCC. However, only a few patients achieved clinical benefits due to resistance. Therefore, precise and accurate predictive biomarkers should be identified for personalized immunotherapy in clinical settings. Because the tumor immune microenvironment can potentially influence the patient's response to immune checkpoint inhibitors, tumor immunity, such as PD‐L1 expression on tumors, tumor‐infiltrating lymphocytes, tumor‐associated macrophages, and myeloid‐derived suppressor cells, in ESCC should be further investigated. In this review, accumulated evidence regarding the tumor immune microenvironment and immune checkpoint inhibitors in ESCC are summarized.     

脑胶质瘤免疫微环境的研究进展

脑胶质瘤是最常见的中枢神经系统原发性肿瘤,由于存在血脑屏障及其独特的组织器官区域免疫特性,对脑组织免疫微环境与疾病发生发展的相关性研究显得尤为重要。本文将聚焦于生理与病理状态下脑局部免疫微环境的改变,通过对脑胶质瘤局部的各类免疫细胞、免疫分子的作用及机制的介绍,阐明脑胶质瘤局部免疫微环境的抑制效应促进了肿瘤的生长;通过对脑胶质瘤局部免疫微环境的调控和干预,期望改善或逆转上述负性作用,为脑胶质瘤的免疫及综合治疗提供依据。     

肿瘤免疫微环境在肿瘤常规治疗效应中的作用

机体免疫系统能识别和杀伤恶变的细胞,从而清除肿瘤细胞或控制其生长.在机体免疫选择压力下,肿瘤细胞可以依靠自身的高突变特性,逃避免疫监视,逐步建立起免疫抑制微环境,以抵抗和抑制机体抗肿瘤免疫反应,从而能够突破限制而持续扩增,最终发展成为临床可见的肿瘤.目前肿瘤治疗的策略主要是着眼于直接抑制肿瘤细胞增殖以及杀伤和清除肿瘤细胞,然而越来越多的研究结果表明,常规治疗导致的肿瘤细胞免疫原性死亡,可以激活先天性免疫信号通路,诱发机体内在的抗肿瘤免疫反应,在肿瘤治疗效应中起着关键作用,尤其对防止残存肿瘤细胞的复发具有非常重要的意义.本文概述肿瘤发生、发展和常规治疗过程中,机体抗肿瘤免疫反应与肿瘤免疫抑制微环境的细胞和分子机制,重点讨论两者在肿瘤常规治疗效应中的作用,解析以肿瘤免疫微环境为靶点的治疗策略,讨论该策略对提高目前肿瘤常规治疗疗效和发展新的肿瘤治疗方案的积极意义.