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Erschienen in: Gastric Cancer 2/2012

01.04.2012 | Original article

CD83+ dendritic cells and Foxp3+ regulatory T cells in primary lesions and regional lymph nodes are inversely correlated with prognosis of gastric cancer

verfasst von: Seigo Kashimura, Zenichiro Saze, Masanori Terashima, Nobutoshi Soeta, Satoshi Ohtani, Fumihiko Osuka, Michihiko Kogure, Mitsukazu Gotoh

Erschienen in: Gastric Cancer | Ausgabe 2/2012

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Abstract

Background

Dendritic cells (DCs) are potent antigen-presenting cells that are central to the regulation, maturation, and maintenance of the cellular immune response against cancer. In contrast, CD4+CD25+ regulatory T cells (Tregs) play a central role in self-tolerance and suppress antitumor immunity. In this study, we investigated the clinical significance of mature CD83+ DCs and Foxp3+ Tregs in the primary tumor and regional lymph nodes from the viewpoint of the two opposing players in the immune responses.

Methods

We investigated, immunohistochemically, the density of CD83+ DCs and Foxp3+ Tregs in primary lesions of gastric cancer (n = 123), as well as in regional lymph nodes with (n = 40) or without metastasis (n = 40).

Results

Decreased density of CD83+ DCs and increased density of Foxp3+ Tregs were observed in the primary tumor and metastatic lymph nodes. Density was significantly correlated with certain clinicopathological features. Poor prognosis was observed in patients with a low density of CD83+ DCs and a high density of Foxp3+ Tregs in primary lesions. For patients with metastatic lymph nodes, the density of CD83+ DCs in negative lymph nodes was found to be an independent prognostic factor by multivariate analysis.

Conclusion

The density of CD83+ DCs and Foxp3+ Tregs was inversely correlated with tumor progression and reflected the prognosis of gastric cancer.
Literatur
1.
Zurück zum Zitat Banchereau J, Briere F, Caux C, et al. Immunobiology of dendritic cells. Annu Rev Immunol. 2000;18:767–811.PubMedCrossRef Banchereau J, Briere F, Caux C, et al. Immunobiology of dendritic cells. Annu Rev Immunol. 2000;18:767–811.PubMedCrossRef
2.
Zurück zum Zitat Zhou LJ, Schwarting R, Smith HM, Tedder TF. A novel cell-surface molecule expressed by human interdigitating reticulum cells, Langerhans cells, and activated lymphocytes is a new member of the Ig superfamily. J Immunol. 1992;149:735–42.PubMed Zhou LJ, Schwarting R, Smith HM, Tedder TF. A novel cell-surface molecule expressed by human interdigitating reticulum cells, Langerhans cells, and activated lymphocytes is a new member of the Ig superfamily. J Immunol. 1992;149:735–42.PubMed
3.
Zurück zum Zitat Zhou LJ, Tedder TF. Human blood dendritic cells selectively express CD83, a member of the immunoglobulin superfamily. J Immunol. 1995;154:3821–35.PubMed Zhou LJ, Tedder TF. Human blood dendritic cells selectively express CD83, a member of the immunoglobulin superfamily. J Immunol. 1995;154:3821–35.PubMed
4.
Zurück zum Zitat Bell D, Chomarat P, Broyles D, et al. In breast carcinoma tissue, immature dendritic cells are located in peritumoral areas. J Exp Med. 1999;190:1417–25.PubMedCrossRef Bell D, Chomarat P, Broyles D, et al. In breast carcinoma tissue, immature dendritic cells are located in peritumoral areas. J Exp Med. 1999;190:1417–25.PubMedCrossRef
5.
Zurück zum Zitat Zhou L, Tedder TF. CD14+ blood monocytes can differentiate into functionally mature CD83+ dendritic cells. Immunology. 1999;93:2588–92. Zhou L, Tedder TF. CD14+ blood monocytes can differentiate into functionally mature CD83+ dendritic cells. Immunology. 1999;93:2588–92.
6.
Zurück zum Zitat Thurner M, Radmayr C, Ramoner R, et al. Human renal-cell carcinoma tissue contain dendritic cells. Int J Cancer. 1996;68:1–7.CrossRef Thurner M, Radmayr C, Ramoner R, et al. Human renal-cell carcinoma tissue contain dendritic cells. Int J Cancer. 1996;68:1–7.CrossRef
7.
Zurück zum Zitat Tsukayama S, Omura K, Yoshida K, Tanaka Y, Watanabe G. Prognostic value of CD83 positive mature dendritic cells and their relation to vascular endothelial growth factor in advanced human gastric cancer. Oncol Rep. 2005;14:369–75.PubMed Tsukayama S, Omura K, Yoshida K, Tanaka Y, Watanabe G. Prognostic value of CD83 positive mature dendritic cells and their relation to vascular endothelial growth factor in advanced human gastric cancer. Oncol Rep. 2005;14:369–75.PubMed
8.
Zurück zum Zitat Saito H, Osaki T, Murakami D, et al. Prediction of sites of recurrence in gastric carcinoma using immunohistochemical parameters. J Surg Oncol. 2007;95:123–8.PubMedCrossRef Saito H, Osaki T, Murakami D, et al. Prediction of sites of recurrence in gastric carcinoma using immunohistochemical parameters. J Surg Oncol. 2007;95:123–8.PubMedCrossRef
9.
Zurück zum Zitat Naito Y, Saito K, Shibata K, et al. CD8+ T cells infiltrated within cancer cell nests as a prognostic factor in human colorectal cancer. Cancer Res. 1998;58:3491–4.PubMed Naito Y, Saito K, Shibata K, et al. CD8+ T cells infiltrated within cancer cell nests as a prognostic factor in human colorectal cancer. Cancer Res. 1998;58:3491–4.PubMed
10.
Zurück zum Zitat Furihata M, Ono Y, Ichikawa K, Tomita S, Fujimori T, Kubota K. Prognostic significance of CD83 positive, mature dendritic cells in the gallbladder carcinoma. Oncol Rep. 2005;14:353–6.PubMed Furihata M, Ono Y, Ichikawa K, Tomita S, Fujimori T, Kubota K. Prognostic significance of CD83 positive, mature dendritic cells in the gallbladder carcinoma. Oncol Rep. 2005;14:353–6.PubMed
11.
Zurück zum Zitat Miyagawa S, Soeda J, Takagi S, Miwa S, Ichikawa E, Noike T. Prognostic significance of mature dendritic cells and factors associated with their accumulation in metastatic liver tumors from colorectal cancer. Hum Pathol. 2004;35:1392–6.PubMedCrossRef Miyagawa S, Soeda J, Takagi S, Miwa S, Ichikawa E, Noike T. Prognostic significance of mature dendritic cells and factors associated with their accumulation in metastatic liver tumors from colorectal cancer. Hum Pathol. 2004;35:1392–6.PubMedCrossRef
12.
Zurück zum Zitat Iwamoto M, Shinohara H, Miyamoto A, et al. Prognostic value of tumor-infiltrating dendritic cells expressing CD83 in human breast carcinomas. Int J Cancer. 2003;104:92–7.PubMedCrossRef Iwamoto M, Shinohara H, Miyamoto A, et al. Prognostic value of tumor-infiltrating dendritic cells expressing CD83 in human breast carcinomas. Int J Cancer. 2003;104:92–7.PubMedCrossRef
13.
Zurück zum Zitat Jonuleit H, Schmitt E, Stassen M, Tuettenberg A, Knop J. Identification and functional characterization of human CD4+CD25+ T cells with regulatory properties isolated from peripheral blood. J Exp Med. 2001;193:1285–94.PubMedCrossRef Jonuleit H, Schmitt E, Stassen M, Tuettenberg A, Knop J. Identification and functional characterization of human CD4+CD25+ T cells with regulatory properties isolated from peripheral blood. J Exp Med. 2001;193:1285–94.PubMedCrossRef
14.
Zurück zum Zitat Ng WF, Duggan PJ, Ponchel F, et al. Human CD4+CD25+ cells: a naturally occurring population of regulatory T cells. Blood. 2001;98:2736–44.PubMedCrossRef Ng WF, Duggan PJ, Ponchel F, et al. Human CD4+CD25+ cells: a naturally occurring population of regulatory T cells. Blood. 2001;98:2736–44.PubMedCrossRef
15.
Zurück zum Zitat Sakaguchi S, Sakaguchi N, Asano M, Itoh M, Toda M. Immunologic self-tolerance maintained by activated T cells expressing IL-2 receptor α-chains (CD25). J Immunol. 1995;155:1151–64.PubMed Sakaguchi S, Sakaguchi N, Asano M, Itoh M, Toda M. Immunologic self-tolerance maintained by activated T cells expressing IL-2 receptor α-chains (CD25). J Immunol. 1995;155:1151–64.PubMed
16.
Zurück zum Zitat Sakaguchi S, Ono M, Setoguchi R, et al. Foxp3+CD25+CD4+ natural regulatory T cells in dominant self-tolerance and autoimmune disease. Immunol Rev. 2006;212:8–27.PubMedCrossRef Sakaguchi S, Ono M, Setoguchi R, et al. Foxp3+CD25+CD4+ natural regulatory T cells in dominant self-tolerance and autoimmune disease. Immunol Rev. 2006;212:8–27.PubMedCrossRef
17.
Zurück zum Zitat Dejaco C, Dultner C, Grubeck B, Schirmer M. Imbalance of regulatory T cells in human autoimmune diseases. Immunology. 2005;117:289–300.CrossRef Dejaco C, Dultner C, Grubeck B, Schirmer M. Imbalance of regulatory T cells in human autoimmune diseases. Immunology. 2005;117:289–300.CrossRef
19.
Zurück zum Zitat Viehl C, Moore T, Liyanaga U, et al. Depletion of CD4+CD25+ regulatory T cells promotes a tumor-specific immune response in pancreas cancer-bearing mice. Ann Surg Oncol. 2005;13:1252–8.CrossRef Viehl C, Moore T, Liyanaga U, et al. Depletion of CD4+CD25+ regulatory T cells promotes a tumor-specific immune response in pancreas cancer-bearing mice. Ann Surg Oncol. 2005;13:1252–8.CrossRef
20.
Zurück zum Zitat Rudge G, Barrett SP, Scott B, Driel IR. Infiltration of a mesothelioma by IFN-γ-producing cells and tumor rejection after depletion of regulatory T cells. J Immunol. 2007;178:4089–96.PubMed Rudge G, Barrett SP, Scott B, Driel IR. Infiltration of a mesothelioma by IFN-γ-producing cells and tumor rejection after depletion of regulatory T cells. J Immunol. 2007;178:4089–96.PubMed
21.
Zurück zum Zitat Hori S, Nomura T, Sakaguchi S. Control of regulatory T cells development by the transcription factor Foxp3. Science. 2003;299:1057–61.PubMedCrossRef Hori S, Nomura T, Sakaguchi S. Control of regulatory T cells development by the transcription factor Foxp3. Science. 2003;299:1057–61.PubMedCrossRef
22.
Zurück zum Zitat Fontenot JD, Gavin MA, Rudensky A. Foxp3 programs the development and function of CD4+CD25+ regulatory T cells. Nat Immunol. 2003;10:1330–6. Fontenot JD, Gavin MA, Rudensky A. Foxp3 programs the development and function of CD4+CD25+ regulatory T cells. Nat Immunol. 2003;10:1330–6.
23.
Zurück zum Zitat Fontenot JD, Rasmussen JP, Williams M, Dooley L, Farr AG, Rudensky Y, et al. Regulatory T cell lineage specification by the forkhead transcription factor foxp3. Immunity. 2005;22:329–41.PubMedCrossRef Fontenot JD, Rasmussen JP, Williams M, Dooley L, Farr AG, Rudensky Y, et al. Regulatory T cell lineage specification by the forkhead transcription factor foxp3. Immunity. 2005;22:329–41.PubMedCrossRef
24.
Zurück zum Zitat Woo EY, Chu CS, Goletz TJ, et al. Regulatory CD4+CD25+T cells in tumors from patients with early-stage non-small cell lung cancer and last-stage ovarian cancer. Cancer Res. 2001;61:4766–72.PubMed Woo EY, Chu CS, Goletz TJ, et al. Regulatory CD4+CD25+T cells in tumors from patients with early-stage non-small cell lung cancer and last-stage ovarian cancer. Cancer Res. 2001;61:4766–72.PubMed
25.
Zurück zum Zitat Badoual C, Hans S, Rodriguez J, et al. Prognostic value of tumor-infiltrating C+ T cells subpopulations in head and neck cancers. Clin Cancer Res. 2006;12:465–72.PubMedCrossRef Badoual C, Hans S, Rodriguez J, et al. Prognostic value of tumor-infiltrating C+ T cells subpopulations in head and neck cancers. Clin Cancer Res. 2006;12:465–72.PubMedCrossRef
26.
Zurück zum Zitat Wolf D, Wolf A, Rumpold H, et al. The expression of the regulatory T cell-specific forkhead box transcription factor FoxP3 is associated with poor prognosis in ovarian cancer. Clin Cancer Res. 2005;11:8326–31.PubMedCrossRef Wolf D, Wolf A, Rumpold H, et al. The expression of the regulatory T cell-specific forkhead box transcription factor FoxP3 is associated with poor prognosis in ovarian cancer. Clin Cancer Res. 2005;11:8326–31.PubMedCrossRef
27.
Zurück zum Zitat Kobayashi N, Hiraoka N, Yamagami W, et al. FOXP3+ regulatory T cells affect the development and progression of hepatocarcinogenesis. Clin Cancer Res. 2007;13:902–11.PubMedCrossRef Kobayashi N, Hiraoka N, Yamagami W, et al. FOXP3+ regulatory T cells affect the development and progression of hepatocarcinogenesis. Clin Cancer Res. 2007;13:902–11.PubMedCrossRef
28.
Zurück zum Zitat Hiraoka N, Onozato K, Kosuge T, Hirohashi S. Prevalence of FOXP3+ regulatory T cells increases during the progression of pancreatic ductal adenocarcinoma and its premalignant lesions. Clin Cancer Res. 2006;12:5423–34.PubMedCrossRef Hiraoka N, Onozato K, Kosuge T, Hirohashi S. Prevalence of FOXP3+ regulatory T cells increases during the progression of pancreatic ductal adenocarcinoma and its premalignant lesions. Clin Cancer Res. 2006;12:5423–34.PubMedCrossRef
29.
Zurück zum Zitat Mizukami Y, Kono K, Kawaguchi Y, et al. Localisation pattern of Foxp3+ regulatory T cells is associated with clinical behaviour in gastric cancer. Br J Cancer. 2008;98:148–53.PubMedCrossRef Mizukami Y, Kono K, Kawaguchi Y, et al. Localisation pattern of Foxp3+ regulatory T cells is associated with clinical behaviour in gastric cancer. Br J Cancer. 2008;98:148–53.PubMedCrossRef
30.
Zurück zum Zitat Siddiqui SA, Frigola X, Bonne-Annee S, et al. Tumor-infiltrating Foxp3-CD4+CD25+ T cells predict poor survival in renal cell carcinoma. Clin Cancer Res. 2007;13:2075–81.PubMedCrossRef Siddiqui SA, Frigola X, Bonne-Annee S, et al. Tumor-infiltrating Foxp3-CD4+CD25+ T cells predict poor survival in renal cell carcinoma. Clin Cancer Res. 2007;13:2075–81.PubMedCrossRef
31.
Zurück zum Zitat Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma, 2nd English edition. Gastric Cancer. 1998;1:10–24.PubMedCrossRef Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma, 2nd English edition. Gastric Cancer. 1998;1:10–24.PubMedCrossRef
32.
Zurück zum Zitat Tsujitani S, Kakeji Y, Watanabe A, Kohnoe S, Maehara Y, Sugimachi K. Infiltration of dendritic cells in relation to tumor invasion and lymph node metastasis in human gastric cancer. Cancer. 1990;66:2012–6.PubMedCrossRef Tsujitani S, Kakeji Y, Watanabe A, Kohnoe S, Maehara Y, Sugimachi K. Infiltration of dendritic cells in relation to tumor invasion and lymph node metastasis in human gastric cancer. Cancer. 1990;66:2012–6.PubMedCrossRef
33.
Zurück zum Zitat Dadabayev A, Sandel M, Menon A, et al. Dendritic cells in colorectal cancer correlate with other tumor-infiltrating immune cells. Cancer Immunol Immunother. 2004;53:978–86.PubMedCrossRef Dadabayev A, Sandel M, Menon A, et al. Dendritic cells in colorectal cancer correlate with other tumor-infiltrating immune cells. Cancer Immunol Immunother. 2004;53:978–86.PubMedCrossRef
34.
Zurück zum Zitat Miyake M, Taki T, Hitomi S, Hakomori S. Correlation of expression of H/Ley/Leb antigen with survival in patients with carcinoma of the lung. N Engl J Med. 1992;327:14–8.PubMedCrossRef Miyake M, Taki T, Hitomi S, Hakomori S. Correlation of expression of H/Ley/Leb antigen with survival in patients with carcinoma of the lung. N Engl J Med. 1992;327:14–8.PubMedCrossRef
35.
Zurück zum Zitat Matsuda H, Mori M, Tsujitani S, Ohno S, Kuwano H, Sugimachi K. Immunohistochemical evaluation of squamous cell carcinoma antigen and S-100 protein-positive cells in human malignant esophageal tissues. Cancer. 1990;65:2261–5.PubMedCrossRef Matsuda H, Mori M, Tsujitani S, Ohno S, Kuwano H, Sugimachi K. Immunohistochemical evaluation of squamous cell carcinoma antigen and S-100 protein-positive cells in human malignant esophageal tissues. Cancer. 1990;65:2261–5.PubMedCrossRef
36.
Zurück zum Zitat Schwaab T, Weiss JE, Schned AR, Barth RJ Jr. Dendritic cell infiltration in colon cancer. J Immunother. 2001;24:130–7.CrossRef Schwaab T, Weiss JE, Schned AR, Barth RJ Jr. Dendritic cell infiltration in colon cancer. J Immunother. 2001;24:130–7.CrossRef
37.
Zurück zum Zitat Kawaida H, Kono K, Takahashi A, et al. Distribution of CD4(+)CD25 high regulatory T-cells in tumor-draining lymph nodes in patients with gastric cancer. J Surg Oncol. 2005;124:151–7. Kawaida H, Kono K, Takahashi A, et al. Distribution of CD4(+)CD25 high regulatory T-cells in tumor-draining lymph nodes in patients with gastric cancer. J Surg Oncol. 2005;124:151–7.
38.
Zurück zum Zitat Strauss L, Bergmann C, Szczepanski M, Gooding W, Johnson JT, Whiteside TL. A unique subset of CD4+CD25highFoxp3+ T cells secreting interleukin-10 and transforming growth factor-beta1 mediates suppression in the tumor microenvironment. Clin Cancer Res. 2007;13:4345–54.PubMedCrossRef Strauss L, Bergmann C, Szczepanski M, Gooding W, Johnson JT, Whiteside TL. A unique subset of CD4+CD25highFoxp3+ T cells secreting interleukin-10 and transforming growth factor-beta1 mediates suppression in the tumor microenvironment. Clin Cancer Res. 2007;13:4345–54.PubMedCrossRef
39.
Zurück zum Zitat Sarrs M, Andersen KG, Randow F, Mayr L, Betz AG. Neuropilin-1 expression on regulatory T cells enhances their interactions with dendritic cells during antigen recognition. Immunity. 2008;28:402–13.CrossRef Sarrs M, Andersen KG, Randow F, Mayr L, Betz AG. Neuropilin-1 expression on regulatory T cells enhances their interactions with dendritic cells during antigen recognition. Immunity. 2008;28:402–13.CrossRef
40.
Zurück zum Zitat Terme M, Chaput N, Combadiere B, Ma A, Ohteki T, Zitvogel L. Regulatory T cells control dendritic cell/NK cell cross-talk in lymph nodes at the steady state by inhibiting CD4+ self-reactive T cells. J Immunol. 2008;180:4679–86.PubMed Terme M, Chaput N, Combadiere B, Ma A, Ohteki T, Zitvogel L. Regulatory T cells control dendritic cell/NK cell cross-talk in lymph nodes at the steady state by inhibiting CD4+ self-reactive T cells. J Immunol. 2008;180:4679–86.PubMed
41.
Zurück zum Zitat Fehervari A, Sakaguchi S. Control of Foxp3+CD4+ regulatory cell activation and function by dendritic cells. Int Immunol. 2004;16:1769–80.PubMedCrossRef Fehervari A, Sakaguchi S. Control of Foxp3+CD4+ regulatory cell activation and function by dendritic cells. Int Immunol. 2004;16:1769–80.PubMedCrossRef
42.
Zurück zum Zitat Yamaguchi T, Hirota K, Nagahama K, et al. Control of immune responses by antigen-specific regulatory T cells expressing the folate receptor. Immunity. 2007;27:145–59.PubMedCrossRef Yamaguchi T, Hirota K, Nagahama K, et al. Control of immune responses by antigen-specific regulatory T cells expressing the folate receptor. Immunity. 2007;27:145–59.PubMedCrossRef
43.
Zurück zum Zitat Schmidt J, Eisold S, Büchler MW, Märten A. Dendritic cells reduce number and function of CD4+CD25+ cells in cytokine-induced killer cells derived from patients with pancreatic carcinoma. Cancer Immunol Immunother. 2004;53:1018–26.PubMedCrossRef Schmidt J, Eisold S, Büchler MW, Märten A. Dendritic cells reduce number and function of CD4+CD25+ cells in cytokine-induced killer cells derived from patients with pancreatic carcinoma. Cancer Immunol Immunother. 2004;53:1018–26.PubMedCrossRef
44.
Zurück zum Zitat Van Meirvenne S, Dullaers M, Heirman C, Straetman L, Michiels A, Thielemans K. In vivo depletion of CD4+CD25+ regulatory T cells enhances the antigen-specific primary and memory CTL response elicited by mature mRNA-electroporated dendritic cells. Mol Ther. 2005;12:922–32.PubMedCrossRef Van Meirvenne S, Dullaers M, Heirman C, Straetman L, Michiels A, Thielemans K. In vivo depletion of CD4+CD25+ regulatory T cells enhances the antigen-specific primary and memory CTL response elicited by mature mRNA-electroporated dendritic cells. Mol Ther. 2005;12:922–32.PubMedCrossRef
Metadaten
Titel
CD83+ dendritic cells and Foxp3+ regulatory T cells in primary lesions and regional lymph nodes are inversely correlated with prognosis of gastric cancer
verfasst von
Seigo Kashimura
Zenichiro Saze
Masanori Terashima
Nobutoshi Soeta
Satoshi Ohtani
Fumihiko Osuka
Michihiko Kogure
Mitsukazu Gotoh
Publikationsdatum
01.04.2012
Verlag
Springer Japan
Erschienen in
Gastric Cancer / Ausgabe 2/2012
Print ISSN: 1436-3291
Elektronische ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-011-0090-9

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