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CO-SIGNALING MOLECULES AND ANTITUMOR IMMUNITY IN AGING Co-signaling signals are essential for the augmentation of APC-mediated T cell responses in antitumor immunity. For example, expression of CD80 (B7.1) and CD86 (B7.2) on APCs or tumor cells is crucial for promoting antitumor T cell responses.82 Several studies have demonstrated decreased expression of these co-signaling molecules on aged DCs, which may contribute to the reduced capacity for T cell stimulation by DCs during aging.73,74 Lustgarten et al. investigated whether CD80 expression on tumor cells was important for the enhancement of antitumor responses in aged mice. Immunization with the foreign protein enhanced GFP (EGFP)-expressing BM-185 pre-B-cell lymphoma cells (BM-185-EGFP) yielded an antitumor immune response in young, but not in aged, mice. However, immunization with CD80-expressing BM-185-EGFP tumor cells (BM-185-EGFP-CD80) yielded an antitumor immune response in both young and aged mice, although the tumor rejection was lower in aged mice compared with young mice.83 There is increasing evidence that several other members of the TNFR family, including OX40 (CD134), 4-1BB (CD137), CD27, and CD30, may be important as secondary costimulatory molecules when co-signaling molecules are reduced and insufficient for T cell stimulation during aging. In studies evaluating the effect of additional OX40 signaling in antitumor immune responses in aged mice, immunization with BM-185-EGFP-CD80 in combination with an anti-OX40 mAb markedly improved antitumor response in aged mice.83 Similarly, an apoptotic tumor cell-pulsed DC vaccine in combination with an anti- OX40 mAb significantly enhanced the antitumor immune response in aged mice.84 Interestingly, Ruby and Weinberg investigated the efficacy of an anti-OX40 mAb alone in middle-aged and elderly sarcoma-tumor-bearing mice, and confirmed that the administration of the mAb to these mice significantly reduced antitumor efficacy because of the decreased number of differentiated T cells, and was not due to an alteration of the surface expression of OX40 on T cells.85,86 Furthermore, administration of the anti-OX40 mAb in combination with IL-12, a cytokine that is essential for T cell differentiation, partially restored the deficiency in OX40-mediated antitumor efficacy in older mice. 4-1BB is also a member of the TNFR family that is expressed on activated T cells and co-stimulates both CD4 and CD8 T cells. In particular, Bansal- Pakala and Croft reported that the administration of an agonist Ab to 4-1BB rescued defective T cell priming in aged mice.87 Similarly, Sharma et al. revealed that apoptotic tumor cell-pulsed DC vaccination in combination with an anti-4-1BB mAb significantly enhanced the antitumor immune response in aged mice.84 These results suggest that the insufficient antitumor immune responses in aging may be restored by the efficient expression of co-stimulatory signals. V. TLRS AND ANTITUMOR IMMUNITY IN AGING Recent studies have revealed that innate immune responses and adaptive immune responses collaborate to induce a strong antitumor immune response. For example, the mediation of innate immune responses by members of the Toll-like receptor (TLR) family results in the subsequent induction of protective adaptive immune responses in antitumor immunity.88,89 Several studies have demonstrated that advancing age may affect the expression and function of TLRs, and the response to TLR ligands in the innate immune system. Renshaw et al. reported that aged splenic and peritoneal macrophages express significantly lower levels of TLRs and secrete significantly lower levels of cytokines after stimulation with various TLR ligands.90 Previous studies have shown that CpG-ODN stimulates plasmacytoid DCs to produce type I interferons (IFN ¦Á and ¦Â), which inhibit the synthesis of Th2 cytokines by CD4 T cells and induce IL-4-inhibited Th1 cells to synthesize IL-2, IL-12, and IFN-¦Ã. In turn, these induce NK cells, NKT cells, and CTLs in the antitumor immune responses.91 Sharma et al. reported that the intratumoral injection of CpG-ODN yielded complete rejection of in vivo tumors in both young and old mice; however, injection of poly I:C exhibited in vivo tumor rejection only in young mice.92 The authors also revealed that the induction of the antitumor immune response by in vivo challenge with CpG-ODN, but not poly I:C in old mice, was correlated with the upregulation of pro-inflammatory cytokine secretion, significant accumulation of CD4 T cells, CD8 T cells, NK cells, and APCs within the tumor, and reduction of the number of Tregs within the tumor. These results indicate that the efficacy of TLR ligands in antitumor immunity may be reduced during the aging process. Moreover, there is a difference in capacity to induce immune responses among the various TLR ligands in the old mice.92 It appears that CpG-ODN may constitute a possible therapeutic approach to overcome the age-associated immune defects in cancer immunotherapy and restore the antitumor immune response in the elderly. VI. IMMUNOSUPPRESSIVE CELLS AND ANTITUMOR IMMUNITY IN AGING Advancing age may alter the prevalence and function of immune suppressive cells such as CD4+ CD25+FoxP3+ regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). Tregs accumulate in tumor-bearing hosts and play fundamental roles in blocking antitumor immune responses.93,94 MDSCs, a heterogeneous population comprised of immature myeloid cells, accumulate within sites of cancer, inflammation, and infection,95,96 and have a strong capability to suppress both adaptive and innate immune responses. Accumulating evidence has revealed that the elimination of either population in a tumorbearing host may contribute to enhanced antitumor immune responses. Whereas the age-dependent changes in the number of Tregs and their function remain controversial, 30 several studies have suggested that Tregs accumulate with age and are involved in the age-associated immune dysfunction. Gregg et al. reported that the number of human peripheral blood Tregs increases with age, whereas the function of these cells is comparable between the young and the old.97 Sharma et al. reported that the increased frequency of Tregs in aged mice prevented the cytotoxic T cell response in aged tumorbearing mice.98 Pan et al. also showed that the accumulation of Tregs in aged humans and mice was closely associated with lung tumor burden.99 Further studies will be required to test Treg frequency and functions in the periphery versus within the tumor itself, and the impact on clinical outcome. Similar to the Tregs, it has been demonstrated that the decline of antitumor T cell function in aged animal is also correlated with the accumulation of MDSCs with age. Grizzle et al. revealed that MDSCs are increased in the spleen of aged mice, and that adoptive transfer of these aged MDSCs delayed tumor rejection significantly in young tumor-bearing mice Similarly, Sharma et al. revealed that apoptotic tumor cell-pulsed DC vaccination in combination with an anti-4-1BB mAb significantly enhanced the antitumor immune response in aged mice.84 These results suggest that the insufficient antitumor immune responses in aging may be restored by the efficient expression of co-stimulatory signals. Tomihara et al. Page 5 Crit Rev Oncog. Author manuscript; available in PMC 2014 March 20. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript V. TLRS AND ANTITUMOR IMMUNITY IN AGING Recent studies have revealed that innate immune responses and adaptive immune responses collaborate to induce a strong antitumor immune response. For example, the mediation of innate immune responses by members of the Toll-like receptor (TLR) family results in the subsequent induction of protective adaptive immune responses in antitumor immunity.88,89 Several studies have demonstrated that advancing age may affect the expression and function of TLRs, and the response to TLR ligands in the innate immune system. Renshaw et al. reported that aged splenic and peritoneal macrophages express significantly lower levels of TLRs and secrete significantly lower levels of cytokines after stimulation with various TLR ligands.90 Previous studies have shown that CpG-ODN stimulates plasmacytoid DCs to produce type I interferons (IFN ¦Á and ¦Â), which inhibit the synthesis of Th2 cytokines by CD4 T cells and induce IL-4-inhibited Th1 cells to synthesize IL-2, IL-12, and IFN-¦Ã. In turn, these induce NK cells, NKT cells, and CTLs in the antitumor immune responses.91 Sharma et al. reported that the intratumoral injection of CpG-ODN yielded complete rejection of in vivo tumors in both young and old mice; however, injection of poly I:C exhibited in vivo tumor rejection only in young mice.92 The authors also revealed that the induction of the antitumor immune response by in vivo challenge with CpG-ODN, but not poly I:C in old mice, was correlated with the upregulation of pro-inflammatory cytokine secretion, significant accumulation of CD4 T cells, CD8 T cells, NK cells, and APCs within the tumor, and reduction of the number of Tregs within the tumor. These results indicate that the efficacy of TLR ligands in antitumor immunity may be reduced during the aging process. Moreover, there is a difference in capacity to induce immune responses among the various TLR ligands in the old mice.92 It appears that CpG-ODN may constitute a possible therapeutic approach to overcome the age-associated immune defects in cancer immunotherapy and restore the antitumor immune response in the elderly. VI. IMMUNOSUPPRESSIVE CELLS AND ANTITUMOR IMMUNITY IN AGING Advancing age may alter the prevalence and function of immune suppressive cells such as CD4+ CD25+FoxP3+ regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). Tregs accumulate in tumor-bearing hosts and play fundamental roles in blocking antitumor immune responses.93,94 MDSCs, a heterogeneous population comprised of immature myeloid cells, accumulate within sites of cancer, inflammation, and infection,95,96 and have a strong capability to suppress both adaptive and innate immune responses. Accumulating evidence has revealed that the elimination of either population in a tumorbearing host may contribute to enhanced antitumor immune responses. Whereas the age-dependent changes in the number of Tregs and their function remain controversial, 30 several studies have suggested that Tregs accumulate with age and are involved in the age-associated immune dysfunction. Gregg et al. reported that the number of human peripheral blood Tregs increases with age, whereas the function of these cells is comparable between the young and the old.97 Sharma et al. reported that the increased frequency of Tregs in aged mice prevented the cytotoxic T cell response in aged tumorbearing mice.98 Pan et al. also showed that the accumulation of Tregs in aged humans and mice was closely associated with lung tumor burden.99 Further studies will be required to test Treg frequency and functions in the periphery versus within the tumor itself, and the impact on clinical outcome. Similar to the Tregs, it has been demonstrated that the decline of antitumor T cell function in aged animal is also correlated with the accumulation of MDSCs with age. Grizzle et al. revealed that MDSCs are increased in the spleen of aged mice, and that adoptive transfer of these aged MDSCs delayed tumor rejection significantly in young tumor-bearing mice.100 Tomihara et al. Page 6 Crit Rev Oncog. Author manuscript; available in PMC 2014 March 20. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript More recently, the proportion of MDSCs was found to be elevated significantly in elderly patients with a history of cancer.101 Importantly, a number of pro-inflammatory cytokines that are required for the differentiation of MDSCs (e.g., TNF-¦Á, IL-6, and IL-1¦Â) are increased in the old,101,102 suggesting that the age-related inflammatory milieu possibly promotes the accumulation and activation of MDSCs that subsequently could contribute to the increased aging-associated cancer incidence. Interestingly, it is possible to note a mutual interaction between the Treg cells and the MDSCs. In fact, MDSC contributes to Treg induction in cancer, but, in turn, Tregs may regulate MDSC expansion with a mechanism of positive feedback. In support, our group reported an age-specific inverse correlation between the prevalence of Tregs and MDSCs.103 We examined the antitumor response to Treg depletion in the B16 melanoma model and revealed that Treg depletion alone using denileukin diftitox (DT) exerted therapeutic effects only in young mice but not aged mice. Furthermore, Treg depletion using DT in aged mice resulted in an increased number of MDSCs. MDSC depletion in combination with Treg depletion restored the impaired efficacy of Treg depletion in aged mice, suggesting that Tregs control the prevalence of MDSCs in aged mice and that Treg depletion in combination with MDSC depletion may be an effective cancer immune therapy approach for the elderly. |
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encore19850(RXMCDM´ú·¢): ½ð±Ò+10, ¶àлӦÖú£¡ 2015-02-01 08:53:54
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