Background & Aims
The role of radiation therapy in the treatment of patients with
pancreatic ductal adenocarcinoma (PDA) is controversial. Randomized
controlled trials investigating the efficacy of radiation therapy in
patients with locally advanced unresectable PDA have reported mixed results,
with effects ranging from modest benefit to worse outcome, compared with
control therapies. We investigated whether radiation causes inflammatory
cells to acquire an immune-suppressive phenotype that limits the therapeutic
effects of radiation on invasive PDAs and accelerates progression of
pre-invasive foci.
Methods
We investigated the effects of radiation in
p48Cre;LSL-KrasG12D (KC) and
p48Cre;LSLKrasG12D;LSL-Trp53R172H (KPC)
mice, as well as in C57BL/6 mice with orthotopic tumors grown from FC1242
cells derived from KPC mice. Some mice were given neutralizing antibodies
against macrophage colony stimulating factor 1 (CSF1 or MCSF) or F4/80.
Pancreata were exposed to doses of radiation ranging from 2–12 Gy
and analyzed by flow cytometry.
Results
Pancreata of KC mice exposed to radiation had a higher frequency of
advanced pancreatic intraepithelial lesions and more foci of invasive cancer
than pancreata of unexposed mice (controls); radiation reduced survival time
by more than 6 months. A greater proportion of macrophages from invasive and
pre-invasive pancreatic tumors had an immune-suppressive, M2-like phenotype,
compared with control mice. Pancreata from mice exposed to radiation had
fewer CD8+ T cells than controls and greater numbers of
CD4+ T cells of T-helper 2 and T-regulatory cell phenotypes.
Adoptive transfer of T cells from irradiated PDA to tumors of control mice
accelerated tumor growth. Radiation induced production of MCSF by PDA cells.
An antibody against MCSF prevented radiation from altering the phenotype of
macrophages in tumors, increasing the anti-tumor T-cell response and slowing
tumor growth.
Conclusions
Radiation exposure causes macrophages in PDAs of mice to acquire an
immune-suppressive phenotype and reduce T-cell mediated anti-tumor
responses. Agents that block MCSF prevent this effect, allowing radiation to
have increased efficacy in slowing tumor growth.
Zambirinis et al. show that TLR9 stimulation has a protumorigenic effect in pancreatic carcinoma by inducing pancreatic stellate cells to become fibrogenic and produce chemokines that stimulate epithelial cell proliferation. Activation of TLR9 results also in an immune suppressive tumor microenvironment via recruitment of regulatory T cells and induction of myeloid-derived suppressor cell proliferation.
ObjectivePlasma apolipoprotein (apo)D, a ubiquitously expressed protein that binds small hydrophobic ligands, is found mainly on HDL particles. According to studies of human genetics and lipid disorders, plasma apoD levels positively correlate with HDL-cholesterol and apoAI levels. Thus, we tested the hypothesis that apoD was a regulator of HDL metabolism.Methods & ResultsWe compared the plasma lipid and lipoprotein profiles of wild-type (WT) C57BL/6 mice with apoD−/− mice on a C57BL/6 background after receiving a high fat-high cholesterol diet for 12 weeks. ApoD−/− mice had higher HDL-cholesterol levels (61±13-apoD−/− vs. 52±10-WT-males; 37±11-apoD−/− vs. 22±2 WT-female) than WT mice with sex-specific changes in total plasma levels of cholesterol and other lipids. Compared to WT, the HDL of apoD−/− mice showed an increase in large, lipid-rich HDL particles and according to size various quantities and sizes of LDL particles. Plasma levels of lecithin:cholesterol acyltransferase in the control and apoD−/− mice were not different, however, plasma phospholipid transfer protein activity was modestly elevated (+10%) only in male apoD−/− mice. An in
vivo HDL metabolism experiment with isolated Western-fed apoD−/− HDL particles showed that female apoD−/− mice had a 36% decrease in the fractional catabolic rate of HDL cholesteryl ester. Hepatic SR-BI and LDLR protein levels were significantly decreased; accordingly, LDL-cholesterol and apoB levels were increased in female mice.ConclusionIn the context of a high fat-high cholesterol diet, apoD deficiency in female mice is associated with increases in both plasma HDL and LDL-cholesterol levels, reflecting changes in expression of SR-BI and LDL receptors, which may impact diet-induced atherosclerosis.
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