The clinical successes in immunotherapy have been both astounding and at the same time unsatisfactory. Countless patients with varied tumor types have seen pronounced clinical response with immunotherapeutic intervention; however, many more patients have experienced minimal or no clinical benefit when provided the same treatment. As technology has advanced, so has the understanding of the complexity and diversity of the immune context of the tumor microenvironment and its influence on response to therapy. It has been possible to identify different subclasses of immune environment that have an influence on tumor initiation and response and therapy; by parsing the unique classes and subclasses of tumor immune microenvironment (TIME) that exist within a patient’s tumor, the ability to predict and guide immunotherapeutic responsiveness will improve, and new therapeutic targets will be revealed.
Intratumoral stimulatory dendritic cells (SDCs) play an important role in stimulating cytotoxic T cells and driving immune responses against cancer. Understanding the mechanisms that regulate their abundance in the tumor microenvironment (TME) could unveil new therapeutic opportunities. We find that in human melanoma, SDC abundance is associated with intratumoral expression of the gene encoding the cytokine FLT3LG. FLT3LG is predominantly produced by lymphocytes, notably natural killer (NK) cells in mouse and human tumors. NK cells stably form conjugates with SDCs in the mouse TME, and genetic and cellular ablation of NK cells in mice demonstrates their importance in positively regulating SDC abundance in tumor through production of FLT3L. Although anti-PD-1 'checkpoint' immunotherapy for cancer largely targets T cells, we find that NK cell frequency correlates with protective SDCs in human cancers, with patient responsiveness to anti-PD-1 immunotherapy, and with increased overall survival. Our studies reveal that innate immune SDCs and NK cells cluster together as an excellent prognostic tool for T cell-directed immunotherapy and that these innate cells are necessary for enhanced T cell tumor responses, suggesting this axis as a target for new therapies.
Highlights d cDC2 initiate activation but not differentiation of antitumor CD4 + T conv d T reg depletion relieves cDC2 suppression driving antitumor CD4 + T conv differentiation d Human equivalent of mouse cDC2 are present in the tumor and draining lymph node d The balance of human cDC2/T reg in the TME dictates T cell quality and prognosis
The coronavirus disease 2019 (COVID-19) pandemic has resulted in millions of patients
infected worldwide and indirectly affecting even more individuals through disruption of
daily living. Long-term adverse outcomes have been reported with similar diseases from
other coronaviruses, namely Middle East Respiratory Syndrome (MERS) and Severe Acute
Respiratory Syndrome (SARS). Emerging evidence suggests that COVID-19 adversely affects
different systems in the human body. This review summarizes the current evidence on the
short-term adverse health outcomes and assesses the risk of potential long-term adverse
outcomes of COVID-19. Major adverse outcomes were found to affect different body systems:
immune system (including but not limited to Guillain-Barré syndrome and paediatric
inflammatory multisystem syndrome), respiratory system (lung fibrosis and pulmonary
thromboembolism), cardiovascular system (cardiomyopathy and coagulopathy), neurological
system (sensory dysfunction and stroke), as well as cutaneous and gastrointestinal
manifestations, impaired hepatic and renal function. Mental health in patients with
COVID-19 was also found to be adversely affected. The burden of caring for COVID-19
survivors is likely to be huge. Therefore, it is important for policy makers to develop
comprehensive strategies in providing resources and capacity in the healthcare system.
Future epidemiological studies are needed to further investigate the long-term impact on
COVID-19 survivors.
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