Tumor-derived galectin-1 (Gal-1), a -galactoside-binding S-type lectin, has been shown to encourage T-cell death and promote T cell-mediated tumor immune escape. In this report, we show that patients with leukemic cutaneous T-cell lymphomas, known to have limited complexity of their T-cell repertoires, have a predominant T helper type-2 (Th2) cytokine profile and significantly elevated plasma levels of Gal-1 compared with healthy controls. Circulating clonal malignant T cells were a major source of Gal-1.
IntroductionContraction of the T-cell repertoire and Th2 cytokine skewing are 2 immunosuppressive features linked to high morbidity and mortality of patients with leukemic cutaneous T-cell lymphoma (L-CTCL). [1][2][3][4][5] Certain soluble factor(s) expressed by clonal malignant cells or dermal fibroblasts (eg, IL-18, eotaxins) could be responsible for this immunologic signature; nevertheless, mechanistic evidence on how these cells elicit their immunoregulatory function is still incomplete. 6,7 Recently, the -galactoside binding protein, galectin-1 (Gal-1), has been implicated in the induction of a Th2 signature and suppression of antitumor immune responses in patients with Hodgkin lymphoma. 8,9 Gal-1 functions as a homodimer with affinity for N-acetyllactosamine-bearing glycoproteins on effector T cells that, on engagement, induces proapoptotic and/or immunosuppressive activities. 10,11 Gal-1-binding interactions induce deletion of pro-inflammatory T helper (Th)-1 and Th17 cells but spare naive, regulatory, and Th2 cells, leading to a tolerogenic environment that favors tumor immune escape. 12,13 Indeed, in patients with Hodgkin disease, increased Gal-1 expression is correlated with poor prognoses and implicated as a biomarker of disease progression. 14 Although a prior study shows that Gal-1 expression is elevated in epidermotropic malignant T cells in patients with mycosis fungoides, 15 its presence and role in more advanced leukemic forms of CTCL have not been addressed. Here we show that clonal malignant T cells in patients with stage 3 or 4 CTCL exhibited a Th2 cytokine signature and high intracellular Gal-1 expression. Moreover, L-CTCL patients exhibited higher plasma Gal-1 levels than healthy controls, and conditioned supernatants from primary L-CTCL cell cultures significantly attenuated normal T-cell proliferation and diminished Th1 responses in a -galactosidedependent manner. Collectively, these data suggest that elevated levels of Gal-1 in L-CTCL patients may inhibit the proliferation of nonmalignant T cells and favor Th2 skewing, leading to impaired antitumor responses and increased susceptibility to infection. These studies suggest that neutralization of Gal-1-Gal-1 ligand interactions may be an effective strategy for enhancing antitumor immune responses in L-CTCL patients.
Methods
PBMCs and plasma samplesAll studies were performed in accordance with the Declaration of Helsinki and approved by the review board of the Partners Human Research Committee. PBMCs and plasma were obtained using Fico...