Recent studies on acute myelogenous leukemia (AML) patients have revealed the existence of T-cell immunodeficiencies, characterized by peripheral T lymphocytes that are unable to interact with blasts, reduced thymic emigrants and oligoclonal restricted repertoires. These observations suggest that there is a profound thymic dysregulation, which is difficult to study in AML patients. Using the C1498 AML mouse model, we demonstrated that leukemia development was associated with thymus atrophy, which was defined by abnormal organ weight and reduced cellularity. In addition, we observed a dramatic loss of peripheral CD4 + and CD8 + T-cell numbers with increased frequencies of CD4 + FoxP3 + regulatory and activated/memory T cells. Investigating the mechanisms leading to this atrophy, we observed a significant accumulation of the monocyte chemoattractant protein 1 (MCP-1/CCL2) in thymi of leukemic mice. Treatment of AML-bearing animals with a blocking anti-CCL2 antibody revealed a lower tumor burden, augmented antileukemic T-cell responses, and improved survival rate compared to nontreated mice. These results were not observed when neutralization of CCL2 was performed in thymectomized mice. Altogether, we show that the CCL2 protein participates in thymic atrophy in AML mice, and this could have important implications for future immunotherapeutic strategies.Keywords: Acute myeloid leukemia r MCP-1/CCL2 r mouse model r T-cell response r thymus Additional supporting information may be found in the online version of this article at the publisher's web-site
IntroductionAcute myeloid leukemia (AML) is characterized by impaired hematopoiesis. At the time of diagnosis and prior to chemotherapy, it has been shown that myeloid and plasmacytoid dendritic cell (DC) subsets are also affected by leukemogenesis and may exhibit the leukemic genotype. However, the myeloid-derived DCs retain their maturation capacity and ability to stimulate T lymphocytes [1]. Despite these observations, poor immune T-cell Correspondence: Dr. Carine Brinster e-mail: carine.brinster@inserm.fr responses are associated with AML in patients [2,3], and this immunodeficiency has been suggested to promote the expansion of malignant cells [4]. AML patients have normal-to-reduced levels of peripheral total CD3 + T lymphocytes that are unable to form effective immune synapses with autologous blasts [5]. Previous studies have described increased levels of circulating immunosuppressive CD4 + CD25 high regulatory T cells (Treg) in patients with untreated AML [6,7], which may contribute to the induction of tolerance to the leukemic cells. Furthermore, an altered T-cell repertoire associated with clonal expansion of certain T-cell receptor (TCR) Vβ subsets has been found in leukemic patients [8]
Results
Leukemia leads to thymic atrophyIn patients, the leukemic process appears to contribute to a profound state of immune suppression that affects the T-cell compartment [5]. Therefore, we investigated to what extent T-cell phenotype, function, and thymic differentiation ...