250Dhifaf Sarhan et al. Eur. J. Immunol. 2013. 43: 249-257 to the TNF receptor superfamily and include Fas (CD95) and TNF-related apoptosis-inducing ligand (TRAIL) receptors. We have previously demonstrated that peripheral blood NK cells express low levels of TRAIL and are unable to kill TRAIL-sensitive tumors [8]. Zoledronic acid (ZA) is a bisphosphonate that is used to prevent the loss of bone mass and to lower the risk of skeletal complication in patients with bone metastasis [9]. ZA has also been shown to play a role in activation of γδ T cells in an antigen-dependent manner [10]. Furthermore, treatment with ZA and interleukin-2 (IL-2) results in increased serum levels of TRAIL in patients with prostate cancer [11]. In these patients, high serum levels of TRAIL correlated with improved prognosis. Although ZA has been shown to upregulate NKG2D expression on NK cells in vitro [12], it has not been studied whether ZA treatment can augment the expression of TRAIL on human NK cells.Here, we investigated if exposure to ZA would increase the expression of TRAIL on human NK cells and lead to increased TRAIL-mediated killing of tumor cells. When cocultured with monocytes, ZA induced an IFN-γ-dependent upregulation of TRAIL expression on NK cells. As a result, these NK cells displayed increased cytotoxic potential against TRAIL-sensitive tumors in vitro and in vivo. Our findings suggest that adoptive infusion of ZA-primed NK cells with an improved targeting of TRAIL-sensitive tumors may lead to improved outcome in patients with cancer.
ResultsTreatment with ZA induces changes in phenotype of NK cells NK cells were isolated from healthy donors and cocultured with irradiated PBMCs and IL-2 with (ZA-primed) or without ZA (unprimed). Following exposure to ZA at concentrations ranging from 1 to 10 μM, surface expression of TRAIL was upregulated compared to NK cells not treated with ZA. However, no changes in surface expression of NKG2D, DNAM-1, FasL, perforin, granzymeB, NKp30, or NKp46 were observed. A minor upregulation in expression of CD69 and NKp44 was detected on NK cells following exposure to ZA (Fig. 1A). In contrast, when purified NK cells were treated with ZA in absence of feeder cells, no changes in TRAIL expression were observed (Supporting Information Fig. 1A), suggesting a requirement for PBMC feeder cells to be present during culturing to induce upregulation of TRAIL on NK cells.
ZA upregulates TRAIL expression on NK cells indirectly via monocytesTo determine what cells within the PBMC population were responsible for the increased TRAIL expression on NK cells following treatment with ZA, experiments using different feeder cells were performed. In experiments where NK cells were cocultured with Fig. 1B). In contrast, no change in NKG2D expression on NK cells was observed in presence or absence of ZA upon coculture with monocytes (Supporting Information Fig. 1C). The fold change in TRAIL expression following treatment with ZA was higher when NK cells were cocultured with purified monocytes (3.5-fold, p =...