Pub Date : 2024-07-16eCollection Date: 2024-01-01DOI: 10.1080/2162402X.2024.2378520
Claudia Cantoni, Michela Falco, Massimo Vitale, Gabriella Pietra, Enrico Munari, Daniela Pende, Maria Cristina Mingari, Simona Sivori, Lorenzo Moretta
The long story of NK cells started about 50 y ago with the first demonstration of a natural cytotoxic activity within an undefined subset of circulating leukocytes, has involved an ever-growing number of researchers, fascinated by the apparently easy-to-reach aim of getting a "universal anti-tumor immune tool". In fact, in spite of the impressive progress obtained in the first decades, these cells proved far more complex than expected and, paradoxically, the accumulating findings have continuously moved forward the attainment of a complete control of their function for immunotherapy. The refined studies of these latter years have indicated that NK cells can epigenetically calibrate their functional potential, in response to specific environmental contexts, giving rise to extraordinarily variegated subpopulations, comprehensive of memory-like cells, tissue-resident cells, or cells in various differentiation stages, or distinct functional states. In addition, NK cells can adapt their activity in response to a complex body of signals, spanning from the interaction with either suppressive or stimulating cells (myeloid-derived suppressor cells or dendritic cells, respectively) to the engagement of various receptors (specific for immune checkpoints, cytokines, tumor/viral ligands, or mediating antibody-dependent cell-mediated cytotoxicity). According to this picture, the idea of an easy and generalized exploitation of NK cells is changing, and the way is opening toward new carefully designed, combined and personalized therapeutic strategies, also based on the use of genetically modified NK cells and stimuli capable of strengthening and redirecting their effector functions against cancer.
关于 NK 细胞的漫长故事始于 50 年前,当时首次证明了循环白细胞中一个未定义的亚群具有天然的细胞毒性活性,越来越多的研究人员为获得 "通用抗肿瘤免疫工具 "这一看似容易实现的目标而着迷。事实上,尽管在最初的几十年里取得了令人瞩目的进展,但事实证明这些细胞远比预期的要复杂得多。近些年的深入研究表明,NK 细胞可以根据特定的环境背景对其功能潜力进行表观遗传学校准,从而产生极其多样的亚群,包括记忆样细胞、组织驻留细胞或处于不同分化阶段或不同功能状态的细胞。此外,NK 细胞还能根据复杂的信号调整其活性,包括与抑制细胞或刺激细胞(分别为髓源性抑制细胞或树突状细胞)的相互作用,以及与各种受体(免疫检查点特异性受体、细胞因子、肿瘤/病毒配体或介导抗体依赖性细胞介导的细胞毒性)的接触。根据这一情况,轻松、普遍地利用 NK 细胞的想法正在改变,新的精心设计、联合和个性化治疗策略的道路正在开辟,这些策略也是基于使用基因改造的 NK 细胞和刺激物,这些刺激物能够加强和重新引导 NK 细胞的抗癌效应功能。
{"title":"Human NK cells and cancer.","authors":"Claudia Cantoni, Michela Falco, Massimo Vitale, Gabriella Pietra, Enrico Munari, Daniela Pende, Maria Cristina Mingari, Simona Sivori, Lorenzo Moretta","doi":"10.1080/2162402X.2024.2378520","DOIUrl":"10.1080/2162402X.2024.2378520","url":null,"abstract":"<p><p>The long story of NK cells started about 50 y ago with the first demonstration of a natural cytotoxic activity within an undefined subset of circulating leukocytes, has involved an ever-growing number of researchers, fascinated by the apparently easy-to-reach aim of getting a \"universal anti-tumor immune tool\". In fact, in spite of the impressive progress obtained in the first decades, these cells proved far more complex than expected and, paradoxically, the accumulating findings have continuously moved forward the attainment of a complete control of their function for immunotherapy. The refined studies of these latter years have indicated that NK cells can epigenetically calibrate their functional potential, in response to specific environmental contexts, giving rise to extraordinarily variegated subpopulations, comprehensive of memory-like cells, tissue-resident cells, or cells in various differentiation stages, or distinct functional states. In addition, NK cells can adapt their activity in response to a complex body of signals, spanning from the interaction with either suppressive or stimulating cells (myeloid-derived suppressor cells or dendritic cells, respectively) to the engagement of various receptors (specific for immune checkpoints, cytokines, tumor/viral ligands, or mediating antibody-dependent cell-mediated cytotoxicity). According to this picture, the idea of an easy and generalized exploitation of NK cells is changing, and the way is opening toward new carefully designed, combined and personalized therapeutic strategies, also based on the use of genetically modified NK cells and stimuli capable of strengthening and redirecting their effector functions against cancer.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2378520"},"PeriodicalIF":6.5,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09eCollection Date: 2024-01-01DOI: 10.1080/2162402X.2024.2376264
Zheng Chen, Mincheng Yu, Bo Zhang, Lei Jin, Qiang Yu, Shuang Liu, Binghai Zhou, Jiuliang Yan, Wentao Zhang, Xiaoqiang Li, Yongfeng Xu, Yongsheng Xiao, Jian Zhou, Jia Fan, Mien-Chie Hung, Qinghai Ye, Hui Li, Lei Guo
Functional roles of SIGLEC15 in hepatocellular carcinoma (HCC) were not clear, which was recently found to be an immune inhibitor with similar structure of inhibitory B7 family members. SIGLEC15 expression in HCC was explored in public databases and further examined by PCR analysis. SIGLEC15 and PD-L1 expression patterns were examined in HCC samples through immunohistochemistry. SIGLEC15 expression was knocked-down or over-expressed in HCC cell lines, and CCK8 tests were used to examine cell proliferative ability in vitro. Influences of SIGLEC15 expression on tumor growth were examined in immune deficient and immunocompetent mice respectively. Co-culture system of HCC cell lines and Jurkat cells, flow cytometry analysis of tumor infiltrated immune cells and further sequencing analyses were performed to investigate how SIGLEC15 could affect T cells in vitro and in vivo. We found SIGLEC15 was increased in HCC tumor tissues and was negatively correlated with PD-L1 in HCC samples. In vitro and in vivo models demonstrated inhibition of SIGLEC15 did not directly influence tumor proliferation. However, SIGLEC15 could promoted HCC immune evasion in immune competent mouse models. Knock-out of Siglec15 could inhibit tumor growth and reinvigorate CD8+ T cell cytotoxicity. Anti-SIGLEC15 treatment could effectively inhibit tumor growth in mouse models with or without mononuclear phagocyte deletion. Bulk and single-cell RNA sequencing data of treated mouse tumors demonstrated SIGLEC15 could interfere CD8+ T cell viability and induce cell apoptosis. In all, SIGLEC15 was negatively correlated with PD-L1 in HCC and mainly promote HCC immune evasion through inhibition of CD8+ T cell viability and cytotoxicity.
{"title":"SIGLEC15, negatively correlated with PD-L1 in HCC, could induce CD8+ T cell apoptosis to promote immune evasion.","authors":"Zheng Chen, Mincheng Yu, Bo Zhang, Lei Jin, Qiang Yu, Shuang Liu, Binghai Zhou, Jiuliang Yan, Wentao Zhang, Xiaoqiang Li, Yongfeng Xu, Yongsheng Xiao, Jian Zhou, Jia Fan, Mien-Chie Hung, Qinghai Ye, Hui Li, Lei Guo","doi":"10.1080/2162402X.2024.2376264","DOIUrl":"10.1080/2162402X.2024.2376264","url":null,"abstract":"<p><p>Functional roles of SIGLEC15 in hepatocellular carcinoma (HCC) were not clear, which was recently found to be an immune inhibitor with similar structure of inhibitory B7 family members. SIGLEC15 expression in HCC was explored in public databases and further examined by PCR analysis. SIGLEC15 and PD-L1 expression patterns were examined in HCC samples through immunohistochemistry. SIGLEC15 expression was knocked-down or over-expressed in HCC cell lines, and CCK8 tests were used to examine cell proliferative ability in vitro. Influences of SIGLEC15 expression on tumor growth were examined in immune deficient and immunocompetent mice respectively. Co-culture system of HCC cell lines and Jurkat cells, flow cytometry analysis of tumor infiltrated immune cells and further sequencing analyses were performed to investigate how SIGLEC15 could affect T cells in vitro and in vivo. We found SIGLEC15 was increased in HCC tumor tissues and was negatively correlated with PD-L1 in HCC samples. In vitro and in vivo models demonstrated inhibition of SIGLEC15 did not directly influence tumor proliferation. However, SIGLEC15 could promoted HCC immune evasion in immune competent mouse models. Knock-out of <i>Siglec15</i> could inhibit tumor growth and reinvigorate CD8+ T cell cytotoxicity. Anti-SIGLEC15 treatment could effectively inhibit tumor growth in mouse models with or without mononuclear phagocyte deletion. Bulk and single-cell RNA sequencing data of treated mouse tumors demonstrated SIGLEC15 could interfere CD8+ T cell viability and induce cell apoptosis. In all, SIGLEC15 was negatively correlated with PD-L1 in HCC and mainly promote HCC immune evasion through inhibition of CD8+ T cell viability and cytotoxicity.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2376264"},"PeriodicalIF":6.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09eCollection Date: 2024-01-01DOI: 10.1080/2162402X.2024.2373519
Iñaki Eguren-Santamaría, Inmaculada Rodríguez, Claudia Herrero-Martin, Eva Fernández de Piérola, Arantza Azpilikueta, Sandra Sánchez-Gregorio, Elixabet Bolaños, Gabriel Gomis, Paula Molero-Glez, Enrique Chacón, José Ángel Mínguez, Santiago Chiva, Fernando Diez-Caballero, Carlos de Andrea, Álvaro Teijeira, Miguel F Sanmamed, Ignacio Melero
Biomarkers for cancer immunotherapy are an unmet medical need. The group of Daniela Thommen at the NKI recently reported on novel methodologies based on short-term cultures of patient-derived tumor fragments whose cytokine concentrations in the supernatants and activation markers on infiltrating T cells were associated with clinical response to PD-1 blockade. We set up a similar culture technology with tumor-derived fragments using mouse tumors transplanted into syngeneic immunocompetent mice to test an agonist anti-CD137 mAb and its combinations with anti-PD-1 and/or anti-TGF-β. Increases in IFNγ concentrations in the tissue culture supernatants were detected upon in-culture activation with the anti-CD137 and anti-PD-1 mAb combinations or concanavalin A as a positive control. No other cytokine from a wide array was informative of stimulation with these mAbs. Interestingly, increases in Ki67 and other activation markers were substantiated in lymphocytes from cell suspensions gathered at the end of 72 h cultures. In mice bearing bilateral tumors in which one was excised prior to in vivo anti-CD137 + anti-PD-1 treatment to perform the fragment culture evaluation, no association was found between IFNγ production from the fragments and the in vivo therapeutic outcome in the non-resected contralateral tumors. The experimental system permitted freezing and thawing of the fragments with similar functional outcomes. Using a series of patient-derived tumor fragments from excised solid malignancies, we showed IFNγ production in a fraction of the studied cases, that was conserved in frozen/thawed fragments. The small tumor fragment culture technique seems suitable to preclinically explore immunotherapy combinations.
癌症免疫疗法的生物标志物是一项尚未满足的医疗需求。NKI 的 Daniela Thommen 小组最近报告了一种新方法,该方法基于短期培养患者来源的肿瘤片段,其上清液中的细胞因子浓度和浸润 T 细胞上的活化标记物与 PD-1 阻断剂的临床反应相关。我们利用移植到免疫功能健全小鼠体内的小鼠肿瘤,建立了类似的肿瘤片段培养技术,以测试激动剂抗 CD137 mAb 及其与抗 PD-1 和/或抗 TGF-β 的组合。在使用抗 CD137 和抗 PD-1 mAb 组合或作为阳性对照的海参素 A 进行培养激活时,检测到组织培养上清液中的 IFNγ 浓度增加。在这些 mAb 的刺激下,各种细胞因子中没有其他细胞因子能提供信息。有趣的是,72 小时培养结束时收集的细胞悬浮液中的淋巴细胞证实了 Ki67 和其他活化标记物的增加。在体内抗 CD137 + 抗 PD-1 治疗前切除一个肿瘤以进行片段培养评估的双侧肿瘤小鼠中,没有发现片段产生的 IFNγ 与未切除的对侧肿瘤的体内治疗效果之间存在关联。实验系统允许冷冻和解冻片段,但功能结果相似。通过使用一系列从切除的实体恶性肿瘤中提取的患者肿瘤片段,我们发现研究病例中有一部分产生了 IFNγ,而冷冻/解冻后的肿瘤片段则保持了这一特性。小型肿瘤片段培养技术似乎适合于临床前探索免疫疗法组合。
{"title":"Short-term cultured tumor fragments to study immunotherapy combinations based on CD137 (4-1BB) agonism.","authors":"Iñaki Eguren-Santamaría, Inmaculada Rodríguez, Claudia Herrero-Martin, Eva Fernández de Piérola, Arantza Azpilikueta, Sandra Sánchez-Gregorio, Elixabet Bolaños, Gabriel Gomis, Paula Molero-Glez, Enrique Chacón, José Ángel Mínguez, Santiago Chiva, Fernando Diez-Caballero, Carlos de Andrea, Álvaro Teijeira, Miguel F Sanmamed, Ignacio Melero","doi":"10.1080/2162402X.2024.2373519","DOIUrl":"10.1080/2162402X.2024.2373519","url":null,"abstract":"<p><p>Biomarkers for cancer immunotherapy are an unmet medical need. The group of Daniela Thommen at the NKI recently reported on novel methodologies based on short-term cultures of patient-derived tumor fragments whose cytokine concentrations in the supernatants and activation markers on infiltrating T cells were associated with clinical response to PD-1 blockade. We set up a similar culture technology with tumor-derived fragments using mouse tumors transplanted into syngeneic immunocompetent mice to test an agonist anti-CD137 mAb and its combinations with anti-PD-1 and/or anti-TGF-β. Increases in IFNγ concentrations in the tissue culture supernatants were detected upon in-culture activation with the anti-CD137 and anti-PD-1 mAb combinations or concanavalin A as a positive control. No other cytokine from a wide array was informative of stimulation with these mAbs. Interestingly, increases in Ki67 and other activation markers were substantiated in lymphocytes from cell suspensions gathered at the end of 72 h cultures. In mice bearing bilateral tumors in which one was excised prior to <i>in vivo</i> anti-CD137 + anti-PD-1 treatment to perform the fragment culture evaluation, no association was found between IFNγ production from the fragments and the <i>in vivo</i> therapeutic outcome in the non-resected contralateral tumors. The experimental system permitted freezing and thawing of the fragments with similar functional outcomes. Using a series of patient-derived tumor fragments from excised solid malignancies, we showed IFNγ production in a fraction of the studied cases, that was conserved in frozen/thawed fragments. The small tumor fragment culture technique seems suitable to preclinically explore immunotherapy combinations.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2373519"},"PeriodicalIF":6.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08eCollection Date: 2024-01-01DOI: 10.1080/2162402X.2024.2376782
Gwenann Cadiou, Tiffany Beauvais, Lucine Marotte, Sylvia Lambot, Cécile Deleine, Caroline Vignes, Malika Gantier, Melanie Hussong, Samuel Rulli, Anne Jarry, Sylvain Simon, Bernard Malissen, Nathalie Labarriere
Immune checkpoint (IC) blockade and adoptive transfer of tumor-specific T-cells (ACT) are two major strategies to treat metastatic melanoma. Their combination can potentiate T-cell activation in the suppressive tumor microenvironment, but the autoimmune adverse effects associated with systemic injection of IC blockers persist with this strategy. ACT of tumor-reactive T-cells defective for IC expression would overcome this issue. For this purpose, PD-1 and TIGIT appear to be relevant candidates, because their co-expression on highly tumor-reactive lymphocytes limits their therapeutic efficacy within the tumor microenvironme,nt. Our study compares the consequences of PDCD1 or TIGIT genetic deletion on anti-tumor properties and T-cell fitness of melanoma-specific T lymphocytes. Transcriptomic analyses revealed down-regulation of cell cycle-related genes in PD-1KO T-cells, consistent with biological observations, whereas proliferative pathways were preserved in TIGITKO T-cells. Functional analyses showed that PD-1KO and TIGITKO T-cells displayed superior antitumor reactivity than their wild-type counterpart in vitro and in a preclinical melanoma model using immunodeficient mice. Interestingly, it appears that TIGITKO T-cells were more effective at inhibiting tumor cell proliferation in vivo, and persist longer within tumors than PD-1KO T-cells, consistent with the absence of impact of TIGIT deletion on T-cell fitness. Taken together, these results suggest that TIGIT deletion, over PD-1 deletion, in melanoma-specific T-cells is a compelling option for future immunotherapeutic strategies.
免疫检查点(IC)阻断和肿瘤特异性 T 细胞(ACT)的采纳性转移是治疗转移性黑色素瘤的两种主要策略。二者结合可在抑制性肿瘤微环境中增强T细胞活化,但全身注射IC阻断剂带来的自身免疫不良反应在这一策略中依然存在。对肿瘤有反应的 T 细胞表达 IC 缺陷的 ACT 可解决这一问题。为此,PD-1 和 TIGIT 似乎是相关的候选者,因为它们在高肿瘤反应性淋巴细胞上的共同表达限制了它们在肿瘤微环境中的疗效。我们的研究比较了 PDCD1 或 TIGIT 基因缺失对黑色素瘤特异性 T 淋巴细胞抗肿瘤特性和 T 细胞适应性的影响。转录组分析表明,PD-1KO T细胞中细胞周期相关基因下调,这与生物学观察结果一致,而TIGITKO T细胞中增殖途径得以保留。功能分析显示,在体外和使用免疫缺陷小鼠的临床前黑色素瘤模型中,PD-1KO 和 TIGITKO T 细胞的抗肿瘤反应性优于野生型细胞。有趣的是,与 PD-1KO T 细胞相比,TIGITKO T 细胞似乎能更有效地抑制体内肿瘤细胞的增殖,在肿瘤内存活的时间也更长,这与 TIGIT 基因缺失对 T 细胞适应性没有影响是一致的。综上所述,这些结果表明,黑色素瘤特异性T细胞的TIGIT缺失比PD-1缺失更有吸引力,是未来免疫治疗策略的一种选择。
{"title":"Differential impact of genetic deletion of TIGIT or PD-1 on melanoma-specific T-lymphocytes.","authors":"Gwenann Cadiou, Tiffany Beauvais, Lucine Marotte, Sylvia Lambot, Cécile Deleine, Caroline Vignes, Malika Gantier, Melanie Hussong, Samuel Rulli, Anne Jarry, Sylvain Simon, Bernard Malissen, Nathalie Labarriere","doi":"10.1080/2162402X.2024.2376782","DOIUrl":"10.1080/2162402X.2024.2376782","url":null,"abstract":"<p><p>Immune checkpoint (IC) blockade and adoptive transfer of tumor-specific T-cells (ACT) are two major strategies to treat metastatic melanoma. Their combination can potentiate T-cell activation in the suppressive tumor microenvironment, but the autoimmune adverse effects associated with systemic injection of IC blockers persist with this strategy. ACT of tumor-reactive T-cells defective for IC expression would overcome this issue. For this purpose, PD-1 and TIGIT appear to be relevant candidates, because their co-expression on highly tumor-reactive lymphocytes limits their therapeutic efficacy within the tumor microenvironme,nt. Our study compares the consequences of <i>PDCD1</i> or <i>TIGIT</i> genetic deletion on anti-tumor properties and T-cell fitness of melanoma-specific T lymphocytes. Transcriptomic analyses revealed down-regulation of cell cycle-related genes in PD-1<sup>KO</sup> T-cells, consistent with biological observations, whereas proliferative pathways were preserved in TIGIT<sup>KO</sup> T-cells. Functional analyses showed that PD-1<sup>KO</sup> and TIGIT<sup>KO</sup> T-cells displayed superior antitumor reactivity than their wild-type counterpart <i>in vitro</i> and in a preclinical melanoma model using immunodeficient mice. Interestingly, it appears that TIGIT<sup>KO</sup> T-cells were more effective at inhibiting tumor cell proliferation <i>in vivo</i>, and persist longer within tumors than PD-1<sup>KO</sup> T-cells, consistent with the absence of impact of TIGIT deletion on T-cell fitness. Taken together, these results suggest that TIGIT deletion, over PD-1 deletion, in melanoma-specific T-cells is a compelling option for future immunotherapeutic strategies.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2376782"},"PeriodicalIF":6.5,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TCRαβ+ CD4- CD8- double-negative T (DNT) cells are minor populations in peripheral blood, and their roles have mostly been discussed in inflammation and autoimmunity. However, the functions of DNT cells in tumor microenvironment remain to be elucidated. We investigated their characteristics, possible origins and functions in colorectal cancer tissues as well as their corresponding tumor-draining lymph nodes. We found a significant enrichment of DNT cells in tumor tissues compared with their corresponding lymph nodes, especially in tumors with lower T cell infiltration. T cell receptor (TCR) sequence analysis of CD4+ T, CD8+ T and DNT cells indicated that TCR sequences detected in DNT cells were found in CD8+ T cells, but rarely in CD4+ T cells, suggesting that a part of DNT cells was likely to be originated from CD8+ T cells. Through a single-cell transcriptomic analysis of DNT cells, we found that a DNT cell cluster, which showed similar phenotypes to central memory CD8+ T cells with low expression of effector and exhaustion markers, revealed some specific gene expression patterns, including higher GZMK expression. Moreover, in flow cytometry analysis, we found that DNT cells lost production of cytotoxic mediators. These findings imply that DNT cells might function as negative regulators of anti-tumor immune responses in tumor microenvironment.
{"title":"Characterization of double-negative T cells in colorectal cancers and their corresponding lymph nodes.","authors":"Kazumi Okamura, Lifang Wang, Satoshi Nagayama, Makiko Yamashita, Tomohiro Tate, Saki Matsumoto, Manabu Takamatsu, Shigehisa Kitano, Kazuma Kiyotani, Yusuke Nakamura","doi":"10.1080/2162402X.2024.2373530","DOIUrl":"10.1080/2162402X.2024.2373530","url":null,"abstract":"<p><p>TCRαβ+ CD4- CD8- double-negative T (DNT) cells are minor populations in peripheral blood, and their roles have mostly been discussed in inflammation and autoimmunity. However, the functions of DNT cells in tumor microenvironment remain to be elucidated. We investigated their characteristics, possible origins and functions in colorectal cancer tissues as well as their corresponding tumor-draining lymph nodes. We found a significant enrichment of DNT cells in tumor tissues compared with their corresponding lymph nodes, especially in tumors with lower T cell infiltration. T cell receptor (TCR) sequence analysis of CD4+ T, CD8+ T and DNT cells indicated that TCR sequences detected in DNT cells were found in CD8+ T cells, but rarely in CD4+ T cells, suggesting that a part of DNT cells was likely to be originated from CD8+ T cells. Through a single-cell transcriptomic analysis of DNT cells, we found that a DNT cell cluster, which showed similar phenotypes to central memory CD8+ T cells with low expression of effector and exhaustion markers, revealed some specific gene expression patterns, including higher GZMK expression. Moreover, in flow cytometry analysis, we found that DNT cells lost production of cytotoxic mediators. These findings imply that DNT cells might function as negative regulators of anti-tumor immune responses in tumor microenvironment.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2373530"},"PeriodicalIF":6.5,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03eCollection Date: 2024-01-01DOI: 10.1080/2162402X.2024.2372875
Osama Hamida, Frans Karlsson, Andreas Lundqvist, Marco Gerling, Lisa L Liu
Immune checkpoint inhibitors (ICIs) are linked to diverse immune-related adverse events (irAEs). Rare irAEs surface first in clinical practice. Here, we systematically studied the rare irAE, cytokine-release syndrome (CRS), in a cohort of 2672 patients treated with ICIs at Karolinska University Hospital in Stockholm, Sweden. We find that the risk of ICI-induced CRS - defined as fever, negative microbiological findings and absence of other probable causes within 30 days after ICI treatment - is approximately 1%, higher than previously reported. ICI-induced CRS was often mild and rechallenge with ICIs after mild CRS was generally safe. However, two out of 28 patients experienced high-grade CRS, and one was fatal. While C-reactive protein (CRP) and procalcitonin were not discriminative of fatal CRS, our data suggest that the quick Sequential Organ Failure Assessment (qSOFA) score might identify high-risk patients. These data provide a framework for CRS risk assessment and motivate multicenter studies to improve early CRS diagnosis.
{"title":"Cytokine release syndrome after treatment with immune checkpoint inhibitors: an observational cohort study of 2672 patients from Karolinska University Hospital in Sweden.","authors":"Osama Hamida, Frans Karlsson, Andreas Lundqvist, Marco Gerling, Lisa L Liu","doi":"10.1080/2162402X.2024.2372875","DOIUrl":"10.1080/2162402X.2024.2372875","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) are linked to diverse immune-related adverse events (irAEs). Rare irAEs surface first in clinical practice. Here, we systematically studied the rare irAE, cytokine-release syndrome (CRS), in a cohort of 2672 patients treated with ICIs at Karolinska University Hospital in Stockholm, Sweden. We find that the risk of ICI-induced CRS - defined as fever, negative microbiological findings and absence of other probable causes within 30 days after ICI treatment - is approximately 1%, higher than previously reported. ICI-induced CRS was often mild and rechallenge with ICIs after mild CRS was generally safe. However, two out of 28 patients experienced high-grade CRS, and one was fatal. While C-reactive protein (CRP) and procalcitonin were not discriminative of fatal CRS, our data suggest that the quick Sequential Organ Failure Assessment (qSOFA) score might identify high-risk patients. These data provide a framework for CRS risk assessment and motivate multicenter studies to improve early CRS diagnosis.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2372875"},"PeriodicalIF":6.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01eCollection Date: 2024-01-01DOI: 10.1080/2162402X.2024.2374954
Marius Bredon, Camille Danne, Hang Phuong Pham, Pauline Ruffié, Alban Bessede, Nathalie Rolhion, Laura Creusot, Loic Brot, Iria Alonso, Philippe Langella, Lisa Derosa, Alexis B Cortot, Bertrand Routy, Laurence Zitvogel, Nicola Segata, Harry Sokol
Gut microbiota impacts responses to immune checkpoint inhibitors (ICI). A high level of Faecalibacterium prausnitzii have been associated with a positive response to ICI in multiple cancer types. Here, based on fecal shotgun metagenomics data, we show in two independent cohorts of patients with non-small cell lung cancer and advanced melanoma that a high level of F. prausnitzii at baseline is positively associated with a better clinical response to ICI. In MCA205 tumor-bearing mice, administration of F.prausnitzii strain EXL01, already in clinical development for Inflammatory Bowel Disease, restores the anti-tumor response to ICI in the context of antibiotic-induced microbiota perturbation at clinical and tumor transcriptomics level. In vitro, EXL01 strain enhances T cell activation in the presence of ICI. Interestingly, oral administration of EXL01 strain did not induce any change in fecal microbiota diversity or composition, suggesting a direct effect on immune cells in the small intestine. F. prausnitzii strain EXL01 will be evaluated as an adjuvant to ICI in multiple cancers in the near future.
{"title":"<i>Faecalibaterium prausnitzii</i> strain EXL01 boosts efficacy of immune checkpoint inhibitors.","authors":"Marius Bredon, Camille Danne, Hang Phuong Pham, Pauline Ruffié, Alban Bessede, Nathalie Rolhion, Laura Creusot, Loic Brot, Iria Alonso, Philippe Langella, Lisa Derosa, Alexis B Cortot, Bertrand Routy, Laurence Zitvogel, Nicola Segata, Harry Sokol","doi":"10.1080/2162402X.2024.2374954","DOIUrl":"10.1080/2162402X.2024.2374954","url":null,"abstract":"<p><p>Gut microbiota impacts responses to immune checkpoint inhibitors (ICI). A high level of <i>Faecalibacterium prausnitzii</i> have been associated with a positive response to ICI in multiple cancer types. Here, based on fecal shotgun metagenomics data, we show in two independent cohorts of patients with non-small cell lung cancer and advanced melanoma that a high level of <i>F. prausnitzii</i> at baseline is positively associated with a better clinical response to ICI. In MCA205 tumor-bearing mice, administration of <i>F.</i> <i>prausnitzii</i> strain EXL01, already in clinical development for Inflammatory Bowel Disease, restores the anti-tumor response to ICI in the context of antibiotic-induced microbiota perturbation at clinical and tumor transcriptomics level. In vitro, EXL01 strain enhances T cell activation in the presence of ICI. Interestingly, oral administration of EXL01 strain did not induce any change in fecal microbiota diversity or composition, suggesting a direct effect on immune cells in the small intestine. <i>F. prausnitzii</i> strain EXL01 will be evaluated as an adjuvant to ICI in multiple cancers in the near future.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2374954"},"PeriodicalIF":6.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-28eCollection Date: 2024-01-01DOI: 10.1080/2162402X.2024.2372886
Anne Hansen Ree, Eirik Høye, Ying Esbensen, Ann-Christin R Beitnes, Anne Negård, Linn Bernklev, Linn Kruse Tetlie, Åsmund A Fretland, Hanne M Hamre, Christian Kersten, Eva Hofsli, Marianne G Guren, Halfdan Sorbye, Hilde L Nilsen, Kjersti Flatmark, Sebastian Meltzer
The randomized METIMMOX trial (NCT03388190) examined if patients with previously untreated, unresectable abdominal metastases from microsatellite-stable (MSS) colorectal cancer (CRC) might benefit from potentially immunogenic, short-course oxaliplatin-based chemotherapy alternating with immune checkpoint blockade (ICB). Three of 38 patients assigned to this experimental treatment had metastases from BRAF-mutant MSS-CRC, in general a poor-prognostic subgroup explored here. The ≥70-year-old females presented with ascending colon adenocarcinomas with intermediate tumor mutational burden (6.2-11.8 mutations per megabase). All experienced early disappearance of the primary tumor followed by complete response of all overt metastatic disease, resulting in progression-free survival as long as 20-35 months. However, they encountered recurrence at previously unaffected sites and ultimately sanctuary organs, or as intrahepatic tumor evolution reflected in the terminal loss of initially induced T-cell clonality in liver metastases. Yet, the remarkable first-line responses to short-course oxaliplatin-based chemotherapy alternating with ICB may offer a novel therapeutic option to a particularly hard-to-treat MSS-CRC subgroup.
随机METIMMOX试验(NCT03388190)研究了既往未经治疗、无法切除的微卫星稳定型(MSS)结直肠癌(CRC)腹部转移灶患者是否能从潜在免疫原性、基于奥沙利铂的短程化疗与免疫检查点阻断(ICB)交替治疗中获益。在被分配接受这种实验性治疗的38名患者中,有3名患者是BRAF突变型MSS-CRC的转移患者,总的来说是这里探讨的预后较差的亚组。这些≥70岁的女性患者患有升结肠腺癌,肿瘤突变负荷处于中等水平(每兆碱基6.2-11.8个突变)。所有患者都经历了原发肿瘤的早期消失,随后所有明显的转移性疾病都出现了完全反应,无进展生存期长达 20-35 个月。然而,他们在以前未受影响的部位和最终的圣区器官复发,或肝内肿瘤演变,反映在肝转移瘤中最初诱导的 T 细胞克隆性最终丧失。然而,以奥沙利铂为基础的短程化疗与 ICB 交替使用所产生的显著一线反应可能为特别难以治疗的 MSS-CRC 亚群提供了一种新的治疗选择。
{"title":"Complete response of metastatic microsatellite-stable <i>BRAF</i> V600E colorectal cancer to first-line oxaliplatin-based chemotherapy and immune checkpoint blockade.","authors":"Anne Hansen Ree, Eirik Høye, Ying Esbensen, Ann-Christin R Beitnes, Anne Negård, Linn Bernklev, Linn Kruse Tetlie, Åsmund A Fretland, Hanne M Hamre, Christian Kersten, Eva Hofsli, Marianne G Guren, Halfdan Sorbye, Hilde L Nilsen, Kjersti Flatmark, Sebastian Meltzer","doi":"10.1080/2162402X.2024.2372886","DOIUrl":"10.1080/2162402X.2024.2372886","url":null,"abstract":"<p><p>The randomized METIMMOX trial (NCT03388190) examined if patients with previously untreated, unresectable abdominal metastases from microsatellite-stable (MSS) colorectal cancer (CRC) might benefit from potentially immunogenic, short-course oxaliplatin-based chemotherapy alternating with immune checkpoint blockade (ICB). Three of 38 patients assigned to this experimental treatment had metastases from <i>BRAF</i>-mutant MSS-CRC, in general a poor-prognostic subgroup explored here. The ≥70-year-old females presented with ascending colon adenocarcinomas with intermediate tumor mutational burden (6.2-11.8 mutations per megabase). All experienced early disappearance of the primary tumor followed by complete response of all overt metastatic disease, resulting in progression-free survival as long as 20-35 months. However, they encountered recurrence at previously unaffected sites and ultimately sanctuary organs, or as intrahepatic tumor evolution reflected in the terminal loss of initially induced T-cell clonality in liver metastases. Yet, the remarkable first-line responses to short-course oxaliplatin-based chemotherapy alternating with ICB may offer a novel therapeutic option to a particularly hard-to-treat MSS-CRC subgroup.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2372886"},"PeriodicalIF":6.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isolation of tumor-specific T cells and their antigen receptors (TCRs) from malignant pleural effusions (MPE) may facilitate the development of TCR-transduced adoptive cellular immunotherapy products for advanced lung cancer patients. However, the characteristics and markers of tumor-specific T-cells in MPE are largely undefined. To this end, to establish the phenotypes and antigen specificities of CD8+ T cells, we performed single-cell RNA and TCR sequencing of samples from three advanced lung cancer patients. Dimensionality reduction on a total of 4,983 CD8+ T cells revealed 10 clusters including naïve, memory, and exhausted phenotypes. We focused particularly on exhausted T cell clusters and tested their TCR reactivity against neoantigens predicted from autologous cancer cell lines. Four different TCRs specific for the same neoantigen and one orphan TCR specific for the autologous cell line were identified from one of the patients. Differential gene expression analysis in tumor-specific T cells relative to the other T cells identified CXCL13, as a candidate gene expressed by tumor-specific T cells. In addition to expressing CXCL13, tumor-specific T cells were present in a higher proportion of T cells co-expressing PDCD1(PD-1)/TNFRSF9(4-1BB). Furthermore, flow cytometric analyses in advanced lung cancer patients with MPE documented that those with high PD-1/4-1BB expression have a better prognosis in the subset of 57 adenocarcinoma patients (p = .039). These data suggest that PD-1/4-1BB co-expression might identify tumor-specific CD8+ T cells in MPE, which are associated with patients' prognosis. (233 words).
从恶性胸腔积液(MPE)中分离出肿瘤特异性 T 细胞及其抗原受体(TCR)有助于开发 TCR 转导的晚期肺癌患者采用性细胞免疫疗法产品。然而,MPE 中肿瘤特异性 T 细胞的特征和标记在很大程度上尚未明确。为此,为了确定 CD8+ T 细胞的表型和抗原特异性,我们对三名晚期肺癌患者的样本进行了单细胞 RNA 和 TCR 测序。对总共 4,983 个 CD8+ T 细胞进行降维后发现了 10 个细胞群,包括幼稚型、记忆型和衰竭型表型。我们特别关注衰竭T细胞群,并测试了它们对自体癌细胞系预测的新抗原的TCR反应性。我们从其中一名患者身上鉴定出了对同一新抗原特异的四种不同的 TCR 和对自体细胞系特异的一种孤儿 TCR。通过对肿瘤特异性 T 细胞与其他 T 细胞的基因表达差异分析,确定了肿瘤特异性 T 细胞表达的候选基因 CXCL13。除了表达 CXCL13 外,肿瘤特异性 T 细胞还存在较高比例的共表达 PDCD1(PD-1)/TNFRSF9(4-1BB)的 T 细胞。此外,对患有 MPE 的晚期肺癌患者进行的流式细胞分析表明,在 57 例腺癌患者子集中,PD-1/4-1BB 高表达的患者预后较好(p = .039)。这些数据表明,PD-1/4-1BB共表达可识别MPE中的肿瘤特异性CD8+ T细胞,而这些细胞与患者的预后有关。(233个字)。
{"title":"Candidate tumor-specific CD8<sup>+</sup> T cell subsets identified in the malignant pleural effusion of advanced lung cancer patients by single-cell analysis.","authors":"Yusuke Sugita, Daisuke Muraoka, Ayako Demachi-Okamura, Hiroyasu Komuro, Katsuhiro Masago, Eiichi Sasaki, Yasunori Fukushima, Takuya Matsui, Shuichi Shinohara, Yusuke Takahashi, Reina Nishida, Chieko Takashima, Teppei Yamaguchi, Yoshitsugu Horio, Kana Hashimoto, Ichidai Tanaka, Hiroshi Hamana, Hiroyuki Kishi, Daiki Miura, Yuki Tanaka, Kousuke Onoue, Kazuhide Onoguchi, Yoshiko Yamashita, Richard Stratford, Trevor Clancy, Rui Yamaguchi, Hiroaki Kuroda, Hironori Ishibashi, Kenichi Okubo, Hirokazu Matsushita","doi":"10.1080/2162402X.2024.2371556","DOIUrl":"10.1080/2162402X.2024.2371556","url":null,"abstract":"<p><p>Isolation of tumor-specific T cells and their antigen receptors (TCRs) from malignant pleural effusions (MPE) may facilitate the development of TCR-transduced adoptive cellular immunotherapy products for advanced lung cancer patients. However, the characteristics and markers of tumor-specific T-cells in MPE are largely undefined. To this end, to establish the phenotypes and antigen specificities of CD8<sup>+</sup> T cells, we performed single-cell RNA and TCR sequencing of samples from three advanced lung cancer patients. Dimensionality reduction on a total of 4,983 CD8<sup>+</sup> T cells revealed 10 clusters including naïve, memory, and exhausted phenotypes. We focused particularly on exhausted T cell clusters and tested their TCR reactivity against neoantigens predicted from autologous cancer cell lines. Four different TCRs specific for the same neoantigen and one orphan TCR specific for the autologous cell line were identified from one of the patients. Differential gene expression analysis in tumor-specific T cells relative to the other T cells identified <i>CXCL13</i>, as a candidate gene expressed by tumor-specific T cells. In addition to expressing <i>CXCL13</i>, tumor-specific T cells were present in a higher proportion of T cells co-expressing <i>PDCD1</i>(PD-1)/<i>TNFRSF9</i>(4-1BB). Furthermore, flow cytometric analyses in advanced lung cancer patients with MPE documented that those with high PD-1/4-1BB expression have a better prognosis in the subset of 57 adenocarcinoma patients (<i>p</i> = .039). These data suggest that PD-1/4-1BB co-expression might identify tumor-specific CD8<sup>+</sup> T cells in MPE, which are associated with patients' prognosis. (233 words).</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2371556"},"PeriodicalIF":6.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate cancer (PCa) is characterized as a "cold tumor" with limited immune responses, rendering the tumor resistant to immune checkpoint inhibitors (ICI). Therapeutic messenger RNA (mRNA) vaccines have emerged as a promising strategy to overcome this challenge by enhancing immune reactivity and significantly boosting anti-tumor efficacy. In our study, we synthesized Tetra, an mRNA vaccine mixed with multiple tumor-associated antigens, and ImmunER, an immune-enhancing adjuvant, aiming to induce potent anti-tumor immunity. ImmunER exhibited the capacity to promote dendritic cells (DCs) maturation, enhance DCs migration, and improve antigen presentation at both cellular and animal levels. Moreover, Tetra, in combination with ImmunER, induced a transformation of bone marrow-derived dendritic cells (BMDCs) to cDC1-CCL22 and up-regulated the JAK-STAT1 pathway, promoting the release of IL-12, TNF-α, and other cytokines. This cascade led to enhanced proliferation and activation of T cells, resulting in effective killing of tumor cells. In vivo experiments further revealed that Tetra + ImmunER increased CD8+T cell infiltration and activation in RM-1-PSMA tumor tissues. In summary, our findings underscore the promising potential of the integrated Tetra and ImmunER mRNA-LNP therapy for robust anti-tumor immunity in PCa.
{"title":"Novel mRNA adjuvant ImmunER enhances prostate cancer tumor-associated antigen mRNA therapy via augmenting T cell activity.","authors":"Zhen Xu, Ze-Xiu Xiao, Jing Wang, Hao-Wei Qiu, Fei Cao, Shi-Qiang Zhang, Yuan-Dong Xu, Han-Qi Lei, Heng Xia, Yun-Ru He, Gao-Feng Zha, Jun Pang","doi":"10.1080/2162402X.2024.2373526","DOIUrl":"10.1080/2162402X.2024.2373526","url":null,"abstract":"<p><p>Prostate cancer (PCa) is characterized as a \"cold tumor\" with limited immune responses, rendering the tumor resistant to immune checkpoint inhibitors (ICI). Therapeutic messenger RNA (mRNA) vaccines have emerged as a promising strategy to overcome this challenge by enhancing immune reactivity and significantly boosting anti-tumor efficacy. In our study, we synthesized Tetra, an mRNA vaccine mixed with multiple tumor-associated antigens, and ImmunER, an immune-enhancing adjuvant, aiming to induce potent anti-tumor immunity. ImmunER exhibited the capacity to promote dendritic cells (DCs) maturation, enhance DCs migration, and improve antigen presentation at both cellular and animal levels. Moreover, Tetra, in combination with ImmunER, induced a transformation of bone marrow-derived dendritic cells (BMDCs) to cDC1-CCL22 and up-regulated the JAK-STAT1 pathway, promoting the release of IL-12, TNF-α, and other cytokines. This cascade led to enhanced proliferation and activation of T cells, resulting in effective killing of tumor cells. In vivo experiments further revealed that Tetra + ImmunER increased CD8<sup>+</sup>T cell infiltration and activation in RM-1-PSMA tumor tissues. In summary, our findings underscore the promising potential of the integrated Tetra and ImmunER mRNA-LNP therapy for robust anti-tumor immunity in PCa.</p>","PeriodicalId":48714,"journal":{"name":"Oncoimmunology","volume":"13 1","pages":"2373526"},"PeriodicalIF":6.5,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11212567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}