1
|
Cubillos-Zapata C, Balbás-García C, Avendaño-Ortiz J, Toledano V, Torres M, Almendros I, Casitas R, Zamarrón E, García-Sánchez A, Feliu J, Aguirre LA, Farre R, López-Collazo E, García-Rio F. Age-dependent hypoxia-induced PD-L1 upregulation in patients with obstructive sleep apnoea. Respirology 2019; 24:684-692. [PMID: 30656807 DOI: 10.1111/resp.13470] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/26/2018] [Accepted: 12/16/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVE In obstructive sleep apnoea (OSA), intermittent hypoxia (IH) compromises immune surveillance through the upregulation of the programmed cell death-1 (PD-1) receptor and its ligand (PD-L1). Because the risk of OSA-related cancer depends on age, we assessed PD-L1/PD-1 expression in middle-aged and older patients with OSA as well as in a murine model. METHODS PD-L1 expression was studied in 41 patients with severe OSA and 40 healthy volunteers (HV), divided into two groups (≤55 and >55 years of age). We used flow cytometry, quantitative PCR (qPCR) and ELISA to determine PD-L1 expression on monocytes and plasma PD-L1 protein levels. Moreover, we analysed PD-L1 expression on an in vivo IH model with old and young mice. RESULTS In subjects up to 55 years of age, severe OSA increased PD-L1 surface protein and mRNA level expression on monocytes and soluble-PD-L1 protein concentration in plasma compared to HV. PD-L1 and hypoxia-induced factor (HIF)-1α expression correlated with age in HV, whereas in patients with OSA there was a negative relationship. In the mice exposed to IH, PD-L1 expression on F4/80+ splenocytes was also only increased in young animals. HIF-1α expression was significantly higher in patients with OSA than in HV in subjects up to 55 years of age, while PD-L1 expression in monocytes was related to HIF-1α expression in young patients with OSA. CONCLUSION PD-L1 upregulation in patients with OSA as a consequence of HIF-1α activation occurs mainly in young patients. In older patients with OSA, upregulation was not detected, possibly due to impaired oxygen sensitivity.
Collapse
Affiliation(s)
- Carolina Cubillos-Zapata
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Cristina Balbás-García
- Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Jose Avendaño-Ortiz
- The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Victor Toledano
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Marta Torres
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Sleep Laboratory, Pneumology Service, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Isaac Almendros
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Biophysics and Bioengineering Unit, Faculty of Medicine, University of Barcelona-IDIBAPS, Barcelona, Spain
| | - Raquel Casitas
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Ester Zamarrón
- Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Aldara García-Sánchez
- Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Jaime Feliu
- Oncology Service, La Paz University Hospital, IdiPAZ, Madrid, Spain.,Biomedical Research Networking Center on Cancer (CIBERONC), Madrid, Spain
| | - Luis A Aguirre
- The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Ramón Farre
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Biophysics and Bioengineering Unit, Faculty of Medicine, University of Barcelona-IDIBAPS, Barcelona, Spain
| | - Eduardo López-Collazo
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Francisco García-Rio
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| |
Collapse
|
2
|
Cubillos-Zapata C, Avendaño-Ortiz J, Hernandez-Jimenez E, Toledano V, Casas-Martin J, Varela-Serrano A, Torres M, Almendros I, Casitas R, Fernández-Navarro I, Garcia-Sanchez A, Aguirre LA, Farre R, López-Collazo E, García-Rio F. Hypoxia-induced PD-L1/PD-1 crosstalk impairs T-cell function in sleep apnoea. Eur Respir J 2017; 50:50/4/1700833. [PMID: 29051270 DOI: 10.1183/13993003.00833-2017] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/23/2017] [Indexed: 12/16/2022]
Abstract
Obstructive sleep apnoea (OSA) is associated with higher cancer incidence, tumour aggressiveness and cancer mortality, as well as greater severity of infections, which have been attributed to an immune deregulation. We studied the expression of programmed cell death (PD)-1 receptor and its ligand (PD-L1) on immune cells from patients with OSA, and its consequences on immune-suppressing activity. We report that PD-L1 was overexpressed on monocytes and PD-1 was overexpressed on CD8+ T-cells in a severity-dependent manner. PD-L1 and PD-1 overexpression were induced in both the human in vitro and murine models of intermittent hypoxia, as well as by hypoxia-inducible factor-1α transfection. PD-L1/PD-1 crosstalk suppressed T-cell proliferation and activation of autologous T-lymphocytes and impaired the cytotoxic activity of CD8+ T-cells. In addition, monocytes from patients with OSA exhibited high levels of retinoic acid related orphan receptor, which might explain the differentiation of myeloid-derived suppressor cells. Intermittent hypoxia upregulated the PD-L1/PD-1 crosstalk in patients with OSA, resulting in a reduction in CD8+ T-cell activation and cytotoxicity, providing biological plausibility to the increased incidence and aggressiveness of cancer and the higher risk of infections described in these patients.
Collapse
Affiliation(s)
- Carolina Cubillos-Zapata
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Jose Avendaño-Ortiz
- The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Enrique Hernandez-Jimenez
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Victor Toledano
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Jose Casas-Martin
- The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | | | - Marta Torres
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Sleep Laboratory, Pneumology Service, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Isaac Almendros
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Biophysics and Bioengineering Unit, Faculty of Medicine, University of Barcelona-IDIBAPS, Barcelona, Spain
| | - Raquel Casitas
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Isabel Fernández-Navarro
- Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Aldara Garcia-Sanchez
- Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Luis A Aguirre
- The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - Ramón Farre
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,Biophysics and Bioengineering Unit, Faculty of Medicine, University of Barcelona-IDIBAPS, Barcelona, Spain
| | - Eduardo López-Collazo
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain.,The Innate Immune Response Group, La Paz University Hospital, IdiPAZ, Madrid, Spain.,Joint principal investigators
| | - Francisco García-Rio
- Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain .,Respiratory Diseases Group, Respiratory Service, La Paz University Hospital, IdiPAZ, Madrid, Spain.,Dept of Medicine, Autonomous University of Madrid, Madrid, Spain.,Joint principal investigators
| |
Collapse
|
3
|
Hernández-Jiménez E, Cubillos-Zapata C, Toledano V, Pérez de Diego R, Fernández-Navarro I, Casitas R, Carpio C, Casas-Martín J, Valentín J, Varela-Serrano A, Avendaño-Ortiz J, Alvarez E, Aguirre L, Pérez-Martínez A, De Miguel MP, Belda-Iniesta C, García-Río F, López-Collazo E. Monocytes inhibit NK activityviaTGF-β in patients with obstructive sleep apnoea. Eur Respir J 2017; 49:49/6/1602456. [DOI: 10.1183/13993003.02456-2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/05/2017] [Indexed: 12/29/2022]
Abstract
Obstructive sleep apnoea (OSA) is associated with cancer incidence and mortality. The contribution of the immune system appears to be crucial; however, the potential role of monocytes and natural killer (NK) cells remains unclear.Quantitative reverse transcriptase PCR, flow cytometry andin vitroassays were used to analyse the phenotype and immune response activity in 92 patients with OSA (60 recently diagnosed untreated patients and 32 patients after 6 months of treatment with continuous positive airway pressure (CPAP)) and 29 healthy volunteers (HV).We determined that monocytes in patients with OSA exhibit an immunosuppressive phenotype, including surface expression of glycoprotein-A repetitions predominant protein (GARP) and transforming growth factor-β (TGF-β), in contrast to those from the HV and CPAP groups. High levels of TGF-β were detected in OSA sera. TGF-β release by GARP+monocytes impaired NK cytotoxicity and maturation. This altered phenotype correlated with the hypoxic severity clinical score (CT90). Reoxygenation eventually restored the altered phenotypes and cytotoxicity.This study demonstrates that GARP+monocytes from untreated patients with OSA have an NK-suppressing role through their release of TGF-β. Our findings show that monocyte plasticity immunomodulates NK activity in this pathology, suggesting a potential role in cancer incidence.
Collapse
|
4
|
Cubillos-Zapata C, Córdoba R, Avendaño-Ortiz J, Lopez-Collazo E. RETRACTED ARTICLE: Thalidomide analog CC-122 induces a refractory state in monocytes from patients with diffuse large B cell lymphoma. Leuk Lymphoma 2017; 58:1999-2001. [DOI: 10.1080/10428194.2016.1272686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Carolina Cubillos-Zapata
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain
- Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Center for Biomedical Research Network, CIBEres, Madrid, Spain
| | - Raúl Córdoba
- Lymphoma Unit, Oncohealth Institute and Health Research Institute IIS-FJS-Autonomous University of Madrid, Madrid, Spain
- START Madrid FJD, Phase 1 Clinical Trials Unit, Foundation Jiménez Díaz University Hospital, Madrid, Spain
| | - Jose Avendaño-Ortiz
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain
- Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Center for Biomedical Research Network, CIBEres, Madrid, Spain
| | - Eduardo Lopez-Collazo
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain
- Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Center for Biomedical Research Network, CIBEres, Madrid, Spain
| |
Collapse
|
5
|
Cubillos-Zapata C, Avendaño-Ortiz J, Córdoba R, Hernández-Jiménez E, Toledano V, Pérez de Diego R, López-Collazo E. Ibrutinib as an antitumor immunomodulator in patients with refractory chronic lymphocytic leukemia. Oncoimmunology 2016; 5:e1242544. [PMID: 28123879 DOI: 10.1080/2162402x.2016.1242544] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/23/2016] [Accepted: 09/23/2016] [Indexed: 01/01/2023] Open
Abstract
Ibrutinib has emerged as a promising therapy for patients with chronic lymphocytic leukemia (CLL) who are nonresponsive to standard therapies. The refractory state of monocytes and T-cell exhaustion in patients with CLL could explain the morbidity and mortality reported in these patients. We studied the effect of ibrutinib on the immune response of four relapsed patients with CLL during the first treatment cycle. We observed the ability to recover the standard response against bacterial stimulus in CD14+ cells, improving levels of phospho-Erk1/2 and antigen presentation. Meanwhile, ibrutinib drove Th1-selective pressure in T lymphocytes, thus, reducing the PD-1 and PDL-1 expression. Our data suggest the impact of BTK inhibition along with immunomodulation on the innate immune response and a switch to the specific adaptive immune response, which might help to decrease infectious complications. The potential effect of ibrutinib on CLL patient outcomes is worthy of further study, because infections could be reduced with the use of ibrutinib.
Collapse
Affiliation(s)
- Carolina Cubillos-Zapata
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain; Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain; Center for Biomedical Research Network, CIBEres, Madrid, Spain
| | - Jose Avendaño-Ortiz
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain; Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Raúl Córdoba
- Lymphoma Unit, Oncohealth Institute and Health Research Institute IIS-FJS, Autonomous University of Madrid, Madrid, Spain; START Madrid FJD, Phase 1 Clinical Trials Unit, Foundation Jiménez Díaz University Hospital, Madrid, Spain
| | - Enrique Hernández-Jiménez
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain; Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain; Center for Biomedical Research Network, CIBEres, Madrid, Spain
| | - Victor Toledano
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain; Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain; Center for Biomedical Research Network, CIBEres, Madrid, Spain
| | - Rebeca Pérez de Diego
- Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain; Laboratory of Immunogenetics of Diseases, Madrid, Spain
| | - Eduardo López-Collazo
- Tumor Immunology Laboratory, IdiPAZ, Madrid, Spain; Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain; Center for Biomedical Research Network, CIBEres, Madrid, Spain
| |
Collapse
|