Therapeutic reduction of cell-mediated immunosuppression in mycosis fungoides and Sézary syndrome

Cancer Immunol Immunother. 2018 Mar;67(3):423-434. doi: 10.1007/s00262-017-2090-z. Epub 2017 Dec 4.

Abstract

Tumor progression is associated with progressive immunosuppression mediated in part by T regulatory cell(s) (Treg) and/or myeloid-derived suppressor cell(s) (MDSC). Development of strategies to reduce populations of immune cells with suppressive function in cancer patients may enable the induction or recovery of immunity against tumor cells, which may limit or reverse disease progression. With a goal of developing Treg and MDSC neutralizing strategies to treat mycosis fungoides (MF) and Sézary syndrome (SzS), we determined the association between disease stage and suppressor cell populations in patients with MF/SzS, including those responding to therapy. We found elevations in Treg populations, across Treg subtypes, in patients with SzS, and these Treg markedly suppressed proliferation of autologous CD4+CD25- responder T cells. Interestingly, while MDSC numbers were not increased in MF/SzS patients, MDSC from patients with stage IB and above produced significantly more reactive oxygen species than those from stage IA MF patients and control cohorts. Therapy with the CD25-targeting agent denileukin diftitox or IFN-α2b was associated with a reduction in Treg numbers or MDSC function, respectively. These studies identify potential mechanisms of action for these therapies and support the development of coordinated strategies targeting both Treg and MDSC activities in patients with MF/SzS.

Keywords: Cutaneous T-cell lymphoma; Mycosis fungoides; Myeloid-derived suppressor cells; Sézary syndrome; T regulatory cells.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / pharmacology*
  • Cells, Cultured
  • Diphtheria Toxin / pharmacology
  • Drug Combinations
  • Female
  • Humans
  • Immune Tolerance / drug effects
  • Immune Tolerance / immunology*
  • Immunosuppression Therapy*
  • Interferon alpha-2
  • Interferon-alpha / pharmacology
  • Interleukin-2 / pharmacology
  • Male
  • Middle Aged
  • Mycosis Fungoides / drug therapy*
  • Mycosis Fungoides / immunology
  • Mycosis Fungoides / pathology
  • Recombinant Fusion Proteins / pharmacology
  • Sezary Syndrome / drug therapy*
  • Sezary Syndrome / immunology
  • Sezary Syndrome / pathology
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology
  • T-Lymphocytes, Regulatory / drug effects
  • T-Lymphocytes, Regulatory / immunology*

Substances

  • Antineoplastic Agents
  • Diphtheria Toxin
  • Drug Combinations
  • Interferon alpha-2
  • Interferon-alpha
  • Interferon-alpha2b
  • Interleukin-2
  • Recombinant Fusion Proteins
  • denileukin diftitox