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"Balkwill, Frances R."
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Inflammation and cancer: advances and new agents
2015
Key Points
Inflammation and innate immunity have a vital and complex role in driving tumorigenesis
Strong epidemiological and preclinical data support an anti-inflammatory approach to prevention and treatment of cancer
Several therapeutic agents targeting inflammatory cytokines, transcription factors and immune cells are being developed and tested in the clinical setting
Current successes of treatments targeting adaptive immunity indicate a great need to further our clinical understanding of the inflammatory and innate immune system to identify further targets for cancer treatment
Combining treatments that target the adaptive and innate immune systems in the tumour microenvironment might be advantageous
Tumour-promoting inflammation is an enabling characteristic of many cancers. Conversely, many cancers can cause inflammation. Inflammation in the tumour microenvironment arises from the interplay of many different inflammatory cells and mediators, many of which are potential treatment targets. Herein, the authors review our current knowledge of the interplay between inflammation and tumorigenesis and discuss the potential of treatments that target cancer-related inflammation.
Tumour-promoting inflammation is considered one of the enabling characteristics of cancer development. Chronic inflammatory disease increases the risk of some cancers, and strong epidemiological evidence exists that NSAIDs, particularly aspirin, are powerful chemopreventive agents. Tumour microenvironments contain many different inflammatory cells and mediators; targeting these factors in genetic, transplantable and inducible murine models of cancer substantially reduces the development, growth and spread of disease. Thus, this complex network of inflammation offers targets for prevention and treatment of malignant disease. Much potential exists in this area for novel cancer prevention and treatment strategies, although clinical research to support targeting of cancer-related inflammation and innate immunity in patients with advanced-stage cancer remains in its infancy. Following the initial successes of immunotherapies that modulate the adaptive immune system, we assert that inflammation and innate immunity are important targets in patients with cancer on the basis of extensive preclinical and epidemiological data. The adaptive immune response is heavily dependent on innate immunity, therefore, inhibiting some of the tumour-promoting immunosuppressive actions of the innate immune system might enhance the potential of immunotherapies that activate a nascent antitumour response.
Journal Article
Murine CD27⁽⁻⁾ Vγ6⁽⁺⁾ γδ T cells producing IL-17A promote ovarian cancer growth via mobilization of protumor small peritoneal macrophages
by
Natacha Gonçalves-Sousa
,
Telma Lança
,
Sofia Mensurado
in
animal ovaries
,
Animals
,
Biological Sciences
2014
Cancer-associated inflammation mobilizes a variety of leukocyte populations that can inhibit or enhance tumor cell growth in situ. These subsets include γδ T cells, which can infiltrate tumors and typically provide large amounts of antitumor cytokines, such as IFN-γ. By contrast, we report here that in a well-established transplantable (ID8 cell line) model of peritoneal/ovarian cancer, γδ T cells promote tumor cell growth. γδ T cells accumulated in the peritoneal cavity in response to tumor challenge and could be visualized within solid tumor foci. Functional characterization of tumor-associated γδ T cells revealed preferential production of interleukin-17A (IL-17), rather than IFN-γ. Consistent with this finding, both T cell receptor (TCR)δ-deficient and IL-17–deficient mice displayed reduced ID8 tumor growth compared with wild-type animals. IL-17 production by γδ T cells in the tumor environment was essentially restricted to a highly proliferative CD27 ⁽⁻⁾ subset that expressed Vγ6 instead of the more common Vγ1 and Vγ4 TCR chains. The preferential expansion of IL-17–secreting CD27 ⁽⁻⁾ Vγ6 ⁽⁺⁾ γδ T cells associated with the selective mobilization of unconventional small peritoneal macrophages (SPMs) that, in comparison with large peritoneal macrophages, were enriched for IL-17 receptor A, and for protumor and proangiogenic molecular mediators, which were up-regulated by IL-17. Importantly, SPMs were uniquely and directly capable of promoting ovarian cancer cell proliferation. Collectively, this work identifies an IL-17–dependent lymphoid/myeloid cross-talk involving γδ T cells and SPMs that promotes tumor cell growth and thus counteracts cancer immunosurveillance.
Journal Article
Harnessing cytokines and chemokines for cancer therapy
2022
During the past 40 years, cytokines and cytokine receptors have been extensively investigated as either cancer targets or cancer treatments. A strong preclinical rationale supports therapeutic strategies to enhance the growth inhibitory and immunostimulatory effects of interferons and interleukins, including IL-2, IL-7, IL-12 and IL-15, or to inhibit the inflammatory and tumour-promoting actions of cytokines such as TNF, IL-1β and IL-6. This rationale is underscored by the discovery of altered and dysregulated cytokine expression in all human cancers. These findings prompted clinical trials of several cytokines or cytokine antagonists, revealing relevant biological activity but limited therapeutic efficacy. However, most trials involved patients with advanced-stage disease, which might not be the optimal setting for cytokine-based therapy. The advent of more effective immunotherapies and an increased understanding of the tumour microenvironment have presented new approaches to harnessing cytokine networks in the treatment of cancer, which include using cytokine-based therapies to enhance the activity or alleviate the immune-related toxicities of other treatments as well as to target early stage cancers. Many challenges remain, especially concerning delivery methods, context dependencies, and the pleiotropic, redundant and often conflicting actions of many cytokines. Herein, we discuss the lessons learnt from the initial trials of single-agent cytokine-based therapies and subsequent efforts to better exploit such agents for the treatment of solid tumours.A variety of cytokines have diverse antitumour and/or pro-tumour activities and, accordingly, alterations in cytokine networks contribute to cancer development and progression. Therefore, cytokines and their receptors have long been investigated as therapeutic agents or targets in oncology, although with mostly disappointing results. Herein, Propper and Balkwill discuss the lessons learnt from initial clinical trials of monotherapy approaches as well as subsequent strategies to better leverage cytokines and cytokine antagonists in the treatment of solid tumours.
Journal Article
B regulatory cells and the tumor-promoting actions of TNF-α during squamous carcinogenesis
by
Rosser, Elizabeth C.
,
Balkwill, Frances R.
,
Schioppa, Tiziana
in
9,10-Dimethyl-1,2-benzanthracene - toxicity
,
Adoptive Transfer
,
Animals
2011
The inflammatory cytokine TNF-α has been recognized as a critical tumor promoter, but the effector cells that mediate its action have not been fully characterized. Because B cells regulate squamous and prostate carcinogenesis, and Tnf-/- mice harbor B-cell defects, we investigated the hypothesis that B cells are important effector cells for TNF-α—mediated promotion of cancer development. Using an adoptive transfer strategy and the 7,12-dimethylbenz[α]anthracene/terephthalic acid (DMBA/TPA) two-stage model of skin carcinogenesis, we found that both B cells and TNF-α are critical for the development of DMBA/TPA-induced papilloma. Transfer of B cells from DMBA/TPA-treated wild-type mice to Tnf-/- mice rescued papilloma development to a wild-type level, a result not observed when B cells from Tnf-/- mice were transferred to Rag2-/- mice or when TNF-α was eliminated selectively in B cells. Resistance to papilloma development in Tnf-/- mice was associated with increased IFN-γ and CD8+ T cells in skin and a significant reduction in IL-10—producing B regulatory cells alongside an increase in IFN-γ—producing CD8+ T cells in the spleen. These data indicate that during DMBA/TPA-induced squamous carcinogenesis TNF-α mediates tumor-promoting activity via regulatory B cells that repress antitumor immunity.
Journal Article
Discrepancies in the Tumor Microenvironment of Spontaneous and Orthotopic Murine Models of Pancreatic Cancer Uncover a New Immunostimulatory Phenotype for B Cells
by
Balkwill, Frances R.
,
Candido, Juliana B.
,
Ghirelli, Cristina
in
Adenocarcinoma
,
Animal models
,
Animals
2019
B cells are salient features of pancreatic ductal adenocarcinoma (PDAC) tumors, yet their role in this disease remains controversial. Murine studies have indicated a protumoral role for B cells, whereas clinical data show tumor-infiltrating B cells are a positive prognostic factor, both in PDAC and other cancers. This disparity needs to be clarified in order to develop effective immunotherapies. In this study, we provide new evidence that reconcile human and mouse data and highlight the importance of using relevant preclinical tumor models when assessing B cell function. We compared B cell infiltration and activation in both a genetic model of murine PDAC (KPC mouse) and an injectable orthotopic model. A pronounced B cell infiltrate was only observed in KPC tumors and correlated with T cell infiltration, mirroring human disease. In contrast, orthotopic tumors exhibited a relative paucity of B cells. Accordingly, KPC-derived B cells displayed markers of B cell activation (germinal center entry, B cell memory, and plasma cell differentiation) accompanied by significant intratumoral immunoglobulin deposition, a feature markedly weaker in orthotopic tumors. Tumor immunoglobulins, however, did not appear to form immune complexes. Furthermore, in contrast to the current paradigm that tumor B cells are immunosuppressive, when assessed as a bulk population, intratumoral B cells upregulated several proinflammatory and immunostimulatory genes, a distinctly different phenotype to that of splenic-derived B cells; further highlighting the importance of studying tumor-infiltrating B cells over B cells from secondary lymphoid organs. In agreement with the current literature, genetic deletion of B cells (μMT mice) resulted in reduced orthotopic tumor growth, however, this was not recapitulated by treatment with B-cell-depleting anti-CD20 antibody and, more importantly, was not observed in anti-CD20-treated KPC mice. This suggests the result from B cell deficient mice might be caused by their altered immune system, rather than lack of B cells. Therefore, our data indicate B cells do not favor tumor progression. In conclusion, our analysis of relevant preclinical models shows B cells to be active members of the tumor microenvironment, producing immunostimulatory factors that might support the adaptive antitumor immune response, as suggested by human PDAC studies.
Journal Article
Combining measures of immune infiltration shows additive effect on survival prediction in high-grade serous ovarian carcinoma
by
Moore, Luiza
,
Balkwill, Frances R.
,
Montfort, Anne
in
631/250/2503
,
692/4028/67/1517/1709
,
Biomedicine
2020
Background
In colorectal and breast cancer, the density and localisation of immune infiltrates provides strong prognostic information. We asked whether similar automated quantitation and combined analysis of immune infiltrates could refine prognostic information in high-grade serous ovarian carcinoma (HGSOC) and tested associations between patterns of immune response and genomic driver alterations.
Methods
Epithelium and stroma were semi-automatically segmented and the infiltration of CD45RO
+
, CD8
+
and CD68
+
cells was automatically quantified from images of 332 HGSOC patient tissue microarray cores.
Results
Epithelial CD8 [
p
= 0.027, hazard ratio (HR) = 0.83], stromal CD68 (
p
= 3 × 10
−4
, HR = 0.44) and stromal CD45RO (
p
= 7 × 10
−4
, HR = 0.76) were positively associated with survival and remained so when averaged across the tumour and stromal compartments. Using principal component analysis, we identified optimised multiparameter survival models combining information from all immune markers (
p
= 0.016, HR = 0.88). There was no significant association between PTEN expression, type of
TP53
mutation or presence of
BRCA1/BRCA2
mutations and immune infiltrate densities or principal components.
Conclusions
Combining measures of immune infiltration provided improved survival modelling and evidence for the multiple effects of different immune factors on survival. The presence of stromal CD68
+
and CD45RO
+
populations was associated with survival, underscoring the benefits evaluating stromal immune populations may bring for prognostic immunoscores in HGSOC.
Journal Article
Airway dendritic cell maturation in children exposed to air pollution
by
Padovan, Michele G.
,
Balkwill, Frances R.
,
Whitehouse, Abigail L.
in
Adolescent
,
Air Pollutants - adverse effects
,
Air pollution
2020
Urban particulate matter (PM) enhances airway dendritic cell (DC) maturation in vitro. However, to date, there are no data on the association between exposure to urban PM and DC maturation in vivo. We sought to determine whether exposure of school-age children (8 to 14 y) to PM was associated with expression of CD86, a marker of maturation of airway conventional DCs (cDC). Healthy London school children underwent spirometry and sputum induction. Flow cytometry was used to identify CD86 and CCR7 expression on cDC subsets (CD1c+ cDC2 and CD141+ cDC1). Tertiles of mean annual exposure to PM ≤ 10 microns (PM10) at the school address were determined using the London Air Quality Toolkit model. Tertiles of exposure from the 409 children from 19 schools recruited were; lower (23.1 to 25.6 μg/m3, n = 138), middle (25.6 to 26.8 μg/m3, n = 126), and upper (26.8 to 31.0 μg/m3, n = 145). DC expression was assessed in 164/370 (44%) children who completed sputum induction. The proportion (%) of cDC expressing CD86 in the lower exposure tertile (n = 47) was lower compared with the upper exposure tertile (n = 49); (52% (44 to 70%) vs 66% (51 to 82%), p<0.05). There was a higher percentage of cDC1 cells in the lower tertile of exposure (6.63% (2.48 to 11.64) vs. 2.63% (0.72 to 7.18), p<0.05). Additionally; children in the lower exposure tertile had increased FEV1 compared with children in the upper tertile; (median z-score 0.15 (-0.59 to 0.75) vs. -0.21 (-0.86 to 0.48), p<0.05. Our data reveal that children attending schools in the highest areas of PM exposure in London exhibit increased numbers of \"mature\" airway cDCs, as evidenced by their expression of the surface marker CD86. This data is supportive of previous in vitro data demonstrating an alteration in the maturation of airway cDCs in response to exposure to pollutants.
Journal Article
Cells are Us – combining research and public engagement
2021
The COVID-19 pandemic has reminded scientists and clinicians about the importance of public engagement with science. One way to make this routine, and improve engagement skills of staff and students, is to embed an informal science learning centre within a research institute.The COVID-19 pandemic has reminded scientists and clinicians about the importance of public engagement with science. This World View argues that one way accomplish this is to embed an informal science learning centre within a research institute.
Journal Article
A Darker Side to Retinoic Acid Revealed by Sarcomas
2020
A recent study of mouse models and human sarcoma tissue implicates retinoic acid, produced by the tumor cells of sarcomas, in blunting antitumor immune mechanisms.
Journal Article