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Dormant tumors circumvent tumor-specific adaptive immunity by establishing a Treg-dominated niche via DKK3
Timothy N. Trotter, Carina E. Dagotto, Delila Serra, Tao Wang, Xiao Yang, Chaitanya R. Acharya, Junping Wei, Gangjun Lei, H. Kim Lyerly, Zachary C. Hartman
Timothy N. Trotter, Carina E. Dagotto, Delila Serra, Tao Wang, Xiao Yang, Chaitanya R. Acharya, Junping Wei, Gangjun Lei, H. Kim Lyerly, Zachary C. Hartman
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Research Article Immunology Oncology

Dormant tumors circumvent tumor-specific adaptive immunity by establishing a Treg-dominated niche via DKK3

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Abstract

Approximately 30% of breast cancer survivors deemed free of disease will experience locoregional or metastatic recurrence even up to 30 years after initial diagnosis, yet how residual/dormant tumor cells escape immunity elicited by the primary tumor remains unclear. We demonstrate that intrinsically dormant tumor cells are indeed recognized and lysed by antigen-specific T cells in vitro and elicit robust immune responses in vivo. However, despite close proximity to CD8+ killer T cells, dormant tumor cells themselves support early accumulation of protective FoxP3+ T regulatory cells (Tregs), which can be targeted to reduce tumor burden. These intrinsically dormant tumor cells maintain a hybrid epithelial/mesenchymal state that is associated with immune dysfunction, and we find that the tumor-derived, stem cell/basal cell protein Dickkopf WNT signaling pathway inhibitor 3 (DKK3) is critical for Treg inhibition of CD8+ T cells. We also demonstrate that DKK3 promotes immune-mediated progression of proliferative tumors and is significantly associated with poor survival and immunosuppression in human breast cancers. Together, these findings reveal that latent tumors can use fundamental mechanisms of tolerance to alter the T cell microenvironment and subvert immune detection. Thus, targeting these pathways, such as DKK3, may help render dormant tumors susceptible to immunotherapies.

Authors

Timothy N. Trotter, Carina E. Dagotto, Delila Serra, Tao Wang, Xiao Yang, Chaitanya R. Acharya, Junping Wei, Gangjun Lei, H. Kim Lyerly, Zachary C. Hartman

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Figure 3

Dormant tumors are highly infiltrated by T cells but induce a Treg-rich microenvironment.

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Dormant tumors are highly infiltrated by T cells but induce a Treg-rich ...
(A) D2A1 or D2.1 cells were implanted into the mammary fat pad of BALB/c mice (1 × 106/mouse). Small, volume-matched D2A1 tumors (“Early D2A1”; n = 6), large, duration-matched D2A1 (“D2A1”; n = 4) tumors, or small D2.1 (n = 4) tumors were collected as indicated. (B) Final volume of tumors in A. (C) Flow cytometric analysis of total T cells (CD45+CD11b–CD4+ or CD45+CD11b–CD8β+) among total immune cells (CD45+) in tumors at time of euthanasia. (D) Percentage of CD8+ cells among total CD45+ cells. (E) Percentage of CD4+ cells among total CD45+ cells. (F) Left: Flow plots of FoxP3+CD4+ cells in D2A1 and D2.1 tumors obtained on day 35 (shown gated on CD45+ cells). Right: Quantification of Tregs in tumors from A. (G) The CD8+ cell to Treg (FoxP3+CD4+) ratio in total T cells by flow cytometry. One-way ANOVA with Tukey’s post hoc analysis was used to compare 3 groups for B–G. (H) Representative IHC image of tumor border from endpoint D2A1 tumors. Dashed lines indicate stromal/tumor interface and arrows indicate positively stained CD8+ (top) or CD4+ (bottom) cells. (I) Representative images of sized-matched D2A1 or D2.1 tumor interiors stained for CD8 (top) or CD4 (bottom). (J and K) Quantification of CD8+ (J) or CD4+ (K) cells/mm2 in D2A1 and D2.1 tumor interiors (n = 5 each). (L) Representative images (left) and quantification (right) of FoxP3+ cells in tumors from H–K. Scale bars: 50 μm (H, I, and L). Density analysis was performed on 5 random fields/tumor using ImageJ software and comparisons were performed via 2-tailed t test (J–L). (M and N) Correlation of endpoint volume and CD8+ density (M) or FoxP3+ density (N) in D2.1 tumors of different sizes (n = 17). Pearson’s correlation is displayed in each plot. Data are presented as mean ± SEM.

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