Cyclophosphamide promotes chronic inflammation-dependent immunosuppression and prevents antitumor response in melanoma

Low-dose cyclophosphamide (CP) therapy induces immunogenic tumor cell death and decreases regulatory T cell (Treg) numbers in mice with transplantable tumors. Using the ret transgenic murine melanoma model that resembles human melanoma, we detected no beneficial antitumor effects with such treatment...

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Main Authors: Sevko, Alexandra (Author) , Michels, Tillmann (Author) , Umansky, Ludmila (Author) , Ramacher, Marcel (Author) , Umansky, Viktor (Author)
Format: Article (Journal)
Language:English
Published: 2013
In: The journal of investigative dermatology
Year: 2013, Volume: 133, Issue: 6, Pages: 1610-1619
ISSN:1523-1747
DOI:10.1038/jid.2012.444
Online Access:Verlag, Volltext: http://dx.doi.org/10.1038/jid.2012.444
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0022202X15362989
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Author Notes:Alexandra Sevko, Moshe Sade-Feldman, Julia Kanterman, Tillmann Michels, Christine S. Falk, Ludmila Umansky, Marcel Ramacher, Masashi Kato, Dirk Schadendorf, Michal Baniyash and Viktor Umansky
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Summary:Low-dose cyclophosphamide (CP) therapy induces immunogenic tumor cell death and decreases regulatory T cell (Treg) numbers in mice with transplantable tumors. Using the ret transgenic murine melanoma model that resembles human melanoma, we detected no beneficial antitumor effects with such treatment, despite a decrease in Tregs. On the contrary, low-dose CP enhanced the production of chronic inflammatory mediators in melanoma lesions associated with increased accumulation of Gr1+CD11b+ myeloid-derived suppressor cells (MDSCs), which exhibit elevated suppressive activity and nitric oxide (NO) production as well as inhibition of T-cell proliferation. Moreover, the frequencies of CD8+ T cells in the tumors and their ability to produce perforin were decreased. To study whether the observed CP-induced MDSC expansion and activation also occurs under chronic inflammatory tumor-free conditions, mice exhibiting chronic inflammation were treated with CP. Similar to tumor-bearing mice, CP-treated inflamed mice displayed elevated levels of MDSCs with enhanced production of NO, reactive oxygen species, and a suppressed in vivo natural killer (NK) cell cytotoxic activity indicating CP effects on the host immune system independent of the tumor. We suggest that melanoma therapy with low-dose CP could be efficient only when combined with the neutralization of MDSC immunosuppressive function and chronic inflammatory microenvironment.
Item Description:Published online: 6 December 2012
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Physical Description:Online Resource
ISSN:1523-1747
DOI:10.1038/jid.2012.444