[HTML][HTML] Cyclophosphamide Promotes Chronic Inflammation–Dependent Immunosuppression and Prevents Antitumor Response in Melanoma

A Sevko, M Sade-Feldman, J Kanterman… - Journal of Investigative …, 2013 - Elsevier
A Sevko, M Sade-Feldman, J Kanterman, T Michels, CS Falk, L Umansky, M Ramacher…
Journal of Investigative Dermatology, 2013Elsevier
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 …
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.
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