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2016 ; 150
(7
): 1659-1672.e5
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Radiation Therapy Induces Macrophages to Suppress T-Cell Responses Against
Pancreatic Tumors in Mice
#MMPMID26946344
Seifert L
; Werba G
; Tiwari S
; Giao Ly NN
; Nguy S
; Alothman S
; Alqunaibit D
; Avanzi A
; Daley D
; Barilla R
; Tippens D
; Torres-Hernandez A
; Hundeyin M
; Mani VR
; Hajdu C
; Pellicciotta I
; Oh P
; Du K
; Miller G
Gastroenterology
2016[Jun]; 150
(7
): 1659-1672.e5
PMID26946344
show ga
BACKGROUND & AIMS: The role of radiation therapy in the treatment of patients
with pancreatic ductal adenocarcinoma (PDA) is controversial. Randomized
controlled trials investigating the efficacy of radiation therapy in patients
with locally advanced unresectable PDA have reported mixed results, with effects
ranging from modest benefit to worse outcomes compared with control therapies. We
investigated whether radiation causes inflammatory cells to acquire an
immune-suppressive phenotype that limits the therapeutic effects of radiation on
invasive PDAs and accelerates progression of preinvasive foci. METHODS: We
investigated the effects of radiation therapy in p48(Cre);LSL-Kras(G12D) (KC) and
p48(Cre);LSLKras(G12D);LSL-Trp53(R172H) (KPC) mice, as well as in C57BL/6 mice
with orthotopic tumors grown from FC1242 cells derived from KPC mice. Some mice
were given neutralizing antibodies against macrophage colony-stimulating factor 1
(CSF1 or MCSF) or F4/80. Pancreata were exposed to doses of radiation ranging
from 2 to 12 Gy and analyzed by flow cytometry. RESULTS: Pancreata of KC mice
exposed to radiation had a higher frequency of advanced pancreatic
intraepithelial lesions and more foci of invasive cancer than pancreata of
unexposed mice (controls); radiation reduced survival time by more than 6 months.
A greater proportion of macrophages from radiation treated invasive and
preinvasive pancreatic tumors had an immune-suppressive, M2-like phenotype
compared with control mice. Pancreata from mice exposed to radiation had fewer
CD8(+) T cells than controls, and greater numbers of CD4(+) T cells of T-helper 2
and T-regulatory cell phenotypes. Adoptive transfer of T cells from irradiated
PDA to tumors of control mice accelerated tumor growth. Radiation induced
production of MCSF by PDA cells. A neutralizing antibody against MCSF prevented
radiation from altering the phenotype of macrophages in tumors, increasing the
anti-tumor T-cell response and slowing tumor growth. CONCLUSIONS: Radiation
treatment causes macrophages murine PDA to acquire an immune-suppressive
phenotype and disabled T-cell-mediated anti-tumor responses. MCSF blockade
negates this effect, allowing radiation to have increased efficacy in slowing
tumor growth.