Perioperative influenza vaccination reduces postoperative metastatic disease by reversing surgery-induced dysfunction
Lee-Hwa Tai1, Jiqing Zhang, Karen J Scott
1Authors' Affiliations: Centre for Innovative Cancer Research, Ottawa Hospital Research Institute; Departments of Cellular and Molecular Medicine, Biochemistry, Microbiology, and Immunology, and Surgery, University of Ottawa, Ottawa, Canada; Department of Neurosurgery, The Second Hospital of Shandong University, Shandong, China; Targeted & Biological Therapies Group, Leeds Institute of Cancer Studies and Pathology, Leeds, United Kingdom; Department of Medical Laboratory Technology, University of Tabuk, Tabuk; and College of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia.
Purpose:
Surgical removal of solid primary tumors is an essential component of cancer treatment. Surgery-induced dysfunction in natural killer (NK) cells has been linked to the development of metastases in animal models and patients with cancer. We investigated the activation of NK cells using influenza vaccine in the perioperative period to eradicate micrometastatic disease.
Experimental Design:
Both the B16lacZ and 4T1 tumor models in immunocompetent mice were used to assess the in vivo efficacy of perioperative influenza vaccine administration. In healthy human donors and cancer surgery patients, we assessed NK cell function pre- and post-influenza vaccination using both in vivo and ex vivo assays.
Results:
Using the TLR3 agonist poly(I:C), we showed as proof-of-principle that perioperative administration of a nonspecific innate immune stimulant can inhibit surgery-induced dysfunction in NK cells and attenuate metastases. Next, we assessed a panel of prophylactic vaccines for NK cell activation and determined that inactivated influenza vaccine was the best candidate for perioperative administration. Perioperative influenza vaccine significantly reduced tumor metastases and improved NK cytotoxicity in preclinical tumor models. Significantly, IFNα is the main cytokine mediator for the therapeutic effect of influenza vaccination. In human studies, influenza vaccine significantly enhanced NK cell activity in healthy human donors and cancer surgery patients.
Conclusion:
These results provide the preclinical rationale to pursue future clinical trials of perioperative NK cell activation, using vaccination in cancer surgery patients. Research into perioperative immune therapy is warranted to prevent immune dysfunction following surgery and eradicate metastatic disease.
Insights
Perioperative influenza vaccination activates natural killer (NK) cells, reducing cancer metastases and immune dysfunction following surgery. This approach shows promise for eradicating micrometastatic disease in cancer patients.
Area of Science:
- Immunology
- Oncology
- Vaccinology
Background:
- Surgical tumor removal is crucial but can impair natural killer (NK) cell function, potentially promoting metastasis.
- Surgery-induced NK cell dysfunction is a significant concern in cancer treatment.
- Activating NK cells perioperatively may combat micrometastatic disease.
Purpose of the Study:
- To investigate perioperative influenza vaccination for NK cell activation.
- To determine if this strategy can prevent surgery-induced NK cell dysfunction.
- To assess the potential for eradicating micrometastatic disease.
Main Methods:
- Utilized B16lacZ and 4T1 mouse tumor models to evaluate perioperative influenza vaccine efficacy.
- Assessed NK cell function in healthy human donors and cancer surgery patients.
- Employed in vivo and ex vivo assays to measure NK cell activity and cytokine production (IFNα).
Main Results:
- Perioperative administration of innate immune stimulants, like poly(I:C) and inactivated influenza vaccine, inhibited surgery-induced NK cell dysfunction.
- Influenza vaccine significantly reduced tumor metastases and enhanced NK cell cytotoxicity in preclinical models.
- Influenza vaccination significantly boosted NK cell activity in both healthy humans and cancer surgery patients, with IFNα identified as a key mediator.
Conclusions:
- Preclinical data support clinical trials for perioperative NK cell activation via vaccination in cancer surgery patients.
- Perioperative immunotherapy is a promising strategy to counteract surgical immune dysfunction and eliminate metastatic disease.
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