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PPARγ induces PD-L1 expression in MSS+ colorectal cancer cells
Tobias Gutting1, Veronika Hauber1, Jens Pahl2,3
1Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Abstract:
Only a small subset of colorectal cancer (CRC) patients benefits from immunotherapies, comprising blocking antibodies (Abs) against checkpoint receptor "programmed-cell-death-1" (PD1) and its ligand (PD-L1), because most cases lack the required mutational burden and neo-antigen load caused by microsatellite instability (MSI) and/or an inflamed, immune cell-infiltrated PD-L1+ tumor microenvironment. Peroxisome proliferator-activated-receptor-gamma (PPARγ), a metabolic transcription factor stimulated by anti-diabetic drugs, has been previously implicated in pre/clinical responses to immunotherapy. We therefore raised the hypothesis that PPARγ induces PD-L1 on microsatellite stable (MSS) tumor cells to enhance Ab-target engagement and responsiveness to PD-L1 blockage. We found that PPARγ-agonists upregulate PD-L1 mRNA/protein expression in human gastrointestinal cancer cell lines and MSS+ patient-derived tumor organoids (PDOs). Mechanistically, PPARγ bound to and activated DNA-motifs similar to cognate PPARγ-responsive-elements (PPREs) in the proximal -2 kb promoter of the human PD-L1 gene. PPARγ-agonist reduced proliferation and viability of tumor cells in co-cultures with PD-L1 blocking Ab and lymphokine-activated killer cells (LAK) derived from the peripheral blood of CRC patients or healthy donors. Thus, metabolic modifiers improved the antitumoral response of immune checkpoint Ab, proposing novel therapeutic strategies for CRC.
Insights
Metabolic drugs targeting peroxisome proliferator-activated receptor-gamma (PPARγ) can increase programmed cell death-1 ligand (PD-L1) expression in colorectal cancer (CRC) cells. This enhances immunotherapy effectiveness for patients with microsatellite stable (MSS) tumors.
Area of Science:
- Oncology
- Immunology
- Metabolic pathways
Background:
- Immunotherapies targeting programmed-cell-death-1 (PD1) and its ligand (PD-L1) show limited efficacy in most colorectal cancer (CRC) patients due to low mutational burden and lack of an inflamed tumor microenvironment.
- Peroxisome proliferator-activated receptor-gamma (PPARγ), a metabolic transcription factor, has been linked to immunotherapy response.
- Microsatellite stable (MSS) CRC tumors often do not respond to current immunotherapies.
Purpose of the Study:
- To investigate if PPARγ activation can enhance the efficacy of PD-L1 blockade in MSS CRC.
- To explore the mechanism by which PPARγ influences PD-L1 expression in CRC cells.
- To evaluate the therapeutic potential of combining PPARγ agonists with PD-L1 inhibitors for CRC treatment.
Main Methods:
- Treatment of human gastrointestinal cancer cell lines and patient-derived tumor organoids (PDOs) with PPARγ agonists.
- Analysis of PD-L1 mRNA and protein expression.
- Chromatin immunoprecipitation assays to assess PPARγ binding to the PD-L1 promoter.
- Co-culture experiments involving tumor cells, PD-L1 blocking antibodies, and lymphokine-activated killer (LAK) cells.
Main Results:
- PPARγ agonists significantly upregulated PD-L1 expression in cancer cell lines and MSS+ PDOs.
- PPARγ was shown to directly bind to response elements in the PD-L1 gene promoter, activating its transcription.
- Combined treatment with PPARγ agonists and PD-L1 blocking antibodies reduced tumor cell proliferation and viability in co-culture models.
Conclusions:
- PPARγ activation can induce PD-L1 expression on MSS CRC cells, making them more susceptible to PD-L1 blockade.
- Metabolic modulation via PPARγ agonists represents a promising strategy to enhance anti-tumor immune responses in CRC.
- This study proposes novel therapeutic combinations for treating MSS colorectal cancer.
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