细粒棘球蚴感染早期对小鼠肝脏NKT细胞及其相关因子的影响

目的探讨细粒棘球蚴感染早期对小鼠肝脏自然杀伤T(Natural killer T,NKT)细胞及其相关因子的影响。方法将24只雌性C57BL/6小鼠随机分为对照组与感染组,每组12只。感染组经肝门静脉接种细粒棘球蚴原头蚴,对照组注射等量生理盐水,4周后,每组各取6只小鼠的肝脏组织进行Masson染色,另外6只小鼠的肝脏组织用于分离淋巴细胞以进行流式细胞术检测小鼠肝脏不同NKT细胞亚群比例和相关细胞因子干扰素-γ(Interforn-γ,IFN-γ)、肿瘤坏死因子-α(Tumour necrosis factor-α,TNF-α)、白细胞介素-4(Interleukin-4,IL-4)、白细胞介素-10(Interleukin-10,IL-10)和白细胞介素-17A(Interleukin-17A,IL-17A)的表达。结果与对照组纤维占比比较,感染组肝脏侵袭部位及其邻近肝脏组织呈现结缔组织病变,纤维化明显,纤维占比显著增加,且分布较广,包绕肉芽肿四周形成条索状纤维间隔。与对照组比较,感染组小鼠肝脏NKT细胞比例和CD4^(+)NKT细胞比例显著降低,差异均有统计学意义(P均<0.01);与对照组比较,感染组小鼠肝脏NKT细胞分泌TNF-α的比例、CD4^(+)NKT细胞分泌TNF-α的比例显著升高,差异均有统计学意义(P<0.05)。结论细粒棘球蚴感染早期小鼠肝脏纤维化程度增加,肝脏NKT细胞及其亚群CD4^(+)NKT细胞产生TNF-α的水平增加,提示肝脏NKT细胞可能参与细粒棘球蚴感染早期肝脏免疫应答反应。

iNKT细胞与缺血性脑卒中后免疫抑制关系的研究进展

缺血性脑卒中即各种脑血管病变导致的脑组织供血供氧障碍从而出现的神经系统损伤。卒中后免疫抑制诱发的严重感染是影响患者生存预后的重要因素。抗生素治疗受到药物耐药性增加的限制,因此,免疫调节治疗受到广泛的关注。卒中后,不变的自然杀伤T细胞(iNKT)在免疫抑制中发挥重要作用,其作为上游调节免疫系统中的CD4^(+)T和CD8^(+)T细胞,促使免疫系统Th1向Th2改变,从而导致卒中后免疫抑制。用α-半乳糖神经酰胺(α-GalCer)直接调节iNKT细胞或通过阻断去甲肾上腺素能神经递质有助于减少卒中后的感染率。但iNKT细胞如何被远距离激活,如何在卒中后推动免疫系统改变的机制尚不明确。该文就iNKT细胞的生物学特征、功能及如何影响卒中后免疫抑制做一综述。

Subgroups of peripheral immune effector cells in cervical cancer patients are more sensitive to radiation therapy than chemotherapy

Background:CD8 positive T lymphocytes and natural killer(NK)cells in the peripheral blood of cervical cancer patients exhibit varying sensitivities to radiotherapy and chemotherapy.Methods:A total of 50 healthy peoples and 60 cervical cancer patients were recruited.The patients with cervical cancer were separated into two groups:radiation and chemotherapy,and blood sample were collected before and after treatment.Data on the proportion of CD8 positive T lymphocytes and NK cells were gathered for analytical evaluation.Results:Compared to healthy individuals,patients with cervical cancer exhibit a reduced proportion of CD8 positive T cells within their peripheral blood.And for patients with cervical cancer,radiation therapy has been found to be more effective than chemotherapy in increasing the proportion of CD8 positive T lymphocytes and NK cells.Conclusions:These results suggest that radiation therapy increases the levels of CD8 positive T lymphocytes and NK cells within the peripheral blood of patients with cervical cancer.The study hypothesis that the changes in the percentage of CD8 positive T lymphocytes may serve as a potential indicator for predicting treatment efficacy.

Association of the frequency of peripheral natural killer T cells with nonalcoholic fatty liver disease

AIM: To investigate whether changes in the frequencyof peripheral natural killer T (NKT) cells were correlatedwith liver disease in patients who had metabolicpredispositions to nonalcoholic fatty liver disease(NAFLD).METHODS: Peripheral blood samples were obtainedfrom 60 Chinese NAFLD patients and 60 age and gendermatched healthy controls. The frequency of peripheralNKT cells was detected by flow cytometry. Clinical andlaboratory data were collected for further analysis. RESULTS: NAFLD patients had a lower frequencyof peripheral NKT cells than healthy controls (1.21%± 0.06% vs 1.62% ± 0.07%, P < 0.001). Furtheranalysis revealed that the frequency of peripheralNKT cells was negatively correlated with body massindex, waist circumference and serum levels of alanineaminotransferase. Logistic regression analysis revealedthat elevated body mass index [hazard ratio (HR):2.991], aspartate aminotransferase levels (HR: 1.148)and fasting blood sugar (HR: 3.133) increased the riskof NAFLD, whereas an elevated frequency of peripheralNKT cells (HR: 0.107) decreased the risk. CONCLUSION: Changes in the frequency of peripheralNKT cells were correlated with NAFLD and a decreasedfrequency of peripheral NKT cells was a risk factor forNAFLD.

Distribution of natural killer cells and T-lymphocyte subsets in peripheral blood,gallbladder cancer and surrounding tissue

BACKGROUND: The patient with malignant tumor always show immunologic function drawback and ingravescent with tumor development, especially in the aspect of cell-mediated immunity. This study was undertaken to define the relationship between the immune function of local cells and cancer development by investigating the distribution of natural killer (NK) cells and T-lymphocyte subsets in peripheral blood, the cancer tissue and the tissue surrounding gallbladder carcinoma. METHODS: The numbers of CD4(+) and CD8(+) T-lymphocytes and NK cells were measured by flow cytometry in samples taken from gallbladder cancer tissue, the surrounding tissues and peripheral blood of 38 patients, and compared with the numbers in the peripheral blood and gallbladder tissue of 30 patients with cholecystitis as controls. RESULTS: The numbers of CD4(+) and CD8(+) T-cells and NK cells in gallbladder cancer tissues were significantly higher than those in the surrounding tissue and gallbladder with gallstone. However, the ratio of CD4(+)/CD8(+) was lower in the cancer tissue than that in the surrounding tissue and tissue from gallbladders with gallstones. The distribution of CD4(+) and CD8(+) T-cells and NK cells in mucous membrane of cholecystitis gallbladder and that in the tissue surrounding gallbladder cancer were significantly different. CONCLUSIONS: Disproportionate and imbalanced distribution of NK cells and subsets of T-lymphocytes occurs in the mucous membrane proper of gallbladder cancer and surrounding tissue. Although gallbladder cancer tissue has higher expressions of CD4(+), CD8(+) and NK cells, the immune function is low or in an inhibited state. In gallbladder cancer immunization therapy, local cellular immunological function should be enhanced and the protective barrier improved.

Inhibition effect of natural killer T cells on transplantation hepatocellular carcinoma in mice

Objective:The aim of this study was to investigate the inhibition effect of natural killer T(NKT) cells on transplantation hepatocellular carcinoma in mice.Methods:α-galactosylceramide(α-GalCer)-pulsed DC and Hep S were prepared as stimulus.Hepatoma xenograft model was established and mice were randomly divided into 4 groups(n=13 each group):(1) control group,intravenous injection of the same volume of saline.(2) mature DC group,intravenous injection of mature DC cells(4×106 cells).(3) α-GalCer-pulsed HepS group,intravenous injection of α-GalCer-pulsed HepS(4×106 cells).(4) α-GalCer-pulsed mature DC group,intravenous injection of α-GalCer-pulsed DC(4×106 cells).The changes of tumor volume in mice and survival period were measured every 2 days.Percentage of NKT cells in spleens and cytotoxicity of spleen cells were detected by flow cytometry.Tumor tissues were analyzed by histopathological examination.Results:In α-GalCer-pulsed Heps and DC groups,the average survival period was prolonged and tumor volume was markedly decreased,spleen cells and NKT cells were significantly increased,and tumor necrosis was evident,compared to the control group.Conclusion:α-GalCer-pulsed DC and HepS could activate NKT cells in vivo,also increase NKT cells cytotoxicity,inhibit the growth of hepatomas and prolong survival period.

CD4+ T cells and natural killer cells: Biomarkers for hepatic fibrosis in human immunodeficiency virus/hepatitis C virus-coinfected patients

AIM To characterize peripheral blood natural killer(NK) cells phenotypes by flow cytometry as potential biomarker of liver fibrosis in human immunodeficiency virus(HIV)/hepatitis C virus(HCV) coinfected patients.METHODS Peripheral mononuclear cells from 24 HIV/HCV(HBVnegative) coinfected and 5 HIV/HCV/HBV seronegative individuals were evaluated. HIV/HCV coinfected patients were divided in to groups: G1, patients with METAVIR F0-F2 and G2, patients with METAVIR F3-F4. NK surface cell staining was performed with: AntiCD3(APC/Cy7), anti-CD56(PE/Cy5), anti-CD57(APC), anti-CD25(PE), anti-CD69(FITC), anti-NKp30(PE), antiNKp46(PE/Cy7), anti-NKG2D(APC), anti-DNAM(FITC); anti-CD62L(PE/Cy7), anti-CCR7(PE), anti-TRAIL(PE), anti-Fas L(PE), anti CD94(FITC). Flow cytometry data acquisition was performed on BD FACSCanto, analyzed using Flow Jo software. Frequency of fluorescence was analyzed for all single markers. Clinical records were reviewed, and epidemiological and clinical data were obtained.RESULTS Samples from 11 patients were included in G1 and from 13 in G2. All patients were on ARV, with undetectable HIV viral load. Liver fibrosis was evaluated by transient elastography in 90% of the patients and with biopsy in 10% of the patients. Mean HCV viral load was(6.18 ± 0.7 log10). Even though, no major significant differences were observed between G1 and G2 regarding NK surface markers, it was found that patients with higher liver fibrosis presented statistically lower percentage of NK cells than individual with low to mild fibrosis and healthy controls(G2: 5.4% ± 2.3%, G1: 12.6% ± 8.2%, P = 0.002 and healthy controls 12.2% ± 2.7%, P = 0.008). It was also found that individuals with higher liver fibrosis presented lower CD4 LT count than those from G1(G2: 521 ± 312 cells/μL, G1: 770 ± 205 cells/μL; P = 0.035).CONCLUSION Higher levels of liver fibrosis were associated with lower percentage of NK cells and LTCD4+ count; and they may serve as noninvasive biomarkers of liver damage.

Activation of natural killer T cells contributes to Th1 bias in the murine liver after 14 d of ethinylestradiol exposure

BACKGROUND As the main component of oral contraceptives(OCs),ethinylestradiol(EE)has been widely applied as a model drug to induce murine intrahepatic cholestasis.The clinical counterpart of EE-induced cholestasis includes women who are taking OCs,sex hormone replacement therapy,and susceptible pregnant women.Taking intrahepatic cholestasis of pregnancy(ICP)as an example,ICP consumes the medical system due to its high-risk fetal burden and the impotency of ursodeoxycholic acid in reducing adverse perinatal outcomes.AIM To explore the mechanisms and therapeutic strategies of EE-induced cholestasis based on the liver immune microenvironment.METHODS Male C57BL/6J mice or invariant natural killer T(iNKT)cell deficiency(Jα18-/-mice)were administered with EE(10 mg/kg,subcutaneous)for 14 d.RESULTS Both Th1 and Th2 cytokines produced by NKT cells increased in the liver skewing toward a Th1 bias.The expression of the chemokine/chemokine receptor Cxcr6/Cxcl16,toll-like receptors,Ras/Rad,and PI3K/Bad signaling was upregulated after EE administration.EE also influenced bile acid synthase Cyp7a1,Cyp8b1,and tight junctions ZO-1 and Occludin,which might be associated with EEinduced cholestasis.iNKT cell deficiency(Jα18-/-mice)robustly alleviated cholestatic liver damage and lowered the expression of the abovementioned signaling pathways.CONCLUSION Hepatic NKT cells play a pathogenic role in EE-induced intrahepatic cholestasis.Our research improves the understanding of intrahepatic cholestasis by revealing the hepatic immune microenvironment and also provides a potential clinical treatment by regulating iNKT cells.

Effects of Intraoperative Administration of Dexmedetomidine on the Percentage of T-Lymphocyte Subsets and Natural Killer Cells in Patients with Colorectal Cancer

Study Objective: To observe the effect of dexmedetomidine (DEX) on T-lymphocyte subsets and natural killer (NK) cells in the peripheral blood of perioperative patients with colorectal cancer. Design: A random double-blind control clinical study. Setting: A university hospital. Patients: Forty patients with colorectal cancer, ASA I-П. Interventions: All patients were randomly divided into a DEX group (n = 20) and a control group (n = 20). Before induction of anesthesia, epidural catheters were placed in the L1-L2 or T12-L1 intervertebral spaces. The DEX group received 1 μg/kg of DEX (200 μg/50 ml) intravenously for 15 min prior to the surgery, which was then infused at a rate of 0.5 μg/kg/h until 30 min before the end of the surgery. The control group received an intravenous infusion of saline (50 ml) instead of DEX during the same periods as the DEX group. All patients received routine anesthesia and postoperative analgesia. Measurements: Blood samples from all patients were collected at the following time points: before anesthesia (T0), 24 h after surgery (T1), 48 h after surgery (T2) and 72 h after surgery (T3). Changes in T-lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and NK cells were determined by flow cytometry. Main Results: Compared with the control group, the percentages of CD3+ and CD4+ cells and the CD4+/CD8+ ratio in the DEX group increased significantly from T1 to T3

Syndecan-1-coating of interleukin-17-producing natural killer T cells provides a specific method for their visualization and analysis

Natural killer T cells(NKT cells) are innate-like T cells that acquire effector functions while developing in the thymus, polarize into three distinct functional subsets viz. NKT1, NKT2 and NKT17 cells that produce interferon(IFN)-γ, interleukin(IL)-4 and IL-17, respectively. However, there has been no unique surface markers that define each subsets, forcing investigators to use intracellular staining of transcription factors and cytokines in combination of surface markers to distinguish among these subsets. Intracellular staining, however, causes apoptosis and prevents subsequent utilization of NKT cells in functional in vitro and in vivo assays that require viable cells. This limitation has significantly impeded understanding the specific properties of each subset and their interactions with each other. Therefore, there has been fervent efforts to find a specific markers for each NKT cell subset. We have recently identified that syndecan-1(SDC-1; CD138) as a specific surface marker of NKT17 cells. This discovery now allows visualization of NKT17 in situ and study of their peripheral tissue distribution, characteristics of their TCR and viable sorting for in vitro and in vivo analysis. In addition, it lays the ground working for investigating significance of SDC-1 expression on this particular subset in regulating their roles in host defense and glucose metabolism.

Human CD4- CD8- Invariant Natural Killer T Cells Promote IgG Secretion from B Cells Stimulated by Cross-Linking of Their Antigen Receptors

Immunoglobulin (Ig) M production can be induced by the interaction of thymus-independent type-2 (TI-2) antigen (Ag) with B cell Ag receptors (BCRs) without the involvement of conventional T cells;for IgG production through the same process, however, a second signal is required. Previous studies have reported that invariant natural killer T (iNKT) cells may be responsible for the second signal involved in IgG production. In the present study, we addressed whether human iNKT cells could participate in the production of Ig against TI-2 Ag in vitro. Two major distinct subsets of human iNKT cells, CD4+ CD8β- (CD4) and CD4- CD8β- [double negative (DN)] cells, were generated from peripheral blood monocytes from a healthy volunteer. BCR engagement, triggered by anti-IgM antibody stimulation, examined here as a model of BCR engagement triggered by TI-2 Ag, induced abundant IgM production by B cells. Both CD4 and DN iNKT cells reduced IgM production and conversely enhanced IgG production in a dose-dependent manner. In addition, IgG production by CD19+CD27- (naïve) and CD19+CD27+ (memory) B cells was predominantly promoted by DNiNKT cells rather than CD4 iNKT cells;nevertheless, IgM production by both B cell subsets was similarly reduced by either subset of iNKT cells. These results suggest that the DN iNKT subsets may preferentially promote Ig class switching by B cells upon stimulation with TI-2 Ag.

HIV感染者脏腑虚损与NK、NKT细胞功能研究

目的:通过对人免疫缺陷病毒(HIV)感染者脾虚与肾虚患者自然杀伤(NK)细胞、自然杀伤T(NKT)细胞功能的研究,分析不同脏腑虚损状态下NK细胞、NKT细胞功能的差异。方法:选取HIV感染者92例,根据中医证候量表分为脾虚组和肾虚组,对两组NK细胞、NKT细胞功能进行检测。结果:肾虚组患者干扰素-γ(INF-γ)表达降低,但两组间CD3-CD56+、CD3+CD56+、CD107a、CD4+T淋巴细胞表达均无差异。结论:脾虚与肾虚患者NK细胞数量及功能、NKT细胞数量均无差异,而肾虚患者NKT细胞功能较脾虚组降低。

治疗前淋巴细胞与C反应蛋白比值对结外NK/T细胞淋巴瘤预后的判断价值

目的:探讨治疗前淋巴细胞与C反应蛋白比值(LCR)对结外NK/T细胞淋巴瘤(ENKTL)预后的判断价值。方法:回顾性分析郑州大学第一附属医院收治的203例初诊为ENKTL患者的临床资料,ROC曲线得到LCR预测5 a总生存期(OS)的最佳截断值,并根据截断值将患者分为两组,绘制Kaplan-Meier生存曲线,采用Cox回归分析无进展生存期(PFS)和OS的影响因素。结果:LCR预测5 a OS的最佳截断值为0.19,低LCR组患者预后较差(P<0.001)。Cox回归分析结果表明,低LCR组ENKTL患者预后较差,PFS和OS的HR(95%CI)分别为0.462(0.336~0.636)和0.381(0.275~0.527)。结论:治疗前LCR可影响ENKTL预后,低LCR患者的预后较差。

NKT细胞与肝纤维化的研究进展

自然杀伤T细胞(NKT)是一类具有NK细胞受体和T细胞受体且显示NK细胞和T细胞两方面性质的T细胞亚群,NKT将先天性免疫应答和获得性免疫应答连接起来,限制性识别CD1d-糖脂类抗原,活化后迅速分泌大量细胞因子从而调节机体的免疫应答。人体的肝脏内富含NKT细胞,因此,NKT细胞在肝脏中的作用引起了人们的广泛兴趣。本文总结了近年来NKT细胞在肝纤维化发生发展中的免疫学研究进展。

基线^(18)F-FDG PET/CT代谢参数在ENKTL中的预后价值

目的:探讨结外NK/T细胞淋巴瘤(extranodal natural killer/T-cell lymphoma,ENKTL)患者基线^(18)F-脱氧葡萄糖(^(18)Ffluorodeoxy glucose,^(18)F-FDG)正电子发射计算机断层显像(positron emission tomography/computed tomography,PET/CT)代谢参数的预后价值。方法:回顾性分析83例初诊ENKTL患者治疗前的临床及PET/CT资料。以最大标准摄取值(maximum standardized uptake value,SUVmax)的41%作为阈值,获得全身病灶的SUVmax、肿瘤代谢总体积(total metabolic tumor volume,TMTV)和糖酵解总量(totallesion glycolysis,TLG)。Kaplan-Meier曲线和Log-rank检验用于生存分析,多因素分析使用Cox比例风险回归。结果:中位随访21.6(8.9,38.3)个月,其中37(44.6%)例患者进展,32(38.6%)例死亡。受试者工作特征(receiver-operating characteristic,ROC)曲线获得SUVmax、TMTV、TLG预测预后的最佳临界值分别为16.7、64.9 cm^(3)和490.4。单因素分析显示高SUVmax、TMTV、TLG与较差的无进展生存(progression-free survival,PFS)率和总生存(overall survival,OS)率有关。多因素分析表明TMTV、TLG和NK细胞淋巴瘤预后指数(prognostic index of natural killer lymphoma,PINK)是影响PFS(HR 5.411,P=0.001;HR 7.905,P<0.001;HR 2.858,P=0.011)与OS(HR 6.137,P=0.002;HR 8.014,P<0.001;HR 2.666,P=0.023)的独立危险因素,治疗模式和β2-微球蛋白(β2-microglobulin,β2-MG)分别为PFS和OS的独立预后因素(HR 2.323,P=0.021;HR 2.627,P=0.021)。TMTV与PINK评分结合可以优化预后分层。结论:ENKTL患者基线高SUVmax、TMTV、TLG可以预测不良预后,TMTV、TLG和PINK评分为PFS和OS的独立预测因子。此外,TMTV和PINK联合可以更好地对患者进行风险分层。

Intrahepatic natural killer T cell populations are increased in human hepatic steatosis

AIM: To determine if natural killer T cell (NKT) populations are affected in nonalcoholic fatty liver disease (NAFLD). METHODS: Patients undergoing bariatric surgery underwent liver biopsy and blood sampling during surgery. The biopsy was assessed for steatosis and immunocyte infiltration. Intrahepatic lymphocytes (IHLs) were isolated from the remainder of the liver biopsy, and peripheral blood mononuclear cells (PBMCs) were isolated from the blood. Expression of surface proteins on both IHLs and PBMCs were quantified using flow cytometry. RESULTS: Twenty-seven subjects participated in thisstudy. Subjects with moderate or severe steatosis had a higher percentage of intrahepatic CD3+/CD56+ NKT cells (38.6%) than did patients with mild steatosis (24.1%, P = 0.05) or those without steatosis (21.5%, P = 0.03). Patients with moderate to severe steatosis also had a higher percentage of NKT cells in the blood (12.3%) as compared to patients with mild steatosis (2.5% P = 0.02) and those without steatosis (5.1%, P = 0.05). CONCLUSION: NKT cells are significantly increased in the liver and blood of patients with moderate to severe steatosis and support the role of NKT cells in NAFLD.

Revolutionizing gastric cancer treatment:The potential of immunotherapy

Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus infections.Unfortunately,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited success.For advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted therapy.Emerging immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific immunomodulators.In this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.

治疗前中性粒细胞淋巴细胞比值和血小板淋巴细胞比值对结外NK/T细胞淋巴瘤的预后价值

目的:探讨治疗前中性粒细胞淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)和血小板淋巴细胞比值(platelet-lymphocyte ratio,PLR)在结外NK/T细胞淋巴瘤(extranodal natural killer/T-cell lymphoma,ENKTL)患者中的预后价值。方法:回顾性分析我院2012年01月至2016年12月新诊断的ENKTL患者的临床资料。根据受试者工作特征(ROC)曲线确定NLR和PLR的最佳截断值并对患者分组。采用卡方检验或Fisher确切概率法比较不同分组间的临床特征和近期疗效差异。我们使用Cox比例风险模型来确定与生存相关的单因素和多因素。生存曲线采用Kaplan-Meier法绘制,它们的差异采用log-rank检验分析。差异具有统计学意义(P<0.05)。结果:NLR和PLR的最佳截断值分别为2.62和228.8。治疗前NLR和PLR与B症状和EBV DNA拷贝数相关(P<0.05)。不同NLR、PLR分组的近期疗效差异无统计学意义(P>0.05)。单因素和多因素分析显示,NLR(P=0.009)、PLR(P=0.008)和LDH(P=0.019)是ENKTL患者OS的独立危险因素。高NLR或高PLR的患者OS率较低(P<0.001)。结论:治疗前NLR和PLR可作为结外NK/T淋巴瘤患者的独立预后因素,高NLR、高NLR提示患者预后不良。

CD30 expression in extranodal natural killer/T-cell lymphoma,nasal type among 622 cases of mature T-cell and natural killer-cell lymphoma at a single institution in South China

Background:Mature T-cell and natural killer(NK)-cell lymphomas compose a heterogeneous group of non-Hodgkin lymphomas,and extranodal NK/T-cell lymphoma,nasal type(ENKTL) is an aggressive subtype with sporadic CD30 expression.However,the significance of CD30 expression in ENKTL is controversial.We aimed to classify a large cohort of patients with mature T-cell and NK-cell lymphomas according to the 2016 World Health Organization(WHO) classification guidelines and to study the association between CD30 expression and prognosis of patients with ENKTL.Methods:We selected consecutive patients with mature T-cell and NK-cell lymphomas who attended our institution between September 1,2009 and August 31,2013.We classified the lymphomas according to the 2016 revision of the WHO classification of lymphoid neoplasms,analyzed the associations between CD30 expression and clinicopathologic features of ENKTL patients,and evaluated the prognostic implications of CD30 expression.Results:We identified 622 consecutive patients with mature T-cell and NK-cell lymphomas,including 317(51.0%)patients with ENKTL.In addition,CD30 expression was detected in 43(47.3%) of a subset of 91 patients with ENKTL.No clinicopathologic features were associated with CD30 expression,and CD30 positivity showed no prognostic significance in patients with ENKTL.Conclusions:ENKTL is the most common type of mature T-cell and NK-cell lymphoma diagnosed at our institution.CD30 is frequently expressed in ENKTL and represents a therapeutic target;however,it may not be a prognostic marker.

Updating targets for natural killer/T-cell lymphoma immunotherapy

Natural killer/T-cell lymphoma(NKTCL)is a highly invasive subtype of non-Hodgkin lymphoma,typically positive for cytoplasmic CD3,CD56,cytotoxic markers,including granzyme B and TIA1,and Epstein-Barr virus(EBV).The current treatment methods for NKTCL are associated with several drawbacks.For example,chemotherapy can lead to drug resistance,while treatment with radiotherapy alone is inadequate and results in frequent relapses.Moreover,hematopoietic stem cell transplantation exhibits limited efficacy and is not well recognized by domestic and foreign experts.In recent years,immunotherapy has shown good clinical results and has become a hot spot in cancer research.Clinical activity of targeted antibodies,such as daratumumab(anti-CD38 antibody)and brentuximab vedotin(anti-CD30 antibody),have been reported in NKTCL.Additionally,dacetuzumab and Campath-1 H have demonstrated promising results.Further encouraging data have been obtained using checkpoint inhibitors.The success of these immunotherapy agents is attributed to high expression levels of programmed death-ligand 1 in NKTCL.Furthermore,anti-CCR4 monoclonal antibodies(m Abs)exert cytotoxic actions on both CCR4+tumor cells and regulatory T cells.Depletion of these cells and the long half-life of anti-CCR4 m Abs result in enhanced induction of antitumor effector T cells.The role of IL10 in NKTCL has also been investigated.It has been proposed that exploitation of this cytokine might provide potential novel therapeutic strategies.Cellular immunotherapy with engineered cytotoxic T lymphocytes targeted against LMP1 and LMP2 has shown promising results and sustained remission.Cellular immunotherapy may be used either as maintenance therapy following initial induction chemotherapy or in cases of relapsed/refractory disease.The present review outlines the known immunotherapy targets for the treatment of NKTCL.