Abstract B13: Immunogenic chemotherapy alters microbiome-induced T-cell activation

Abstract

Abstract Introduction: The efficacy of cancer immunotherapy is influenced by the patient’s intestinal microbiome. The local and systemic effects of the microbiome on immune function are thought to depend upon a combination of microbial metabolites produced collectively from the diverse bacterial species present in the intestine and the activation of intestine-resident immunocytes such as antigen-presenting cells and T lymphocytes. The interactions between the microbiome and the immune response are regulated by Intestinal epithelial cells, which together maintain intestinal immune homeostasis. The oral chemotherapeutics lenalidomide (Len) and cyclophosphamide (CP) are currently licensed for the treatment of numerous cancers. These agents are also potent immune modulators and have been studied alongside checkpoint inhibition (CPI) with promising results. Few studies have sought to investigate the effect of these immune-modulatory agents on immune responses activated by the intestinal microbiome. In this study the immunomodulatory properties of low-dose Len and CP on IEC function and T-cell activation were investigated in combination with microbial TLR ligands and short-chain fatty acids (SFCA), immunogenic metabolites produced by intestinal bacteria. Results: Both Len and CP altered cytokine expression from IEC in response to stimulation by TLR ligands including lipopolysaccharide, peptidoglycan, and flagellin. Combinations of SCFA modulated the viability and proinflammatory effects of CP on IEC. SCFA and LEN in combination enhanced the expression of antimicrobial peptides from IEC. LEN enhanced IFN-γ and IL-17A expression by CD8+ and CD4+ T-cells. Combinations of LEN and the SCFA acetate further enhanced IFN-γ and IL-17A expression. Cytokines expressed by IEC predispose towards the development of Th2 immune responses; however, in the presence of IEC expressed Th2 skewing cytokines including IL-33 and TSLP, LEN promoted IFN-γ expressing Th1 responses. CP inhibited the ability of the SCFA butyrate to induce T-regulatory cells while Len mitigated the Th1 inhibitory effect of butyrate. Conclusions: LEN and SCFA synergize to drive Th1 responses while CP mitigate their immune-regulatory properties. Both LEN and CP prime IEC function. Collectively these data provide evidence supporting the ability of low-dose LEN and CP to alter components of intestinal immune network consisting of IEC, Immunocytes, and the microbiome. These findings have implications for the homeostasis of intestinal immunity and the maintenance of the intestinal microbiome during chemotherapeutic treatment. The influence of these agents on the microbiome and CPI immunotherapy is under investigation. Citation Format: Peter L. Smith, A.G. Dalgleish. Immunogenic chemotherapy alters microbiome-induced T-cell activation [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2019 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2020;8(3 Suppl):Abstract nr B13.