Abstract

Lung cancer is currently the leading cause of cancer-related mortality with very limited effective therapy. Screening of a variety of traditional Chinese medicines (TCMs) for their capacity to inhibit the proliferation of human lung cancer A549 cells and to induce the in vitro maturation of human DCs led to the identification of cryptotanshinone (CT), a compound purified from the TCM Salvia miltiorrhiza Bunge. Here, CT was shown to inhibit the proliferation of mouse Lewis lung carcinoma (LLC) cells by upregulating p53, downregulating cyclin B1 and Cdc2, and, consequently, inducing G2/M cell-cycle arrest of LLC cells. In addition, CT promoted maturation of mouse and human DCs with upregulation of costimulatory and MHC molecules and stimulated DCs to produce TNFα, IL-1β, and IL-12p70, but not IL-10 in vitro. CT-induced maturation of DCs depended on MyD88 and also involved the activation of NF-κB, p38, and JNK. CT was effective in the treatment of LLC tumors and, when used in combination with low doses of anti-PD-L1, cured LLC-bearing mice with the induction of subsequent anti-LLC long-term specific immunity. CT treatment promoted T-cell infiltration and elevated the expression of genes typical of Th1 polarization in LLC tumor tissue. The therapeutic effect of CT and low doses of anti-PD-L1 was reduced by depletion of CD4 and CD8 T cells. This paper provides the first report that CT induces immunological antitumor activities and may provide a new promising antitumor immunotherapeutic.

Highlights

  • Lung cancer is the leading cause of cancer-related mortality worldwide, with a 5-year overall survival rate of only 15% for all stages of patients [1]

  • CT inhibited the proliferation of Lewis lung carcinoma (LLC) cells based on G2/M cell‐cycle arrest

  • To investigate how CT inhibited LLC proliferation, LLC cells were cultured with various concentrations of CT or 1% NaN3 for 24 h and subsequently stained with FITCconjugated annexin V and propidium iodide (PI) to detect apoptosis. ­NaN3 caused apoptotic death of LLC with a dramatic increase in the percentage of annexin V-positive cells (Fig. 1b, right plot)

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Summary

Introduction

Lung cancer is the leading cause of cancer-related mortality worldwide, with a 5-year overall survival rate of only 15% for all stages of patients [1]. The majority (~ 75%) of lung cancer patients are diagnosed at an advanced stage of the disease [1,2,3]. Cancer Immunology, Immunotherapy (2019) 68:1059–1071 lymphoma kinase (crizotinib and ceritinib) is helpful only for a small subgroup of patients with relevant targetable genomic alterations [2]. Checkpoint inhibitor antibodies against PD1 (Nivolumab and Pembrolizumab) or PD-L1 (Duvalumab, Atezolizumab, and Avelumab) have been used to treat lung cancer patients with an overall response rate of approximately 20–25% [3]. The development of additional effective therapies for lung cancers is still needed

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