Abstract

Lymphomas represent a diverse group of malignancies that emerge from lymphocytes. Despite improvements in diagnosis and treatment of lymphomas of B-cell origin, relapsed and refractory disease represents an unmet clinical need. Therefore, it is of utmost importance to better understand the lymphomas’ intrinsic features as well as the interactions with their cellular microenvironment for developing novel therapeutic strategies. In fact, the role of immune-based approaches is steadily increasing and involves amongst others the use of monoclonal antibodies against tumor antigens, inhibitors of immunological checkpoints, and even genetically modified T-cells. Metabolic reprogramming and immune escape both represent well established cancer hallmarks. Tumor metabolism as introduced by Otto Warburg in the early 20th century promotes survival, proliferation, and therapeutic resistance. Simultaneously, malignant cells employ a plethora of mechanisms to evade immune surveillance. Increasing evidence suggests that metabolic reprogramming does not only confer cell intrinsic growth and survival advantages to tumor cells but also impacts local as well as systemic anti-tumor immunity. Tumor and immune cells compete over nutrients such as carbohydrates or amino acids that are critical for the immune cell function. Moreover, skewed metabolic pathways in malignant cells can result in abundant production and release of bioactive metabolites such as lactic acid, kynurenine or reactive oxygen species (ROS) that affect immune cell fitness and function. This “metabolic re-modeling” of the tumor microenvironment shifts anti-tumor immune reactivity toward tolerance. Here, we will review molecular events leading to metabolic alterations in B-cell lymphomas and their impact on anti-tumor immunity.

Highlights

  • Metabolic reprogramming is a well-established hallmark of cancer [1]

  • Circulating chronic lymphocytic leukemia (CLL) cells possess a marked metabolic activity that differs from healthy B-lymphocytes. As they traffic between hypoxic (i.e., lymph nodes (LNs) and bone marrow (BM)) and normoxic compartments, CLL cells were found to constitutively express hypoxia-inducible factor (HIF-1a), which gets further upregulated within LNs promoting aerobic glycolysis [36, 37]

  • The most studied example of nutrient competition is the increased glucose consumption by malignant cells caused by elevated expression levels of glucose transporters and enzymes of the glycolytic machinery {as seen in B-cell receptor (BCR)-Diffuse Large B-cell Lymphoma (DLBCL) [e.g., GAPDH expression [52] and lactate secretion [13]], transformed Follicular Lymphoma (FL) [e.g., GAPDH and aldolase A [27, 28]], Mantle Cell Lymphoma (MCL) [e.g., glycolytic flux [33]], and CLL in the LN-/BM-niche [e.g., glycolytic flux and key glycolytic enzymes [44]]}

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Summary

INTRODUCTION

Metabolic reprogramming is a well-established hallmark of cancer [1]. emerging evidence suggests that metabolic reprogramming does confer bioenergetic advantages and impacts immune surveillance, being closely interconnected with immune escape, another hallmark of cancer [1]. As a central hub for the integration of metabolic processes, mammalian target of rapamycin (mTOR) controls nutrient/ amino acid sensing, glycolysis, OxPhos, and proliferation and survival It serves as the core component of two multi-protein complexes (mTORC1 and mTORC2) that regulate different cell processes [reviewed in [17]]. Circulating CLL cells possess a marked metabolic activity that differs from healthy B-lymphocytes As they traffic between hypoxic (i.e., LN and BM) and normoxic compartments (i.e., peripheral blood), CLL cells were found to constitutively express hypoxia-inducible factor (HIF-1a), which gets further upregulated within LNs promoting aerobic glycolysis [36, 37]. CLL samples with higher glycolytic flexibility showed an increased resistance to novel drugs affecting the mitochondria, such as venetoclax and navitoclax [43] Another metabolically important aspect is the role of free fatty acids (FFAs). They confer enhanced survival, proliferation, and therapeutic resistance but at the same time, we can therapeutically exploit them

LYMPHOMA METABOLISM AND ITS POTENTIAL IMPACT ON ANTILYMPHOMA IMMUNITY
Findings
CONCLUSION AND FUTURE PERSPECTIVES
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