Abstract

Natural killer (NK) cells play a key role in the control of cancer development, progression and metastatic dissemination. However, tumor cells develop an array of strategies capable of impairing the activation and function of the immune system, including NK cells. In this context, a major event is represented by the establishment of an immunosuppressive tumor microenvironment (TME) composed of stromal cells, myeloid-derived suppressor cells, tumor-associated macrophages, regulatory T cells and cancer cells themselves. The different immunoregulatory cells infiltrating the TME, through the release of several immunosuppressive molecules or by cell-to-cell interactions, cause an impairment of the recruitment of NK cells and other lymphocytes with effector functions. The different mechanisms by which stromal and tumor cells impair NK cell function have been particularly explored in adult solid tumors and, in less depth, investigated and discussed in a pediatric setting. In this review, we will compare pediatric and adult solid malignancies concerning the respective mechanisms of NK cell inhibition, highlighting novel key data in neuroblastoma and Wilms' tumor, two of the most frequent pediatric extracranial solid tumors. Indeed, both tumors are characterized by the presence of stromal cells acting through the release of immunosuppressive molecules. In addition, specific tumor cell subsets inhibit NK cell cytotoxic function by cell-to-cell contact mechanisms likely controlled by the transcriptional coactivator TAZ. These findings could lead to a more performant diagnostic approach and to the development of novel immunotherapeutic strategies targeting the identified cellular and molecular targets.

Highlights

  • Natural killer (NK) cells play a major role in controlling tumor progression and metastatic spread by mediating tumor cell killing and producing pro-inflammatory cytokines and chemokines [1].NK cells display a wide array of inhibitory and activating receptors on their cell surface

  • The most important NK cell-activating receptors include natural cytotoxicity receptors (NCRs, NKp46, NKp30, and NKp44), DNAX accessory molecule-1 (DNAM-1), and NK group 2 member D (NKG2D), characterized in their transmembrane domains by sequences that, interacting with different adaptor proteins, trigger signals leading to the release of perforin and granzyme B, with consequent target cell lysis [2]

  • The immunosuppression of NK cells represents an important pathogenic event occurring in the tumor microenvironment (TME) of adult and pediatric solid cancers

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Summary

Introduction

Natural killer (NK) cells play a major role in controlling tumor progression and metastatic spread by mediating tumor cell killing and producing pro-inflammatory cytokines and chemokines [1]. Adoptive cell transfer can be subverted by a patient’s immunosuppressive tumor microenvironment (TME), where cancer and stromal cells promote several immune evasion mechanisms targeting both innate and adaptive immune cells These mechanisms have been widely explored in adult solid cancer, while in pediatric cancers, much fewer data are available. We will discuss in depth recent data revealing that, in both NB and WT, stromal and cancer cells display powerful inhibitory activity on NK cell function, leading to the impairment of their cytotoxic potential In these pediatric tumors, the characterization of the immune environment and the impact on tumor cells could facilitate the identification of new therapeutic strategies capable of overcoming the inhibitory mechanisms, reducing toxicity and improving the long-term efficacy of the current treatments

From Neuroblastoma to Wilms’ Tumor
Immune Evasion Mechanisms of Neuroblastoma
Neuroblastoma-NK Cell Interactions
Neuroblastoma Stromal Cells
Neuroblastoma Cancer Cells
General Characteristics and Tumor Microenvironment of Wilms’ Tumor
Blastemal and Epithelial Primary Cultures
Diagnostic and Therapeutic Perspectives
Conclusions
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