Abstract

The tumor microenvironment is a key determinant for radio-responsiveness. Immune cells play an important role in shaping tumor microenvironments; however, there is limited understanding of how natural killer (NK) cells can enhance radiation effects. This study aimed to assess the mechanism of reciprocal complementation of radiation and NK cells on tumor killing. Various tumor cell lines were co-cultured with human primary NK cells or NK cell line (NK-92) for short periods and then exposed to irradiation. Cell proliferation, apoptosis and transwell assays were performed to assess apoptotic efficacy and cell viability. Western blot analysis and immunoprecipitation methods were used to determine XIAP (X-linked inhibitor of apoptosis protein) and Smac (second mitochondria-derived activator of caspase) expression and interaction in tumor cells. Co-culture did not induce apoptosis in tumor cells, but a time- and dose-dependent enhancing effect was found when co-cultured cells were irradiated. A key role for caspase activation via perforin/granzyme B (Grz B) after cell-cell contact was determined, as the primary radiation enhancing effect. The efficacy of NK cell killing was attenuated by upregulation of XIAP to bind caspase-3 in tumor cells to escape apoptosis. Knockdown of XIAP effectively potentiated NK cell-mediated apoptosis. Radiation induced Smac released from mitochondria and neutralized XIAP and therefore increased the NK killing. Our findings suggest NK cells in tumor microenvironment have direct radiosensitization effect through Grz B injection while radiation enhances NK cytotoxicity through triggering Smac release.

Highlights

  • Radiation is a highly effective tumoricidal modality, but its efficacy is modulated by the tumor microenvironment [1,2]

  • We found that neoadjuvant immunotherapy given before radiotherapy improved the radiosensitization effect over immunotherapy given after radiotherapy, through activation of natural killer (NK) cells [13]

  • NK Cells Enhance Radiosensitivity The ability of primary human NK cells (pNK) cells to enhance radiation in cancer cell lines was examined by irradiating cells after a 4-h co-incubation with pNK

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Summary

Introduction

Radiation is a highly effective tumoricidal modality, but its efficacy is modulated by the tumor microenvironment [1,2]. There is increased interest in modulation of immune cells infiltrating the tumor microenvironment to enhance the therapeutic efficacy of radiation [6,7].Patients received vaccine before the standard chemotherapy/radiotherapy to achieve a better result has successfully reported on prostate and head and neck cancer [8,9,10]. The combination of immunotherapy and radiotherapy is theoretically synergistic and complementary to each other. It is not clearly understood why an improved immunological environment is critical for the efficacy of subsequent radiotherapy nor why an irradiated tumor improves the subsequent immunotherapy effect

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