Abstract

Simple SummaryThe pathogenesis of CRC relies on complex interactions between developing cancer and surrounding tissue, including the immune system. One of the most abundant tumor-infiltrating cell populations is represented by tumor-associated macrophages (TAMs). TAMs play a detrimental role and are associated with a poor prognosis in many tumors and are characterized by an impaired antigen-presenting capability and by immunosuppressive activity. However, their role in CRC is still controversial. Our study aimed to elucidate how the colorectal cancer environment educates macrophages toward a pro-tumoral profile, exploiting them to escape the immune response. We demonstrate that both CRC cells and the extracellular matrix are actively involved in defining the macrophage profile, which is characterized by immunosuppressive activity and an impaired antigen-presenting ability. Dissecting the contribution of the tumor environment to the influence on the macrophage profile will provide additional knowledge for the development of new antitumor strategies.Tumor-associated macrophages (TAMs) are major components of the tumor microenvironment. In colorectal cancer (CRC), a strong infiltration of TAMs is accompanied by a decrease in effector T cells and an increase in the metastatic potential of CRC. We investigated the functional profile of TAMs infiltrating CRC tissue by immunohistochemistry, flow cytometry, ELISA, and qRT-PCR and their involvement in impairing the activation of effector T cells. In CRC biopsies, we evidenced a high percentage of macrophages with low expression of the antigen-presenting complex MHC-II and high expression of CD206. Monocytes co-cultured with tumor cells or a decellularized tumor matrix differentiated toward a pro-tumoral macrophage phenotype characterized by decreased expression of MHC-II and CD86 and increased expression of CD206 and an abundant release of pro-tumoral cytokines and chemokines. We demonstrated that the hampered expression of MHC-II in macrophages is due to the downregulation of the MHC-II transactivator CIITA and that this effect relies on increased expression of miRNAs targeting CIITA. As a result, macrophages become unable to present antigens to CD4 T lymphocytes. Our data suggest that the tumor microenvironment contributes to defining a pro-tumoral profile of macrophages infiltrating CRC tissue with impaired capacity to activate T cell effector functions.

Highlights

  • Colorectal cancer (CRC) is the most common malignant cancer of the gastrointestinal tract, and it is considered the second most common cause of death related to cancer.Approximately one third of patients develop metastatic disease [1]

  • We found that colorectal cancer (CRC) tissue was more densely infiltrated with CD163+ macrophages than normal matched intestinal mucosa

  • The large majority of CD163+ macrophages in normal mucosa showed a robust expression of MHC-II

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Summary

Introduction

Colorectal cancer (CRC) is the most common malignant cancer of the gastrointestinal tract, and it is considered the second most common cause of death related to cancer.Approximately one third of patients develop metastatic disease [1]. By 2030, the global burden of CRC is expected to reach more than 2.2 million new cases and 1.1 million deaths [1]. Despite significant advances in standard-of-care therapies, patients diagnosed with metastatic CRC achieve a five-year survival rate of 12% [2]. The tumor microenvironment is a complex society of many cell types and the extracellular matrix (ECM), which together generate tumor “tissue.” In this framework, innate immune cells are highly represented, and, among them, the most abundant are tumor-associated macrophages (TAMs) [3,4]. Macrophages are regarded as involved in antitumor immunity, compelling evidence supports the notion that in the majority of cases, these cells interact with tumor cells to promote the initiation, growth, and metastasis of tumors [5]. Macrophages may be divided into two distinct subtypes

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