Implication des cellules myéloïdes immunosuppressives (MDSC) et des lymphocytes TH17 dans l’efficacité des chimiothérapies et de l’immunothérapie

Abstract : Actual oncology is still facing resistance and rapid progression of cancer. Intrinsic resistance mechanisms developed by tumor cells determine chemotherapy and immunotherapy efficacy. It is now recognized that the host immune response status is in part implicated in the therapeutic outcome of patients. The aim of our research team is to characterize this response and to study the impact of therapies in order to identify the mechanisms associated with future exhaust of the tumor. In this context, we have shown that chemotherapy (5-FU, oxaliplatin, anti-VEGF: FOLFOX-bevacizumab) in some patients causes a drop in devices gMDSC (granulocytic myeloid derived suppressive cells) that is associated with better therapeutic response. Nevertheless, as in mice, this effect on gMDSC causes an elevation of Th17, a pro-angiogenic population, which limits the effectiveness of chemotherapy. The result of our work was aimed to test the effect "anti-Th17" activating SIRT1 deacetylase histone. SIRT1 is an enzyme capable of disrupting the acetylation of STAT3, a key factor in the differentiation of Th17. We have shown that by using pharmacological agonists SIRT1 (resveratrol, SRT1720, metformin) inhibits Th17 polarization by deacetylation of STAT3 and that this effect can limit tumor growth in colorectal and melanoma murine models (B16F10, CT26). We validated this concept in humans, suggesting that it is possible to target Th17 cells by this strategy in addition to chemotherapy. The final component of this work is devoted to the comparison of peripheral immunological profile of healthy volunteers to a prospective cohort of non-small cell lung cancer. This study has allowed us to highlight the immune alterations induced by the tumor and to link these changes in response to nivolumab (anti-PD-1). A first response predictive model could be generated using data from a panel analysis of myeloid cells. This model proves once again that gMDSC have a negative predictive role, while antigen presenting (dendritic cells and monocytes) expressing PD-L1 has a good predictive role. Data presented in this section are preliminary and must be confirmed with the validation cohort that is currently included. All of this work has shown that it is essential to specifically target immunosuppressive myeloid cells and Th17 to promote the efficacy of chemotherapy and immunotherapy in cancer.
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Emeric Limagne. Implication des cellules myéloïdes immunosuppressives (MDSC) et des lymphocytes TH17 dans l’efficacité des chimiothérapies et de l’immunothérapie. Immunologie. PSL Research University, 2017. Français. ⟨NNT : 2017PSLEP004⟩. ⟨tel-02105270⟩

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