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COMBINATORIAL INHIBITION OF TIGIT AND CD39 INCREASE T-CELL MEDIATED KILLING IN AML
Author(s): ,
Franziska Brauneck
Affiliations:
II. Department of Medicine, Center for Oncology, University Medical Center Hamburg-Eppendorf,University Medical Center Hamburg-Eppendorf,Hamburg,Germany
,
Stephan Menzel
Affiliations:
Institute of Immunology, University Medical CenHamburg-Eppendorf (UKE),University Medical Center Hamburg-Eppendorf,Hamburg,Germany
,
Jasmin Wellbrock
Affiliations:
II. Department of Medicine, Center for Oncology, University Medical Center Hamburg-Eppendorf,University Medical Center Hamburg-Eppendorf,Hamburg,Germany
,
Julian Schulze zur Wiesch
Affiliations:
I. Department of Medicine, Section Infectious Diseases,University Medical Center Hamburg-Eppendorf,Hamburg,Germany
,
Christin Ackermann
Affiliations:
I. Department of Medicine, Section Infectious Diseases,University Medical Center Hamburg-Eppendorf,Hamburg,Germany
Walter Fiedler
Affiliations:
II. Department of Medicine, Center for Oncology, University Medical Center Hamburg-Eppendorf,University Medical Center Hamburg-Eppendorf,Hamburg,Germany
EHA Library. Brauneck F. 06/09/21; 325164; EP410
Franziska Brauneck
Franziska Brauneck
Contributions
Abstract
Presentation during EHA2021: All e-poster presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: EP410

Type: E-Poster Presentation

Session title: Acute myeloid leukemia - Biology & Translational Research

Background
The inhibitory receptor TIGIT, as well as the ectonucleotidases CD39 and CD73 constitute potential exhaustion markers for T cells. Detailed analysis of these markers may shed light into dysregulation of the T-cell response in acute myeloid leukemia (AML) and help to identify potential therapeutic targets. 

Aims

In the current study we analyzed multiple inhibitory receptors and members of the purinergic system which have also been involved into downregulation of T-cell effector function aiming to identify relevant new pathways of T-cell mediated immune failure in AML.

Methods
The differentiation state, phenotype and expression of transcription factors was assessed on T cells derived from peripheral blood (PB n=38) and bone marrow (BM n=43). PB and BM collected from patients with newly diagnosed primary AML, at relapse after intensive chemotherapy and in remission were compared to healthy volunteers (HD n=12). The surface expression of PD-1, TIGIT, CD73, and CD39, as well as of the differentiation markers CD45RO, CCR7, CD25 and CD127 were determined on CD8+and conventional and regulatory CD4+(CD4+CD127-CD25hi)cells using multiparameter flow cytometry. 

Results

An increased frequency of terminally differentiated (CD45R-CCR7-) CD8T cells was confirmed in the PB and BM regardless of the AML disease status (p<0,05). Moreover, CD39 was aberrantly expressed on this population: we observed an increased frequency of CD39+TIGIT+CD73-CD8T cells in PB from patients with newly diagnosed AML and relapsed AML compared to PB from HDs (13,47 ± 4,03 vs. 15,8 ± 3,04 vs. 3,03 ± 1,21; p<0.05; p<0.01). For analysis of the functional relevance of the CD39+TIGIT+CD73-CD8T cells mononuclear cells of the PB (PBMC) from HDs were pre-incubated with inhibitors against TIGIT (50µg/ml) and CD39 (50µg/ml) and co-cultured with either AML OCI-3 or OCI-5 cells (E:T Ratio 6:1, n=3). After 24 hours of co-culture lysis of AML cells was assessed by flow cytometry. Treatment of anti-TIGIT, anti-CD39 or the combinatorial inhibition significantly increased T-cell mediated lysis of AML cells (lysis of AML OCI-3 cells measured by fold change: anti-CD39 1,53; anti-TIGIT 2,22 ; anti-CD39 + anti-TIGIT 2,67 and lysis of AML OCI-5 cells: anti-CD39 2,21; anti-TIGIT 1,63 ; anti-CD39 + anti-TIGIT 2,81).

Conclusion
CD8T cells in the PB and BM from patients with AML exhibit a key signature of CD39+TIGIT+CD73-CD8T cells that were specifically increased at different stages of the disease. Through inhibition of CD39 in combination with TIGIT T-cell mediated lysis could be increased in AML. These results provide a rationale to further evaluate the TIGIT checkpoint blockade in combination with inhibition of the purinergic signaling to improve T-cell mediated cytotoxicity in AML.

Keyword(s): AML, CD8 T cells, Immune therapy

Presentation during EHA2021: All e-poster presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: EP410

Type: E-Poster Presentation

Session title: Acute myeloid leukemia - Biology & Translational Research

Background
The inhibitory receptor TIGIT, as well as the ectonucleotidases CD39 and CD73 constitute potential exhaustion markers for T cells. Detailed analysis of these markers may shed light into dysregulation of the T-cell response in acute myeloid leukemia (AML) and help to identify potential therapeutic targets. 

Aims

In the current study we analyzed multiple inhibitory receptors and members of the purinergic system which have also been involved into downregulation of T-cell effector function aiming to identify relevant new pathways of T-cell mediated immune failure in AML.

Methods
The differentiation state, phenotype and expression of transcription factors was assessed on T cells derived from peripheral blood (PB n=38) and bone marrow (BM n=43). PB and BM collected from patients with newly diagnosed primary AML, at relapse after intensive chemotherapy and in remission were compared to healthy volunteers (HD n=12). The surface expression of PD-1, TIGIT, CD73, and CD39, as well as of the differentiation markers CD45RO, CCR7, CD25 and CD127 were determined on CD8+and conventional and regulatory CD4+(CD4+CD127-CD25hi)cells using multiparameter flow cytometry. 

Results

An increased frequency of terminally differentiated (CD45R-CCR7-) CD8T cells was confirmed in the PB and BM regardless of the AML disease status (p<0,05). Moreover, CD39 was aberrantly expressed on this population: we observed an increased frequency of CD39+TIGIT+CD73-CD8T cells in PB from patients with newly diagnosed AML and relapsed AML compared to PB from HDs (13,47 ± 4,03 vs. 15,8 ± 3,04 vs. 3,03 ± 1,21; p<0.05; p<0.01). For analysis of the functional relevance of the CD39+TIGIT+CD73-CD8T cells mononuclear cells of the PB (PBMC) from HDs were pre-incubated with inhibitors against TIGIT (50µg/ml) and CD39 (50µg/ml) and co-cultured with either AML OCI-3 or OCI-5 cells (E:T Ratio 6:1, n=3). After 24 hours of co-culture lysis of AML cells was assessed by flow cytometry. Treatment of anti-TIGIT, anti-CD39 or the combinatorial inhibition significantly increased T-cell mediated lysis of AML cells (lysis of AML OCI-3 cells measured by fold change: anti-CD39 1,53; anti-TIGIT 2,22 ; anti-CD39 + anti-TIGIT 2,67 and lysis of AML OCI-5 cells: anti-CD39 2,21; anti-TIGIT 1,63 ; anti-CD39 + anti-TIGIT 2,81).

Conclusion
CD8T cells in the PB and BM from patients with AML exhibit a key signature of CD39+TIGIT+CD73-CD8T cells that were specifically increased at different stages of the disease. Through inhibition of CD39 in combination with TIGIT T-cell mediated lysis could be increased in AML. These results provide a rationale to further evaluate the TIGIT checkpoint blockade in combination with inhibition of the purinergic signaling to improve T-cell mediated cytotoxicity in AML.

Keyword(s): AML, CD8 T cells, Immune therapy

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