Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitis

Immune-related adverse events represent a major hurdle to the success of immunotherapy. The immunological mechanisms underlying their development and relation to antitumor responses are poorly understood. By examining both systemic and tissue-specific immune changes induced by combination anti–CTLA-...

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Main Authors: Kazi J. Nahar, Felix Marsh-Wakefield, Robert V. Rawson, Tuba N. Gide, Angela L. Ferguson, Ruth Allen, Camelia Quek, Ines Pires da Silva, Stephen Tattersal, Christopher J. Kiely, Neomal Sandanayake, Matteo S. Carlino, Geoff McCaughan, James S. Wilmott, Richard A. Scolyer, Georgina V. Long, Alexander M. Menzies, Umaimainthan Palendira
Format: Article
Language:English
Published: American Society for Clinical investigation 2022-11-01
Series:JCI Insight
Subjects:
Online Access:https://doi.org/10.1172/jci.insight.157839
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author Kazi J. Nahar
Felix Marsh-Wakefield
Robert V. Rawson
Tuba N. Gide
Angela L. Ferguson
Ruth Allen
Camelia Quek
Ines Pires da Silva
Stephen Tattersal
Christopher J. Kiely
Neomal Sandanayake
Matteo S. Carlino
Geoff McCaughan
James S. Wilmott
Richard A. Scolyer
Georgina V. Long
Alexander M. Menzies
Umaimainthan Palendira
author_facet Kazi J. Nahar
Felix Marsh-Wakefield
Robert V. Rawson
Tuba N. Gide
Angela L. Ferguson
Ruth Allen
Camelia Quek
Ines Pires da Silva
Stephen Tattersal
Christopher J. Kiely
Neomal Sandanayake
Matteo S. Carlino
Geoff McCaughan
James S. Wilmott
Richard A. Scolyer
Georgina V. Long
Alexander M. Menzies
Umaimainthan Palendira
author_sort Kazi J. Nahar
collection DOAJ
description Immune-related adverse events represent a major hurdle to the success of immunotherapy. The immunological mechanisms underlying their development and relation to antitumor responses are poorly understood. By examining both systemic and tissue-specific immune changes induced by combination anti–CTLA-4 and anti–PD-1 immunotherapy, we found distinct repertoire changes in patients who developed moderate-severe colitis, irrespective of their antitumor response to therapy. The proportion of circulating monocytes were significantly increased at baseline in patients who subsequently developed colitis compared with patients who did not develop colitis, and biopsies from patients with colitis showed monocytic infiltration of both endoscopically and histopathologically normal and inflamed regions of colon. The magnitude of systemic expansion of T cells following commencement of immunotherapy was also greater in patients who developed colitis. Importantly, we show expansion of specific T cell subsets within inflamed regions of the colon, including tissue-resident memory CD8+ T cells and Th1 CD4+ T cells in patients who developed colitis. Our data also suggest that CD8+ T cell expansion was locally induced, while Th1 cell expansion was systemic. Together, our data show that exaggerated innate and T cell responses to combination immunotherapy synergize to propel colitis in susceptible patients.
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spelling doaj.art-3735f33fbccb4897a34d7c5e7b4644662023-11-07T16:24:47ZengAmerican Society for Clinical investigationJCI Insight2379-37082022-11-01721Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitisKazi J. NaharFelix Marsh-WakefieldRobert V. RawsonTuba N. GideAngela L. FergusonRuth AllenCamelia QuekInes Pires da SilvaStephen TattersalChristopher J. KielyNeomal SandanayakeMatteo S. CarlinoGeoff McCaughanJames S. WilmottRichard A. ScolyerGeorgina V. LongAlexander M. MenziesUmaimainthan PalendiraImmune-related adverse events represent a major hurdle to the success of immunotherapy. The immunological mechanisms underlying their development and relation to antitumor responses are poorly understood. By examining both systemic and tissue-specific immune changes induced by combination anti–CTLA-4 and anti–PD-1 immunotherapy, we found distinct repertoire changes in patients who developed moderate-severe colitis, irrespective of their antitumor response to therapy. The proportion of circulating monocytes were significantly increased at baseline in patients who subsequently developed colitis compared with patients who did not develop colitis, and biopsies from patients with colitis showed monocytic infiltration of both endoscopically and histopathologically normal and inflamed regions of colon. The magnitude of systemic expansion of T cells following commencement of immunotherapy was also greater in patients who developed colitis. Importantly, we show expansion of specific T cell subsets within inflamed regions of the colon, including tissue-resident memory CD8+ T cells and Th1 CD4+ T cells in patients who developed colitis. Our data also suggest that CD8+ T cell expansion was locally induced, while Th1 cell expansion was systemic. Together, our data show that exaggerated innate and T cell responses to combination immunotherapy synergize to propel colitis in susceptible patients.https://doi.org/10.1172/jci.insight.157839ImmunologyOncology
spellingShingle Kazi J. Nahar
Felix Marsh-Wakefield
Robert V. Rawson
Tuba N. Gide
Angela L. Ferguson
Ruth Allen
Camelia Quek
Ines Pires da Silva
Stephen Tattersal
Christopher J. Kiely
Neomal Sandanayake
Matteo S. Carlino
Geoff McCaughan
James S. Wilmott
Richard A. Scolyer
Georgina V. Long
Alexander M. Menzies
Umaimainthan Palendira
Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitis
JCI Insight
Immunology
Oncology
title Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitis
title_full Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitis
title_fullStr Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitis
title_full_unstemmed Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitis
title_short Distinct pretreatment innate immune landscape and posttreatment T cell responses underlie immunotherapy-induced colitis
title_sort distinct pretreatment innate immune landscape and posttreatment t cell responses underlie immunotherapy induced colitis
topic Immunology
Oncology
url https://doi.org/10.1172/jci.insight.157839
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