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CD8+ T cells regulate tumour ferroptosis during cancer immunotherapy

Weimin Wang, Michael Green, Jae Eun Choi, Miguel Gijón, Paul D. Kennedy, Jeffrey K. Johnson, Peng Liao, Xueting Lang, Ilona Kryczek, Amanda Sell, Houjun Xia, Jiajia Zhou, Gaopeng Li, Jing Li, Wei Li, Shuang Wei, Linda Vatan, Hongjuan Zhang, Wojciech Szeliga, Wei Gu, Rebecca Liu, Theodore S. Lawrence, Candice Lamb, Yuri Tanno, Marcin Cieslik, Everett Stone, George Georgiou, Timothy A. Chan, Arul Chinnaiyan and Weiping Zou ()
Additional contact information
Weimin Wang: University of Michigan School of Medicine
Michael Green: University of Michigan Rogel Cancer Center, University of Michigan School of Medicine
Jae Eun Choi: University of Michigan Rogel Cancer Center, University of Michigan School of Medicine
Miguel Gijón: Cayman Chemical Company
Paul D. Kennedy: Cayman Chemical Company
Jeffrey K. Johnson: Cayman Chemical Company
Peng Liao: University of Michigan School of Medicine
Xueting Lang: University of Michigan School of Medicine
Ilona Kryczek: University of Michigan School of Medicine
Amanda Sell: University of Michigan School of Medicine
Houjun Xia: University of Michigan School of Medicine
Jiajia Zhou: University of Michigan School of Medicine
Gaopeng Li: University of Michigan School of Medicine
Jing Li: University of Michigan School of Medicine
Wei Li: University of Michigan School of Medicine
Shuang Wei: University of Michigan School of Medicine
Linda Vatan: University of Michigan School of Medicine
Hongjuan Zhang: University of Michigan School of Medicine
Wojciech Szeliga: University of Michigan School of Medicine
Wei Gu: Columbia University
Rebecca Liu: University of Michigan School of Medicine
Theodore S. Lawrence: University of Michigan School of Medicine
Candice Lamb: University of Texas at Austin
Yuri Tanno: University of Texas at Austin
Marcin Cieslik: University of Michigan School of Medicine
Everett Stone: University of Texas at Austin
George Georgiou: University of Texas at Austin
Timothy A. Chan: Memorial Sloan Kettering Cancer Center
Arul Chinnaiyan: University of Michigan School of Medicine
Weiping Zou: University of Michigan School of Medicine

Nature, 2019, vol. 569, issue 7755, 270-274

Abstract: Abstract Cancer immunotherapy restores or enhances the effector function of CD8+ T cells in the tumour microenvironment1,2. CD8+ T cells activated by cancer immunotherapy clear tumours mainly by inducing cell death through perforin–granzyme and Fas–Fas ligand pathways3,4. Ferroptosis is a form of cell death that differs from apoptosis and results from iron-dependent accumulation of lipid peroxide5,6. Although it has been investigated in vitro7,8, there is emerging evidence that ferroptosis might be implicated in a variety of pathological scenarios9,10. It is unclear whether, and how, ferroptosis is involved in T cell immunity and cancer immunotherapy. Here we show that immunotherapy-activated CD8+ T cells enhance ferroptosis-specific lipid peroxidation in tumour cells, and that increased ferroptosis contributes to the anti-tumour efficacy of immunotherapy. Mechanistically, interferon gamma (IFNγ) released from CD8+ T cells downregulates the expression of SLC3A2 and SLC7A11, two subunits of the glutamate–cystine antiporter system xc−, impairs the uptake of cystine by tumour cells, and as a consequence, promotes tumour cell lipid peroxidation and ferroptosis. In mouse models, depletion of cystine or cysteine by cyst(e)inase (an engineered enzyme that degrades both cystine and cysteine) in combination with checkpoint blockade synergistically enhanced T cell-mediated anti-tumour immunity and induced ferroptosis in tumour cells. Expression of system xc− was negatively associated, in cancer patients, with CD8+ T cell signature, IFNγ expression, and patient outcome. Analyses of human transcriptomes before and during nivolumab therapy revealed that clinical benefits correlate with reduced expression of SLC3A2 and increased IFNγ and CD8. Thus, T cell-promoted tumour ferroptosis is an anti-tumour mechanism, and targeting this pathway in combination with checkpoint blockade is a potential therapeutic approach.

Date: 2019
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DOI: 10.1038/s41586-019-1170-y

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