A hallmark of cancer is the ability of tumor cells to avoid immune destruction. Activated immune cells in tumor microenvironment (TME) secrete proinflammatory cytokines and chemokines which foster the proliferation of tumor cells. Specific antigens expressed by cancer cells are recognized by the main actors of immune response that are involved in their elimination (immunosurveillance). By the recruitment of immunosuppressive cells, decreasing the tumor immunogenicity, or through other immunosuppressive mechanisms, tumors can impair the host immune cells within the TME and escape their surveillance. Within the TME, cells of the innate (e.g., macrophages, mast cells, neutrophils) and the adaptive (e.g., lymphocytes) immune responses are interconnected with epithelial cancer cells, fibroblasts, and endothelial cells via cytokines, chemokines, and adipocytokines. The molecular pattern of cytokines and chemokines has a key role and could explain the involvement of the immune system in tumor initiation and progression. Thyroid cancer-related inflammation is an important target for diagnostic procedures and novel therapeutic strategies. Anticancer immunotherapy, especially immune checkpoint inhibitors, unleashes the immune system and activates cytotoxic lymphocytes to kill cancer cells. A better knowledge of the molecular and immunological characteristics of TME will allow novel and more effective immunotherapeutic strategies in advanced thyroid cancer.

https://www.mdpi.com/1422-0067/20/18/4413/pdf

Immune and Inflammatory Cells in Thyroid Cancer Microenvironment

The precise ultrastructural morphology and functions in reactive conditions of lymphoid follicles (LF) and dendritic cells, including follicular dendritic cells (FDC) are reviewed; as well as the pathognomonic role of FDC in some disease conditions and finally, the cellular origin of FDC. In reactive conditions, FDC in each of the five follicular zones have distinct ultrastructural features, reflecting the different three-dimensional structures and functions of these zones. The FDC framework may be supported by some characteristic factors, including desmosome-like junctions between FDC and the expression of fibronectin and laminin receptors and caldesmon on FDC. FDC, especially in the light zone, express various cytokine receptors, but produce only one cytokine, TGF-beta. The outer zone may not only be a cellular pathway in the LF, but may also provide a site for germinal center B cell proliferation, and the FDC-lymphocyte cluster is not the site of germinal center B cell division. In patients with auto-immune diseases, such as Hashimoto's thyroiditis and rheumatoid arthritis, FDC may be in a hyperfunctional state, whereas those in patients with immunosuppressive disorders, such as Kimura's disease and AIDS, may be in a dysfunctional state. FDC may be derived from fibroblastic reticulum cells in lymphatic tissues rather than in bone marrow cells. The data discussed in this review provide fascinating insight into the roles of FDC, which are intimately related to the migration, proliferation, cell selection and differentiation of B cells in secondary LF.

Morphology, function and pathology of follicular dendritic cells.

Tumor-induced modulation of dendritic cell function.

Multicellular tumor spheroids (MCTS) are a well-established 3-D in vitro model system that reflects the pathophysiological in vivo situation in tumor microregions and of avascular micrometastatic sites. Because monocytes and other immune cells infiltrate into MCTS of different origin, such spheroid cocultures are a valuable, still underestimated tool to systematically study heterologous interactions between tumor and immune cells. The present article gives a brief overview on work that has been published on tumor-immune cell interactions in MCTS and also summarizes mechanisms of immune suppression in the tumor milieu focussing on myeloid cells. Using the coculture model, we recently demonstrated that tumor-derived lactic acid is a potent modulator of human monocyte as lactic acid inhibited the differentiation of monocytes (MO) into dendritic cells (DC) and also impaired antigen presentation. We show herein, that the capacity of various tumor cells in MCTS to secrete lactic acid differs up to tenfold, suggesting that this capacity is dependent on the tumor cell type. It is further demonstrated that lactic acid disturbs the migration of MO into MCTS as infiltration could be increased by blocking lactic acid production. We therefore discuss lactic acid which accumulates in many tumors and tumor microregions as a potent immune suppressor for MO/DC in the tumor milieu and conclude that these data are highly relevant for adoptive immunotherapy protocols with DC.

Brave little world: spheroids as an in vitro model to study tumor-immune-cell interactions.

Tumor-related inflammation does influence the biological behavior of neoplastic cells and ultimately the patient's outcome. With specific regard to thyroid cancer, the issue of tumor-associated inflammation has been extensively studied and recently reviewed. However, the role of chemokines, which play a crucial role in determining the immuno-phenotype of tumor-related inflammation, was not addressed in previous reviews on the topic. Experimental evidence shows that thyroid cancer cells actively secrete a wide spectrum of chemokines and, at least for some of them, solid scientific data support a role for these immune-active molecules in the aggressive behavior of the tumor. Our proposal for a review article on chemokines and thyroid cancer stems from the notion that chemokines, besides having the ability to attract and maintain immune cells at the tumor site, also produce several pro-tumorigenic actions, which include proangiogenetic, cytoproliferative, and pro-metastatic effects. Studies taking into account the role of CCL15, C-X-C motif ligand 12, CXCL16, CXCL1, CCL20, and CCL2 in the context of thyroid cancer will be reviewed with particular emphasis on CXCL8. The reason for focusing on CXCL8 is that this chemokine is the most studied one in human malignancies, displaying multifaceted pro-tumorigenic effects. These include enhancement of tumor cells growth, metastatization, and angiogenesis overall contributing to the progression of several cancers including thyroid cancer. We aim at reviewing current knowledge on the (i) ability of both normal and tumor thyroid cells to secrete CXCL8; (ii) direct/indirect pro-tumorigenic effects of CXCL8 demonstrated by in vitro and in vivo studies specifically performed on thyroid cancer cells; and (iii) pharmacologic strategies proven to be effective for lowering CXCL8 secretion and/or its effects on thyroid cancer cells.

/pdf/role-of-chemokines-in-thyroid-cancer-microenvironment-is-2p77vb3x4p.pdf

Role of Chemokines in Thyroid Cancer Microenvironment: Is CXCL8 the Main Player?

Recent immunohistochemical investigations of thyroid carcinomas have revealed that dense infiltration by dendritic cells (DCs) is correlated with a favorable prognosis. The present study was done to clarify the frequency and characteristics of DC infiltration in thyroid carcinomas, and also cytokines associated with DC maturation and migration. Compared with follicular carcinomas, papillary carcinomas contained significantly higher numbers of DCs, interleukin (IL)-1 alpha- and tumor necrosis factor (TNF)-alpha-positive cells, and cells positive for two TNF-alpha receptors (p60 and p80). The centers of cancer nodules had large numbers of CD1a- and CD1c-positive DCs suggesting that they were Langerhans cells, whereas the periphery of cancer nodules and inflamed surrounding thyroid tissues had numerous CD1b-, L-M2- and X-12-positive DCs suggesting that they were interdigitating cells, as well as many CD1a- and CD1c-positive DCs. Neoplastic cells of papillary carcinomas were more frequently reactive with antibodies against IL-1 alpha and TNF-alpha than those of follicular carcinomas, and a good correlation between their immunoreactivity and the frequency of DCs was found. These data suggest that cytokines such as IL-1 alpha and TNF-alpha released from carcinoma cells and cells in the cancer stroma may regulate the infiltration and maturation of dendritic/Langerhans cells, and that this process may be better preserved in papillary than in follicular carcinomas.

Immunohistochemical analysis of dendritic/Langerhans cells in thyroid carcinomas.

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Immunohistochemical analysis of dendritic/Langerhans cells in thyroid carcinomas.