Gut Liver.  2022 Jul;16(4):645-659. 10.5009/gnl210311.

CD40 Agonists Alter the Pancreatic Cancer Microenvironment by Shifting the Macrophage Phenotype toward M1 and Suppress Human Pancreatic Cancer in Organotypic Slice Cultures

• Lim CY
• Chang JH
• Lee WS
• Kim J
• Park IY

• KMID: 2531247
• DOI: http://doi.org/10.5009/gnl210311

Abstract

Background/Aims
CD40 agonists are thought to generate antitumor effects on pancreatic cancer via macrophages and T cells. We aimed to investigate the role of CD40 agonists in the differentiation of macrophages and treatment of human pancreatic adenocarcinoma.
Methods
Immunohistochemistry was performed on paraffin-embedded surgical blocks from patients with pancreatic cancers to evaluate macrophage phenotypes and their relationship with survival. The effects of CD40 agonists on macrophage phenotypes and human pancreatic cancer were evaluated utilizing cell cocultures and organotypic slice cultures.
Results
CD163 ⁺ (predominant in M2 macrophages) and FOXP3 ⁺ (predominant in regulatory T cells) expression levels in the tumors were significantly lower in patients with stage IB pancreatic cancer than in those with stage II or III disease (p=0.002 and p=0.003, respectively). Patients with high CD163 ⁺ expression had shorter overall survival than those with low CD163 ⁺ expression (p=0.002). In vitro treatment of THP-1 macrophages with a CD40 agonist led to an increase in HLA-DR ⁺ (predominant in M1 macrophages) and a decrease in CD163 ⁺ expression in THP-1 cells. Cell cocultures showed that CD40 agonists facilitate the suppression of PANC-1 human pancreatic cancer cells by THP-1 macrophages. Organotypic slice cultures showed that CD40 agonists alter the pancreatic cancer microenvironment by shifting the macrophage phenotype toward M1 (increase HLA-DR ⁺ and decrease CD163 ⁺ expression), decreasing the abundance of regulatory T cells, and increasing tumor cell apoptosis.
Conclusions
CD163 is related to advanced human pancreatic cancer stages and shorter overall survival. CD40 agonists alter macrophage phenotype polarization to favor the M1 phenotype and suppress human pancreatic cancer.

Keyword

CD40 immunoglobulin; CD163 antigen; Macrophages; Pancreatic neoplasm; Tumor microenvironment