Abstract
Despite the clinical success of checkpoint inhibitors, a substantial gap still exists in our understanding of their mechanism of action. While antibodies to cytotoxic T lymphocyte-associated protein-4 (CTLA-4) were developed to block inhibitory signals in T cells, several recent studies have demonstrated that Fcγ receptor (FcγR)-dependent depletion of regulatory T cells (Treg) is critical for antitumor activity. Here, using single-cell RNA sequencing, we dissect the impact of anti-CTLA-4-blocking, Treg cell-depleting and FcR-engaging activity on the immune response within tumors. We observed a rapid remodeling of the innate immune landscape as early as 24 h after treatment. Using genetic Treg cell ablation models, we show that immune remodeling was not driven solely by Treg cell depletion or CTLA-4 blockade but mainly through FcγR engagement, downstream activation of type I interferon signaling and reduction of suppressive macrophages. Our findings indicate that FcγR engagement and innate immune remodeling are involved in successful anti-CTLA-4 treatment, supporting the development of optimized immunotherapy agents bearing these features.
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Data availability
Raw and processed scRNA-seq data can be downloaded from NCBI Gene Expression Omnibus with accession number GSE186484. Source data are provided with this paper. All other data supporting the findings of this study are available from the corresponding author on reasonable request.
Code availability
Custom code has been deposited to GitHub and can be accessed at https://github.com/tomerlan/paper_aCTLA4_MOA.
Change history
14 November 2022
A Correction to this paper has been published: https://doi.org/10.1038/s43018-022-00487-7
References
Sharma, P. et al. The next decade of immune checkpoint therapy. Cancer Discov. 11, 838–857 (2021).
Weiss, S. A., Wolchok, J. D. & Sznol, M. Immunotherapy of melanoma: facts and hopes. Clin. Cancer Res. 25, 5191–5201 (2019).
Hegde, P. S. & Chen, D. S. Top 10 challenges in cancer immunotherapy. Immunity 52, 17–35 (2020).
Walker, L. S. K. & Sansom, D. M. Confusing signals: recent progress in CTLA-4 biology. Trends Immunol. 36, 63–70 (2015).
Walker, L. S. K. Treg and CTLA-4: two intertwining pathways to immune tolerance. J. Autoimmun. 45, 49–57 (2013).
Leach, D. R., Krummel, M. F. & Allison, J. P. Enhancement of antitumor immunity by CTLA-4 blockade. Science 271, 1734–1736 (1996).
Simpson, T. R. et al. Fc-dependent depletion of tumor-infiltrating regulatory T cells co-defines the efficacy of anti-CTLA-4 therapy against melanoma. J. Exp. Med. 210, 1695–1710 (2013).
Arce Vargas, F. et al. Fc effector function contributes to the activity of human anti-CTLA-4 antibodies. Cancer Cell 33, 649–663 (2018).
Bulliard, Y. et al. Activating Fcγ receptors contribute to the antitumor activities of immunoregulatory receptor-targeting antibodies. J. Exp. Med. 210, 1685–1693 (2013).
Selby, M. J. et al. Anti-CTLA-4 antibodies of IgG2a isotype enhance antitumor activity through reduction of intratumoral regulatory T cells. Cancer Immunol. Res. 1, 32–42 (2013).
Quezada, S. A. & Peggs, K. S. Lost in translation: deciphering the mechanism of action of anti-human CTLA-4. Clin. Cancer Res. 25, 1130–1132 (2019).
Yofe, I., Dahan, R. & Amit, I. Single-cell genomic approaches for developing the next generation of immunotherapies. Nat. Med. 26, 171–177 (2020).
Giladi, A. & Amit, I. Single-cell genomics: a stepping stone for future immunology discoveries. Cell 172, 14–21 (2018).
Mulder, K. et al. Cross-tissue single-cell landscape of human monocytes and macrophages in health and disease. Immunity 54, 1883–1900 (2021).
Li, H. et al. Dysfunctional CD8 T cells form a proliferative, dynamically regulated compartment within human melanoma. Cell 176, 775–789 (2019).
Ledergor, G. et al. Single cell dissection of plasma cell heterogeneity in symptomatic and asymptomatic myeloma. Nat. Med. 24, 1867–1876 (2018).
Cohen, Y. C. et al. Identification of resistance pathways and therapeutic targets in relapsed multiple myeloma patients through single-cell sequencing. Nat. Med. 27, 491–503 (2021).
Katzenelenbogen, Y. et al. Coupled scRNA-seq and intracellular protein activity reveal an immunosuppressive role of TREM2 in cancer. Cell 182, 872–885 (2020).
Giladi, A. et al. Dissecting cellular crosstalk by sequencing physically interacting cells. Nat. Biotechnol. 38, 629–637 (2020).
Nimmerjahn, F. & Ravetch, J. V. Fcγ receptors as regulators of immune responses. Nat. Rev. Immunol. 8, 34–47 (2008).
Jeong, H. J. et al. Myeloid-derived suppressor cells mediate inflammation resolution in humans and mice with autoimmune uveoretinitis. J. Immunol. 200, 1306–1315 (2018).
Veglia, F., Sanseviero, E. & Gabrilovich, D. I. Myeloid-derived suppressor cells in the era of increasing myeloid cell diversity. Nat. Rev. Immunol. 21, 485–498 (2021).
Mehta, A. K., Kadel, S., Townsend, M. G., Oliwa, M. & Guerriero, J. L. Macrophage biology and mechanisms of immune suppression in breast cancer. Front. Immunol. 12, 643771 (2021).
Shao, X. et al. CellTalkDB: a manually curated database of ligand–receptor interactions in humans and mice. Brief. Bioinform. 22, bbaa269 (2021).
Molgora, M. et al. TREM2 modulation remodels the tumor myeloid landscape enhancing anti-PD-1 immunotherapy. Cell 182, 886–900 (2020).
Deczkowska, A., Weiner, A. & Amit, I. The physiology, pathology, and potential therapeutic applications of the TREM2 signaling pathway. Cell 181, 1207–1217 (2020).
Nagarsheth, N., Wicha, M. S. & Zou, W. Chemokines in the cancer microenvironment and their relevance in cancer immunotherapy. Nat. Rev. Immunol. 17, 559–572 (2017).
Clark, N. M. et al. Regulatory T cells support breast cancer progression by opposing IFN-γ-dependent functional reprogramming of myeloid cells. Cell Rep. 33, 108482 (2020).
Kim, J. M., Rasmussen, J. P. & Rudensky, A. Y. Regulatory T cells prevent catastrophic autoimmunity throughout the lifespan of mice. Nat. Immunol. 8, 191–197 (2007).
Dhodapkar, K. M. et al. Selective blockade of the inhibitory Fcγ receptor (FcγRIIB) in human dendritic cells and monocytes induces a type I interferon response program. J. Exp. Med. 204, 1359–1369 (2007).
Riaz, N. et al. Tumor and microenvironment evolution during immunotherapy with nivolumab. Cell 171, 934–949 (2017).
Snyder, A. et al. Genetic basis for clinical response to CTLA-4 blockade in melanoma. N. Engl. J. Med. 371, 2189–2199 (2014).
Dolgin, E. Antibody engineers seek optimal drug targeting TIGIT checkpoint. Nat. Biotechnol. 38, 1007–1009 (2020).
Gubin, M. M. et al. Checkpoint blockade cancer immunotherapy targets tumour-specific mutant antigens. Nature 515, 577–581 (2014).
Romano, E. et al. Ipilimumab-dependent cell-mediated cytotoxicity of regulatory T cells ex vivo by nonclassical monocytes in melanoma patients. Proc. Natl Acad. Sci. USA 112, 6140–6145 (2015).
Mujal, A. M. et al. Holistic characterization of tumor monocyte-to-macrophage differentiation integrates distinct immune phenotypes in kidney cancer. Cancer Immunol. Res. 10, 403–419 (2022).
Sharma, A. et al. Anti-CTLA-4 immunotherapy does not deplete FOXP3+ regulatory T cells (Tregs) in human cancers. Clin. Cancer Res. 25, 1233–1238 (2019).
Smith, P., DiLillo, D. J., Bournazos, S., Li, F. & Ravetch, J. V. Mouse model recapitulating human Fcγ receptor structural and functional diversity. Proc. Natl Acad. Sci. USA 109, 6181–6186 (2012).
Prinz, M. et al. Distinct and nonredundant in vivo functions of IFNAR on myeloid cells limit autoimmunity in the central nervous system. Immunity 28, 675–686 (2008).
Deczkowska, A. et al. XCR1+ type 1 conventional dendritic cells drive liver pathology in non-alcoholic steatohepatitis. Nat. Med. 27, 1043–1054 (2021).
Karlsson, F., Robinson-Jackson, S. A., Gray, L., Zhang, S. & Grisham, M. B. Ex vivo generation of regulatory T cells: characterization and therapeutic evaluation in a model of chronic colitis. Methods Mol. Biol. 677, 47–61 (2011).
Keren-Shaul, H. et al. MARS-seq2.0: an experimental and analytical pipeline for indexed sorting combined with single-cell RNA sequencing. Nat. Protoc. 14, 1841–1862 (2019).
Stuart, T. et al. Comprehensive integration of single-cell data. Cell 177, 1888–1902 (2019).
Hafemeister, C. & Satija, R. Normalization and variance stabilization of single-cell RNA-seq data using regularized negative binomial regression. Genome Biol. 20, 1–15 (2019).
Butler, A., Hoffman, P., Smibert, P., Papalexi, E. & Satija, R. Integrating single-cell transcriptomic data across different conditions, technologies, and species. Nat. Biotechnol. 36, 411–420 (2018).
Wilkerson, D. M. & Hayes, N. D. ConsensusClusterPlus: a class discovery tool with confidence assessments and item tracking. Bioinform. 26, 1572–1573 (2010).
Korotkevich, G., Sukhov, V. & Sergushichev, A. (2019). Fast gene set enrichment analysis. bioRxiv. http://biorxiv.org/content/early/2016/06/20/060012
Liberzon, A. et al. Molecular signatures database (MSigDB) 3.0. Bioinform. 27, 1739–1740 (2011).
Acknowledgements
We thank N.D. Geller from the Scientific Illustration unit of the Weizmann Institute for artwork. I.Y. is a Cancer Research Institute Irvington Fellow supported by the Cancer Research Institute. I.A. is an Eden and Steven Romick Professorial Chair, supported by Merck KGaA, Darmstadt, Germany, the Chan Zuckerberg Initiative, the HHMI International Scholar award, the European Research Council Consolidator grant (ERC-COG) 724471- HemTree2.0, an SCA award of the Wolfson Foundation and Family Charitable Trust, an MRA Established Investigator Award (509044), the Helen and Martin Kimmel award for innovative investigation, the NeuroMac DFG/Transregional Collaborative Research Center grant, a Cancer Research Institute Technology Impact Award (CRI Award CRI3250), an International Progressive MS Alliance/NMSS PA-1604 08459 and an Adelis Foundation grant. S.A.Q. is funded by a Cancer Research UK (CRUK) Senior Cancer Research Fellowship (C36463/A22246) and a CRUK Biotherapeutic Program grant (C36463/A20764). K.S.P. received funding from the NIHRBTRU for Stem Cells and Immunotherapies (167097). C.C. is funded by Becas Chile. Part of this work was undertaken at UCL with support from the CRUK-UCL Centre (C416/A18088) and the Cancer Immuno-therapy Accelerator Award (CITA-CRUK) (C33499/A20265).
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I.Y., T.L., A.Y., S.A.Q. and I.A. conceived the project, designed the experiments, analyzed the data and wrote the manuscript. I.Y., T.L., A.Y., I.S., C.C. and D.F.D. performed the experiments, E.D. contributed to data analysis, M.S., C.B., O.B. and I.M. contributed experimentally and K.S.P., S.A.Q. and I.A. supervised the project.
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Extended data
Extended Data Fig. 1 Flow cytometry gating strategy and scRNAseq data pre-processing steps.
(a) Gating strategy used to sort CD45+ cells or TCRb+ (T) cells. (b) Violin plot depicting the distribution of detected genes per cell per sample. (c) Violin plot depicting the distribution of unique molecular identifiers (UMIs) per cell per sample. (d) Violin plot depicting the distribution of percentage of UMIs coming from mitochondrial genes per cell per sample. (e) Explained variance (Y) as function of principal components (PCs, X) for PCA of normalized expression values of all cells and 3,000 most variable genes (Methods). UMAP of all cells before (left) and after (right) batch correction by CCA (Methods).
Extended Data Fig. 2 Characterization of immune dynamics in the TME following anti-CTLA-4 treatments.
(a) Principle component analysis (PCA) of the relative abundance of each cell type in each sample, or the mean gene expression of genes with UMI > 2 in cells > 5 in each sample. Performed separately on lymphoid and myeloid cells. Pointes are samples color coded for treatment arm. Dashed line separates control and anti-CTLA-4 m1 from anti-CTLA-4 m2a. (b) Comparison of the fractions of the indicated lymphoid cell types in individual mice in each treatment group. n = 3, 2 and 3 biologically independent samples for Ctrl, m1 and m2a groups respectively were used for statistical analysis. (c) Comparison of the fractions of the indicated myeloid cell types in individual mice in each treatment group. n = 5, 3 and 5 biologically independent samples for Ctrl, m1 and m2a groups respectively were used for statistical analysis. Bars represent mean ± SE of mice per treatment arm. Two-tailed Student’s t test was used.
Extended Data Fig. 3 Anti-CTLA-4 m2a treatment drives rapid and broad rearrangement of the adaptive and innate immune TME.
(a) UMAP of scRNA-seq data from day 1 post-treatment tumor infiltrating immune cells. Color code for cell type assignment is indicated in the legend. (b) UMAP projections of relative cell density per treatment, or relative CTLA-4 expression. (c) Comparison of the fractions of the indicated lymphoid cell types in individual mice in each treatment group. n = 3, 6 and 7 biologically independent samples for Ctrl, m1 and m2a groups respectively were used for statistical analysis. (d) Comparison of the fractions of the indicated myeloid cell types in individual mice in each treatment group. n = 2, 6 and 7 biologically independent samples for Ctrl, m1 and m2a groups respectively were used for statistical analysis. (e) Consensus hierarchical clustering (n clusters = 2, Methods) of cellular makeup across samples with Spearman correlation as distance metric. Color coded for P co-clustering after 500 iterations. (f) Histogram of CD4+ draining lymph node-derived cells frequency per FOXP3 protein expression, as measured by flow cytometry. n = 5 per group. Average percentage to the right of the dashed line is stated. Day 4 post-treatment. (g) As in (f) for day 1 post-treatment. (h) Growth curves of MCA-205 tumors in mice untreated, or treated with 50 µg/mouse anti-CTLA-4 m2a at days 6, 9, 12, with or without 100 µg/mouse anti-Gr1 at days 5 and 13. n = 5 mice per arm. In (c) and (d), bars represent mean ± SE of mice per treatment arm. Two-way ANOVA (fraction ~ treatment * batch) was used.
Extended Data Fig. 4 Molecular dissection of the immediate response to anti-CTLA-4 mAbs.
(a) 12 leading DEGs for myeloid cell populations. Log2 fold-change is relative to all other cells. (b) Number of DEGs per metacluster in anti-CTLA-4 m1 vs. control. (c) Scatterplot comparing anti-CTLA-4 m2a (Y) vs. Control (X) gene expression changes in monocytes. Leading DEGs are annotated. (d) Scatterplot comparing anti-CTLA-4 m2a (Y) vs. Control (X) gene expression changes in TAMs. Leading DEGs are annotated. (e) Scatterplot comparing anti-CTLA-4 m2a (Y) vs. Control (X) gene expression changes in monocytes and TAMs combined. Leading DEGs are annotated. Differential gene expression is estimated using two-sided Wilcoxon rank-sum test, Benjamini-Hochberg adjusted p-value < 0.05, FC > 1.25.
Extended Data Fig. 5 FcγR dependent activation underlies myeloid reprograming following anti-CTLA-4 m2a treatment.
(a) Enrichment of lymphoid cell type frequencies in DT vs control in Foxp3DTR background, or anti-CTLA-4 m2a versus control in WT background. Values are log2 fold change of the mean frequency of each cell type across mice, dot size indicates the average frequency of the cell population between treatments, and color the p-value of two-tailed Student’s t test between each treatment and control. (b) Comparison of the fractions of the indicated lymphoid cell types in individual mice in each treatment group. n = 4 and 5 biologically independent samples for Ctrl and DT groups respectively were used for statistical analysis. (c) As in (a), but for myeloid cells. (d) As in (b), but for myeloid cells. n = 4 and 5 biologically independent samples for Ctrl and DT groups respectively were used for statistical analysis. (e) Enrichment of lymphoid cell type frequencies in anti-CTLA-4 m2a versus anti-CTLA-4 m1 in FCGR KO background, or anti-CTLA-4 m2a versus anti-CTLA-4 m1 in WT background. Values are log2 fold change of the mean frequency of each cell type across mice, dot size indicates the average frequency of the cell population between treatments, and color the p-value of two-tailed Student’s t test between each treatment and control. (f) Comparison of the fractions of the indicated lymphoid cell types in individual mice in each treatment group. n = 7 and 4 biologically independent samples for m1 and m2a groups respectively were used for statistical analysis. (g) As in (e), but for myeloid cells. (h) As in (f), but for myeloid cells. n = 6 and 6 biologically independent samples for m1 and m2a groups respectively were used for statistical analysis. In (b), (d), (f), and (h), Bars represent mean ± SE of mice per treatment arm. Two-tailed Student’s t test was used.
Extended Data Fig. 6 FcγR engagement drives a robust activation of type-I IFN signaling.
(a) Comparison of the fractions of the indicated cell populations in individual mice in each genotype and treatment group. n = 6, 4, and 3 biologically independent samples for each of Ctrl, m1 and m2a in WT, FCGR KO and IFNAR KO groups respectively, were used for statistical analysis. (b) Scatterplot comparing anti-CTLA-4 m2a WT (Y) vs. anti-CTLA-4 m2a FCGR KO (X) gene expression changes in BMDM cells. Leading DEGs are annotated. (c) Scatterplot comparing anti-CTLA-4 m2a WT (Y) vs. anti-CTLA-4 m2a IFNAR KO (X) gene expression changes in BMDM cells. Leading DEGs are annotated. (d) Scatterplot comparing anti-CTLA-4 m2a FCGR KO (Y) vs. anti-CTLA-4 m2a IFNAR KO (X) gene expression changes in BMDM cells. Leading DEGs are annotated. (e) Percent of proliferating T cells and interferon gamma secretion in idle T cells, activated T cells, and activated T cells co-cultured with Cd11b+ cells purified from MCA-205 tumors treated with anti-CTLA-4 m2a in WT or IFNAR KO mice. n = 4 biologically independent samples for each group were used for statistical analysis. In (a), bars represent mean ± SE of mice per treatment arm. Two-way ANOVA (fraction ~ treatment * batch) was used. Differential gene expression is estimated using two-sided Wilcoxon rank-sum test, Benjamini-Hochberg adjusted p-value < 0.05, FC > 1.25.
Extended Data Fig. 7 melanoma patients data provides mechanistic link between anti-tumor activity of anti-CTLA-4 treatment in mice and humans.
(a–d) Gene set enrichment analysis (GSEA) for responder vs non-responder patients. Green line shows running enrichment score for indicated gene ontology (GO) terms. All gene log2 fold-changes are ranked (bottom, grey) and genes belonging to the gene set are shown in black (top).
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Yofe, I., Landsberger, T., Yalin, A. et al. Anti-CTLA-4 antibodies drive myeloid activation and reprogram the tumor microenvironment through FcγR engagement and type I interferon signaling. Nat Cancer 3, 1336–1350 (2022). https://doi.org/10.1038/s43018-022-00447-1
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DOI: https://doi.org/10.1038/s43018-022-00447-1
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