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Global immune fingerprinting in glioblastoma patient peripheral blood reveals immune-suppression signatures associated with prognosis
Tyler J. Alban, … , Michael A. Vogelbaum, Justin D. Lathia
Tyler J. Alban, … , Michael A. Vogelbaum, Justin D. Lathia
Published November 2, 2018
Citation Information: JCI Insight. 2018;3(21):e122264. https://doi.org/10.1172/jci.insight.122264.
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Research Article Immunology Oncology

Global immune fingerprinting in glioblastoma patient peripheral blood reveals immune-suppression signatures associated with prognosis

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Abstract

Glioblastoma (GBM) remains uniformly lethal, and despite a large accumulation of immune cells in the microenvironment, there is limited antitumor immune response. To overcome these challenges, a comprehensive understanding of GBM systemic immune response during disease progression is required. Here, we integrated multiparameter flow cytometry and mass cytometry TOF (CyTOF) analysis of patient blood to determine changes in the immune system among tumor types and over disease progression. Utilizing flow cytometry analysis in a cohort of 259 patients ranging from benign to malignant primary and metastatic brain tumors, we found that GBM patients had a significant elevation in myeloid-derived suppressor cells (MDSCs) in peripheral blood but not immunosuppressive Tregs. In GBM patient tissue, we found that increased MDSC levels in recurrent GBM portended poor prognosis. CyTOF analysis of peripheral blood from newly diagnosed GBM patients revealed that reduced MDSCs over time were accompanied by a concomitant increase in DCs. GBM patients with extended survival also had reduced MDSCs, similar to the levels of low-grade glioma (LGG) patients. Our findings provide a rationale for developing strategies to target MDSCs, which are elevated in GBM patients and predict poor prognosis.

Authors

Tyler J. Alban, Alvaro G. Alvarado, Mia D. Sorensen, Defne Bayik, Josephine Volovetz, Emily Serbinowski, Erin E. Mulkearns-Hubert, Maksim Sinyuk, James S. Hale, Giovana R. Onzi, Mary McGraw, Pengjing Huang, Matthew M. Grabowski, Connor A. Wathen, Manmeet S. Ahluwalia, Tomas Radivoyevitch, Harley I. Kornblum, Bjarne W. Kristensen, Michael A. Vogelbaum, Justin D. Lathia

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Figure 1

Patient analysis identifies peripheral and tumoral MDSCs associated with glioma grade and patient prognosis.

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Patient analysis identifies peripheral and tumoral MDSCs associated with...
(A) Experimental design: patients entering the clinic for surgical resection were consented, and a blood sample was acquired intraoperatively. Subsequently, PBMCs were isolated via Ficoll-Paque gradient within 24 hours before being frozen in freezing media for future use. (B) Pie chart with the distribution of patient samples totaling n = 259 patients analyzed. (C and D) Analysis of immunosuppressive M-MDSCs and Tregs via multiparameter flow cytometry analysis, where individual unpaired 2-tailed Student’s t tests were used and then corrected with Benjamini-Hochberg method (horizontal lines represent mean values, **P < 0.01, ***P < 0.001). (E) Kaplan-Meier analysis of patients separated by median levels of MDSC signal in the CD33+ area demonstrates decreased survival (P = 0.001). Statistical significance evaluated by log-rank analysis (n = 22). (F) Kaplan-Meier analysis of patients divided by median CD33 levels identifies increased overall survival using log-rank test (P = 0.032, n = 22).

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