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ISG15/GRAIL1/CD3 axis influences survival of patients with esophageal adenocarcinoma
Dyke P. McEwen, Paramita Ray, Derek J. Nancarrow, Zhuwen Wang, Srimathi Kasturirangan, Saeed Abdullah, Ayushi Balan, Rishi Hoskeri, Dafydd Thomas, Theodore S. Lawrence, David G. Beer, Kiran H. Lagisetty, Dipankar Ray
Dyke P. McEwen, Paramita Ray, Derek J. Nancarrow, Zhuwen Wang, Srimathi Kasturirangan, Saeed Abdullah, Ayushi Balan, Rishi Hoskeri, Dafydd Thomas, Theodore S. Lawrence, David G. Beer, Kiran H. Lagisetty, Dipankar Ray
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Research Article Gastroenterology Immunology

ISG15/GRAIL1/CD3 axis influences survival of patients with esophageal adenocarcinoma

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Abstract

Immunosuppression is a common feature of esophageal adenocarcinoma (EAC) and has been linked to poor overall survival (OS). We hypothesized that upstream factors might negatively influence CD3 levels and T cell activity, thus promoting immunosuppression and worse survival. We used clinical data and patient samples of those who progressed from Barrett’s to dysplasia to EAC, investigated gene (RNA-Seq) and protein (tissue microarray) expression, and performed cell biology studies to delineate a pathway impacting CD3 protein stability that might influence EAC outcome. We showed that the loss of both CD3-ε expression and CD3+ T cell number correlated with worse OS in EAC. The gene related to anergy in lymphocytes isoform 1 (GRAIL1), which is the prominent isoform in EACs, degraded (ε, γ, δ) CD3s and inactivated T cells. In contrast, isoform 2 (GRAIL2), which is reduced in EACs, stabilized CD3s. Further, GRAIL1-mediated CD3 degradation was facilitated by interferon-stimulated gene 15 (ISG15), a ubiquitin-like protein. Consequently, the overexpression of a ligase-dead GRAIL1, ISG15 knockdown, or the overexpression of a conjugation-defective ISG15–leucine-arginine-glycine-glycine mutant could increase CD3 levels. Together, we identified an ISG15/GRAIL1/mutant p53 amplification loop negatively influencing CD3 levels and T cell activity, thus promoting immunosuppression in EAC.

Authors

Dyke P. McEwen, Paramita Ray, Derek J. Nancarrow, Zhuwen Wang, Srimathi Kasturirangan, Saeed Abdullah, Ayushi Balan, Rishi Hoskeri, Dafydd Thomas, Theodore S. Lawrence, David G. Beer, Kiran H. Lagisetty, Dipankar Ray

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Figure 1

CD3-ε expression during progression from BE to EAC and effects on OS.

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CD3-ε expression during progression from BE to EAC and effects on OS.
A ...
A TMA consisting of patients with treatment-naive EAC was stained via mIHC for a combination of CD3-ε, CD8, CD163, FoxP3, PanCK, and PD-L1. Tissue sections were classified as squamous tissue (SQ), Barrett’s esophagus (BE), low-grade dysplasia (LGD), high-grade dysplasia (HGD), or esophageal adenocarcinoma (EAC) by an independent pathologist. Stroma is defined as PanCK-negative tissue, while Target indicates PanCK-positive tissue. (A) CD3-ε expression in stromal tissue increases from BE to HGD. However, CD3-ε expression decreases from HGD to EAC. (B) Similarly, in target tissue, CD3-ε increases during progression from BE to HGD. EAC tissues are immune poor and lack CD3-ε expression. (C and D) Survival analysis looking at the effects of CD3-ε expression on OS. EACs from panels A and B were binned into high- and low-expressing populations. For both isoforms, patients with low CD3 expression had worse OS than patients with high CD3-ε expression, regardless of tissue location. For histograms, significance was determined by 1-way ANOVA test with Tukey’s multiple comparison. For statistical significance, *P < 0.05, **P < 0.01, ***P < 0.005, ****P < 0.001. Survival curve differences were determined using Mantel-Cox regression analysis.

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