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Immunoregulation of Dendritic Cell Subsets by Inhibitory Receptors in Urothelial Cancer


Blockade of inhibitory receptors (IRs) overexpressed by T cells can activate antitumor immune responses, resulting in the most promising therapeutic approaches, particularly in bladder cancer, currently able to extend patient survival. Thanks to their ability to cross-present antigens to T cells, dendritic cells (DCs) are an immune cell population that plays a central role in the generation of effective antitumor T-cell responses. While IR function and expression have been investigated in T cells, very few data are available for DCs. Therefore, we analyzed whether DCs express IRs that can decrease their functions. To this end, we investigated several IRs (PD-1, CTLA-4, BTLA, TIM-3, and CD160) in circulating CD1c+ DCs, CD141+ DCs, and plasmacytoid DCs from healthy donors and patients with urothelial cancer (UCa). Different DC subsets expressed BTLA and TIM-3 but not other IRs. More importantly, BTLA and TIM-3 were significantly upregulated in DCs from blood of UCa patients. Locally, bladder tumor–infiltrating DCs also overexpressed BTLA and TIM-3 compared to DCs from paired nontumoral tissue. Finally, in vitro functional experiments showed that ligand-mediated engagement of BTLA and TIM-3 receptors significantly reduced the secretion of effector cytokines by DC subpopulations. Our findings demonstrate that UCa induces local and systemic overexpression of BTLA and TIM-3 by DCs that may result in their functional inhibition, highlighting these receptors as potential targets for UCa treatment.

Patient summary

We investigated the expression and function of a panel of inhibitory receptors in dendritic cells (DCs), an immune cell subpopulation critical in initiation of protective immune responses, among patients with urothelial carcinoma. We found high expression of BTLA and TIM-3 by blood and tumor DCs, which could potentially mediate decreased DC function. The results suggest that BTLA and TIM-3 might be new targets for urothelial carcinoma treatment.

Take Home Message

The inhibitory receptors BTLA and TIM-3 are overexpressed on circulating and intratumoral dendritic cells in urothelial cancer, mediating reduction of dendritic cell function.

Keywords: Urothelial cancer, Inhibitory receptors, TIM-3, BTLA, Dendritic cells.


a Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

b Department of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

c Department of Oncology and Ludwig Cancer Research, University of Lausanne, Switzerland

Corresponding author. Department of Urology, Centre Hospitalier Universitaire Vaudois, Bugnon 48, 1011 Lausanne, Switzerland. Tel. +41 21 3140373; Fax: +41 21 3144060.

These authors contributed equally to this work.

Article information

PII: S0302-2838(16)30712-6
DOI: 10.1016/j.eururo.2016.10.009
© 2016 European Association of Urology, Published by Elsevier B.V.

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