title: Frequencies and role of regulatory T cells in patients with (pre)malignant cervical neoplasia.
abstract: Oncogenic human papillomavirus (HPV)-infection is crucial for developing cervical cancer and its precursor lesions [cervical intraepithelial neoplasia (CIN)]. Regulatory T cells (T(regs)) might be involved in the failure of the immune system to control the development of HPV-induced cancer. We investigated frequencies, phenotype and activity of T(regs) in patients with cervical neoplasia. CIN and cervical cancer patients showed increased CD4(+)/CD25(high) T cell frequencies in peripheral blood and CD4(+) T cell fraction. These CD4(+)/CD25(high) T cells represent T(regs) as demonstrated by their low proliferation rate, low interferon (IFN)-gamma/interleukin (IL)-10 ratio, high expression of CD45RO, GITR, CTLA-4, forkhead box P3 (FoxP3) and low CD45RA expression. Moreover, in HPV16(+) cervical cancer patients, in-vitro depletion of CD25(+) T cells resulted in increased IFN-gamma T cell responses against HPV16 E6- and E7 peptides. Thus, increased frequencies of T(regs) in cervical cancer patients may indeed suppress HPV-specific immunity. Longitudinal analysis of CD4(+)/CD25(high) T cell frequencies in patients showed a modest decline 1 year after curative surgery or chemoradiation. This study demonstrates increased frequencies and suppressive activity of T(regs) in cervical cancer. These results imply that T(regs) may suppress the immune control of cervical neoplasia and furthermore that suppression of immunity by T(regs) will be another hurdle to overcome in therapeutic immunization strategies against cervical neoplasia.
authors.affiliation: Department of Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. j.t.j.visser@med.umcg.nl
authors.forename: J
authors.initials: J
authors.lastname: Visser
authors.forename: H W
authors.initials: HW
authors.lastname: Nijman
authors.forename: B-N
authors.initials: BN
authors.lastname: Hoogenboom
authors.forename: P
authors.initials: P
authors.lastname: Jager
authors.forename: D
authors.initials: D
authors.lastname: van Baarle
authors.forename: E
authors.initials: E
authors.lastname: Schuuring
authors.forename: W
authors.initials: W
authors.lastname: Abdulahad
authors.forename: F
authors.initials: F
authors.lastname: Miedema
authors.forename: A G
authors.initials: AG
authors.lastname: van der Zee
authors.forename: T
authors.initials: T
authors.lastname: Daemen
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016207:Cytokines / Q000096:biosynthesis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D051858:Forkhead Transcription Factors / Q000097:blood; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D006801:Humans; D016130:Immunophenotyping; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000276:immunology; D050725:Papillomavirus E7 Proteins; D030361:Papillomavirus Infections / Q000276:immunology; D012097:Repressor Proteins / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D002583:Uterine Cervical Neoplasms / Q000276:immunology* / Q000628:therapy / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000276:immunology* / Q000628:therapy / Q000821:virology
chemical_list: D016207:Cytokines; C068651:E6 protein, Human papillomavirus type 16; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D009856:Oncogene Proteins, Viral; D050725:Papillomavirus E7 Proteins; D012097:Repressor Proteins; C059731:oncogene protein E7, Human papillomavirus type 16