title: CXCL10/CXCR3 signaling mobilized-regulatory T cells promote liver tumor recurrence after transplantation.
abstract: Liver graft injury and tumor recurrence are the major challenges of liver transplantation for the patients with hepatocellular carcinoma (HCC). Here, we aimed to explore the role and mechanism of liver graft injury mobilizing regulatory T cells (Tregs), which lead to late phase tumor recurrence after liver transplantation.
  
  
  
  The correlation among tumor recurrence, liver graft injury and Tregs mobilization were studied in 257 liver transplant recipients with HCC and orthotopic rat liver transplantation models. The direct roles of CXCL10/CXCR3 signaling on Tregs mobilization and tumor recurrence were investigated in CXCL10-/-and CXCR3-/-mice models with hepatic IR injury.
  
  
  
  Clinically, patients received the graft with graft weight ratio (GWR) <60% had higher HCC recurrence after liver transplantation than the recipients with GWR ⩾60% graft. More circulating Tregs and higher intragraft TLR4/CXCL10/CXCR3 levels were detected in recipients with GWR <60% graft. These results were further validated in rat transplantation model. Foxp3+cells and expressions of TLR4, CXCL10, TGFβ, CTLA-4 and CD274 were increased in rat liver tumor tissues from small-for-size graft group. In mouse model, the mobilization and recruitment of Tregs were decreased in TLR4-/-, CXCL10-/-and CXCR3-/-mice compared to wild-type mice. Moreover, less CXCR3+Tregs were recruited into liver in CXCL10-/-mice after hepatic IR injury. The knockout of CXCL10 and depletion of Tregs inhibited tumor recurrence after hepatic IR injury.
  
  
  
  CXCL10/CXCR3 signaling upregulated at liver graft injury directly induced the mobilization and intragraft recruitment of Tregs, which further promoted HCC recurrence after transplantation.
  
  
  
  There were positive correlation among tumor recurrence, circulating Tregs and liver graft injury after human transplantation for HCC patients. The knockout of CXCL10 decreased hepatic recruitment of CXCR3+Tregs and late phase tumor recurrence after hepatic IR injury.
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Chang Xian
authors.initials: CX
authors.lastname: Li
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China; Department of General Surgery, Affiliated Hospital of Nantong University, Nantong city, 226001, China.
authors.forename: Chang Chun
authors.initials: CC
authors.lastname: Ling
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Department of Medicine, The University of Hong Kong, Hong Kong, China.
authors.forename: Aimin
authors.initials: A
authors.lastname: Xu
authors.affiliation: Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Xiang Cheng
authors.initials: XC
authors.lastname: Li
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, China.
authors.forename: Kevin Tak-Pan
authors.initials: KT
authors.lastname: Ng
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Xiao Bing
authors.initials: XB
authors.lastname: Liu
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Yuen Yuen
authors.initials: YY
authors.lastname: Ma
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Qi
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Oscar Wai Ho
authors.initials: OW
authors.lastname: Yeung
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China; Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Xin Xiang
authors.initials: XX
authors.lastname: Yang
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Qing Sheng
authors.initials: QS
authors.lastname: Liu
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Yin Fan
authors.initials: YF
authors.lastname: Lam
authors.affiliation: Department of Surgery, David Geffen School of Medicine, University of California at Los Angeles, USA.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhai
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, China.
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, China. Electronic address: kwanman@hku.hk.
authors.forename: Kwan
authors.initials: K
authors.lastname: Man
mesh_terms: D000818:Animals; D006528:Carcinoma, Hepatocellular; D006801:Humans; D008113:Liver Neoplasms; D016031:Liver Transplantation; D051379:Mice; D009364:Neoplasm Recurrence, Local; D051381:Rats; D054367:Receptors, CXCR3; D050378:T-Lymphocytes, Regulatory
chemical_list: D054367:Receptors, CXCR3
keywords: Hepatocellular carcinoma; Liver graft injury; Liver transplantation; Regulatory T cells; Tumor recurrence