Reversal of indoleamine 2,3-dioxygenase-mediated cancer immune suppression by systemic kynurenine depletion with a therapeutic enzyme

利用治疗性酶进行全身性犬尿氨酸耗竭可逆转吲哚胺2,3-双加氧酶介导的癌症免疫抑制

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作者:Todd A Triplett ,Kendra C Garrison ,Nicholas Marshall ,Moses Donkor ,John Blazeck ,Candice Lamb ,Ahlam Qerqez ,Joseph D Dekker ,Yuri Tanno ,Wei-Cheng Lu ,Christos S Karamitros ,Kyle Ford ,Bing Tan ,Xiaoyan M Zhang ,Karen McGovern ,Silvia Coma ,Yoichi Kumada ,Mena S Yamany ,Enrique Sentandreu ,George Fromm ,Stefano Tiziani ,Taylor H Schreiber ,Mark Manfredi ,Lauren I R Ehrlich ,Everett Stone ,George Georgiou

Abstract

Increased tryptophan (Trp) catabolism in the tumor microenvironment (TME) can mediate immune suppression by upregulation of interferon (IFN)-γ-inducible indoleamine 2,3-dioxygenase (IDO1) and/or ectopic expression of the predominantly liver-restricted enzyme tryptophan 2,3-dioxygenase (TDO). Whether these effects are due to Trp depletion in the TME or mediated by the accumulation of the IDO1 and/or TDO (hereafter referred to as IDO1/TDO) product kynurenine (Kyn) remains controversial. Here we show that administration of a pharmacologically optimized enzyme (PEGylated kynureninase; hereafter referred to as PEG-KYNase) that degrades Kyn into immunologically inert, nontoxic and readily cleared metabolites inhibits tumor growth. Enzyme treatment was associated with a marked increase in the tumor infiltration and proliferation of polyfunctional CD8+ lymphocytes. We show that PEG-KYNase administration had substantial therapeutic effects when combined with approved checkpoint inhibitors or with a cancer vaccine for the treatment of large B16-F10 melanoma, 4T1 breast carcinoma or CT26 colon carcinoma tumors. PEG-KYNase mediated prolonged depletion of Kyn in the TME and reversed the modulatory effects of IDO1/TDO upregulation in the TME.

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