<div> <div> <p>Purpose: Preclinical studies have demonstrated that cancer cells may produce innate immune signals such as type-I interferons following radiation damage, which derives from activation of the cGAS-STING pathway following detection of cytosolic dsDNA. Limited studies have explored how these mechanisms vary from the conditions of the radiation exposure. High- linear energy transfer (LET) radiation induces more DNA double-strand breaks (DSB) per dose than low-LET radiation, thus is expected to be more immunogenic. However, DNA damage in hypoxic cells is more probable to undergo chemical repair due to limitations in oxygen fixation, thus is expected to be more immunosuppressive. Our goal is to study and model the dose response characteristics of IFNβ and Trex1 in vitro following exposure of radiations with varying LET and to develop techniques for further study in vivo.<br></p><p><br></p> <p>Methods: Reference data from Vanpouille-Box (2017) on STING dose response was applied to develop empirical models of cytosolic dsDNA and Trex1 regulation as a function of dose and quantity of DNA DSB, the latter of which is dependent on particle LET and oxygenation and is calculated using Monte Carlo Damage Simulation (MCDS) software. These models were used as preliminary data to guide in vitro experiments using Merkel cell carcinoma cells. The dose response of pro-inflammatory IFNβ and exonuclease Trex1, an anti-inflammatory suppressor of cGAS-STING, was measured post-irradiation. MCDS was again used to model fast neutron relative biological effectiveness for DSB induction (RBEDSB) and compared to laboratory measurements of the RBE for IFNβ production (RBEIFNβ). RBEIFNβ models were applied to radiation transport simulations to quantify the potential secretion of IFNβ in representative clinical beams. To enable intra-tumor radiation targeting of tumor hypoxia, mice were seeded with syngeneic tumors and imaged longitudinally with PCT- spectroscopy to determine local variations hemoglobin concentration (Hb) and oxygen saturation (SaO2) over time. Hypoxia classification was based on SaO2 levels in voxels containing hemoglobin relative to a “hypoxia threshold” of SaO2 < 0.2.</p><p><br></p> <p>Results: Based on analysis of published data, our preliminary models of cytosolic DNA and Trex1 dose responses demonstrate dose enhancements from high-LET radiation, such as that at the distal edge of a Bragg peak, and suppression from cellular hypoxia. This manifests as an RBE-dependent ‘shift’ in STING response. Laboratory measurements in MCC13 cells show peak IFNβ production at 6.1 Gy following fast neutron irradiation and 14.5 Gy following x-rays (RBEIFNβ = 2.4). However, IFNβ signal amplitudes were not significantly different between these radiation types. Trex1 signal increased linearly with dose, with fourfold higher upregulation per dose for fast neutrons. Modeling of RBE in clinical beams suggests that ion sources may induce spatially localized IFNβ near their end of range, which is potentially advantageous for initiation of tumor-specific immune activity. Uncharged sources stimulate IFNβ more uniformly with depth. Longitudinal PCT-S scanning is able to localize and distinguish chronic and acute hypoxia in vivo. Changes in the hypoxic classification from tumor growth and following anti-angiogenic therapy are distinguishable.<br> </p><p> </p><div> <div> <div> <p>Conclusion: Radiation-induced immunogenicity can be induced differentially based on radiation quality and is expected to be affected by cellular oxygenation. High-LET radiation, such as fast neutrons, drives greater IFNβ innate immune response per dose than low-LET radiation, such as x-rays, which may enhance abscopal effects when used in combination with immune-stimulating agents. However, anti-inflammatory signaling is greater per dose for fast neutrons, and it remains unclear if high-LET radiations are therapeutically advantageous over low-LET radiation for pro-inflammatory tumor signaling. High resolution in vivo imaging of tumor hypoxia is feasible with photoacoustic techniques, which can potentially be leveraged to study selective immunogenicity enhancement of the hypoxic niche following radiation therapy. <br></p> </div> </div> </div> <p> </p> </div></div>

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23804号 / 医博第4850号 / 新制||医||1058(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 井上 治久, 教授 林 康紀, 教授 竹内 理 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Central driving forces in the pathogenesis of liver disease are hepatocyte death and immune cell-driven inflammation. The interplay between outcomes, stemming from these two major cell types, is present from the earliest ethanol exposure, and are both determinants in advanced stages of liver disease particularly in alcoholic liver disease (ALD). The complexities associated with advanced ALD are many and therapies are limited. Due to the liver’s role in ethanol metabolism and filtering gut-derived products, it is becoming increasingly clear that innate immunity plays a central role in triggering activation of cell death and inflammatory pathways in ALD. We identified interferon regulatory factor 3 (IRF3) activation as a mediator of hepatocyte death as the first event after ethanol exposure, and the inflammasome as a protein complex responsible for the subsequent inflammatory cascade, driven by the NLRP3 inflammasome. Our novel findings in murine samples and human patients with alcoholic hepatitis demonstrate that ethanol-induced inflammasome activity results in Caspase-1-mediated pyroptosis and extracellular ASC aggregates in the liver and circulation. Pyroptosis can be abrogated by therapeutic inhibition of inflammasome components, NLRP3 or Caspase-1. Taken together, the event leading to mtDNA release into the cytoplasm is the inception of the pathogenesis of ALD, triggering hepatocyte death, culminating in a pro-inflammatory cascade driven by the NLRP3 inflammasome and pyroptotic release of ASC.