MINI REVIEW article

Front. Microbiol., 10 January 2020

Sec. Infectious Agents and Disease

Volume 10 - 2019 | https://doi.org/10.3389/fmicb.2019.02924

Trained Immunity for Personalized Cancer Immunotherapy: Current Knowledge and Future Opportunities

  • 1. ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Lisbon, Portugal

  • 2. Digestive Unit, Champalimaud Clinical Centre, Lisbon, Portugal

  • 3. Molecular and Experimental Pathology Laboratory, Champalimaud Centre for the Unknown, Lisbon, Portugal

  • 4. Department of Pathology, Champalimaud Clinical Centre, Lisbon, Portugal

  • 5. Lisbon Centre for Blood and Transplantation, Instituto Português do Sangue e Transplantação, Lisbon, Portugal

  • 6. Division of Infection and Immunity, NIHR Biomedical Research Centre, UCL Hospitals, NHS Foundation Trust, University College London, London, United Kingdom

Abstract

Memory formation, guided by microbial ligands, has been reported for innate immune cells. Epigenetic imprinting plays an important role herein, involving histone modification after pathogen-/danger-associated molecular patterns (PAMPs/DAMPs) recognition by pattern recognition receptors (PRRs). Such “trained immunity” affects not only the nominal target pathogen, yet also non-related targets that may be encountered later in life. The concept of trained innate immunity warrants further exploration in cancer and how these insights can be implemented in immunotherapeutic approaches. In this review, we discuss our current understanding of innate immune memory and we reference new findings in this field, highlighting the observations of trained immunity in monocytic and natural killer cells. We also provide a brief overview of trained immunity in non-immune cells, such as stromal cells and fibroblasts. Finally, we present possible strategies based on trained innate immunity that may help to devise host-directed immunotherapies focusing on cancer, with possible extension to infectious diseases.

Background

Monocytic cells including macrophages and dendritic cells (DCs), granulocytes and natural killer (NK) cells, which feature a spectrum of innate immune cells, constitute the quintessential first line of host innate immune defense and appear to undergo epigenetic reprograming during an antimicrobial immune response (Nakayama et al., 2011; ; Saeed et al., 2014; Vono et al., 2017). The permanent polarization of certain subsets of these cells – triggered by pathogen-driven inflammation – leads to the development of molecular signatures forming an “immunological matrix.” This “trained immunity” does not resemble immunological memory of adaptive immune cells, i.e., T and B cells, but rather pre-programing of cells that will respond with similar effector molecules to subsequent challenge driven by recognition of pathogen-/danger-associated molecular patterns (PAMPs/DAMPs) by pathogen-recognition receptors (PRRs), such as Toll-like receptors (TLRs) (). Stroma-associated mesenchymal stromal cells (MSC) and fibroblasts, which can also harbor pathogens (; McCormack et al., 2013; ; ), are equipped with the capacity to present antigens to T cells via the human leukocyte antigen (HLA) class I and class II pathways during inflammation (; Romieu-Mourez et al., 2007; Morandi et al., 2008; ; ; ), and have been discussed to possess trained immunity characteristics ().

There are several examples of the clinical use of attenuated microorganisms in immunotherapy, such as the attenuated Mycobacterium bovis Bacille Calmette-Guerín (BCG) strain as an adjuvant for treatment of non-muscle-invasive bladder cancer (Pettenati and Ingersoll, 2018). BCG induces upregulation of cytokine production, e.g., granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-15, tumor-necrosis factor (TNF), expression of MHC class II on urothelial cells and activation of APCs associated with clinically relevant host responses (; Mitropoulos, 2005; ; Pettenati and Ingersoll, 2018). Clinical studies in Guinea-Bissau have shown that the tuberculosis (TB) vaccine BCG induces cross-protective immune responses among infants in low-resource settings concomitant with a high level of exposure to different infectious agents (). This is clinically significant, since exposure to a variety of infectious agents early in life in countries with high pathogen transmission rates has been postulated to protect against immunological diseases later in adulthood (MacGillivray and Kollmann, 2014), with a crucial role for PAMP-driven shaping of innate immune responses. Further to the unmistakable role of adaptive immunological memory in immunity, the role of trained immunity in innate immune cells demands attention. In line with this, BCG-primed hematopoietic stem cells (HSCs) – which gave rise to epigenetically modified macrophages – were shown to induce superior recall responses against virulent Mycobacterium tuberculosis (Mtb) challenge in a mouse model (). Inflammation and HSC plasticity as well as development is similar to immuno-physiological processes occurring in the bone marrow during disease, i.e., TNF-α and IFN-α upregulation and HSC differentiation, G-CSF and IL-1β expression leading to HSC proliferation (Pietras, 2017).

Trained innate immunity may in part be responsible for local fine-tuning and immunomodulation within the bone marrow (and other tissue compartments), where long-term memory T-cell populations can be found in healthy adults (Okhrimenko et al., 2014). Alternatively, initial stimulation of myeloid cells by fungal cell wall-derived β-glucan has been shown to promote superior control of subsequent infection with bacterial pathogens (Quintin et al., 2012; ; Rusek et al., 2018). The role of trained immunity in the context of immunomodulation in cancer was also recently reviewed (Netea et al., 2017), expanding the biological relevance of trained immunity. In this review/viewpoint, we summarize known information concerning trained immunity and discuss relevant observations in view of personalized cancer immunotherapy, particularly on adaptive T-cell responses directed against cancer cells.

Innate Immune Cells and Immunological Memory

Macrophages and Dendritic Cells

Priming of human monocytes and monocyte-derived macrophages with LPS, an integral component of bacterial endotoxin (TLR4 ligand), or zymosan, a polysaccharide which belongs to the fungal cell wall (TLR2 and Dectin-1 ligand), has been shown to be cross-reactive (LPS- or -zymosan-primed monocytes can react to either stimulus), albeit with a dependence of the dose of the stimulus (Madej et al., 2017). Importantly, IL-1β production by macrophages initially primed by LPS or Escherichia coli is markedly reduced following re-exposure, although in monocytes re-exposure to E. coli, but not LPS, produced much higher amounts of IL-1β (Madej et al., 2017). This observation strongly hinted at the exposure of monocytic cells to one type of pathogen affording immune reactivity to another, i.e., bacteria vs. fungi. The immune tolerance induced by LPS could, in part, explain T-cell dysfunction in sepsis syndrome – which is reversible by exogenous IL-7 administration in patients (). A study in mice showed that trained immunity in DC driven by protective vaccination against Cryptococcus neoformans, an opportunistic fungal pathogen of the lungs (), allowed the trained DCs to generate stronger pro-inflammatory responses against bacterial pathogens in vitro, suggesting an effect of trained immunity ().

There is also evidence of Plasmodium falciparum (Pf)-induced trained immunity in adherent cells from peripheral blood mononuclear cells (PBMCs) – most likely macrophages – which undergo H3K4 trimethylation leading to their subsequent ability to produce high amounts of IL-6 an TNF-α in response to TLR1/2 stimulation with Pam3CSK4 in a manner dependent on hemozoin or Pf-infected erythrocytes (Schrum et al., 2018). TLR1 and 2 recognize peptidoglycan, a quintessential component of the bacterial cell wall, and can engage NF-κB activation for pro-inflammatory cytokine signaling, as shown in the context of antimycobacterial immune responses (Takeuchi et al., 2002). As such, TLR1/2-sensisitized macrophages may have a role in the interaction with bacterial pathogens and possibly promote their clearance.

Studies have shown that oxidized low-density lipoprotein particle (oxLDL)- or β-glucan-stimulated macrophages shift to the glycolytic pathway, which promotes polarization to an inflammatory M1 phenotype and induces expression of pro-inflammatory cytokines, such as IL-1β and TNF-α, among others (; ). Both cytokines have pro- as well as anti-tumor properties in cancer immunology, i.e., priming of T-cell responses and tumor elimination vs. induction of chronic, cancerogenic inflammation (Maeurer et al., 1996; ; ; ; Mantovani et al., 2018). Simultaneously, accumulation of lipids in trained macrophages has been linked to the pathogenesis of atherosclerosis (), raising the question of how much fatty acid metabolism is allowable before it contributes to a different pathology. The shift to aerobic glycolysis in cancer cells fuels their uncontrolled growth, while lactate appears to favor disease dissemination (), both of which have also been noted to be necessary for BCG-induced trained immunity in human monocytes (). The implication of this for immunomodulation in cancer requires further assessment.

Subclinical doses of LPS have also been shown to prime and modulate monocyte responses in an interferon regulatory factor 5 (IRF5)-dependent manner, where TIR-domain-containing adapter-inducing interferon-β (TRIF) and TRIF-related adaptor molecule (TRAM), but not Myd88 are involved, following TLR4 activation (Yuan et al., 2016; ). Indeed, IRF5-mediated M1 macrophage responses following LPS exposure appear to be necessary for clearing bacterial infections, concomitant with production of reactive oxygen and nitrogen intermediates (), both of which are necessary in controlling infections but can also promote oncogenesis. The TLR4/TRIF/TRAM pathway is also a currently investigated biological target in cancer immunotherapy (; ). Agonists of TLR7 have also been found to induce immune tolerance in monocytes at higher doses, while more intense TLR3 stimulation promoted an exacerbated inflammatory response (). Both TLRs recognize RNA structures, suggesting pathogen-derived nucleic acids as a potent inducer of trained immunity, with RNA-based cancer vaccine adjuvants having been shown to induce tumor rejection and anti-viral responses without or with only minimal off-target toxicity (Seya et al., 2015; Zhu et al., 2017; Ziegler et al., 2017). In addition to TLRs, other PRRs such as melanoma-differentiation antigen 5 (MDA-5) and retinoic acid-inducible gene I (RIG-I), largely involved in antiviral defense, have also been implicated in mediating tumor-cell apoptosis, DC priming and potentiation of anti-cancer cytotoxic T-cell activation (Wu et al., 2017).

A recent review by van der Heijden et al. (2018) appraised the role and significance of epigenetic modifications in innate immune cells to establish trained immunity (van der Heijden et al., 2018). Infection with Mtb, an intracellular pathogen which prefers to reside in alveolar macrophages, has been shown to induce epigenetic changes in the host cell, i.e., modification of histones 3 and 4 acetylation patterns to promote its prolonged survival (; Moores et al., 2017; Singh et al., 2017). Furthermore, Mtb also triggers the synthesis of host microRNA species to modulate immune responses to its benefit (; ; ; von Both et al., 2018). Whether Mtb-infected macrophages (and DCs) can modulate immune responses associated with cancer or other infections remains yet to be explored. One study has shown that infection of macrophages with Mtb H37Rv, a virulent, laboratory-adapted strain, upregulated PD-L1 expression which lead to increased Treg infiltration into lymph nodes and exacerbated disease in NSCLC-bearing mice (Zhou et al., 2017). It is important to be able to visualize how Mtb exposure of monocytic cells in humans may predispose them to either control or succumb to exacerbated inflammation, which may promote cancer in some individuals, and warrants thorough investigation due to the worrying global burden of TB (World Health Organization [WHO], 2018).

Another interesting point is the impact of microbial products in affecting tumor-associated macrophages (TAM), which have been reported as pro-tumoral, promoting angiogenesis, tumor-invasion, metastasis, and fine-tuning tumor-associated inflammation (; Qian and Pollard, 2010; Szebeni et al., 2017). The TAMs can be originated from circulating monocytes that will enter the tissue and differentiate into macrophages, bone-marrow-derived macrophages (BMDMs) or can result from an accumulation of tissue-resident macrophages (TRMs) (Pathria et al., 2019). Indeed, there is a crescent number of reports correlating TAMs with higher tumor grade and shorter survival for breast cancer, renal cell carcinoma, glioblastoma, pancreatic cancer, head and neck cancer, and lymphoma (Zhang et al., 2013, 2018; Pedersen et al., 2014; Tiainen et al., 2015; Wang et al., 2015; ; ; ; Sorensen et al., 2018; Pathria et al., 2019). The relationship between TAMs and the tumor invasiveness and ability to metastasis is suggested to be related to epithelial-mesenchymal transition (EMT) (Su et al., 2014; ; Ravi et al., 2016). Indeed, showed that EMT hotspots in hepatocellular carcinoma were associated with TAMs infiltration (). However, TAMs and invasiveness are certainly affected by other factors, e.g., N-cadherin and Snail (; Lin et al., 2019).

Nevertheless, the reacquisition of proinflammatory characteristics in macrophages, so called repolarization, was associated with increased survival in mice and patients with different cancer types and may be a future approach for cancer therapy (; Pathria et al., 2019). Two recent studies reported that the inhibition of phosphatidylinositol-3-kinase (PI3K) by genetic depletion or pharmacological inhibition, lead to proinflammatory expression in TAMs, with a downstream effect in T-cell activation (, ). The authors also identified that a downstream effect would be to promote NF-kB phosphorylation and DNA binding activity, therefore increasing proinflammatory gene expression associated to such pathway. Another effect is the activation of Bruton’s tyrosine kinase (BTK), which inhibition by ibrutinib stimulates macrophage polarization, myeloid cell infiltration reduction and increase in CD8 + T cells infiltration in murine pancreatic ductal adenocarcinoma (PDAC) (). Another molecule associated to the composition of tumor microenvironment effects is the growth arrest specific 6 (Gas6), since it interacts with TAM receptors Mer (Lew et al., 2014), with the downstream effect of PI3K, ERK, and NK-kB pathway activation. Interestingly, overexpression of Gas6 was described in a wide variety of cancers, such as melanoma, schwannoma, glioblastoma, and PDAC (; ; Song et al., 2011; ; ). There are other molecules that may be targeted to address the TAMs repolarization, such as receptor-interacting serine/threonine kinase 1 (RIPK1) or Janus kinase 2/signal transducer and activator of transcription 3 (Jak2/Stat3). The first one is increased in TAMs in human PDAC and its inhibition will repolarize TAMs and increase MHC class II, TNF-α and INF-γ expression besides reducing tumor growth (Wang et al., 2018). Besides, RIPK1 inhibition will also activate CD8 + T cells, increase differentiation of CD4 + T cells toward a Th1 phenotype and may have a synergic action with anti-PD-1 antibody (Wang et al., 2018). Regarding Jak2/Stat3, inhibition of Stat3 also leads to repolarization of TAMs and increases infiltration of cytotoxic T lymphocytes (CTLs), which could also be achieved by targeting Jak2 (upstream activator) (Pathria et al., 2015). TAMs may also express a molecule named macrophage receptor with collagenous structure (MARCO), involved in the recognition of PAMPs and TLRs linking innate immune responses in the tumor – microenvironment to pathogens (Mukhopadhyay et al., 2011; ). Indeed, TLR agonists polarize macrophages toward a proinflammatory phenotype, therefore also having a possible role for cancer therapy. The downside of such agonists is the concomitant expression of PD-L1 in macrophages, which could be blocked by the synergistic use of anti-PD-1 antibodies (, ).

NK Cells

Recent translational studies using human material have shed more light on the molecular changes in “memory-like” NK cells and ways to identify them. Hypomethylation of AT-rich interaction domain 5B (ARID5B) and co-expression of CD57, NKG2C, and reduced CD56 mark an “adaptive” subset of NK cells (). Viral infection of NK cells induces the expression of natural cytotoxicity receptors (NCRs), such as NKp46, NKp44 [a HLA-DP401 ligand, which is also associated with tumor recognition (Odunsi et al., 2007; Straetemans et al., 2012; ; Lu et al., 2017; Niehrs et al., 2019)] and NKp30 as well as the NKG2D receptor, which binds to the non-classical HLA class I-associated molecules MICA/B on tumor cells (). Particularly, human CMV infection may also drive the expansion of adaptive NK-cell populations phenotypically characterized as FcεRγ, tyrosine kinase SYK, EAT-2 and master transcription factor PLZFlow, with reduced IL-12 and IL-18 responsiveness connected to PLZF downregulation (Schlums et al., 2015). CMV-experienced FcγRIII/CD16+ NKG2C+ memory-like NK cells also undergo Syk DNA hypermethylation, but retain responsiveness to antibody-mediated cell expansion via CD16 binding upon exposure to CMV-infected target cells (). As in mice, memory-like, intrahepatic NKG2C+ CD49a+ DX5 NK cells co-expressing CD25 and IgG-like receptor, have also been described in humans (Peng et al., 2013; Marquardt et al., 2015). A recent translational study showed that “trained,” intrauterine NK-cell populations with epigenetic modifications in the IFN-γ and VEGF-A and high propensity to produce these cytokines following stimulation loci might play an important role in successful placentation (). Functional studies in mice revealed that virus-induced memory-like NK cells, after contraction, go on to reside in lymphoid and non-lymphoid organs and are able to facilitate enhanced viral control following adoptive transfer (Sun et al., 2009). Thus, tissue-derived NK cells may have specific trained immunity features which are of biological relevance not only in cross-protective immunity but also tissue physiology.

The generation of memory-like NK cells has also been demonstrated by exposing them to a combination of IL-12, IL-15 and IL-18, referred to as cytokine-induced memory-like (CIML) NK cells, resulting in a population of effector cells which also exhibits superior control of K562 leukemia cells (; Rosario et al., 2014). It is important to note that these cytokines are also produced by macrophages and DCs as a first-line immune armament during infection (). As such, additionally to pathogen-derived stimuli, the local cytokine milieu may also promote immunological memory in NK cells in tissue. Taking these observations into consideration, how pathogen-driven formation of immunological memory in NK cells would affect tumor immunosurveillance warrants formal testing using appropriate models and may be very significant for clinical immunotherapy.

Non-Immune Cells and Trained Immunity

Trained immunity in non-immune cells has been appreciated and extensively reviewed elsewhere (). Regulation of trained immunity in MSCs by microRNA expression and DNA methylation has been demonstrated following LPS exposure, where pro-inflammatory cytokine expression was maintained even in the absence of stimulus (Liu et al., 2015). Fibroblasts are highly specialized cells required for immune signaling during infection and tissue repair following inflammation-induced cell damage, making them a potential drug target to ameliorate chronic inflammation (). Their expression of TLRs and close interaction with surrounding and infiltrating immune cells places fibroblasts at an important axis linking trained immunity and immunopathology (Miteva et al., 2014). For instance, sustained activation of the Twist1-Prrx1-TNC PFL in cancer-associated fibroblasts (CAFs) perpetrates fibrotic lesions during idiopathic pulmonary fibrosis (; Yeo et al., 2018). Tissue fibrosis, impairment of organ function and immune-suppression are also reminiscent of pulmonary TB () and solid tumors (), hinting at similar mechanism at play. Intestinal stromal cells have been previously described to provide long-lasting pro-inflammatory immune responses against pathogens further to recruiting immune cells to the site of infection (Owens, 2015). Transformed cells, stromal cells and fibroblasts also provide a rich source of growth factors, pro-tumorigenic and immune-suppressive cytokine production that facilitates tumor progression (Todoric and Karin, 2019). Suitable disease models and well-defined clinical samples are necessary to address the role of trained non-immune cells in the cross-reactive immune responses in infectious diseases and malignant transformation.

Can Trained Immunity Be Exploited for Therapeutic Purposes?

While trained immunity may induce unwanted, pathological inflammation and, therefore, constitutes an avenue of pharmacological intervention (Mourits et al., 2018; Mulder et al., 2019), its utility in shaping the repertoire of antigen-specific/antigen-experienced immune cells may be useful against different diseases indicates an element of “in-built adjuvanticity.” In a recently reported phase 1 clinical study, BCG-vaccinated individuals given a dose of P. falciparum were shown to afford better control of malaria, concomitant with early activation of granzyme B+ NK cells and HLA-DR+ monocytes (Walk et al., 2019). Non-vaccinated controls did not show similar results, suggesting that BCG-driven innate immune activation leads to cross-protection against a protozoan parasite, in keeping with a previous finding describing pro-inflammatory, adherent innate immune cells responses due to plasmodium-triggered, trained immune responses (Schrum et al., 2018). In another study, reported that BCG vaccination would induce a genome-wide epigenetic reprograming of monocytes. Epigenetic changes due to BCG vaccination involved G protein-coupled receptors and protein kinases, and several signaling pathways involved in cytokines and chemokines production, such as the PI3K/AKT (phosphatidylinositol 3-kinase) pathway, epidermal growth factor receptor (EGFR), fibroblast growth factor (FGF), and vascular endothelial growth factor (VEGF) signaling pathways. The translation of this epigenetic reprograming was a higher pro-inflammatory cytokine production (TNF-α, IL-1β, and IL-6) of PBMCs from vaccinated, as compared to placebo-treated individuals, emphasizing the impact of trained immunity. Besides, these immune changes would also confer a higher protection to an unrelated infection (yellow fever virus), due to a higher production of IL-1β, and as a trained immunity response (). Another interesting aspect was described by , reporting that BCG induced trained immunity in monocytes with an unrelated stimulus, measured by increase of IL-6 and TNF-α cytokines, would not occur when autophagy was blocked. Indeed, both pharmacological inhibition of autophagy or single nucleotide polymorphisms (SNPs) in the autophagy genes (ATG2B and ATG5) reduced the trained immunity effect of BCG, due to the blocking of epigenetic reprograming of monocytes at H3K4 trimethylation (). Besides, the authors also describe an increase rate of recurrence and progression of non-muscular invasive bladder cancer patients after intravesical instillations of BCG in patients who exhibited SNP in the autophagy gene ATG2B. This observation supports the importance of the genetic background in non-specific effects of BCG in trained immunity and argues for genetic analyses of tissue material from patients undergoing BCG installation. Other pathogens affect as well immune cells. C. neoformans was shown to produce prostaglandin E2 (PGE2) to suppress T-cell activation for promoting its own growth and survival in macrophages (). PGE2 has several important anti-inflammatory effects encompassing the TNF/IL-6/IL-17 axis and IL-8 production by inducing epigenetic modifications (Venza et al., 2012; ; ). Whether microbe-trained PGE2 production by memory-like monocytic cells may have a biologically relevant role in ameliorating chronic inflammation has to be elucidated. IFN-γ- and LPS (TLR4)-primed macrophages, although capable of superior phagocytosis of apoptotic lymphoma cells compared to non-primed macrophages, were skewed toward an M2 (anti-inflammatory phenotype) and exhibited pro-tumor effects in vivo (Voss et al., 2017) in a preclinical (murine) model. It is, however, unknown whether TLR activation driven by factors in the tumor microenvironment (such as bacteria or fungal commensals, please see below) can promote trained immunity and, if so, whether such innate immune memory help control transformed cells and/or pathogens (see Figure 1).

FIGURE 1

Personalized Cancer Immunotherapy

Natural killer cell-mediated immune reactivity – particularly in hematological malignancies and in combination with chimeric antigen receptor (CAR) expression – forms a central structure in cancer immunotherapy (; Tang et al., 2018). A highly favorable characteristic of NK cells pertinent to clinical use is that they are obtainable from allogeneic sources for therapy, can mediate graft-versus-leukemia (GvL) responses (Locatelli et al., 2018) and are amenable to in vitro conditioning to acquire memory-like properties (; Liang et al., 2017). NKG2A, the NK cell/CD8+ T cell-expressed interaction partner for HLA-E on targets cells, represents a new immune checkpoint molecule which has already shown therapeutic potential in several preclinical cancer models (Tognarelli et al., 2018; van Montfoort et al., 2018; ). NK-cell exposure to CMV induces NKG2A upregulation albeit not compromising the cells’ ability to produce IFN-γ (Petersen et al., 2010). NKG2A+ memory-like NK cells may, therefore, be clinically beneficial for cellular therapy of patients with HLA-Ehi malignancies (; ; ; Lin et al., 2011; ). CMV may also imprint on anti-cancer directed immune responses, which may be of clinical relevance, since CMV as well as EBV-reactive T- and B-cells infiltrate into tumor lesions (Meng et al., 2018; Lerias et al., 2019). Reprograming of tumor-associate T-cells by epigenetic targeting of CD8 + tissue resident memory (Trm) cells and tumor infiltrating T-lymphocytes (TIL) may also promote tumor control, in part by increasing “mitochondrial fitness” (Li et al., 2019).

Modulation of histone methylation using pharmacological agents has been proposed as a potential host-directed strategy to capitalize on trained innate immunity to provide immune protection (Mulder et al., 2019; Rodriguez et al., 2019). Among the crucial host proteins involved in histone methylation is lysine demethylase 6B (KDM6B), also known as Jumonji Domain-containing 3 (JMJD3). LPS activation of macrophages, a cardinal early event in sepsis, leads to downstream mobilization of several KDM6B targets, especially those associated with pro-inflammatory responses (). A similar effect is true for serum amyloid protein A (SAA)-driven inflammatory responses in macrophages (Yan et al., 2014), which is linked to the pathogenesis of rheumatoid arthritis and potentially cancer as well as metastasis (Liu, 2012; Zhou et al., 2018; ). KDM6B expression is linked to better prognosis in patients with neuroblastoma (Yang et al., 2019) and stabilization of the tumor suppressor protein p53 in glioblastoma stem cells () while its loss has been shown to promote pancreatic cancer-cell aggressiveness (Yamamoto et al., 2014). Thus, the role LPS-triggered “training” of macrophages via its effect on KDM6B warrants further elucidation in the context of personalized cancer medicine.

Conversely, with respect to helminth infections, KDM6B along with IRF4 triggers the anti-inflammatory reprograming of macrophages (M2 phenotype), downstream of which manifests in Th2 cytokine release and antibody production (Satoh et al., 2010). These observations hint at the pleiotropic nature of KDM6B engagement in modulating host macrophage function as an essential therapeutic target to protect against a myriad of extrinsic (pathogen-associated) and intrinsic (host-associated) insults. Interestingly, amino acids 1110-1120 of KDM6B contain a strong 8 amino-acid match with selected residues between positions 251–265 in the influenza A virus (H1N1) hemagglutinin (HA) protein (derived from the California/New York strains of the 2009 pandemic flu), which provides a small hint about molecular mimicry and the possibility of TCR binding. Further studies are necessary to understand how pre-programing of KDM6B activity affects disease outcome in infectious diseases.

The microbiome has an important role in promoting trained immunity due to effect in development of the immune system, host control of chronic infections (e.g., TB), and clinical responses to immune checkpoint blockade in cancer for developing next-generation personalized cancer immunotherapies (Nash et al., 2017; ; ; ). Indeed, gut microbial/non-microbial ligands are essential for the adaptative immunity during secondary infection/pathogenic exposures, being involved in the production of immunomodulatory metabolites, such as short-chain fatty acids or secondary bile acids, regulating innate immune cells metabolism and functions (; Tremaroli and Backhed, 2012; Levy et al., 2016; Rooks and Garrett, 2016; ). Importantly, commensals in the gut are involved in the production of immunomodulatory metabolites that comprise short-chain fatty acids (SCFAs) such as butyrate, acetate, and propionate (50–52). Further, commensals such as Bacteroides, Lactobacillus, and Bifidobacteria species synthesize secondary bile acids that are derived from the metabolism of primary bile acids (53–55). Binding of these bioactive molecules to the receptors on the innate cells regulate their metabolism and functions (Negi et al., 2019). Cancer associated microbiomes have recently been linked to clinical outcomes in pancreatic cancer: The mycobiome (fungal components of the microbiome) has been shown to accelerate pancreatic cancer, via a carbohydrate moiety on Malassezia that activates the complement pathway (). In contrast, the tumor microbiome characterized by Saccharolpolyspora, Pseudoxanthomonas, Bacillius clausii and Streptomyces species has been associated with long-term survival for patients with pancreatic cancer (Riquelme et al., 2019). Future studies will show the impact of these bacterial/fungal species and their metabolites on immune cell programing.

Cancer antigens are released into the external environment usually by dying cells or packaged in exosomes (Wolfers et al., 2001). This may (i) facilitate training of immune cells and help them respond to a future infection or other cancer indications or (ii) activate immune cells subsets which are pre-wired – by a previous infection or exposure to autoantigens – to exhibit enhanced phagocytic functions, cytokine production capacity and unleash strong anti-tumor T-cell responses (Netea et al., 2017). Indeed, the durable changes after training of innate myeloid cells, involve the increase of expression and release of cytokines associated to a long-term regulation of gene transcription through epigenetic mechanisms (; Quintin et al., 2012; Netea et al., 2017). More specific effects of trained immune cells is, for example, the switch from oxidative phosphorylation to glycolysis in trained monocytes (). Besides, trained monocytes also show the accumulation of fumarate in the Krebs cycle, inhibiting the KDM5 family of H3K4 demethylases, therefore ensuring the maintenance of the H3K4me3 open chromatin mark (Sun et al., 2015).

Dendritic cells -based vaccination constitutes a major area of targeted personalized immunotherapy, with naturally occurring circulating DCs with certain pre-programed characteristics being considered of value for therapeutic applications (). Herein, trained immunity in DCs – such as that shown in response to anti-C. neoformans vaccination () – warrants investigation in the context of tailored anti-cancer immune responses. The DC vaccines involve the ability of these cells to act as an antitumoral effector in both CTLs and NK cells, in order to eradicate malignant cells (). There are several types of DC-vaccines, being the most frequently used the reinfusion of ex vivo derived DC pulsed with tumor-associated antigens (TAAs) or tumor cell lysates and stimulated with TNF-α, IL-1β, IL-6, and prostaglandin E2 (PGE2) (; ; ). The DC-based immunotherapy efficiency may be enhanced using immune checkpoint inhibitors, such as anti PD-1 or anti-CTLA-4 antibodies (Mastelic-Gavillet et al., 2019). Carreno and colleges described the vaccination of three stage III resected melanoma patients who received mature autologous DCs pulsed with peptides derived from mutated antigens, with a previous treatment with CTLA-4 blockade. Interestingly, besides the identification of peptide-specific T cell responses, after vaccination blood samples showed a more diverse TCR repertoire (). DC vaccines can also be considered to be combined with chemotherapy, since it is reported that chemotherapy may deplete specific cell types, such as Tregs and myeloid derived suppressor cells (MDSCs) and modulate the immune system to a more pro-inflammatory state (; ).

Conclusion

With increasing evidence emerging from basic and translational studies, trained immunity warrants further dissection for its capacity to offer powerful and durable anti-cancer immune responses – and potential reprograming of “non-productive” to “productive” (i.e., anti-cancer or pathogen-directed) immune responses. A large repertoire of innate immune and non-immunes cells enriches the repertoire of responders to insults of various origins and nature, and their interplay in shaping immunity. Combining biomarker information from various clinical studies and drug trials will increase the possibilities for designing treatment strategies. Trained immunity-based approaches will inevitably enhance T-cell responses in conferring host protection and facilitating long-term adaptive memory responses against pathogens or transformed cells.

Statements

Author contributions

MR, JL, AZ, and MM wrote the first draft and conceptualized the review. All authors were involved in further development, writing and proofreading of the review.

Funding

This work was supported by the Champalimaud Foundation.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

  • 1

    AbbasA.LichtmanA. H.PilaiS. (2014). Basic Immunology: Functions and Disorders of the Immune System.Philadelphia: W.B. Saunders Company.

  • 2

    AdamikJ.HenkelM.RayA.AuronP. E.DuerrR.BarrieA. (2013). The IL17A and IL17F loci have divergent histone modifications and are differentially regulated by prostaglandin E2 in Th17 cells.Cytokine64404412. 10.1016/j.cyto.2013.05.010

  • 3

    AmmounS.ProvenzanoL.ZhouL.BarczykM.EvansK.HiltonD. A.et al (2014). Axl/Gas6/NFkappaB signalling in schwannoma pathological proliferation, adhesion and survival.Oncogene33336346. 10.1038/onc.2012.587

  • 4

    AnguilleS.SmitsE. L.LionE.van TendelooV. F.BernemanZ. N. (2014). Clinical use of dendritic cells for cancer therapy.Lancet Oncol.15e257e267. 10.1016/S1470-2045(13)70585-0

  • 5

    ArtsR. J. W.CarvalhoA.La RoccaC.PalmaC.RodriguesF.SilvestreR.et al (2016). Immunometabolic pathways in BCG-induced trained immunity.Cell Rep.1725622571. 10.1016/j.celrep.2016.11.011

  • 6

    ArtsR. J. W.JoostenL. A. B.NeteaM. G. (2018a). The potential role of trained immunity in autoimmune and autoinflammatory disorders.Front. Immunol.9:298. 10.3389/fimmu.2018.00298

  • 7

    ArtsR. J. W.MoorlagS.NovakovicB.LiY.WangS. Y.OostingM.et al (2018b). BCG vaccination protects against experimental viral infection in humans through the induction of cytokines associated with trained immunity.Cell Host Microbe23:89-100.e5. 10.1016/j.chom.2017.12.010

  • 8

    AtanasovG.PotnerC.AustG.SchierleK.DietelC.BenzingC.et al (2018). TIE2-expressing monocytes and M2-polarized macrophages impact survival and correlate with angiogenesis in adenocarcinoma of the pancreas.Oncotarget92971529726. 10.18632/oncotarget.25690

  • 9

    AwasthiS. (2014). Toll-like receptor-4 modulation for cancer immunotherapy.Front. Immunol.5:328328. 10.3389/fimmu.2014.00328

  • 10

    AykutB.PushalkarS.ChenR.LiQ.AbengozarR.KimJ. I.et al (2019). The fungal mycobiome promotes pancreatic oncogenesis via activation of MBL.Nature574264267. 10.1038/s41586-019-1608-2

  • 11

    BalkwillF. (2009). Tumour necrosis factor and cancer.Nat. Rev. Cancer9:361. 10.1038/nrc2628

  • 12

    BeamerG.MajorS.DasB.Campos-NetoA. (2014). Bone marrow mesenchymal stem cells provide an antibiotic-protective niche for persistent viable Mycobacterium tuberculosis that survive antibiotic treatment.Am. J. Pathol.18431703175. 10.1016/j.ajpath.2014.08.024

  • 13

    BenevoloM.MottoleseM.TremanteE.RolloF.DiodoroM. G.ErcolaniC.et al (2011). High expression of HLA-E in colorectal carcinoma is associated with a favorable prognosis.J. Transl. Med.9:184. 10.1186/1479-5876-9-184

  • 14

    BentR.MollL.GrabbeS.BrosM. (2018). Interleukin-1 Beta-A friend or foe in malignancies?Int. J. Mol. Sci.19:2155. 10.3390/ijms19082155

  • 15

    BisiauxA.ThiounnN.TimsitM. O.EladaouiA.ChangH. H.MapesJ.et al (2009). Molecular analyte profiling of the early events and tissue conditioning following intravesical bacillus calmette-guerin therapy in patients with superficial bladder cancer.J. Urol.18115711580. 10.1016/j.juro.2008.11.124

  • 16

    BiswasS. K. (2015). Metabolic reprogramming of immune cells in cancer progression.Immunity43435449. 10.1016/j.immuni.2015.09.001

  • 17

    BjorklundA. T.CarlstenM.SohlbergE.LiuL. L.ClancyT.KarimiM.et al (2018). Complete remission with reduction of high-risk clones following haploidentical NK-cell therapy against MDS and AML.Clin. Cancer Res.2418341844. 10.1158/1078-0432.CCR-17-3196

  • 18

    BolK. F.SchreibeltG.RaboldK.WculekS. K.SchwarzeJ. K.DzionekA.et al (2019). The clinical application of cancer immunotherapy based on naturally circulating dendritic cells.J. ImmunoTher. Cancer7:109. 10.1186/s40425-019-0580-6

  • 19

    BracciL.SchiavoniG.SistiguA.BelardelliF. (2014). Immune-based mechanisms of cytotoxic chemotherapy: implications for the design of novel and rationale-based combined treatments against cancer.Cell Death. Differ.211525. 10.1038/cdd.2013.67

  • 20

    BuffenK.OostingM.QuintinJ.NgA.KleinnijenhuisJ.KumarV.et al (2014). Autophagy controls BCG-induced trained immunity and the response to intravesical BCG therapy for bladder cancer.PLoS Pathog.10:e1004485. 10.1371/journal.ppat.1004485

  • 21

    CantoniC.GrauwetK.PietraG.ParodiM.MingariM. C.MariaA. D.et al (2015). Role of NK cells in immunotherapy and virotherapy of solid tumors.Immunotherapy7861882. 10.2217/imt.15.53

  • 22

    CarrenoB. M.MagriniV.Becker-HapakM.KaabinejadianS.HundalJ.PettiA. A.et al (2015). Cancer immunotherapy. a dendritic cell vaccine increases the breadth and diversity of melanoma neoantigen-specific T cells.Science348803808. 10.1126/science.aaa3828

  • 23

    CassoneA. (2018). The case for an expanded concept of trained immunity.mBio9:e570-18. 10.1128/mBio.00570-18

  • 24

    ChengS. C.QuintinJ.CramerR. A.ShepardsonK. M.SaeedS.KumarV.et al (2014). mTOR- and HIF-1alpha-mediated aerobic glycolysis as metabolic basis for trained immunity.Science345:1250684. 10.1126/science.1250684

  • 25

    CichockiF.WuC. Y.ZhangB.FelicesM.TesiB.TuiningaK.et al (2018). ARID5B regulates metabolic programming in human adaptive NK cells.J. Exp. Med.21523792395. 10.1084/jem.20172168

  • 26

    CreelanB. C.AntoniaS. J. (2019). The NKG2A immune checkpoint—a new direction in cancer immunotherapy.Nat. Rev. Clin. Oncol.16277278. 10.1038/s41571-019-0182-8

  • 27

    CrowleyT.BuckleyC. D.ClarkA. R. (2018). Stroma: the forgotten cells of innate immune memory.Clin. Exp. Immunol.1932436. 10.1111/cei.13149

  • 28

    DasB.KashinoS. S.PuluI.KalitaD.SwamiV.YegerH.et al (2013). CD271(+) bone marrow mesenchymal stem cells may provide a niche for dormant Mycobacterium tuberculosis.Sci. Transl. Med.5:170ra13. 10.1126/scitranslmed.3004912

  • 29

    de KruijfE. M.SajetA.van NesJ. G.NatanovR.PutterH.SmitV. T.et al (2010). HLA-E and HLA-G expression in classical HLA class I-negative tumors is of prognostic value for clinical outcome of early breast cancer patients.J. Immunol.18574527459. 10.4049/jimmunol.1002629

  • 30

    De SantaF.NarangV.YapZ. H.TusiB. K.BurgoldT.AustenaaL.et al (2009). Jmjd3 contributes to the control of gene expression in LPS-activated macrophages.EMBO J.2833413352. 10.1038/emboj.2009.271

  • 31

    DemarestS. J.GardnerJ.VendelM. C.AilorE.SzakS.HuangF.et al (2013). Evaluation of Tyro3 expression, Gas6-mediated Akt phosphorylation, and the impact of anti-Tyro3 antibodies in melanoma cell lines.Biochemistry5231023118. 10.1021/bi301588c

  • 32

    DhedaK.BoothH.HuggettJ. F.JohnsonM. A.ZumlaA.RookG. A. (2005). Lung remodeling in pulmonary tuberculosis.J. Infect. Dis.19212011209. 10.1086/444545

  • 33

    EneC. I.EdwardsL.RiddickG.BaysanM.WoolardK.KotliarovaS.et al (2012). Histone demethylase Jumonji D3 (JMJD3) as a tumor suppressor by regulating p53 protein nuclear stabilization.PLoS One7:e51407. 10.1371/journal.pone.0051407

  • 34

    EspositoI.MenicagliM.FunelN.BergmannF.BoggiU.MoscaF.et al (2004). Inflammatory cells contribute to the generation of an angiogenic phenotype in pancreatic ductal adenocarcinoma.J. Clin. Pathol.57630636. 10.1136/jcp.2003.014498

  • 35

    EsterhuyseM. M.WeinerJ. I. I. I.CaronE.LoxtonA. G.IannacconeM.WagmanC.et al (2015). Epigenetics and proteomics join transcriptomics in the quest for tuberculosis biomarkers.mBio6:e1187-15. 10.1128/mBio.01187-15

  • 36

    EvansR. J.PlineK.LoynesC. A.NeedsS.AldrovandiM.TiefenbachJ.et al (2019). 15-keto-prostaglandin E2 activates host peroxisome proliferator-activated receptor gamma (PPAR-γ) to promote Cryptococcus neoformans growth during infection.PLoS Pathog.15:e1007597. 10.1371/journal.ppat.1007597

  • 37

    FesslerJ.MatsonV.GajewskiT. F. (2019). Exploring the emerging role of the microbiome in cancer immunotherapy.J. ImmunoTher. Cancer7:108. 10.1186/s40425-019-0574-4

  • 38

    FlavellS. J.HouT. Z.LaxS.FilerA. D.SalmonM.BuckleyC. D. (2008). Fibroblasts as novel therapeutic targets in chronic inflammation.Br. J. Pharmacol.153S241S246.

  • 39

    FosterS. L.HargreavesD. C.MedzhitovR. (2007). Gene-specific control of inflammation by TLR-induced chromatin modifications.Nature447972978. 10.1038/nature05836

  • 40

    FrancoisB.JeannetR.DaixT.WaltonA. H.ShotwellM. S.UnsingerJ.et al (2018). Interleukin-7 restores lymphocytes in septic shock: the IRIS-7 randomized clinical trial.JCI Insight3:98960. 10.1172/jci.insight.98960

  • 41

    FuX. T.DaiZ.SongK.ZhangZ. J.ZhouZ. J.ZhouS. L.et al (2015). Macrophage-secreted IL-8 induces epithelial-mesenchymal transition in hepatocellular carcinoma cells by activating the JAK2/STAT3/Snail pathway.Int. J. Oncol.46587596. 10.3892/ijo.2014.2761

  • 42

    GamlielM.Goldman-WohlD.IsaacsonB.GurC.SteinN.YaminR.et al (2018). Trained memory of human uterine NK cells enhances their function in subsequent pregnancies.Immunity48:951-962.e5. 10.1016/j.immuni.2018.03.030

  • 43

    GartrellR. D.MarksD. K.HartT. D.LiG.DavariD. R.WuA.et al (2018). Quantitative analysis of immune infiltrates in primary melanoma.Cancer Immunol. Res.6481493. 10.1158/2326-6066.CIR-17-0360

  • 44

    GengS.YuanR.LiL. (2017). Dynamic programming and memory of monocytes by varying signal strengths of innate stimulants.J. Immunol.198(1 Suppl):221.14.

  • 45

    GoodenM.LampenM.JordanovaE. S.LeffersN.TrimbosJ. B.van der BurgS. H.et al (2011). HLA-E expression by gynecological cancers restrains tumor-infiltrating CD8+T lymphocytes.Proc. Natl. Acad. Sci. U.S.A.108:10656-61. 10.1073/pnas.1100354108

  • 46

    GourbalB.PinaudS.BeckersG. J. M.Van Der MeerJ. W. M.ConrathU.NeteaM. G. (2018). Innate immune memory: an evolutionary perspective.Immunol. Rev.2832140. 10.1111/imr.12647

  • 47

    GrohL.KeatingS. T.JoostenL. A. B.NeteaM. G.RiksenN. P. (2017). Monocyte and macrophage immunometabolism in atherosclerosis.Semi. Immunopathol.40203214. 10.1007/s00281-017-0656-7

  • 48

    GrossS.ErdmannM.HaendleI.VolandS.BergerT.SchultzE.et al (2017). Twelve-year survival and immune correlates in dendritic cell-vaccinated melanoma patients.JCI Insight2:e91438. 10.1172/jci.insight.91438

  • 49

    GundersonA. J.KanedaM. M.TsujikawaT.NguyenA. V.AffaraN. I.RuffellB.et al (2016). Bruton tyrosine kinase-dependent immune cell cross-talk drives pancreas cancer.Cancer Discov.6270285. 10.1158/2159-8290.CD-15-0827

  • 50

    Guney EskilerG.Deveci OzkanA.KaleliS.BilirC. (2019). Inhibition of TLR4/TRIF/IRF3 signaling pathway by curcumin in breast cancer cells.J. Pharm. Pharm. Sci.22281291. 10.18433/jpps30493

  • 51

    GuptaN.KumarR.AgrawalB. (2018). New players in immunity to tuberculosis: the host microbiome, lung epithelium, and innate immune cells.Front. Immunol.9:709. 10.3389/fimmu.2018.00709

  • 52

    HamadaA.TorreC.DrancourtM.GhigoE. (2019). Trained immunity carried by non-immune cells.Front. Microbiol.9:32253225. 10.3389/fmicb.2018.03225

  • 53

    HariziH. (2015). Epigenetic regulations of inflammatory cyclooxygenase-derived prostanoids: molecular basis and pathophysiological consequences.Media. Inflamm.2015:9. 10.1155/2015/841097

  • 54

    HedlM.YanJ.WittH.AbrahamC. (2018). IRF5 is required for bacterial clearance in human M1-polarized macrophages, and IRF5 immune-mediated disease risk variants modulate this outcome.J. Immunol.202920930. 10.4049/jimmunol.1800226

  • 55

    HelmO.Held-FeindtJ.Grage-GriebenowE.ReilingN.UngefrorenH.VogelI.et al (2014). Tumor-associated macrophages exhibit pro- and anti-inflammatory properties by which they impact on pancreatic tumorigenesis.Int. J. Cancer135843861. 10.1002/ijc.28736

  • 56

    HoleC. R.WagerC. M. L.Castro-LopezN.CampuzanoA.CaiH.WozniakK. L.et al (2019). Induction of memory-like dendritic cell responses in vivo.Nat. Commun.10:2955. 10.1038/s41467-019-10486-5

  • 57

    HuY.HeM. Y.ZhuL. F.YangC. C.ZhouM. L.WangQ.et al (2016). Tumor-associated macrophages correlate with the clinicopathological features and poor outcomes via inducing epithelial to mesenchymal transition in oral squamous cell carcinoma.J. Exp. Clin. Cancer Res.3512. 10.1186/s13046-015-0281-z

  • 58

    HuangJ.JiaoJ.XuW.ZhaoH.ZhangC.ShiY.et al (2015). MiR-155 is upregulated in patients with active tuberculosis and inhibits apoptosis of monocytes by targeting FOXO3.Mol. Med. Rep.1271027108. 10.3892/mmr.2015.4250

  • 59

    HuttererM.KnyazevP.AbateA.ReschkeM.MaierH.StefanovaN.et al (2008). Axl and growth arrest-specific gene 6 are frequently overexpressed in human gliomas and predict poor prognosis in patients with glioblastoma multiforme.Clin. Cancer Res.14130138. 10.1158/1078-0432.CCR-07-0862

  • 60

    IannacconeM.DorhoiA.KaufmannS. H. (2014). Host-directed therapy of tuberculosis: what is in it for microRNA?Expert. Opin. Ther. Targets18491494. 10.1517/14728222.2014.897696

  • 61

    IkedaN.ToidaI.IwasakiA.KawaiK.AkazaH. (2002). Surface antigen expression on bladder tumor cells induced by bacillus Calmette-Guerin (BCG): a role of BCG internalization into tumor cells.Int. J. Urol.92935. 10.1046/j.1442-2042.2002.00415.x

  • 62

    IlangumaranS.FinanD.La RoseJ.RaineJ.SilversteinA.De SepulvedaP.et al (2002). A positive regulatory role for suppressor of cytokine signaling 1 in IFN-gamma-induced MHC class II expression in fibroblasts.J. Immunol.16950105020. 10.4049/jimmunol.169.9.5010

  • 63

    IliopoulouE. G.KountourakisP.KaramouzisM. V.DoufexisD.ArdavanisA.BaxevanisC. N.et al (2010). A phase I trial of adoptive transfer of allogeneic natural killer cells in patients with advanced non-small cell lung cancer.Cancer Immunol. Immunother.5917811789. 10.1007/s00262-010-0904-3

  • 64

    ItoM.NakashimaM.NakayamaT.OhtsuruA.NagayamaY.TakamuraN.et al (2002). Expression of receptor-type tyrosine kinase, Axl, and its ligand, Gas6, in pediatric thyroid carcinomas around chernobyl.Thyroid12971975. 10.1089/105072502320908303

  • 65

    JensenK. J.LarsenN.Biering-SorensenS.AndersenA.EriksenH. B.MonteiroI.et al (2015). Heterologous immunological effects of early BCG vaccination in low-birth-weight infants in Guinea-Bissau: a randomized-controlled trial.J. Infect. Dis.211956967. 10.1093/infdis/jiu508

  • 66

    JiaW.XieG.JiaW. (2018). Bile acid-microbiota crosstalk in gastrointestinal inflammation and carcinogenesis.Nat. Rev. Gastroenterol. Hepatol.15111128. 10.1038/nrgastro.2017.119

  • 67

    JiangB. (2017). Aerobic glycolysis and high level of lactate in cancer metabolism and microenvironment.Genes Dis.42527. 10.1016/j.gendis.2017.02.003

  • 68

    JiangH.HegdeS.KnolhoffB. L.ZhuY.HerndonJ. M.MeyerM. A.et al (2016). Targeting focal adhesion kinase renders pancreatic cancers responsive to checkpoint immunotherapy.Nat. Med.22851860. 10.1038/nm.4123

  • 69

    KanedaM. M.CappelloP.NguyenA. V.RalainirinaN.HardamonC. R.FoubertP.et al (2016a). Macrophage PI3Kgamma drives pancreatic ductal adenocarcinoma progression.Cancer Discov.6870885. 10.1158/2159-8290.cd-15-1346

  • 70

    KanedaM. M.MesserK. S.RalainirinaN.LiH.LeemC. J.GorjestaniS.et al (2016b). PI3Kgamma is a molecular switch that controls immune suppression.Nature539437442. 10.1038/nature19834

  • 71

    KanjanapraditK.KosjerinaZ.TanomkiatW.KeeratichananontW.PanthuwongS. (2017). Pulmonary cryptococcosis presenting with lung mass: report of 7 cases and review of literature.Clin. Med. Insights Pathol.10:1179555717722962. 10.1177/1179555717722962

  • 72

    KaufmannE.SanzJ.DunnJ. L.KhanN.MendoncaL. E.PacisA.et al (2018). BCG educates hematopoietic stem cells to generate protective innate immunity against tuberculosis.Cell172:176-190.e19.

  • 73

    KershawM. H.DevaudC.JohnL. B.WestwoodJ. A.DarcyP. K. (2013). Enhancing immunotherapy using chemotherapy and radiation to modify the tumor microenvironment.Oncoimmunology2:e25962. 10.4161/onci.25962

  • 74

    KhanA.MannL.PapannaR.LyuA.SinghC. R.OlsonS.et al (2017). Mesenchymal stem cells internalize Mycobacterium tuberculosis through scavenger receptors and restrict bacterial growth through autophagy.Sci. Rep.7:15010. 10.1038/s41598-017-15290-z

  • 75

    KirkwoodJ. M.ButterfieldL. H.TarhiniA. A.ZarourH.KalinskiP.FerroneS. (2012). Immunotherapy of cancer in 2012.CA Cancer J. Clin.62309335. 10.3322/caac.20132

  • 76

    KissickH. T.DunnL. K.GhoshS.NechamaM.KobzikL.ArredouaniM. S. (2014). The scavenger receptor MARCO modulates TLR-induced responses in dendritic cells.PLoS One9:e104148. 10.1371/journal.pone.0104148

  • 77

    KitaharaM.TakamineF.ImamuraT.BennoY. (2001). Clostridium hiranonis sp. nov., a human intestinal bacterium with bile acid 7alpha-dehydroxylating activity.Int. J. Syst. Evol. Microbiol.513944. 10.1099/00207713-51-1-39

  • 78

    KoskiG. K.CohenP. A.RosesR. E.XuS.CzernieckiB. J. (2008). Reengineering dendritic cell-based anti-cancer vaccines.Immunol. Rev.222256276. 10.1111/j.1600-065X.2008.00617.x

  • 79

    KumarM.SahuS. K.KumarR.SubuddhiA.MajiR. K.JanaK.et al (2015). MicroRNA let-7 modulates the immune response to Mycobacterium tuberculosis infection via Control of A20, an Inhibitor of the NF-κB Pathway.Cell Host Microbe17345356. 10.1016/j.chom.2015.01.007

  • 80

    LaheurteC.GalaineJ.BeziaudL.DossetM.KerzerhoJ.JacquemardC.et al (2016). Immunoprevalence and magnitude of HLA-DP4 versus HLA-DR-restricted spontaneous CD4(+) Th1 responses against telomerase in cancer patients.Oncoimmunology5:e1137416. 10.1080/2162402X.2015.1137416

  • 81

    LedererD. J.MartinezF. J. (2018). Idiopathic pulmonary fibrosis.N. Engl. J. Med.37818111823.

  • 82

    LeeA. W.TruongT.BickhamK.FonteneauJ.-F.LarssonM.Da SilvaI.et al (2002). A clinical grade cocktail of cytokines and PGE2 results in uniform maturation of human monocyte-derived dendritic cells: implications for immunotherapy.Vaccine20A8A22.

  • 83

    LeeJ.ZhangT.HwangI.KimA.NitschkeL.KimM.et al (2015). Epigenetic modification and antibody-dependent expansion of memory-like NK cells in human cytomegalovirus-infected individuals.Immunity42431442. 10.1016/j.immuni.2015.02.013

  • 84

    LeeJ. W.StoneM. L.PorrettP. M.ThomasS. K.KomarC. A.LiJ. H.et al (2019). Hepatocytes direct the formation of a pro-metastatic niche in the liver.Nature567249252. 10.1038/s41586-019-1004-y

  • 85

    LeongJ. W.SchneiderS. E.SullivanR. P.CooperM.FehnigerT. A. (2013). Human cytokine-induced memory-like (CIML) NK cells exhibit potent anti-leukemia cytotoxicity and maintain memory-like functionality after adoptive transfer into immunodeficient NOD-SCID-Gc-/- (NSG) Mice.Blood122:4501. 10.1182/blood.v122.21.4501.4501

  • 86

    LeriasJ. R.ParaschoudiG.SilvaI.MartinsJ.de SousaE.CondecoC.et al (2019). Clinically relevant immune responses against cytomegalovirus: implications for precision medicine.Int. J. Mol. Sci.20:E1986. 10.3390/ijms20081986

  • 87

    LevyM.ThaissC. A.ElinavE. (2016). Metabolites: messengers between the microbiota and the immune system.Genes Dev.3015891597. 10.1101/gad.284091.116

  • 88

    LewE. D.OhJ.BurrolaP. G.LaxI.ZagórskaA.TravésP. G.et al (2014). Differential TAM receptor–ligand–phospholipid interactions delimit differential TAM bioactivities.eLife3:e03385.

  • 89

    LiC.ZhuB.SonY. M.WangZ.JiangL.XiangM.et al (2019). The transcription factor Bhlhe40 programs mitochondrial regulation of resident CD8(+) T Cell fitness and functionality.Immunity51:e7. 10.1016/j.immuni.2019.08.013

  • 90

    LiangS.XuK.NiuL.WangX.LiangY.ZhangM.et al (2017). Comparison of autogeneic and allogeneic natural killer cells immunotherapy on the clinical outcome of recurrent breast cancer.Oncotargets Ther.1042734281. 10.2147/OTT.S139986

  • 91

    LinA.ZhangX.RuanY. Y.WangQ.ZhouW. J.YanW. H. (2011). HLA-F expression is a prognostic factor in patients with non-small-cell lung cancer.Lung Cancer74504509. 10.1016/j.lungcan.2011.04.006

  • 92

    LinY.XuJ.LanH. (2019). Tumor-associated macrophages in tumor metastasis: biological roles and clinical therapeutic applications.J. Hematol. Oncol.12:76. 10.1186/s13045-019-0760-3

  • 93

    LiuC. (2012). Serum amyloid a protein in clinical cancer diagnosis.Pathol. Oncol. Res.18117121. 10.1007/s12253-011-9459-7

  • 94

    LiuG. Y.LiuY.LuY.QinY. R.DiG. H.LeiY. H.et al (2015). Short-term memory of danger signals or environmental stimuli in mesenchymal stem cells: implications for therapeutic potential.Cell. Mol. Immunol.13:369. 10.1038/cmi.2015.11

  • 95

    LocatelliF.PendeD.FalcoM.Della ChiesaM.MorettaA.MorettaL. (2018). NK Cells mediate a crucial graft-versus-leukemia effect in haploidentical-HSCT to cure high-risk acute leukemia.Trends Immunol.39577590. 10.1016/j.it.2018.04.009

  • 96

    LuY. C.ParkerL. L.LuT.ZhengZ.ToomeyM. A.WhiteD. E.et al (2017). Treatment of patients with metastatic cancer using a major histocompatibility complex class II-restricted T-Cell receptor targeting the cancer germline antigen MAGE-A3.J. Clin. Oncol.3533223329. 10.1200/JCO.2017.74.5463

  • 97

    MacGillivrayD. M.KollmannT. R. (2014). The role of environmental factors in modulating immune responses in early life.Front. Immunol.5:434. 10.3389/fimmu.2014.00434

  • 98

    MadejM. P.TöpferE.BoraschiD.ItalianiP. (2017). Different regulation of interleukin-1 production and activity in monocytes and macrophages: innate memory as an endogenous mechanism of IL-1 inhibition.Front. Pharmacol.8:335. 10.3389/fphar.2017.00335

  • 99

    MaeurerM. J.MartinD.WalterW.LiuK.ZitvogelL.HalusczcakK.et al (1996). Human intestinal Vdelta1+ lymphocytes recognize tumor cells of epithelial origin.J. Exp. Med.18316811696. 10.1084/jem.183.4.1681

  • 100

    MantovaniA.BarajonI.GarlandaC. (2018). IL-1 and IL-1 regulatory pathways in cancer progression and therapy.Immunol. Rev.2815761. 10.1111/imr.12614

  • 101

    MarquardtN.BeziatV.NystromS.HengstJ.IvarssonM. A.KekalainenE.et al (2015). Cutting edge: identification and characterization of human intrahepatic CD49a+ NK cells.J. Immunol.19424672471. 10.4049/jimmunol.1402756

  • 102

    Mastelic-GavilletB.BalintK.BoudousquieC.GannonP. O.KandalaftL. E. (2019). Personalized dendritic cell vaccines-recent breakthroughs and encouraging clinical results.Front. Immunol.10:766766. 10.3389/fimmu.2019.00766

  • 103

    McCormackR.de ArmasL. R.ShiratsuchiM.RamosJ. E.PodackE. R. (2013). Inhibition of intracellular bacterial replication in fibroblasts is dependent on the perforin-like protein (perforin-2) encoded by macrophage-expressed gene 1.J. Innate Immun.5185194. 10.1159/000345249

  • 104

    MengQ.ValentiniD.RaoM.DodooE.MaeurerM. (2018). CMV and EBV targets recognized by tumor-infiltrating B lymphocytes in pancreatic cancer and brain tumors.Sci. Rep.8:17079. 10.1038/s41598-018-34710-2

  • 105

    MitevaK.Van LinthoutS.TschöpeC. (2014). Crosstalk between fibroblasts and inflammatory cells.Cardiovasc. Res.102258269. 10.1093/cvr/cvu062

  • 106

    MitropoulosD. N. (2005). Novel insights into the mechanism of action of intravesical immunomodulators.In Vivo19611621.

  • 107

    MooresR. C.BrilhaS.SchutgensF.ElkingtonP. T.FriedlandJ. S. (2017). Epigenetic regulation of matrix metalloproteinase-1 and -3 expression in mycobacterium tuberculosis infection.Front. Immunol.8:602. 10.3389/fimmu.2017.00602

  • 108

    MorandiF.RaffaghelloL.BianchiG.MeloniF.SalisA.MilloE.et al (2008). Immunogenicity of human mesenchymal stem cells in HLA-class I-restricted T-cell responses against viral or tumor-associated antigens.Stem Cells2612751287. 10.1634/stemcells.2007-0878

  • 109

    MouritsV. P.WijkmansJ. C.JoostenL. A.NeteaM. G. (2018). Trained immunity as a novel therapeutic strategy.Curr. Opin. Pharmacol.415258. 10.1016/j.coph.2018.04.007

  • 110

    MukhopadhyayS.VarinA.ChenY. Y.LiuB. Y.TryggvasonK.GordonS. (2011). SR-A/MARCO-mediated ligand delivery enhances intracellular TLR and NLR function, but ligand scavenging from cell surface limits TLR4 response to pathogens.Blood11713191328. 10.1182/blood-2010-03-276733

  • 111

    MulderW. J. M.OchandoJ.JoostenL. A. B.FayadZ. A.NeteaM. G. (2019). Therapeutic targeting of trained immunity.Nat. Rev. Drug Discov.18553566. 10.1038/s41573-019-0025-4

  • 112

    NakayamaM.TakedaK.KawanoM.TakaiT.IshiiN.OgasawaraK. (2011). Natural killer (NK)-dendritic cell interactions generate MHC class II-dressed NK cells that regulate CD4+ T cells.Proc. Natl. Acad. Sci. U.S.A.1081836018365. 10.1073/pnas.1110584108

  • 113

    NashM. J.FrankD. N.FriedmanJ. E. (2017). Early microbes modify immune system development and metabolic homeostasis-the “Restaurant”. Hypothesis Revisited.Front. Endocrinol.8:349. 10.3389/fendo.2017.00349

  • 114

    NegiS.DasD. K.PahariS.NadeemS.AgrewalaJ. N. (2019). Potential role of gut microbiota in induction and regulation of innate immune memory.Front. Immunol.10:2441. 10.3389/fimmu.2019.02441

  • 115

    NeteaM. G.JoostenL. A. B.van der MeerJ. W. M. (2017). Hypothesis: stimulation of trained immunity as adjunctive immunotherapy in cancer.J. Leukoc. Biol.10213231332. 10.1189/jlb.5RI0217-064RR

  • 116

    NiehrsA.Garcia-BeltranW. F.NormanP. J.WatsonG. M.HölzemerA.ChapelA.et al (2019). A subset of HLA-DP molecules serve as ligands for the natural cytotoxicity receptor NKp44.Nat. Immunol.2011291137. 10.1038/s41590-019-0448-4

  • 117

    OdunsiK.QianF.MatsuzakiJ.Mhawech-FaucegliaP.AndrewsC.HoffmanE. W.et al (2007). Vaccination with an NY-ESO-1 peptide of HLA class I/II specificities induces integrated humoral and T cell responses in ovarian cancer.Proc. Natl. Acad. Sci. U.S.A.1041283712842. 10.1073/pnas.0703342104

  • 118

    OkhrimenkoA.GrunJ. R.WestendorfK.FangZ.ReinkeS.von RothP.et al (2014). Human memory T cells from the bone marrow are resting and maintain long-lasting systemic memory.Proc. Natl. Acad. Sci. U.S.A.11192299234. 10.1073/pnas.1318731111

  • 119

    OwensB. M. J. (2015). Inflammation, innate immunity, and the intestinal stromal cell niche: opportunities and challenges.Front. Immunol.6:319. 10.3389/fimmu.2015.00319

  • 120

    PathriaP.GotthardtD.Prchal-MurphyM.PutzE. M.HolcmannM.SchledererM.et al (2015). Myeloid STAT3 promotes formation of colitis-associated colorectal cancer in mice.Oncoimmunology4:e998529.

  • 121

    PathriaP.LouisT. L.VarnerJ. A. (2019). Targeting tumor-associated macrophages in cancer.Trends Immunol.40310327.

  • 122

    PedersenM. B.DanielsenA. V.Hamilton-DutoitS. J.BendixK.NorgaardP.MollerM. B.et al (2014). High intratumoral macrophage content is an adverse prognostic feature in anaplastic large cell lymphoma.Histopathology65490500. 10.1111/his.12407

  • 123

    PengH.JiangX.ChenY.SojkaD. K.WeiH.GaoX.et al (2013). Liver-resident NK cells confer adaptive immunity in skin-contact inflammation.J. Clin. Invest.12314441456. 10.1172/JCI66381

  • 124

    PetersenL.PetersenC. C.Moller-LarsenA.HoklandM. E. (2010). Short-term exposure to human cytomegalovirus-infected fibroblasts induces a proportional increase of active CD94/NKG2A(+) natural killer cells.Hum. Immunol.712935. 10.1016/j.humimm.2009.09.355

  • 125

    PettenatiC.IngersollM. A. (2018). Mechanisms of BCG immunotherapy and its outlook for bladder cancer.Nat. Rev. Urol.15615625. 10.1038/s41585-018-0055-4

  • 126

    PietrasE. M. (2017). Inflammation: a key regulator of hematopoietic stem cell fate in health and disease.Blood13016931698. 10.1182/blood-2017-06-780882

  • 127

    QianB. Z.PollardJ. W. (2010). Macrophage diversity enhances tumor progression and metastasis.Cell1413951. 10.1016/j.cell.2010.03.014

  • 128

    QuintinJ.SaeedS.MartensJ. H. A.Giamarellos-BourboulisE. J.IfrimD. C.LogieC.et al (2012). Candida albicans infection affords protection against reinfection via functional reprogramming of monocytes.Cell Host Microbe12223232. 10.1016/j.chom.2012.06.006

  • 129

    RaviJ.ElbazM.WaniN. A.NasserM. W.GanjuR. K. (2016). Cannabinoid receptor-2 agonist inhibits macrophage induced EMT in non-small cell lung cancer by downregulation of EGFR pathway.Mol. Carcinog.5520632076. 10.1002/mc.22451

  • 130

    RiquelmeE.ZhangY.ZhangL.MontielM.ZoltanM.DongW.et al (2019). Tumor microbiome diversity and composition influence pancreatic cancer outcomes.Cell178:795-806.e12. 10.1016/j.cell.2019.07.008

  • 131

    RodriguezR. M.Suarez-AlvarezB.Lopez-LarreaC. (2019). Therapeutic epigenetic reprogramming of trained immunity in myeloid cells.Trends Immunol.406680. 10.1016/j.it.2018.11.006

  • 132

    Romieu-MourezR.FrancoisM.BoivinM. N.StaggJ.GalipeauJ. (2007). Regulation of MHC class II expression and antigen processing in murine and human mesenchymal stromal cells by IFN-gamma, TGF-beta, and cell density.J. Immunol.17915491558. 10.4049/jimmunol.179.3.1549

  • 133

    RooksM. G.GarrettW. S. (2016). Gut microbiota, metabolites and host immunity.Nat. Rev. Immunol.16341352. 10.1038/nri.2016.42

  • 134

    RosarioM.RomeeR.SchneiderS. E.LeongJ. W.SullivanR. P.FehnigerT. A. (2014). Human cytokine-induced memory-like (CIML) NK cells are active against myeloid leukemia in vitro and vivo.Blood12411171117. 10.1182/blood.v124.21.1117.1117

  • 135

    RusekP.WalaM.DruszczyńskaM.FolM. (2018). Infectious agents as stimuli of trained innate immunity.Int. J. Mol. Sci.19:456. 10.3390/ijms19020456

  • 136

    SaeedS.QuintinJ.KerstensH. H.RaoN. A.AghajanirefahA.MatareseF.et al (2014). Epigenetic programming of monocyte-to-macrophage differentiation and trained innate immunity.Science345:1251086. 10.1126/science.1251086

  • 137

    SatohT.TakeuchiO.VandenbonA.YasudaK.TanakaY.KumagaiY.et al (2010). The Jmjd3-Irf4 axis regulates M2 macrophage polarization and host responses against helminth infection.Nat. Immunol.11936944. 10.1038/ni.1920

  • 138

    SchlumsH.CichockiF.TesiB.TheorellJ.BeziatV.HolmesT. D.et al (2015). Cytomegalovirus infection drives adaptive epigenetic diversification of NK cells with altered signaling and effector function.Immunity42443456. 10.1016/j.immuni.2015.02.008

  • 139

    SchrumJ. E.CrabtreeJ. N.DobbsK. R.KiritsyM. C.ReedG. W.GazzinelliR. T.et al (2018). Cutting edge: plasmodium falciparum induces trained innate immunity.J. Immunol.20012431248. 10.4049/jimmunol.1701010

  • 140

    SeyaT.TakedaY.MatsumotoM. (2015). Tumor vaccines with dsRNA adjuvant ARNAX induces antigen-specific tumor shrinkage without cytokinemia.Oncoimmunology5:e1043506. 10.1080/2162402x.2015.1043506

  • 141

    SinghV.PrakharP.RajmaniR. S.MahadikK.BorboraS. M.BalajiK. N. (2017). Histone methyltransferase SET8 epigenetically reprograms host immune responses to assist mycobacterial survival.J. Infect. Dis.216477488. 10.1093/infdis/jix322

  • 142

    SongX.WangH.LogsdonC. D.RashidA.FlemingJ. B.AbbruzzeseJ. L.et al (2011). Overexpression of receptor tyrosine kinase Axl promotes tumor cell invasion and survival in pancreatic ductal adenocarcinoma.Cancer117734743. 10.1002/cncr.25483

  • 143

    SorensenM. D.DahlrotR. H.BoldtH. B.HansenS.KristensenB. W. (2018). Tumour-associated microglia/macrophages predict poor prognosis in high-grade gliomas and correlate with an aggressive tumour subtype.Neuropathol. Appl. Neurobiol.44185206. 10.1111/nan.12428

  • 144

    StraetemansT.van BrakelM.van SteenbergenS.BroertjesM.DrexhageJ.HegmansJ.et al (2012). TCR gene transfer: MAGE-C2/HLA-A2 and MAGE-A3/HLA-DP4 epitopes as melanoma-specific immune targets.Clin. Dev. Immunol.2012:586314. 10.1155/2012/586314

  • 145

    SuS.LiuQ.ChenJ.ChenJ.ChenF.HeC.et al (2014). A positive feedback loop between mesenchymal-like cancer cells and macrophages is essential to breast cancer metastasis.Cancer Cell.25605620. 10.1016/j.ccr.2014.03.021

  • 146

    SunJ. C.BeilkeJ. N.LanierL. L. (2009). Adaptive immune features of natural killer cells.Nature457557561. 10.1038/nature07665

  • 147

    SunM.ZhaoW.XieQ.ZhanY.WuB. (2015). Lentinan reduces tumor progression by enhancing gemcitabine chemotherapy in urothelial bladder cancer.Surg. Oncol.242834. 10.1016/j.suronc.2014.11.002

  • 148

    SzebeniG. J.VizlerC.KitajkaK.PuskasL. G. (2017). Inflammation and cancer: extra- and intracellular determinants of tumor-associated macrophages as tumor promoters.Media. Inflamm.2017:9294018. 10.1155/2017/9294018

  • 149

    TakeuchiO.SatoS.HoriuchiT.HoshinoK.TakedaK.DongZ.et al (2002). Cutting edge: role of Toll-like receptor 1 in mediating immune response to microbial lipoproteins.J. Immunol.1691014. 10.4049/jimmunol.169.1.10

  • 150

    TangX.YangL.LiZ.NalinA. P.DaiH.XuT.et al (2018). First-in-man clinical trial of CAR NK-92 cells: safety test of CD33-CAR NK-92 cells in patients with relapsed and refractory acute myeloid leukemia.Am. J. Cancer Res.810831089.

  • 151

    TiainenS.TumeliusR.RillaK.HamalainenK.TammiM.TammiR.et al (2015). High numbers of macrophages, especially M2-like (CD163-positive), correlate with hyaluronan accumulation and poor outcome in breast cancer.Histopathology66873883. 10.1111/his.12607

  • 152

    TodoricJ.KarinM. (2019). The fire within: cell-autonomous mechanisms in inflammation-driven cancer.Cancer Cell35714720. 10.1016/j.ccell.2019.04.001

  • 153

    TognarelliS.WirschingS.von MetzlerI.RaisB.JacobsB.ServeH.et al (2018). Enhancing the activation and releasing the brakes: a double hit strategy to improve NK cell cytotoxicity against multiple myeloma.Front. Immunol.9:2743. 10.3389/fimmu.2018.02743

  • 154

    TremaroliV.BackhedF. (2012). Functional interactions between the gut microbiota and host metabolism.Nature489242249. 10.1038/nature11552

  • 155

    van der HeijdenC. D. C. C.NozM. P.JoostenL. A. B.NeteaM. G.RiksenN. P.KeatingS. T. (2018). Epigenetics and trained immunity.Antioxidants Redox Signal.2910231040. 10.1089/ars.2017.7310

  • 156

    van MontfoortN.BorstL.KorrerM. J.SluijterM.MarijtK. A.SantegoetsS. J.et al (2018). NKG2A blockade potentiates CD8 T cell immunity induced by cancer vaccines.Cell175:1744-1755.e15.

  • 157

    VenzaI.VisalliM.FortunatoC.RuggeriM.RatoneS.CaffoM.et al (2012). PGE2 induces interleukin-8 derepression in human astrocytoma through coordinated DNA demethylation and histone hyperacetylation.Epigenetics713151330. 10.4161/epi.22446

  • 158

    von BothU.BerkM.AgapowP. M.WrightJ. D.GitA.HamiltonM. S.et al (2018). Mycobacterium tuberculosis exploits a molecular off switch of the immune system for intracellular survival.Sci. Rep.8:661. 10.1038/s41598-017-18528-y

  • 159

    VonoM.LinA.Norrby-TeglundA.KoupR. A.LiangF.LoréK. (2017). Neutrophils acquire the capacity for antigen presentation to memory CD4(+) T cells in vitro and ex vivo.Blood12919912001. 10.1182/blood-2016-10-744441

  • 160

    VossJ. J. L. P.FordC. A.PetrovaS.MelvilleL.PatersonM.PoundJ. D.et al (2017). Modulation of macrophage antitumor potential by apoptotic lymphoma cells.Cell Death. Differ.24:971. 10.1038/cdd.2016.132

  • 161

    WalkJ.de BreeL. C. J.GraumansW.StoterR.van GemertG.-J.van de Vegte-BolmerM.et al (2019). Outcomes of controlled human malaria infection after BCG vaccination.Nat. Commun.10:874. 10.1038/s41467-019-08659-3

  • 162

    WangH.LiP.WangL.XiaZ.HuangH.LuY.et al (2015). High numbers of CD68+ tumor-associated macrophages correlate with poor prognosis in extranodal NK/T-cell lymphoma, nasal type.Ann. Hematol.9415351544. 10.1007/s00277-015-2401-4

  • 163

    WangW.MarinisJ. M.BealA. M.SavadkarS.WuY.KhanM.et al (2018). RIP1 kinase drives macrophage-mediated adaptive immune tolerance in pancreatic cancer.Cancer Cell34:e7. 10.1016/j.ccell.2018.10.006

  • 164

    World Health Organization [WHO] (2018). Global Tuberculosis Report.Geneva: World Health Organization.

  • 165

    WolfersJ.LozierA.RaposoG.RegnaultA.TheryC.MasurierC.et al (2001). Tumor-derived exosomes are a source of shared tumor rejection antigens for CTL cross-priming.Nat. Med.7297303. 10.1038/85438

  • 166

    WuY.WuX.WuL.WangX.LiuZ. (2017). The anticancer functions of RIG-I-like receptors, RIG-I and MDA5, and their applications in cancer therapy.Transl Res.1905160. 10.1016/j.trsl.2017.08.004

  • 167

    YamamotoK.TateishiK.KudoY.SatoT.YamamotoS.MiyabayashiK.et al (2014). Loss of histone demethylase KDM6B enhances aggressiveness of pancreatic cancer through downregulation of C/EBPalpha.Carcinogenesis3524042414. 10.1093/carcin/bgu136

  • 168

    YanQ.SunL.ZhuZ.WangL.LiS.YeR. D. (2014). Jmjd3-mediated epigenetic regulation of inflammatory cytokine gene expression in serum amyloid A-stimulated macrophages.Cell. Signal.2617831791. 10.1016/j.cellsig.2014.03.025

  • 169

    YangL.ZhaY.DingJ.YeB.LiuM.YanC.et al (2019). Histone demethylase KDM6B has an anti-tumorigenic function in neuroblastoma by promoting differentiation.Oncogenesis8:3. 10.1038/s41389-018-0112-0

  • 170

    YeoS. Y.LeeK. W.ShinD.AnS.ChoK. H.KimS. H. (2018). A positive feedback loop bi-stably activates fibroblasts.Nat. Commun.9:3016. 10.1038/s41467-018-05274-6

  • 171

    YuanR.GengS.LiL. (2016). Molecular mechanisms that underlie the dynamic adaptation of innate monocyte memory to varying stimulant strength of TLR ligands.Front. Immunol.7:497.

  • 172

    ZhangW. J.WangX. H.GaoS. T.ChenC.XuX. Y.SunQ.et al (2018). Tumor-associated macrophages correlate with phenomenon of epithelial-mesenchymal transition and contribute to poor prognosis in triple-negative breast cancer patients.J. Surg. Res.22293101. 10.1016/j.jss.2017.09.035

  • 173

    ZhangY.ChengS.ZhangM.ZhenL.PangD.ZhangQ.et al (2013). High-infiltration of tumor-associated macrophages predicts unfavorable clinical outcome for node-negative breast cancer.PLoS One8:e76147. 10.1371/journal.pone.0076147

  • 174

    ZhouJ.ShengJ.FanY.ZhuX.TaoQ.HeY.et al (2018). Association between serum amyloid A levels and cancers: a systematic review and meta-analysis.Postgrad. Med. J.94499507. 10.1136/postgradmedj-2018-136004

  • 175

    ZhouY.HuZ.CaoS.YanB.QianJ.ZhongH. (2017). Concomitant Mycobacterium tuberculosis infection promotes lung tumor growth through enhancing Treg development.Oncol. Rep.38685692. 10.3892/or.2017.5733

  • 176

    ZhuG.MeiL.VishwasraoH. D.JacobsonO.WangZ.LiuY.et al (2017). Intertwining DNA-RNA nanocapsules loaded with tumor neoantigens as synergistic nanovaccines for cancer immunotherapy.Nat. Commun.8:1482. 10.1038/s41467-017-01386-7

  • 177

    ZieglerA.SoldnerC.LienenklausS.SpanierJ.TrittelS.RieseP.et al (2017). A new RNA-based adjuvant enhances virus-specific vaccine responses by locally triggering TLR- and RLH-Dependent effects.J. Immunol.19815951605. 10.4049/jimmunol.1601129

Summary

Keywords

trained immunity, macrophages, dendritic cells, inflammation, cancer, pathogens, immune responses, immunotherapy

Citation

Lérias JR, de Sousa E, Paraschoudi G, Martins J, Condeço C, Figueiredo N, Carvalho C, Dodoo E, Maia A, Castillo-Martin M, Beltrán A, Ligeiro D, Rao M, Zumla A and Maeurer M (2020) Trained Immunity for Personalized Cancer Immunotherapy: Current Knowledge and Future Opportunities. Front. Microbiol. 10:2924. doi: 10.3389/fmicb.2019.02924

Received

28 June 2019

Accepted

04 December 2019

Published

10 January 2020

Volume

10 - 2019

Edited by

Petros Karakousis, Johns Hopkins University, United States

Reviewed by

Silvia Sánchez-Ramón, Complutense University of Madrid, Spain; Jose Luis Subiza, Inmunotek Alergia e Inmunología, Spain

Updates

Copyright

*Correspondence: Markus Maeurer,

This article was submitted to Infectious Diseases, a section of the journal Frontiers in Microbiology

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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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