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Data from ACE2 Enhances Sensitivity to PD-L1 Blockade by Inhibiting Macrophage-Induced Immunosuppression and Angiogenesis

作者:Peiyi Xie, Lei Guo, Qiang Yu, Yufei Zhao, Mincheng Yu, Hui Wang, Mengyuan Wu, Wenxin Xu, Min Xu, Xiao‐Dong Zhu, Yongfeng Xu, Yong-Sheng Xiao, Cheng Huang, Jian Zhou, Jia Fan, Mien‐Chie Hung, Hui‐Chuan Sun, Qing‐Hai Ye, Bo Zhang, Hui Li · 年份:2025 · DOI:10.1158/0008-5472.c.7627200 · 被引用次数:1 · 研究领域:Cancer Immunotherapy and Biomarkers、Ferroptosis and cancer prognosis、Immune cells in cancer

<div>Abstract<p>Anti–PD-L1–based combination immunotherapy has become the first-line treatment for unresectable hepatocellular carcinoma (HCC). However, the objective response rate is lower than 40%, highlighting the need to identify mechanisms of tolerance to immune checkpoint inhibitors and accurate biomarkers of response. In this study, we used next-generation sequencing to analyze HCC samples from 10 patients receiving anti–PD-L1 therapy. Activation of the renin–angiotensin system was elevated in nonresponders compared with responders, and angiotensin-converting enzyme 2 (<i>ACE2</i>) expression was significantly downregulated in nonresponders. <i>ACE2</i> deficiency promoted HCC development and anti–PD-L1 resistance, whereas <i>ACE2</i> overexpression inhibited HCC progression in immune-competent mice. Mass cytometry by time of flight revealed that <i>ACE2</i>-deficient murine orthotopic tumor tissues featured elevated M2-like tumor-associated macrophages, displayed a CCR5<sup>+</sup>PD-L1<sup>+</sup> immunosuppressive phenotype, and exhibited high VEGFα expression. ACE2 downregulated tumor-intrinsic chemokine (C–C motif) ligand 5 expression by suppressing NF-κB signaling through the ACE2/angiotensin-(1–7)/Mas receptor axis. The lower chemokine (C–C motif) ligand 5 levels led to reduced activation of the JAK–STAT3 pathway and suppressed PD-L1 and VEGFα expression in macrophages, blocking ...