- Open Access
Upregulated expression of indoleamine 2, 3-dioxygenase in CHO cells induces apoptosis of competent T cells and increases proportion of Treg cells
- Jingyan Sun†1,
- Jinpu Yu†2,
- Hui Li2,
- Lili Yang2,
- Feng Wei2,
- Wenwen Yu2,
- Juntian Liu1Email author and
- Xiubao Ren2Email author
© Sun et al; licensee BioMed Central Ltd. 2011
- Received: 25 May 2011
- Accepted: 14 September 2011
- Published: 14 September 2011
The inflammatory enzyme indoleamine 2, 3-dioxygenase (IDO) participates in immune tolerance and promotes immune escape of IDO+ tumors. A recent hypothesis suggested that IDO may contribute to the differentiation of new T regulatory cells (Tregs) from naive CD4+ T cells. In this study we investigated the role of IDO in induction of immunosuppression in breast cancer by increasing the apoptosis of T cells and the proportion of Tregs.
An IDO expression plasmid was constructed and Chinese hamster ovary (CHO) cells were stably transfected with human IDO. Purified CD3+ T cells were isolated from the peripheral blood monouclear cells of breast cancer patients. After co-culturing IDO expressing or untransfected (control) CHO cells with T cells, T cells apoptosis were determined by flow cytometry analysis and annexin-V and PI staining. The proportion of the regulatory T cell (Tregs [CD4 + CD25 + CD127-]) subset was measured by flow cytometry analysis. T cells total RNA and cellular protein samples were isolated for detecting Foxp3 gene and protein expression.
IDO transgenic CHO cells yielded high levels of IDO enzymatic activity, resulting in complete depletion of tryptophan from the culture medium. We found that apoptosis occurred in 79.07 ± 8.13% of CD3+T cells after co-cultured with IDO+ CHO cells for 3 days and the proportion of CD4 + CD25 + CD127- T cells increased from 3.43 ± 1.07% to 8.98 ± 1.88% (P < 0.05) as well. The specific inhibitor of IDO,1-MT efficiently reversed enhancement of T cells apoptosis and amplification of Tregs in vitro. Increased expression of Foxp3, a key molecular marker of Tregs, was confirmed by RT-PCR, real-time RT-PCR and Western blot analysis at the same time.
These results suggest that IDO helps to create a tolerogenic milieu in breast tumors by directly inducing T cell apoptosis and enhancing Treg-mediated immunosuppression.
- Indoleamine-Pyrrole 2
- breast neoplasms
- immune tolerance
- CHO Cells
- regulatory T-Lymphocytes
The molecular mechanisms underlying tumor-induced tolerance are the subject of active research, and a number of contributing mechanisms have been identified. Indoleamine 2, 3-dioxygenase (IDO/INDO), an important enzyme in the metabolism of tryptophan, catalyzes the rate-limiting step of tryptophan degradation along the kynurenine pathway. Reduction in the local tryptophan concentration and generation of tryptophan metabolites can suppress T cell proliferation or induce T cell apoptosis [1, 2], and IDO has been implicated in the endogenous induction of peripheral tolerance and immunosuppression [3, 4]. In addition, many human solid tumors express IDO, indicating that it may contribute to the induction of tumor tolerance [5–8].
Regulatory T cells (Tregs [CD4+CD25+CD127-]) can inhibit most types of immune responses and are emerging as a key component of acquired tolerance to tumors . Increased Treg activity facilitates tumor growth, whereas depletion of Tregs allows for effective anti-tumor immune responses . Previous studies have shown that IDO is expressed in tumor-draining lymph nodes. Interestingly, we previously found that IDO expression in primary breast cancer tumors is accompanied by Treg infiltration (unpublished data), suggesting a correlation between IDO activity and Tregs in these tumors. However, the role of increased IDO expression in tumor cells in development of Treg cells is not clear. In this study, we investigated the potential effects of IDO on development of Treg cells in breast cancer tumors using a stable IDO-expressing Chinese hamster ovary (CHO) cell line.
Cell lines and culture conditions
The Chinese hamster ovary (CHO) cell line was purchased from the Shanghai Institute of Cell Biology, Chinese Academy of Sciences (Shanghai, China). The breast cancer cell line MDA-MB-435s was obtained from American Type Culture Collection (Manassas, VA). Both cell lines were maintained in culture as adherent monolayer in RPMI-1640 (Gibco, Invitrogen Corp., Carlsbad, CA) medium supplemented with 10% fetal bovine serum (FBS), L-glutamine (1%) and penicillin (0.1%). Cells were incubated at 37°C in a humidified atmosphere with 5% CO2.
Construction of a recombinant plasmid containing human IDO cDNA
Total RNA was isolated from breast cancer MDA-MB-435s cells using Trizol (Invitrogen, Carlsbad, CA) according to the manufacturer's instructions. A 1225 kb fragment encompassing the entire coding region of human IDO cDNA was obtained using RT-PCR (Takara, Dalian, China) with the following primer pair: sense 5'-AGATCTGCCACCATGGCACACGCTATGGAAAAC-3', and antisense 5'-GTCGACTTAACCTTCCTTCAAAAGGGATTTC-3'. The PCR products were inserted into the pMD19-T Simple Vector (Takara) using TA-cloning procedures, and sequencing analysis was used to identify the product of interest (pMD19-IDO).
Establishment of stable transformants
For construction of stable transformants, pMD19-IDO and pIRES2-EGFP (Clontech, Santa Clara, CA) were digested with Bgl II and Sal I. The fragments of interests were recovered by agarose gel analysis, purified and ligated using T4 DNA ligase to generate the expression plasmid pIRES2-EGFP-IDO. The recombinant expression plasmid was confirmed by digestion with Bgl II and Sal I and sequencing. CHO cells were cultured in RPMI medium 1640 with 10% FBS for 24 h and then transfected with 10 μg of pIRES2-EGFP-IDO using a standard electroporation method (field strength of 350 V/cm, 60 μs, 1 pulse). The pIRES2-EGFP vector was used as a plasmid control, and CHO cells transfected with pIRES2-EGFP (CHO/EGFP) were used as a control cell line. The CHO/EGFP cells were established as described previously . G418 (1 mg/ml) was added to the medium 48 h after transfection, and the medium was changed every 48 h for 4 weeks to obtain G418-resistant transformants. CHO cells containing pIRES2-EGFP-IDO were then identified by flow cytometric analysis.
Detection of IDO gene transcripts in CHO cells and Foxp3 in co-cultured cells by RT-PCR
To investigate IDO gene integration into CHO cells, total RNA was isolated from CHO cells transfected with pIRES2-EGFP-IDO using Trizol. RT-PCR primers were: IDO (188 bp), sense 5'-CATCTGCAAATCGTGACTAAG-3'; antisense 5'-CAGTCGACACATTAACCTTCCTTC-3'. β-actin (186 bp) was used as an internal control; sense 5'-TGGCACCCAGCACAATGAA-3'; antisense 5'-CTAAGTCATAGTCCGCCTAGAAGCA-3'. cDNA was prepared by Oligo-(dT)15 from 1 μg of total RNA, and PCR was performed using a RT-PCR kit (Takara) according to the manufacturer's instructions. To analyze Foxp3 gene expression in co-cultured cells, total RNA was isolated using Trizol as described above, with Foxp3 (488 bp) primers, forward primer 5'-CCCACTTACAGGCACTCCTC-3'; reverse primer 5'-CTTCTCCTTCTCCAGCACCA-3'. RT-PCR was performed in a volume of 20 μL using 50 ng of RNA, 2 μL of 10× PCR buffer (Takara, Japan), 10 mM of each deoxynucleoside triphosphate (dNTP), 1 μL of each primer, 0.5 μL of Takara Taq polymerase and 13.5 μL of water. Conditions were 94° for 5 min, followed by 30 cycles of 30 s at 94°C, 30 s at 60°C, and 1 min at 72°C, with a final extension cycle of 72°C for 10 min. PCR products were analyzed by separation on 2% agarose gels.
Quantitative real-time RT-PCR detection of Foxp3
Foxp3 gene expressions in T cells from different co-cultures were also assessed by quantitative real-time RT-PCR using β-actin mRNA as an internal control. Foxp3 primers, sense 5'-CCCACTTACAGGCACTCCTC-3'; antisense 5'-CTTCTCCTTCTCCAGCACCA-3'; β-actin, sense 5'-TGGCACCCAGCACAATGAA-3'; antisense 5'-CTAAGTCATAGTCCGCCTAGAAGCA-3'. PCR amplifications were performed in a 20 μl volume with each reaction containing 2 μl of 10× buffer, 0.4 μl (10 mmol/l) dNTP mixture, 1 μl (10 μmol/l) of each primer, 2 μl cDNA, 1 μl (20×) SYBR Green I, 3.2 μl (25 mmol/l) MgCl2, 1 U Taq DNA polymerase, 2.0 μl (1 mg/ml) BSA and 6.4 μl ddH2O. The thermal cycling conditions used were 95°C for 5 min, 94°C for 20 s, 60°C for 30 s, 72°C for 20 s, 80°C for 1 s; this was repeated for 40 cycles. All samples were measured in duplicate, and the average value was quantitated. To correct for sample-to-sample variation, an endogenous control, β-actin, was amplified with the target and served as an internal reference to normalize the data. The expression levels of Foxp3 relative to that ofβ-actin were calculated by using the 2-ddCt method.
Western blot analysis
Total cellular extracts for Western blot analysis were obtained by lysis of 1 × 107 positively cloned CHO cells in lysis buffer (Pierce Biochemical, Rockford, IL), and the protein concentration was quantitated using the Micro BCA protein assay kit (Pierce). The extracts were heat denatured for 10 min in a 100°C water bath. Aliquots of cell lysates containing 50 μg of proteins were separated on a 12% SDS-polyacrylamide gel and transferred to PVDF membranes (Pall Corporation, Ann Arbor, MI). The filters were blocked with TBST buffer containing 2% BSA and incubated with an IDO monoclonal antibody (Chemicon International, Temecula, CA, 1:1000) overnight. Horseradish peroxidase-linked anti-mouse IgG (Chemicon, 1:5000) was then added, followed by immersion in SuperSignal West Pico Chemiluminescent Substrate (Pierce Biotechnology, Rockford, IL) for visualization of bands. The intensity of each band was recorded using the ChemiDoc XRS imaging system and was analyzed using Quantity One software (Bio-rad Laboratories, Milan, Italy). For detection of Foxp3 in co-cultures of IDO+ and CD3+ T cells (using mouse monoclonal antibody to Foxp3 [Clone PCH101, 1:1000 dilution; eBioscience]), inadherent cells were obtained 7 days after co-culture of CHO+ and CD3+ T cells, and the analysis was performed as described above.
IDO activity assay
IDO expressing or untransfected (control) CHO cells (1 × 107) were incubated in RPMI 1640 with 10% FBS (Gibco). The supernatants of cell culture were harvested 72 h after incubation, and 2 mls were added to 0.1 g sulfosalicylic acid, followed by centrifugation at 4°C for 30 min. The concentrations of the enzymatic products were measured using the Hitachi amino acid L-8800-automatic analyzer (Hitachi, Tokyo, Japan). Enzyme activity was expressed as the product content per hour per milligram of protein.
Co-culture of IDO+ CHO cells and CD3+T cells
Mononuclear cells were isolated from the peripheral blood of breast cancer patients using the CS-3000 Plus Blood Cell Separator (Baxter, Munich, Germany) according to the operator's manual. CD3+T cells were isolated and purified using the RosetteSep Human CD3 Depletion Cocktail kit (StemCell Technologies Inc., Vancouver, BC, Canada) according to the manufacturer's instructions. Informed consent was obtained from all subjects, and the study was approved by the University Ethics Committee. CHO/EGFP cells or CHO cells with stable IDO expression (1 × 105) were seeded per well of a 24-well plate, and 2 × 106 purified CD3+T cells and 200 U/ml human recombinant IL-2 (R&D Systems) were added. The cells were incubated in RPMI 1640 medium with 10% FBS at 37°C in a 5% CO2 incubator. The medium was changed every 2-3 days for 7 days. We added 1-MT, the specific inhibitor of IDO at concentration of 1 mM in the co-culture system composing of CHO/IDO cells and CD3+T cells to elucidate the regulatory effect of IDO both in promoting apoptosis and increasing Tregs.
Flow cytometry assay
Co-cultured cells were harvested after 96 h for analysis of apoptosis. The apoptosis levels of T cells in the harvested cells (1 × 106/ml), which were gated using PE-Cy5 labeled anti-CD3 monoclonal antibody, were assessed by FITC labeled Annexin V and PI (BD Pharmingen, San Diego, CA) staining. As a positive control for apoptosis, CD3+ T cell apoptosis was also assessed 96 h after incubation in medium supplemented with 200 U/ml IL-2. To detect the proportion of Tregs after 7 days of co-culture, cells were harvested and incubated with 10 μl anti-CD4-PE-Cy5, 10 μl anti-CD25-FITC and 3 μl anti-CD127-PE (BD Pharmingen) at 4°C for 30 min in the dark. A minimum of 1 × 104 cells were washed 2 times with PBS and resuspended in 2% paraformaldehyde. Flow cytometric analysis was performed using a FACSAria flow cytometer (Becton Dickinson). The ratio of Tregs to CD3+T cells before culture was also assessed. The data were analyzed using Cell Quest software (Becton Dickinson).
All data were expressed as ( ± SD) and analyzed with statistical package SPSS 11.5 for Windows (SPSS Inc., Chicago, IL). The SNK-q method was used to determine statistically significant differences among the groups. One-way analysis of variance (ANOVA) and the Student's t test were used to determine the means of two different groups. P < 0.05 was considered statistically significant.
Identification of the recombinant plasmid pIRES2-EGFP-IDO
Effect of IDO+ CHO cells on CD3+T cell apoptosis
In vitro induction of peripheral CD4 + CD25 + CD127- T cells by IDO+ CHO cells in the peripheral blood of breast cancer patients
RT-PCR analysis of Foxp3 gene expression
Quantitative real-time RT-PCR analysis of Foxp3 gene expression
Foxp3 gene expression was detected in CD3+T cells after 7 days of co-culture with IDO+ CHO cells by quantitative RT-PCR analysis. CD3+T cells and CD3+T cells co-cultured with CHO/EGFP cells were used as negative controls. The relative expression of Foxp3 in CD3+ T cells from IDO+ CHO cell co-cultures, in CD3+ T cells and in CD3+T cells from co-cultures with CHO/EGFP cells were 0.00056 ± 0.00012, 0.00028 ± 0.00013 and 0.00023 ± 0.00005, respectively. Relative Foxp3 gene expression was higher in T cells co-cultured with IDO+ CHO cells than in T cells from the control groups (P < 0.05) (Figure 4B).
Western blot analysis of Foxp3 expression
Foxp3 protein expression was detected in CD3+ T cells 7 days after co-culture with IDO+ CHO cells. CD3+T cells and CD3+T cells co-cultured with CHO/EGFP cells were used as negative controls. Cell lysates from T cells isolated from co-cultures with IDO+ CHO cells contained a 48 kDa protein band reactive to a Foxp3-specific monoclonal antibody. This band was not present in cell lysates from T cells from the control group cultures (Figure 4C).
IDO is expressed in many human and animal tissues and cells as well as on the surface of human tumor cells. An in-depth analysis is needed to identify the specific mechanisms that underly the role of IDO in tumor immune tolerance. Recent studies have shown that acute myeloid leukemia (AML) cells that express IDO can transform CD4+CD25-T cells into CD4+CD25+T cells . However further study is needed to elucidate the mechanism behind this transformation and the relationship between IDO and Treg cells in solid tumors [13–18]. In this study, we constructed a stable cell line expressing IDO and carried out preliminary in vitro analysis of the induction effect of IDO on Tregs isolated from the peripheral blood of patients with breast cancer.
IDO is expressed both in tissues of patients with breast cancer and in breast cancer cell lines [19, 20]. In this study, during the preparation of the IDO gene expression vector, we identified IDO gene expression in the human breast cancer cell lines MDA-MB-231, MDA-MB-435S, MDA-MB-453, SK-Br-3, T47D, ZR-75-1 and normal breast cells HBL-60; the gene was highly expressed in MDA-MB-435S, T47D, MCF-7. We also detected IDO expression in patients with primary breast cancer and in lymph nodes draining the tumor; IDO expression in lymph node tissue was consistent with results previously reported in the literature [4, 21, 22]. Moreover, in our previous study, we found that the proportion of CD4+CD25+ regulatory T cells in the peripheral blood of patients with breast cancer was higher than that in the peripheral blood of patients with benign breast tumors and healthy volunteers; the proportion of CD4+CD25+Tcells was directly related to tumor size . This phenomenon suggests that in patients with breast cancer, a mechanism may exist that can increase the proportion of Tregs. We also added 1-MT, the specific inhibitor of IDO in the co-culture system composing of CHO/IDO cells and CD3+T cells to elucidate the regulatory effect of IDO both in promoting apoptosis and increasing Tregs. It demonstrated that 1-MT could efficiently reversed enhancement of T cells apoptosis and increased Tregs proportion in vitro. It implied that IDO is indeed responsible for the changes observed in vitro.
Some studies have indicated a close relationship between IDO and regulatory T cells. Some dendritic cells in the lymph nodes draining tumors that express IDO had local infiltration of Tregs cells [21, 22, 22, 24]. Furthermore, when IDO was expressed in the primary tumor of breast cancer patients, there was a direct correlation between an increase in volume of the primary breast cancer tumor and the proportion of Tregs in the peripheral circulation . Tregs cells are also likely to be involved in IDO-mediated tumor immune tolerance [11, 12]. To investigate this hypothesis, we established a CHO cell line that stably expressed IDO. Western blot analysis confirmed that CHO cells transfected with IDO expressed IDO protein with an expected molecular weight of approximately 42 kDa. At the same time, we detected a decrease in tryptophan in the culture medium, and an increase in its metabolite kynurenine, suggesting that IDO expressed by the transfected cells was functional and could lead to the depletion of tryptophan in the environment. Analysis of apoptosis after co-culture of IDO-expressing CHO cells and CD3+T cells isolated from the peripheral blood of patients with breast cancer showed that a significantly higher proportion of CD3+T cells were apoptotic than in the control group, suggesting that IDO may affect the T cell proliferation and induce T cell apoptosis. In our recent study, we found that cell proliferation and IL-2 synthesis triggered by the TCR activating anti-CD3 monoclonal antibody OKT3 was inhibited in T-cells which were co-cultured with IDO-expressing CHO cells. Furthermore, co-cultured of CHO/IDO with T-cells could inhibit Vav1 mRNA and protein expression in T-cells. However, an inhibitor of IDO, 1-MT, attenuated CHO/IDO-induced decrease of T-cell proliferation, IL-2 levels in T-cells and inhibition of Vav1 . These data suggested that Vav1 is a target molecule involved in the regulatory effect of IDO on T-cells.
Whether IDO can induce the maturation and differentiation of Tregs is unclear. Investigation into the relationship between IDO expression and regulation of Tregs is likely to be key to revealing a tumor immune tolerance-related mechanism [11, 25]. A recent experiment showed that in patients with acute myeloid leukemia, IDO-expressing tumor cells can induce the transformation of CD4+CD25-T cells to CD4+CD25+T cells . In this study, we explored the inductive effect of IDO on Tregs isolated from the solid tumors of patients with breast cancer, and used low expression of CD127 as a more accurate and specific surface molecular marker of inhibitory Tregs [9, 10]. We detected an increase in CD4+CD25+CD127- regulatory T cells in the CD3+T cell population from co-cultures of IDO-expressing CHO cells and CD3+T cells isolated from the peripheral blood of patients with breast cancer. This phenomenon may be due to the IDO induced differentiation of CD3+T into CD4+CD25+CD127- cells, but further study will be needed to confirm this conclusion.
Endogenous IDO may be involved in a variety of peripheral tolerance mechanisms and immunosuppressive responses, as well as having a role in other cellular mechanisms. We established a cell line that stably expressed IDO and preliminarily confirmed that active expression of IDO could induce apoptosis in T cells isolated from the peripheral blood of patients with breast cancer; we confirm the role of IDO in the maturation and development of Tregs in breast cancer patients. This study provides an experimental basis for further study into the mechanism underlying the interaction between IDO and Tregs in tumor immunity.
We thanked Dr. Sharma's work in establishment of the vivo model for activated mature Tregs by IDO. We also thanked Yizi Cong and Lijuan Wei of Tianjin Medical University Cancer Hospital and Institute for their technical assistance. This work was supported by grants from the National Natural Science Foundation of China (30972694, 81072159) and Tianjin Municipal Education Commission(20090133, 20090217), P. R. China.
- Uyttenhove C, Pilotte L, Theate I, et al: Evidence for a tumoral immune resistance mechanism based on tryptophan degradation by indoleamine 2,3-dioxygenase. Nat Med. 2003, 9: 1269-74. 10.1038/nm934.View ArticlePubMedGoogle Scholar
- Mellor AL, Keskin DB, Johnson T, et al: Cells expressing indoleamine 2,3-dioxygenase inhibit T cell responses. J Immunol. 2002, 168: 3771-6.View ArticlePubMedGoogle Scholar
- Munn DH, Zhou M, Attwood JT, et al: Prevention of allogeneic fetal rejection by tryptophan catabolism. Science. 1998, 281: 1191-3.View ArticlePubMedGoogle Scholar
- Munn DH, Mellor AL: Indoleamine 2,3-dioxygenase and tumor-induced tolerance. J Clin Invest. 2007, 117: 1147-54. 10.1172/JCI31178.PubMed CentralView ArticlePubMedGoogle Scholar
- Astigiano S, Morandi B, Costa R, et al: Eosinophil granulocytes account for indoleamine 2,3-dioxygenase-mediated immune escape in human non-small cell lung cancer. Neoplasia. 2005, 7: 390-6. 10.1593/neo.04658.PubMed CentralView ArticlePubMedGoogle Scholar
- Brandacher G, Perathoner A, Ladurner R, et al: Prognostic value of indoleamine 2,3-dioxygenase expression in colorectal cancer: effect on tumor-infiltrating T cells. Clin Cancer Res. 2006, 12: 1144-51. 10.1158/1078-0432.CCR-05-1966.View ArticlePubMedGoogle Scholar
- Okamoto A, Nikaido T, Ochiai K, et al: Indoleamine 2,3-dioxygenase serves as a marker of poor prognosis in gene expression profiles of serous ovarian cancer cells. Clin Cancer Res. 2005, 11: 6030-9. 10.1158/1078-0432.CCR-04-2671.View ArticlePubMedGoogle Scholar
- Sakurai K, Amano S, Enomoto K, et al: [Study of indoleamine 2,3-dioxygenase expression in patients with breast cancer]. Gan To Kagaku Ryoho. 2005, 32: 1546-9.PubMedGoogle Scholar
- Chatila TA: Role of regulatory T cells in human diseases. J Allergy Clin Immunol. 2005, 116: 949-59. 10.1016/j.jaci.2005.08.047. quiz 60View ArticlePubMedGoogle Scholar
- Schwartz RH: Natural regulatory T cells and self-tolerance. Nat Immunol. 2005, 6: 327-30. 10.1038/ni1184.View ArticlePubMedGoogle Scholar
- Li R, Wei F, Yu J, et al: IDO inhibits T-cell function through suppressing Vav1 expression and activation. Cancer Biol Ther. 2009, 8: 1402-8. 10.4161/cbt.8.14.8882.View ArticlePubMedGoogle Scholar
- Curti A, Pandolfi S, Valzasina B, et al: Modulation of tryptophan catabolism by human leukemic cells results in the conversion of CD25- into CD25+ T regulatory cells. Blood. 2007, 109: 2871-7.PubMedGoogle Scholar
- Mellor AL, Munn DH: Tryptophan catabolism and T-cell tolerance: immunosuppression by starvation?. Immunol Today. 1999, 20: 469-73. 10.1016/S0167-5699(99)01520-0.View ArticlePubMedGoogle Scholar
- Grohmann U, Orabona C, Fallarino F, et al: CTLA-4-Ig regulates tryptophan catabolism in vivo. Nat Immunol. 2002, 3: 1097-101. 10.1038/ni846.View ArticlePubMedGoogle Scholar
- Munn DH, Sharma MD, Baban B, et al: GCN2 kinase in T cells mediates proliferative arrest and anergy induction in response to indoleamine 2,3-dioxygenase. Immunity. 2005, 22: 633-42. 10.1016/j.immuni.2005.03.013.View ArticlePubMedGoogle Scholar
- Grohmann U, Volpi C, Fallarino F, et al: Reverse signaling through GITR ligand enables dexamethasone to activate IDO in allergy. Nat Med. 2007, 13: 579-86. 10.1038/nm1563.View ArticlePubMedGoogle Scholar
- Nakamura T, Shima T, Saeki A, et al: Expression of indoleamine 2, 3-dioxygenase and the recruitment of Foxp3-expressing regulatory T cells in the development and progression of uterine cervical cancer. Cancer Sci. 2007, 98: 874-81. 10.1111/j.1349-7006.2007.00470.x.View ArticlePubMedGoogle Scholar
- Witkiewicz A, Williams TK, Cozzitorto J, et al: Expression of indoleamine 2,3-dioxygenase in metastatic pancreatic ductal adenocarcinoma recruits regulatory T cells to avoid immune detection. J Am Coll Surg. 2008, 206: 849-54. 10.1016/j.jamcollsurg.2007.12.014. discussion 54-6View ArticlePubMedGoogle Scholar
- Travers MT, Gow IF, Barber MC, et al: Indoleamine 2,3-dioxygenase activity and L-tryptophan transport in human breast cancer cells. Biochim Biophys Acta. 2004, 1661: 106-12. 10.1016/j.bbamem.2003.12.004.View ArticlePubMedGoogle Scholar
- Mansfield AS, Heikkila PS, Vaara AT, et al: Simultaneous Foxp3 and IDO expression is associated with sentinel lymph node metastases in breast cancer. BMC Cancer. 2009, 15: 231-View ArticleGoogle Scholar
- Sharma MD, Baban B, Chandler P, et al: Plasmacytoid dendritic cells from mouse tumor-draining lymph nodes directly activate mature Tregs via indoleamine 2,3-dioxygenase. J Clin Invest. 2007, 117: 2570-82. 10.1172/JCI31911.PubMed CentralView ArticlePubMedGoogle Scholar
- Munn DH, Sharma MD, Hou D, et al: Expression of indoleamine 2,3-dioxygenase by plasmacytoid dendritic cells in tumor-draining lymph nodes. J Clin Invest. 2004, 114: 280-90.PubMed CentralView ArticlePubMedGoogle Scholar
- Liu JT, Yue J, Ren XB, et al: [Measurement of CD4+CD25+ T cells in breast cancer patients and its significance]. Zhonghua Zhong Liu Za Zhi. 2005, 27: 423-5.PubMedGoogle Scholar
- Larmonier N, Marron M, Zeng Y, et al: Tumor-derived CD4(+)CD25(+) regulatory T cell suppression of dendritic cell function involves TGF-beta and IL-10. Cancer Immunol Immunother. 2007, 56: 48-59.View ArticlePubMedGoogle Scholar
- Puccetti P, Grohmann U: IDO and regulatory T cells: a role for reverse signalling and non-canonical NF-kappaB activation. Nat Rev Immunol. 2007, 7: 817-23. 10.1038/nri2163.View ArticlePubMedGoogle Scholar
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