Monocytic myeloid-derived suppressor cells as a potent suppressor of tumor immunity in non-small cell lung cancer.

Immunotherapy is a promising therapeutic option for patients with non-small cell lung cancer (NSCLC) who do not qualify for surgery. In patients with advanced NSCLC, systemic immune suppression is frequently observed, therefore, researchers are investigating the tumor microenvironment for less invasive and more effective methods of treating lung cancer. Monocytic myeloid-derived suppressor cells (Mo-MDSCs) are potent suppressors of tumor immunity; therefore, this population may significantly impede the application of immunotherapy to treat cancer. The present study evaluated the distribution of Mo-MDSCs and monocytes/macrophages in the peripheral blood, lymph nodes and tumor tissue of patients with NSCLC. Furthermore, the profiles of cytokines produced by these cell populations, including interleukin (IL)-1 beta, IL-12/23p40, IL-10, transforming growth factor-beta (TGF-beta) and tumor necrosis factor (TNF), were compared. The cell populations and the expression of cytokines were assessed by flow cytometry after 4 h in culture with mitogens and Brefeldin A. Mo-MDSCs were more numerous than monocytes/macrophages in all tissues and their prevalence was highest in the peripheral blood; they expressed higher levels of TGF-beta than monocytes/macrophages in all tissues and expression of TGF-beta produced by Mo-MDSCs was higher in the blood than in lymph nodes and tumor tissues. A higher percentage of monocytes/macrophages was observed in lymph nodes and tumor tissues than in blood. CD14(+)HLA-DR+ cells also produced more IL-10 in lymph nodes than Mo-MDSCs and more IL-1 beta and TNF in all tissues. A higher prevalence of cluster of differentiation 14(+) human leukocyte antigen-D related(+) cells secreting IL-1 beta, TNF and IL-12/23p40 was observed in peripheral blood. Thus, the results of the current study support the statement that Mo-MDSCs and monocytes/macrophages participate in NSCLC induced immunosuppression, and is consistent with previous research into associations between the TGF-beta signaling pathway and tumor cell invasion, motility and metastasis. The study also demonstrated that Mo-MDSCs promote tumor growth through their immunosuppressive activity. In addition, the profile of cytokines expressed by monocytes/macrophages suggests that this cell population may be associated with metastasis formation and angiogenesis promotion in patients with NSCLC.