Targeting of Cdc42 GTPase in regulatory T cells unleashes antitumor T-cell immunity

Background: Cancer Immunotherapy has taken center stage in Cancer treatment. However, the current immunotherapies only benefit a small proportion of patients with Cancer, necessitating better understanding of the mechanisms of tumor immune evasion and improved Cancer Immunotherapy strategies. Regulatory T (Treg) cells play an important role in maintaining immune tolerance through inhibiting effector T-cell function. In the tumor microenvironment, Treg cells are used by tumor cells to counteract effector T cell-mediated tumor suppression. Targeting Treg cells may thus unleash the antitumor activity of effector T cells. While systemic depletion of Treg cells can cause excessive effector T-cell responses and subsequent autoimmune diseases, controlled targeting of Treg cells may benefit patients with Cancer.

Methods: Treg cells from Treg cell-specific heterozygous Cdc42 knockout mice, C57BL/6 mice treated with a Cdc42 inhibitor CASIN, and control mice were examined for their homeostasis and stability by flow cytometry. The autoimmune responses in Treg cell-specific heterozygous Cdc42 knockout mice, CASIN-treated C57BL/6 mice, and control mice were assessed by H&E staining and ELISA. Antitumor T-cell immunity in Treg cell-specific heterozygous Cdc42 knockout mice, CASIN-treated C57BL/6 mice, humanized NSGS mice, and control mice was assessed by challenging the mice with MC38 mouse colon Cancer cells, KPC mouse pancreatic Cancer cells, or HCT116 human colon Cancer cells.

Results: Treg cell-specific heterozygous deletion or pharmacological targeting of Cdc42 with CASIN does not affect Treg cell numbers but induces Treg cell instability, leading to antitumor T-cell immunity without detectable autoimmune reactions. Cdc42 targeting causes an additive effect on immune checkpoint inhibitor anti-programmed cell death protein-1 antibody-induced T-cell response against mouse and human tumors. Mechanistically, Cdc42 targeting induces Treg cell instability and unleashes antitumor T-cell immunity through Carbonic Anhydrase I-mediated pH changes.

Conclusions: Rational targeting of Cdc42 in Treg cells holds therapeutic promises in Cancer Immunotherapy.

T-Lymphocytes; adaptive immunity; immunotherapy; lymphocytes, tumor-infiltrating.