Biology subjects

Cristovao-Ferreira, S.

Publications and source records attributed to Cristovao-Ferreira, S..

3 recordsLinked to original sources

bioRxiv2026

CCR4+low-density neutrophils define a novel immunosuppressive subset associated with breast cancer progression and early mortality

Neutrophils are increasingly recognized as key players in cancer progression, yet their functional heterogeneity limits their therapeutic exploitation. In breast cancer (BC), elevated circulating and tumor-associated neutrophils have been associated with poor prognosis, and low-density neutrophils (LDN), particularly, have been linked to immunosuppression. However, the specific neutrophil subsets driving these effects remain undefined. Here, we identify a previously unrecognized CCR4-expressing neutrophil subset, strongly enriched among LDN, whose frequency rises with disease stage and correlates with faster progression and shorter survival. Serial blood sampling further showed that CCR4+LDN levels fluctuate in line with clinical course, with increases indicating near-term risk in metastatic patients. Our findings also reveal that this subset has an immunosuppressive signature more pronounced than that of the remaining LDN, migrates preferentially toward tumor-derived chemokines, and dampens T cell-driven tumor killing even when PD-1 is blocked. Additionally, in a pilot cohort of Triple-Negative BC patients on anti-PD-1 therapy, early changes in this population were associated with treatment outcome. Together, these results reveal a distinct neutrophil population that actively contributes to immune escape and tumor progression, establishing CCR4+LDN as a minimally invasive real-time biomarker of disease course and treatment response, and as a promising target for neutrophil-directed therapies in BC.

immunology↗

bioRxiv2025

Neutrophils matter: New clinical insights on their role in the progression of metastatic breast cancer

BackgroundMetastatic breast cancer (BC) remains a significant clinical challenge, needing innovative strategies to improve disease management and extend patient survival. Increased neutrophil levels have been observed in both peripheral blood and tumor tissues of patients with different types of cancer, often being associated with poor clinical outcomes. These findings suggest a crucial role for neutrophils in tumor progression, raising interest in neutrophil-based therapies. However, the functional and phenotypic heterogeneity of neutrophils complicates their therapeutic targeting. This study aims to investigate the clinical impact of immunosuppressive, protumor low-density neutrophils (LDN) in metastatic BC, comparing them with normal high-density neutrophils (HDN) to better understand their role in disease progression. MethodsLDN and HDN subpopulations were isolated from the blood of 151 BC patients (72 metastatic, 79 non-metastatic) using density gradient centrifugation. Their frequency, phenotype, and function were analyzed by flow cytometry and in vitro experiments. Correlations between LDN levels and clinical data from metastatic BC patients were evaluated, alongside individual longitudinal assessments. ResultsLDN accumulated significantly in the blood of BC patients, particularly in those with metastatic disease. Elevated LDN levels in these patients were associated with faster disease progression and reduced life expectancy, regardless of metastatic site. Longitudinal analysis revealed that higher LDN percentages often correlated with adverse clinical events, whereas lower levels of LDN were linked to stable disease. Functionally, LDN exhibited protumor properties, including elevated expressions of PD-L1 and MMP-9, contributing to immunosuppression and metastasis. Unlike HDN, which demonstrated cytotoxicity against tumor cells, LDN failed to reduce BC cell line viability in 3D co-cultures. Notably, BC cell lines exposed to LDN-conditioned medium showed increased invasive capacity and proliferation, while T cells cultured in the same medium displayed impaired activation, likely due to the effect of arginase. ConclusionOur results highlighted LDN and their secreted factors as major drivers of BC progression and increased aggressiveness. These findings suggest that incorporating LDN assessment into clinical practice could aid in identifying high-risk patients and enable more personalized treatment approaches. Furthermore, our data strengthen the relevance of targeting specific neutrophil subsets or their functions to improve metastatic BC management and patient outcomes.

immunology↗

bioRxiv2024

Enhancing HLA-DR in Cytotoxic T Lymphocytes is crucial for the development of efficient adoptive T cell Therapies for Breast Cancer

BackgroundDespite advances in breast cancer (BC) therapies, more effective interventions are needed, especially for chemotherapy-resistant tumors. Immune checkpoint inhibitors show promise for triple-negative breast cancer, but their effectiveness across all BC subtypes remains challenging. Therefore, novel strategies, including adoptive cellular therapy, employing patients own T lymphocytes expanded ex vivo, are under investigation. Previously, we demonstrated that cytotoxic T lymphocytes (CTLs) expressing high HLA-DR levels in the tumor microenvironment are associated with a good response to neoadjuvant chemotherapy (NACT), due to their pronounced anti-tumor properties compared to CTLs with low or no HLA-DR expression. In this paper, we demonstrated that HLA-DR expression in CTLs is crucial for efficient T lymphocytes-based therapies. MethodsTo clarify the role of HLA-DR in CTLs anti-tumor abilities, we performed in vitro and in vivo experiments. We also improved a protocol to expand ex vivo HLA-DR-expressing CTLs and employed a 3D co-culture platform to test the potential of different immune agents, namely an anti-PD1, anti-OX40, anti-VEGF and anti-CD137, on CTLs cytotoxicity against BC cells. Additionally, we conducted a bioinformatic analysis of scRNA-seq data of BC patients to better understand the modulation of HLA-DR expression in CTLs. ResultsOur findings revealed that CTLs require HLA-DR expression to eliminate tumor cells. Additionally, we unveiled that blocking HLA-DR or depleting CD4+ T cells compromised CTLs activation and cytotoxicity, suggesting antigen presentation by CTLs through HLA-DR, and CD4+ T cells, as probable mechanisms for CTLs increased anti-tumor immune response and treatment efficacy. We refined an ex vivo stimulation and cytokine supplementation protocol, observing that short-term stimulation increases HLA-DR expression while boosting CTLs functionality, unlike prolonged expansion. This result highlights the importance of prioritizing cell quality, over quantity, for therapy efficiency. Additionally, we verified that anti-PD-1 further increases HLA-DR levels in CTLs, enhancing their anti-tumor efficiency. Notably, an in silico analysis revealed that PD-1 in CTLs shares 34 co-expressed genes with HLA-DR, including several non-coding RNAs, suggesting a PD-1-mediated regulation of HLA-DR expression. ConclusionsGlobally, our findings underscore that heightening HLA-DR expression in CTLs, by combining anti-PD-1 with short-term stimulation, offers promise for improving T lymphocyte-based therapies for BC. Key MessageO_LIWhat is already known on this topic: While immunotherapy holds promise for breast cancer (BC), its success is still limited. Novel strategies are under investigation to improve outcomes across all BC subtypes. Previously we established a correlation between HLA-DR expression on CTLs and a positive response to neoadjuvant chemotherapy, likely due to enhanced anti-tumor properties of HLA-DR-expressing CTLs. However, the specific role of HLA-DR on CTLs and its implications for T lymphocyte-based therapies requires further investigation. C_LIO_LIWhat this study adds: This study revealed that HLA-DR expression is essential for CTLs to effectively eliminate tumor cells. Blocking HLA-DR or depleting CD4+ T cells impairs CTLs activation and cytotoxicity, indicating that HLA-DR-mediated antigen presentation and interaction with CD4+ T cell are crucial for CTLs function. The study also shows that combining ex vivo short-term stimulation and anti-PD-1 treatment increases HLA-DR levels in CTLs, enhancing their anti-tumor activity. C_LIO_LIHow this study might affect research, practice or policy: By emphasizing the importance of optimizing CTLs quality over quantity, this approach has the potential to improve the design of more efficient T lymphocyte-based therapies for BC. This could influence future research directions, clinical practices, and treatment policies, leading to improved therapeutic outcomes. C_LI

immunology↗