Phosphodiesterase-5 inhibition augments endogenous antitumor immunity by reducing myeloid-derived suppressor cell function

P Serafini, K Meckel, M Kelso, K Noonan… - The Journal of …, 2006 - rupress.org
P Serafini, K Meckel, M Kelso, K Noonan, J Califano, W Koch, L Dolcetti, V Bronte, I Borrello
The Journal of experimental medicine, 2006rupress.org
Phosphodiesterase-5 (PDE5) inhibitors (sildenafil, tadalafil, and vardenafil) are agents
currently in clinical use for nonmalignant conditions. We report the use of PDE5 inhibitors as
modulators of the antitumor immune response. In several mouse tumor models, PDE5
inhibition reverses tumor-induced immunosuppressive mechanisms and enables a
measurable antitumor immune response to be generated that substantially delays tumor
progression. In particular, sildenafil, down-regulates arginase 1 and nitric oxide synthase–2 …
Phosphodiesterase-5 (PDE5) inhibitors (sildenafil, tadalafil, and vardenafil) are agents currently in clinical use for nonmalignant conditions. We report the use of PDE5 inhibitors as modulators of the antitumor immune response. In several mouse tumor models, PDE5 inhibition reverses tumor-induced immunosuppressive mechanisms and enables a measurable antitumor immune response to be generated that substantially delays tumor progression. In particular, sildenafil, down-regulates arginase 1 and nitric oxide synthase–2 expression, thereby reducing the suppressive machinery of CD11b+/Gr-1+ myeloid-derived suppressor cells (MDSCs) recruited by growing tumors. By removing these tumor escape mechanisms, sildenafil enhances intratumoral T cell infiltration and activation, reduces tumor outgrowth, and improves the antitumor efficacy of adoptive T cell therapy. Sildenafil also restores in vitro T cell proliferation of peripheral blood mononuclear cells from multiple myeloma and head and neck cancer patients. In light of the recent data that enzymes mediating MDSC-dependent immunosuppression in mice are active also in humans, these findings demonstrate a potentially novel use of PDE5 inhibitors as adjuncts to tumor-specific immune therapy.
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