1. Academic Validation
  2. Adiponectin reduces immune checkpoint inhibitor-induced inflammation without blocking anti-tumor immunity

Adiponectin reduces immune checkpoint inhibitor-induced inflammation without blocking anti-tumor immunity

  • Cancer Cell. 2025 Feb 10;43(2):269-291.e19. doi: 10.1016/j.ccell.2025.01.004.
Lukas M Braun 1 Sophie Giesler 2 Geoffroy Andrieux 3 Roxane Riemer 2 Nana Talvard-Balland 2 Sandra Duquesne 2 Tamina Rückert 1 Susanne Unger 4 Stefanie Kreutmair 4 Melissa Zwick 1 Marie Follo 2 Alina Hartmann 2 Natascha Osswald 2 Wolfgang Melchinger 2 Stefanie Chapman 2 James A Hutchinson 5 Sebastian Haferkamp 6 Leopold Torster 7 Julian Kött 7 Christoffer Gebhardt 7 Dirk Hellwig 8 Nikolaos Karantzelis 2 Till Wallrabenstein 2 Theresa Lowinus 2 Mehtap Yücel 2 Niklas Brehm 2 Justyna Rawluk 2 Dietmar Pfeifer 2 Peter Bronsert 9 Manuel Rogg 9 Sven Mattern 10 Mathias Heikenwälder 11 Stefano Fusco 12 Nisar P Malek 12 Stephan Singer 13 Annette Schmitt-Graeff 14 Fatih Ceteci 15 Florian R Greten 15 Bruce R Blazar 16 Melanie Boerries 17 Natalie Köhler 18 Justus Duyster 19 Gabriele Ihorst 20 Silke Lassmann 9 Philip Keye 21 Susana Minguet 22 Dirk Schadendorf 23 Selma Ugurel 24 David Rafei-Shamsabadi 25 Robert Thimme 26 Peter Hasselblatt 26 Bertram Bengsch 27 Christoph Schell 9 Erika L Pearce 28 Frank Meiss 25 Burkhard Becher 4 Carolin Funke-Lorenz 24 Jan-Malte Placke 24 Petya Apostolova 29 Robert Zeiser 30
Affiliations

Affiliations

  • 1 Department of Internal Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Faculty of Biology, University of Freiburg, Freiburg, Germany.
  • 2 Department of Internal Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 3 Institute of Medical Bioinformatics and Systems Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 4 Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland.
  • 5 Department of Surgery, University Hospital Regensburg, Regensburg, Germany.
  • 6 Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.
  • 7 Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • 8 Department of Nuclear Medicine, University Hospital Regensburg, Regensburg, Germany.
  • 9 Institute of Surgical Pathology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 10 Institute of Pathology, University Hospital Tübingen, 72076 Tübingen, Germany.
  • 11 Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany; M3 Research Center, Eberhard Karls University Tübingen, Tübingen, Germany; Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Tübingen, Germany.
  • 12 Medizinische Klinik I, Uniklinik Tübingen, Tübingen, Germany.
  • 13 Institute of Pathology, University Hospital Tübingen, 72076 Tübingen, Germany; Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Tübingen, Germany.
  • 14 University of Freiburg, Freiburg, Germany.
  • 15 Institute for Tumor Biology and Experimental Therapy, Georg-Speyer-Haus, Frankfurt/Main, Germany.
  • 16 Department of Pediatrics, Division of Blood & Marrow Transplant & Cellular Therapy, University of Minnesota, Minneapolis, MN, United States.
  • 17 Institute of Medical Bioinformatics and Systems Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, a Partnership Between DKFZ and Medical Center - University of Freiburg, Freiburg im Breisgau, Germany.
  • 18 Department of Internal Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; CIBSS - Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany.
  • 19 Department of Internal Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, a Partnership Between DKFZ and Medical Center - University of Freiburg, Freiburg im Breisgau, Germany.
  • 20 Clinical Trials Unit, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 21 Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 22 Signalling Research Centres BIOSS and CIBSS, Freiburg. Germany. Department of Synthetic Immunology, Faculty of Biology and Centre for Chronic Immunodeficiency (CCI), Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 23 Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany, and German Cancer Consortium (DKTK), Partner Site Essen/Duesseldorf, Essen, Germany; National Center for Tumor Diseases (NCT)-West, Campus Essen, & Research Alliance Ruhr, Research Center One Health, University Duisburg-Essen, Essen, Germany.
  • 24 Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany, and German Cancer Consortium (DKTK), Partner Site Essen/Duesseldorf, Essen, Germany.
  • 25 Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 26 Department of Internal Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • 27 German Cancer Consortium (DKTK), Partner Site Freiburg, a Partnership Between DKFZ and Medical Center - University of Freiburg, Freiburg im Breisgau, Germany; Department of Internal Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Signalling Research Centres BIOSS and CIBSS - Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany.
  • 28 Department of Oncology, The Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
  • 29 Department of Internal Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, a Partnership Between DKFZ and Medical Center - University of Freiburg, Freiburg im Breisgau, Germany; Department of Oncology, The Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Biomedicine, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland; Division of Hematology, University Hospital Basel, Basel, Switzerland. Electronic address: petya.apostolova@unibas.ch.
  • 30 Department of Internal Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, a Partnership Between DKFZ and Medical Center - University of Freiburg, Freiburg im Breisgau, Germany; Signalling Research Centres BIOSS and CIBSS - Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany. Electronic address: robert.zeiser@uniklinik-freiburg.de.
Abstract

Immune-related adverse events (irAEs) in Cancer patients receiving Immune Checkpoint inhibitors (ICIs) cause morbidity and necessitate cessation of treatment. Comparing irAE treatments, we find that anti-tumor immunity is preserved in mice after extracorporeal photopheresis (ECP) but reduced with glucocorticosteroids, TNFα blockade, and α4β7-integrin inhibition. Local Adiponectin production elicits a tissue-specific effect by reducing pro-inflammatory T cell frequencies in the colon while sparing tumor-specific T cell development. A prospective phase-1b/2 trial (EudraCT-No.2021-002073-26) with 14 patients reveals low ECP-related toxicity. Overall response rate for all irAEs is 92% (95% confidence interval [CI]: 63.97%-99.81%); colitis-specific complete remission rate is 100% (95% CI: 63.06%-100%). Glucocorticosteroid dosages could be reduced for all patients after ECP therapy. The ECP-adiponectin axis reduces intestinal tissue-resident memory T cell activation and CD4+IFN-γ+ T cells in patients with ICI-induced colitis without evidence of loss of anti-tumor immunity. In conclusion, we identify Adiponectin as an immunomodulatory molecule that controls ICI-induced irAEs without blocking anti-tumor immunity.

Keywords

adiponectin; anti-tumor immunity; arginase-1; cancer immunotherapy; colitis; extracorporeal photopheresis; immune checkpoint inhibition; immune-related adverse events; immunomodulation; immunosuppression.

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