Abstract. Malignant mesothelioma (MM) is a highly fatal tumor arising from inner body membranes, whose extensive growth is facilitated by its week immunogenicity and by its ability to blunt the immune response which should arise from the huge mass of leukocytes typically infiltrating this tumor. It has been reported that the inflammatory infiltrate found in MM tissues is characterized by a high prevalence of macrophages. Thus, in this work we evaluated the ability of human MM cells to modulate the inflammatory phenotype of human THP-1 monocytes and macrophages, a widely used in vitro model of monocyte/macrophage differentiation. Furthermore, we tested the hypothesis that the exposure to MM cells could alter the differentiation of THP-1 monocytes favoring the development of alternatively activated, tumor-supporting macrophages. Our data prove for the first time that MM cells can polarize monocytes towards an altered inflammatory phenotype and macrophages towards an immunosuppressive phenotype. Moreover, we demonstrate that monocytes cocultivated with MM cells 'keep a memory' of their encounter with the tumor which influences their differentiation to macrophages. On the whole, we provide evidence that MM cells exert distinct, cell-specific effects on monocytes and macrophages. The thorough characterization of such effects may be of a crucial importance for the rational design of new immunotherapeutic protocols.
IntroductionMalignant mesothelioma (MM) is a rare tumor which originates from the mesothelial cell linings of the pleura and, less frequently, peritoneum and pericardium (1,2). Although it has a low metastatic efficiency, MM is highly invasive to surrounding tissues and its extensive growth leads to the failure of the organs underlying the serosal membranes (1,2). The median survival from diagnosis of MM is less than two years (2,3). Indeed, this aggressive tumor is seldom amenable to surgical intervention and poorly responsive to radiotherapy and chemotherapy (2,3). MM is also regarded as a weakly immunogenic tumor, whose ability to escape immune recognition relies on multiple mechanisms (4). Nonetheless, MM tissues are characterized by the presence of massive leukocyte infiltrates, mainly composed of macrophages (Mº), natural killer cells and both CD4 + and CD8 + lymphocytes (4).During recent years, substantial evidence has indicated that under the pressure of tumor microenvironmental factors including growth factors, cytokines and prostaglandins, tumorinfiltrating leukocytes can undergo a dramatic shift in their activities, aborting immunosurveillance and starting to actively support tumor growth, angiogenesis and tissue remodeling (5,6). Tumor-associated Mº (TAMs) appear to play a major role in this regard (7,8). It is well established that Mº can act as both positive or negative regulators of the immune system so that, depending on their pro-or anti-inflammatory functional program, mature Mº are classified as M1, or 'classically activated', or as M2, or 'alternatively activated'. M1 Mº are powerful imm...