Journal
IMMUNITY INFLAMMATION AND DISEASE
Volume 10, Issue 9, Pages -Publisher
WILEY
DOI: 10.1002/iid3.690
Keywords
indoleamine 2,3-dioxygenase; nasopharyngeal carcinoma; peripheral blood; progression; survival
Categories
Funding
- Ministry of Higher Education and Scientific Research
- Ministry of Health of the Republic of Tunisia
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This study found that IDO1 mRNA expression was significantly upregulated and IDO2 mRNA expression was significantly downregulated in peripheral blood of NPC patients. Additionally, plasma Kyn levels and Kyn/Trp ratio were significantly higher in patients compared to controls. The plasma Kyn/Trp ratio at diagnosis was associated with cancer stage and predicted survival outcome.
Introduction: Indoleamine 2,3-dioxygenase (IDO) is an immunosuppressive tryptophan-depleting enzyme expressed in nasopharyngeal carcinoma (NPC) tissue. However, IDO has not been reported in the peripheral blood of NPC patients. The aim of this study was to analyze, IDO1 and IDO2 messenger RNA (mRNA) expression, the kynurenine (Kyn) and tryptophan (Trp) plasma levels, their clinical values and their relationship with cytokine levels in NPC. Methods: We evaluated IDO1 and IDO2 mRNA expression in peripheral blood mononuclear cells (PBMC) by quantitative real-time PCR, plasma Trp and Kyn levels by HPLC, and cytokine levels by ELISA in 75 NPC patients and 51 healthy controls. Results: Compared to controls, IDO1 mRNA expression was significantly upregulated and IDO2 mRNA expression was significantly downregulated in PBMC of patients. Also compared to controls, plasma Kyn levels and Kyn/Trp ratio were significantly higher in patients. At the time of diagnosis, the plasma Kyn/Trp ratio was associated with advanced cancer status and was an independent prognostic factor for worse disease-specific survival. According to cancer stages, IDO1 mRNA expression was positively correlated with plasma Kyn/Trp ratio in patients with earlier stages (I-II-III) but negatively correlated in patients with the late-stage cancer (IV). Tumor necrosis factor-alpha, interleukin (IL)-6 and IL-10 levels were significantly higher in patients compared to controls. Moreover, and despite treatment, patients simultaneously carrying high plasma Kyn/Trp ratio and high plasma IL-6 and IL-10 levels at diagnosis died approximately 1 year after first diagnosis. Conclusion: Measuring blood IDO mRNA expression and Kyn/Trp ratio at diagnosis could be a potential marker to evaluate NPC progression and predict survival outcome.
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