T cell immunity in interstitial lung disease with non-small cell lung cancer patients

Objectives: Limited treatment options are available for non-small cell lung cancer (NSCLC) patients with inter-stitial lung disease (ILD). The rationale for immunotherapy and its adverse events for NSCLC with ILD remains unclear. In this study, we examined T cell profiles and functions in the lung tissues of NSCLC patients with or without ILD to provide evidence for the potential mechanism of immune checkpoint inhibitor (ICI)-related pneumonitis in NSCLC patients with ILD.Material and Methods: We investigated T cell immunity in the lung tissues of NSCLC patients with ILD to support the application of immunotherapy for these patients. We analyzed T cell profiles and functions in surgically resected lung tissues from NSCLC patients with and without ILD. The T cell profiles of infiltrating cells in lung tissues were analyzed by flow cytometry. T cell functions were measured based on cytokine production by T cells stimulated with phorbol 12-myristate 13-acetate and ionomycin.Results: The percentages of CD4+ T cells expressing immune checkpoint molecules (Tim-3, ICOS, and 4-1BB), CD103+CD8+ T cells, and regulatory T (Treg) cells were higher in NSCLC patients with than in those without ILD. A functional analysis of T cells in lung tissues indicated that CD103+CD8+ T cells positively correlated with IFN & gamma; production, whereas Treg cells negatively correlated with IFN & gamma; and TNF & alpha; production. Cytokine production by CD4+ and CD8+ T cells did not significantly differ between NSCLC patients with and without ILD, except for TNF & alpha; production by CD4+ T cells being lower in the former than in the latter.Conclusion: In NSCLC patients with ILD stable for surgery, T cells were active participants and balanced in part by Treg cells in lung tissues, suggesting the potential development of ICI-related pneumonitis in NSCLC patients with ILD.

Automated summary

This study aimed to investigate the rationale and adverse events of immunotherapy in NSCLC patients with ILD. T cell profiles and functions in the lung tissues of NSCLC patients were analyzed to provide evidence for the potential mechanism of ICI-related pneumonitis in NSCLC patients with ILD.