Max Kallenbach (Essen), Ekaterina Pylaeva (Essen), Irem Özel (Essen), Anthony Squire (Essen), Cornelius Kürten (Essen), Stephan Lang (Essen), Jadwiga Jablonska (Essen)
Introduction Cancer immunology often overlooks lymph nodes (LNs), focusing mainly on tumor sites. Our previous research demonstrated that neutrophils in tumor-draining LNs of head and neck cancer (HNC) patients enhance survival by promoting B cell activation. We aim to explore the underlying mechanisms of this interaction.
Materials and Methods We analyzed FFPE samples from 43 HNC patients' tumor-draining LNs, assessing LN morphology with a focus on follicles and germinal centers (GC). Immunohistochemistry targeted B cell activation markers (BLIMP1, IgG3) and neutrophil chemokines (BAFF, APRIL) involved in B cell activation. LN cytokines were analyzed with a multiplex array, and mechanisms are studied in vitro by flow cytometry.
Results Reduced GC formation in metastatic LNs correlated with poor prognosis, suggesting that enhanced B cell activation may improve survival. N0 LNs showed higher B cell-stimulating potential, with increased cytokine expression compared to advanced-stage LNs. A gradient of B cell activation was observed, with the highest BLIMP1 expression in the sinuses and medulla. Spatial analysis revealed neutrophils did not directly influence BLIMP1 in B cells, and BLIMP1 levels were not linked to prognosis, yet HNC-derived factors suppressed BAFF expression in neutrophils, limiting B cell activation.
Discussion In early-stage LNs, elevated cytokines and GC presence are in line with the tertiary lymphatic structures positive HNC prognostic impact. While BLIMP1 expression in B cells did not correlate with immune responses, further investigation into BAFF, APRIL, and IgG3 may clarify the mechanisms of neutrophil-mediated B cell activation in tumor-draining LNs. These findings could guide new therapeutic strategies targeting this immune pathway in HNC.
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