Anti-CD40L therapy prevents the formation of precursor lesions to gastric B-cell MALT lymphoma in a mouse model

J Pathol. 2023 Apr;259(4):402-414. doi: 10.1002/path.6053. Epub 2023 Feb 17.

Abstract

Mucosa-associated lymphoid tissue (MALT) lymphoma is a B-cell tumour that develops over many decades in the stomachs of individuals with chronic Helicobacter pylori infection. We developed a new mouse model of human gastric MALT lymphoma in which mice with a myeloid-specific deletion of the innate immune molecule, Nlrc5, develop precursor B-cell lesions to MALT lymphoma at only 3 months post-Helicobacter infection versus 9-24 months in existing models. The gastric B-cell lesions in the Nlrc5 knockout mice had the histopathological features of the human disease, notably lymphoepithelial-like lesions, centrocyte-like cells, and were infiltrated by dendritic cells (DCs), macrophages, and T-cells (CD4+ , CD8+ and Foxp3+ ). Mouse and human gastric tissues contained immune cells expressing immune checkpoint receptor programmed death 1 (PD-1) and its ligand PD-L1, indicating an immunosuppressive tissue microenvironment. We next determined whether CD40L, overexpressed in a range of B-cell malignancies, may be a potential drug target for the treatment of gastric MALT lymphoma. Importantly, we showed that the administration of anti-CD40L antibody either coincident with or after establishment of Helicobacter infection prevented gastric B-cell lesions in mice, when compared with the control antibody treatment. Mice administered the CD40L antibody also had significantly reduced numbers of gastric DCs, CD8+ and Foxp3+ T-cells, as well as decreased gastric expression of B-cell lymphoma genes. These findings validate the potential of CD40L as a therapeutic target in the treatment of human gastric B-cell MALT lymphoma. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Keywords: APRIL; B-cell; BAFF; CD40 ligand; Helicobacter; MALT lymphoma; NLRC5; PD-L1; multiplex immunohistochemistry.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • B-Lymphocytes
  • CD40 Ligand
  • Forkhead Transcription Factors / metabolism
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / drug therapy
  • Helicobacter pylori* / genetics
  • Intracellular Signaling Peptides and Proteins / metabolism
  • Lymphoma, B-Cell, Marginal Zone* / drug therapy
  • Lymphoma, B-Cell, Marginal Zone* / genetics
  • Lymphoma, B-Cell, Marginal Zone* / prevention & control
  • Mice
  • Stomach Neoplasms* / pathology
  • Tumor Microenvironment

Substances

  • CD40 Ligand
  • Forkhead Transcription Factors
  • Intracellular Signaling Peptides and Proteins
  • NLRC5 protein, human
  • NLRC5 protein, mouse

Supplementary concepts

  • Familial primary gastric lymphoma