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      Cytotoxic T-cells mediate exercise-induced reductions in tumor growth

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          Abstract

          Exercise has a wide range of systemic effects. In animal models, repeated exertion reduces malignant tumor progression, and clinically, exercise can improve outcome for cancer patients. The etiology of the effects of exercise on tumor progression are unclear, as are the cellular actors involved. We show here that in mice, exercise-induced reduction in tumor growth is dependent on CD8+ T cells, and that metabolites produced in skeletal muscle and excreted into plasma at high levels during exertion in both mice and humans enhance the effector profile of CD8+ T-cells. We found that activated murine CD8+ T cells alter their central carbon metabolism in response to exertion in vivo, and that immune cells from trained mice are more potent antitumor effector cells when transferred into tumor-bearing untrained animals. These data demonstrate that CD8+ T cells are metabolically altered by exercise in a manner that acts to improve their antitumoral efficacy.

          eLife digest

          Exercise affects almost all tissues in the body, and scientists have found that being physically active can reduce the risk of several types of cancer as well as improving outcomes for cancer patients. However, it is still unknown how exercise exerts its protective effects. One of the hallmarks of cancer is the ability of cancer cells to evade detection by the immune system, which can in some cases stop the body from eliminating tumor cells.

          Rundqvist et al. used mice to investigate how exercise helps the immune system act against tumor progression. They found that when mice exercised, tumor growth was reduced, and this decrease in growth depended on the levels of a specific type of immune cell, the CD8+ T cell, circulating in the blood. Additionally, Rundqvist et al. found that CD8+ T cells were made more effective by molecules that muscles released into the blood during exercise. Isolating immune cells after intense exercise showed that these super-effective CD8+ T cells alter how they use molecules for energy production after exertion. Next, immune cells from mice that had exercised frequently were transferred into mice that had not exercised, where they were more effective against tumor cells than the immune cells from untrained mice.

          These results demonstrate that CD8+ T cells are altered by exercise to improve their effectiveness against tumors. The ability of T cells to identify and eliminate cancer cells is essential to avoid tumor growth, and is one of the foundations of current immune therapy treatments. Exercise could improve the outcome of these treatments by increasing the activation of the immune system, making tumor-fighting cells more effective.

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          Most cited references56

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          A guide to immunometabolism for immunologists.

          In recent years a substantial number of findings have been made in the area of immunometabolism, by which we mean the changes in intracellular metabolic pathways in immune cells that alter their function. Here, we provide a brief refresher course on six of the major metabolic pathways involved (specifically, glycolysis, the tricarboxylic acid (TCA) cycle, the pentose phosphate pathway, fatty acid oxidation, fatty acid synthesis and amino acid metabolism), giving specific examples of how precise changes in the metabolites of these pathways shape the immune cell response. What is emerging is a complex interplay between metabolic reprogramming and immunity, which is providing an extra dimension to our understanding of the immune system in health and disease.
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            Cancer immunoediting: from immunosurveillance to tumor escape.

            The concept that the immune system can recognize and destroy nascent transformed cells was originally embodied in the cancer immunosurveillance hypothesis of Burnet and Thomas. This hypothesis was abandoned shortly afterwards because of the absence of strong experimental evidence supporting the concept. New data, however, clearly show the existence of cancer immunosurveillance and also indicate that it may function as a component of a more general process of cancer immunoediting. This process is responsible for both eliminating tumors and sculpting the immunogenic phenotypes of tumors that eventually form in immunocompetent hosts. In this review, we will summarize the historical and experimental basis of cancer immunoediting and discuss its dual roles in promoting host protection against cancer and facilitating tumor escape from immune destruction.
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              LDHA-Associated Lactic Acid Production Blunts Tumor Immunosurveillance by T and NK Cells.

              Elevated lactate dehydrogenase A (LDHA) expression is associated with poor outcome in tumor patients. Here we show that LDHA-associated lactic acid accumulation in melanomas inhibits tumor surveillance by T and NK cells. In immunocompetent C57BL/6 mice, tumors with reduced lactic acid production (Ldha(low)) developed significantly slower than control tumors and showed increased infiltration with IFN-γ-producing T and NK cells. However, in Rag2(-/-)γc(-/-) mice, lacking lymphocytes and NK cells, and in Ifng(-/-) mice, Ldha(low) and control cells formed tumors at similar rates. Pathophysiological concentrations of lactic acid prevented upregulation of nuclear factor of activated T cells (NFAT) in T and NK cells, resulting in diminished IFN-γ production. Database analyses revealed negative correlations between LDHA expression and T cell activation markers in human melanoma patients. Our results demonstrate that lactic acid is a potent inhibitor of function and survival of T and NK cells leading to tumor immune escape.
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                Author and article information

                Contributors
                Role: Reviewing Editor
                Role: Senior Editor
                Journal
                eLife
                Elife
                eLife
                eLife
                eLife Sciences Publications, Ltd
                2050-084X
                23 October 2020
                2020
                : 9
                : e59996
                Affiliations
                [1 ]Department of Cell and Molecular Biology, Karolinska Institutet StockholmSweden
                [2 ]Department of Laboratory Medicine, Karolinska Institutet StockholmSweden
                [3 ]Department of Surgery, Oncology, and Gastroenterology, University of Padova PaduaItaly
                [4 ]The Francis Crick Institute LondonUnited Kingdom
                [5 ]Department of Physiology, Development, and Neuroscience, University of Cambridge CambridgeUnited Kingdom
                [6 ]Department of Physiology and Pharmacology, Karolinska Institutet StockholmSweden
                [7 ]Department of Oncology-Pathology, Karolinska Institutet StockholmSweden
                Tsinghua University China
                Institute of Industrial Science, The University of Tokyo Japan
                Tsinghua University China
                Author information
                https://orcid.org/0000-0002-5617-9076
                http://orcid.org/0000-0002-0557-8544
                https://orcid.org/0000-0001-9932-2664
                http://orcid.org/0000-0002-6718-5797
                http://orcid.org/0000-0003-0151-2780
                http://orcid.org/0000-0003-1632-0394
                http://orcid.org/0000-0002-2452-4277
                https://orcid.org/0000-0002-4084-6639
                Article
                59996
                10.7554/eLife.59996
                7584454
                33095157
                c4cd9447-df93-4769-ad3e-ed2e20d78168
                © 2020, Rundqvist et al

                This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited.

                History
                : 14 June 2020
                : 29 September 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004063, Knut och Alice Wallenbergs Stiftelse;
                Award ID: Wallenberg Scholar
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004359, Vetenskapsrådet;
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100002794, Cancerfonden;
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100006313, Barncancerfonden;
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100007687, Svenska Läkaresällskapet;
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000289, Cancer Research UK;
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: Principal Research Fellowship 214283/Z/18/Z
                Award Recipient :
                The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
                Categories
                Research Article
                Cancer Biology
                Immunology and Inflammation
                Custom metadata
                Exercise can induce metabolic changes that strikingly impact cytotoxic T cell function and in turn affect cancer progression.

                Life sciences
                exercise,metabolism,immunotherapy,human,mouse
                Life sciences
                exercise, metabolism, immunotherapy, human, mouse

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