Lewinsky et al. showed that CD84 (which is self-associative and upregulated in chronic lymphocytic leukemia (CLL) and the TME) mediated the upregulation of PD-L1 on CLL and other cells within the TME via a cellular pathway (distinct from IFNγ-induced activation) involving Akt/mTOR, S6, and STAT3. Activation of CD84 on T cells directly contributed to upregulation of exhaustion markers and decreased the functionality of T cells. Blocking CD84 reduced expression of PD-L1 on CLL cells and resulted in increased lysis of CLL by patient-derived T cells.
Chronic lymphocytic leukemia (CLL) is characterized by clonal proliferation and progressive accumulation of mature, B lymphocytes in the peripheral blood, lymphoid tissues and bone marrow. CLL is characterized by profound immune defects, leading to severe infectious complications. T cells are numerically, phenotypically, and functionally highly abnormal in CLL, with only limited ability to exert antitumor immune responses. Exhaustion of T cells has also been implicated as playing an important role in anti-tumor responses. The CLL-mediated T cell exhaustion is achieved by aberrant expression of several inhibitory molecules on CLL and their environment, prominently the PD-L1/PD-1 receptors. Previously, we showed that CD84, a member of the SLAM family of receptors, bridges between CLL cells and their microenvironment. In the current study, we followed CD84 regulation of T cell function. We showed that a cell-cell interaction mediated through human and mouse CD84 upregulates PDL1 expression on CLL and their microenvironment, and PD1 expression on T cells. This resulted in suppression of T cell response and activity in vitro and in vivo. Thus, our results demonstrated a role for CD84 in regulation of immune checkpoints by leukemia cells, and suggested CD84 blockade as a therapeutic strategy to reverse tumor-induced immune suppression.