Wang, Zheyi, Zhao, Yue, Wo, Yang, Peng, Yizhou, Hu, Weilei, Wu, Zhigang, Liu, Pengcheng, Shang, Yan, Liu, Chunnan, Chen, Xiao, Huang, Kan, Chen, Yuting, Hong, Hui, Li, Fei, and Sun, Yihua
Neoadjuvant immunotherapy represents promising strategy in the treatment of esophageal squamous cell carcinoma (ESCC). However, the mechanisms underlying its impact on treatment sensitivity or resistance remain a subject of controversy. In this study, we conducted single-cell RNA and T/B cell receptor (scTCR/scBCR) sequencing of CD45+ immune cells on samples from 10 patients who received neoadjuvant immunotherapy and chemotherapy. We also validated our findings using multiplexed immunofluorescence and analyzed bulk RNA-seq from other cohorts in public database. By integrating analysis of 87357 CD45+ cells, we found GZMK + effector memory T cells (Tem) were relatively enriched and CXCL13+ exhausted T cells (Tex) and regulator T cells (Treg) decreased among responders, indicating a persistent anti-tumor memory process. Additionally, the enhanced presence of BCR expansion and somatic hypermutation process within TNFRSF13B + memory B cells (Bmem) suggested their roles in antigen presentation. This was further corroborated by the evidence of the T-B co-stimulation pattern and CXCL13-CXCR5 axis. The complexity of myeloid cell heterogeneity was also particularly pronounced. The elevated expression of S100A7 in ESCC, as detected by bulk RNA-seq, was associated with an exhausted and immunosuppressive tumor microenvironment. In summary, this study has unveiled a potential regulatory network among immune cells and the clonal dynamics of their functions, and the mechanisms of exhaustion and memory conversion between GZMK + Tem and TNFRSF13B + Bmem from antigen presentation and co-stimulation perspectives during neoadjuvant PD-1 blockade treatment in ESCC. • By integrating analysis of 87357 CD45+ cells, we defined CD8+ CXCL13+ exhausted T cells (Tex) were enriched and clonal expanded in the non-responsive patients and CD4+ LAIR2+Treg were in activated states and highly plastic with various clonal sharing, which pointed out an exhausted and immunosuppressive environment in non-responsive patient following PD-1 blockade treatment. While, GZMK + effector memory T cells (Tem) were relatively enriched in responders, which suggested a memory lasting anti-tumor process with the stem-like ab + and FCRL4+ memory B (Bmem) with more differentiated states and the BCR expansion phenomenon were observed in responders. The class-switch recombination (CSR) and somatic hypermutation (SHM) process were also enriched in TNFRSF13B + Bmem implying its mature state as antigen-presenting (APC) roles. Furthermore, T-B crosstalk process via CD28 − CD86 co-stimulation pattern and CXCL13-CXCR5 chemokines axis was validated using cellphoneDB algorithm and multiplex immunofluorescence (mIF) method. We also extracted a TNFRSF13B signature to predict response and OS benefits to immune checkpoint blockade in different cohorts to underscore their clinical relevance. • And the heterogeneity of myeloid cells was quite complex. According to pan-cancer results, we also validated FOLR2+ tissue-resident macrophage in our cohort showed a correlation with increment of Tem clusters, suggesting its APC roles. On the contrary, CCL3L1+ Neutrophils tended to a pro-tumoral phenotype with immunosuppressive and neutrophil extracellular traps (NETs) features. • While the elevated S100A7 in our ESCC cohort revealed by bulk RNA-seq relating to an exhaustion and immunosuppressive TME in upstream pathway may explain the inherent ICB resistance mechanism. [ABSTRACT FROM AUTHOR]