32 These observations suggest that the proinflammatory responses

32 These observations suggest that the proinflammatory responses in peritumoral stroma may not represent the host reaction to the malignancy, but that they instead constitute effects that are rerouted in a tumor-promoting direction to induce Everolimus tissue remodeling and angiogenesis. This notion is supported by our recent investigations in which we found that the frequency of tissue Th17 cells was positively correlated with microvessel density in tumors, and high numbers of monocytes in peritumoral stroma were selectively

associated with vascular invasion and poor prognosis in HCC patients.10, 21 Consistent with our observations, recent studies have shown that IL-17 could recruit neutrophils, which in turn stimulate angiogenesis and tissue remodeling.33–34 Despite recent advances in understanding the differentiation of Th17 cells in humans,15–19 little is known about the mechanisms underlying the regulation

of Th17 cells in tumors. The present investigation provides evidence that proinflammatory cytokines released by tumor-activated monocytes/Mψ play a dominant role in the development of Th17 cells in HCCs, as indicated by the results of four sets of experiments. First, we observed that the level of Th17 cells was about 4 times higher in peritumoral stroma than in cancer nests, and there were significant correlations between the densities of Th17 and HLA-DRhighCD68+ cells in INCB018424 ic50 peritumoral stroma, which was not the case in cancer nests, where most of the CD68+ cells were negative for HLA-DR. Second, tumor-activated monocytes were significantly superior to the suppressive TAMs in inducing expansion of Th17 cells exhibiting phenotypic features more similar to those of tumor-infiltrating Th17 cells (e.g., a remarkable proportion of Th17/Th1). Third, blocking a set of cytokines released

from tumor-activated monocytes clearly inhibited the generation of Th17 cells, and relatively low concentrations of the recombinant cytokines could mimic the stimulatory effect of TCM culturing in this regard. Fourth, inhibition of monocytes/Mψ inflammation medchemexpress in hepatoma-bearing mice markedly reduced the number of tumor Th17 cells and tumor growth. Therefore, activation of monocytes in tumors may represent a novel route to promote Th17 expansion in human cancer. This concept is supported by studies showing that activated APCs are involved in the differentiation and expansion of Th17 cells and thereby also in Th17-mediated chronic inflammation.16, 35, 36 It should be noted that, in addition to the local expansion of Th17 cells, migration from blood is also a potential source for the increased Th17 cells in tumors. In this context, we have recently found that CCR6 is expressed in the majority of Th17 cells and that CCL20, the ligand for CCR6, is significantly increased in HCCs.21 In one of our latest studies21 we observed that most of the Th17 isolated from HCCs exhibited a CD45RO+CD62L−CCR7− effector memory phenotype.

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