The PD-1/PD-L1 axis contributes to T-cell dysfunction in chronic lymphocytic leukemia

Davide Brusa, Sara Serra, Marta Coscia, Davide Rossi, Giovanni D'Arena, Luca Laurenti, Ozren Jaksic, Giorgio Fedele, Giorgio Inghirami, Gianluca Gaidano, Fabio Malavasi, Silvia Deaglio

Research output: Contribution to journalArticle

128 Citations (Scopus)


Chronic lymphocytic leukemia is marked by profound defects in T-cell function. Programmed death-1 is a receptor involved in tumor-mediated immunosuppression through binding of the PD-L1 ligand. Multiparametric flow cytometry and immunohistochemistry were used to study PD-1/PD-L1 expression. Functional assays were used to determine the involvement of the PD-1/PD-L1 axis in T-cell responses. PD-1 expression by CD4(+) and CD8(+) T lymphocytes was significantly higher in 117 chronic lymphocytic leukemia patients than in 33 donors of a comparable age. CD4(+) and CD8(+) T lymphocytes from chronic lymphocytic leukemia patients displayed increased numbers of effector memory and terminally differentiated cells, respectively, when compared to controls. The number of effector memory CD4(+) and terminally differentiated CD8(+) lymphocytes positively associated with a more advanced stage of disease, treatment requirements and unfavorable genomic aberrations. Furthermore, leukemic lymphocytes expressed higher levels of PD-L1 than circulating B lymphocytes from normal donors. PD-1 and PD-L1 surface expression spiked in proliferating T and B lymphocytes, suggesting that this interaction works efficiently in activated environments. Within chronic lymphocytic leukemia proliferation centers in the lymph node, CD4(+)/PD-1(+) T lymphocytes were found to be in close contact with PD-L1(+) chronic lymphocytic leukemia cells. Lastly, functional experiments using recombinant soluble PD-L1 and blocking antibodies indicated that this axis contributes to the inhibition of IFN-γ production by CD8(+) T cells. These observations suggest that pharmacological manipulation of the PD-1/PD-L1 axis may contribute to restoring T-cell functions in the chronic lymphocytic leukemia microenvironment.
Original languageEnglish
Pages (from-to)953-963
Number of pages11
Publication statusPublished - 2013


  • Adult
  • Age Factors
  • Aged
  • Antigens, CD274
  • CD4-Positive T-Lymphocytes
  • CD8-Positive T-Lymphocytes
  • Cell Communication
  • Cell Differentiation
  • Cell Proliferation
  • Disease Progression
  • Female
  • Gene Expression
  • Humans
  • Immunologic Memory
  • Interferon-gamma
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Male
  • Middle Aged
  • Programmed Cell Death 1 Receptor
  • Protein Binding
  • T-Lymphocyte Subsets


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