CpG Blocks Immunosuppression by Myeloid-Derived Suppressor Cells in Tumor-Bearing Mice

Purpose: The Toll-like receptor (TLR) 9 ligand CpG has been used successfully for the immunotherapy of cancer. Chronic CpG application in tumor-free hosts leads, however, to the expansion of myeloidderived suppressor cells (MDSC), which can cause T-cell suppression and may thus hamper the development of an effective immune response. Here, we investigated the effect of TLR9 activation on the function of MDSC in tumor-bearing mice. Experimental Design: We investigated the effect of CpG treatment on the number, phenotype, and function of MDSC in mice bearing subcutaneous C26 tumors and in CEA424-TAg mice bearing autochthonous gastric tumors. Results: CpG treatment blocks the suppressive activity of MDSC on T-cell proliferation in both tumor models. Inhibition of MDSC function by CpGwas particularly pronounced for a highly suppressive Ly6G polymorphonuclear subset of MDSC. We further show that TLR9 activation by CpG promotes maturation and differentiation ofMDSC and strongly decreases the proportion of Ly6G MDSC in both tumor-bearing and tumor-free mice. We demonstrate that IFN-a produced by plasmacytoid dendritic cells upon CpG stimulation is a key effector for the induction of MDSCmaturation in vitro and show that treatment of mice with recombinant IFN-a is sufficient to block MDSC suppressivity. Conclusions: We show here for the first time that TLR9 activation inhibits the regulatory function of MDSC in tumor-bearing mice and define a role for the antitumoral cytokine IFN-a in this process. Clin Cancer Res; 17(7); 1765–75. 2011 AACR.