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Blood, 1 October 2006, Vol. 108, No. 7, pp. 2280-2289.
Prepublished online as a Blood First Edition Paper on June 6, 2006; DOI 10.1182/blood-2006-04-015164.


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Submitted April 5, 2006
Accepted May 18, 2006

Expression of LAG-3 by tumor-infiltrating lymphocytes is co-incident with the suppression of latent membrane antigen-specific CD8+ T-cell function in Hodgkin lymphoma patients

Maher K Gandhi, Eleanore Lambley, Jaikumar Duraiswamy, Ujjwal Dua, Corey Smith, Suzanne Elliott, Devinder Gill, Paula Marlton, John Seymour, and Rajiv Khanna*

Tumor Immunology Laboratory,Division of Infectious Diseases,Queensland Institute of Medical Research
Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia
Haematology Service, Peter MacCallum Cancer Centre & University of Melbourne, Australia

* Corresponding author; email: rajiv.khanna{at}qimr.edu.au.

In Hodgkin' s Lymphoma (HL) the malignant Hodgkin Reed- Sternberg (HRS) cells comprise only 0.5-10% of the diseased tissue. The surrounding cellular infiltrate in enriched with T-cells which are hypothesized to modulate anti-tumor immunity. We show that a marker of regulatory T-cells, LAG-3 is strongly expressed on infiltrating lymphocytes present in proximity to HRS cells. Circulating regulatory T-cells (CD4+CD25hiCD45ROhi, CD4+CTLA4hi and CD4+LAG-3hi) were elevated in HL patients with active disease when compared to remission. Longitudinal profiling of EBV-specific CD8+ T-cell responses in 94 HL patients revealed a selective loss of interferon-gamma expression by CD8+ T-cells specific for latent membrane proteins (LMP) 1 and 2, irrespective of EBV tissue status. Intra-tumoral LAG-3 expression was associated with EBV tissue positivity, whereas FOXP3 was linked with neither LAG-3 or EBV tissue status. The level of LAG-3 and FOXP3 expression on the tumor- infiltrating lymphocytes was co-incident with impairment of LMP1/2-specific T-cell function. In vitro pre- exposure of peripheral blood mononuclear cells to HRS cell-line supernatant significantly increased the expansion of regulatory T-cells and suppressed LMP- specific T-cell responses. Deletion of CD4+ LAG-3+ T- cells enhanced LMP-specific immunity. These findings indicate a pivotal role for regulatory T-cells and LAG-3 in the suppression of EBV-specific cell-mediated immunity in HL.


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