Stress-glucocorticoid-TSC22D3 axis compromises therapy-induced antitumor immunity

Heng Yang, Lin Xia, Jian Chen, Shuqing Zhang, Vincent Martin, Qingqing Li, Shangqing Lin, Jinfeng Chen, Joseph Calmette, Min Lu, Lingyi Fu, Jie Yang, Zhizhong Pan, Kuai Yu, Jingjing He, Eric Morand, Géraldine Schlecht-Louf, Roman Krzysiek, Laurence Zitvogel, Boxi KangZeming Zhang, Andrew Leader, Penghui Zhou, Laurence Lanfumey, Minxin Shi, Guido Kroemer, Yuting Ma

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63 Citations (Scopus)


Psychological distress has long been suspected to influence cancer incidence and mortality. It remains largely unknown whether and how stress affects the efficacy of anticancer therapies. We observed that social defeat caused anxiety-like behaviors in mice and dampened therapeutic responses against carcinogen-induced neoplasias and transplantable tumors. Stress elevated plasma corticosterone and upregulated the expression of glucocorticoid-inducible factor Tsc22d3, which blocked type I interferon (IFN) responses in dendritic cell (DC) and IFN-γ+ T cell activation. Similarly, close correlations were discovered among plasma cortisol levels, TSC22D3 expression in circulating leukocytes and negative mood in patients with cancer. In murine models, exogenous glucocorticoid injection, or enforced expression of Tsc22d3 in DC was sufficient to abolish therapeutic control of tumors. Administration of a glucocorticoid receptor antagonist or DC-specific Tsc22d3 deletion reversed the negative impact of stress or glucocorticoid supplementation on therapeutic outcomes. Altogether, these results indicate that stress-induced glucocorticoid surge and Tsc22d3 upregulation can subvert therapy-induced anticancer immunosurveillance.

Original languageEnglish
Pages (from-to)1428-1441
Number of pages14
JournalNature Medicine
Issue number9
Publication statusPublished - 1 Sep 2019

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