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Review
. 2023 Mar 13;15(6):1743.
doi: 10.3390/cancers15061743.

Addressing Natural Killer Cell Dysfunction and Plasticity in Cell-Based Cancer Therapeutics

Kassandra M Coyle  1 , Lindsey G Hawke  2 , Mark L Ormiston  1   2
Affiliations
Review

Addressing Natural Killer Cell Dysfunction and Plasticity in Cell-Based Cancer Therapeutics

Kassandra M Coyle et al. Cancers (Basel). .

Abstract

Natural killer (NK) cells are cytotoxic group 1 innate lymphoid cells (ILC), known for their role as killers of stressed, cancerous, and virally infected cells. Beyond this cytotoxic function, NK cell subsets can influence broader immune responses through cytokine production and have been linked to central roles in non-immune processes, such as the regulation of vascular remodeling in pregnancy and cancer. Attempts to exploit the anti-tumor functions of NK cells have driven the development of various NK cell-based therapies, which have shown promise in both pre-clinical disease models and early clinical trials. However, certain elements of the tumor microenvironment, such as elevated transforming growth factor (TGF)-β, hypoxia, and indoalemine-2,3-dioxygenase (IDO), are known to suppress NK cell function, potentially limiting the longevity and activity of these approaches. Recent studies have also identified these factors as contributors to NK cell plasticity, defined by the conversion of classical cytotoxic NK cells into poorly cytotoxic, tissue-resident, or ILC1-like phenotypes. This review summarizes the current approaches for NK cell-based cancer therapies and examines the challenges presented by tumor-linked NK cell suppression and plasticity. Ongoing efforts to overcome these challenges are discussed, along with the potential utility of NK cell therapies to applications outside cancer.

Keywords: HIF1α; NK cell dysfunction; NK cell plasticity; NK cell therapeutics; TGFβ; indoalemine-2,3-dioxygenase.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Current NK cell therapies. Schematic showing the current use of NK cell therapies, starting with source, expansion, and activation, then demonstrating the recently developed alternative approaches. Figure created with BioRender.
Figure 2
Figure 2
NK cell suppression. Schematic showing NK cell suppression after exposure to (A) TGFβ, (B) hypoxia, or (C) IDO. Figure created with BioRender (https://www.biorender.com/ [accessed on 10 February 2013]).
Figure 3
Figure 3
Current interventions targeting NK cell suppressive factors. NK cell suppression via (A) TGFβ, (B) hypoxia, or (C) IDO. Figure created with BioRender (https://www.biorender.com/ [accessed on 11 February 2013]).
See this image and copyright information in PMC

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Grants and funding

This manuscript was funded by the Canadian Institutes of Health Research, grant number PJT-180356.