Evidence map›Paper›PMID 40977848›Full record

ArticleImmunotherapy advances2025

CD40L and IL-4 suppress NK cell-mediated antibody-dependent cellular cytotoxicity through the HLA-E:NKG2A axis.

Lara V Graham, Ludmila Horehajova, Marco V Haselager, Jack G Fisher, Jamie Lee Roos, Russell B Foxall, Mel John, Kerry L Cox, Robert J Oldham, Martin C Taylor and 10 more

Abstract read
In one paragraph

Article in Immunotherapy advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Lara V GrahamSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.ORCID https://orcid.org/0009-0006-5420-9020
Ludmila HorehajovaSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.
Marco V HaselagerDepartment of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Meibergdreef, The Netherlands.
Jack G FisherSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.
Jamie Lee RoosDepartment of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Meibergdreef, The Netherlands.
Russell B FoxallSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.
Mel JohnSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.
Kerry L CoxSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.
Robert J OldhamSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.
Martin C TaylorSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.
Margaret Ashton-KeySchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.
Ben SaleSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.
Laura G BartlettSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.
Ali RoghanianSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.ORCID https://orcid.org/0000-0003-1316-4218
Eric ElderingDepartment of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Meibergdreef, The Netherlands.
Andres F VallejoSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.
Francesco ForconiSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.
Salim I KhakooSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.
Mark S CraggSchool of Cancer Sciences, University of Southampton, Southampton, United Kingdom.ORCID https://orcid.org/0000-0003-2077-089X
Matthew D BluntSchool of Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.ORCID https://orcid.org/0000-0003-1099-3985

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Anti-CD20 antibodies are first-line treatments for B cell malignancies. Natural killer (NK) cells are important mediators of anti-CD20 antibody efficacy in humans through antibody-dependent cellular cytotoxicity (ADCC). In B cell malignancies, the lymph nodes are a critical site of pathology and the T cell-derived signals CD40L and IL-4 within the lymph node microenvironment can mediate tumour proliferation, survival and resistance to pro-apoptotic therapy. CD40L and IL-4 have recently been shown to inhibit NK cell activation against chronic lymphocytic leukaemia (CLL) cells via the HLA-E:NKG2A immune checkpoint axis. However, the effect of these signals on NK cell-mediated ADCC of malignant B cells is unclear. Methods: Using a combination of clinical samples, murine models, flow cytometry, immunoblotting, immunohistochemistry, ELISA, bioinformatics and functional assays, we examined the impact of lymph node-mimicking conditions on NK cell-mediated ADCC against malignant B cells. Exogenous CD40L and IL-4 were used to mimic T-B cell interactions in 2D malignant B cell cultures, in addition to a 3D spheroid model of T cell-dependent CLL proliferation. Results: CD40L and IL-4 increased HLA-E expression on the surface of primary CLL cells and non-Hodgkin's lymphoma (NHL) cell lines, and this decreased NK cell-mediated ADCC via ligation of the inhibitory receptor NKG2A. High HLA-E surface expression was observed in lymph node FFPE sections of CLL and NHL patients and in a 3D Conclusion: These results reveal a novel mechanism of resistance to anti-CD20 therapy in B cell malignancies and demonstrate that the combination of anti-NKG2A with anti-CD20 could improve the treatment of patients with CLL or NHL.

Indexed as

ADCCHLA-Elymph nodesmonalizumabNK cellsNKG2Arituximab

Identifiers

PMID40977848
PMCPMC12448733

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.