Functional diversity of the highly polymorphic human leukocyte antigen class I (HLA-I) genes underlies successful immunologic control of both infectious disease and cancer. The divergent allele advantage hypothesis dictates that an HLA-I genotype with two alleles with sequences that are more divergent enables presentation of more diverse immunopeptidomes1-3. However, the effect of sequence divergence between HLA-I alleles-a quantifiable measure of HLA-I evolution-on the efficacy of immune checkpoint inhibitor (ICI) treatment for cancer remains unknown. In the present study the germline HLA-I evolutionary divergence (HED) of patients with cancer treated with ICIs was determined by quantifying the physiochemical sequence divergence between HLA-I alleles of each patient's genotype. HED was a strong determinant of survival after treatment with ICIs. Even among patients fully heterozygous at HLA-I, patients with an HED in the upper quartile respond better to ICIs than patients with a low HED. Furthermore, HED strongly impacts the diversity of tumor, viral and self-immunopeptidomes and intratumoral T cell receptor clonality. Similar to tumor mutation burden, HED is a fundamental metric of diversity at the major histocompatibility complex-peptide complex, which dictates ICI efficacy. The data link divergent HLA allele advantage to immunotherapy efficacy and unveil how ICI response relies on the evolved efficiency of HLA-mediated immunity.

译文

高度多态性的人类白细胞抗原I类 (hla-i) 基因的功能多样性是对传染病和癌症的成功免疫控制的基础。分歧等位基因优势假说规定,具有两个等位基因的hla-i基因型具有更分歧的序列,能够呈现更多样的immunopeptidomes1-3。然而,hla-i等位基因之间的序列差异 (hla-i进化的可量化量度) 对免疫检查点抑制剂 (ICI) 治疗癌症疗效的影响仍然未知。在本研究中,通过量化每个患者基因型的hla-i等位基因之间的理化序列差异,确定了用ICIs治疗的癌症患者的种系hla-i进化差异 (HED)。HED是ICIs治疗后生存的重要决定因素。即使在hla-i完全杂合的患者中,上四分位HED的患者对ICIs的反应也比低HED的患者更好。此外,HED强烈影响肿瘤,病毒和自身免疫肽的多样性以及肿瘤内T细胞受体克隆性。与肿瘤突变负荷相似,HED是主要组织相容性复合物-肽复合物的多样性的基本指标,它决定了ICI的功效。该数据将不同的HLA等位基因优势与免疫治疗功效联系起来,并揭示了ICI反应如何依赖于HLA介导的免疫的进化效率。

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