The immunomodulatory role of tumor Syndecan-1 (CD138) on ex vivo tumor microenvironmental CD4⁺ T cell polarization in inflammatory and non-inflammatory breast cancer patients

by Moshira Ezzat Saleh, Ramy Gadalla, Hebatallah Hassan, Ahmed Afifi, Martin Götte, Mohamed El-Shinawi, Mona Mostafa Mohamed, Sherif Abdelaziz Ibrahim

Herein, we aimed to identify the immunomodulatory role of tumor Syndecan-1 (CD138) in the polarization of CD4⁺ T helper (Th) subsets isolated from the tumor microenvironment of inflammatory breast cancer (IBC) and non-IBC patients. Lymphocytes and mononuclear cells isolated from the axillary tributaries of non-IBC and IBC patients during modified radical mastectomy were either stimulated with the secretome as indirect co-culture or directly co-cultured with control and Syndecan-1-silenced SUM-149 IBC cells. In addition, peripheral blood mononuclear cells (PBMCs) of normal subjects were used for the direct co-culture. Employing flow cytometry, we analyzed the expression of the intracellular IFN-γ, IL-4, IL-17, and Foxp3 markers as readout for basal and co-cultured Th₁, Th₂, Th₁₇, and T_reg CD4⁺ subsets, respectively. Our data revealed that IBC displayed a lower basal frequency of Th₁ and Th₂ subsets than non-IBC. Syndecan-1-silenced SUM-149 cells significantly upregulated only T_reg subset polarization of normal subjects relative to controls. However, Syndecan-1 silencing significantly enhanced the polarization of Th₁₇ and T_reg subsets of non-IBC under both direct and indirect conditions and induced only Th₁ subset polarization under indirect conditions compared to control. Interestingly, qPCR revealed that there was a negative correlation between Syndecan-1 and each of IL-4, IL-17, and Foxp3 mRNA expression in carcinoma tissues of IBC and that the correlation was reversed in non-IBC. Mechanistically, Syndecan-1 knockdown in SUM-149 cells promoted Th₁₇ cell expansion via upregulation of IL-23 and the Notch ligand DLL4. Overall, this study indicates a low frequency of the circulating antitumor Th₁ subset in IBC and suggests that tumor Syndecan-1 silencing enhances ex vivo polarization of CD4⁺ Th₁₇ and T_reg cells of non-IBC, whereby Th₁₇ polarization is possibly mediated via upregulation of IL-23 and DLL4. These findings suggest the immunoregulatory role of tumor Syndecan-1 expression in Th cell polarization that may have therapeutic implications for breast cancer.