Case Reports:

Placental immune editing switch (PIES): learning about immunomodulatory pathways from a unique case report

Miguel H. Bronchud _, Francesc Tresserra, Wenjie Xu, Sarah Warren, Maite Cusido, Bernat Zantop, Ana Claudia Zenclussen and Alessandra Cesano

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Oncotarget. 2016; 7:83817-83827. https://doi.org/10.18632/oncotarget.13306

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Miguel H. Bronchud1, Francesc Tresserra2, Wenjie Xu3, Sarah Warren3, Maite Cusido4, Bernat Zantop5, Ana Claudia Zenclussen6 and Alessandra Cesano3

1 Institut Bellmunt Oncologia, Hospital Universitario Dexeus. Grupo Quirón Salud, Barcelona, Spain

2 Servei Anatomia Patològica, Hospital Universitario Dexeus. Grupo Quirón Salud, Barcelona, Spain

3 Nanostring Technologies, Immune Oncology, Seattle, WA, USA

4 Ginecologia Oncològica, Hospital Universitario Dexeus. Grupo Quirón Salud, Barcelona, Spain

5 Servei Obstetricia i Neonatologia, Hospital Universitario Dexeus. Grupo Quirón Salud, Barcelona, Spain

6 Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany

Correspondence to:

Miguel H. Bronchud, email:

Keywords: materno-fetal tolerance, cancer microenvironment, placental microenvironment, immune vigilance, carcinogenesis

Received: July 11, 2016 Accepted: October 25, 2016 Published: November 11, 2016


The hypothesis of this work is that, in order to escape the natural immune surveillance mechanisms, cancer cells and the surrounding microenvironment might express ectopically genes that are physiologically present in the placenta to mediate fetal immune-tolerance. These natural “placental immune-editing switch” mechanisms (PIES) may represent the result of millions of years of mammalian evolution developed to allow materno-fetal tolerance. Here, we introduce genes of the immune regulatory pathways that are either similarly over- or under-expressed in tumor vs normal tissue. Our analysis was carried out in primary breast cancer with metastatic homolateral axillary lymph nodes as well as placenta tissue (both uterine decidual tissue and term placenta tissue) from a pregnant woman. Gene expression profiling of paired non-self and self tissues (i.e. placenta/uterus; breast cancer/normal breast tissue; metastatic lymphnode/normal lymphnode tissue) was performed using the PanCancer Immune gene panel, a 770 Nanostring gene expression panel. Our findings reveal overlapping in specific immune gene expression in placenta and cancer tissue, suggesting that these genes might play an important role in maintaining immune tolerance both physiologically (in the placenta) and pathologically (in the cancer setting).

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