Nasopharyngeal carcinoma (NPC) is a malignant tumour of the head and neck affecting localised regions of the world, with the highest rates described in Southeast Asia, Northern Africa, and Greenland. Its high morbidity rate is linked to both late-stage diagnosis and unresponsiveness to conventional anti-cancer treatments. Multiple aetiological factors have been described including environmental factors, genetics, and viral factors (Epstein Barr Virus, EBV), making NPC treatment that much more complex. The most common forms of NPCs are those that originate from the epithelial tissue lining the nasopharynx and are often linked to EBV infection. Indeed, they represent 75–95% of NPCs in the low-risk populations and almost 100% of NPCs in high-risk populations. Although conventional surgery has been improved with nasopharyngectomy’s being carried out using more sophisticated surgical equipment for better tumour resection, recent findings in the tumour microenvironment have led to novel treatment options including immunotherapies and photodynamic therapy, able to target the tumour and improve the immune system. This review provides an update on the disease’s aetiology and the future of NPC treatments with a focus on therapies activating T cell immunity.

Virus infections are involved in chronic inflammation and, in some cases, cancer development. Although a viral infection activates the immune system’s response that eradicates the pathogen mainly through inflammatory mechanisms, it is now recognized that this inflammatory condition is also favorable to the development of tumors. Indeed, it is well described that viruses, such as hepatitis C virus (HCV), Epstein Barr virus (EBV), human papillomavirus (HPV) or human T-cell lymphotropic virus type-1 (HTLV-1), are important risk factors for tumor malignancies. The inflammatory response is a fundamental immune mechanism which involves several molecular and cellular components consisting of cytokines and chemokines that are released by various proinflammatory cells. In parallel to this process, some endogenous recruited components release anti-inflammatory mediators to restore homeostasis. The development of tools and strategies using viruses to hijack the immune response is mostly linked to the presence of regulatory T-cells (Treg) that can inhibit inflammation and antiviral responses of other effector cells. In this review, we will focus on current understanding of the role of natural and induced Treg in the control and the resolution of inflammatory response in HCV-, HTLV-1-, and EBV-associated cancers.

Impact des exosomes tumoraux dérivés de carcinome du nasopharynx dans l’émergence de cellules dendritiques tolérogènes: Le carcinome du nasopharynx (CNP) est un cancer des voies aérodigestives supérieures qui est associé à une infection par le virus d’Epstein Barr (EBV) dans près de 100% des cas. Le microenvironnement dans le CNP se caractérise par la présence massive de lymphocytes T régulateurs (Treg) et d’exosomes tumoraux (exoCNP) aux propriétés immunosuppressives. Notre équipe a montré que ces exosomes synergisent avec les Treg et contribuent à l’échappement à l’immunosurveillance du CNP. Notre hypothèse est que les exoCNP isolés de la tumeur puissent induire des cellules dendritiques (DC) tolérogènes qui favorisent la tolérance en induisant des Treg. Des premiers résultats dévoilent que les exoCNP favorisent l’émergence de DC semi-matures (smDC). Outre le phénotype, des études fonctionnelles de l’enzyme immunosuppressive indoléamine 2,3-dioxygénase 1 (IDO1) ainsi que de la sécrétion de cytokines régulatrices (IL-10 et TGF-β) montrent que les smDC générées mettent en place un microenvironnement immunosuppressif. Des résultats encourageants témoignent de l’activité tolérogène des smDC, capables d’induire des Treg fonctionnels et d’inhiber la prolifération des lymphocytes T effecteurs. Enfin, nous avons également montré que les exoCNP sont à même d’attirer préférentiellement les DC tolérogènes vers le site tumoral par la chimiokine CCL20. Nos résultats prometteurs semblent confirmer que les exoCNP induisent des DC tolérogènes contribuant à l’échappement immunitaire de la tumeur. Notre projet devrait ainsi ouvrir de nouvelles voies d’immunothérapies anti-tumorales ciblant des facteurs impliqués dans l’émergence des Treg et donc de la progression du cancer.