Natural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancer

Abstract Background Natural killer (NK) cells are among the first immune cell populations to recover after autologous hematopoietic stem cell transplantation (autoHSCT ), yet their dynamic function in pediatric patients remains understudied. Investigating NK cell recovery could improve understanding...

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Main Authors: Gabirel Astarloa-Pando, Diego Polanco-Alonso, Víctor Sandá, Ane Orrantia, Ainhoa Amarilla-Irusta, Silvia Pérez-Fernández, Raquel Pérez-Garay, Arrate Sevilla, Ainara Lopez-Pardo, Aritz Tijero, José J. Úriz, Mercedes Rey, Itziar Astigarraga, Bárbara Manzanares-Martin, Aitor Zarandona-Garai, Naiara G. Bediaga, Laura Amo, Olatz Zenarruzabeitia, Francisco Borrego
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00911-w
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author Gabirel Astarloa-Pando
Diego Polanco-Alonso
Víctor Sandá
Ane Orrantia
Ainhoa Amarilla-Irusta
Silvia Pérez-Fernández
Raquel Pérez-Garay
Arrate Sevilla
Ainara Lopez-Pardo
Aritz Tijero
José J. Úriz
Mercedes Rey
Itziar Astigarraga
Bárbara Manzanares-Martin
Aitor Zarandona-Garai
Naiara G. Bediaga
Laura Amo
Olatz Zenarruzabeitia
Francisco Borrego
author_facet Gabirel Astarloa-Pando
Diego Polanco-Alonso
Víctor Sandá
Ane Orrantia
Ainhoa Amarilla-Irusta
Silvia Pérez-Fernández
Raquel Pérez-Garay
Arrate Sevilla
Ainara Lopez-Pardo
Aritz Tijero
José J. Úriz
Mercedes Rey
Itziar Astigarraga
Bárbara Manzanares-Martin
Aitor Zarandona-Garai
Naiara G. Bediaga
Laura Amo
Olatz Zenarruzabeitia
Francisco Borrego
author_sort Gabirel Astarloa-Pando
collection DOAJ
description Abstract Background Natural killer (NK) cells are among the first immune cell populations to recover after autologous hematopoietic stem cell transplantation (autoHSCT ), yet their dynamic function in pediatric patients remains understudied. Investigating NK cell recovery could improve understanding of post-autoHSCT immune reconstitution and optimize clinical outcomes. Methods We characterized NK cells in 13 children (male: 8; female: 5; age range: 3–11 years) with various tumors before and up to 6 months after autoHSCT. Multiparametric flow cytometry analyses and plasma cytokine level determinations were performed. In vitro experiments, including single-cell RNA sequencing, were conducted to elucidate post-autoHSCT changes in the NK cell repertoire using 8 adult healthy donors (male: 5; female: 3; age range: 25–62 years). Results Key findings highlight a transient decidual-like NK cell phenotype emerging early post-transplant. These cells are immature and activated, with increased inhibitory receptor expression and diminished activating receptor levels. This activated and decidual-like phenotype is characterized by elevated expression of CD56, CD9, CD49a, CD151, CD38, HLA-DR, and CD55. Plasma levels of several cytokines are associated with the observed changes in NK cells’ phenotype. In addition, in vitro experiments recapitulate the alterations observed in NK cells shortly after autoHSCT. Specifically, results demonstrate that the combination of IL-15 and TGF-β induces this distinctive phenotype on NK cells after autoHSCT. Finally, we observe a positive correlation between relapse and the percentage of CD56dim NK cells shortly after autoHSCT in our cohort of pediatric patients. Conclusions Altogether, our findings provide valuable insights into the physiopathology of NK cells during immune system reconstitution after autoHSCT and can potentially help in the management of cancer in children.
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spelling doaj-art-d16eb707a2df41f38eeb7a7ca06fe5412025-08-20T03:16:51ZengNature PortfolioCommunications Medicine2730-664X2025-05-015111610.1038/s43856-025-00911-wNatural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancerGabirel Astarloa-Pando0Diego Polanco-Alonso1Víctor Sandá2Ane Orrantia3Ainhoa Amarilla-Irusta4Silvia Pérez-Fernández5Raquel Pérez-Garay6Arrate Sevilla7Ainara Lopez-Pardo8Aritz Tijero9José J. Úriz10Mercedes Rey11Itziar Astigarraga12Bárbara Manzanares-Martin13Aitor Zarandona-Garai14Naiara G. Bediaga15Laura Amo16Olatz Zenarruzabeitia17Francisco Borrego18Immunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteBioinformatics, Biostatistics and Information Systems Platform, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteBiogipuzkoa Health Research Institute, Service of Pediatrics, Donostia University HospitalBiogipuzkoa Health Research Institute, Service of Immunology, Donostia University HospitalPediatric Oncology Group, Department of Pediatrics, Biobizkaia Health Research Institute, Cruces University HospitalMaimónides Biomedical Research Institute of Córdoba (IMIBIC), Immunology and Allergy Department of Reina Sofía University Hospital and Transfusion, Tissue and Cells Centre (CTTC)Bioinformatics, Biostatistics and Information Systems Platform, Biobizkaia Health Research InstituteBioinformatics, Biostatistics and Information Systems Platform, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteImmunopathology Group, Biobizkaia Health Research InstituteAbstract Background Natural killer (NK) cells are among the first immune cell populations to recover after autologous hematopoietic stem cell transplantation (autoHSCT ), yet their dynamic function in pediatric patients remains understudied. Investigating NK cell recovery could improve understanding of post-autoHSCT immune reconstitution and optimize clinical outcomes. Methods We characterized NK cells in 13 children (male: 8; female: 5; age range: 3–11 years) with various tumors before and up to 6 months after autoHSCT. Multiparametric flow cytometry analyses and plasma cytokine level determinations were performed. In vitro experiments, including single-cell RNA sequencing, were conducted to elucidate post-autoHSCT changes in the NK cell repertoire using 8 adult healthy donors (male: 5; female: 3; age range: 25–62 years). Results Key findings highlight a transient decidual-like NK cell phenotype emerging early post-transplant. These cells are immature and activated, with increased inhibitory receptor expression and diminished activating receptor levels. This activated and decidual-like phenotype is characterized by elevated expression of CD56, CD9, CD49a, CD151, CD38, HLA-DR, and CD55. Plasma levels of several cytokines are associated with the observed changes in NK cells’ phenotype. In addition, in vitro experiments recapitulate the alterations observed in NK cells shortly after autoHSCT. Specifically, results demonstrate that the combination of IL-15 and TGF-β induces this distinctive phenotype on NK cells after autoHSCT. Finally, we observe a positive correlation between relapse and the percentage of CD56dim NK cells shortly after autoHSCT in our cohort of pediatric patients. Conclusions Altogether, our findings provide valuable insights into the physiopathology of NK cells during immune system reconstitution after autoHSCT and can potentially help in the management of cancer in children.https://doi.org/10.1038/s43856-025-00911-w
spellingShingle Gabirel Astarloa-Pando
Diego Polanco-Alonso
Víctor Sandá
Ane Orrantia
Ainhoa Amarilla-Irusta
Silvia Pérez-Fernández
Raquel Pérez-Garay
Arrate Sevilla
Ainara Lopez-Pardo
Aritz Tijero
José J. Úriz
Mercedes Rey
Itziar Astigarraga
Bárbara Manzanares-Martin
Aitor Zarandona-Garai
Naiara G. Bediaga
Laura Amo
Olatz Zenarruzabeitia
Francisco Borrego
Natural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancer
Communications Medicine
title Natural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancer
title_full Natural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancer
title_fullStr Natural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancer
title_full_unstemmed Natural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancer
title_short Natural killer cells adopt an activated and decidual-like phenotype after autologous hematopoietic stem cell transplantation in children with cancer
title_sort natural killer cells adopt an activated and decidual like phenotype after autologous hematopoietic stem cell transplantation in children with cancer
url https://doi.org/10.1038/s43856-025-00911-w
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