The TT treatment reduces tumour size and weight, extends survival in B16 melanoma-bearing mice
Our previous findings suggest that the triple therapy (TT), which combines F1/F3 peptides with therapeutic vaccines and α-CD47, can significantly inhibit tumour growth (unpublished data). To further investigate whether F1/F3 can enhance systemic immunity induced by the therapeutic vaccine, we established a bilateral tumour model to simulate tumour metastasis (Fig. 1A). Tumours on both the left and right sides of different groups were collected and measured comparatively. The results showed that in the right-side tumours (with treatments), tumour volume was reduced in the control group (P3 + V + α-CD47) compared to the untreated (UN) group (PBS only), with the maximum difference observed on Day 21 (three days after treatment completion) (Fig. 1B). However, tumour volume in the control group increased quickly and reached a level similar to the UN group by Day 29, with no significant difference detected. Throughout the entire observation period, the TT group exhibited significantly inhibited tumour growth compared to the other two groups. For the left side tumours (without treatment), no significant difference was observed between the PBS group (UN) and the control group. Notably, TT significantly inhibited tumour growth, with tumour volume decreased by approximately 60% at Day 29 (Fig. 1C). Additionally, the survival of mice in the TT group was significantly extended on both sides, with a more pronounced effect on the right side (Fig. 1D and 1E).
After the treatment concluded, the mice were dissected, and the tumours on the left and right sides were weighed and compared in Fig. 1F and Figure S1, respectively. The results clearly showed that the TT significantly reduced tumour weight on both sides compared to either the control group or the UN group, with particularly notable effects on the right side. Statistical analysis revealed significant differences in tumour weights on both sides between the TT group, the control, and the UN groups (Fig. 1G and Fig. 1H). These findings indicate that the intra-tumoral injection of F1/F3 peptides significantly enhanced the therapeutic efficacy of the vaccine and α-CD47, effectively inhibiting tumour growth on both the primary and the metastatic tumour sides, respectively.
Figure 1 Effect of F1/F3 peptides in combination with therapeutic vaccines and α-CD47 triple therapy (TT) on bilateral tumour growth and survival. (A) The establishment of a bilateral tumour model to simulate B16 tumour metastasis and the treatments in this study. (B) Tumour growth on the right side (with treatment). No significant difference was observed between the UN group (PBS only) and the control group (P3 + V + α-CD47) post-treatment. The TT group exhibited significantly inhibited tumour growth and improved therapeutic efficacy against B16 melanoma compared to the control group. (C) Tumour growth on the left side (without treatment). Tumour volume was reduced in the control group compared to the UN group, and the TT group demonstrated superior efficacy on both the left and right sides. (D) Survival of mice with tumours on the right side. Mice treated with the TT exhibited significantly extended survival compared to the control groups. (E) Survival of mice with tumours on the left side. Mice treated with the TT exhibited significantly extended survival compared to the control groups. Results are expressed as the mean ± standard error of the mean (SEM), and inter-group differences were statistically analysed using two-way ANOVA, where *P-value < 0.05 and **P-value < 0.01 indicate significant differences, and ns indicates no significant difference. (F) Statistical graph depicting tumour weight on the right side. (G) Dissection diagram illustrating tumour placement on the left side of the mice. (H) Statistical representation of tumour weight on the left side. (See Figure S1 for the dissection diagram of tumours placement on the right side)
scRNA-seq revealed the modulation of CD45+ cell heterogeneity in B16 tumour on the metastasis side
Total viable CD45+ leukocytes were isolated from both sides of the UN, control, and TT groups (Fig. 2 and Table S1). After quality control, a total of 7,007, 8,165, and 8,307 cells were utilised for downstream analysis in the UN, control, and TT groups, respectively. Gene expression data from extracted CD45+ cells were aligned and projected into a two-dimensional space using t-stochastic neighbour embedding (t-SNE) to identify tumour-associated immune cell populations and differentially expressed genes (Fig. 3A and Figure S2A). This unsupervised clustering analysis identified 21 cell clusters (labelled "0" to "20"), consistently present across all three groups, indicating robust cell-type identification independent of treatments. Compared to the UN group (Fig. 3B), the control (Fig. 3C) and TT (Fig. 3D) groups showed reduced populations in clusters 2, 11, 13, and 17, while exhibiting higher populations in clusters 3, 7, 8, 10, and 12 (Figure S2B). Notably, clusters 4 and 18 were significantly expanded only in the TT group (Table S1). The TT group contributed more cells to clusters 3, 4, 7, 18, and 19, while contributing lest cells to clusters 9, 13, 15, and 20 (Figure S2C).
Figure 2 The scRNA-seq analysis of the B16 tumour tissues in the left side of mice. t-Stochastic neighbour embedding (t-SNE) representation of aligned gene expression data in CD45+ single cells extracted from the TME of B16 tumours shows partition into 21 distinct clusters, the distribution of the clusters in the UN (A), control (B) and TT (C) groups. (D) Selected enriched genes used for biological identification of each cluster and the top 5 DEGs of each cluster (in Z-score). MΦ represents macrophage; NK cell, natural killer cell; migDC, migratory DC; cDC1, conventional DC type 1; pDC, plasmacytoid dendritic cell; ASPCs, adipogenic stem and precursor cells; NECs, neuroendocrine cells. (see Table S2 for the full list of all marker genes detected)
Differentially expressed genes (DEGs) were analysed to identify cell type-specific marker genes (Fig. 2D and Table S2). Established canonical markers such as Cd3d, Cd3g, Cd79a, Gzma, Prf1, Klrk1, Cd19, and Cd8b1 indicated lymphocyte lineages (Fig. 2E). Myeloid cell identities were supported by markers including Itgam, Adgre1, Itgax, Csf1r, Lgals3, Itgae, Siglec1, Mrc1, H2-Ab1, S100a8/S100a9, Ly6g1, and Ly6c1[12, 21]. Clusters were annotated with predicted cell-type identities based on known marker genes from literature sources[28]. Notable macrophage subtypes included Arg1hi MΦ (cluster 0; marker genes: Arg1, Mmp12, Mmp13, and Nos2)[12], tissue-resident macrophages (Res-like MΦ) (cluster 1; marker genes: C1qa, C1qc, Ms4a7, and Ccl12)[29], MHCIIhi MΦ (cluster 4; marker genes: Chil3, Ifitm6, H2-DMb1, and H2-DMa), and tumour associated macrophages (TAMs) (cluster 11; marker genes: Cd209f, Lyve1, Folr2, and Ccl8)[30].
T cell subsets[12, 21] identified included, including CD4+CD8+ T cells (cluster 3; marker genes: Ctsw, Nkg7, and Trbc2), CD4+CD25+ T cells (cluster 7; marker genes: Ctla4, Il2ra, and Tigit), and CD8+ T cells (cluster 12; marker genes: Cd8a, Cd8b1, and Cd3d). High populations of natural killer (NK) cells (cluster 8; marker genes: Nkg7, Gzma, and Prf1), neutrophils (cluster 9; marker genes: Retnlg, S100a9, and S100a8), and monocytes (cluster 10; marker genes: Ifit1, Cmpk2, Ifit3, and Ifit3b) were also detected. Cluster 13 represented B, supported by the marker genes such as Fcmr, Cd79a, and Ebf1. Also, three clusters showed the signature of dendritic cells, i.e., migratory DCs (migDCs) (cluster 14; Ccl22, Bcl2l14, and Il12b), plasmacytoid dendritic cells (pDCs) (cluster 16; Siglech, Klk1, and Klk1b27), and conventional DC type 1 (cDC1s) (cluster 18; Xcr1, Clec9a, and Mycl)[31]. Notably, cluster 5 showed characteristics of Langerhans cells, such as Camk1d, Lrmda, and Dennd1a[32, 33].
Additionally, fibroblasts (cluster 2; marker genes: Ptgds, Cort, Cmtm5, and Paqr6), erythroblasts (cluster 6; marker genes: Esco2, H3c4, Tk1, and Asf1b), adipogenic stem and precursor cells (ASPCs) (cluster 15; marker genes: Col6a2, Col3a1, Dpt, and Col1a1)[34], neuronal cells (cluster 17; marker genes: Prickle2, Grik2, and Npas3)[35–37], melanocyte (Mlana, Pmel, and Tyrp1)[38–40], and neuroendocrine cells (NECs) (cluster 20; marker genes: Alas2, Isg20, and Hbb-bt)[41, 42] were identified, possibly indicating contaminants. The expressions of the marker genes of each cluster were compared, showing a relatively high correlation (score > 0.80) between Arg1hi MΦs, Res-like MΦs, MHCIIhi MΦs, erythroblasts, monocytes, TAMs, CD8+ T cells, and pDCs, respectively (Figure S2D).
The TT treatment reprograms tumour macrophages and expands MHCIIhi population
Four distinct populations of macrophages were clearly identified: Arg1hi MΦs, Res-like MΦs, MHCIIhi MΦs, and TAMs. The proportions of these macrophage populations across different groups were analysed. It was observed that Arg1hi MΦs were significantly more prevalent in the control group (55.3%) compared to the UN (37.0%) or TT (37.6%) groups (Fig. 3A and Table S2). Notably, MHCIIhi MΦs were notably higher in the TT group (24.2%) compared to the UN (15.5%) and control (12.7%) groups. The population of TAMs showed a decrease in both the control and TT groups, with a more pronounced decrease in the control group. Differential gene expression analysis between the TT and control groups revealed that the MHCIIhi MΦs exhibited the highest number of upregulated (983) and downregulated (1,140) DEGs, followed by Res-like MΦs (Fig. 3B). There was a relatively high overlap in DEGs among Arg1hi, Res-like, and MHCIIhi MΦs, indicating similarities in gene expression profiles among these populations, while TAMs showed a distinct gene expression pattern compared to other macrophage types, suggesting a unique TAM phenotype.
Figure 3 Modulation of Arg1hi and tumour-associated macrophages in the tumour microenvironment by TT treatment. (A) Comparison of the proportions of four macrophage (MΦ) populations among the UN, control, and TT groups. (B) Upset graph comparing the upregulated and downregulated differentially expressed genes (DEGs) in different macrophage populations in the TT group relative to the control group. (C) Beanplot showing the expression levels (in Log2 values) of selected tumour-associated macrophage marker genes across the four macrophage populations in the control and TT groups. (D) Gene Set Enrichment Analysis (GSEA) of hallmark pathways enriched in Arg1hi macrophages of the TT group compared to the control group. (E) GSEA of hallmark pathways enriched in TAMs of the TT group compared to the control group. Significance levels are indicated as follows: *: P-value < 0.05, **: P-value < 0.01, ***: P-value < 0.001, and ****: P-value < 0.0001; by two-way Student’s t-test.
The expression profiles of selected marker genes associated with M2-like macrophages, known for promoting tumour cell growth and inducing an immunosuppressive TME, were compared across four macrophage populations between the TT and control groups (Fig. 3C). The downregulation of these genes in treatments relative to the UN group was confirmed (Table S3). Particularly noteworthy was the comparative downregulation of many of these genes in the MHCIIhi and Res-like MΦs of the TT group compared to the control group. Significant suppression of Cd68 expression was evident across all macrophage populations in the TT group. Downregulation of Arg1 was observed in all macrophage types, with notably significant decreases in Res-like and Arg1hi MΦs, which exhibited the highest baseline expression of Arg1 among all macrophages. A similar pattern was observed for Mmp12 and Mmp13. Two hallmark pathways showed significant positive association with Arg1hi MΦs in the TT group: 'oxidative phosphorylation' (OXPHOS) and 'MYC target V1' (Fig. 3D). Conversely, several hallmark pathways directly linked to immune response—such as IFN α/γ response, inflammatory response, and IL6/JAK/STAT3 signalling—were significantly inhibited in the control group compared to the TT group, though their activation in the TT group did not reach significance. Enrichment analysis revealed significant activation of IFN α response specifically in TAMs of the TT group, while OXPHOS remained prominently enriched (Fig. 3E).
Similarly, several pathways associated with pro-inflammatory responses were suppressed in MHCIIhi (Fig. 4A) and Res-like MΦs (Fig. 4B) of the control group compared to the TT group, with the latter also showing reduced apoptosis. Interestingly, the P53 pathway exhibited comparatively higher activation in these two macrophage types within the TT group. Additionally, metabolic pathways such as glycolysis, heme metabolism, and xenobiotic metabolism were downregulated in MHCIIhi MΦs of the control group, along with fatty acid metabolism in Res-like MΦs. Comparative analysis with the UN group using IPA revealed that regulation of MHC class I quantity on cell surfaces was significantly activated in MHCIIhi MΦs of the TT group compared to the control group, primarily modulated by Stat1 (Fig. 4C). Moreover, regulatory networks associated with inhibiting tumour growth, developing tumour cell lines, and cancer invasion were more prominent in MHCIIhi MΦs of the TT group relative to those in the control group, as evidenced by downregulation of key regulators such as Arg1, Spp1, Adrb2, Myc, Ilk, Gpnmb, and Eno1 (Fig. 4D). Regarding TAMs, pathways related to 'invasion of cells', particularly involving lymphocytes and leukocytes, were more activated in the control group compared to the TT group relative to the UN group (Figure S3A). Similar to MHCIIhi MΦs, TAMs in the TT group showed downregulation of pathways related to cancer cell growth, with further inhibition of angiogenesis and neoplasia of tumour cell lines (Figure S3B).
Figure 4 Modulation of MHCIIhi and tissue-resident in the tumour microenvironment by TT treatment. (A) Gene Set Enrichment Analysis (GSEA) of hallmark pathways enriched in MHCIIhi MΦs of the TT group compared to the control group. (B) GSEA of hallmark pathways enriched in Res-like MΦs of the TT group compared to the control group. The top two most activated networks in the MHCIIhi MΦs of the TT group relative to the UN group, identified by Ingenuity Pathway Analysis (IPA): (C) Quantity of MHC class I on cell surface and (D) Inhibition of tumour growth. Cellular events/canonical pathways/regulators that were activated are indicated in orange, while others that were suppressed are indicated in blue.
The TT treatment recruits more immune-responsive CD4+CD8+ and CD4 + CD25 + T cells
Three types of T cells were present: CD4+CD8+, CD4+CD25+, and CD8+ T cells, with CD4 + CD8 + T cells being the most abundant (Table S1). The TT treatment significantly increased the populations of CD4+CD8+ and CD4+CD25+ T cells compared to both the untreated (UN) and control groups (Fig. 5A). In contrast, the control group had the highest population of CD8+ T cells. In terms of functional modulation induced by the treatments, GSEA revealed that OXPHOS was activated in CD8+ T cells of the TT group, while IFN-γ and inflammatory responses were inhibited in CD8+ T cells of the control group (Fig. 5B). Similar functional modulation was observed in CD4+CD8+ T cells between the TT and control groups (Figure S4A). For CD4+CD25+ T cells, several metabolic pathways were downregulated in the control group compared to the TT group (Figure S4B). Interestingly, many marker genes associated with T cell activation, such as Lat2, Tax1bp1, Gzmb, and Cd8a, were upregulated in the control group relative to both the UN and TT groups (Fig. 5C). In contrast, the expression of Trbc1 and Nfat5 was more pronounced in the TT group.
Figure 5 Expansion of CD4+CD8+ and CD4+CD25+ T cells with TT treatment in the TME on the metastatic side. (A) Comparison of T cell populations in the UN, the control, and the TT groups. (B) Gene Set Enrichment Analysis (GSEA) of hallmark pathways enriched in CD8+ T cells of the TT group compared to the control group. (C) Bubble graphs comparing the expression of selected marker genes associated with T cell activation across different T cell populations in the untreated, control, and TT treatment groups. The bubble size represents the percentage of cells expressing each gene, while the bubble colour indicates the average expression level of the gene in each cell type. (D) Beanplot showing the expression levels (in Log2 values) of selected Treg marker across the three T cell populations in the control and TT groups. The most activated networks in the CD4+CD25+ T cells of the control (E) and the TT group (F) relative to the UN group, identified by Ingenuity Pathway Analysis (IPA). Cellular events/canonical pathways/regulators that were activated are indicated in orange, while others that were suppressed are indicated in blue.
The expression of selected Treg marker genes, including Foxp3, Ctla4, Il7r, Lag3, and Il2ra, was compared across T cell populations (Fig. 5D). Significant downregulation of all these genes was detected in CD4+CD25+ T cells of the TT group. Additionally, Il7r was suppressed in the other two T cell populations of the TT group compared to the control group. To understand the regulatory networks in CD4+CD25+ T cells, we analysed the pathways activated in the control and TT groups. In the control group, the 'function of antigen presenting cells' pathway was more activated, while the 'infection of mammalia' pathway was more inhibited relative to the UN group, likely due to the high expression of activated T cell marker genes (Fig. 5E). In contrast, CD4+CD25+ T cells in the TT group showed significant inhibition in pathways related to tumour growth, migration, and invasion, as well as the 'proliferation of connective tissue cells' pathway, which are highly relevant to metastasis (Fig. 5F). In CD8+ T cells, the 'activation of cells' pathway was most activated in the control group, while the ‘cell movement of mononuclear leukocytes' pathway was most activated in the TT group (Figures S4C and S4D). For CD4+CD8+ T cells, the 'sensitivity of tumour cell lines' pathway was highly activated in the control group (Figure S4E). In contrast, the TT group showed activation of pathways inhibiting vasculogenesis, advanced malignant tumours, and invasive cancer, relative to the UN group (Figure S4F).
The TT expands dendritic cells (excluding Langerhans cells) and activates NK cells
The populations of all three dendritic cell (DC) types expanded in the TT group, with a notable increase in cDC1s, which rose by approximately 29% and 300% compared to the UN and control groups, respectively (Fig. 6A and Table S1). Among the most upregulated genes in the TT group was Gm10736 (equivalent to Hla-dqb1 in human), a key MHC class II molecule (Fig. 6B). Several genes related to mitochondrial function, including Mrpl52, Mrps21, Mrpl33, and Mrpl12, were upregulated in DCs, especially in cDC1s, suggesting enhanced assembly and functioning of mitochondrial ribosomes. The expression of Cd63 and Cd302 was significantly higher in migDCs of the TT group. Additionally, several pseudogenes, such as Gm8186, Gm3699, Gm3511, and Gm4149, were substantially upregulated in cDC1s of the TT group, indicating their potential roles in modulating immune-related gene expression. Although the population of Langerhans cells slightly decreased in the TT group (4.44%) compared to the UN (4.87%) and control groups (5.62%), their phenotype was significantly modulated (Fig. 6C). Pathways supporting an inflammatory phenotype, including the IFN α/γ response, inflammatory response, and complement pathways, were negatively associated with the control group compared to the TT group. The ‘E2F targets’ pathway was the only hallmark pathway significantly activated in the TT group.
Figure 6 Modulation of dendritic cells and NK cells in the tumour microenvironment by TT treatment. (A) Contributions to migratory dendritic cells (migDCs), plasmacytoid dendritic cells (pDCs), and conventional dendritic cells type 1 (cDC1s) from the UN, control, and TT groups. (B) Bubble graph comparing the expression of the top 50 upregulated DEGs in cDC1s of the TT group relative to the control group, in migDCs and pDCs. The bubble size corresponds to the percentage of expression, and the bubble colour corresponds to the average expression of the gene in each cell type. (C) Gene Set Enrichment Analysis (GSEA) of hallmark pathways enriched in Langerhans cells of the TT group compared to the control group. (D) GSEA of hallmark pathways enriched in natural killer (NK) cells of the TT group compared to the control group. (E) Violin plots showing the expression levels of selected marker genes activating NK cells. (F) The most activated regulatory network, ‘biosynthesis of ribonucleotide,’ in NK cells of the TT group relative to the UN group, identified by Ingenuity Pathway Analysis (IPA). Cellular events/canonical pathways/regulators that were activated are indicated in orange, while others that were suppressed are indicated in blue.
The population of NK cells was significantly elevated in both the control and TT groups compared to the UN group, with the increase being more pronounced in the control group (Figure S1 and Table S1). The phenotype of NK cells in the TT group exhibited more inflammatory features compared to the control group, which showed significant downregulation of IFN-γ and inflammatory response pathways (Fig. 6D). Additionally, ‘IL2/STAT5 signalling’ was negatively associated with the control group. Interestingly, the expression levels of marker genes for priming NK cells in the TT group, such as Klrk1, Prf1, Gzmb, Ncr1, Lamp1, and Fcgr3, were lower than those in the control or UN groups (Fig. 6E). Ingenuity Pathway Analysis (IPA) identified ‘biosynthesis of ribonucleotide’ as the top relevant network modulated by TT compared to the UN group, a network that was absent in the control group when compared to the UN group (Fig. 6E). Additionally, pathways associated with ‘cell proliferation of tumour cell lines,’ ‘cell viability of breast cancer cell lines,’ and ‘migration of cells’ were downregulated, whereas ‘sensitivity of cells’ was activated, indicating that TT treatment modulated NK cells to create an inhibitory environment for tumours.
The treatments markedly reduces the B cell population
The population of B cells significantly decreased, dropping from 4.52% in the UN group to 0.67% in the control group and 0.64% in the TT group (Table S1). Notably, the expression of many antigen-associated genes, such as Cd86, Cd53, Cd68, and Cd22, was markedly elevated in the control group compared to the other two groups (Fig. 7A). Additionally, three MHC class II antigens, including H2-DMb2, H2-DMa, and H2-Aa, were upregulated by the control treatment. In the TT group, the upregulation of Cd52 and a B cell marker gene Bcl2a1b was observed. GSEA indicated that energy metabolism-associated biological processes were more activated in the TT group compared to the control group (Fig. 7B). Conversely, several autophagy-related processes were comparatively less active in the control group. IPA revealed an inhibition of 'organismal death' in the B cells of the control group (Fig. 7C), while apoptosis was more activated in the B cells of the TT group (Figure S5). Furthermore, the TT group showed enhanced signalling in 'differentiation of T lymphocytes,' 'immune response of antigen-presenting cells,' and 'phagocytosis,' relative to the UN group, which was not detected in the control group with high consistency.
Figure 7 The effect of TT treatment on B cell phenotype and cell-cell communication in the TME. (A) Comparison of the expression levels of selected antigen-associated marker genes and B cell features. (B) Gene Set Enrichment Analysis (GSEA) of hallmark pathways enriched in B cells from the TT group compared to the control group. (C) Identification of the most activated regulatory network in B cells of the control group relative to the UN group, as determined by Ingenuity Pathway Analysis (IPA). Cellular events/canonical pathways/regulators that were activated are indicated in orange, while others that were suppressed are indicated in blue. (D) Communication network among immune cells in the TT group (P-value < 0.01). (E) Heatmap comparing the interaction probability between cDC1s and other cell types across the three groups. (see Table S4 for cell-cell communication results in detail.)
The TT induces more cDC1/CD8+ T cell communication
The cell-cell communication among immune response-relevant cells was analysed, with the networks of the TT group shown in Fig. 7C. The networks of the UN and control groups are compared in Figure S5. No communication (P-value < 0.01) was detected between cDC1s and CD8+ T cells in the UN group, similar to the lack of communication between Langerhans cells in the treatment groups. Additionally, cDC1s interacted with TAMs, Arg1hi, and Res-like MΦs to a lesser extent in both the control and TT groups, as well as with pDCs and B cells. The interaction probability between cDC1s and other cell types is compared in Fig. 8D, showing that most communication was reduced in the control group compared to the UN group, except with NK and CD4+CD8+ T cells. Notably, the interaction between cDC1s and four cell types was significantly elevated by the TT, including MHCIIhi MΦs (by 22% relative to the UN group), CD4+CD25+ T cells (56%), migDCs (18%), and CD8+ T cells (by 73% relative to the control). On the other hand, the control appeared to enforce more communication between migDCs, pDCs and Langerhans cells with other cell types, such as Arg1hi MΦs, neutrophils, B cells, NK cells, CD4 + CD8 + T cells, and CD8 + T cells, compared to the UN and the TT groups; notably, TAMs showed highest communication with these three DC types in the TT group (Table S4).