ARTICLE https://doi.org/10.1038/s41467-020-20447-y OPEN Identification of a subset of immunosuppressive P2RX1-negative neutrophils in pancreatic cancer liver metastasis Xu Wang1,2,4, Li-Peng Hu1,4, Wei-Ting Qin1,4, Qin Yang1,4, De-Yu Chen2,4, Qing Li1, Kai-Xia Zhou1, Pei-Qi Huang1, Chun-Jie Xu1, Jun Li1, Lin-Li Yao1, Ya-Hui Wang1, Guang-Ang Tian1, Jian-Yu Yang3, ✉ ✉ ✉ Min-Wei Yang3, De-Jun Liu3, Yong-Wei Sun 3 , Shu-Heng Jiang 1 , Xue-Li Zhang 1 & ✉ Zhi-Gang Zhang 1 1234567890():,; The immunosuppressive microenvironment that is shaped by hepatic metastatic pancreatic ductal adenocarcinoma (PDAC) is essential for tumor cell evasion of immune destruction. Neutrophils are important components of the metastatic tumor microenvironment and exhibit heterogeneity. However, the specific phenotypes, functions and regulatory mechan- isms of neutrophils in PDAC liver metastases remain unknown. Here, we show that a subset of P2RX1-negative neutrophils accumulate in clinical and murine PDAC liver metastases. RNA sequencing of murine PDAC liver metastasis-infiltrated neutrophils show that P2RX1- deficient neutrophils express increased levels of immunosuppressive molecules, including PD-L1, and have enhanced mitochondrial metabolism. Mechanistically, the transcription factor Nrf2 is upregulated in P2RX1-deficient neutrophils and associated with PD-L1 expression and metabolic reprogramming. An anti-PD-1 neutralizing antibody is sufficient to compromise the immunosuppressive effects of P2RX1-deficient neutrophils on OVA- activated OT1 CD8+ T cells. Therefore, our study uncovers a mechanism by which metastatic PDAC tumors evade antitumor immunity by accumulating a subset of immuno- suppressive P2RX1-negative neutrophils. 1 State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China. 2 Department of Radiation Oncology, Institute of Oncology, Affiliated Hospital of Jiangsu University, Zhenjiang, P.R. China. 3 Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China. 4These authors contributed equally: Xu ✉ Wang, Li-Peng Hu, Wei-Ting Qin, Qin Yang, De-Yu Chen. email: [email protected]; [email protected]; [email protected]; [email protected] NATURE COMMUNICATIONS | (2021) 12:174 | https://doi.org/10.1038/s41467-020-20447-y | www.nature.com/naturecommunications 1 ARTICLE NATURE COMMUNICATIONS | https://doi.org/10.1038/s41467-020-20447-y ancreatic ductal adenocarcinoma (PDAC) is the fourth Fig. 1a). Differential analysis comparing primary PDAC and most common cause of death from cancer, with a 5-year adjacent pancreas identified a set of differentially expressed genes, P 1 survival rate of 8% . PDAC remains one of the most lethal 82 of which were involved in immune responses (Fig. 1a). In cancers in part due to its aggressive metastatic nature2. The liver comparison, 320 differentially expressed genes between liver is the most common site of distant metastases of PDAC, and metastases and adjacent liver tissues were implicated in immune more than half of PDAC patients are diagnosed with liver responses (Fig. 1a). We also found that primary PDAC samples metastases. Whole-genome sequencing studies revealed limited and liver metastatic tissues showed significant differences in genetic heterogeneity between primary and metastatic tumors, immune responses. with remarkably uniform mutations in PDAC driver genes, To identify specific immune cells linked to PDAC liver including KRAS, TP53, and SMAD43. However, when comparing metastasis, the immunome, a compendium of 28 immune cell the transcriptome data of primary and metastatic tumors that types that infiltrated in tumors, was analyzed14. The results contain microenvironment tissues, major differences were showed that immune cell infiltration was intensively repro- uncovered4. To establish metastatic tumors in liver tissues, the grammed in primary and metastatic PDAC (Fig. 1b). We noticed cells must successfully negotiate complex steps within a foreign that antitumor immune cells, including activated CD8+, central microenvironment. The acquisition of genomic alterations does memory CD8+, effector memory CD8+ and T helper type 1 not fully explain the process of liver metastases, which is likely to (Th1) cells, were markedly downregulated in PDAC liver be influenced not only by tumor cells but also by the tumor metastases compared to those in primary PDAC and adjacent microenvironment. liver tissues, whereas the classically recognized protumoral Th2 PDAC is nonimmunogenic and characterized by a desmo- cells were upregulated (Fig. 1b). Additionally, gene ontology (GO) plastic tumor microenvironment, with high numbers of fibro- analysis revealed substantial enrichment of certain antitumor blasts and extracellular matrix deposition5. Although liver immunity-associated pathways, including antigen processing and metastases were also identified with a similar desmoplastic presentation and the T cell receptor signaling pathway, that were stroma, recent studies observed that the metastatic tumor downregulated compared to those of adjacent nontumoral liver microenvironment possesses a relatively abundant infiltration of tissue, whereas tumor growth-related pathways, such as DNA immune cells6. Therefore, shaping an immunosuppressive replication and epithelial cell proliferation, were upregulated microenvironment is a critical step by which metastatic tumors (Fig. 1c). These analyses demonstrated a local immunosuppres- evade antitumor immunity and colonize foreign tissues. The sive microenvironment in hepatic metastatic PDAC, which might immunosuppressive microenvironment at the primary tumor site facilitate local tumor growth. Emerging evidence suggests that has been studied for decades; however, relatively little is known neutrophils play important roles in tumor metastasis15. We found about how the hepatic local immune microenvironment is that neutrophils were rare in primary PDAC and adjacent mediated by metastatic tumors. pancreas (Fig. 1b). However, in PDAC liver metastases and Neutrophils have long been recognized as a homogeneous cell adjacent liver tissues, neutrophils were among the most abundant population that constitutes the first line of defense against immunocytes, which suggested that they might have potential invading pathogens. Recently, accumulating evidence has revealed roles in PDAC liver metastasis. Apart from Th1 and Th2 cells, the the essential role of neutrophils in the tumor microenvironment, role of Th17 cells in tumor microenvironment has recently with both tumor-suppressing and tumor-promoting effects7,8. attracted much attention, with both promotive16 and suppres- However, the specific phenotypes and mechanisms that char- sive17 effects on tumor metastasis having been reported. Our acterize this heterogeneity remain unclarified. analyses showed that primary PDAC and PDAC liver metastases Extracellular nucleotides (particularly ATP) and adenosine had more Th17 cells as compared to adjacent pancreas and (ADO) are major biochemical constituents of tumor micro- adjacent liver tissues, respectively (Fig. 1b). The specific function environment9. By activating tumoral purinergic P2- and P1- of Th17 in PDAC progression remains to be explored. receptors, extracellular purines facilitate the tumor growth Interestingly, we noted that the purinergic receptor signaling directly10. In addition, host immune cells express abundant P2- pathway and response to ATP-related gene expression were and P1- receptors, and extracellular purines are essential for dysregulated in PDAC liver metastases (Fig. 1b). Given the mediating immune cells trafficking and immune phenotypes11. essential role of purinergic signaling in manipulating the immune The purinergic receptor P2RX1 is an ATP-gated ion channel and response and tumor growth11,18, we next assessed the relevance of participates in smooth muscle contraction and immunity12,13. purinergic signaling-associated molecules in PDAC liver metas- In this work, we identify a subset of P2RX1-negative (P2RX1−) tases, which included 18 purinergic receptors, 46 purine neutrophils that is mobilized and recruited in PDAC liver transmitters and 37 purine hydrolases. The results showed that metastases. P2RX1 deficiency shapes the immunosuppressive these molecules were thoroughly reprogrammed, with 26 sig- nature of this subset of neutrophils and promotes PDAC liver nificantly upregulated and 46 significantly downregulated mole- metastases. Further studies demonstrate that upregulated activity cules (Supplementary Fig. 1b, c). Venn diagram analysis indicated of the anti-inflammatory transcription factor Nrf2 contributes to that ADORA2B, a well-recognized immunosuppressive purinergic the generation of the immunosuppressive phenotype of P2RX1- receptor, overlapped in upregulated gene lists, whereas P2RX1 neutrophils. overlapped in the downregulated gene lists when comparing liver metastases vs adjacent liver tissue, primary PDAC vs liver metastases and primary PDAC vs adjacent pancreas (Fig. 1d, Results Supplementary Fig. 1b and c). Reduced P2RX1 is associated with an immunosuppressive Next, correlations between PDAC metastatic immune compo- microenvironment in PDAC liver metastases. To investigate nents and purinergic signaling molecules were analyzed (Supple- specific transcriptome alterations that might influence PDAC mentary Fig. 2a). We observed that ADORA2B was negatively liver metastases and its microenvironment, bioinformatics