HLA-E

Overview

HLA-E encodes a non-classical MHC class I molecule that engages the inhibitory NKG2A receptor on NK cells and CD8+ T cells, suppressing cytotoxicity. In HGSOC, HLA-E is progressively upregulated from the earliest precursor stages and is proposed as a key immune evasion mechanism.

Alterations observed in the corpus

  • HLA-E is progressively upregulated across HGSOC progression: p53 signature (median 4% HLA-E+ epithelial cells) to STIC.C (26%); upregulation is strongly associated with IFN and IRDS gene signatures PMID:39386723.
  • HLA-E-positive tumor regions are characterized by decreased NK cell infiltration (nearly undetectable NK cells in STIC.I, STIC.C, and cancer; median 0.02% vs 0.1% in normal/p53.I), consistent with NKG2A-mediated immune suppression PMID:39386723.

Cancer types (linked)

  • HGSOC — progressive upregulation from p53 signatures through invasive cancer; proposed mechanism for NK cell evasion; potential early interception target with anti-NKG2A antibodies (e.g., monalizumab) in high-risk incidental STIC patients PMID:39386723.

Co-occurrence and mutual exclusivity

Therapeutic relevance

  • Anti-NKG2A antibodies (e.g., monalizumab) represent a candidate early-interception strategy targeting the HLA-E/NKG2A immune evasion axis in HGSOC precursors, particularly for high-risk patients with incidental STICs PMID:39386723.

Open questions

  • Functional validation of the proposed HLA-E/NKG2A immune evasion axis in HGSOC precursors is needed PMID:39386723.
  • The relative contribution of HLA-E vs other immune suppressive mechanisms (Treg accumulation, CD8+ T cell exhaustion) to the overall immune evasion in HGSOC is unresolved PMID:39386723.

Sources

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