The Th1 signature found in E-MpMs did not include a detectable TNFA or IL2 gene transcription, suggesting that, despite their Th1 polarisation, the E-MpM-infiltrating T cells were probably dysfunctional or exhausted, which is in line with the detection of PD1 positivity in a fraction of EMpMs. The impaired T cell immunity was associated with clear signs of immunosuppression and the presence of IL10 and TGFB1 cytokines in all of the E-MpM variants, albeit at different levels and with the clear prevalence of the first.
EIT therefore seems to be a crucial step toward more aggressive EMpMs in which transdifferentiation may be detected in Pro-E-MpMs and in the residual epithelioid foci of HG-EMpMs, but not in fully mesenchymal S-MpMs.
