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As AM lacks the UV-radiation mutational signatures that characterize other cutaneous melanomas, it is considered devoid of immunogenicity and is rarely included in clinical trials assessing novel immunotherapeutic regimes aiming to recover the antitumor function of immune cells. We studied a Mexican cohort of melanoma patients from the Mexican Institute of Social Security (IMSS) (n = 38) and found an overrepresentation of AM (73.9%). We developed a multiparametric immunofluorescence technique coupled with a machine learning image analysis to evaluate the presence of conventional type 1 dendritic cells (cDC1) and CD8 T cells in the stroma of melanoma, two of the most relevant immune cell types for antitumor responses. We observed that both cell types infiltrate AM at similar and even higher levels than other cutaneous melanomas. Both melanoma types harbored programmed cell death protein 1 (PD-1+) CD8 T cells and PD-1 ligand (PD-L1+) cDC1s. Despite this, CD8 T cells appeared to preserve their effector function and expanding capacity as they expressed interferon-\u03b3 (IFN-\u03b3) and KI-67. The density of cDC1s and CD8 T cells significantly decreased in advanced stage III and IV melanomas, supporting these cells\u2019 capacity to control tumor progression. These data also argue that AM could respond to anti-PD-1-PD-L1 immunotherapy.<\/jats:p>","DOI":"10.3390\/ijms24054786","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T03:29:00Z","timestamp":1677727740000},"page":"4786","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Acral Melanoma Is Infiltrated with cDC1s and Functional Exhausted CD8 T Cells Similar to the Cutaneous Melanoma of Sun-Exposed Skin"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2451-0123","authenticated-orcid":false,"given":"Sara\u00ed G.","family":"De Leon-Rodr\u00edguez","sequence":"first","affiliation":[{"name":"UMAE Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Unidad de Investigaci\u00f3n M\u00e9dica en Inmunoqu\u00edmica, Mexico City 06720, Mexico"},{"name":"Posgrado en Ciencias Biol\u00f3gicas, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Aguilar-Flores","sequence":"additional","affiliation":[{"name":"UMAE Hospital de Pediatr\u00eda, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2402-2135","authenticated-orcid":false,"given":"Juli\u00e1n A.","family":"Gaj\u00f3n","sequence":"additional","affiliation":[{"name":"UMAE Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Unidad de Investigaci\u00f3n M\u00e9dica en Inmunoqu\u00edmica, Mexico City 06720, Mexico"},{"name":"Posgrado en Ciencias Bioqu\u00edmicas, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Mantilla","sequence":"additional","affiliation":[{"name":"Servicio de Patolog\u00eda, Hospital de Oncolog\u00eda Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Gerson-Cwilich","sequence":"additional","affiliation":[{"name":"Cancer Center, Medical Center American British Cowdray, Mexico City 01120, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9894-2204","authenticated-orcid":false,"given":"Jos\u00e9 Fabi\u00e1n","family":"Mart\u00ednez-Herrera","sequence":"additional","affiliation":[{"name":"Cancer Center, Medical Center American British Cowdray, Mexico City 01120, Mexico"},{"name":"Latin American Network for Cancer Research (LAN-CANCER), Lima 11702, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3212-4898","authenticated-orcid":false,"given":"Benigno E.","family":"Rodr\u00edguez-Soto","sequence":"additional","affiliation":[{"name":"International Cancer Center, Campus Santa Fe, Mexico City 05348, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia T.","family":"Guti\u00e9rrez-Quiroz","sequence":"additional","affiliation":[{"name":"UMAE Hospital de Especialidades, Centro M\u00e9dico Nacional General Manuel Avila Camacho, Puebla 72000, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9118-8800","authenticated-orcid":false,"given":"Vadim","family":"P\u00e9rez-Koldenkova","sequence":"additional","affiliation":[{"name":"Laboratorio Nacional de Microscop\u00eda Avanzada-IMSS, Divisi\u00f3n de Desarrollo de la Investigaci\u00f3n, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9547-2515","authenticated-orcid":false,"given":"Samira","family":"Mu\u00f1oz-Cruz","sequence":"additional","affiliation":[{"name":"UMAE Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Unidad de Investigaci\u00f3n M\u00e9dica en Inmunoqu\u00edmica, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Bonifaz","sequence":"additional","affiliation":[{"name":"UMAE Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Unidad de Investigaci\u00f3n M\u00e9dica en Inmunoqu\u00edmica, Mexico City 06720, Mexico"},{"name":"Coordinaci\u00f3n de Investigaci\u00f3n en Salud, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2872-0459","authenticated-orcid":false,"given":"Ezequiel M.","family":"Fuentes-Panan\u00e1","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n en Virolog\u00eda y C\u00e1ncer, Hospital Infantil de M\u00e9xico Federico G\u00f3mez, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.suc.2019.09.005","article-title":"Epidemiology and Risk Factors of Melanoma","volume":"100","author":"Carr","year":"2020","journal-title":"Surg. 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