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Distinct Immune Signatures Indicative of Treatment Response and Immune-Related Adverse Events in Melanoma Patients under Immune Checkpoint Inhibitor Therapy. Int J Mol Sci 2021; 22:ijms22158017. [PMID: 34360781 PMCID: PMC8348898 DOI: 10.3390/ijms22158017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/14/2022] Open
Abstract
To identify potential early biomarkers of treatment response and immune-related adverse events (irAE), a pilot immune monitoring study was performed in stage IV melanoma patients by flow cytometric analysis of peripheral blood mononuclear cells (PBMC). Overall, 17 patients were treated with either nivolumab or pembrolizumab alone, or with a combination of nivolumab and ipilimumab every three weeks. Of 15 patients for which complete response assessment was available, treatment responders (n = 10) as compared to non-responders (n = 5) were characterized by enhanced PD-1 expression on CD8+ T cells immediately before treatment (median ± median absolute deviation/MAD 26.7 ± 10.4% vs. 17.2 ± 5.3%). Responders showed a higher T cell responsiveness after T cell receptor ex vivo stimulation as determined by measurement of programmed cell death 1 (PD-1) expression on CD3+ T cells before the second cycle of treatment. The percentage of CD8+ effector memory (CD8+CD45RA−CD45RO+CCR7−) T cells was higher in responders compared to non-responders before and immediately after the first cycle of treatment (median ± MAD 39.2 ± 7.3% vs. 30.5 ± 4.1% and 37.7 ± 4.6 vs. 24.0 ± 6.4). Immune-related adverse events (irAE) were accompanied by a higher percentage of activated CD4+ (CD4+CD38+HLADR+) T cells before the second treatment cycle (median ± MAD 14.9 ± 3.9% vs. 5.3 ± 0.4%). In summary, PBMC immune monitoring of immune-checkpoint inhibition (ICI) treatment in melanoma appears to be a promising approach to identify early markers of treatment response and irAEs.
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Gabcova G, Horak P, Mikulkova Z, Skacelova M, Zehnalova S, Smrzova A, Petrackova A, Mrazek F, Kriegova E. Modulatory Effect of the Euro-Lupus Low-Dose Intravenous Cyclophosphamide Regimen on Circulating Immune Cells in Systemic Lupus Erythematosus. Arch Immunol Ther Exp (Warsz) 2019; 67:415-425. [PMID: 31620814 DOI: 10.1007/s00005-019-00563-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/28/2019] [Indexed: 12/26/2022]
Abstract
A Euro-Lupus regimen of low-dose intravenous cyclophosphamide (CFA) is commonly used to treat severe organ manifestations of systemic lupus erythematosus (SLE), particularly lupus nephritis (LN). There are no data on the distributions and dynamics of immune cell populations in patients with various treatment outcomes. The circulating immune cells of 11 female SLE patients were assessed before and after Euro-Lupus regimen (cumulative dose of 3000 mg CFA) by flow cytometry together with those of 16 healthy women. A subanalysis was performed in LN patients who achieved complete remission (CR; n = 3), partial remission (PR; n = 4), and no response (NR; n = 2). In SLE, the Euro-Lupus regimen decreased the percentage and absolute count of B cells; increased the percentage of CD8+ T cells, T regulatory cells, neutrophils, and monocyte subsets; and activated T and NK cells compared to healthy controls (P < 0.050). Patients with LN achieving CR had significantly lower proportions of CD27+ B memory cells compared to poor responders (PR/NR, P = 0.035). The post-treatment percentages and absolute numbers of B cells, T cells, NK cells, monocytes, and neutrophils showed high inter-individual variability with no association with treatment outcome. Our pilot study revealed the dynamics of changes in immune cell populations in SLE patients during a Euro-Lupus regimen, mainly the lowering of B cells. In LN patients who achieved CR, a lower proportion of CD27+ B memory cells was evident compared to poor responders (PR/NR). Further studies on usefulness of monitoring immune cells for treatment response prediction on larger cohorts are needed.
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Affiliation(s)
- Gabriela Gabcova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Hnevotinska 3, 775 15, Olomouc, Czech Republic
| | - Pavel Horak
- Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Zuzana Mikulkova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Hnevotinska 3, 775 15, Olomouc, Czech Republic
| | - Martina Skacelova
- Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Sarka Zehnalova
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Ostrava, Czech Republic
| | - Andrea Smrzova
- Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Anna Petrackova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Hnevotinska 3, 775 15, Olomouc, Czech Republic
| | - Frantisek Mrazek
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Hnevotinska 3, 775 15, Olomouc, Czech Republic
| | - Eva Kriegova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Hnevotinska 3, 775 15, Olomouc, Czech Republic.
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Sack U, Boldt A, Mallouk N, Gruber R, Krenn V, Berger-Depincé AE, Conrad K, Tarnok A, Lambert C, Reinhold D, Fricke S. Cellular analyses in the monitoring of autoimmune diseases. Autoimmun Rev 2016; 15:883-9. [PMID: 27392502 DOI: 10.1016/j.autrev.2016.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/05/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Ulrich Sack
- Universitätsklinikum Leipzig, Department für Diagnostik, Institut für Klinische Immunologie, Johannisallee 30, 04103, Leipzig, Germany.
| | - Andreas Boldt
- Universitätsklinikum Leipzig, Department für Diagnostik, Institut für Klinische Immunologie, Johannisallee 30, 04103, Leipzig, Germany.
| | - Nora Mallouk
- URCIP, CHU Saint-Etienne, Hôpital Nord, 42055 Saint-Etienne Cedex 02, France.
| | - Rudolf Gruber
- Institut für Labormedizin, Mikrobiologie und Krankenhaushygiene, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Straße 86, 93049, Regensburg, Germany.
| | - Veit Krenn
- Medizinisches Versorgungszentrum für Histologie, Zytologie und Molekulare Diagnostik Trier, Max-Planck-Str. 5, 54296, Trier, Germany.
| | | | - Karsten Conrad
- Institut für Immunologie, Medizinische Fakultät "Carl Gustav Carus" der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Attila Tarnok
- Universitätsklinikum Leipzig, Department für Diagnostik, Institut für Klinische Immunologie, Johannisallee 30, 04103, Leipzig, Germany.
| | - Claude Lambert
- Immunology laboratory, Pole de Biologie-Pathologie, University Hospital. CNRS UMR5307 Labo Georges Friedel (LGF); 42055 Saint-Etienne Cedex 02, France.
| | - Dirk Reinhold
- Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät, Institut für Molekulare und Klinische Immunologie, Leipziger Straße 44, 39120, Magdeburg, Germany.
| | - Stephan Fricke
- Fraunhofer Institut für Zelltherapie und Immunologie, Perlickstraße 1, 04103, Leipzig, Germany.
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