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Wintering A, Tischer-Zimmermann S, Schultze-Florey R, Beier R, Sauer M, Blasczyk R, Heim A, Eiz-Vesper B, Maecker-Kolhoff B. Adenoviral penton and hexon proteins are equivalent immunogenic targets of virus-specific T cells after HSCT in children. Transplant Cell Ther 2023:S2666-6367(23)01172-7. [PMID: 36934995 DOI: 10.1016/j.jtct.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Human adenovirus (HAdV) infection is a serious complication that can lead to significant morbidity and mortality, especially in immunocompromised pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Control and elimination of HAdV requires the presence of the respective antiviral T cells, and adoptive transfer of virus-specific T cells has become an important new treatment option for patients refractory to antiviral treatment. Although the adenoviral capsid protein hexon was shown to be a major immunodominant T-cell target across HAdV species, up to 30% of HAdV-seropositive donors show no T-cell responses to the overlapping peptide pool spanning the entire protein. OBJECTIVES AND STUDY DESIGN Our group has recently verified the capsid protein penton as a second immunodominant target in HAdV infection. Here, we aimed to investigate the prevalence of both penton- and hexon-specific HAdV T cells and their impact in virus control after HSCT. Therefore, we analyzed the prevalence and characteristics of HAdV-specific T cells in 33 consecutive pediatric patients with HAdV reactivation following allogeneic HSCT and correlated them with viral load analysis. RESULTS AND CONCLUSION Our study demonstrates that penton is an important immunodominant target antigen of HAdV reactivation/infection after HSCT in most patients. We demonstrate that in the majority of patients, both penton- and hexon-specific T cells appear at similar time intervals after transplantation. Despite the prevalence for either hexon- or penton-specific T cells in individual patients, we were unable to attribute the pre-dominance to specific HLA types or HAdV serotypes. The occurrence of HAdV-specific T cells was closely linked to viral control arguing for immune monitoring strategies to tailor antiviral treatment and adoptive T cell therapy.
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Affiliation(s)
- Astrid Wintering
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Sabine Tischer-Zimmermann
- Institute for Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover Germany
| | | | - Rita Beier
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Martin Sauer
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Rainer Blasczyk
- Institute for Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover Germany
| | - Albert Heim
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Britta Eiz-Vesper
- Institute for Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover Germany; German Center for Infection Research (DZIF)
| | - Britta Maecker-Kolhoff
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany; German Center for Infection Research (DZIF).
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2
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Mouton W, Conrad A, Alcazer V, Boccard M, Bodinier M, Oriol G, Subtil F, Labussière-Wallet H, Ducastelle-Lepretre S, Barraco F, Balsat M, Fossard G, Brengel-Pesce K, Ader F, Trouillet-Assant S. Distinct Immune Reconstitution Profiles Captured by Immune Functional Assays at 6 Months Post Allogeneic Hematopoietic Stem Cell Transplantation. Transplant Cell Ther 2023; 29:94.e1-94.e13. [PMID: 36336259 DOI: 10.1016/j.jtct.2022.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022]
Abstract
Immune reconstitution after allogeneic-hematopoietic-stem-cell transplantation (allo-HSCT) is a complex and individual process. In this cross-sectional study, whole-blood (WB) immune functional assay (IFA) was used to characterize immune function by assessing immune-related gene/pathway alterations. The usefulness of this tool in the context of infection, 6 months after transplantation, was evaluated. Sixty allo-HSCT recipients at 6 months after transplantation and 10 healthy volunteers (HV) were included. WB was stimulated in standardized TruCulture tubes using lipopolysaccharides and Staphylococcal enterotoxin B. Gene expression was quantified using a custom 144-gene panel using NanoString nCounter technology and analyzed using Ingenuity Pathway Analysis. The relationships between immune function and clinical characteristics, immune cell counts, and post-transplantation infections were assessed. Allo-HSCT recipients were able to activate similar networks of the innate and adaptive immune response compared to HV, with, nevertheless, a lower intensity. A reduced number and a lower expression of genes associated with immunoregulatory and inflammatory processes were observed in allo-HSCT recipients. The use of immunosuppressive treatments was associated with a protracted immune reconstitution revealed by transcriptomic immunoprofiling. No difference in immune cell counts was observed among patients receiving or not receiving immunosuppressive treatments using a large immunophenotyping panel. Moreover, the expression of a set of genes, including CCL3/CCL4, was significantly lower in patients with Herpesviridae reactivation (32%, 19/60), which once again was not identified using classical immune cell counts. Transcriptional IFA revealed the heterogeneity among allo-HSCT recipients with a reduced immune function, a result that could not be captured by circulating immune cell counts. This highlights the potential added value of this tool for the personalized care of immunocompromised patients.
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Affiliation(s)
- William Mouton
- Joint Research Unit Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France; Virology and Human Pathology - Virpath Team, International Centre for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France
| | - Anne Conrad
- Legionella Pathogenesis Team, International Centre for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France; Infectious and Tropical Diseases Department, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France; Claude Bernard Lyon I University, Villeurbanne, France
| | - Vincent Alcazer
- Clinical Hematology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France; LIB TEAM, International Centre for Research in Infectiology (CIRI), Oullins, France
| | - Mathilde Boccard
- Joint Research Unit Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France; Legionella Pathogenesis Team, International Centre for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France; Infectious and Tropical Diseases Department, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | - Maxime Bodinier
- Joint Research Unit Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Guy Oriol
- Joint Research Unit Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Fabien Subtil
- Biostatistics Department, Hospices Civils de Lyon, Lyon France, Lyon 1 University, Villeurbanne, France; CNRS, Biometrics and Evolutionary Biology Laboratory UMR, Villeurbanne, France
| | - Hélène Labussière-Wallet
- Clinical Hematology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | | | - Fiorenza Barraco
- Clinical Hematology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Marie Balsat
- Clinical Hematology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Gaëlle Fossard
- Clinical Hematology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Karen Brengel-Pesce
- Joint Research Unit Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Florence Ader
- Legionella Pathogenesis Team, International Centre for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France; Infectious and Tropical Diseases Department, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France; Claude Bernard Lyon I University, Villeurbanne, France.
| | - Sophie Trouillet-Assant
- Joint Research Unit Hospices Civils de Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France; Virology and Human Pathology - Virpath Team, International Centre for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France
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3
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Abdel-Azim H, Dave H, Jordan K, Rawlings-Rhea S, Luong A, Wilson AL. Alignment of practices for data harmonization across multi-center cell therapy trials: a report from the Consortium for Pediatric Cellular Immunotherapy. Cytotherapy 2022; 24:193-204. [PMID: 34711500 PMCID: PMC8792313 DOI: 10.1016/j.jcyt.2021.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/13/2021] [Accepted: 08/27/2021] [Indexed: 02/03/2023]
Abstract
Immune effector cell (IEC) therapies have revolutionized our approach to relapsed B-cell malignancies, and interest in the investigational use of IECs is rapidly expanding into other diseases. Current challenges in the analysis of IEC therapies include small sample sizes, limited access to clinical trials and a paucity of predictive biomarkers of efficacy and toxicity associated with IEC therapies. Retrospective and prospective multi-center cell therapy trials can assist in overcoming these barriers through harmonization of clinical endpoints and correlative assays for immune monitoring, allowing additional cross-trial analysis to identify biomarkers of failure and success. The Consortium for Pediatric Cellular Immunotherapy (CPCI) offers a unique platform to address the aforementioned challenges by delivering cutting-edge cell and gene therapies for children through multi-center clinical trials. Here the authors discuss some of the important pre-analytic variables, such as biospecimen collection and initial processing procedures, that affect biomarker assays commonly used in IEC trials across participating CPCI sites. The authors review the recent literature and provide data to support recommendations for alignment and standardization of practices that can affect flow cytometry assays measuring immune effector function as well as interpretation of cytokine/chemokine data. The authors also identify critical gaps that often make parallel comparisons between trials difficult or impossible.
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Affiliation(s)
- Hisham Abdel-Azim
- Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Hema Dave
- Center for Cancer and Blood Disorders, Children's National Hospital, George Washington School of Medicine, Washington, DC, USA
| | - Kimberly Jordan
- Department of Immunology and Microbiology, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA
| | - Stephanie Rawlings-Rhea
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Annie Luong
- Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Ashley L Wilson
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, Washington, USA.
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Papadopoulou A, Koukoulias K, Alvanou M, Papadopoulos VK, Bousiou Z, Kalaitzidou V, Kika FS, Papalexandri A, Mallouri D, Batsis I, Sakellari I, Anagnostopoulos A, Yannaki E. Patient risk stratification and tailored clinical management of post‐transplant CMV‐, EBV‐, and BKV‐infections by monitoring virus‐specific T‐cell immunity. EJHAEM 2021; 2:428-439. [PMID: 35844677 PMCID: PMC9175754 DOI: 10.1002/jha2.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 12/13/2022]
Abstract
Background Despite routine post‐transplant viral monitoring and pre‐emptive therapy, viral infections remain a major cause of allogeneic hematopoietic cell transplantation‐related morbidity and mortality. Objective We here aimed to prospectively assess the kinetics and the magnitude of cytomegalovirus‐(CMV), Epstein Barr virus‐(EBV), and BK virus‐(BKV)‐specific T cell responses post‐transplant and evaluate their role in guiding therapeutic decisions by patient risk‐stratification. Study design The tri‐virus‐specific immune recovery was assessed by Elispot, in 50 consecutively transplanted patients, on days +20, +30, +60, +100, +150, +200 post‐transplant and in case of reactivation, weekly for 1 month. Results The great majority of the patients experienced at least one reactivation, while over 40% of them developed multiple reactivations from more than one of the tested viruses, especially those transplanted from matched or mismatched unrelated donors. The early reconstitution of virus‐specific immunity (day +20), favorably correlated with transplant outcomes. Εxpanding levels of CMV‐, EBV‐, and BKV‐specific T cells (VSTs) post‐reactivation coincided with decreasing viral load and control of infection. Certain cut‐offs of absolute VST numbers or net VST cell expansion post‐reactivation were determined, above which, patients with CMV or BKV reactivation had >90% probability of complete response (CR). Conclusion Immune monitoring of virus‐specific T‐cell reconstitution post‐transplant may allow risk‐stratification of virus reactivating patients and enable patient‐tailored treatment. The identification of individuals with high probability of CR will minimize unnecessary overtreatment and drug‐associated toxicity while allowing candidates for pre‐emptive intervention with adoptive transfer of VSTs to be appropriately selected.
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Affiliation(s)
- Anastasia Papadopoulou
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Kiriakos Koukoulias
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
- Department of Genetics, Development and Molecular Biology, School of Biology Aristotle University of Thessaloniki Thessaloniki Greece
| | - Maria Alvanou
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | | | - Zoe Bousiou
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Vasiliki Kalaitzidou
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Fotini S. Kika
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Apostolia Papalexandri
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Despina Mallouri
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Ioannis Batsis
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Ioanna Sakellari
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Achilles Anagnostopoulos
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
| | - Evangelia Yannaki
- Hematology Department‐Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center “George Papanikolaou” Hospital Thessaloniki Greece
- Department of Medicine University of Washington Seattle Washington USA
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Gjaerde LK, Brooks PT, Andersen NS, Friis LS, Kornblit B, Petersen SL, Schjødt I, Nielsen SD, Ostrowski SR, Sengeløv H. Functional immune reconstitution early after allogeneic haematopoietic cell transplantation: A comparison of pre- and post-transplantation cytokine responses in stimulated whole blood. Scand J Immunol 2021; 94:e13042. [PMID: 33772836 DOI: 10.1111/sji.13042] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/10/2021] [Accepted: 03/21/2021] [Indexed: 01/24/2023]
Abstract
We aimed to use a novel standardized whole-blood stimulation system to evaluate differences in the functional immune reconstitution in patients early after allogeneic haematopoietic cell transplantation (HCT). Between April and September 2018, 30 patients undergoing HCT had whole blood samples collected around day -21 (day 0 being the day of haematopoietic cell infusion) and day +28. Whole blood was transferred to TruCulture assays comprising prefilled incubation tubes with cell culture medium and a standardized stimulus. We used a panel of four stimuli (lipopolysaccharide, resiquimod, heat-killed Candida albicans and polyinosinic:polycytidylic acid) and a blank, designed to evaluate the function of critical extra- and intracellular immunological signalling pathways. For each stimulus, the cytokine response was assessed by the concentration of interferon-γ, interleukin (IL)-12p40, IL-10, IL-1β, IL-6, IL-8, IL-10, IL-12p40, IL-17A and tumour necrosis factor-α using a multiplex Luminex assay. Pre-HCT cytokine responses were globally decreased across several different stimuli. Despite patients receiving immunosuppressive prophylaxis at the time, post-HCT cytokine responses were higher and less intercorrelated than pre-HCT responses, also after adjusting for differences in the leukocyte differential counts. For the resiquimod and heat-killed Candida albicans stimuli, we identified a cluster of patients in whom post-HCT responses were lower than average across several cytokines, indicating a possible functional immune deficiency. Our findings suggest that the standardized whole blood stimulation system can be used to reveal heterogeneity in the in vitro cytokine responses to various stimuli after HCT. Larger studies are needed to address if the functional immune reconstitution after HCT can predict the risk of infections.
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Affiliation(s)
- Lars Klingen Gjaerde
- Bone Marrow Transplant Unit, Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Patrick Terrence Brooks
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Niels Smedegaard Andersen
- Bone Marrow Transplant Unit, Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lone Smidstrup Friis
- Bone Marrow Transplant Unit, Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Brian Kornblit
- Bone Marrow Transplant Unit, Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Søren Lykke Petersen
- Bone Marrow Transplant Unit, Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ida Schjødt
- Bone Marrow Transplant Unit, Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Denmark of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Sengeløv
- Bone Marrow Transplant Unit, Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Giver CR. Antiviral Immune Monitoring and Support in Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:e92-e93. [PMID: 32188575 DOI: 10.1016/j.bbmt.2020.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Cynthia R Giver
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia.
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