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Willyanto SE, Alimsjah YA, Tanjaya K, Tuekprakhon A, Pawestri AR. Comprehensive analysis of the efficacy and safety of CAR T-cell therapy in patients with relapsed or refractory B-cell acute lymphoblastic leukaemia: a systematic review and meta-analysis. Ann Med 2024; 56:2349796. [PMID: 38738799 PMCID: PMC11095278 DOI: 10.1080/07853890.2024.2349796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Relapse/refractory B-cell acute lymphoblastic leukaemia (r/r B-ALL) represents paediatric cancer with a challenging prognosis. CAR T-cell treatment, considered an advanced treatment, remains controversial due to high relapse rates and adverse events. This study assessed the efficacy and safety of CAR T-cell therapy for r/r B-ALL. METHODS The literature search was performed on four databases. Efficacy parameters included minimal residual disease negative complete remission (MRD-CR) and relapse rate (RR). Safety parameters constituted cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). RESULTS Anti-CD22 showed superior efficacy with the highest MRD-CR event rate and lowest RR, compared to anti-CD19. Combining CAR T-cell therapy with haploidentical stem cell transplantation improved RR. Safety-wise, bispecific anti-CD19/22 had the lowest CRS rate, and anti-CD22 showed the fewest ICANS. Analysis of the costimulatory receptors showed that adding CD28ζ to anti-CD19 CAR T-cell demonstrated superior efficacy in reducing relapses with favorable safety profiles. CONCLUSION Choosing a more efficacious and safer CAR T-cell treatment is crucial for improving overall survival in acute leukaemia. Beyond the promising anti-CD22 CAR T-cell, exploring costimulatory domains and new CD targets could enhance treatment effectiveness for r/r B-ALL.
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Affiliation(s)
| | - Yohanes Audric Alimsjah
- Bachelor Study Program of Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Krisanto Tanjaya
- Bachelor Study Program of Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Aekkachai Tuekprakhon
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Aulia Rahmi Pawestri
- Department of Parasitology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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Cardoso TL, de Freitas SB, Seixas Neto ACP, Balassiano IT, Hartwig DD. Advancing serologic diagnosis: assessing the efficacy of rErpY-like protein in human leptospirosis detection. Braz J Microbiol 2024:10.1007/s42770-024-01364-4. [PMID: 38805148 DOI: 10.1007/s42770-024-01364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Leptospirosis is a globally distributed infectious disease caused by pathogenic spirochetes of the Leptospira genus, often overlooked. It is estimated that the disease affects approximately one million people annually, resulting in more than 58,900 deaths. The gold standard for serodiagnosis of leptospirosis is the Microscopic Agglutination Test (MAT). However, the limitations of this technique necessitate the exploration of alternative diagnostic methods. In this study, we evaluated the ErpY-like recombinant protein (rErpY-like) in the development of a serologic diagnostic assay for human leptospirosis. Eighty-six human sera samples, characterized by MAT, underwent evaluation through indirect IgM-ELISA and IgG-ELISA. The sensitivity and specificity values obtained from IgM-ELISA were 60% and 76%, respectively, while those from IgG-ELISA were 96.4% and 100%, respectively. The use of the rErpY-like protein in both IgM-ELISA and IgG-ELISA proves to be a sensitive and specific method for antibody detection. This could potentially serve as a valuable alternative tool in the diagnosis of human leptospirosis.
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Affiliation(s)
- Thayná Laner Cardoso
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Stella Buchhorn de Freitas
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Amilton Clair Pinto Seixas Neto
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Ilana Teruszkin Balassiano
- Bacterial Zoonoses Laboratory, Leptospirosis National Reference Center/Leptospira Collection, WHO/PAHO Collaborating Center for Leptospirosis, Department of Bacteriology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
| | - Daiane Drawanz Hartwig
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil.
- Federal University of Pelotas, University Campus, Pelotas, RS, CEP 96010-900, Brazil.
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Taylor C, Belin E, Brodbelt D, Klaasen HLBM, Catchpole B. Exploration of the potential utility of the luciferase immunoprecipitation system (LIPS) assay for the detection of anti-leptospira antibodies in dogs. Vet Immunol Immunopathol 2023; 264:110661. [PMID: 37827091 DOI: 10.1016/j.vetimm.2023.110661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/04/2023] [Indexed: 10/14/2023]
Abstract
Canine leptospirosis represents a diagnostic challenge to veterinarians, due to the variability in presenting clinical signs and interpretation of serology test results in dogs that have been vaccinated previously. None of the commercially available serological assays, including the microscopic agglutination test (MAT), have been verified to be capable of differentiating infected from vaccinated animals (DIVA). Recent work identified that half of primary practice attending dogs were up to date with their leptospirosis vaccination and would be expected to have circulating anti-leptospira antibodies (Taylor et al., 2022), indicating that this is a relevant issue for suspected leptospirosis cases in dogs in the UK. This study aimed to explore the utility of three leptospiral outer membrane proteins (OMPs: LipL32, LipL21 and LipL41) as potential DIVA targets in the luciferase immunoprecipitation system (LIPS) assay. N and C terminal nanoluciferase tagged recombinant proteins were generated for each OMP. Differences in reactivity between serum samples from MAT positive dogs (n = 29) and paired samples (n = 6 dogs) taken pre and 21 days post leptospirosis vaccination were assessed against these six constructs. Reactivity was greater towards the N terminal than the C terminal recombinant proteins for all three OMPs. None of the constructs appeared to demonstrate DIVA capability, although two (pNLF1-N-FLAG/LipL32 and pNLF1-N-FLAG/LipL21) were able to detect vaccine seroconversion. The findings of this work suggest that these particular OMP targets do not offer DIVA ability, however LipL32 and LipL21 may be suitable for use in immunoassays for vaccine trials or for detection of infections in humans, where there is no requirement for DIVA capability.
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Affiliation(s)
- C Taylor
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom.
| | - E Belin
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - D Brodbelt
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - H L B M Klaasen
- Global Companion Animals Research and Development, Merck Sharp and Dohme Animal Health, Boxmeer, the Netherlands
| | - B Catchpole
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
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Takahashi MB, Teixeira AF, Nascimento ALTO. Overcoming problems to produce the recombinant protein LipL21 of Leptospira interrogans. Biotechniques 2023; 74:137-142. [PMID: 37067289 DOI: 10.2144/btn-2022-0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
The production of leptospiral recombinant proteins in the soluble form and in high yield from Escherichia coli is still a challenge. This work presents the cloning, expression and purification of the outer membrane protein of Leptospira interrogans, LipL21, which is considered an interesting target for vaccine and diagnostics development. The expression profile and yield of LipL21 was compared after cloning in the vectors pAE, pET28a and pET-SUMO, and it was observed that LipL21 was expressed in a low amount with pAE vector. By using the pET-28a vector, protein expression was increased, but the majority of the product was obtained as inclusion bodies. As a highlight, using a pET-SUMO vector was shown to overcome the problems of low expression and solubility of the lipoprotein LipL21.
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Affiliation(s)
- Maria Beatriz Takahashi
- Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Avenida Lineu Prestes, São Paulo, 2415 - 05508-900, Brazil
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, Avenida Vital Brazil, São Paulo, 1500 - 05503-900, Brazil
| | - Aline Florencio Teixeira
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, Avenida Vital Brazil, São Paulo, 1500 - 05503-900, Brazil
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A New Recombinant Multiepitope Chimeric Protein of Leptospira interrogans Is a Promising Marker for the Serodiagnosis of Leptospirosis. Trop Med Infect Dis 2022; 7:tropicalmed7110362. [DOI: 10.3390/tropicalmed7110362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/20/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022] Open
Abstract
The zoonotic disease leptospirosis is caused by pathogenic species of the genus Leptospira and was recently included in the list of Neglected Diseases by the World Health Organization. Leptospirosis burden is estimated to have over a million human cases and cause 60 thousand deaths annually, in addition to its economic impact and veterinary concern. The microscopic agglutination test (MAT), recommended by the World Health Organization, exhibits reduced sensitivity at the beginning of the disease, in addition to being technically difficult. New recombinant antigens are being pursued for rapid and specific serodiagnostic tests, especially in the initial phase of the disease, and chimeric multiepitope proteins are a strategy with a great potential to be implemented in serology. Based on previous subproteomic results, we designed a synthetic construct comprising 10 conserved leptospiral surface antigens, and the recombinant protein was purified and evaluated regarding its diagnostic potential. The protein termed rChi2 was recognized by antibodies in serum from patients both at the onset (MAT−) and in the convalescent (MAT+) phase in 75 and 82% of responders, respectively. In addition, rChi2 immunization in hamsters elicited a strong humoral response, and anti-rChi2 antibodies recognized several immobilized intact Leptospira species, validating its potential as an early, broad, and cross-reactive diagnostic test.
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Zhou J, Chen J, Peng Y, Xie Y, Xiao Y. A Promising Tool in Serological Diagnosis: Current Research Progress of Antigenic Epitopes in Infectious Diseases. Pathogens 2022; 11:1095. [PMID: 36297152 PMCID: PMC9609281 DOI: 10.3390/pathogens11101095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 07/30/2023] Open
Abstract
Infectious diseases, caused by various pathogens in the clinic, threaten the safety of human life, are harmful to physical and mental health, and also increase economic burdens on society. Infections are a complex mechanism of interaction between pathogenic microorganisms and their host. Identification of the causative agent of the infection is vital for the diagnosis and treatment of diseases. Etiological laboratory diagnostic tests are therefore essential to identify pathogens. However, due to its rapidity and automation, the serological diagnostic test is among the methods of great significance for the diagnosis of infections with the basis of detecting antigens or antibodies in body fluids clinically. Epitopes, as a special chemical group that determines the specificity of antigens and the basic unit of inducing immune responses, play an important role in the study of immune responses. Identifying the epitopes of a pathogen may contribute to the development of a vaccine to prevent disease, the diagnosis of the corresponding disease, and the determination of different stages of the disease. Moreover, both the preparation of neutralizing antibodies based on useful epitopes and the assembly of several associated epitopes can be used in the treatment of disease. Epitopes can be divided into B cell epitopes and T cell epitopes; B cell epitopes stimulate the body to produce antibodies and are therefore commonly used as targets for the design of serological diagnostic experiments. Meanwhile, epitopes can fall into two possible categories: linear and conformational. This article reviews the role of B cell epitopes in the clinical diagnosis of infectious diseases.
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Mohd Ali MR, Sum JS, Aminuddin Baki NN, Choong YS, Nor Amdan NA, Amran F, Lim TS. Development of monoclonal antibodies against recombinant LipL21 protein of pathogenic Leptospira through phage display technology. Int J Biol Macromol 2020; 168:289-300. [PMID: 33310091 DOI: 10.1016/j.ijbiomac.2020.12.062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 01/06/2023]
Abstract
Leptospirosis is a potentially fatal zoonosis that is caused by spirochete Leptospira. The signs and symptoms of leptospirosis are usually varied, allowing it to be mistaken for other causes of acute febrile syndromes. Thus, early diagnosis and identification of a specific agent in clinical samples is crucial for effective treatment. This study was aimed to develop specific monoclonal antibodies against LipL21 antigen for future use in leptospirosis rapid and accurate immunoassay. A recombinant LipL21 (rLipL21) antigen was optimized for expression and evaluated for immunogenicity. Then, a naïve phage antibody library was utilized to identify single chain fragment variable (scFv) clones against the rLipL21 antigen. A total of 47 clones were analysed through monoclonal phage ELISA. However, after taking into consideration the background OD405 values, only 4 clones were sent for sequencing to determine human germline sequences. The sequence analysis showed that all 4 clones are identical. The in silico analysis of scFv-lip-1 complex indicated that the charged residues of scFv CDRs are responsible for the recognition with rLipL21 epitopes. The generated monoclonal antibody against rLipL21 will be evaluated as a detection reagent for the diagnosis of human leptospirosis in a future study.
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Affiliation(s)
- Mohammad Ridhuan Mohd Ali
- Bacteriology Unit, Infectious Disease Research Center (IDRC), Institute for Medical Research (IMR), 40170 Setia Alam, Malaysia
| | - Jia Siang Sum
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Nurul Najian Aminuddin Baki
- Bacteriology Unit, Infectious Disease Research Center (IDRC), Institute for Medical Research (IMR), 40170 Setia Alam, Malaysia
| | - Yee Siew Choong
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Nur Asyura Nor Amdan
- Bacteriology Unit, Infectious Disease Research Center (IDRC), Institute for Medical Research (IMR), 40170 Setia Alam, Malaysia
| | - Fairuz Amran
- Bacteriology Unit, Infectious Disease Research Center (IDRC), Institute for Medical Research (IMR), 40170 Setia Alam, Malaysia
| | - Theam Soon Lim
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia; Analytical Biochemistry Research Centre, Universiti Sains Malaysia, 11800 Penang, Malaysia.
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