Novel immunomodulatory oligonucleotides prevent development of allergic airway inflammation and airway hyperresponsiveness in asthma

The Evolution of Antisense Oligonucleotide Chemistry-A Personal Journey

Over the last four decades, tremendous progress has been made in use of synthetic oligonucleotides as therapeutics. This has been possible largely by introducing chemical modifications to provide drug like properties to oligonucleotides. In this article I have summarized twists and turns on use of chemical modifications and their road to success and highlight areas of future directions.

Immunological and hematological toxicities challenging clinical translation of nucleic acid-based therapeutics

INTRODUCTION

Nucleic acid-based therapeutics (NATs) are proven agents in correcting disorders caused by gene mutations, as treatments against cancer, microbes and viruses, and as vaccine adjuvants. Although many traditional small molecule NATs have been approved for clinical use, commercialization of macromolecular NATs has been considerably slower, and only a few have successfully reached the market. Preclinical and clinical evaluation of macromolecular NATs has revealed many assorted challenges in immunotoxicity, hematotoxicity, pharmacokinetics (PKs), toxicology and formulation. Extensive review has been given to the PK and toxicological concerns of NATs including approaches designed to overcome these issues. Immunological and hematological issues are a commonly reported side effect of NAT treatment; however, literature exploring the mechanistic background of these effects is sparse.

AREAS COVERED

This review focuses on the immunomodulatory properties of various types of therapeutic nucleic acid concepts. The most commonly observed immunological and hematological toxicities are described for various NAT classes, with citations of how to circumvent these toxicities.

EXPERT OPINION

Although some success with overcoming immunological and hematological toxicities of NATs has been achieved in recent years, immunostimulation remains the main dose-limiting factor challenging clinical translation of these promising therapies. Novel delivery vehicles should be considered to overcome this challenge.

Strategy for selecting nanotechnology carriers to overcome immunological and hematological toxicities challenging clinical translation of nucleic acid-based therapeutics

INTRODUCTION

Clinical translation of nucleic acid-based therapeutics (NATs) is hampered by assorted challenges in immunotoxicity, hematotoxicity, pharmacokinetics, toxicology and formulation. Nanotechnology-based platforms are being considered to help address some of these challenges due to the nanoparticles' ability to change drug biodistribution, stability, circulation half-life, route of administration and dosage. Addressing toxicology and pharmacology concerns by various means including NATs reformulation using nanotechnology-based carriers has been reviewed before. However, little attention was given to the immunological and hematological issues associated with nanotechnology reformulation.

AREAS COVERED

This review focuses on application of nanotechnology carriers for delivery of various types of NATs, and how reformulation using nanoparticles affects immunological and hematological toxicities of this promising class of therapeutic agents.

EXPERT OPINION

NATs share several immunological and hematological toxicities with common nanotechnology carriers. In order to avoid synergy or exaggeration of undesirable immunological and hematological effects of NATs by a nanocarrier, it is critical to consider the immunological compatibility of the nanotechnology platform and its components. Since receptors sensing nucleic acids are located essentially in all cellular compartments, a strategy for developing a nanoformulation with reduced immunotoxicity should first focus on precise delivery to the target site/cells and then on optimizing intracellular distribution.

A prophylactic effect of an oligodeoxynucleotide containing a cytidine-guanosine motif against Japanese cedar pollen-induced T-helper type 2 allergic response

BACKGROUND

Over 10% of entire population in Japan suffer from allergic diseases induced by Japanese cedar pollen (JCP) every spring. In terms of preventive medicine, it has become a matter of urgency to establish successful prophylactic and therapeutic strategies for controlling the disorders. The effect of an oligodeoxynucleotide containing a cytidine-guanosine motif (CpG ODN) on the regulation of immune responses induced by JCP was investigated in this study.

METHODS

BALB/c mice were inoculated with CpG ODN intraperitoneally before intranasal sensitization to JCP. Cellular infiltration in the lung of BALB/c mice after treatment with CpG ODN or JCP was performed by hematoxylin and eosin (H&E) staining. Antibody titers and cytokines levels were determined by ELISA.

RESULTS

Intranasal inoculation of BALB/c mice with JCP induced a T-helper type 2 (Th2-type) dominant immune response, as characterized by the production of interleukin (IL)-4 and IL-5 in the lung and of JCP-specific IgE antibody in serum. Prior intraperitoneal administration of CpG ODN to mice suppressed the subsequent JCP-induced antibody production and infiltration of inflammatory cells in the lung. The inhibitory mechanism of CpG ODN seemed to be attributable to a CpG ODN-induced Th1-type dominant environment, which down-regulated Th2-type response subsequently induced by JCP allergen sensitization. Furthermore, administration with CpG ODN decreased the production of JCP-induced IL-17, which has been found to play a pivotal role in several inflammatory diseases including allergic asthma. The decreased production of IL-17, together with reduced secretion of IL-4 and IL-5, may contribute to diminish the inflammation in the lung of JCP-sensitized mice.

CONCLUSION

This work provides evidence that the CpG ODN has a prophylactic effect on the JCP-induced Th2-type allergic responses by establishing or restoring a Th1-type shift of immune environments.

Intradermal cytosine-phosphate-guanosine treatment reduces lung inflammation but induces IFN-γ-mediated airway hyperreactivity in a murine model of natural rubber latex allergy

Asthma and other allergic diseases are continuously increasing, causing considerable economic and sociologic burden to society. The hygiene hypothesis proposes that lack of microbial T helper (Th) 1-like stimulation during early childhood leads to increased Th2-driven allergic disorders later in life. Immunostimulatory cytosine-phosphate-guanosine (CpG)-oligodeoxynucleotide motifs are candidate molecules for immunotherapeutic studies, as they have been shown to shift the Th2 response toward the Th1 direction and reduce allergic symptoms. Using natural rubber latex (NRL)-induced murine model of asthma, we demonstrated that intradermal CpG administration with allergen reduced pulmonary eosinophilia, mucus production, and Th2-type cytokines, but unexpectedly induced airway hyperreactivity (AHR) to inhaled methacholine, one of the hallmarks of asthma. We found that induction in AHR was dependent on STAT4, but independent of STAT6 signaling. CpG treatment increased production of IFN-γ in the airways and shifted the ratio of CD4(+):CD8(+) T cells toward CD8(+) dominance. By blocking soluble IFN-γ with neutralizing antibody, AHR diminished and the CD4(+):CD8(+) ratio returned to CD4(+) dominance. These results indicate that increased production of IFN-γ in the lungs may lead to severe side effects, such as enhancement of bronchial hyperreactivity to inhaled allergen. This finding should be taken into consideration when planning prophylaxis treatment of asthma with intradermal CpG injections.

Synthesis and immunological activities of novel agonists of toll-like receptor 9

Novel agonists of TLR9 with two 5'-ends and synthetic immune stimulatory motifs, referred to as immune modulatory oligonucleotides (IMOs) are potent agonists of TLR9. In the present study, we have designed and synthesized 15 novel IMOs by incorporating specific chemical modifications and studied their immune response profiles both in vitro and in vivo. Analysis of the immunostimulatory profiles of these IMOs in human and NHP cell-based assays suggest that changes in the number of synthetic immunostimulatory motifs gave only a subtle change in immune stimulation of pDCs as indicated by IFN-alpha production and pDC maturation while the addition of self-complementary sequences produced more dramatic changes in both pDC and B cell stimulation. All IMOs induced cytokine production in vivo immediately after administration in mice. Representative compounds were also compared for the ability to stimulate cytokine production in vivo (IFN-alpha and IP-10) in rhesus macaques after intra-muscular administration.

Emerging oligonucleotide therapies for asthma and chronic obstructive pulmonary disease

Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) are disorders of the airways largely related to the presence of persistent inflammation. The approval of inhaled corticosteroids in the early 1970s pioneered a new age of therapy in treating chronic inflammatory airway diseases. This was the first time that an anti-inflammatory product was available to reduce the characteristic lung inflammation in airways and the associated obstruction, inflammation and hyper-responsiveness. Fast forward 40 years: corticosteroids are still an important therapeutic intervention; however, they exhibit limited use in moderate to severe asthma and COPD. Oligonucleotide therapies are an emerging class which include the antisense, the RNAi (siRNA and miRNA), the immunomodulatory, the aptamer and the decoy approaches. As these approaches are rather recent in the respiratory field, most are still early in development. Nevertheless, with limitations of current small molecule therapies and the hurdles faced with biologics, the use of oligonucleotides is relevant and the door is open to the development of this category of therapeutics. This review focuses on the major classes of oligonucleotides that are currently in late stage preclinical or clinical development for the treatment of asthma and COPD, and discusses the implications for their use as therapies for respiratory diseases.

Recent advances in the understanding of egg allergens: basic, industrial, and clinical perspectives

The emergence of egg allergy has had both industrial and clinical implications. In industrialized countries, egg allergy accounts for one of the most prevalent food hypersensitivities, especially in children. Atopic dermatitis represents the most common clinical manifestation in infancy; however, the range of clinical signs is broad and encompasses life-threatening anaphylaxis. The dominant egg allergens are proteins and are mainly present in the egg white, for example, ovalbumin, ovomucoid, ovotransferrin, and lysozyme. However, egg yolk also displays low-level allergenicity, for example, alpha-livetin. Strict avoidance of the offending food remains the most common recommendation for egg-allergic individuals. Nevertheless, the omnipresence of egg-derived components in prepackaged or prepared foods makes it difficult. Therefore, more efficient preventive approaches are investigated to protect consumers from inadvertent exposure and ensuing adverse reactions. On the one hand, commercial kits have become readily available that allow for the detection of egg contaminants at trace levels. On the other hand, attempts to produce hypoallergenic egg-containing products through food-processing techniques have met with promising results, but the approach is limited due to its potentially undesirable effects on the unique functional and sensory attributes of egg proteins. Therefore, the development of preventive or curative strategies for egg allergy remains strongly warranted. Pilot studies have suggested that oral immunotherapy (IT) with raw or cooked preparations of egg may represent a safe alternative, immediately available to allergic subjects, but remains applicable to only nonanaphylactic patients. Due to the limitations of conventional IT, novel forms of immunotherapy are sought based on information obtained from the molecular characterization of major egg allergens. In the past decade, promising approaches to the treatment and prevention of egg allergy have been explored and include, among others, the production of hypoallergenic recombinant egg proteins, the development of customized peptides, and bacterial-mediated immunotherapy. Nonspecific approaches have also been evaluated, and preliminary trials with the use of probiotic bacteria have yielded encouraging results. The current understanding of egg allergens offers novel approaches toward the making of food products safe for human consumption and the development of efficient immunotherapeutic strategies.

Dendritic cells in allergic airway inflammation

Dendritic cells (DCs) are primary antigen-presenting cells involved in interactions with T cells leading to the proliferation of TH1 or TH2 cell types. In asthma, predominance of TH2 cells appears to be responsible for disease pathogenesis. Differentiation of TH2 cells is driven by a variety of factors such as the expression of high levels of costimulatory molecules, the cytokine profile, and the subset of DCs. Many inflammatory cells involved in the pathogenesis of asthma either directly or indirectly modulate DC function. Traditional treatments for asthma decrease the number of airway DCs in animals as well as in patients with asthma. Immunomodulators including interleukin (IL)-10, transforming growth factor (TGF)-beta, cytosine-phosphate-guanosine-containing oligodeoxynucleotides (CpG-ODN), 1alpha,25-dihydroxyvitamin D3, and fetal liver tyrosine kinase 3 ligand (Flt3L) are involved in the modulation of the function of DCs. Based on the critical review of the interaction between DCs and other inflammatory cells, we propose that activation of T cells by DCs and sensitization to inhaled allergen and resulting airway inflammation are dependent on plasmacytoid and myeloid subset of lung DCs to induce an immune response or tolerance and are tightly regulated by T-regulatory cells. Effects of various therapeutic agents to modulate the function of lung myeloid DCs have been discussed.

Synthetic agonists of Toll-like receptors 7, 8 and 9

TLRs (Toll-like receptors) are a family of innate immune receptors that induce protective immune responses against infections. Single-stranded viral RNA and bacterial DNA containing unmethylated CpG motifs are the ligands for TLR7 and TLR8 and 9 respectively. We have carried out extensive structure–activity relationship studies of DNA- and RNA-based compounds to elucidate the impact of nucleotide motifs and structures on these TLR-mediated immune responses. These studies have led us to design novel DNA- and RNA-based compounds, which act as potent agonists of TLR9 and TLR7 and 8 respectively. These novel synthetic agonists produce different immune response profiles depending on the structures and nucleotide motifs present in them. The ability to modulate TLR-mediated immune responses with these novel DNA- and RNA-based agonists in a desired fashion may allow targeting a broad range of diseases, including cancers, asthma, allergies and infections, alone or in combination with other therapeutic agents, and their use as adjuvants with vaccines. IMO-2055, our first lead candidate, is a TLR9 agonist that is currently in clinical evaluation in oncology patients. A second candidate, IMO-2125, is also a TLR9 agonist that has been shown to induce high and sustained levels of IFN (interferon) in non-human primates and is being evaluated in HepC-infected human subjects.

Immune modulatory oligonucleotides in prevention of nasal allergen-induced Eustachian tube dysfunction in rats

OBJECTIVES

Develop a model of nasal allergen-induced Eustachian tube dysfunction (ETD) in a rat and investigate the role of immune modulatory oligonucleotides (IMOs) in the prevention of nasal allergen-induced ETD.

STUDY DESIGN AND SETTING

Prospective, randomized study. Brown Norway rats were sensitized to ova albumin (OVA) and randomized to receive pretreatment with IMOs or phosphate-buffered saline. All animals were challenged intranasally with aerosolized OVA. Dynamic measures of Eustachian tube (ET) function were analyzed.

RESULTS

Animals that were OVA-sensitized and IMO-pretreated had significantly lower mean passive opening (95% confidence interval [95% CI] 15.0,19.4) and closing (95% CI 4.8,7.8) ET pressures compared with those of (95% CI 24.1,32.7) and (95% CI 12.1,18.8) OVA-sensitized untreated rats, respectively. In addition, the IMO-pretreated animals demonstrated the ability to actively clear a significantly higher proportion of negative pressure (95% CI 0.64,0.96) compared with the untreated animals (95% CI 0.09,0.39). IMO-pretreated animals also demonstrated significantly improved mean mucociliary clearance times in seconds (95% CI 115,195) than those in untreated animals (95% CI 308,668).

CONCLUSIONS

Pretreatment with IMOs prevented allergen-induced allergic inflammation around the Eustachian tube (ET) and resulted in improved ventilatory function of the ET compared with sensitized untreated animals. IMOs offer considerable promise in the management of nasal allergic disease as well as otitis media with effusion.

Immune modulatory oligonucleotides in the prevention and treatment of OVA-induced eustachian tube dysfunction in rats

BACKGROUND

Otitis media with effusion (OME) is often associated with allergies. Immune modulatory oligonucleotides (IMO) mediate allergic inflammation and may therefore be efficacious in the treatment of airway inflammation.

OBJECTIVE

To evaluate the role of an IMO via transtympanic mucosal application in prevention and treatment of ovalbumin-induced OME.

DESIGN

Forty brown Norway rats were divided into control and treatment groups. Eustachian tube dysfunction was evaluated by passive opening pressures, passive closing pressures, active clearance of negative pressure, and mucociliary clearance transit time.

RESULTS

Rats who underwent IMO treatment required 50% less pressure to open and close the eustachian tube (P < 0.05) and were able to actively clear 50% more negative pressure than the ovalbumin-control rats (P < 0.001). The treatment rats' mucociliary clearance time was half that of the control group (P < 0.001).

CONCLUSION

IMO via transtympanic application can prevent and treat allergy-induced eustachian tube dysfunction in rats. IMO may offer substantial promise in the future management of OME.

Oral administration of a synthetic agonist of Toll-like receptor 9 potently modulates peanut-induced allergy in mice

BACKGROUND

Agonists of Toll-like receptor 9 have been shown to induce potent T(H)1-type immune responses and prevent and reverse ovalbumin-induced T(H)2-dominant allergic asthma in mice.

OBJECTIVE

We examined oral administration of a synthetic agonist of Toll-like receptor 9 (immune modulatory oligonucleotide [IMO]) to modulate peanut-induced allergy in mice.

METHODS

In the prevention model mice were sensitized 3 times by means of oral administration of peanut in the presence or absence of IMO. In a treatment protocol mice were sensitized orally with peanut on days 0 and 14 and treated 4 times with oral administration of IMO starting on day 21.

RESULTS

In the prevention study mice that received the combination of IMO/peanut showed decreased IgE and increased IgG2a levels in the serum and intestinal tissue compared with mice sensitized with peanut only. In spleen cell recall experiments, production of IL-5 and IL-13 was inhibited and production of IFN-gamma was increased in mice immunized with the peanut/IMO combination compared with those sensitized with peanut only. In the treatment model IMO-treated mice showed decreased IgE, IL-5, and IL-13 levels and increased IgG2a and IFN-gamma levels in the serum, intestines, and spleen cells compared with PBS-treated mice. A reduction in local inflammation and restoration of normal structure in the intestines was found in the mice that received IMO in both models.

CONCLUSION

These results indicate that IMOs can switch peanut-induced T(H)2 immune responses toward T(H)1 responses accompanied by reduced inflammation in the gastrointestinal tract and anaphylaxis in both the prevention and treatment models.

CLINICAL IMPLICATIONS

IMOs might be suitable candidates for the management of peanut-induced allergy.

The role of immunomodulatory oligonucleotides in prevention of OVA-induced Eustachian tube dysfunction

OBJECTIVE

To evaluate the potential role of immunomodulatory oligonucleotides (IMO) in the prevention of OVA-induced Eustachian tube dysfunction (ETD) in a rat model.

METHODS

Brown-Norway rats were sensitized to ovalbumin (OVA) and randomized to receive pre-treatment with IMO or phosphate buffered saline (PBS). After systemic sensitization, subjects received a transtympanic OVA challenge followed by evaluation of the Eustachian tube's dynamic function.

RESULTS

Pre-treatment of OVA sensitized animals with IMO normalized passive opening and closing Eustachian tube pressures, improved active clearance of negative pressure in the middle ear, and resulted in reduced mean mucociliary transit times compared to untreated OVA-sensitized animals (P<0.001).

CONCLUSION

These data demonstrate that pre-treatment with IMO prevent OVA-induced ETD in the rat. IMO treatment in the future may offer considerable promise in the management of OME in children.

Novel and emerging therapies for asthma

At present, there are a wide variety of novel and emerging therapeutic approaches for the treatment of asthma. Here, we will summarize these state-of-the-art approaches, including specific and nonspecific mediator inhibition-- a quest that has been on going for more than 25 years-- together with cytokine modulation in asthma (primarily attempting to modulate the Th2-Th1 balance in asthma), targeting cell recruitment, angiogenesis, signal transduction and gene transduction pathways. Finally, we will discuss the recently approved anti-IgE therapy for the treatment of allergic asthma and immune modulation using CpG oligodeoxynucleotides.

Toll-like receptor modulation in cardiovascular disease: a target for intervention?

Toll-like receptors (TLRs) form a family of pattern recognition receptors that have emerged as key mediators of innate immunity. These receptors sense invading microbes and initiate the immune response. TLR-mediated inflammation is an important pathogenic link between innate immunity and a diverse panel of clinical disorders. Among the processes in which TLRs play a role are cardiovascular disorders such as cardiac ischaemia, coronary artery disease, ventricular remodelling, cancer angiogenesis or transplant rejection. From these, many important opportunities for disease modification through TLR signalling manipulation can be imagined. Their role as potential targets for therapeutic intervention is just beginning to be appreciated and this article reviews the current status of these treatment strategies for cardiovascular disease.

Novel oligodeoxynucleotide agonists of TLR9 containing N3-Me-dC or N1-Me-dG modifications

Synthetic oligodeoxynucleotides containing unmethylated CpG motifs activate Toll-Like Receptor 9 (TLR9). Our previous studies have shown the role of hydrogen-bond donor and acceptor groups of cytosine and guanine in the CpG motif and identified synthetic immunostimulatory motifs. In the present study to elucidate the significance of N3-position of cytosine and N1-position of guanine in the CpG motif, we substituted C or G of a CpG dinucleotide with N3-Me-cytosine or N1-Me-guanine, respectively, in immunomodulatory oligodeoxynucleotides (IMOs). IMOs containing N-Me-cytosine or N-Me-guanine in C- or G-position, respectively, of the CpG dinucleotide showed activation of HEK293 cells expressing TLR9, but not TLR3, 7 or 8. IMOs containing N-Me-cytosine or N-Me-guanine modification showed activity in mouse spleen cell cultures, in vivo in mice, and in human cell cultures. In addition, IMOs containing N-Me-substitutions reversed antigen-induced Th2 immune responses towards a Th1-type in OVA-sensitized mouse spleen cell cultures. These studies suggest that TLR9 tolerates a methyl group at N1-position of G and a methyl group at N3-position of C may interfere with TLR9 activation to some extent. These are the first studies elucidating the role of N3-position of cytosine and N1-position of guanine in a CpG motif for TLR9 activation and immune stimulation.

Immunostimulatory oligonucleotides in therapy of allergic diseases

At present, the improvement of hygienic life standards is considered as an environmental condition, increasing the prevalence of allergic diseases, as early contact with some pathogens is, according to the hygiene hypothesis, required for maturation of the immune system. The recognition of microbial components involves acquired and innate immunity mechanisms. Recently, the link between innate and acquired immunity has been discovered. It involves the evolutionarily old Toll-like receptor (TLR) system. Ligands recognised by TLRs include unmethylated deoxycytidil-deoxyguanosine (CpG) motif-containing microbial DNA. TLR-mediated signalling induces expression of cytokines preferentially promoting a Th1-directed response. Therefore, synthetic CpG motif-containing immunostimulatory oligonucleotides could be employed in causal allergy treatment. This review discusses some molecular aspects of the TLR system, as well as results of animal studies and early experiences, including treatment safety, from human clinical trials with immunostimulatory CpG motif-containing oligonucleotides.

Immunostimulatory CpG oligonucleotides abrogate allergic susceptibility in a murine model of maternal asthma transmission

We tested the potential of CpG oligodeoxynucleotides (ODN) to reverse the increased susceptibility to allergic airways disease in neonatal mice in a model of maternal transmission of asthma risk. Offspring of OVA-sensitized and challenged BALB/c mother mice were subjected to an intentionally suboptimal sensitization protocol that has minimal effects on normal mice, but results in airway hyperresponsiveness (AHR) and airway inflammation (AI) in babies of asthmatic mother mice. We evaluated pulmonary function and AI in CpG- or control ODN-treated offspring. CpG treatment of neonates on day 4 of life prevents the AHR otherwise seen in this model (enhanced pause at 100 mg/ml methacholine: CpG, 0.9 +/- 0.1; ODN control, 3.8 +/- 0.6; n = 62; p < 0.005). It also prevented the development of AI, as evident in decreased bronchoalveolar lavage eosinophilia (CpG, 1.2 +/- 0.3%; ODN, 31.4 +/- 4.1%; n = 56; p < 0.005), diminished the severity of AI on histopathology, and resulted in lower IL-5 levels in bronchoalveolar lavage fluid. The effect of CpG persisted for at least 4-6 wk and was allergen independent. Treatment with CpG just before OVA aerosol challenge also prevented allergic responses. The data support the potential for immunomodulatory therapy with CpG in early life to reduce susceptibility to asthma.

Formulation with CpG oligodeoxynucleotides prevents induction of pulmonary immunopathology following priming with formalin-inactivated or commercial killed bovine respiratory syncytial virus vaccine

Commercial killed bovine respiratory syncytial virus (K-BRSV) and formalin-inactivated BRSV (FI-BRSV) tend to induce Th2-type immune responses, which may not be protective and may even be detrimental during subsequent exposure to the virus. In this study we assessed the ability of CpG oligodeoxynucleotides (ODNs) to aid in the generation of effective and protective BRSV-specific immune responses. Mice were immunized subcutaneously with FI-BRSV formulated with CpG ODN, Emulsigen (Em), CpG ODN and Em, or non-CpG ODN and Em. Two additional groups were immunized with K-BRSV or K-BRSV and CpG ODN. After two vaccinations, the mice were challenged with BRSV. FI-BRSV induced Th2-biased immune responses characterized by production of serum immunoglobulin G1 (IgG1) and IgE, as well as interleukin-4 (IL-4), by in vitro-restimulated splenocytes. Formulation of FI-BRSV with CpG ODN, but not with non-CpG ODN, enhanced serum IgG2a and IFN-gamma production by splenocytes, whereas serum IgE was reduced. Although the immune response induced by K-BRSV was not as strongly Th2 biased, the addition of CpG ODN to this commercial vaccine also resulted in a more Th1-type response. Furthermore, the addition of CpG ODN to the BRSV vaccine formulations resulted in enhanced neutralizing antibody responses. Significant production of IL-5, eotaxin, and eosinophilia was observed in the lungs of FI-BRSV- and K-BRSV-immunized mice. However, IL-5 and eotaxin levels, as well as the number of eosinophils, were decreased in the mice vaccinated with the CpG ODN-formulated vaccines. Finally, when formulated with CpG ODN, both FI-BRSV and K-BRSV significantly reduced virus production after challenge with BRSV.

Treatment with Flt3 ligand plasmid reverses allergic airway inflammation in ovalbumin-sensitized and -challenged mice

We have previously reported that fms-like tyrosine kinase 3 ligand (Flt3-L) prevents and reverses established allergic airway inflammation in an ovalbumin (OVA) induced mouse model of asthma. In this study, we investigated the effect of pUMVC3-hFLex, a plasmid, mammalian expression vector for the secretion of Flt3-L on the same mouse model as well as the duration of the effect of the treatment. Allergic airway inflammation to OVA was established in BALB/c mice. OVA-sensitized mice received three intramuscular (i.m.) injections of 200 mug pUMVC3-hFLex over 10 days. The response to pUMVC3-hFLex therapy was assessed based on airway hyperresponsiveness (AHR) to methacholine and inflammation, measured as serum cytokine and immunoglobulins (Ig) levels, and the total and differential cells in bronchoalveolar lavage fluid (BALF). pUMVC3-hFLex treatment completely reversed established AHR (P<0.01) and this effect lasted for at least 24 days after the last treatment injection (P<0.001). pUMVC3-hFLex treatment significantly increased BALF interferon-gamma (IFN-gamma) (P<0.01), serum interleukin (IL)-10 (P<0.01) and anti-OVA IgG2a levels (P<0.01). In contrast, serum IL-4 and IgE levels were significantly reduced (P<0.05). Total BALF cellularity, eosinophiles counts and BALF IL-5 levels were also reduced (P<0.01). pUMVC3-hFLex treatment can reverse established experimental asthma and might provide a novel approach for treating asthma.

Immunomodulation in asthma: a distant dream or a close reality?

The search for new treatments of asthma or any other disease for that matter is an infinite exercise. The scope for discovering new forms of treatment has increased now more than ever due to a better understanding of the molecular pathogenesis of the disease. Regulation of biomolecular or immunological events could occur at numerous points in the disease pathogenesis. This review describes the strategies to regulate the inappropriate immune responses that are elicited after exposure to an allergen. One such successful therapy is treatment with omalizumab, the anti-IgE antibody. Other therapies include cytokine antagonists, transcription factor antagonists, immunostimulatory DNA therapy, cytokine therapy and anti-T cell strategies. All these agents have been shown to be promising and could serve as an alternative approach to the treatment of asthma and maybe other allergic diseases.

Immunomodulatory oligonucleotides containing a cytosine-phosphate-2'-deoxy-7-deazaguanosine motif as potent toll-like receptor 9 agonists

Bacterial DNA and synthetic oligomers containing CpG dinucleotides activate the immune system through Toll-like receptor (TLR) 9. Here, we compare the immunostimulatory activity of three immunomers with different nucleotide sequences containing a synthetic cytosine-phosphate-2'-deoxy-7-deazaguanosine dinucleotide (CpR), called immunomodulatory oligonucleotides (IMOs), in mouse, human, and monkey systems. IMOs induced IL-12 and IFN-gamma secretion more than a control non-CpG IMO in mice. All three IMOs activated HEK293 cells expressing TLR9 but not TLR3, -7, or -8. IMOs induced human B-cell proliferation and enhanced expression of CD86 and CD69 surface markers on B cells. The three IMOs induced CD86 expression on human plasmacytoid dendritic cells, but only IMOs that contained a 5'-terminal TCR nucleotide sequence induced IFN-alpha secretion. A sequence that forms a duplex structure also was required for IFN-alpha induction in human peripheral blood mononuclear cell cultures. IMOs induced chemokine and cytokine gene expression in human peripheral blood mononuclear cells. In monkeys, all three IMOs induced transient changes in peripheral blood leukocytes and lymphocytes and activated B and T lymphocytes. All three IMOs induced IFN-alpha in vivo in monkeys; the IMO sequence that forms a stable secondary structure induced the highest levels of IFN-alpha. These studies are, to our knowledge, the first comprehensive studies to compare the activity of IMOs containing synthetic stimulatory CpR dinucleotides in mouse, monkey, and human systems. These results suggest that IMOs induce strong and rapid immunostimulation and that the CpR dinucleotide is recognized by TLR9, leading to immune-cell activation and cytokine secretion in vitro and in vivo.

Modulation of ovalbumin-induced Th2 responses by second-generation immunomodulatory oligonucleotides in mice

Oligodeoxynucleotides containing unmethylated CpG dinucleotides (CpG DNAs) prevent development of T-helper type 2 (Th2) immune responses and reverse established allergic responses in mouse models. We recently reported that second-generation immunomodulatory oligonucleotides (IMOs) containing novel structures (immunomers) and a synthetic immunostimulatory CpR (R=2'-deoxy-7-deazguanosine) motif induce the production of distinct cytokine secretion profiles in vitro and in vivo. In the present study, we evaluated IMOs containing CpG and CpR motifs to modulate allergen-induced Th2 immune responses in prevention and treatment models. Mice sensitized and challenged with ovalbumin (OVA) were treated with a CpG DNA or an IMO by administration either at the time of OVA sensitization (co-administration; prevention) or after establishment of an allergic response (treatment). Spleens, blood, and lungs were collected and analyzed for immune responses. Spleen-cell cultures harvested from OVA-sensitized mice showed a significant decrease in Th2 cytokine levels with a concomitant increase in Th1 cytokine levels only when CpG DNA or IMOs were co-administered with OVA. The co-administration of CpG DNA or IMOs during OVA sensitization significantly reduced serum OVA-specific and total IgE levels in mice. The mice who received CpG DNA or IMOs co-administered with OVA showed a small reduction in serum OVA-specific and total IgG1 levels and a significant increase in serum OVA-specific and total IgG2a levels. Similar results were found in mice with established allergic responses who received IMO treatment. IMO treatment also resulted in strong inhibition of inflammatory cell infiltration and goblet cell hyperplasia in the lungs compared with untreated mice lungs. These data demonstrate that IMOs prevent antigen-induced Th2 immune responses when co-administered to mice during OVA sensitization and that IMOs reverse established allergic responses induced by OVA.