Selective loss of viability of mouse NK cells in culture is associated with decreased NK cell lytic function

CD155 blockade enhances allogeneic natural killer cell-mediated antitumor response against osteosarcoma

Background

Allogeneic bone marrow transplant (alloBMT) is curative for hematologic malignancies through the graft-versus-tumor (GVT) effect but has been ineffective for solid tumors like osteosarcoma (OS). OS expresses CD155 which interacts strongly with inhibitory receptors TIGIT and CD96 but also binds to activating receptor DNAM-1 on natural killer (NK) cells. CD155 has never been targeted after alloBMT. Combining adoptively transferred allogeneic NK (alloNK) cells with CD155 blockade after alloBMT may enhance a GVT effect against OS.

Methods

Murine NK cells were activated and expanded ex vivo with soluble IL-15/IL-15Rα. AlloNK and syngeneic NK (synNK) cell phenotype, cytotoxicity, cytokine production, and degranulation against CD155-expressing murine OS cell line K7M2 were assessed in vitro. Mice bearing pulmonary OS metastases underwent alloBMT and alloNK cell infusion with anti-CD155 either before or after tumor induction, with select groups receiving anti-DNAM-1 pretreated alloNK cells. Tumor growth, GVHD and survival were monitored, and differential gene expression of lung tissue was assessed by RNA microarray.

Results

AlloNK cells exhibited superior cytotoxicity against CD155-expressing OS compared to synNK cells, and this activity was enhanced by CD155 blockade. CD155 blockade increased alloNK cell degranulation and interferon gamma production through DNAM-1. In vivo, CD155 blockade with alloNK infusion increased survival when treating OS that relapsed after alloBMT. No benefit was seen for treating established OS before alloBMT. Treatment with combination CD155 and anti-DNAM-1 pretreated alloNK ameliorated survival and tumor control benefits seen with CD155 blockade alone. RNA microarray showed mice treated with alloNK and CD155 blockade had increased expression of cytotoxicity genes and the NKG2D ligand H60a, whereas mice treated with anti-DNAM-1 pretreated alloNK cells resulted in upregulation of NK cell inhibitory receptor genes. Whereas blocking DNAM-1 on alloNK abrogated cytotoxicity, blocking NKG2D had no effect, implying DNAM-1:CD155 engagement drives alloNK activation against OS.

Conclusions

These results demonstrate the safety and efficacy of infusing alloNK cells with CD155 blockade to mount a GVT effect against OS and show benefits are in part through DNAM-1. Defining the hierarchy of receptors that govern alloNK responses is critical to translating alloNK cell infusions and immune checkpoint inhibition for solid tumors treated with alloBMT.

WHAT IS ALREADY KNOWN ON THIS TOPIC

Allogeneic bone marrow transplant (alloBMT) has yet to show efficacy in treating solid tumors, such as osteosarcoma (OS). CD155 is expressed on OS and interacts with natural killer (NK) cell receptors, such as activating receptor DNAM-1 and inhibitory receptors TIGIT and CD96 and has a dominant inhibitory effect on NK cell activity. Targeting CD155 interactions on allogeneic NK cells could enhance anti-OS responses, but this has not been tested after alloBMT.

WHAT THIS STUDY ADDS

CD155 blockade enhances allogeneic natural killer cell-mediated cytotoxicity against OS and improved event-free survival after alloBMT in an in vivo mouse model of metastatic pulmonary OS. Addition of DNAM-1 blockade abrogated CD155 blockade-enhanced allogeneic NK cell antitumor responses.

HOW THIS STUDY MIGHT AFFECT RESEARCH PRACTICE OR POLICY

These results demonstrate efficacy of allogeneic NK cells combined with CD155 blockade to mount an antitumor response against CD155-expressing OS. Translation of combination adoptive NK cell and CD155 axis modulation offers a platform for alloBMT treatment approaches for pediatric patients with relapsed and refractory solid tumors.

Positive and negative regulation by NK cells in cancer

Our understanding of NK biology has expanded immensely since the initial discovery of natural killer cells in 1975. New studies have uncovered various levels of immune regulation both on and by unique subsets of NK cells, which go well beyond simple receptor-ligand interactions between NK cells and target cancer cells. Distinct suppressor and effector populations of NK cells have been delineated in both viral and tumor models. Interactions between NK cells and dendritic cells, T cells, and B cells also dramatically alter the overall immune response to cancer. To exploit the diverse functional abilities of NK cell subsets for cancer immunotherapies, it is important to understand NK cell biology and NK regulator mechanisms.

Utilization of mouse models to decipher natural killer cell biology and potential clinical applications

Natural killer (NK) cells represent a key component of innate immunity. The utility of mouse models to recapitulate the human immune response has been a matter of ongoing debate, especially with regard to NK cells. However, mouse models of NK cells have provided significant advancements in our understanding of the biology of the cells that bridge these species. Initial characterization of NK cell activity was in mouse hematopoietic stem cell transplantation models. Recent findings include uncovering functionally disparate subsets of NK cells based on unique inhibitory receptor expression patterns, the existence of memory-like NK cells, and immunoregulatory NK cells that affect hematopoiesis and T-cell function. In addition, the biology of these cells with regard to MHC-binding receptors that affect NK cell subset maturation and function in the context of licensing, the importance of cytokines such as IL-15 in their development and maintenance, and evidence of NK exhaustion have been initially studied in mice. Many of these findings have been validated in clinical studies and demonstrate the significant wealth of knowledge that can be obtained by mouse models. However, it is important to understand the limitations and conditions of the mouse models, particularly when studying NK cells in hematopoietic stem cell transplantation and cancer.

Compromised peripheral immunity of mice injected intrastriatally with six-hydroxydopamine

Intracisternal or intracerebroventricular administration of six-hydroxydopamine (6-OHDA), which results in decreased norepinephrine (NE) and dopamine (DA) levels throughout the brain, causes impaired peripheral immunity. However, in vivo immunocompetence following selective striatal depletion of DA by 6-OHDA has not been investigated. Thus, we sought to determine whether striatal DA depletion compromises host resistance to Listeria monocytogenes (LM) and impairs the immune response to keyhole limpet hemocyanin (KLH). Mice treated with 6-OHDA (90% decrease in striatal DA) had (i) increased LM colonization in liver and spleen, (ii) lower primary IgM and IgG(1) antibody titers, as well as secondary IgM titers, and (iii) compromised DTH response compared to controls. Co-administration of a DA uptake inhibitor partially (40%) spared striatal DA depletion and completely prevented the increase in LM burden, but was ineffective in preventing any of the 6-OHDA-induced suppressions of the immune responses to KLH. Thus, striatal DA is suggested to play a response-specific role in peripheral immunological functions.

Ethanol suppresses polyinosinic:polycytidylic acid-induced activation of natural killer cells primarily by acting on natural killer cells, not through effects on other cell types

Natural killer (NK) cells can be activated in vitro and in vivo by polyinosinic:polycytidylic acid (poly I:C) through induction of type I interferons or other cytokines. Ethanol suppresses in vivo and ex vivo poly I:C activation of NK cell activity in a mouse model for binge drinking, but it is not known whether this effect is mediated by changes in NK cells or in other cell types (e.g., those that produce NK cell-activating cytokines). Splenocytes were obtained from C57BL/6 [NK cell-competent (NKc)] and C57BL/6 perforin knockout [NK cell-incompetent (NKi)] mice 6 h after administration of ethanol (6 g/kg) or vehicle (VH; dH(2)O). Cells were incubated in vitro 18 h with poly I:C (100 micro g/ml), followed by a 4-h 51Cr release assay with the use of YAC-1 target cells. Results of cell-mixing experiments involving all relevant combinations of splenocytes obtained from NKc and NKi mice treated with VH or ethanol strongly supported the suggestion that NK cells, not other cell types, are the primary target of ethanol-induced suppression of NK cell activation. For example, mixing of splenocytes obtained from ethanol-treated NKc and VH-treated NKi mice or from ethanol-treated NKc and ethanol-treated NKi mice yielded similar cytolytic function. However, mixing of splenocytes obtained from ethanol-treated NKc and VH-treated NKi mice yielded significantly less cytolytic activity than that of splenocytes from VH-treated NKc and ethanol-treated NKi mice. In addition, mixing of splenocytes obtained from VH-treated NKc and NKi mice resulted in lower cytolytic activity than when splenocytes from the NKi mice were treated with ethanol instead of with VH, demonstrating that ethanol did not decrease the function of other cell types. A strikingly similar pattern of results was observed when B6C3F1 mice, rendered NK cell deficient by administration of anti-NK 1.1 monoclonal antibody, were used instead of perforin knockout mice. These results indicate that ethanol suppresses activation of NK cells primarily by suppressing the NK cell response to poly I:C, not by acting on another cell type.