CD 1-reactive leukemic cells in bone marrow: Presence of Langerhans cell marker on leukemic monocytic cells

Acute Myeloid Leukemia With t(9;11) (p22;q23) and Synchronous Langerhans Cell Histiocytosis

We present here the first report of an adult patient with simultaneous LCH and AML with t(9;11).5

Phage display generation of a novel human anti-CD1A monoclonal antibody with potent cytolytic activity

CD1A is a cell surface protein expressed on Langerhans cells and cortical thymocytes that could potentially be used as an immunotherapeutic target in Langerhans Cell Histiocytosis (LCH), the cortical subtype of T-cell acute lymphocytic leukaemia (T-ALL) and other CD1A-positive tumours. The monoclonal antibody (mAb) CR2113 was selected from a panel of six fully human mAbs isolated from a semi-synthetic phage display library, based on specificity and avidity against cells expressing CD1 antigen variants. CR2113 recognized CD1A in T-ALL cell lines and patient samples. Confocal microscopy revealed that the CR2113-CD1A complex was internalized at 37°C. Furthermore, while CR2113 induced moderate complement-dependent cytotoxicity (CDC), potent antibody-dependent cell cytotoxicity (ADCC) activity was observed against CD1A expressing cell lines as well as T-ALL cell lines and T-ALL patient samples. In vivo experiments showed that CR2113 as a naked antibody has modest but specific anti-tumour activity against CD1A-expressing tumours. CR2113 is a high-affinity human anti-CD1A mAb with significant ADCC activity. These properties make CR2113 a candidate for clinical diagnostic imaging and therapeutic targeting of LCH as well as potential use in other clinical applications.

Upregulation and atypical expression of the CD1 molecules on monocytes in sickle cell disease

Human CD1 group I molecules CD1a, b, and c are expressed on antigen-presenting cells, notably dendritic cells, and implicated in glycolipids presentation to T lymphocytes. Expression of CD1 on monocytes is a hallmark of their activation. Because monocyte activation has been reported during steady state disease in sickle cell anemia (SCA) patients, we have analyzed CD1 expression on monocytes from 45 SCA patients originating from Africa and 27 healthy control subjects. CD1 expression was detected on monocytes in the majority of SCA patients (75%), whereas it was not observed in the vast majority of the control group (70.4%). CD1b and CD1c were highly expressed in Sbeta thalassemia patients and CD1a expression was predominant in SDPunjab patients. This expression of the CD1 molecules is correlated with an increased expression of the major histocompatibility complex class II invariant chain (CD74). Finally, we have observed that the majority of SCA patients (68%) express only two or one CD1 isoforms. This study demonstrates the particular phenotype of SCA monocytes intermediate between normal resting and activated monocytes, a phenotype that could have consequences on regulation of the infection outcome.

Malignant Langerhans cell tumor: a case with a favorable outcome associated with the absence of blood dendritic cell proliferation

Malignant Langerhans cell tumor is a rare malignant proliferation of Langerhans cells, with a negative prognosis due to its dissemination throughout the body, leading to death within 1 year. This disease has to be distinguished from Langerhans cell histiocytosis. The favorable evolution of a case of Langerhans cell tumor, characterized by the absence of metastasis 18 months after its occurrence, may be due to the initial treatment, which consisted of complete and large resection of the tumor. The authors searched for abnormal dendritic cells or progenitors in the blood but found no large amounts or proliferation of CD34(+) or CD1a(+) cells at the diagnosis and 1 year later. This case report shows that malignant Langerhans cell tumor is not always a lethal disease. The condition may be related to surgical treatment and the absence of malignant cells in the blood when the diagnosis was performed.

The efficient generation of CD83 positive immunocompetent dendritic cells from CD14 positive acute myelomonocytic or monocytic leukemia cells in vitro

The ability of leukemic cells to differentiate to mature dendritic cells (DCs) was investigated in six acute myelomonocytic or monocytic leukemia cases. It was found that CD14 positive cells were more efficiently changed to CD83 positive mature typed DCs with granulocyte-macrophage colony-stimulating factor (GM-CSF)/interleukin-4 (IL-4) and tumor necrosis factor alpha (TNF-alpha) compared with CD14 negative cells. Such leukemia derived DCs expressed a sufficient level of costimulatory molecules (CD80 and CD86), and were shown to be monoclonal based on an the X-inactivation analysis. They also stimulated not only allo- but auto-T lymphocytes, which thereafter became cytotoxic T lymphocytes (CTLs).

Human CD1a molecule expressed on monocytes plays an accessory role in the superantigen-induced activation of T lymphocytes

The CD1 molecules exhibit characteristics of the MHC class I and class II molecules. They are expressed on cortical thymocytes and, similarly to MHC class II molecules, on antigen-presenting cells. In the present study, we investigated the role of the CD1 molecules in the T-cell response to bacterial superantigens. Indeed, we have observed that CD1 molecules could be detected on the CD14-positive population of some healthy donors (14% of donors tested). The CD1 expression on monocytes is correlated with an activation state of the donors as demonstrated by the increased expression of the CD25, CD38, CD45R0, and MHC class II molecules on their lymphocytes. On these donors, CD1a mAbs induced a clear inhibition (65%) of lymphocyte proliferation induced by either staphylococcal enterotoxin A or toxic shock syndrome toxin-1, whereas this proliferation was constantly unaffected by the addition of mAbs directed against CD1b or CD1c. Moreover, an intracellular calcium flux was induced in monocytes following CD1a engagement, and this calcium flux was partially inhibited by preincubation of these cells with the superantigen. These results attribute to the CD1a molecule expressed by monocytes a role in the transduction of signal(s) involved in superantigen-induced activation.

Diagnostic and therapeutic evaluation of an anti-Langerhans cell histiocytosis monoclonal antibody (NA1/34) in a new xenograft model

Scintigraphy using monoclonal antibodies has been suggested as a possible adjunct to conventional staging techniques for the routine staging and diagnosis of Langerhans cell histiocytosis. In this study we have developed a model for Langerhans cell histiocytosis comprising a CD1a-positive subcutaneous xenograft in the flanks of nude (nu/nu) mice. The anti-CD1a murine monoclonal antibody NA1/34 was investigated for its potential both as an imaging and as a therapeutic targeting agent in this model. Biodistribution with NA1/34 compared with irrelevant isotype-matched monoclonal antibody demonstrated specific accumulation within the xenografts of 10.0%id per g (percentage injected dose per gram) and 3.3%id per g at 48 h postinjection, respectively. NA1/34 displayed no specific accumulation to CD1a-negative xenografts. F(ab')2 fragments of NA1/34 displayed a faster clearance time of 19.6 h compared with the intact antibody, 122.4 h, resulting in a more rapid maximum xenograft uptake time of 5 h compared with 48 h postinjection for the intact antibody. Although the overall xenograft/tissue ratio for the F(ab')2 was at no time greater than that for the intact antibody, the F(ab')2 did display dramatically greater xenograft/blood ratios, reaching 19:1 at 120 h postinjection Xenograft regression using single doses of 350 microCi and 500 microCi 131I-labeled NA1/34 significantly (p < 0.001) delayed xenograft progression compared with control nonirradiated xenografts, with average delays of 3.2 and 5.7 times the control, respectively. This study suggests that the anti-CD1a monoclonal antibody, NA1/34, offers advantages in the prognosis and staging of Langerhans cell histiocytosis, in a human setting. We discuss the advantages of radioimmunoscintigraphy over conventional differential diagnostic techniques. The potential for the future radioimmunotherapy of Langerhans cell histiocytosis is also discussed.

Human acute myeloblastic leukemia cells differentiate in vitro into mature dendritic cells and induce the differentiation of cytotoxic T cells against autologous leukemias

An immune response is involved in the control of leukemias as demonstrated by allogeneic bone marrow transplantation, by the eradication of residual leukemic cells by cytotoxic T cells and finally by the identification of tumor antigens which are recognized by effector T cells. Dendritic cells (DC) are professional antigen-presenting cells (APC) able to present antigens in the context of co-stimulatory signals necessary for T cell activation. Although tumor cells may express tumor antigens, they are usually unable to elicit an immune response since they are devoid of co-stimulatory capacities. To overcome this problem, engineering tumors to provide APC function could potentially result in polyvalent immunization to multiple tumor antigens. We have tested the differentiation of AML-5 (monoblastic, promonocytic and monocytic) leukemia cells and demonstrated that eight out of the ten fresh human acute myeloid leukemia populations tested can differentiate in vitro into bona fide APC. Leukemic cells acquire in vitro DC morphology, mature DC markers such as CD83, the up-regulation of MHC and co-stimulatory molecules and the ability to produce IL-12 upon maturation, while retaining their characteristic caryotypic abnormalities. However, we could not obtain an immature DC phenotype. They also acquire the ability to induce the differentiation of allogeneic naive cord blood CD4 and CD8 T cells as well as resting autologous cytotoxic T cells. These results demonstrate that some tumor cells acquire APC phenotype and functions and can thereby induce a potent autologous immune response that will be a valuable tool for detection of new tumor antigens and for in vivo immunization.

Epidermal and mucosal dendritic cells and HIV1 infection

The major modes of HIV1 transmission involve circumstances and behavior that promote exchange of blood or body fluids containing HIV virus and/or HIV infected cells. In the second group, semen, vaginal secretions, exudates and occasionally saliva have been documented as sources of transmission. If the skin, protected by the horny layer, does not seem easily infected, the mucous membrane and especially the vaginal, rectal or oral mucosa are the main sites of HIV entry in absence of lesions. In mucosa, a well identified population of dendritic cells may be considered as the first target of HIV1: the Langerhans cells. Originated from the bone marrow, the Langerhans cells migrate into the peripheral epithelia (skin, mucous membranes) and play a key role in the immune surveillance system against foreign antigens. They act as antigenpresenting cells through a specific cooperation with CD4+ lymphocytes after migration to the proximal lymph nodes. As HIV1-susceptible cells, Langerhans cells in genital or rectal mucosa may be the first infected cell type and may be the vectors of infection for CD4 positive T cells. It is clearly demonstrated that LC may be infected in HIV1 seropositive patients. Recently in vitro, experimental infection of Langerhans cells was reproduced using a co-culture assay with HIV1 infected cells. Recent data obtained with transgenic mice containing HIV1 gene underline the key role of Langerhans cells in the pathogenesis process of HIV infection.

S100 protein and neuron-specific enolase on monocytic leukemic CD1+ cells, probable precursors of Langerhans cells

Langerhans cells are characterized by specific markers, such as Birbeck granules and CD1a antigen. S100 protein and neuron-specific enolase are less specific but are expressed only on Langerhans cells among the cells of the phagocytic mononuclear system. In this study, the expression of these two antigens on many monocytic leukemic cells is shown. These cells could be precursors of Langerhans cells which have been transformed into malignant cells.

Langerhans' cell histiocytosis (histiocytosis X): immunophenotype and growth fraction

The immunophenotype and proliferation fraction have been investigated in 26 cases of Langerhans' cell histiocytosis (LCH). In all cases LCH cells were positive for S-100 protein, CD1a, or both. In most cases LCH cells expressed the macrophage-associated marker CD68 and in two cases they contained lysozyme. Expression of both cytoplasmic CD2 and CD3 was observed in cryostat sections. An unexpected finding was the presence of placental alkaline phosphatase in LCH cells. Langerhans' cells in normal skin were negative for both CD2 and CD3, but a proportion contained placental alkaline phosphatase. In four cases of Rosai-Dorfman disease the histiocytic cells, which share certain immunophenotypic properties with Langerhans' cells, also were positive for placental alkaline phosphatase. A significant proportion of LCH cells stained positively with the antibody to proliferating cell nuclear antigen and also with the proliferation marker Ki-S1. A good correlation between the percentage of Ki-67-positive and proliferating cell nuclear antigen- and Ki-S1-positive cells, respectively, was observed. Thus, in comparison with their putative precursors, LCH cells have an aberrant phenotype and are proliferating locally. This might suggest that LCH is a neoplastic rather than a reactive process.