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Yoon DH, Koh Y, Jung M, Kwak JE, Shin EC, Hwang YK, Kim WS. Phase I Study: Safety and Efficacy of an Ex Vivo-Expanded Allogeneic Natural Killer Cell (MG4101) with Rituximab for Relapsed/Refractory B Cell Non-Hodgkin Lymphoma. Transplant Cell Ther 2023; 29:253.e1-253.e9. [PMID: 36610490 DOI: 10.1016/j.jtct.2022.12.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/01/2022] [Accepted: 12/30/2022] [Indexed: 01/05/2023]
Abstract
The prognosis of non-Hodgkin lymphoma (NHL) remains poor, with an unmet need for novel therapies. MG4101, an ex vivo-expanded allogeneic natural killer (NK) cell, can enhance rituximab antibody-dependent cytotoxicity in relapsed/refractory (r/r) B cell non-Hodgkin lymphoma. This study assessed the safety and efficacy of MG4101 plus rituximab for patients with r/r NHL. Patients received escalating doses of i.v. MG4101 plus rituximab every 2 weeks. IL-2 was administered s.c. after MG4101 treatment. Fludarabine plus cyclophosphamide was administered i.v. before rituximab treatment in cycles 1, 3, and 5. A 3+3 design was used to determine the maximum tolerated dose (MTD) and maximum feasible dose. Assessments were performed over a 6-cycle period, with an extended maintenance period of up to 8 cycles. Nine patients received 3 different doses of MG4101 and rituximab. MTD could not be determined because of the absence of dose-limiting toxicity. Treatment-related adverse events, mostly grade 1 or 2, occurred in 89% of patients. Only 1 patient experienced grade 1 cytokine release syndrome. MG4101 persisted for at least 7 days in 7 patients. Four patients achieved a partial response and 1 patient attained a complete response, for an overall response rate of 55.6%. Two patients showed prolonged responses and low exhaustion marker levels in T cells. For allogeneic NK cell therapy, strategies including the use of the high-affinity hFcγRIIIaV158 variant of the KIR B/x haplotype with lymphodepleting chemotherapy may be promising options for improving clinical efficacy in the antibody combination therapeutic setting as an off-the-shelf product. MG4101 plus rituximab presented a favorable safety profile and overall response rate in patients with r/r NHL.
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Affiliation(s)
- Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Youngil Koh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Miyoung Jung
- Cell Therapy Research Center, GC Cell, Yongin, South Korea
| | - Jeong-Eun Kwak
- Cell Therapy Research Center, GC Cell, Yongin, South Korea
| | - Eui-Cheol Shin
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | | | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Phan MTT, Kim J, Koh SK, Lim Y, Yu H, Lee M, Lee JM, Kang ES, Kim HY, Kim SK, Hwang I, Cho D. Selective Expansion of NKG2C+ Adaptive NK Cells Using K562 Cells Expressing HLA-E. Int J Mol Sci 2022; 23:ijms23169426. [PMID: 36012691 PMCID: PMC9409060 DOI: 10.3390/ijms23169426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022] Open
Abstract
Adaptive natural killer (NK) cells expressing self-specific inhibitory killer-cell immunoglobulin-like receptors (KIRs) can be expanded in vivo in response to human cytomegalovirus (HCMV) infection. Developing a method to preferentially expand this subset is essential for effective targeting of allogeneic cancer cells. A previous study developed an in vitro method to generate single KIR+ NK cells for enhanced targeting of the primary acute lymphoblastic leukemia cells; however, the expansion rate was quite low. Here, we present an effective expansion method using genetically modified K562-HLA-E feeder cells for long-term proliferation of adaptive NK cells displaying highly differentiated phenotype and comparable cytotoxicity, CD107a, and interferon-γ (IFN-γ) production. More importantly, our expansion method achieved more than a 10,000-fold expansion of adaptive NK cells after 6 weeks of culture, providing a high yield of alloreactive NK cells for cell therapy against cancer.
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Affiliation(s)
- Minh-Trang Thi Phan
- Cell and Gene Therapy Institute (CGTI), Samsung Medical Center, Seoul 06351, Korea
| | - Jinho Kim
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06355, Korea
| | - Seung Kwon Koh
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06355, Korea
| | - Yuree Lim
- Department of Biopharmaceutical Convergence, Sungkyunkwan University, Suwon 16419, Korea
| | - Hongbi Yu
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06355, Korea
| | - Mijeong Lee
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06355, Korea
| | - Jong-Min Lee
- Bio Research Center, Lugensci Co., Ltd., Bucheon 14556, Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Hyun-Young Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Sang-Ki Kim
- Department of Companion and Laboratory Animal Science, Kongju National University, Yesan 32439, Korea
| | - Ilwoong Hwang
- Department of Emergency Medicine, Soonchunhyang University Gumi Hospital, Gumi 39371, Korea
- Correspondence: (I.H.); (D.C.)
| | - Duck Cho
- Cell and Gene Therapy Institute (CGTI), Samsung Medical Center, Seoul 06351, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06355, Korea
- Department of Biopharmaceutical Convergence, Sungkyunkwan University, Suwon 16419, Korea
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Correspondence: (I.H.); (D.C.)
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Roh EY, Oh S, Yoon JH, Kim BJ, Song EY, Shin S. Umbilical Cord Blood Units Cryopreserved in the Public Cord Blood Bank: A Breakthrough in iPSC Haplobanking? Cell Transplant 2021; 29:963689720926151. [PMID: 32623908 PMCID: PMC7563803 DOI: 10.1177/0963689720926151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The use of induced pluripotent stem cells (iPSCs) is an emerging therapeutic option for precision medicine. Cord blood (CB) cells with lower immunogenicity, fewer genomic changes, and persistent epigenetic memory might be ideal candidates for iPSC production. Based on the human leukocyte antigen (HLA) distribution of cord blood units (CBUs) in the public CB bank, we estimated the coverage of the Korean population with HLA-homozygous iPSCs to repurpose cryopreserved CBUs. We analyzed a total of 27,904 Korean CBUs donated to the public CB bank. Low-to-intermediate resolution typing was performed for HLA-A, -B, and -DRB1 alleles, and individuals possessing homozygous HLA haplotypes were identified by direct counting. Moreover, the matching probabilities for zero-mismatch transplantation were calculated for 27,904 CBUs and 50,000,000 potential Korean patients. Among the preserved CBUs, 15 HLA-A, 40 HLA-B, and 13 HLA-DRB1 alleles as well as 48 homozygous HLA-A-B-DRB1 haplotypes were identified at serological equivalents (2 digits). The 48 identified homozygous haplotypes cumulatively matched 78.18% of the 27,904 Korean CB donors as zero HLA-mismatch iPSC sources. Among the combinations of 1,699 haplotypes with frequencies greater than 0.001%, assuming a population of 50 million, those 48 haplotypes can provide a match for 78.37% of potential Korean recipients. A practicable number of HLA-A, -B, and -DRB1 homozygous iPSC lines derived from CBUs may be an efficient option in allogeneic iPSC therapy because this type of haplobanking may provide cell lines with optimal HLA matching for up to three-quarters of the Korean population.
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Affiliation(s)
- Eun Youn Roh
- Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Republic of Korea.,Seoul Metropolitan Public Cord Blood Bank-ALLCORD, Republic of Korea.,Department of Laboratory Medicine, Seoul National University College of Medicine, Republic of Korea.,Both the authors contributed equally to this study as co-first authors
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Republic of Korea.,Both the authors contributed equally to this study as co-first authors
| | - Jong Hyun Yoon
- Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Republic of Korea.,Seoul Metropolitan Public Cord Blood Bank-ALLCORD, Republic of Korea.,Department of Laboratory Medicine, Seoul National University College of Medicine, Republic of Korea
| | - Byoung Jae Kim
- Seoul Metropolitan Public Cord Blood Bank-ALLCORD, Republic of Korea.,Department of Obstetrics and Gynecology, Seoul National University Boramae Medical Center, Republic of Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Republic of Korea
| | - Sue Shin
- Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Republic of Korea.,Seoul Metropolitan Public Cord Blood Bank-ALLCORD, Republic of Korea.,Department of Laboratory Medicine, Seoul National University College of Medicine, Republic of Korea
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Wright PA. Killer-cell immunoglobulin-like receptor assessment algorithms in haemopoietic progenitor cell transplantation: current perspectives and future opportunities. HLA 2020; 95:435-448. [PMID: 31999071 DOI: 10.1111/tan.13817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/13/2019] [Accepted: 01/22/2020] [Indexed: 12/27/2022]
Abstract
Natural killer cells preferentially target and kill malignant and virally infected cells. Both these properties present compelling clinical utility in the field of haemopoietic progenitor cell transplantation (HPCT), potentially promoting a graft vs leukaemia effect in the absence of graft vs host disease and protecting against cytomegalovirus activation. Killer Ig-like receptors (KIR) play a central role in the cytotoxic action of natural killer cells, providing opportunity for improving transplantation outcomes by prioritising potential donors with optimal characteristics. Numerous algorithms for assessing KIR gene content as part of HPCT donor selection protocols exist, but no single model has been found to be universally applicable in all transplant centres. This review summarises several of the predominant strategies in KIR assessment algorithms, discussing their basic scientific principles, clinical utility and benefits to post-transplant outcomes. Finally, the review will consider how future donor selection protocols could develop towards unifying the concepts of KIR proteomics and genetics for optimising patient care.
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Affiliation(s)
- Paul A Wright
- Transplantation Laboratory, Division of Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Yan YX, Li YN. [Pathogenesis of steroid-resistant asthma and the influence of vitamin D]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:724-729. [PMID: 31315776 PMCID: PMC7389094 DOI: 10.7499/j.issn.1008-8830.2019.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/22/2019] [Indexed: 06/10/2023]
Abstract
Glucocorticoid (GC) is currently the most effective drug for controlling persistent asthma; however, there is a significant difference in the response to GC among patients with asthma. Steroid-resistant asthma is one of the subtypes of asthma and has poor response to high-dose GC treatment. It may affect the quality of life of patients and even threaten their lives. Therefore, it is of great significance to explore the pathogenesis of steroid-resistant asthma and related targeted treatment strategy. In recent years, a variety of pathogeneses have been found to participate in the development and progression of steroid-resistant asthma, including the reduction in the binding between GC receptor and GC, the increase in the expression of GC receptor β, over-activation of nuclear transcription factor activating protein 1 and nuclear factor-κB, abnormality in histone acetylation, and immune-mediated cytokine dysregulation. In addition, many studies have shown that vitamin D can improve the sensitivity to GC among patients with steroid-resistant asthma. This article reviews the pathogenesis of steroid-resistant asthma and the influence of vitamin D.
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Affiliation(s)
- Yu-Xiao Yan
- First Clinical Medical College of Lanzhou University, Lanzhou 730000, China.
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Keating BJ, Pereira AC, Snyder M, Piening BD. Applying genomics in heart transplantation. Transpl Int 2018; 31:278-290. [PMID: 29363220 PMCID: PMC5990370 DOI: 10.1111/tri.13119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/18/2017] [Accepted: 01/17/2018] [Indexed: 12/13/2022]
Abstract
While advances in patient care and immunosuppressive pharmacotherapies have increased the lifespan of heart allograft recipients, there are still significant comorbidities post-transplantation and 5-year survival rates are still significant, at approximately 70%. The last decade has seen massive strides in genomics and other omics fields, including transcriptomics, with many of these advances now starting to impact heart transplant clinical care. This review summarizes a number of the key advances in genomics which are relevant for heart transplant outcomes, and we highlight the translational potential that such knowledge may bring to patient care within the next decade.
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Affiliation(s)
- Brendan J. Keating
- Division of Transplantation, Department of Surgery, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Alexandre C. Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Michael Snyder
- Department of Genetics, Stanford University, Stanford, CA, USA
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Lee H, Park KH, Park HS, Ryu JH, Lim J, Kim Y, Na GH, Kim DG, Oh EJ. Human Leukocyte Antigen-C Genotype and Killer Immunoglobulin-like Receptor-Ligand Matching in Korean Living Donor Liver Transplantation. Ann Lab Med 2017; 37:45-52. [PMID: 27834065 PMCID: PMC5107617 DOI: 10.3343/alm.2017.37.1.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/24/2016] [Accepted: 09/12/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The interaction between killer immunoglobulin-like receptors (KIRs) and HLA class I regulates natural killer (NK) cell cytotoxicity and function. The impact of NK cell alloreactivity through KIR in liver transplantation remains unelucidated. Since the frequency of HLA-C and KIR genotypes show ethnic differences, we assessed the impact of HLA-C, KIR genotype, or KIR-ligand mismatch on the allograft outcome of Korean liver allografts. METHODS One hundred eighty-two living donor liver transplant patients were studied. Thirty-five patients (19.2%) had biopsy-confirmed acute rejection (AR), and eighteen (9.9%) had graft failure. The HLA-C compatibility, KIR genotypes, ligand-ligand, and KIR-ligand matching was retrospectively investigated for association with allograft outcomes. RESULTS Homozygous C1 ligands were predominant in both patients and donors, and frequency of the HLA-C2 allele in Koreans was lower than that in other ethnic groups. Despite the significantly lower frequency of the HLA-C2 genotype in Koreans, donors with at least one HLA-C2 allele showed higher rates of AR than donors with no HLA-C2 alleles (29.2% vs 15.7%, P=0.0423). Although KIR genotypes also showed ethnic differences, KIR genotypes and the number of activating KIR/inhibitory KIR were not associated with the allograft outcome. KIR-ligand mismatch was expected in 31.6% of Korean liver transplants and had no impact on AR or graft survival. CONCLUSIONS This study could not confirm the clinical impact of KIR genotypes and KIR-ligand mismatch. However, we demonstrated that the presence of HLA-C2 allele in the donor influenced AR of Korean liver allografts.
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Affiliation(s)
- Hyeyoung Lee
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Ki Hyun Park
- Department of Biomedical Science, Graduate School, the Catholic University of Korea, Seoul, Korea
| | - Hye Sun Park
- Department of Biomedical Science, Graduate School, the Catholic University of Korea, Seoul, Korea
| | - Ji Hyeong Ryu
- Department of Biomedical Science, Graduate School, the Catholic University of Korea, Seoul, Korea
| | - Jihyang Lim
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Yonggoo Kim
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Gun Hyung Na
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Dong Goo Kim
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Eun Jee Oh
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea.
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Kannan GS, Aquino-Lopez A, Lee DA. Natural killer cells in malignant hematology: A primer for the non-immunologist. Blood Rev 2016; 31:1-10. [PMID: 27665023 DOI: 10.1016/j.blre.2016.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 08/03/2016] [Accepted: 08/29/2016] [Indexed: 12/19/2022]
Abstract
Natural killer cells were first described over 40years ago, but the last 15years has shown tremendous progress in our understanding of their biology and our ability to manipulate them for clinical therapeutic effect. Despite the increased understanding by clinicians and scientists investigating these cells, their biology remains a confusing subject for many because of the wide array of receptors, complex interactions, multiple models of predicting function, and contradictory data in the literature. While they are microscopically indistinguishable from T cells and share many of the same effector functions, their mechanisms of target recognition are completely distinct from yet complimentary to T cells. In this review we provide a basic understanding of NK cell biology and HLA recognition as compared and contrasted to T cells using a metaphor of border patrol and passports. We conclude with a summary of the evidence for NK cell effects in hematologic malignancies and describe new advances in NK cell immunotherapy aimed at improving these effects.
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Affiliation(s)
- Geoffrey S Kannan
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, 450 Brooklyn Ave, Boston, MA 02215, USA.
| | - Arianexys Aquino-Lopez
- Clinical and Translational Sciences Program, University of Texas Graduate School of Biomedical Sciences, 6767 Bertner Avenue, Houston, TX 77030, USA; Division of Pediatrics, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 853, Houston, TX 77030, USA.
| | - Dean A Lee
- Division of Hematology, Oncology, and BMT, Nationwide Children's Hospital, 700 Children's Drive, WA4023, Columbus, OH 43205, USA.
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