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Felux J, Erbacher A, Breckler M, Hervé R, Lemeiter D, Mannherz HG, Napirei M, Rammensee HG, Decker P. Deoxyribonuclease 1-Mediated Clearance of Circulating Chromatin Prevents From Immune Cell Activation and Pro-inflammatory Cytokine Production, a Phenomenon Amplified by Low Trap1 Activity: Consequences for Systemic Lupus Erythematosus. Front Immunol 2021; 12:613597. [PMID: 33746957 PMCID: PMC7969502 DOI: 10.3389/fimmu.2021.613597] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/05/2021] [Indexed: 12/11/2022] Open
Abstract
Increased concentrations of circulating chromatin, especially oligo-nucleosomes, are observed in sepsis, cancer and some inflammatory autoimmune diseases like systemic lupus erythematosus (SLE). In SLE, circulating nucleosomes mainly result from increased apoptosis and decreased clearance of apoptotic cells. Once released, nucleosomes behave both as an autoantigen and as a damage-associated molecular pattern (DAMP) by activating several immune cells, especially pro-inflammatory cells. Deoxyribonuclease 1 (DNase1) is a major serum nuclease whose activity is decreased in mouse and human lupus. Likewise, the mitochondrial chaperone tumor necrosis factor (TNF) receptor-associated protein-1 (Trap1) protects against oxidative stress, which is increased in SLE. Here, using wild type, DNase1-deficient and DNase1/Trap1-deficient mice, we demonstrate that DNase1 is a major serum nuclease involved in chromatin degradation, especially when the plasminogen system is activated. In vitro degradation assays show that chromatin digestion is strongly impaired in serum from DNase1/Trap1-deficient mice as compared to wild type mice. In vivo, after injection of purified chromatin, clearance of circulating chromatin is delayed in DNase1/Trap1-deficient mice in comparison to wild type mice. Since defective chromatin clearance may lead to chromatin deposition in tissues and subsequent immune cell activation, spleen cells were stimulated in vitro with chromatin. Splenocytes were activated by chromatin, as shown by interleukin (IL)-12 secretion and CD69 up-regulation. Moreover, cell activation was exacerbated when Trap1 is deficient. Importantly, we also show that cytokines involved in lupus pathogenesis down-regulate Trap1 expression in splenocytes. Therefore, combined low activities of both DNase1 and Trap1 lead to an impaired degradation of chromatin in vitro, delayed chromatin clearance in vivo and enhanced activation of immune cells. This situation may be encountered especially, but not exclusively, in SLE by the negative action of cytokines on Trap1 expression.
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Affiliation(s)
- Jasmin Felux
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | - Annika Erbacher
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | - Magali Breckler
- Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
| | - Roxane Hervé
- Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
| | - Delphine Lemeiter
- Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
| | - Hans Georg Mannherz
- Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr-University Bochum, Bochum, Germany
| | - Markus Napirei
- Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr-University Bochum, Bochum, Germany
| | - Hans-Georg Rammensee
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | - Patrice Decker
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany.,Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
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Döring M, Cabanillas Stanchi KM, Lenglinger K, Treuner C, Gieseke F, Erbacher A, Mezger M, Vaegler M, Schlegel PG, Greil J, Bettoni da Cunha Riehm C, Faul C, Schumm M, Lang P, Handgretinger R, Müller I. Long-Term Follow-Up After the Application of Mesenchymal Stromal Cells in Children and Adolescents with Steroid-Refractory Graft-Versus-Host Disease. Stem Cells Dev 2021; 30:234-246. [PMID: 33446053 DOI: 10.1089/scd.2020.0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Steroid-refractory graft-versus-host disease (GvHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation (alloHSCT). Alternative treatment options are often insufficient. Several studies have proven the efficacy of mesenchymal stromal cells (MSCs) in the treatment of therapy-refractory acute GvHD in adult and pediatric patients. Long-term data in pediatric patients are scarce. In this retrospective analysis, a total of 25 patients with a median age of 10.6 years (range 0.6-22.1 years) who received bone marrow-derived MSCs after alloHSCT for the treatment of steroid-refractory III and IV GvHD were analyzed. The median observation period of the surviving patients was 9.3 years (1.3-12.7 years) after HSCT. Among the 25 patients, 10 (40.0%) died [relapse (n = 3), multiorgan failure (n = 6), cardiorespiratory failure (n = 1)] at median 0.5 years (0.2-2.3 years) after HSCT. Partial response and complete remission (PR, CR) of the GvHD were achieved in 76.0% and 24.0% of the patients, respectively. Transplant-related mortality was 0% in the patients who achieved CR after MSC treatment and 26.3% for those with PR. A median improvement by one intestinal or liver GvHD stage (range 1-4) could be achieved after MSC application. No potentially MSC-related long-term adverse effects, for example, secondary malignancy, were identified. In conclusion, the intravenous application of allogeneic MSCs was safe and proved effective for the treatment of steroid-refractory GvHD. However, larger, prospective, and randomized trials are needed to evaluate these findings.
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Affiliation(s)
- Michaela Döring
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | | | - Katrin Lenglinger
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Claudia Treuner
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Friederike Gieseke
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Annika Erbacher
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Markus Mezger
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Martin Vaegler
- Experimental and Clinical Research Center, GMP-Facility for Cellular Therapies, Charité Universitätsmedizin Berlin, Campus Berlin Buch, Berlin, Germany
| | - Paul-Gerhardt Schlegel
- Department of Pediatric Hematology and Oncology, University of Würzburg, Würzburg, Germany
| | - Johann Greil
- Department of Pediatric Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Christoph Faul
- University Hospital and Comprehensive Cancer Center Tübingen, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Michael Schumm
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Peter Lang
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Rupert Handgretinger
- Department I-General Pediatrics, Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany
| | - Ingo Müller
- Division for Pediatric Stem Cell Transplantation and Immunology, Clinic for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Döring M, Kluba T, Cabanillas Stanchi KM, Kahle P, Lenglinger K, Tsiflikas I, Treuner C, Vaegler M, Mezger M, Erbacher A, Schumm M, Lang P, Handgretinger R, Müller I. Longtime Outcome After Intraosseous Application of Autologous Mesenchymal Stromal Cells in Pediatric Patients and Young Adults with Avascular Necrosis After Steroid or Chemotherapy. Stem Cells Dev 2020; 29:811-822. [PMID: 32295491 DOI: 10.1089/scd.2020.0019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Avascular necrosis (AVN) is a severe complication of immunosuppressant therapy or chemotherapy. A beneficial AVN therapy with core decompression (CD) and intraosseous infusion of mesenchymal stromal cells (MSCs) has been described in adult patients, but there are only few data on MSC applications in pediatric and young adult patients (PYAP). Between 2006 and 2015, 14 AVN lesions of 10 PYAP (6 females) with a median age of 16.9 years (range 8.5-25.8 years) received CD and intraosseous application of autologous MSCs. Data of these patients were analyzed regarding efficacy, safety, and feasibility of this procedure as AVN therapy and compared with a control group of 13 AVN lesions of 11 PYAP (5 females) with a median age of 17.9 years (range 13.5-27.5 years) who received CD only. During the follow-up analysis [MSC group: median 3.1 (1.6-5.8) years after CD; CD group: median 2.0 (1.5-8.5) years after CD], relative lesion sizes (as assessed by magnetic resonance imaging) compared with the initial lesion volume, were significantly lower (P < 0.05) in the MSC group (volume reduction to a median of 18.5%) when compared with the CD group (58.0%). One lesion in the MSC group comprised a complete remission. Size progression was not observed in either group. Clinical improvement (pain, mobility) was not significantly different between the two groups. None of the patients experienced treatment-related adverse effects. CD and additional MSC application was regarded safe, effective, feasible, and superior in reducing the lesion size when compared with CD only. Prospective, randomized clinical trials are needed to further evaluate these findings.
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Affiliation(s)
- Michaela Döring
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Torsten Kluba
- Department of Orthopedic Surgery, Städtisches Klinikum Dresden, Dresden, Germany
| | - Karin Melanie Cabanillas Stanchi
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Peter Kahle
- Department of Orthopedics, University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Lenglinger
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Ilias Tsiflikas
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Claudia Treuner
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Martin Vaegler
- Charité - Universitätsmedizin Berlin, Campus Berlin Buch, Experimental and Clinical Research Center, Zellkulturlabor für Klinische Prüfung ZKP, Berlin, Germany
| | - Markus Mezger
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Annika Erbacher
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Michael Schumm
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Peter Lang
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Rupert Handgretinger
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
| | - Ingo Müller
- Department I-General Pediatrics, Hematology and Oncology, University Hospital Tuebingen-Children's Hospital Tuebingen, Tuebingen, Germany
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Rapp AE, Bindl R, Recknagel S, Erbacher A, Müller I, Schrezenmeier H, Ehrnthaller C, Gebhard F, Ignatius A. Fracture Healing Is Delayed in Immunodeficient NOD/scid‑IL2Rγcnull Mice. PLoS One 2016; 11:e0147465. [PMID: 26849055 PMCID: PMC4744061 DOI: 10.1371/journal.pone.0147465] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/04/2016] [Indexed: 01/08/2023] Open
Abstract
Following bone fracture, the repair process starts with an inflammatory reaction at the fracture site. Fracture healing is disturbed when the initial inflammation is increased or prolonged, whereby, a balanced inflammatory response is anticipated to be crucial for fracture healing, because it may induce down-stream responses leading to tissue repair. However, the impact of the immune response on fracture healing remains poorly understood. Here, we investigated bone healing in NOD/scid-IL2Rγcnull mice, which exhibit severe defects in innate and adaptive immunity, by biomechanical testing, histomorphometry and micro-computed tomography. We demonstrated that NOD/scid-IL2Rγcnull mice exhibited normal skeletal anatomy and a mild bone phenotype with a slightly reduced bone mass in the trabecular compartment in comparison to immunocompetent Balb/c mice. Fracture healing was impaired in immunodeficient NOD/scid-IL2Rγcnull mice. Callus bone content was unaffected during the early healing stage, whereas it was significantly reduced during the later healing period. Concomitantly, the amount of cartilage was significantly increased, indicating delayed endochondral ossification, most likely due to the decreased osteoclast activity observed in cells isolated from NOD/scid-IL2Rγcnull mice. Our results suggest that—under aseptic, uncomplicated conditions—the immediate immune response after fracture is non-essential for the initiation of bone formation. However, an intact immune system in general is important for successful bone healing, because endochondral ossification is delayed in immunodeficient NOD/scid-IL2Rγcnull mice.
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Affiliation(s)
- Anna E. Rapp
- Institute of Orthopaedic Research and Biomechanics, University of Ulm, Ulm, Germany
- * E-mail:
| | - Ronny Bindl
- Institute of Orthopaedic Research and Biomechanics, University of Ulm, Ulm, Germany
| | - Stefan Recknagel
- Institute of Orthopaedic Research and Biomechanics, University of Ulm, Ulm, Germany
| | - Annika Erbacher
- Department of General Paediatrics, Haematology and Oncology, University Children’s Hospital Tübingen, Tübingen, Germany
| | - Ingo Müller
- Clinic for Paediatric Haematology and Oncology, Bone Marrow Transplantation Unit, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service and University Hospital Ulm, Baden Wuerttemberg-Hessen, Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Christian Ehrnthaller
- Department of Traumatology, Hand-, Plastic, and Reconstructive Surgery, Centre of Surgery, University of Ulm, Ulm, Germany
| | - Florian Gebhard
- Department of Traumatology, Hand-, Plastic, and Reconstructive Surgery, Centre of Surgery, University of Ulm, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopaedic Research and Biomechanics, University of Ulm, Ulm, Germany
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Schilbach K, Alkhaled M, Welker C, Eckert F, Blank G, Ziegler H, Sterk M, Müller F, Sonntag K, Wieder T, Braumüller H, Schmitt J, Eyrich M, Schleicher S, Seitz C, Erbacher A, Pichler BJ, Müller H, Tighe R, Lim A, Gillies SD, Strittmatter W, Röcken M, Handgretinger R. Cancer-targeted IL-12 controls human rhabdomyosarcoma by senescence induction and myogenic differentiation. Oncoimmunology 2015; 4:e1014760. [PMID: 26140238 PMCID: PMC4485786 DOI: 10.1080/2162402x.2015.1014760] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/27/2015] [Accepted: 01/29/2015] [Indexed: 02/07/2023] Open
Abstract
Stimulating the immune system to attack cancer is a promising approach, even for the control of advanced cancers. Several cytokines that promote interferon-γ-dominated immune responses show antitumor activity, with interleukin 12 (IL-12) being of major importance. Here, we used an antibody-IL-12 fusion protein (NHS-IL12) that binds histones of necrotic cells to treat human sarcoma in humanized mice. Following sarcoma engraftment, NHS-IL12 therapy was combined with either engineered IL-7 (FcIL-7) or IL-2 (IL-2MAB602) for continuous cytokine bioavailability. NHS-IL12 strongly induced innate and adaptive antitumor immunity when combined with IL-7 or IL-2. NHS-IL12 therapy significantly improved survival of sarcoma-bearing mice and caused long-term remissions when combined with IL-2. NHS-IL12 induced pronounced cancer cell senescence, as documented by strong expression of senescence-associated p16INK4a and nuclear translocation of p-HP1γ, and permanent arrest of cancer cell proliferation. In addition, this cancer immunotherapy initiated the induction of myogenic differentiation, further promoting the hypothesis that efficient antitumor immunity includes mechanisms different from cytotoxicity for efficient cancer control in vivo.
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Key Words
- CIP1, CDK-interacting protein 1
- DNAM-1, DNAX accessory molecule-1
- KIR, killer-cell immunoglobulin-like receptor
- M1/M2 macrophages
- MICA/B, MHC class I polypeptide-related sequence A/B
- NKG, natural killer group
- NSG, NOD SCID gamma chain knock out mouse
- PCNA, proliferating cell nuclear antigen
- PVR, poliovirus receptor
- RMS, rhabdomyosarcoma, (eRMS: embryonal, aRMS: alveolar)
- ROI, region of interest
- RORC, RAR-related orphan receptor C
- SCT, stem cell transplantation
- SPECT/CT, single-photon emission computed tomography
- TH1-induced senescence
- TH17 cells
- TRBV, T-cell receptor beta chain
- ULBP, UL16 binding protein
- WAF, wild-type activating fragment
- cancer-targeted IL-12
- differentiation
- humanized mice
- immunocytokine
- immunotherapy
- pHP1γ, phosphorylated heterochromatin protein 1 gamma
- rhabdomyosarcoma
- tumor-infiltrating lymphocytes
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Affiliation(s)
- Karin Schilbach
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Mohammed Alkhaled
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Christian Welker
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Franziska Eckert
- Department of Radiation Oncology; Eberhard Karls University ; Tübingen, Germany
| | - Gregor Blank
- Department of General, Visceral and Transplant Surgery; University Hospital ; Tübingen, Germany
| | - Hendrik Ziegler
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Marco Sterk
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Friederike Müller
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Katja Sonntag
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Thomas Wieder
- Department of Dermatology; Eberhard Karls University ; Tübingen, Germany
| | - Heidi Braumüller
- Department of Dermatology; Eberhard Karls University ; Tübingen, Germany
| | - Julia Schmitt
- Werner Siemens Imaging Center; Department for Preclinical Imaging and Radiopharmacy; Eberhard Karls University ; Tübingen, Germany
| | - Matthias Eyrich
- University of Würzburg; Department of Pediatrics; Interdisciplinary Stem Cell Laboratory ; Würzburg, Germany
| | - Sabine Schleicher
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Christian Seitz
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Annika Erbacher
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
| | - Bernd J Pichler
- Werner Siemens Imaging Center; Department for Preclinical Imaging and Radiopharmacy; Eberhard Karls University ; Tübingen, Germany
| | - Hartmut Müller
- Department of General Pathology; Institute of Pathology; Eberhard Karls University ; Tübingen, Germany
| | - Robert Tighe
- EMD Serono Research Institute ; Billerica, MA USA
| | - Annick Lim
- Départment d'Immunologie; Institute Pasteur ; Paris, France
| | | | | | - Martin Röcken
- Department of Dermatology; Eberhard Karls University ; Tübingen, Germany
| | - Rupert Handgretinger
- Department of General Pediatrics; Oncology/Hematology; University Children's Hospital ; Tübingen, Germany
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Rapp AE, Bindl R, Heilmann A, Erbacher A, Müller I, Brenner RE, Ignatius A. Systemic mesenchymal stem cell administration enhances bone formation in fracture repair but not load-induced bone formation. Eur Cell Mater 2015; 29:22-34. [PMID: 25552426 DOI: 10.22203/ecm.v029a02] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Mesenchymal stem cells (MSC) were shown to support bone regeneration, when they were locally transplanted into poorly healing fractures. The benefit of systemic MSC transplantation is currently less evident. There is consensus that systemically applied MSC are recruited to the site of injury, but it is debated whether they actually support bone formation. Furthermore, the question arises as to whether circulating MSC are recruited only in case of injury or whether they also participate in mechanically induced bone formation. To answer these questions we injected green fluorescent protein (GFP)-labelled MSC into C57BL/6J mice, which were subjected either to a femur osteotomy or to non-invasive mechanical ulna loading to induce bone formation. We detected GFP-labelled MSC in the early (day 10) and late fracture callus (day 21) by immunohistochemistry. Stromal cell-derived factor 1 (SDF-1 or CXCL-12), a key chemokine for stem cell attraction, was strongly expressed by virtually all cells near the osteotomy--indicating that SDF-1 may mediate cell migration to the site of injury. We found no differences in SDF-1 expression between the groups. Micro-computed tomography (µCT) revealed significantly more bone in the callus of the MSC treated mice compared to untreated controls. The bending stiffness of callus was not significantly altered after MSC-application. In contrast, we failed to detect GFP-labelled MSC in the ulna after non-invasive mechanical loading. Histomorphometry and µCT revealed a significant load-induced increase in bone formation; however, no further increase was found after MSC administration. Concluding, our results suggest that systemically administered MSC are recruited and support bone formation only in case of injury but not in mechanically induced bone formation.
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Affiliation(s)
- A E Rapp
- Institute of Orthopaedic Research and Biomechanics, Helmholtzstr. 14, 89081 Ulm,
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Döring M, Rohrer KM, Erbacher A, Gieseke F, Schwarze CP, Bader P, Handgretinger R, Hofbeck M, Kerst G. Human leukocyte antigen DR surface expression on CD14+ monocytes during adverse events after hematopoietic stem cell transplantation. Ann Hematol 2014; 94:265-73. [PMID: 25113134 DOI: 10.1007/s00277-014-2185-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/04/2014] [Indexed: 11/28/2022]
Abstract
The human leukocyte antigen DR surface expression on CD14+ monocytes reflects the degree to which these cells have been activated. Given the central role monocytes and macrophages play in the immune system, a decreased human leukocyte antigen DR expression on CD14+ monocytes results in a hallmark of altered immune status during systemic inflammatory response syndrome. We hypothesize that human leukocyte antigen DR expression might be similarly altered after hematopoietic stem cell transplantation and during post-transplant complications. Using flow cytometry, this study investigates the human leukocyte antigen DR surface expression of CD14+ monocytes in 30 pediatric and young adult patients up to 1 year after hematopoietic stem cell transplantation. Normal values were derived from a control group of healthy children, adolescents, and young adults. Human leukocyte antigen DR expression decreased significantly prior and during bacterial infection or sepsis. By contrast, human leukocyte antigen DR expression levels were elevated before and at the time of viremia. Human leukocyte antigen DR expression was also elevated during acute graft-versus-host disease. In contrast, the expression was reduced when patients had hepatic veno-occlusive disease. A significant decrease of human leukocyte antigen DR expression was associated with a relapse of the underlying disease and before death. Human leukocyte antigen DR expression on CD14+ monocytes appears to be a promising parameter that might allow identification of patients at risk after hematopoietic stem cell transplantation.
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Affiliation(s)
- Michaela Döring
- Department I - General Paediatrics, Hematology/Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany,
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Döring M, Müller C, Johann PD, Erbacher A, Kimmig A, Schwarze CP, Lang P, Handgretinger R, Müller I. Analysis of posaconazole as oral antifungal prophylaxis in pediatric patients under 12 years of age following allogeneic stem cell transplantation. BMC Infect Dis 2012; 12:263. [PMID: 23082876 PMCID: PMC3514296 DOI: 10.1186/1471-2334-12-263] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 10/11/2012] [Indexed: 12/03/2022] Open
Abstract
Background Pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) are at high risk of acquiring fungal infections. Antifungal prophylaxis shortly after transplantation is therefore indicated, but data for pediatric patients under 12 years of age are scarce. To address this issue, we retrospectively assessed the safety, feasibility, and initial efficacy of prophylactic posaconazole in children. Methods 60 consecutive pediatric patients with a median age of 6.0 years who underwent allogeneic HSCT between August 2007 and July 2010 received antifungal prophylaxis with posaconazole in the outpatient setting. 28 pediatric patients received an oral suspension at 5 mg/kg body weight b.i.d., and 32 pediatric patients received the suspension at 4 mg/kg body weight t.i.d. The observation period lasted from start of treatment with posaconazole until its termination (maximum of 200 days post-transplant). Results Pediatric patients who received posaconazole at 4 mg/kg body weight t.i.d. had a median trough level of 383 μg/L. Patients who received posaconazole at 5 mg/kg body weight b.i.d. had a median trough level of 134 μg/L. Both regimens were well tolerated without severe side effects. In addition, no proven or probable invasive mycosis was observed. Conclusion Posaconazole was a well-tolerated, safe, and effective oral antifungal prophylaxis in pediatric patients who underwent high-dose chemotherapy and HSCT. Posaconazole at a dosage of 12 mg/kg body weight divided in three doses produced consistently higher morning trough levels than in patients who received posaconazole 5 mg/kg body weight b.i.d. Larger prospective trials are needed to obtain reliable guidelines for antifungal prophylaxis in children after HSCT.
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Affiliation(s)
- Michaela Döring
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany.
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Gieseke F, Mang P, Viebahn S, Sonntag I, Kruchen A, Erbacher A, Pfeiffer M, Handgretinger R, Müller I. Siglec-7 tetramers characterize B-cell subpopulations and leukemic blasts. Eur J Immunol 2012; 42:2176-86. [PMID: 22585296 DOI: 10.1002/eji.201142298] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/29/2012] [Accepted: 04/20/2012] [Indexed: 01/31/2023]
Abstract
Cell surface glycosylation has important regulatory functions in the maturation, activation, and homeostasis of lymphocytes. The family of human sialic acid-binding immunoglobulin-like lectins (siglecs) comprises inhibitory as well as activating receptors intimately involved in the regulation of immune responses. Analyses of the interaction between siglecs and glycans are hampered by the low affinity of this interaction. Therefore, we expressed siglec-7 in eukaryotic cells, allowing for glycosylation, and oligomerized the protein in analogy to MHC tetramers. Using this tool, flow cytometric analysis of lymphocytes became possible. Sialic acid-dependent binding of siglec-7 tetramers was confirmed by glycan array analysis and loss of siglec tetramer binding after neuraminidase treatment of lymphocytes. In contrast to most lymphocyte subpopulations, which showed high siglec-7 ligand expression, B-cell subpopulations could be further subdivided according to different siglec-7 ligand expression levels. We also analyzed blasts from acute lymphoblastic leukemias of the B-cell lineage as well as the T-cell lineage, since malignant transformation is often associated with aberrant cell surface glycosylation. While pediatric T-ALL blasts highly expressed siglec-7 ligands, siglec-7 ligands were barely detectable on cALL blasts. Taken together, oligomerization of recombinant soluble siglec-7 enabled flow cytometric identification of physiologic lymphocyte subpopulations and malignant blasts.
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Döring M, Hartmann U, Erbacher A, Lang P, Handgretinger R, Müller I. Caspofungin as antifungal prophylaxis in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation: a retrospective analysis. BMC Infect Dis 2012; 12:151. [PMID: 22747637 PMCID: PMC3449185 DOI: 10.1186/1471-2334-12-151] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 06/19/2012] [Indexed: 11/10/2022] Open
Abstract
Background Pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) often receive intravenous liposomal amphotericin B (L-AmB) as antifungal prophylaxis. There are no guidelines for antifungal prophylaxis in children in this situation. Caspofungin (CAS), a broad-spectrum echinocandin, could be an effective alternative with lower nephrotoxicity than L-AmB. Methods We retrospectively analyzed the safety, feasibility, and efficacy of CAS in our center, and compared the results with L-AmB as antifungal monoprophylaxis in pediatric patients undergoing HSCT. 60 pediatric patients received L-AmB (1 or 3 mg/kg bw/day) and another 60 patients received CAS (50 mg/m2/day) as antifungal monoprophylaxis starting on day one after HSCT. The median ages of patients receiving L-AmB and CAS were 7.5 years and 9.5 years, respectively. Results No proven breakthrough fungal infection occurred in either group during the median treatment period of 23 days in the L-AmB group and 24 days in the CAS group. One patient receiving CAS developed probable invasive aspergillosis. During L-AmB treatment, potassium levels significantly decreased below normal values. Patients treated with L-AmB had more drug-related side effects and an increased need for oral supplementation with potassium, sodium bicarbonate and calcium upon discharge as compared with the CAS group. CAS was well-tolerated and safe in this cohort of immunocompromised pediatric patients, who underwent high-dose chemotherapy and HSCT. Conclusion Prophylactic CAS and L-AmB showed similar efficacy in this biggest cohort of pediatric patients after allogeneic HSCT reported, so far. A prospective randomized trial in children is warranted to allow for standardized guidelines.
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Affiliation(s)
- Michaela Döring
- Department of Pediatric Hematology/Oncology, University Children's Hospital Tübingen, Tübingen, Germany.
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Lindau D, Rönnefarth V, Erbacher A, Rammensee HG, Decker P. Nucleosome-induced neutrophil activation occurs independently of TLR9 and endosomal acidification: implications for systemic lupus erythematosus. Eur J Immunol 2011; 41:669-81. [PMID: 21287547 DOI: 10.1002/eji.201040593] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 11/04/2010] [Accepted: 12/20/2010] [Indexed: 01/04/2023]
Abstract
The nucleosome is a major autoantigen known to activate PMN in systemic lupus erythematosus (SLE). TLR9 recognizes bacterial and even mammalian DNA under certain circumstances. Nevertheless, the role of TLR9 in SLE development is still unclear. Since nucleosomes are composed of DNA, we investigated whether TLR9 is required for nucleosome-induced PMN activation. Isolated neutrophils were cultured with nucleosomes, plasma from lupus patients and other stimuli in the presence/absence of various inhibitors. Cells were analyzed by flow cytometry, ELISA and confocal microscopy. We found that nucleosomes circulating in lupus plasma induce the secretion of pro-inflammatory cytokines by PMN. Nucleosomes activate human PMN independently of unmethylated CpG sequences in nucleosomal DNA, leading to IL-8/IL-6/TNF secretion and CD11b up-regulation. Nucleosomes accumulate in the cytoplasm of PMN upon endocytosis, induce TLR9 up-regulation and act synergistically with TLR9 ligands. Nucleosome-induced activation was not inhibited by polymyxin B (PB), chloroquine (CQ), ammonium chloride (AC) or a TLR9 antagonist. Moreover, both PMN isolated from WT and TLR9-KO mice were activated by nucleosomes, as detected by MIP-2 secretion and CD11b up-regulation. Activation occurred therefore independently of endotoxins, endosomal acidification, TLR9 and CpG motifs. TLR9 may thus be differently required in the triggering of nucleosome-induced innate immunity and anti-nucleosome B-cell autoimmunity.
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Affiliation(s)
- Dennis Lindau
- University of Tübingen, Institute for Cell Biology, Department of Immunology, Tübingen, Germany
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André MC, Erbacher A, Gille C, Schmauke V, Goecke B, Hohberger A, Mang P, Wilhelm A, Mueller I, Herr W, Lang P, Handgretinger R, Hartwig UF. Long-term human CD34+ stem cell-engrafted nonobese diabetic/SCID/IL-2R gamma(null) mice show impaired CD8+ T cell maintenance and a functional arrest of immature NK cells. J Immunol 2010; 185:2710-20. [PMID: 20668220 DOI: 10.4049/jimmunol.1000583] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation represents the most effective form of immunotherapy for chemorefractory diseases. However, animal models have been missing that allow evaluation of donor-patient-specific graft-versus-leukemia effects. Thus, we sought to establish a patient-tailored humanized mouse model that would result in long-term engraftment of various lymphocytic lineages and would serve as a donor-specific surrogate. Following transfer of donor-derived peripheral blood stem cells into NOD/SCID/IL-2Rgamma(null) (NSG) mice with supplementation of human IL-7, we could demonstrate robust engraftment and multilineage differentiation comparable to earlier studies using cord blood stem cells. Phenotypical and functional analyses of lymphoid lineages revealed that >20 wk posthematopoietic stem cell transplantation, the majority of T lymphocytes consisted of memory-type CD4(+) T cells capable of inducing specific immune functions, whereas CD8(+) T cells were only present in low numbers. Analysis of NSG-derived NK cells revealed the expression of constitutively activated CD56(bright)CD16(-) killer Ig-like receptor(negative) NK cells that exhibited functional impairments. Thus, the data presented in this study demonstrate that humanized NSG mice can be successfully used to develop a xenotransplantation model that might allow patient-tailored treatment strategies in the future, but also highlight the need to improve this model, for example, by coadministration of differentiation-promoting cytokines and induction of human MHC molecules to complement existing deficiencies in NK and CD8(+) T cell development.
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Affiliation(s)
- Maya C André
- Department of Pediatric Hematology/Oncology, University Children's Hospital, Eberhard Karls University, Tuebingen, Germany
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André MC, Erbacher A, Gille C, Schmauke V, Goecke B, Hohberger A, Mang P, Wilhelm A, Müller I, Herr W, Lang P, Handgretinger R, Hartwig UF. Langzeit-transplantierte human-murin chimäre NOD/SCID/IL2Rγnull Mäuse zeigen eine verminderte CD8+ T Zellzahl und eine funktionelle Reifungsstörung von NK Zellen. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Erbacher A, Kruchen A, Mang P, Gondesen I, Gieseke F, Handgretinger R, Mueller I. Characteristic glycosylation patterns of human immune cells in NOD/SCID IL2Rγnull mice. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1254497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mang P, Kruchen A, Gondesen I, Erbacher A, Viebahn S, Gieseke F, Handgretinger R, Müller I. Characterisation of sialylation patterns on the surface of physiologic immune effector cells and tumour cells. Klin Padiatr 2009. [DOI: 10.1055/s-0029-1222659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Erbacher A, Gieseke F, Handgretinger R, Müller I. Dendritic cells: functional aspects of glycosylation and lectins. Hum Immunol 2009; 70:308-12. [PMID: 19236902 DOI: 10.1016/j.humimm.2009.02.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Revised: 02/09/2009] [Accepted: 02/11/2009] [Indexed: 12/14/2022]
Abstract
Dendritic cells (DC) direct immune responses either toward tolerance to a presented antigen or toward inflammatory reactions of effector cells. Many crucial cytokines and cell surface proteins have been identified in this process using gene expression profiling. However, it is becoming evident that important steps involve carbohydrate-protein interactions, which cannot be anticipated by gene expression profiling in most cases. These contacts are crucial for the uptake of certain antigens, migration, and homing, but also for infection by viruses. On one hand, DC use numerous C-type lectins, such as DC-SIGN, dectin-1, langerin, and DEC-205, for antigen uptake. Other lectins, such as CD83, siglecs, and galectins, may be involved in regulation of the immune response to a given antigen. On the other hand, cell surface glycosylation of DC themselves changes significantly depending on the environment and the functional state, generating different signals by altered glycans. Because DC occur at the interface between innate and acquired immunity, it may not be surprising that glycans and lectins play an important role in many biological functions of DC. In this review, we focus on glycobiological aspects of antigen uptake and processing, immune modulation, and viral infections in the context of DC biology.
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Affiliation(s)
- Annika Erbacher
- University Children's Hospital, Department of General Pediatrics, Hematology and Oncology, 72026 Tübingen, Germany
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Dittrich AM, Erbacher A, Specht S, Diesner F, Krokowski M, Avagyan A, Stock P, Ahrens B, Hoffmann WH, Hoerauf A, Hamelmann E. Helminth Infection with Litomosoides sigmodontis Induces Regulatory T Cells and Inhibits Allergic Sensitization, Airway Inflammation, and Hyperreactivity in a Murine Asthma Model. J Immunol 2008; 180:1792-9. [DOI: 10.4049/jimmunol.180.3.1792] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Dittrich A, Erbacher A, Diesner F, Ahrens B, Quarcoo D, Hoffmann W, Hamelmann E. Infection with Litosomoides sigmodontis suppresses allergen-induced sensitization and pulmonary inflammation in a murine asthma model. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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