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Rubenstein E, Maldini C, Vaglio A, Bello F, Bremer JP, Moosig F, Bottero P, Pesci A, Sinico RA, Grosskreutz J, Feder C, Saadoun D, Trivioli G, Maritati F, Rewerska B, Szczeklik W, Fraticelli P, Guida G, Gregorini G, Moroncini G, Hellmich B, Zwerina J, Resche-Rigon M, Emmi G, Neumann T, Mahr A. Cluster Analysis to Explore Clinical Subphenotypes of Eosinophilic Granulomatosis With Polyangiitis. J Rheumatol 2023; 50:1446-1453. [PMID: 37739478 DOI: 10.3899/jrheum.2023-0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Previous studies suggested that distinct phenotypes of eosinophilic granulomatosis with polyangiitis (EGPA; formerly known as Churg-Strauss syndrome) could be determined by the presence or absence of antineutrophil cytoplasmic antibodies (ANCA), reflecting predominant vasculitic or eosinophilic processes, respectively. This study explored whether ANCA-based clusters or other clusters can be identified in EGPA. METHODS This study used standardized data of 15 European centers for patients with EGPA fulfilling widely accepted classification criteria. We used multiple correspondence analysis, hierarchical cluster analysis, and a decision tree model. The main model included 10 clinical variables (musculoskeletal [MSK], mucocutaneous, ophthalmological, ENT, cardiovascular, pulmonary, gastrointestinal, renal, central, or peripheral neurological involvement); a second model also included ANCA results. RESULTS The analyses included 489 patients diagnosed between 1984 and 2015. ANCA were detected in 37.2% of patients, mostly perinuclear ANCA (85.4%) and/or antimyeloperoxidase (87%). Compared with ANCA-negative patients, those with ANCA had more renal (P < 0.001) and peripheral neurological involvement (P = 0.04), fewer cardiovascular signs (P < 0.001), and fewer biopsies with eosinophilic tissue infiltrates (P = 0.001). The cluster analyses generated 4 (model without ANCA) and 5 clusters (model with ANCA). Both models identified 3 identical clusters of 34, 39, and 40 patients according to the presence or absence of ENT, central nervous system, and ophthalmological involvement. Peripheral neurological and cardiovascular involvement were not predictive characteristics. CONCLUSION Although reinforcing the known association of ANCA status with clinical manifestations, cluster analysis does not support a complete separation of EGPA in ANCA-positive and -negative subsets. Collectively, these data indicate that EGPA should be regarded as a phenotypic spectrum rather than a dichotomous disease.
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Affiliation(s)
- Emma Rubenstein
- E. Rubenstein, MD, MPH, Infectious Diseases Department, Saint-Louis Hospital, Paris, France;
| | - Carla Maldini
- C. Maldini, MD, PhD, Catedra de Semiologia UHMI 3, Facultad de Ciencias Medicas, Universidad Nacional de Cordoba, Cordoba, Argentina
| | - Augusto Vaglio
- A. Vaglio, MD, PhD, Department of Biomedical, Experimental and Clinical Sciences, University of Firenze, and Nephrology and Dialysis Unit, Meyer Children's Hospital, Florence, Italy
| | - Federica Bello
- F. Bello, MD, Internal Interdisciplinary Medicine Unit, Careggi University Hospital, and Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy
| | | | - Frank Moosig
- F. Moosig, MD, PhD, Rheumazentrum Schleswig-Holstein Mitte, Neumünster, Germany
| | - Paolo Bottero
- P. Bottero, MD, Allergy and Clinical Immunology, G. Fornaroli Hospital, Milan, Italy
| | - Alberto Pesci
- A. Pesci, MD, Pneumology, University of Milano Bicocca, San Gerardo Hospital, Monza, Italy
| | - Renato Alberto Sinico
- R.A. Sinico, MD, PhD, Department of Nephrology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Julian Grosskreutz
- J. Grosskreutz, MD, Precision Neurology, Excellence Cluster Precision Medicine in Inflammation, University of Lübeck, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Claudia Feder
- C. Feder, MD, Department of Internal Medicine V, Jena University Hospital, Jena, Germany
| | - David Saadoun
- D. Saadoun, MD, PhD, Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre national de références Maladies Autoimmunes et systémiques rares, Centre national de références Maladies Autoinflammatoires rares et Amylose inflammatoire INSERM, UMR S959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Giorgio Trivioli
- G. Trivioli, MD, Department of Nephrology, Cambridge University Hospitals, Cambridge, UK
| | - Federica Maritati
- F. Maritati, MD, Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Barbara Rewerska
- B. Rewerska, MD, PhD, Diamond Clinic, Diamond Medical Centre, Krakow, Poland
| | - Wojciech Szczeklik
- W. Szczeklik, MD, PhD, Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Paolo Fraticelli
- P. Fraticelli, MD, PhD, Medical Clinic, Department of Internal Medicine, Marche University Hospital, Ancona, Italy
| | - Giuseppe Guida
- G. Guida, MD, PhD, Department of Clinical and Biological Sciences, University of Turin, and Severe Asthma and Rare Lung Disease Unit San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Gina Gregorini
- G. Gregorini, MD, Nephrology, Spedali Civili, University of Brescia, Brescia, Italy
| | - Gianluca Moroncini
- G. Moroncini, MD, PhD, Medical Clinic, Department of Clinical and Molecular Science, Marche Polytechnic University, Ancona, Italy
| | - Bernhard Hellmich
- B. Hellmich, MD, PhD, Internal Medicine, Rheumatology and Immunology, Medius Kliniken, University of Tübingen, Kirchheim-Teck, Germany
| | - Jochen Zwerina
- J. Zwerina, MD, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - Matthieu Resche-Rigon
- M. Resche-Rigon, MD, PhD, Clinical Research Unit, Saint-Louis Hospital, Paris, France
| | - Giacomo Emmi
- G. Emmi, MD, PhD, Internal Interdisciplinary Medicine Unit, Careggi University Hospital, Firenze, Italy, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy, and Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Melbourne, Australia
| | - Thomas Neumann
- T. Neumann, MD, Rheumatology and Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland, and Department of Internal Medicine III, Jena University Hospital, Jena, Germany
| | - Alfred Mahr
- A. Mahr, MD, PhD, Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, and Rheumatology and Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Rubenstein E, Maldini C, Vaglio A, Bello F, Bremer JP, Moosig F, Bottero P, Pesci A, Sinico RA, Grosskreutz J, Feder C, Saadoun D, Trivioli G, Maritati F, Rewerska B, Szczeklik W, Fraticelli P, Guida G, Gregorini G, Moroncini G, Hellmich B, Zwerina J, Resche-Rigon M, Emmi G, Neumann T, Mahr A. Cluster Analysis To Explore Clinical Subphenotypes Of Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss). J Rheumatol 2023:jrheum.2023-0325. [PMID: 37657795 DOI: 10.3899/jrheum.2022-0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Previous studies suggested that distinct phenotypes of eosinophilic granulomatosis with polyangiitis (EGPA) could be determined by presence or absence of antineutrophil cytoplasmic antibodies (ANCA), reflecting predominant vasculitic or eosinophilic processes, respectively. This study explored whether ANCA-based clusters or other clusters can be identified in EGPA. METHODS This study used standardized data of 15 European centers for patients with EGPA fulfilling widely accepted classification criteria. We used multiple correspondence analysis, hierarchical cluster analysis, and a decision tree model. The main model included 10 clinical variables (musculoskeletal, mucocutaneous, ophthalmological, ENT, cardiovascular, pulmonary, gastrointestinal, renal, central or peripheral neurological involvement); a second model also included ANCA results. RESULTS The analyses included 489 patients diagnosed in 1984-2015. ANCA were detected in 37.2% of patients, mostly P-ANCA (85.4%) and/or anti-myeloperoxidase (87.0%). Compared with ANCA-negative patients, those with ANCA had more renal (P<0.001) and peripheral neurological involvement (P=0.04), fewer cardiovascular signs (P<0.001) and fewer biopsies with eosinophilic tissue infiltrates (P=0.001). The cluster analyses generated four (model without ANCA) and five clusters (model with ANCA). Both models identified three identical clusters of 34, 39 and 40 patients according to the presence or absence of ENT, CNS and ophthalmological involvement. Peripheral neurological and cardiovascular involvement were not predictive characteristics. CONCLUSION Although reinforcing the known association of ANCA status with clinical manifestations, cluster analysis does not support a complete separation of EGPA in ANCA-positive and -negative subsets. Collectively, these data indicate that EGPA should be regarded as a phenotypic spectrum rather than a dichotomous disease.
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Affiliation(s)
- Emma Rubenstein
- Emma Rubenstein, MD, MPH, Infectious Diseases Department, Saint-Louis Hospital, Paris, France
| | - Carla Maldini
- Carla Maldini, MD, PhD, Catedra de Semiologia UHMI 3, Facultad de Ciencias Medicas, Universidad Nacional de Cordoba, Argentina
| | - Augusto Vaglio
- Augusto Vaglio, MD, PhD, Department of Biomedical, Experimental and Clinical Sciences, University of Firenze; Nephrology and Dialysis Unit, Meyer Children's Hospital, Firenze, Italy
| | - Federica Bello
- Federica Bello, MD, Internal Interdisciplinary Medicine Unit, Careggi University Hospital, and Department of Experimental and Clinical Medicine, University of Firenze, Italy
| | - Jan Phillip Bremer
- Jan Phillip Bremer, MD, PhD, Immunologikum Hamburg, Hamburg, Germany.; Rheumazentrum Schleswig-Holstein Mitte, Neumünster, Germany
| | - Frank Moosig
- Frank Moosig, MD, PhD, Allergy and Clinical Immunology, G. Fornaroli Hospital, Milan, Italy; Pneumology, University of Milano Bicocca, San Gerardo Hospital, Monza, Italy
| | - Paolo Bottero
- Paolo Bottero, MD, Allergy and Clinical Immunology, G. Fornaroli Hospital, Milan, Italy
| | - Alberto Pesci
- Alberto Pesci, MD, Pneumology, University of Milano Bicocca, San Gerardo Hospital, Monza, Italy
| | - Renato Alberto Sinico
- Renato Alberto Sinico, MD, PhD, Department of Nephrology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Julian Grosskreutz
- Julian Grosskreutz, MD, Precision Neurology, Excellence Cluster Precision Medicine in Inflammation, University of Lübeck, University Hospital Schleswig-Holstein Campus Lübeck, Germany
| | - Claudia Feder
- Claudia Feder MD, Department of Internal Medicine V, Jena University Hospital, Jena, Germany
| | - David Saadoun
- David Saadoun, MD, PhD, Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre national de références Maladies Autoimmunes et systémiques rares, Centre national de références Maladies Autoinflammatoires rares et Amylose inflammatoire INSERM, UMR S959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Giorgio Trivioli
- Giorgio Trivioli, MD, Department of Nephrology, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Federica Maritati
- Federica Maritati, MD, PhD, Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Barbara Rewerska
- Barbara Rewerska, MD, PhD, Diamond Clinic, Diamond Medical Centre, Krakow, Poland
| | - Wojciech Szczeklik
- Wojciech Szczeklik, MD, PhD, Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Paolo Fraticelli
- Paolo Fraticelli, MD, PhD, Medical Clinic, Department of Internal Medicine, Marche University Hospital, Ancona, Italy
| | - Giuseppe Guida
- Giuseppe Guida, MD, PhD, Department of Clinical and Biological Sciences, University of Turin, Italy, Severe Asthma and Rare Lung Disease Unit San Luigi Gonzaga University Hospital, Orbassano (TO), Italy
| | - Gina Gregorini
- Gina Gregorini, MD, Nephrology, Spedali Civili, University of Brescia, Italy
| | - Gianluca Moroncini
- Gianluca Moroncini, MD, PhD, Medical Clinic, Department of Clinical and Molecular Science, Marche Polytechnic University, Ancona, Italy
| | - Bernhard Hellmich
- Bernhard Hellmich, MD, PhD, Internal Medicine, Rheumatology and Immunology, Medius Kliniken, University of Tübingen, Kirchheim-Teck, Germany
| | - Jochen Zwerina
- Jochen Zwerina, MD, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - Matthieu Resche-Rigon
- Matthieu Resche-Rigon, MD, PhD, Clinical Research Unit, Saint-Louis Hospital, Paris, France
| | - Giacomo Emmi
- Giacomo Emmi, MD, PhD, Internal Interdisciplinary Medicine Unit, Careggi University Hospital, and Department of Experimental and Clinical Medicine, University of Firenze, Italy; Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Melbourne, Australia
| | - Thomas Neumann
- Thomas Neumann, MD, Rheumatology and Internal Medicine, Kantonsspital St. Gallen, Switzerland; Department of Internal Medicine III, Jena University Hospital, Jena, Germany
| | - Alfred Mahr
- Alfred Mahr, MD, PhD, Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Rheumatology and Internal Medicine, Kantonsspital St. Gallen, Switzerland
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Milger K, Korn S, Feder C, Fuge J, Mühle A, Schütte W, Skowasch D, Timmermann H, Suhling H. Criteria for evaluation of response to biologics in severe asthma - the Biologics Asthma Response Score (BARS). Pneumologie 2023. [PMID: 37625439 DOI: 10.1055/a-2102-8128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
BACKGROUND The introduction of monoclonal antibodies (biologics) has revolutionized the therapy of severe asthma. Even though there is a response in the majority of patients, the degree of response varies. To date criteria for assessment of response to biologics are not consistently defined. AIM To define criteria for evaluation of response to biologics that are precise, simple and suitable for daily use in order to guide decision-making regarding continuation, switching or stopping of biological therapy. METHODS 8 physicians with large experience in this indication, supported by a data-scientist, developed a consensus on criteria to evaluate response to biologics in patients with severe asthma. RESULT We developed a combined score based on current literature, own experience and practicability. It uses the main criteria exacerbations, oral corticosteroid (OCS) therapy and asthma control (asthma control test, ACT). We defined thresholds for "good response", "response" and "insufficient response" rated with a score of "2", "1" and "0" respectively: annual exacerbations ("0 or reduction ≥ 75 %", "reduction 50-74 %", "reductio < 50 %"), daily OCS dose ("stopping or reduction ≥ 75 %", "reduction 50-74 %", "reduction < 50 %"), asthma control ("ACT increase ≥ 6 or ≥ 3 with result ≥ 20", "ACT increase 3-5 with result < 20", "ACT increase < 3"). Additional individual criteria like lung function and comorbidities may be important for evaluation of response. We propose 3, 6 and 12 months timepoint for assessment of tolerability and response. Using the combined score, we developed a scheme to guide the decision whether switching the biologic should be considered. CONCLUSION The Biologic Asthma Response Score (BARS) serves as objective and simple tool to evaluate response to biologic therapy using the three main criteria exacerbations, OCS use and asthma control. A validation of the score was initiated.
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Affiliation(s)
- Katrin Milger
- Medizinische Klinik und Poliklinik V, LMU Klinikum, München, Comprehensive Pneumology Center (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - Stephanie Korn
- Institut für Klinische Forschung, Mainz
- Thoraxklinik, Universitätsklinikum Heidelberg
| | - Claudia Feder
- Klinik für Innere Medizin V, Universitätsklinikum Jena
| | - Jan Fuge
- Deutsches Zentrum für Lungenforschung, Standort Hannover
| | | | - Wolfgang Schütte
- Klinik für Innere Medizin II, Krankenhaus Martha-Maria Halle-Dölau
| | - Dirk Skowasch
- Medizinische Klinik und Poliklinik II - Pneumologie, Herzzentrum des Universitätsklinikums Bonn
| | | | - Hendrik Suhling
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover
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Milger K, Korn S, Feder C, Fuge J, Mühle A, Schütte W, Skowasch D, Timmermann H, Suhling H. [Criteria for evaluation of response to biologics in severe asthma - the Biologics Asthma Response Score (BARS)]. Pneumologie 2023; 77:220-232. [PMID: 36796422 PMCID: PMC10104728 DOI: 10.1055/a-2014-4350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND The introduction of monoclonal antibodies (biologics) has revolutionized the therapy of severe asthma. Even though there is a response in the majority of patients, the degree of response varies. To date criteria for assessment of response to biologics are not consistently defined. AIM To define criteria for evaluation of response to biologics that are precise, simple and suitable for daily use in order to guide decision-making regarding continuation, switching or stopping of biological therapy. METHODS 8 physicians with large experience in this indication, supported by a data-scientist, developed a consensus on criteria to evaluate response to biologics in patients with severe asthma. RESULT We developed a combined score based on current literature, own experience and practicability. It uses the main criteria exacerbations, oral corticosteroid (OCS) therapy and asthma control (asthma control test, ACT). We defined thresholds for "good response", "response" and "insufficient response" rated with a score of "2", "1" and "0" respectively: annual exacerbations ("0 or reduction ≥ 75 %", reduction 50-74 %", "reductio < 50 %"), daily OCS dose ("stopping or reduction ≥ 75 %", "reduction 50-74 %", "reduction < 50 %"), asthma control (ACT increase ≥ 6 or ≥ 3 with result ≥ 20", "ACT increase 3-5 with result < 20", "ACT increase < 3"). Additional individual criteria like lung function and comorbidities may be important for evaluation of response. We propose 3, 6 and 12 months timepoint for assessment of tolerability and response. Using the combined score, we developed a scheme to guide the decision whether switching the biologic should be considered. CONCLUSION The Biologic Asthma Response Score (BARS) serves as objective and simple tool to evaluate response to biologic therapy using the three main criteria exacerbations, OCS use and asthma control. A validation of the score was initiated.
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Affiliation(s)
- Katrin Milger
- Medizinische Klinik und Poliklinik V, LMU Klinikum, München, Comprehensive Pneumology Center (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - Stephanie Korn
- Institut für Klinische Forschung, Mainz.,Thoraxklinik, Universitätsklinikum Heidelberg
| | - Claudia Feder
- Klinik für Innere Medizin V, Universitätsklinikum Jena
| | - Jan Fuge
- Deutsches Zentrum für Lungenforschung, Standort Hannover
| | | | - Wolfgang Schütte
- Klinik für Innere Medizin II, Krankenhaus Martha-Maria Halle-Dölau
| | - Dirk Skowasch
- Medizinische Klinik und Poliklinik II - Pneumologie, Herzzentrum des Universitätsklinikums Bonn
| | | | - Hendrik Suhling
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover
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Adamina M, Bolli M, Albo F, Cavazza A, Zajac P, Padovan E, Schumacher R, Reschner A, Feder C, Marti WR, Oertli D, Heberer M, Spagnoli GC. Encapsulation into sterically stabilised liposomes enhances the immunogenicity of melanoma-associated Melan-A/MART-1 epitopes. Br J Cancer 2004; 90:263-9. [PMID: 14710238 PMCID: PMC2395333 DOI: 10.1038/sj.bjc.6601473] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [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] [Indexed: 01/12/2023] Open
Abstract
Tumour-associated antigens (TAA)-specific vaccination requires highly immunogenic reagents capable of inducing cytotoxic T cells (CTL). Soluble peptides are currently used in clinical applications despite an acknowledged poor immunogenicity. Encapsulation into liposomes has been suggested to improve the immunogenicity of discrete antigen formulations. We comparatively evaluated the capacity of HLA-A2.1 restricted Melan-A/MART-1 epitopes in soluble form (S) or following inclusion into sterically stabilised liposomes (SSL) to be recognised by specific CTL, to stimulate their proliferation and to induce them in healthy donors' peripheral blood mononuclear cells (PBMC), as well as in melanoma-derived tumour-infiltrating lymphocytes (TIL). HLA-A2.1+, Melan-A/MART-1-NA-8 melanoma cells served as targets of specific CTL in 51Cr release assays upon pulsing by untreated or human plasma-treated soluble or SSL-encapsulated Melan-A/MART-1 27–35 (M27–35) or 26–35 (M26–35) epitopes. These reagents were also used to stimulate CTL proliferation, measured as 3H-thymidine incorporation, in the presence of immature dendritic cells (iDC), as antigen-presenting cells (APC). Induction of specific CTL upon stimulation with soluble or SSL-encapsulated peptides was attempted in healthy donors' PBMC or melanoma-derived TIL, and monitored by 51Cr release assays and tetramer staining. Na-8 cells pulsing with SSL M27–35 resulted in a five-fold more effective killing by specific CTL as compared with equal amounts of S M27–35. Encapsulation into SSL also provided a partial (50%) protection of M27–35 from plasma hydrolysis. No specific advantages regarding M26–35 were detectable in these assays. However, at low epitope concentrations (⩽100 ng ml−1), SSL M26–35 was significantly more effective in inducing CTL proliferation than S M26–35, in the presence of iDC, as APC. Preincubation with iDC for 6 h virtually abolished the capacity of S M26–35 to stimulate specific CTL proliferation, but only partially affected that of SSL M26–35. Most importantly, SSL M26–35 was able to enhance the induction of specific CTL in healthy donors PBMC and in melanoma-derived TIL as compared to S M26–35. Taken together, our data indicate that encapsulation of TAA epitopes into SSL results in effective immunogenic formulations suitable for clinical use in active specific tumour immunotherapy.
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Affiliation(s)
- M Adamina
- Department of Surgery, Division of Surgical Research, University of Basel, ZLF, Lab. 401, Hebelstrasse 20, Basel 4031, Switzerland.
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Kalinov A, Feder C. [Heart enzymes in myocardial infarct]. Prensa Med Argent 1968; 55:745-54. [PMID: 5719955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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