Development of HPV16 mouse and dog models for more accurate prediction of human vaccine efficacy

BACKGROUND

Animal models are essential to understand the physiopathology of human diseases but also to evaluate new therapies. However, for several diseases there is no appropriate animal model, which complicates the development of effective therapies. HPV infections, responsible for carcinoma cancers, are among these. So far, the lack of relevant animal models has hampered the development of therapeutic vaccines. In this study, we used a candidate therapeutic vaccine named C216, similar to the ProCervix candidate therapeutic vaccine, to validate new mouse and dog HPV preclinical models. ProCervix has shown promising results with classical subcutaneous murine TC-1 cell tumor isografts but has failed in a phase II study.

RESULTS

We first generated E7/HPV16 syngeneic transgenic mice in which the expression of the E7 antigen could be switched on through the use of Cre-lox recombination. Non-integrative LentiFlash^® viral particles were used to locally deliver Cre mRNA, resulting in E7/HPV16 expression and GFP reporter fluorescence. The expression of E7/HPV16 was monitored by in vivo fluorescence using Cellvizio imaging and by local mRNA expression quantification. In the experimental conditions used, we observed no differences in E7 expression between C216 vaccinated and control groups. To mimic the MHC diversity of humans, E7/HPV16 transgenes were locally delivered by injection of lentiviral particles in the muscle of dogs. Vaccination with C216, tested with two different adjuvants, induced a strong immune response in dogs. However, we detected no relationship between the level of cellular response against E7/HPV16 and the elimination of E7-expressing cells, either by fluorescence or by RT-ddPCR analysis.

CONCLUSIONS

In this study, we have developed two animal models, with a genetic design that is easily transposable to different antigens, to validate the efficacy of candidate vaccines. Our results indicate that, despite being immunogenic, the C216 candidate vaccine did not induce a sufficiently strong immune response to eliminate infected cells. Our results are in line with the failure of the ProCervix vaccine that was observed at the end of the phase II clinical trial, reinforcing the relevance of appropriate animal models.

CRISPR/Cas9-mediated gene knockout and interallelic gene conversion in human induced pluripotent stem cells using non-integrative bacteriophage-chimeric retrovirus-like particles

BACKGROUND

The application of CRISPR/Cas9 technology in human induced pluripotent stem cells (hiPSC) holds tremendous potential for basic research and cell-based gene therapy. However, the fulfillment of these promises relies on the capacity to efficiently deliver exogenous nucleic acids and harness the repair mechanisms induced by the nuclease activity in order to knock-out or repair targeted genes. Moreover, transient delivery should be preferred to avoid persistent nuclease activity and to decrease the risk of off-target events. We recently developed bacteriophage-chimeric retrovirus-like particles that exploit the properties of bacteriophage coat proteins to package exogenous RNA, and the benefits of lentiviral transduction to achieve highly efficient, non-integrative RNA delivery in human cells. Here, we investigated the potential of bacteriophage-chimeric retrovirus-like particles for the non-integrative delivery of RNA molecules in hiPSC for CRISPR/Cas9 applications.

RESULTS

We found that these particles efficiently convey RNA molecules for transient expression in hiPSC, with minimal toxicity and without affecting the cell pluripotency and subsequent differentiation. We then used this system to transiently deliver in a single step the CRISPR-Cas9 components (Cas9 mRNA and sgRNA) to generate gene knockout with high indel rate (up to 85%) at multiple loci. Strikingly, when using an allele-specific sgRNA at a locus harboring compound heterozygous mutations, the targeted allele was not altered by NHEJ/MMEJ, but was repaired at high frequency using the homologous wild type allele, i.e., by interallelic gene conversion.

CONCLUSIONS

Our results highlight the potential of bacteriophage-chimeric retrovirus-like particles to efficiently and safely deliver RNA molecules in hiPSC, and describe for the first time genome engineering by gene conversion in hiPSC. Harnessing this DNA repair mechanism could facilitate the therapeutic correction of human genetic disorders in hiPSC.

FAK alternative splice mRNA variants expression pattern in colorectal cancer

The Focal adhesion kinase (FAK) is a ubiquitous cytoplasmic tyrosine‐kinase promoting tumor progression and metastasis processes by acting in cancer cells and their tumor microenvironment partners. FAK overexpression in primary colon tumors and their metastasis is associated to poor colorectal cancer (CRC) patients’ outcome. Eight FAK mRNA alternative splice variants have been described and contribute to additional level of FAK activity regulation, some of them corresponding to overactivated FAK isoforms. To date, FAK mRNA alternative splice variants expression and implication in CRC processes remain unknown. Here, using different human CRC cells lines displaying differential invasive capacities in an in vivo murine model recapitulating the different steps of CRC development from primary tumors to liver and lung metastasis, we identified three out of the eight mRNA variants (namely FAK⁰, FAK²⁸ and FAK⁶) differentially expressed along the CRC process and the tumor sites. Our results highlight an association between FAK⁰ and FAK⁶ expressions and the metastatic potential of the most aggressive cell lines HT29 and HCT116, suggesting that FAK⁰ and FAK⁶ could represent aggressiveness markers in CRC. Our findings also suggest a more specific role for FAK²⁸ in the interactions between the tumors cells and their microenvironment. In conclusion, targeting FAK⁰, the common form of FAK, might not be a good strategy based on the numerous roles of this kinase in physiological processes. In contrast, FAK⁶ or FAK²⁸ splice variants, or their corresponding protein isoforms, may putatively represent future therapeutic target candidates in the development of CRC primary tumors and metastasis.

What's new?

Overexpression of the focal adhesion kinase (FAK) is associated with poor outcome in patients with colorectal cancer but the role of the eight splice variants of FAK remains unknown. Here the authors correlated FAK splice variant expression in colorectal tumor cell lines with invasiveness in mouse models. FAK⁰ and FAK⁶ splice variant expression was associated with higher aggressiveness and metastatic potential, underscoring that distinct FAK splice variants may represent new targets in the development of drugs against colorectal cancer and associated metastasis.

Abstract 5090: Efficient KO of PD1 into primary T cells using a new non-integrative lentiviral particle expressing CRISPR/Cas9 system

Gene editing by the CRISPR system shows great promises for gene therapy. Nevertheless, it must now face a number of challenges especially for the development of safe and efficient delivery tools for in vivo, as well as ex vivo gene editing. Cas9 and sgRNA delivery, mediated either by viral vectors (AAV- or Lentivirus-derived) or transfection protocols (chemical or by electroporation) have been largely and efficiently used but they bring major drawbacks incompatible with clinical applications. Indeed, viral vectors can display uncontrolled chromosomal integrations and transfection protocols are known to induce cell toxicity and/or phenotype modifications of the target cells.. Moreover, the CRISPR technology entails a “hit-and-run” mechanism that only requires a transient expression of the nuclease complex. Therefore, achieving an efficient delivery into hard-to-transfect cells, such as T cells, remains challenging and the need for delivery tools that would allow efficient transfer on most cell types without causing any cell damages is essential for downstream therapeutic applications. Here, we present an innovative tool, named LentiFlash, allowing RNA delivery into target cells without any genomic scar. The RNA encapsidation is mediated via an RNA/protein interaction: the respective properties of the MS2 bacteriophage and the lentiviral vectors have been combined to build a non-integrative packaging system in which the wild type HIV packaging sequence is replaced by the MS2 stem-loop repeats and the MS2 coat protein is inserted into the Nucleocapsid. This new vector breaks with all existing systems, as the resulting lentiparticle is able to deliver non-viral coding or non-coding RNA, at high efficiency, into the cytoplasm of any cell type. Transduction of a large range of cells, from immortalized cells to delicate primary cells, such as T cells and hematopoietic stem cells, with LentiFlash shows an efficient, fast and transient expression of proteins and RNA, with no cell phenotype modification. In particular, LentiFlash particles were successfully used to deliver Cas9, alone or in association with an sgRNA not only targeting a reporter gene into immortalized cells, but outstandingly knocking-out the PD-1 gene into primary human T lymphocytes. This new RNA delivery system is an efficient and safe tool for the delivery of CRISPR editing machinery in most cell types without affecting cell viability and phenotype. The transient, RNA-based mechanism of LentiFlash vector, preventing the risk of integration, associated with its ability to utilize lentiviral production platforms already validated in clinical settings, make it a promising tool for CRISPR therapeutic applications. As a matter of fact, beyond gene editing efficiency, safety of delivery tools is a major concern that should be addressed to move forward with CRISPR clinical development.

Citation Format: Pascale Bouillé, Régis Gayon, Lucille Lamouroux, Alexandra Iche, Christine Duthoit, Jean-Christophe Pages. Efficient KO of PD1 into primary T cells using a new non-integrative lentiviral particle expressing CRISPR/Cas9 system [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5090. doi:10.1158/1538-7445.AM2017-5090

Abstract 4561: Non-integrative lentiviral particles for immunotherapy: RNA delivery to drive tumoral antigen presentation in a safe and efficient way

Safe and efficient cancer therapies using adoptive transfer of engineered cells are very promising but very challenging approaches. Opportunities to improve gene transfer into primary cells involve a better design of the vectors used. Such improvements must lead to an increase of the efficiency of gene expression, the cell phenotype preservation and the increase of the gene number delivered. The use of lentiviral vectors has largely increased in clinical protocols over the past few years but safety concerns have slowed down this progression. Actually, the permanent genetic modification remains a focus of significant regulatory oversight. On another side, mRNA delivery is a versatile, flexible, and safe mean for protein therapies, but existing techniques, such as chemical or electroporation-based transfection protocols, are known to induce cell toxicity and phenotype modifications of the target cells. Here, we present an innovative tool, named LentiFlash, allowing RNA delivery into target cells without any genomic scar. This tool combines RNA delivery, providing the best expression system to get efficient and transient expression, and lentiviral delivery which exhibits the best efficiency of entry into primary and stem cells. The RNA encapsidation is mediated via an RNA/protein interaction using properties of the MS2 bacteriophage. This new vector breaks with all existing systems. The resulting lentiviral particle is able to efficiently deliver non-viral coding or non-coding RNA into the cytoplasm of any cell type. These LentiFlash particles, are able to transduce delicate primary cells, such as dendritic cells, T cells and hematopoietic stem cells. They show an efficient, fast and transient expression of protein and RNA, such as antigenic peptides or genome editing tools, with no cell phenotype modification. Here we show a proof of concept on primary murine dendritic cells transduction with LentiFlash particles, successfully used to deliver several tumoral antigens. As a result, these dendritic cells are able to present the antigens to the immune system which in turn can efficiently fight a tumor development into wild type mice. This new delivery system gives the opportunity for multiple antigens co-expression to enhance immune responses, avoiding tumor relapse. Such multiple co-expressions into immune cells are expected to mimic the innate and adaptive immune responses. This transient RNA delivery mediated by LentiFlash is a powerful tool to induce an efficient gene delivery. The possibility to express multiple genes at once in the target cells is an attractive therapeutic perspective. The absence of any viral sequence avoids any integration event, an important safety consideration for human use. Finally, another advantage of the LentiFlash system is its ability to utilize lentiviral production platforms already validated in clinical settings.

Citation Format: Pascale Bouillé, Christine Duthoit, Nicolas Martin, Lucille Lamouroux, Jean-Christophe Pages. Non-integrative lentiviral particles for immunotherapy: RNA delivery to drive tumoral antigen presentation in a safe and efficient way [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4561. doi:10.1158/1538-7445.AM2017-4561

Abstract 3743: New non-integrative MS2-based lentiviral particles for mRNA delivery: A safe and efficient opportunity for gene editing and immunotherapy applications

Safe and efficient cancer therapies using adoptive transfer of engineered T cells or gene editing are very challenging but very promising approaches nowadays. The scientific and clinical communities have been working for a long time together to encounter substantial clinical advances they have made possible thanks to numerous improvements in cell culture and gene transfer methods. Opportunities to improve gene transfer into primary T cells or hematopoietic stem cells involve a better design of the vectors used. Such improvements must lead to an increase of the efficiency in the percentage of positive cells, as well as a better level and duration of expression, cell phenotype preservation and the number of genes delivered. Lentiviral vectors have seen their use largely increased in clinical protocols over the past few years but safety concerns have been highlighted. First, the permanent genetic modification remains a focus of significant regulatory oversight and even integrase- or reverse transcriptase-deficient lentiviral vectors leads to residual integration events. Moreover it has been shown that some resulting CAR T cells can exhibit toxicity due to high and persistent expression. If mRNA delivery is a versatile, flexible, and safe mean for protein therapies, chemical or electroporation-based transfection protocols are known to induce cell toxicity and phenotype modifications of the target cells.

Here, we describe a new chimeric lentiviral platform that allows mRNA delivery into the target cells without any genomic signature. The respective properties of the MS2 bacteriophage and the lentiviral vectors have been combined to build a non-integrative packaging system in which the wild type HIV packaging sequence is replaced by the MS2 stem-loop repeats and the MS2 Coat sequence is inserted into the NucleoCapsid sequence. The resulting lentiviral particle is able to deliver a non-viral RNA into the target cell, directly available for protein translation.

Transduction of T cells and HSC with these RNA lentiviral particles (RLP) shows an efficient, fast and transient expression of both reporters and functional proteins such as genome editing enzymes. Cell viability of such engineered cells and multiple genes expression analyses will be presented.

This transient mRNA delivery mediated by a lentiviral particle is a powerful tool, useful to induce an efficient CAR delivery and ensure a complete loss of the CAR-driven T cells activity. The possibility to express multiple genes at once in the target cells is an attractive therapeutic perspective. One of the advantages of the MS2RLP system is its ability to utilize lentiviral production platforms already validated in clinical settings. The RNAs transferred by the MS2RLPs are directly expressed into the cytoplasm, which completely removes the risk of integration, an important safety consideration for human use.

Citation Format: Pascale Bouillé, Cédric Auffray, Jean-Christophe Pagès, Christine Duthoit, Régis Gayon. New non-integrative MS2-based lentiviral particles for mRNA delivery: A safe and efficient opportunity for gene editing and immunotherapy applications. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3743.

Highly efficient in vitro and in vivo delivery of functional RNAs using new versatile MS2-chimeric retrovirus-like particles

RNA delivery is an attractive strategy to achieve transient gene expression in research projects and in cell- or gene-based therapies. Despite significant efforts investigating vector-directed RNA transfer, there is still a requirement for better efficiency of delivery to primary cells and in vivo. Retroviral platforms drive RNA delivery, yet retrovirus RNA-packaging constraints limit gene transfer to two genome-molecules per viral particle. To improve retroviral transfer, we designed a dimerization-independent MS2-driven RNA packaging system using MS2-Coat-retrovirus chimeras. The engineered chimeric particles promoted effective packaging of several types of RNAs and enabled efficient transfer of biologically active RNAs in various cell types, including human CD34(+) and iPS cells. Systemic injection of high-titer particles led to gene expression in mouse liver and transferring Cre-recombinase mRNA in muscle permitted widespread editing at the ROSA26 locus. We could further show that the VLPs were able to activate an osteoblast differentiation pathway by delivering RUNX2- or DLX5-mRNA into primary human bone-marrow mesenchymal-stem cells. Thus, the novel chimeric MS2-lentiviral particles are a versatile tool for a wide range of applications including cellular-programming or genome-editing.

A role for VAV1 in experimental autoimmune encephalomyelitis and multiple sclerosis

Multiple sclerosis, the most common cause of progressive neurological disability in young adults, is a chronic inflammatory disease. There is solid evidence for a genetic influence in multiple sclerosis, and deciphering the causative genes could reveal key pathways influencing the disease. A genome region on rat chromosome 9 regulates experimental autoimmune encephalomyelitis, a model for multiple sclerosis. Using interval-specific congenic rat lines and association of single-nucleotide polymorphisms with inflammatory phenotypes, we localized the gene of influence to Vav1, which codes for a signal-transducing protein in leukocytes. Analysis of seven human cohorts (12,735 individuals) demonstrated an association of rs2546133-rs2617822 haplotypes in the first VAV1 intron with multiple sclerosis (CA: odds ratio, 1.18; CG: odds ratio, 0.86; TG: odds ratio, 0.90). The risk CA haplotype also predisposed for higher VAV1 messenger RNA expression. VAV1 expression was increased in individuals with multiple sclerosis and correlated with tumor necrosis factor and interferon-gamma expression in peripheral blood and cerebrospinal fluid cells. We conclude that VAV1 plays a central role in controlling central nervous system immune-mediated disease and proinflammatory cytokine production critical for disease pathogenesis.

Dermatomyosite induite par la pravastatine

INTRODUCTION

The toxic myopathy caused by statins (HMG-CoA reductase inhibitors) is well established. Recent reports add to these effects systemic immune diseases including systemic lupus erythematosus, vasculitis, polymyositis or dermatomyositis.

EXEGESIS

We report a case of dermatomyositis in a 69-year-old patient treated with pravastatin [Elisor]. She presented with typical features of dermatomyositis 2 years after she started a treatment with pravastatin. The treatment was discontinued and she slowly improved, with a transient dermocorticosteroid treatment. Eight other patients with dermatomyositis and chronic treatment with HMG-CoA reductase inhibitors are reported in the literature. All of them presented with classical features of dermatomyositis. The discontinuation of the treatment was followed by spontaneous clinical and biological improvement in 3/9 patients. The other patients received high doses of corticosteroids and improved, except one patient who died of respiratory failure (pulmonary fibrosis) despite the adjunction of oral cyclophosphamide [Endoxan]. In these patients, dermatomyositis can be considered as a severe adverse reaction to HMG-CoA reductase inhibitors although a distinct casual link cannot be definitely established.

CONCLUSION

The increasing prescription of statins has led to the parallel increment of reported side-effects, where autoimmune diseases are now described. Among them, our case of dermatomyositis in a patient receiving pravastatin adds to the eight reported cases in the literature and highlights the potential role of statins as triggers of immune systemic diseases.

T cell activation correlates with an increasedproportion of antigen among the materials acquiredfrom target cells

We have investigated the density of peptides required to elicit different biological responses in cytotoxic T lymphocytes (CTL), including trogocytosis (i.e., the phenomenon whereby the lymphocytes actively capture fragments of plasma membrane from those cells with which they establish an immune synapse). We have used two separate mouse models of CTL recognising defined peptides presented by MHC class I molecules. In both systems, triggering of cytotoxicity and capture of membrane components reached saturation with low densities of ligand. On the other hand, down-modulation of cell-surface levels of TCR, induction of IFN-gamma production and detection of peptide captured required much higher ligand densities. Interestingly, fratricide (i.e., killing between CTL sharing the same specificity), a mechanism proposed to account for CTL exhaustion, was detected only at antigen concentrations still well above that second threshold leading to full blown activation. Taken together, our results show that the different thresholds that govern the elicitation of different CTL functions correlate with different proportions of antigen among the target cell components being captured via trogocytosis.

Androgen-dependent expression of FcgammaRIIB2 by thyrocytes from patients with autoimmune Graves' disease: a possible molecular clue for sex dependence of autoimmune disease

Thyrocyte expression of HLA class I and class II antigens and related accessory molecules would convert these epithelial cells into functional antigen-presenting cells. Here we show that whereas normal thyrocytes express FcRn, Graves' disease thyrocytes also express FcgammaRIIB2. We further find that expression of FcgammaRIIB2, but not FcRn, is repressed by dihydrotestosterone. By mediating the uptake and transport of autoantibodies, we suggest that these IgG Fc receptors contribute in various ways to the onset and/or progression of autoimmune thyroid diseases. The androgen-mediated decrease of FcgammaRIIB2 expression in Graves' disease thyrocytes also provides a rationale for the predominant susceptibility of women to develop an autoimmune thyroid disease. Our findings open up a new prospect to autoimmunity, linking the role of the target organ to the sex dependence in autoimmune disease.

Analysis of a conformational B cell epitope of human thyroid peroxidase: identification of a tyrosine residue at a strategic location for immunodominance

Thyroid peroxidase (TPO) is involved in autoimmune thyroid diseases and high titers of TPO autoantibodies directed to various conformational B cell epitopes are frequently present in patients' sera. Deciphering these epitopes is a difficult task, but can give insight into the structural basis of autoimmune recognition. TPO is a membrane-bound enzyme with the extracellular part organized in three protein domains, but of unknown three-dimensional structure. We previously localized a TPO B cell epitope within amino acid residues 742-848, a region encompassing the two C-terminal, extracellular domains of the protein. We found that at least one of the three tyrosine residues of the peptide 742-848 might be involved in autoantibody binding. In this study, we show by site-directed mutagenesis that the autoepitope contains tyrosine 772 located near the hinge area between the two protein domains, suggesting they are both involved in the epitope structure. The B cell epitopes of TPO are clustered in two overlapping immunodominant regions. To map the newly localized epitope with respect of these regions, competition experiments were performed using a reference panel of TPO mAb and a further mAb previously found to be specific for the TPO peptide 742-848 at variance with all the other ones. Here, we show that the tyrosine 772-bearing epitope in the peptide 742-848 maps in a region that partly overlaps the reported two immunodominant regions. These results are suggestive of a complex TPO folding that involves all the three TPO protein domains to form a highly conformational immunodominant region.

Hydrogen peroxide-induced production of a 40 kDa immunoreactive thyroglobulin fragment in human thyroid cells: the onset of thyroid autoimmunity?

We recently reported that, during in vitro thyroid-hormone synthesis, H(2)O(2) stress cleaved thyroglobulin (Tg) into C-terminal peptides. These peptides were found to contain the immunodominant region of Tg recognized by Tg autoantibodies from patients with an autoimmune thyroid disease. To test the hypothesis that Tg fragmentation is an early upstream initiating event involved in Tg autoimmune response and the consequence of oxidative injuries, we studied the effect of H(2)O(2) stress on human thyroid cells. In culture conditions allowing Tg synthesis and iodine organification by the cells, we found that bolus addition of increasing millimolar doses of H(2)O(2) induced a dose-response appearance of floating cells in the culture medium. These cells apparently resulted from a necrotic process, and they bore iodinated Tg fragments. These fragments were found to be similar to those previously obtained in vitro from purified Tg. In both cases, Tg peptides were recognized by a well-defined monoclonal antibody directed to the immunodominant region of Tg. The smallest immunoreactive Tg peptide had a molecular mass of 40 kDa and entered human thyrocytes more efficiently than the entire Tg. These data suggest that thyrocytes exposed to locally increased H(2)O(2) doses accumulate fragmented Tg for further delivery into surrounding living thyrocytes in the course of an autoimmune response.

Production of immunoreactive thyroglobulin C-terminal fragments during thyroid hormone synthesis

Here, we studied the fragmentation of the prothyroid hormone, thyroglobulin (Tg), which occurs during thyroid hormone synthesis, a process which involves iodide, thyroperoxidase, and the H2O2-generating system, consisting of glucose and glucose oxidase. Various peptides were found to be immunoreactive to autoantibodies to Tg from patients and monoclonal antibodies directed against the immunodominant region of Tg. The smallest peptide (40 kDa) bore thyroid hormones and was identified at the C-terminal end of the Tg molecule, which shows homologies with acetylcholinesterase. Similar peptides were obtained by performing metal-mediated oxidation of Tg via a Fenton reaction. It was concluded that the oxidative stress induced during hormone synthesis generates free radicals, which, in turn, cleave Tg into immunoreactive peptides.

Molecular model, calcium sensitivity, and disease specificity of a conformational thyroperoxidase B-cell epitope

While studying the humoral mechanisms involved in thyroid autoimmunity, we located a B-cell autoepitope in the extracellular C-terminal region of human thyroperoxidase. Structural modeling showed that this region encompasses both a Sushi-like and an epidermal growth factor-like domain, the flexible arrangement of which was putatively stabilized by calcium. The recombinant peptide was found to contain the previously identified conformational thyroperoxidase autoepitope. The occurrence of a calcium-induced conformational change was confirmed using a recombinant peptide monoclonal antibody, the decrease of which in binding to calcium-saturated thyroperoxidase was reversed by a chelating agent. The disease specificity of recombinant peptide, which was more frequently recognized by Hashimoto's than by Graves' patients, adds to its potential value as a diagnostic and preventive tool in the context of B-cell autoimmunity.

Multicenter study on TGPO autoantibody prevalence in various thyroid and non-thyroid diseases; relationships with thyroglobulin and thyroperoxidase autoantibody parameters

OBJECTIVE

TGPO autoantibodies (aAbs) that bind simultaneously to thyroglobulin (Tg) and thyroperoxidase (TPO) are present in the serum of patients with autoimmune thyroid diseases (AITD) and have been found to differ from monospecific Tg and TPO aAbs. To obtain further insights on the prevalence defined as the rate of occurrence and significance of TGPO aAbs in a large population, we carried out a collaborative study involving 15 European teams.

METHODS

Serum samples from 3122 patients with various thyroid and non-thyroid diseases and normal subjects were assayed using a novel TGPO aAb detection kit. This test was designed so that TGPO aAbs are trapped between the Tg-coated solid phase and the soluble TPO labeled with a radioiodinated monoclonal antibody.

RESULTS

Only three out of the 220 normal subjects (prevalence of 1.4%) were found to have positive TGPO aAb levels, which were mainly observed in the patients with AITD: the group of patients suffering from Hashimoto's thyroiditis had a TGPO aAb prevalence of 40.5% (n=437 patients), those with Graves' disease, a prevalence of 34.6% (n=645) and those with post-partum thyroiditis, 16.0% (n=243). Among the non-AITD patients with positive TGPO aAb levels, the TGPO aAb prevalence ranged from 20.7% among those with thyroid cancer (n=246) to 0% among those with toxic thyroid nodules (n=47). Among the patients with non-thyroid diseases, the TGPO aAb prevalence ranged from 9.8% in the case of Biermer's pernicious anemia (n=78) to 0% in that of premature ovarian failure (n=44). It is worth noting that the groups showing the highest TGPO aAb prevalence also contained the patients with the highest TGPO aAb titers. Statistical comparisons between the TGPO aAb prevalences in the various groups showed that TGPO aAb could be used as a parameter to distinguish between the groups of Hashimoto's and Graves' patients and between the women with post-partum thyroiditis and the post-partum women with only Tg and/or TPO aAb established during early pregnancy. Unexpectedly, the correlations between TGPO aAbs and Tg and TPO aAbs were found to depend mainly on the assay kit used.

CONCLUSION

High TGPO aAb titers are consistently associated with AITD but the reverse was not found to be true. TGPO aAbs are a potentially useful tool, however, for establishing Hashimoto's diagnosis, and would be worth testing in this respect with a view to using them for routine AITD investigations.

Thyroglobulin monoclonal antibody cross-reacting with thyroperoxidase induces in syngeneic mice anti-idiotypic monoclonal antibodies with dual autoantigen binding properties. The intertope hypothesis

Autoimmune thyroid diseases are characterized by antibodies (Ab) directed to thyroglobulin (Tg) and thyroperoxidase (TPO). Some of them, TGPO Ab, are Tg Ab with an interspecies idiotype (Id) reacting with TPO. Taking advantage of a carefully studied TGPO monoclonal antibody (mAb), we examined the basis of the hypothesis that TPO Ab would ultimately derive from TGPO Ab through idiotypic induction. We repeatedly immunized naive, syngeneic mice with the TGPO mAb and we derived three novel mAb directed to both Tg and TPO. The most reactive of them, mAb 4F8, was further purified, radiolabeled and its binding properties studied by radioimmunoassay. mAb 4F8 bound to Tg, TPO, the immunogen Ab1 and even to itself, being thus considered as a self-binding Ab2. Competitive binding inhibition experiments demonstrated that Tg, TPO, Ab1 and Ab2 cross-reacted for Ab2 binding to Tg, TPO and Ab1. Fine specificity mapping using panels of specific mAb revealed that Ab1 and Ab2 were similar because they were directed against the same immunodominant regions on Tg and TPO. We propose that unique Id of TGPO Ab resemble dominant epitopes of Tg as well as paratopes of Ab directed against dominant TPO epitopes. This category of Id that we called intertopes may induce TPO-monospecific Ab from TGPO Ab by idiotypically driven somatic mutations.

A conformational B-cell epitope on the C-terminal end of the extracellular part of human thyroid peroxidase

To investigate the B-cell autoimmune epitopes on human thyroid peroxidase (TPO), we generated proteolytic peptides by enzymatic hydrolysis of TPO in nondenaturing and nonreducing conditions. The hydrolysate was chromatographed on a reverse phase column. We eluted a material immunoreactive with both a TPO monoclonal antibody recognizing a linear epitope (mAb47, amino acid 713-721) and TPO autoantibodies (aAb) from patients. The aAb immunoreactivity, but not that of mAb47, was lost after reduction. Western blots after electrophoresis without reduction showed that the aAb and mAb47 were immunoreactive with a 66-kDa band and that aAb identified a doublet at 20 kDa. For electrophoresis under reducing conditions, the 66-kDa band resolved into two peptides of 40 and 26 kDa, whereas the doublet at 20 kDa remained unchanged. None of these reduced peptides was immunoreactive with aAb, whereas the 40-kDa peptide was immunoreactive with mAb47. The 40-kDa peptide extends from amino acid 549 to 933 of TPO, and its last 192 amino acids overlap the autoimmune 20-kDa peptide. After iodine labeling, the 20-kDa peptide lost its immunoreactivity. We conclude that the C-terminal end of the extracellular part of TPO, which includes all the tyrosine residues of the 20-kDa peptide, contains at least one conformational B-cell epitope involved in autoimmune thyroid diseases.