IFNβ Is a Potent Adjuvant for Cancer Vaccination Strategies

Cancer vaccination drives the generation of anti-tumor T cell immunity and can be enhanced by the inclusion of effective immune adjuvants such as type I interferons (IFNs). Whilst type I IFNs have been shown to promote cross-priming of T cells, the role of individual subtypes remains unclear. Here we systematically compared the capacity of distinct type I IFN subtypes to enhance T cell responses to a whole-cell vaccination strategy in a pre-clinical murine model. We show that vaccination in combination with IFNβ induces significantly greater expansion of tumor-specific CD8+ T cells than the other type I IFN subtypes tested. Optimal expansion was dependent on the presence of XCR1+ dendritic cells, CD4+ T cells, and CD40/CD40L signaling. Therapeutically, vaccination with IFNβ delayed tumor progression when compared to vaccination without IFN. When vaccinated in combination with anti-PD-L1 checkpoint blockade therapy (CPB), the inclusion of IFNβ associated with more mice experiencing complete regression and a trend in increased overall survival. This work demonstrates the potent adjuvant activity of IFNβ, highlighting its potential to enhance cancer vaccination strategies alone and in combination with CPB.

Scrub sink contamination and transmission to operating room personnel

Multiple studies have established the contamination of hospital sinks and transmission to hospital personnel. Few studies have assessed the contamination and transmission of microorganisms from the faucets of operating bay scrub sinks to operating room (OR) personnel, a potential route of infection for patients. This study aimed to investigate if there was pathogenic contamination of scrub sinks and possible transmission of those pathogens to the hands of OR personnel after preoperative hand disinfection. Swabs were taken from the hands of 50 OR personnel and from the faucets of 24 scrubs sinks at two different hospital sites, and were cultured. Hands were swabbed after completing a surgical hand scrub. Results were reported in colony-forming units per millilitre. There was significant scrub sink contamination with primarily Gram-negative organisms, such as Delftia acidovorans and Sphingomonas paucimobilis. There was no overlap in bacterial species between the cultures from hands and scrub sinks. Cultures from the sinks and the hands of the OR personnel from one site had significantly higher bacterial growth compared with the other site (p < 0.0001 and p < 0.0118, respectively). The data showed significant contamination on the faucets of operating bay scrub sinks. However, there was no observed transmission of pathogens from the scrub sinks to OR personnel, shown by the lack of overlap in bacterial species. Routine hygienic maintenance of scrub sinks is recommended.

Identifying the optimal donor for natural killer cell adoptive therapy to treat paediatric B- and T-cell acute lymphoblastic leukaemia

Objectives

Natural killer (NK) cells are an attractive source of cells for an ‘off the shelf’ cellular therapy because of their innate capacity to target malignant cells, and ability to be transferred between donors and patients. However, since not all NK cells are equally effective at targeting cancer, selecting the right donor for cellular therapy is critical for the success of the treatment. Recently, cellular therapies utilising NK cells from cytomegalovirus (CMV)‐seropositive donors have been explored. However, whether these NK cells are the best source to treat paediatric acute lymphoblastic leukaemia (ALL) remains unclear.

Methods

Using a panel of patient‐derived paediatric B‐ and T‐ALL, we assessed the ability of NK cells from 49 healthy donors to mount an effective functional response against these two major subtypes of ALL.

Results

From this cohort, we have identified a pool of donors with superior activity against multiple ALL cells. While these donors were more likely to be CMV⁺, we identified multiple CMV^neg donors within this group. Furthermore, NK cells from these donors recognised B‐ and T‐ALL through different activating receptors. Dividing functional NK cells into 29 unique subsets, we observed that within each individual the same NK cell subsets dominated across all ALL cells. Intriguingly, this occurred despite the ALL cells in our panel expressing different combinations of NK cell ligands. Finally, we can demonstrate that cellular therapy products derived from these superior donors significantly delayed leukaemia progression in preclinical models of ALL.

Conclusions

We have identified a pool of superior donors that are effective against a range of ALL cells, representing a potential pool of donors that can be used as an adoptive NK cell therapy to treat paediatric ALL.

Automated Intra-Operative Analysis of Breast Cancer

Background: Multiple operations are a major problem for breast conservation therapy. Accurate interpretation of intra-operative tumor margins can limit multiple re-excision procedures in order to obtain negative margins while maintaining a good cosmetic result from BCT. Intra-operative touch preparations have been used in the past but can be difficult to interpret without an experienced cytopathologist.Objective: To examine the reliability of fluorescently labeled intra-operative touch preps in conjunction with automated analysis in correctly identifying cancer cells compared to final pathologic diagnosis.Methods: Touch preps were propctively performed on 38 consecutive cases of patients undergoing breast surgery. The surgical cases included 15 invasive tumors, 9 ductal carcinoma in situ, 5 prophylactic mastectomies, and 9 normal tissues from breast reduction operations. Tumors were grossly located by a surgical pathologist and a cross sectional cut was made at the suspected tumor center. Touch preps with poly-l-lysine coated slides were then taken on the tissue surfaces exposed from the cross sectional cut. Additionally, the location where the touch preps were performed was isolated in a cassette and separated for later comparison. In cases of benign disease, touch preps were performed at the center of the excised tissue. The slides were fixed in 95% ethanol and stained with a Cytokeratin, an epithelial cell marker, and Hoechst, a nuclear stain. The prepared slides were then imaged with an automated fluorescent microscope, and suspected cancer cells were detected through standard image processing and statistical techniques.Results: The overall accuracy of our automated fluorescence analysis was 95% for identifying invasive or pre-invasive cancer compared final pathologic diagnosis. The overall specificity was 100% (there were no false positives). The sensitivity for ductal carcinoma in situ was 75% and invasive cancer was 90%. Overall sensitivity was 87% which is comparable to the best reported results from manual examination of touch preparations.Conclusion: Automated analysis of fluorescently stained touch prep slides is highly accurate in identifying cancer with no false positives. The immunofluorescence stains and automated microscopy may help the pathologist to quickly identify cancer cells in fresh breast tissue during BCT operations, and, thus, limit breast re-excisions in the future.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6016.

Leber hereditary optic neuropathy associated with antiretroviral therapy for human immunodeficiency virus infection

PURPOSE

Antiretroviral therapy has reduced the morbidity and mortality associated with human immunodeficiency virus (HIV) infection. However, side effects are increasingly recognized, including a commonly reported toxic mitochondrial myopathy. We report such a case of Leber hereditary optic neuropathy in a patient with antiretroviral therapy for HIV infection and speculate on a possible toxic etiologic role in the development of Leber hereditary optic neuropathy by a shared mitochondrial mechanism.

METHODS

Case Report. Bilateral optic disk abnormalities observed in a 38-year-old HIV positive man with a family history of Leber hereditary optic neuropathy were documented with fundus photography, color vision testing, and visual field testing. Mitochondrial DNA testing was used to confirm the genetic predisposition to Leber hereditary optic neuropathy.

RESULTS

Progressive bilateral optic nerve pallor temporally associated with the administration of antiretroviral medication was observed. Diagnostic testing revealed progressive visual field and color vision loss as well as a mitochondrial DNA mutation consistent with Leber hereditary optic neuropathy.

CONCLUSION

Antiretroviral therapy may be associated with the onset of Leber hereditary optic neuropathy in genetically predisposed patients.

The sympathetic efferent innervation of the cutaneous and muscle veins in cats. A comparative study using retrograde localization with horseradish peroxidase

Previous studies using electrical stimulation, tension recording and fluorescence histochemical methods indicate that variations in the sympathoadrenergic innervation exist in regional veins of the limb. In the present experiment, we used horseradish peroxidase (HRP) as a retrograde tracer to localize and quantitate the sympathetic innervations to the saphenous, femoral and muscle veins in the cat. The animal was anesthetized with pentobarbital. In three groups of cats, a segment of saphenous (n = 8), femoral (n = 8) and muscle (n = 10) vein was isolated. HRP was applied on the outer vein wall for 3-4 h to allow uptake into the nerve endings. The paravertebral sympathetic chain on the same side of HRP application was dissected after the animal was killed and fixed 60 h following the application of tracer. HRP-labeled neurons were counted in each sympathetic ganglion from L1 to S1. The average number of neurons (mean +/- SE) were 913 +/- 99, 732 +/- 70 and 234 +/- 32, respectively, for saphenous, femoral and muscle vein. There was no statistical difference between the saphenous and femoral vein (P > 0.1). The muscle vein was far less innervated (P < 0.001). When the surface area (mm2) of the vein segment for HRP application was taken into account, the neurons per mm2 were 44.1 +/- 4.8 for saphenous vein, 24.6 +/- 1.8 for femoral vein and 10.2 +/- 1.3 for muscle vein. The neuron density was significantly different among the three groups (P < 0.01). In a single ganglion, the distribution of HRP-neurons appeared to be scattering in pattern.(ABSTRACT TRUNCATED AT 250 WORDS)