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Rao A, Agrawal A, Borthakur G, Battula VL, Maiti A. Gamma delta T cells in acute myeloid leukemia: biology and emerging therapeutic strategies. J Immunother Cancer 2024; 12:e007981. [PMID: 38417915 PMCID: PMC10900322 DOI: 10.1136/jitc-2023-007981] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 03/01/2024] Open
Abstract
γδ T cells play an important role in disease control in acute myeloid leukemia (AML) and have become an emerging area of therapeutic interest. These cells represent a minor population of T lymphocytes with intrinsic abilities to recognize antigens in a major histocompatibility complex-independent manner and functionally straddle the innate and adaptive immunity interface. AML shows high expression of phosphoantigens and UL-16 binding proteins that activate the Vδ2 and Vδ1 subtypes of γδ T cells, respectively, leading to γδ T cell-mediated cytotoxicity. Insights from murine models and clinical data in humans show improved overall survival, leukemia-free survival, reduced risk of relapse, enhanced graft-versus-leukemia effect, and decreased graft-versus-host disease in patients with AML who have higher reconstitution of γδ T cells following allogeneic hematopoietic stem cell transplantation. Clinical trials leveraging γδ T cell biology have used unmodified and modified allogeneic cells as well as bispecific engagers and monoclonal antibodies. In this review, we discuss γδ T cells' biology, roles in cancer and AML, and mechanisms of immune escape and antileukemia effect; we also discuss recent clinical advances related to γδ T cells in the field of AML therapeutics.
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Affiliation(s)
- Adishwar Rao
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Akriti Agrawal
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gautam Borthakur
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Venkata Lokesh Battula
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Abhishek Maiti
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Donhauser LV, Veloso de Oliveira J, Schick C, Manlik W, Styblova S, Lutzenberger S, Aigner M, Philipp P, Robert S, Gandorfer B, Hempel D, Hempel L, Zehn D. Responses of patients with cancer to mRNA vaccines depend on the time interval between vaccination and last treatment. J Immunother Cancer 2023; 11:e007387. [PMID: 37730271 PMCID: PMC10510941 DOI: 10.1136/jitc-2023-007387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Personalized mRNA vaccines are promising new therapeutic options for patients with cancer. Because mRNA vaccines are not yet approved for first-line therapy, the vaccines are presently applied to individuals that received prior therapies that can have immunocompromising effects. There is a need to address how prior treatments impact mRNA vaccine outcomes. METHOD Therefore, we analyzed the response to BioNTech/Pfizer's anti-SARS-CoV-2 mRNA vaccine in 237 oncology outpatients, which cover a broad spectrum of hematologic malignancies and solid tumors and a variety of treatments. Patients were stratified by the time interval between the last treatment and first vaccination and by the presence or absence of florid tumors and IgG titers and T cell responses were analyzed 14 days after the second vaccination. RESULTS Regardless of the last treatment time point, our data indicate that vaccination responses in patients with checkpoint inhibition were comparable to healthy controls. In contrast, patients after chemotherapy or cortisone therapy did not develop an immune response until 6 months after the last systemic therapy and patients after Cht-immune checkpoint inhibitor and tyrosine kinase inhibitor therapy only after 12 months. CONCLUSION Accordingly, our data support that timing of mRNA-based therapy is critical and we suggest that at least a 6-months or 12-months waiting interval should be observed before mRNA vaccination in systemically treated patients.
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Affiliation(s)
- Lara Victoria Donhauser
- Division of Animal Physiology and Immunology, Technical University of Munich, Freising, Germany
| | | | | | - Wenzel Manlik
- Division of Animal Physiology and Immunology, Technical University of Munich, Freising, Germany
| | - Sabrina Styblova
- Division of Animal Physiology and Immunology, Technical University of Munich, Freising, Germany
| | - Sarah Lutzenberger
- Division of Animal Physiology and Immunology, Technical University of Munich, Freising, Germany
| | - Michael Aigner
- Division of Animal Physiology and Immunology, Technical University of Munich, Freising, Germany
| | - Patrick Philipp
- System Technologies and Image Exploitation IOSB, Fraunhofer Institute of Optronics, Karlsruhe, Germany
| | - Sebastian Robert
- Division of Applied Health and Social Sciences, Technical University of Applied Sciences, Rosenheim, Germany
| | | | - Dirk Hempel
- Oncological Center Donauwörth, Donauwörth, Germany
| | | | - Dietmar Zehn
- Division of Animal Physiology and Immunology, Technical University of Munich, Freising, Germany
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3
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Westhrin M, Blazevski J, Textor A, Abdollahi P, Gopalakrishnan RP, Ngo LT, Hofgaard PO, Heinzelbecker J, Bobic S, Fossum E, Spång HCL, Braathen R, Bogen B. Id-neoantigen vaccine induces therapeutic CD8 + T cells against multiple myeloma: H chain-loss escapees cause FLC MM. J Immunother Cancer 2023; 11:e006944. [PMID: 37607769 PMCID: PMC10445383 DOI: 10.1136/jitc-2023-006944] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Multiple myeloma (MM) cancers originate from plasma cells that have passed through the germinal center reaction where somatic hypermutation of Ig V regions takes place. Myeloma protein V regions often express many mutations and are thus a rich source of neoantigens (traditionally called idiotopes (Id)). Therefore, these are highly tumor-specific and excellent targets for immunotherapy. METHODS We have developed a DNA Id vaccine which as translated protein targets conventional dendritic cells (cDC) for CCL3-mediated delivery of myeloma protein V regions in a single-chain fragment variable (scFv) format. Vaccine efficacy was studied in the mouse MM model, mineral oil-induced plasmacytoma 315.BM. RESULTS The Id vaccine protected mice against a challenge with MM cells. Moreover, the vaccine had a therapeutic effect. However, in some of the vaccinated mice, MM cells not producing H chains escaped rejection, resulting in free light chain (FLC) MM. Depletion of CD8+ T cells abrogated vaccine efficacy, and protection was observed to be dependent on cDC1s, using Batf3-/- mice. Modifications of scFv in the vaccine demonstrated that CD8+ T cells were specific for two mutated VH sequences. CONCLUSIONS VH neoantigen-specific CD8+ T cells elicited by CCL3-containing Id vaccines had a therapeutic effect against MM in a mouse model. MM cells could escape rejection by losing expression of the H chain, thus giving rise to FLC MM.
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Affiliation(s)
- Marita Westhrin
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jana Blazevski
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ana Textor
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Pegah Abdollahi
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | | | - Linda Thuy Ngo
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Peter Olaf Hofgaard
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Julia Heinzelbecker
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sonja Bobic
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Even Fossum
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | | | - Ranveig Braathen
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Bjarne Bogen
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
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Shah BD, Cassaday RD, Park JH, Houot R, Oluwole OO, Logan AC, Boissel N, Leguay T, Bishop MR, Topp MS, Tzachanis D, O'Dwyer KM, Arellano ML, Lin Y, Baer MR, Schiller GJ, Subklewe M, Abedi M, Minnema MC, Wierda WG, DeAngelo DJ, Stiff PJ, Jeyakumar D, Mao D, Adhikary S, Zhou L, Schuberth PC, Damico Khalid R, Ghobadia A. Impact of prior therapies and subsequent transplantation on outcomes in adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia treated with brexucabtagene autoleucel in ZUMA-3. J Immunother Cancer 2023; 11:e007118. [PMID: 37648261 PMCID: PMC10471850 DOI: 10.1136/jitc-2023-007118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Brexucabtagene autoleucel (brexu-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved in the USA for adults with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) and in the European Union for patients ≥26 years with R/R B-ALL. After 2 years of follow-up in ZUMA-3, the overall complete remission (CR) rate (CR+CR with incomplete hematological recovery (CRi)) was 73%, and the median overall survival (OS) was 25.4 months in 78 Phase 1 and 2 patients with R/R B-ALL who received the pivotal dose of brexu-cel. Outcomes by prior therapies and subsequent allogeneic stem cell transplantation (alloSCT) are reported. METHODS Eligible adults had R/R B-ALL and received one infusion of brexu-cel (1×10⁶ CAR T cells/kg) following conditioning chemotherapy. The primary endpoint was the CR/CRi rate per central review. Post hoc subgroup analyses were exploratory with descriptive statistics provided. RESULTS Phase 1 and 2 patients (N=78) were included with median follow-up of 29.7 months (range, 20.7-58.3). High CR/CRi rates were observed across all prior therapy subgroups examined: 1 prior line of therapy (87%, n=15) and ≥2 prior lines (70%, n=63); prior blinatumomab (63%, n=38) and no prior blinatumomab (83%, n=40); prior inotuzumab (59%, n=17) and no prior inotuzumab (77%, n=61); and prior alloSCT (76%, n=29) and no prior alloSCT (71%, n=49). The frequency of Grade ≥3 cytokine release syndrome, neurological events, and treatment-related Grade 5 adverse events were largely similar among prior therapy subgroups.Median duration of remission (DOR) in responders with (n=14) and without (n=43) subsequent alloSCT was 44.2 (95% CI, 8.1 to not estimable (NE)) and 18.6 months (95% CI, 9.4 to NE); median OS was 47.0 months (95% CI, 10.2 to NE) and not reached (95% CI, 23.2 to NE), respectively. Median DOR and OS were not reached in responders without prior or subsequent alloSCT (n=22). CONCLUSIONS In ZUMA-3, adults with R/R B-ALL benefited from brexu-cel, regardless of prior therapies and subsequent alloSCT status, though survival appeared better in patients without certain prior therapies and in earlier lines of therapy. Additional studies are needed to determine the impact prior therapies and subsequent alloSCT have on outcomes of patients who receive brexu-cel.
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Affiliation(s)
- Bijal D Shah
- Division of Hematology/Oncology, Department of Malignant Hematology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Ryan D Cassaday
- Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington, USA
| | - Jae H Park
- Department of Medicine, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Roch Houot
- Department of Hematology, CHU Rennes, University Hospital Rennes, Inserm & EFS, Rennes, France
| | - Olalekan O Oluwole
- Vanderbilt-Ingram Cancer Center, Division of Hematology and Oncology, Vanderbilt University, Nashville, Tennessee, USA
| | - Aaron C Logan
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
| | - Nicolas Boissel
- Département d'Hématologie Clinique, Hôpital Saint-Louis, Paris, France
| | - Thibaut Leguay
- Department of Hematology, Service d'hématologie clinique et thérapie cellulaire Hôpital du Haut-Leveque CHU de Bordeaux, Bordeaux, France
| | - Michael R Bishop
- The David and Etta Jonas Center for Cellular Therapy, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Max S Topp
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Wurzburg, Germany
| | - Dimitrios Tzachanis
- Moores Cancer Center, University of California San Diego, San Diego, California, USA
| | - Kristen M O'Dwyer
- Wilmot Cancer Institute, University of Rochester, Rochester, New York, USA
| | | | - Yi Lin
- Department of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria R Baer
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland, USA
| | - Gary J Schiller
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Marion Subklewe
- Department of Medicine III, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Mehrdad Abedi
- Davis Comprehensive Cancer Center, University of California, Sacramento, California, USA
| | - Monique C Minnema
- Department of Hematology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - William G Wierda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Daniel J DeAngelo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Patrick J Stiff
- Department of Hematology/Oncology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Deepa Jeyakumar
- Chao Comprehensive Cancer Center, University of California Irvine Medical Center, Irvine, California, USA
| | - Daqin Mao
- Kite, a Gilead Company, Santa Monica, California, USA
| | | | - Lang Zhou
- Kite, a Gilead Company, Santa Monica, California, USA
| | | | | | - Armin Ghobadia
- Division of Medical Oncology, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
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McGray AJR, Chiello JL, Tsuji T, Long M, Maraszek K, Gaulin N, Rosario SR, Hess SM, Abrams SI, Kozbor D, Odunsi K, Zsiros E. BiTE secretion by adoptively transferred stem-like T cells improves FRα+ ovarian cancer control. J Immunother Cancer 2023; 11:e006863. [PMID: 37647218 PMCID: PMC10314690 DOI: 10.1136/jitc-2023-006863] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Cancer immunotherapies can produce complete therapeutic responses, however, outcomes in ovarian cancer (OC) are modest. While adoptive T-cell transfer (ACT) has been evaluated in OC, durable effects are rare. Poor therapeutic efficacy is likely multifactorial, stemming from limited antigen recognition, insufficient tumor targeting due to a suppressive tumor microenvironment (TME), and limited intratumoral accumulation/persistence of infused T cells. Importantly, host T cells infiltrate tumors, and ACT approaches that leverage endogenous tumor-infiltrating T cells for antitumor immunity could effectively magnify therapeutic responses. METHODS Using retroviral transduction, we have generated T cells that secrete a folate receptor alpha (FRα)-directed bispecific T-cell engager (FR-B T cells), a tumor antigen commonly overexpressed in OC and other tumor types. The antitumor activity and therapeutic efficacy of FR-B T cells was assessed using FRα+ cancer cell lines, OC patient samples, and preclinical tumor models with accompanying mechanistic studies. Different cytokine stimulation of T cells (interleukin (IL)-2+IL-7 vs IL-2+IL-15) during FR-B T cell production and the resulting impact on therapeutic outcome following ACT was also assessed. RESULTS FR-B T cells efficiently lysed FRα+ cell lines, targeted FRα+ OC patient tumor cells, and were found to engage and activate patient T cells present in the TME through secretion of T cell engagers. Additionally, FR-B T cell therapy was effective in an immunocompetent in vivo OC model, with response duration dependent on both endogenous T cells and FR-B T cell persistence. IL-2/IL-15 preconditioning prior to ACT produced less differentiated FR-B T cells and enhanced therapeutic efficacy, with mechanistic studies revealing preferential accumulation of TCF-1+CD39-CD69- stem-like CD8+ FR B T cells in the peritoneal cavity over solid tumors. CONCLUSIONS These findings highlight the therapeutic potential of FR-B T cells in OC and suggest FR-B T cells can persist in extratumoral spaces while actively directing antitumor immunity. As the therapeutic activity of infused T cell therapies in solid tumor indications is often limited by poor intratumoral accumulation of transferred T cells, engager-secreting T cells that can effectively leverage endogenous immunity may have distinct mechanistic advantages for enhancing therapeutic responses rates.
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Affiliation(s)
- A J Robert McGray
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
- Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Jessie L Chiello
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Takemasa Tsuji
- Center for Immunotherapy, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
- University of Chicago Medicine Comprehensive Cancer Center and Department of Obstetrics and Gynecology, Chicago, Illinois, USA
| | - Mark Long
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kathryn Maraszek
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Nicole Gaulin
- Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Spencer R Rosario
- Center for Immunotherapy, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Suzanne M Hess
- Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Scott I Abrams
- Center for Immunotherapy, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Danuta Kozbor
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kunle Odunsi
- Center for Immunotherapy, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
- University of Chicago Medicine Comprehensive Cancer Center and Department of Obstetrics and Gynecology, Chicago, Illinois, USA
| | - Emese Zsiros
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
- Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Chatani PD, Lowery FJ, Parikh NB, Hitscherich KJ, Yossef R, Hill V, Gartner JJ, Paria B, Florentin M, Ray S, Bera A, Parkhust M, Robbins P, Krishna S, Rosenberg SA. Cell surface marker-based capture of neoantigen-reactive CD8 + T-cell receptors from metastatic tumor digests. J Immunother Cancer 2023; 11:jitc-2022-006264. [PMID: 37258038 DOI: 10.1136/jitc-2022-006264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Cellular immunotherapies using autologous tumor-infiltrating lymphocytes (TIL) can induce durable regression of epithelial cancers in selected patients with treatment-refractory metastatic disease. As the genetic engineering of T cells with tumor-reactive T-cell receptors (TCRs) comes to the forefront of clinical investigation, the rapid, scalable, and cost-effective detection of patient-specific neoantigen-reactive TIL remains a top priority. METHODS We analyzed the single-cell transcriptomic states of 31 neoantigen-specific T-cell clonotypes to identify cell surface dysfunction markers that best identified the metastatic transcriptional states enriched with antitumor TIL. We developed an efficient method to capture neoantigen-reactive TCRs directly from resected human tumors based on cell surface co-expression of CD39, programmed cell death protein-1, and TIGIT dysfunction markers (CD8+ TILTP). RESULTS TILTP TCR isolation achieved a high degree of correlation with single-cell transcriptomic signatures that identify neoantigen-reactive TCRs, making it a cost-effective strategy using widely available resources. Reconstruction of additional TILTP TCRs from tumors identified known and novel antitumor TCRs, showing that at least 39.5% of TILTP TCRs are neoantigen-reactive or tumor-reactive. Despite their substantial enrichment for neoantigen-reactive TCR clonotypes, clonal dynamics of 24 unique antitumor TILTP clonotypes from four patients indicated that most in vitro expanded TILTP populations failed to demonstrate neoantigen reactivity, either by loss of neoantigen-reactive clones during TIL expansion, or through functional impairment during cognate neoantigen recognition. CONCLUSIONS While direct usage of in vitro-expanded CD8+ TILTP as a source for cellular therapy might be precluded by profound TIL dysfunction, isolating TILTP represents a streamlined effective approach to rapidly identify neoantigen-reactive TCRs to design engineered cellular immunotherapies against cancer.
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Affiliation(s)
- Praveen D Chatani
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Frank J Lowery
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Neilesh B Parikh
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kyle J Hitscherich
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rami Yossef
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Victoria Hill
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jared J Gartner
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Biman Paria
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Maria Florentin
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Satyajit Ray
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Alakesh Bera
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Maria Parkhust
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul Robbins
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sri Krishna
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Steven A Rosenberg
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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7
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Xiao G, Li L, Tanzhu G, Liu Z, Gao X, Wan X, Xiao D, Chen L, Xia X, Zhou R. Heterogeneity of tumor immune microenvironment of EGFR/ALK-positive tumors versus EGFR/ALK-negative tumors in resected brain metastases from lung adenocarcinoma. J Immunother Cancer 2023; 11:jitc-2022-006243. [PMID: 36868569 PMCID: PMC9990629 DOI: 10.1136/jitc-2022-006243] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Previous studies found that lung adenocarcinomas (LUAD) with EGFR-positive and ALK-positive were less responsive to immunotherapy, which may be associated with a suppressive tumor immune microenvironment (TIME). Given the discordance in the TIME between primary lung cancer and brain metastasis, it is urgent to explore the TIME in patients with EGFR/ALK-positive LUAD with brain metastases (BMs). METHODS The transcriptome feature of formalin-fixed and paraffin-embedded samples of BMs and paired primary LUAD from 70 patients with LUAD BMs was illustrated by RNA-sequencing. Six of them were available for paired sample analysis. Then, after excluding 3 co-occurring patients, we divided 67 BMs patients into 41 EGFR/ALK-positive and 26 EGFR/ALK-negative patients. The differences in immune profiling between the two groups were analyzed from three dimensions: TIME, T-cell receptor repertoire, and immunohistochemistry. Finally, the survival data of 55 patients were collected. RESULTS Compared with primary LUAD, BMs present an immunosuppressed TIME, manifested as: inhibition of immune-related pathways; low expression of immune checkpoint; decreased infiltration of CD8+T cells and cytotoxic lymphocyte; increased proportion of suppressive M2 macrophages. In different subgroups based on EGFR/ALK gene variation status, both EGFR-positive and ALK-positive tumors present a relatively immunosuppressive microenvironment, but the heterogeneity of tumor microenvironment may undergo different mechanisms. EGFR-positive BMs showed decreased CD8+T cells and increased regulatory T cells (Treg) cells, while ALK-positive BMs showed decreased CD8+T cells and increased M2 macrophages. Moreover, in the TCGA-LUAD cohort, EGFR-positive tumors showed reduced CD8+T cell infiltrations (p<0.001) and borderline significantly higher Tregs than EGFR/ALK-negative (p=0.072). In parallel, ALK-positive tumors had higher median M2 macrophages infiltrations than EGFR/ALK-negative (p=0.175), although there was no statistical significance. Collectively, there was a similar immunosuppressive milieu between EGFR/ALK-positive primary LUAD and BMs. Moreover, survival analysis uncovered higher CD8A expression, cytotoxic lymphocyte infiltration, and immune scores were significantly associated with better prognosis in both EGFR/ALK-positive and EGFR/ALK-negative groups. CONCLUSION This study found that LUAD-derived BMs exhibited an immunosuppressive TIME and revealed that EGFR-positive and ALK-positive BMs exhibited different immunosuppressive characteristics. Meanwhile, EGFR-negative BMs showed a potential benefit to immunotherapy. These findings boost molecular and clinical understanding of LUAD BMs.
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Affiliation(s)
- Gang Xiao
- Department of Radiation Oncology, Xiangya Hospital Central South University, Changsha, Hunan, China
| | | | - Guilong Tanzhu
- Department of Radiation Oncology, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Zhiyuan Liu
- Department of Radiation Oncology, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Xuan Gao
- Institute of Microbiology, Chinese Academy of Sciences, State Key Laboratory of Microbial Resources, Beijing, China.,GenePlus-Shenzhen Clinical Laboratory, Shenzhen, China
| | - Xin Wan
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Desheng Xiao
- Department of Pathology, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Liu Chen
- Department of Radiation Oncology, Xiangya Hospital Central South University, Changsha, Hunan, China
| | | | - Rongrong Zhou
- Department of Radiation Oncology, Xiangya Hospital Central South University, Changsha, Hunan, China .,Xiangya Lung Cancer Center, Xiangya Hospital Central South University, Changsha, Hunan, China
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Song F, Hu Y, Zhang Y, Zhang M, Yang T, Wu W, Huang S, Xu H, Chang AH, Huang H, Wei G. Safety and efficacy of autologous and allogeneic humanized CD19-targeted CAR-T cell therapy for patients with relapsed/refractory B-ALL. J Immunother Cancer 2023; 11:jitc-2022-005701. [PMID: 36808074 PMCID: PMC9944646 DOI: 10.1136/jitc-2022-005701] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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] [Accepted: 01/17/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Murine chimeric antigen receptor T (CAR-T) cell therapy has demonstrated clinical benefit in patients with relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). However, the potential immunogenicity of the murine single-chain variable fragment domain may limit the persistence of CAR-T cell, leading to relapse. METHODS We performed a clinical trial to determine the safety and efficacy of autologous and allogeneic humanized CD19-targeted CAR-T cell (hCART19) for R/R B-ALL. Fifty-eight patients (aged 13-74 years) were enrolled and treated between February 2020 and March 2022. The endpoints were complete remission (CR) rate, overall survival (OS), event-free survival (EFS), and safety. RESULTS Overall, 93.1% (54/58) of patients achieved CR or CR with incomplete count recovery (CRi) by day 28, with 53 patients having minimal residual disease negativity. With a median follow-up of 13.5 months, the estimated 1-year OS and EFS were 73.6% (95% CI 62.1% to 87.4%) and 46.0% (95% CI 33.7% to 62.8%), with a median OS and EFS of 21.5 months and 9.5 months, respectively. No significant increase in human antimouse antibodies was observed following infusion (p=0.78). Duration of B-cell aplasia in the blood was observed for as long as 616 days, which was longer than that in our prior mCART19 trial. All toxicities were reversible, including severe cytokine release syndrome, which developed in 36% (21/58) of patients and severe neurotoxicity, which developed in 5% (3/58) of patients. Compared with our prior mCART19 trial, patients treated with hCART19 had longer EFS without increased toxicity. Additionally, our data also suggest that patients treated with consolidation therapy, including allogeneic hematopoietic stem cell transplantation or CD22-targeted CAR-T cell, following hCART19 therapy had a longer EFS than those without consolidation therapy. CONCLUSION hCART19 has good short-term efficacy and manageable toxicity in R/R B-ALL patients. TRIAL REGISTRATION NUMBER NCT04532268.
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Affiliation(s)
- Fengmei Song
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Yongxian Hu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | | | - Mingming Zhang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Tingting Yang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Wenjun Wu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Simao Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Huijun Xu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Alex H Chang
- Shanghai YaKe Biotechnology Ltd, ShanghaiChina,Clinical Transformation Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, ShanghaiChina
| | - He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China,Institute of HematologyZhejiang University, Hangzhou, China,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
| | - Guoqing Wei
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China .,Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China.,Institute of HematologyZhejiang University, Hangzhou, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
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9
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Cornel AM, Dunnebach E, Hofman DA, Das S, Sengupta S, van den Ham F, Wienke J, Strijker JGM, van den Beemt DAMH, Essing AHW, Koopmans B, Engels SAG, Lo Presti V, Szanto CS, George RE, Molenaar JJ, van Heesch S, Dierselhuis MP, Nierkens S. Epigenetic modulation of neuroblastoma enhances T cell and NK cell immunogenicity by inducing a tumor-cell lineage switch. J Immunother Cancer 2022; 10:jitc-2022-005002. [PMID: 36521927 PMCID: PMC9756225 DOI: 10.1136/jitc-2022-005002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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] [Accepted: 09/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Immunotherapy in high-risk neuroblastoma (HR-NBL) does not live up to its full potential due to inadequate (adaptive) immune engagement caused by the extensive immunomodulatory capacity of HR-NBL. We aimed to tackle one of the most notable immunomodulatory processes in neuroblastoma (NBL), absence of major histocompatibility complex class I (MHC-I) surface expression, a process greatly limiting cytotoxic T cell engagement. We and others have previously shown that MHC-I expression can be induced by cytokine-driven immune modulation. Here, we aimed to identify tolerable pharmacological repurposing strategies to upregulate MHC-I expression and therewith enhance T cell immunogenicity in NBL. METHODS Drug repurposing libraries were screened to identify compounds enhancing MHC-I surface expression in NBL cells using high-throughput flow cytometry analyses optimized for adherent cells. The effect of positive hits was confirmed in a panel of NBL cell lines and patient-derived organoids. Compound-treated NBL cell lines and organoids were cocultured with preferentially expressed antigen of melanoma (PRAME)-reactive tumor-specific T cells and healthy-donor natural killer (NK) cells to determine the in vitro effect on T cell and NK cell cytotoxicity. Additional immunomodulatory effects of histone deacetylase inhibitors (HDACi) were identified by transcriptome and translatome analysis of treated organoids. RESULTS Drug library screening revealed MHC-I upregulation by inhibitor of apoptosis inhibitor (IAPi)- and HDACi drug classes. The effect of IAPi was limited due to repression of nuclear factor kappa B (NFκB) pathway activity in NBL, while the MHC-I-modulating effect of HDACi was widely translatable to a panel of NBL cell lines and patient-derived organoids. Pretreatment of NBL cells with the HDACi entinostat enhanced the cytotoxic capacity of tumor-specific T cells against NBL in vitro, which coincided with increased expression of additional players regulating T cell cytotoxicity (eg, TAP1/2 and immunoproteasome subunits). Moreover, MICA and MICB, important in NK cell cytotoxicity, were also increased by entinostat exposure. Intriguingly, this increase in immunogenicity was accompanied by a shift toward a more mesenchymal NBL cell lineage. CONCLUSIONS This study indicates the potential of combining (immuno)therapy with HDACi to enhance both T cell-driven and NKcell-driven immune responses in patients with HR-NBL.
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Affiliation(s)
- Annelisa M Cornel
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands,Center for Translational Immunology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Ester Dunnebach
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands,Center for Translational Immunology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Damon A Hofman
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | - Sanjukta Das
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA,School of Biotechnology, KIIT University, Bhubaneswar, India
| | - Satyaki Sengupta
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Femke van den Ham
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | - Judith Wienke
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | | | - Denise A M H van den Beemt
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands,Center for Translational Immunology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Anke H W Essing
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | - Bianca Koopmans
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | - Sem A G Engels
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | - Vania Lo Presti
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands,Center for Translational Immunology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Celina S Szanto
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | - Rani E George
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Jan J Molenaar
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | | | | | - S Nierkens
- Prinses Maxima Centrum voor Kinderoncologie, Utrecht, The Netherlands,Center for Translational Immunology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
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10
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Thelen M, Keller D, Lehmann J, Wennhold K, Weitz H, Bauer E, Gathof B, Brüggemann M, Kotrova M, Quaas A, Mallmann C, Chon SH, Hillmer AM, Bruns C, von Bergwelt-Baildon M, Garcia-Marquez MA, Schlößer HA. Immune responses against shared antigens are common in esophago-gastric cancer and can be enhanced using CD40-activated B cells. J Immunother Cancer 2022; 10:jitc-2022-005200. [PMID: 36600602 PMCID: PMC9743382 DOI: 10.1136/jitc-2022-005200] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Specific immune response is a hallmark of cancer immunotherapy and shared tumor-associated antigens (TAAs) are important targets. Recent advances using combined cellular therapy against multiple TAAs renewed the interest in this class of antigens. Our study aims to determine the role of TAAs in esophago-gastric adenocarcinoma (EGA). METHODS RNA expression was assessed by NanoString in tumor samples of 41 treatment-naïve EGA patients. Endogenous T cell and antibody responses against the 10 most relevant TAAs were determined by FluoroSpot and protein-bound bead assays. Digital image analysis was used to evaluate the correlation of TAAs and T-cell abundance. T-cell receptor sequencing, in vitro expansion with autologous CD40-activated B cells (CD40Bs) and in vitro cytotoxicity assays were applied to determine specific expansion, clonality and cytotoxic activity of expanded T cells. RESULTS 68.3% of patients expressed ≥5 TAAs simultaneously with coregulated clusters, which were similar to data from The Cancer Genome Atlas (n=505). Endogenous cellular or humoral responses against ≥1 TAA were detectable in 75.0% and 53.7% of patients, respectively. We found a correlation of T-cell abundance and the expression of TAAs and genes related to antigen presentation. TAA-specific T-cell responses were polyclonal, could be induced or enhanced using autologous CD40Bs and were cytotoxic in vitro. Despite the frequent expression of TAAs co-occurrence with immune responses was rare. CONCLUSIONS We identified the most relevant TAAs in EGA for monitoring of clinical trials and as therapeutic targets. Antigen-escape rather than missing immune response should be considered as mechanism underlying immunotherapy resistance of EGA.
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Affiliation(s)
- Martin Thelen
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Diandra Keller
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jonas Lehmann
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kerstin Wennhold
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Hendrik Weitz
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Eugen Bauer
- Institute of Transfusion Medicine, University of Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Birgit Gathof
- Institute of Transfusion Medicine, University of Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Monika Brüggemann
- Klinik für Innere Medizin II, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Michaela Kotrova
- Klinik für Innere Medizin II, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Alexander Quaas
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christoph Mallmann
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Seung-Hun Chon
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Axel M Hillmer
- Institute of Pathology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christiane Bruns
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michael von Bergwelt-Baildon
- Department of Internal Medicine III, University Hospital, Ludwig Maximilians University Munich, München, Germany,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Maria Alejandra Garcia-Marquez
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Hans Anton Schlößer
- Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany,Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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11
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Amidi Y, Eckhardt CA, Quadri SA, Malik P, Firme MS, Jones DK, Jain A, Danish HH, Rubin DB, Jacobson CA, Cash SS, Lee JW, Dietrich J, Westover MB. Forecasting immune effector cell-associated neurotoxicity syndrome after chimeric antigen receptor t-cell therapy. J Immunother Cancer 2022; 10:jitc-2022-005459. [PMID: 36450377 PMCID: PMC9716920 DOI: 10.1136/jitc-2022-005459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Immune effector cell-associated neurotoxicity syndrome (ICANS) is a clinical and neuropsychiatric syndrome that can occur days to weeks following administration chimeric antigen receptor (CAR) T-cell therapy. Manifestations of ICANS range from encephalopathy and aphasia to cerebral edema and death. Because the onset and time course of ICANS is currently unpredictable, prolonged hospitalization for close monitoring following CAR T-cell infusion is a frequent standard of care. METHODS This study was conducted at Brigham and Women's Hospital from April 2015 to February 2020. A cohort of 199 hospitalized patients treated with CAR T-cell therapy was used to develop a combined hidden Markov model and lasso-penalized logistic regression model to forecast the course of ICANS. Model development was done using leave-one-patient-out cross validation. RESULTS Among the 199 patients included in the analysis 133 were male (66.8%), and the mean (SD) age was 59.5 (11.8) years. 97 patients (48.7%) developed ICANS, of which 59 (29.6%) experienced severe grades 3-4 ICANS. Median time of ICANS onset was day 9. Selected clinical predictors included maximum daily temperature, C reactive protein, IL-6, and procalcitonin. The model correctly predicted which patients developed ICANS and severe ICANS, respectively, with area under the curve of 96.7% and 93.2% when predicting 5 days ahead, and area under the curve of 93.2% and 80.6% when predicting the entire future risk trajectory looking forward from day 5. Forecasting performance was also evaluated over time horizons ranging from 1 to 7 days, using metrics of forecast bias, mean absolute deviation, and weighted average percentage error. CONCLUSION The forecasting model accurately predicts risk of ICANS following CAR T-cell infusion and the time course ICANS follows once it has begun.Cite Now.
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Affiliation(s)
- Yalda Amidi
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Christine A Eckhardt
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Syed A Quadri
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Preeti Malik
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Marcos Santana Firme
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Daniel K Jones
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Aayushee Jain
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Husain H Danish
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Daniel B Rubin
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA,Cancer Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | | | - Sydney S Cash
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA
| | - Jong Woo Lee
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jorg Dietrich
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - M Brandon Westover
- Harvard Medical School, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA,Clinical Data Animation Center (CDAC), Massachusetts General Hospital, Boston, MA, USA,Cancer Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
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12
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Vardeu A, Davis C, McDonald I, Stahlberg G, Thapa B, Piotrowska K, Marshall MA, Evans T, Wheeler V, Sebastian S, Anderson K. Intravenous administration of viral vectors expressing prostate cancer antigens enhances the magnitude and functionality of CD8+ T cell responses. J Immunother Cancer 2022; 10:jitc-2022-005398. [PMID: 36323434 PMCID: PMC9639133 DOI: 10.1136/jitc-2022-005398] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The use of immunotherapeutic vaccination in prostate cancer is a promising approach that likely requires the induction of functional, cytotoxic T cells . The experimental approach described here uses a well-studied adenovirus-poxvirus heterologous prime-boost regimen, in which the vectors encode a combination of prostate cancer antigens, with the booster dose delivered by either the intravenous or intramuscular (IM) route. This prime-boost regimen was investigated for antigen-specific CD8+ T cell induction. METHODS The coding sequences for four antigens expressed in prostate cancer, 5T4, PSA, PAP, and STEAP1, were inserted into replication-incompetent chimpanzee adenovirus Oxford 1 (ChAdOx1) and into replication-deficient modified vaccinia Ankara (MVA). In four strains of mice, ChAdOx1 prime was delivered intramuscularly, with an MVA boost delivered by either IM or intravenous routes. Immune responses were measured in splenocytes using ELISpot, multiparameter flow cytometry, and a targeted in vivo killing assay. RESULTS The prime-boost regimen was highly immunogenic, with intravenous administration of the boost resulting in a sixfold increase in the magnitude of antigen-specific T cells induced and increased in vivo killing relative to the intramuscular boosting route. Prostate-specific antigen (PSA)-specific responses were dominant in all mouse strains studied (C57BL/6, BALBc, CD-1 and HLA-A2 transgenic). CONCLUSION This quadrivalent immunotherapeutic approach using four antigens expressed in prostate cancer induced high magnitude, functional CD8+ T cells in murine models. The data suggest that comparing the intravenous versus intramuscular boosting routes is worthy of investigation in humans.
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Affiliation(s)
| | | | | | | | | | | | | | - Thomas Evans
- Chief Scientific Officer, Vaccitech Limited, Oxford, UK
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13
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Dong M, Qian M, Ruan Z. CUL3/SPOP complex prevents immune escape and enhances chemotherapy sensitivity of ovarian cancer cells through degradation of PD-L1 protein. J Immunother Cancer 2022; 10:e005270. [PMID: 36198437 PMCID: PMC9535172 DOI: 10.1136/jitc-2022-005270] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cancer immune escape is a main obstacle in designing effective anticancer therapeutic approaches. Our work was aimed to explore the function of cullin 3 (CUL3) in ovarian cancer cell immune escape and chemosensitivity. METHOD Gain and loss of function assays were conducted to investigate the interactions among CUL3, speckle type POZ protein (SPOP) and programmed death ligand-1 (PD-L1) as well as their effects on ovarian cell malignant phenotypes and chemosensitivity. A mouse model of xenografted ovarian cells was further established for in vivo substantiation. RESULT Poorly-expressed CUL3 and SPOP were found in ovarian cancer. Overexpression of CUL3 reduced malignant features as well as immune escape of ovarian cancer cells but enhanced chemosensitivity. Functionally, CUL3 degraded PD-L1 protein by forming complex with SPOP. Overexpression of CUL3 inhibited tumor formation and enhanced chemosensitivity of ovarian cancer cells in mice by degrading PD-L1 protein. CONCLUSION All in all, CUL3/SPOP formed a complex to promote PD-L1 degradation to inhibit ovarian cancer cell immune escape and increase chemosensitivity, offering a therapeutic target for ovarian cancer treatment.
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Affiliation(s)
- Min Dong
- Department of Obstetrics and Gynecology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Qian
- Department of Obstetrics and Gynecology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengyi Ruan
- Department of Obstetrics and Gynecology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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14
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Gaballa MR, Maus MV. High antigen density of BCMA: friend or foe to CAR T cells? J Immunother Cancer 2022; 10:jitc-2022-005822. [PMID: 36137650 PMCID: PMC9511652 DOI: 10.1136/jitc-2022-005822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mahmoud R Gaballa
- Department of Medicine, Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA
| | - Marcela V Maus
- Department of Medicine, Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA
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15
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Yang M, Mahanty A, Jin C, Wong ANN, Yoo JS. Label-free metabolic imaging for sensitive and robust monitoring of anti-CD47 immunotherapy response in triple-negative breast cancer. J Immunother Cancer 2022; 10:jitc-2022-005199. [PMID: 36096527 PMCID: PMC9472253 DOI: 10.1136/jitc-2022-005199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Accepted: 08/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Immunotherapy is revolutionizing cancer treatment from conventional radiotherapies and chemotherapies to immune checkpoint inhibitors which use patients’ immune system to recognize and attack cancer cells. Despite the huge clinical success and vigorous development of immunotherapies, there is a significant unmet need for a robust tool to identify responders to specific immunotherapy. Early and accurate monitoring of immunotherapy response is indispensable for personalized treatment and effective drug development. Methods We established a label-free metabolic intravital imaging (LMII) technique to detect two-photon excited autofluorescence signals from two coenzymes, NAD(P)H (reduced nicotinamide adenine dinucleotide (phosphate) hydrogen) and FAD (flavin adenine dinucleotide) as robust imaging markers to monitor metabolic responses to immunotherapy. Murine models of triple-negative breast cancer (TNBC) were established and tested with different therapeutic regimens including anti-cluster of differentiation 47 (CD47) immunotherapy to monitor time-course treatment responses using the developed metabolic imaging technique. Results We first imaged the mechanisms of the CD47-signal regulatory protein alpha pathway in vivo, which unravels macrophage-mediated antibody-dependent cellular phagocytosis and illustrates the metabolism of TNBC cells and macrophages. We further visualized the autofluorescence of NAD(P)H and FAD and found a significant increase during tumor growth. Following anti-CD47 immunotherapy, the imaging signal was dramatically decreased demonstrating the sensitive monitoring capability of NAD(P)H and FAD imaging for therapeutic response. NAD(P)H and FAD intravital imaging also showed a marked decrease after chemotherapy and radiotherapy. A comparative study with conventional whole-body bioluminescence and fluorescent glucose imaging demonstrated superior sensitivity of metabolic imaging. Flow cytometry validated metabolic imaging results. In vivo immunofluorescent staining revealed the targeting ability of NAD(P)H imaging mainly for tumor cells and a small portion of immune-active cells and that of FAD imaging mainly for immunosuppressive cells such as M2-like tumor-associated macrophages. Conclusions Collectively, this study showcases the potential of the LMII technique as a powerful tool to visualize dynamic changes of heterogeneous cell metabolism of cancer cells and immune infiltrates in response to immunotherapy thus providing sensitive and complete monitoring. Leveraged on ability to differentiate cancer cells and immunosuppressive macrophages, the presented imaging approach provides particularly useful imaging biomarkers for emerged innate immune checkpoint inhibitors such as anti-CD47 therapy.
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Affiliation(s)
- Minfeng Yang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Arpan Mahanty
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chunjing Jin
- The Affiliated Chuzhou Hospital of Anhui Medical University, The First People's Hospital of Chuzhou, Chuzhou, China
| | - Alex Ngai Nick Wong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jung Sun Yoo
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Revenko A, Carnevalli LS, Sinclair C, Johnson B, Peter A, Taylor M, Hettrick L, Chapman M, Klein S, Solanki A, Gattis D, Watt A, Hughes AM, Magiera L, Kar G, Ireland L, Mele DA, Sah V, Singh M, Walton J, Mairesse M, King M, Edbrooke M, Lyne P, Barry ST, Fawell S, Goldberg FW, MacLeod AR. Direct targeting of FOXP3 in Tregs with AZD8701, a novel antisense oligonucleotide to relieve immunosuppression in cancer. J Immunother Cancer 2022; 10:jitc-2021-003892. [PMID: 35387780 PMCID: PMC8987763 DOI: 10.1136/jitc-2021-003892] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [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] [Accepted: 02/21/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Regulatory T cell (Treg) lineage is defined by the transcription factor FOXP3, which controls immune-suppressive gene expression profiles. Tregs are often recruited in high frequencies to the tumor microenvironment where they can suppress antitumor immunity. We hypothesized that pharmacological inhibition of FOXP3 by systemically delivered, unformulated constrained ethyl-modified antisense oligonucleotides could modulate the activity of Tregs and augment antitumor immunity providing therapeutic benefit in cancer models and potentially in man. METHODS We have identified murine Foxp3 antisense oligonucleotides (ASOs) and clinical candidate human FOXP3 ASO AZD8701. Pharmacology and biological effects of FOXP3 inhibitors on Treg function and antitumor immunity were tested in cultured Tregs and mouse syngeneic tumor models. Experiments were controlled by vehicle and non-targeting control ASO groups as well as by use of multiple independent FOXP3 ASOs. Statistical significance of biological effects was evaluated by one or two-way analysis of variance with multiple comparisons. RESULTS AZD8701 demonstrated a dose-dependent knockdown of FOXP3 in primary Tregs, reduction of suppressive function and efficient target downregulation in humanized mice at clinically relevant doses. Surrogate murine FOXP3 ASO, which efficiently downregulated Foxp3 messenger RNA and protein levels in primary Tregs, reduced Treg suppressive function in immune suppression assays in vitro. FOXP3 ASO promoted more than 70% reduction in FOXP3 levels in Tregs in vitro and in vivo, strongly modulated Treg effector molecules (eg, ICOS, CTLA-4, CD25 and 4-1BB), and augmented CD8+ T cell activation and produced antitumor activity in syngeneic tumor models. The combination of FOXP3 ASOs with immune checkpoint blockade further enhanced antitumor efficacy. CONCLUSIONS Antisense inhibitors of FOXP3 offer a promising novel cancer immunotherapy approach. AZD8701 is being developed clinically as a first-in-class FOXP3 inhibitor for the treatment of cancer currently in Ph1a/b clinical trial (NCT04504669).
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Affiliation(s)
| | | | | | - Ben Johnson
- Ionis Pharmaceuticals, Carlsbad, California, USA
| | | | | | | | - Melissa Chapman
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
| | | | | | | | - Andrew Watt
- Ionis Pharmaceuticals, Carlsbad, California, USA
| | | | | | - Gozde Kar
- Oncology R&D, AstraZeneca, Cambridge, UK
| | | | | | - Vasu Sah
- Oncology R&D, AstraZeneca, Waltham, MA, USA
| | | | | | | | | | | | - Paul Lyne
- Oncology R&D, AstraZeneca, Waltham, MA, USA
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Park JH, Cho SH, Kim R, Na SH, Kang ES, Yeom MY, Jang Y. Effect of pregabalin on nociceptive thresholds and immune responses in a mouse model of incisional pain. Korean J Pain 2021; 34:185-192. [PMID: 33785670 PMCID: PMC8019952 DOI: 10.3344/kjp.2021.34.2.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/14/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022] Open
Abstract
Background It is known that some analgesics as well as pain can affect the immune system. The aim of this study was to investigate the analgesic effect and immunomodulation of pregabalin (PGB) in a mouse incisional pain model. Methods A postoperative pain model was induced by hind paw plantar incision in male BALB/c mice. Mice were randomly divided into four groups (n = 8) a saline-treated incision (incision), PGB-treated incision (PGB-incision), sham controls without incision or drug treatment (control), and a PGB-treated control (PGB-control). In the PGB treated groups, PGB was administered intraperitoneally (IP) 30 minutes before and 1 hour after the plantar incision. Changes of the mechanical nociceptive thresholds following incision were investigated. Mice were euthanized for spleen harvesting 12 hours after the plantar incision, and natural killer (NK) cytotoxicity to YAC 1 cells and lymphocyte proliferation responses to phytohemagglutinin were compared among these four groups. Results Mechanical nociceptive thresholds were decreased after plantar incision and IP PGB administration recovered these decreased mechanical nociceptive thresholds (P < 0.001). NK activity was increased by foot incision, but NK activity in the PGB-incision group was significantly lower than that in the Incision group (P < 0.001). Incisional pain increased splenic lymphocyte proliferation, but PGB did not alter this response. Conclusions Incisional pain alters cell immunity of the spleen in BALB/c mice. PGB showed antinocieptive effect on mouse incisional pain and attenuates the activation of NK cells in this painful condition. These results suggest that PGB treatment prevents increases in pain induced NK cell activity.
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Affiliation(s)
- Jung Hyun Park
- Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Seung Hee Cho
- Department of Anesthesiology and Pain Medicine, Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Rip Kim
- Department of Anesthesiology and Pain Medicine, Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Hoon Na
- Department of Anesthesiology and Pain Medicine, Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun-Sun Kang
- Institute for Bio-Medical Convergence, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea
| | - Mi-Young Yeom
- Institute for Bio-Medical Convergence, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea
| | - Yeon Jang
- Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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Crooke SN, Ovsyannikova IG, Kennedy RB, Warner ND, Poland GA. Associations between markers of cellular and humoral immunity to rubella virus following a third dose of measles-mumps-rubella vaccine. Vaccine 2020; 38:7897-7904. [PMID: 33158591 DOI: 10.1016/j.vaccine.2020.10.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/02/2020] [Accepted: 10/21/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Rubella virus (RV) was eliminated in the United States in 2004, although a small portion of the population fails to develop long-term immunity against RV even after two doses of the measles-mumps-rubella (MMR) vaccine. We hypothesized that inherent biological differences in cytokine and chemokine signaling likely govern an individual's response to a third dose of the vaccine. METHODS Healthy young women (n = 97) were selected as study participants if they had either low or high extremes of RV-specific antibody titer after two previous doses of MMR vaccine. We measured cytokine and chemokine secretion from RV-stimulated PBMCs before and 28 days after they received a third dose of MMR vaccine and assessed correlations with humoral immune response outcomes. RESULTS High and low antibody vaccine responders exhibited a strong pro-inflammatory cellular response, with an underlying Th1-associated signature (IL-2, IFN-γ, MIP-1β, IP-10) and suppressed production of most Th2-associated cytokines (IL-4, IL-10, IL-13). IL-10 and IL-4 exhibited significant negative associations with neutralizing antibody titers and memory B cell ELISpot responses among low vaccine responders. CONCLUSION IL-4 and IL-10 signaling pathways may be potential targets for understanding and improving the immune response to rubella vaccination or for designing new vaccines that induce more durable immunity.
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Affiliation(s)
- Stephen N Crooke
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, USA
| | | | | | - Nathaniel D Warner
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, USA.
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Abstract
SUMMARY – Multiple sclerosis (MS) is a multicomponent disease characterized by inflammation, neurodegeneration, and cancellation of the central nervous system recovery mechanisms. The cause of MS is still unknown, but it is undeniable that genetic, environmental and immune factors are involved in the etiopathogenesis of this complex and heterogeneous disease. From the aspect of immunopathogenesis, until recently the opinion prevailed that autoreactive T lymphocytes played a major role, the activation of which is a key step in MS. The knowledge of the effector and regulatory roles of B cells supports a new concept of MS immunopathogenesis that is based on the highly complex interaction of T and B cells, with B cells actively participating in cellular immunity by directing the intensity and quality of cellular immune response. The mechanisms of B cell activity in MS immunopathogenesis are multiple and include antigen presentation and T cell costimulation, cytokine secretion, antibody synthesis, and formation of ectopic lymphoid B cell aggregates in the intrameningeal spaces. The importance of B cells has been confirmed by modern therapeutic options for the treatment of MS.
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Xiong Y, Tan Y, Song YG. Analysis of T Cell Receptor Vβ Diversity in Peripheral CD4+ and CD8+ T Lymphocytes Obtained From Patients With Chronic Severe Hepatitis B. Hepat Mon 2014; 14:e15900. [PMID: 24693310 PMCID: PMC3950627 DOI: 10.5812/hepatmon.15900] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 12/09/2013] [Accepted: 12/15/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND The hepatitis B virus (HBV) antigen-induced cellular immune response plays an important role in HBV clearance. Changes in the diversity of complementarity determining region 3 (CDR3) and T-cell receptor (TCR) sequences are used to monitor the response of T cells to antigens. OBJECTIVES The aim of the present study was to determine whether the TCR Vβ repertoire of patients with chronic severe hepatitis B (CSHB) undergoes increased stimulation, and to identify conserved motifs in specific TCR Vβ families. PATIENTS AND METHODS Peripheral blood mononuclear cells (PBMCs) from 18 patients with CSHB were sorted into CD4+ and CD8+ T subsets, using monoclonal antibody-coated magnetic beads. The TCR Vβ CDR3 was subsequently characterized using immune spectratyping. The TCR Vβ families exhibiting a CDR3 spectratype that underwent monoclonal expansion were sequenced. RESULTS The number of oligoclonal or monoclonal expansion TCR Vβ families detected in the analyzed CD8+ T cells was significantly higher than the number detected in CD4+ T cells. The CDR3 spectratype analysis showed predominant usage of TCR Vβ5, Vβ7, Vβ9, Vβ12, and Vβ18 families in CD8+ T cell subsets of CSHB patients. Furthermore, conserved amino acid motifs were found to be associated with the monoclonal expansion of CD8+ TCR Vβ families. In addition, JB1S1 and JB2S7 region genes were present at a high frequency. CONCLUSIONS The CD4+ and CD8+ TCR Vβ gene families undergo clonal expansion in CSHB patients, and CD8+ T cells play a major role in the pathogenesis of CSHB. Moreover, the conserved motifs and limited use of joining region genes observed in the CSHB patients of this cohort indicated that similar antigenic epitopes are recognized.
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Affiliation(s)
- Ying Xiong
- Central Laboratory, First Affiliated Hospital, Jilin University, Changchun, China
- Life Science Research Center, Beihua University, Jilin, China
| | - Yan Tan
- Central Laboratory, First Affiliated Hospital, Jilin University, Changchun, China
- Cancer Biotherapy Center, Jilin Province People’s Hospital, Changchun, China
- Corresponding Author: Yan Tan, Central Laboratory, First Affiliated Hospital, Jilin University, 130000, Changchun, China. Tel: +86-85595097, Fax: +86-85595097, E-mail:
| | - Yu Guo Song
- Life Science Research Center, Beihua University, Jilin, China
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Goicoa MA, Mariani AL, Palacios MF, Testoni RA, Iannitelli PS, Diez RA, Sen L, Estevez ME. Defect of NK regulation in HIV-infected patients. Arch AIDS Res 2002; 6:15-26. [PMID: 12344006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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22
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Rowland-Jones S, Dong T, Krausa P, Sutton J, Newell H, Ariyoshi K, Gotch F, Sabally S, Corrah T, Kimani J, MacDonald K, Plummer F, Ndinya-Achola J, Whittle H, McMichael A. The role of cytotoxic T-cells in HIV infection. Dev Biol Stand 1998; 92:209-14. [PMID: 9554277] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
HIV-specific cytotoxic T lymphocytes (CTL) are believed to play a major role in controlling virus levels through the asymptomatic period of HIV infection. For the rational design of an HIV vaccine, we need to know whether protective immunity can ever develop following HIV exposure in people who remain uninfected. We have detected HIV-specific CTL in 5/6 repeatedly exposed, persistently seronegative female sex-workers in The Gambia. Their CTL, repeatedly detected over two years, recognise epitopes presented by HLA-B35 which are cross-reactive between HIV-1 & HIV-2, suggesting they could have been primed first by HIV-2 exposure and subsequently boosted by exposure to HIV-1. Using previously identified clade B HIV-1 epitope peptides, we have now detected HIV-specific CTL in 6/15 highly exposed and apparently HIV-resistant Kenyan prostitutes, predominantly towards epitopes highly conserved between B and the Kenyan A & D clades of HIV-1. This CTL activity towards conserved virus epitopes may represent protective immunity to HIV generated in response to repeated exposure, and prophylactic HIV vaccines should aim to generate similar CTL responses.
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Affiliation(s)
- S Rowland-Jones
- Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, U.K
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al-Yaman F, Genton B, Taraika J, Alpers MP. Naturally acquired cellular immune responses to the synthetic malarial peptide SPf66 in children in Papua New Guinea. Trans R Soc Trop Med Hyg 1997; 91:709-12. [PMID: 9509186 DOI: 10.1016/s0035-9203(97)90534-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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] [Indexed: 02/06/2023] Open
Abstract
A prospective longitudinal study to examine the relationship between cellular immune responses to the synthetic malarial peptide SPf66 and malaria infection and morbidity was carried out in 187 children aged 0.5-15 years in the Wosera area of Papua New Guinea. Cellular responses were assessed by proliferation and stimulation of cytokines representing the Th1 and Th2 cell subsets (interferon gamma [IFN gamma] and interleukin-4 [IL-4]. Most children (66%) did not respond to SPf66 by any measure. Among the responders, the highest response was obtained for IL-4 (19%) followed by IFN gamma (10%), and the least for proliferation (5%). Analyses of the relation of T cell response to malaria infection showed that the IFN gamma response to SPf66 was positively correlated with parasite density (r = 0.27, P = 0.001). There was no association between the cellular response to SPf66 and concurrent or subsequent malaria morbidity, whichever clinical definition was used. Thus none of these cellular immune responses predicted efficacy of SPf66 in this highly endemic area.
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Affiliation(s)
- F al-Yaman
- Papua New Guinea Institute of Medical Research, Madang.
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al-Yaman F, Genton B, Taraika J, Anders R, Alpers MP. Association between cellular response (IL-4) to RESA/Pf155 and protection from clinical malaria among Papua New Guinean children living in a malaria endemic area. Parasite Immunol 1997; 19:249-54. [PMID: 9364554 DOI: 10.1046/j.1365-3024.1997.d01-204.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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] [Indexed: 02/05/2023]
Abstract
A prospective study in 207 children aged 0.5-15 years was carried out to examine the relationship between cellular responses to Plasmodium falciparum ring-infected erythrocyte surface antigen (RESA) and malaria infection and morbidity. The prevalence of lymphoproliferative response to RESA was 13%, IFN-gamma prevalence was 40% and IL-4 prevalence was 22%. Only the IFN-gamma, response to RESA increased significantly with age. When proliferation or stimulation of either cytokine was used to assess T-cell activation the overall frequency of responders increased to 55%. The proliferative and IFN-gamma response to RESA were positively associated. Although there was no association between any of the CMI responses to RESA and concurrent morbidity the prevalence of IL-4 response to RESA was significantly lower in children who experienced clinical malaria in the following year. These results coupled with our earlier data showing a negative relationship between humoral responses to RESA and malaria morbidity support the inclusion of RESA in a subunit vaccine against malaria.
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Affiliation(s)
- F al-Yaman
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
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25
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Abstract
As the HIV-1 epidemic continues to spread world wide, the need for an effective vaccine remains urgent. Efforts to develop such a vaccine have been hampered by three main factors: (a) the extraordinary ability of the virus to mutate; (b) inability of most known specificities of anti-HIV antibodies to neutralise HIV primary isolates consistently; and (c) lack of understanding of the correlates of protective immunity to HIV infection. In view of the complex biology of HIV-host interactions, the most fruitful avenue may be development of multivalent HIV immunogens tailored to HIV isolates in specific geographical locations.
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Affiliation(s)
- B F Haynes
- Duke University AIDS Center, Durham, North Carolina, USA
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26
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Levin A, Brubaker G, Shao JS, Kumby D, O'Brien TR, Goedert JJ, Strauss KW, Blattner WA, Hannet I. Determination of T-lymphocyte subsets on site in rural Tanzania: results in HIV-1 infected and non-infected individuals. Int J STD AIDS 1996; 7:288-91. [PMID: 8876362 DOI: 10.1258/0956462961917825] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
With the FACSCount flow cytometer, counts of CD4, CD8 and CD3 lymphocytes and CD4/CD8 ratios were performed in a rural hospital in Tanzania. A total of 168 subjects (21 HIV-1 seropositive and 147 HIV-1 seronegative) were tested as part of a population-based serosurvey and AIDS education programme; 134 other subjects were hospitalized patients who had signs and symptoms suggestive of AIDS (69 HIV-1 seropositive and 65 HIV-seronegative). Mean values for the 147 HIV-1 seronegative subjects from the local population were 980 CD4 cells (95% CI 930, 1031), 598 CD8 cells (560, 635) and CD4/CD8 ratio 1.78 (1.68, 1.89). Seropositive subjects from the local population had significantly lower CD4 cell counts, higher CD8 counts and a lower CD4/CD8 ratio. CD4 cells were significantly lower and CD8 cells significantly higher in HIV-1 seropositive hospital patients compared to HIV-1 seronegative patients. However, 23 (35%) seronegative hospital patients had CD4 counts lower than 600. These results establish baseline values for the lymphocyte subsets in this population and indicate that this technique can be used in remote areas to monitor progress of HIV-infected individuals.
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Affiliation(s)
- A Levin
- Department of Virology, Medical College of St Bartholomew's Hospital, London, UK
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27
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Kam KM, Leung WL, Kwok MY, Hung MY, Lee SS, Mak WP. Lymphocyte subpopulation reference ranges for monitoring human immunodeficiency virus-infected Chinese adults. Clin Diagn Lab Immunol 1996; 3:326-30. [PMID: 8705678 PMCID: PMC170341 DOI: 10.1128/cdli.3.3.326-330.1996] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Two hundred eight healthy human immunodeficiency virus (HIV) type 1- and HIV type 2-seronegative Chinese adults (78 males and 130 females; mean age, 32 years; age range, 18 to 71 years) were analyzed for lymphocyte subsets by a standardized and quality-controlled flow cytometric immunophenotyping technique. While the leukocyte differential values were comparable to those found in studies of Caucasians, the means, medians, and 95% reference ranges of lymphocyte subsets were very different. The 95% reference ranges in absolute counts per microliter of whole blood (percentage of lymphocytes) for CD3+, CD3+ CD4+, CD3+ CD8+, CD3- CD19+ (B), and CD3- with CD16+ and/or CD56+ (NK) cells were 672 to 2,368 (54.8 to 83.0%), 292 to 1,366 (23.1 to 51.0%), 240 to 1,028 (17.9 to 47.5%), 82 to 560 (5.1 to 20.8%), and 130 to 938 (7.1 to 38.0%), respectively. CD3+ CD4+ cells showed significant sex difference (for males, mean of 702 [34.8%] and standard deviation of 258 [7.5%]; for females, mean of 728 [37.3%] and standard deviation of 254 [7.4%]) as well as an increase with age of 42 (1.6%) per decade. Investigations of the NK cell population did not show similar findings. Classification of HIV disease, treatment, and prophylactic regimens based on studies which relied heavily on estimations of lymphocyte subsets alone should be used with special caution for Chinese patients. Provided that adequate quality control measures are taken to ensure comparability of data, we recommend that these ranges be used on a day-to-day basis in laboratories that have not yet established their own reference ranges.
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Affiliation(s)
- K M Kam
- Department of Health, Sai Ying Pun Polyclinic, Hong Kong
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Bem C, Patil PS, Bharucha H, Namaambo K, Luo N. Importance of human immunodeficiency virus-associated lymphadenopathy and tuberculous lymphadenitis in patients undergoing lymph node biopsy in Zambia. Br J Surg 1996; 83:75-8. [PMID: 8653372 DOI: 10.1002/bjs.1800830124] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [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] [Indexed: 02/01/2023]
Abstract
The relative importance of human immunodeficiency virus (HIV)-associated lymphadenopathy amongst patients presenting for lymph node biopsy in Central Africa is unknown. HIV-1 serology and histology of patients undergoing superficial lymph node biopsy during 1989-1990 in Lusaka, Zambia, were examined in a prospective cohort study of HIV serology and by retrospective review of laboratory records. Of 727 lymph nodes biopsied in Lusaka in 1989-1990, 380 (52 per cent) showed tuberculous lymphadenitis, 160 (22 per cent) histology suggestive of primary HIV lymphadenopathy and 66 (9 per cent) nodal Kaposi's disease. HIV serology was tested in 280 adults and was positive in 91 per cent (255 patients), including 89 per cent (153 of 171) of those with tuberculous lymphadenitis, 98 per cent (63 of 64) of those with histology suspicious of primary HIV lymphadenopathy and all (24 of 24) with nodal Kaposi's disease. Other HIV-associated lymphadenopathy included nodal lymphomas and lymphoepithelial cysts. HIV serology was tested in 22 children and was positive in eight, including four of 14 with tuberculous lymphadenitis. It is concluded that HIV-associated lymphadenopathy, especially tuberculous lymphadenitis, is very common amongst patients presenting for lymph node biopsy in Central Africa.
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Affiliation(s)
- C Bem
- School of Medicine, University of Zambia, Republic of Zambia
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"Killer T-cells" give Gambian sex-workers the cutting-edge on HIV. AIDS Anal Afr 1995; 5:3. [PMID: 12288603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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30
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Affiliation(s)
- P Matondo
- University Teaching Hospital, Lusaka, Zambia
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31
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Rowland-Jones S, Sutton J, Ariyoshi K, Dong T, Gotch F, McAdam S, Whitby D, Sabally S, Gallimore A, Corrah T. HIV-specific cytotoxic T-cells in HIV-exposed but uninfected Gambian women. Nat Med 1995; 1:59-64. [PMID: 7584954 DOI: 10.1038/nm0195-59] [Citation(s) in RCA: 604] [Impact Index Per Article: 20.8] [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] [Indexed: 01/26/2023]
Abstract
A crucial requirement in the rational design of a prophylactic vaccine against the human immunodeficiency virus (HIV) is to establish whether or not protective immunity can occur following natural infection. The immune response to HIV infection is characterized by very vigorous HIV-specific cytotoxic T-lymphocyte (CTL) activity. We have identified four HIV-1 and HIV-2 cross-reactive peptide epitopes, presented to CTL from HIV-infected Gambians by HLA-B35 (the most common Gambian class I HLA molecule). These peptides were used to elicit HIV-specific CTLs from three out of six repeatedly exposed but HIV-seronegative female prostitutes with HLA-B35. These women remain seronegative with no evidence of HIV infection by polymerase chain reaction or viral culture. Their CTL activity may represent protective immunity against HIV infection.
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Affiliation(s)
- S Rowland-Jones
- Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, UK
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Abstract
Oral contraceptive (OC) use has been associated with increased incidence of a number of infections, but the mechanisms behind these changes is unclear. The present study compared OC users and nonusers in natural killer (NK) cell activity, NK phenotype, and illness frequency. Subjects were 55 female medical students (19 OC users, 36 nonusers). Three blood samples were obtained, 1 mo apart. Natural cytotoxicity was tested with a 51Cr assay. Self reports of illness symptoms during the previous week were collected at each blood sampling. NK phenotype number was assessed by flow cytometry. Oral contraceptive users had lower natural cytotoxicity and increased frequency of sneezing, gastrointestinal distress, runny nose, sore throat, coughing, and total illness symptoms, relative to nonusers. No differences were found between OC users and nonusers in NK phenotype number. These findings support the hypothesis that differences between users and nonusers in infection rates might be due to alterations in NK activity.
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Affiliation(s)
- J M Scanlan
- Department of Psychiatry, University of Colorado Health Sciences Center, Denver 80220, USA
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Ansaloni L, Acaye GL. Absence of neutropenia in African patients with AIDS and associated pyomyositis. East Afr Med J 1994; 71:736-8. [PMID: 7859659] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The association between AIDS and pyomyositis was recently pointed out in temperate and tropical countries. In Western countries, the patients affected by pyomyositis associated with AIDS in most cases are neutropenic. We compare a group of 17 patients with pyomyositis and AIDS living in temperate climates from the literature, and 11 patients affected by the same association seen by us in northern Uganda. The patients from Western countries were significantly more neutropenic and their mean of the neutrophil count was significantly lower when compared with our group. We suggest that the defective neutrophil function associated with HIV infection play a major role in the pathogenesis of pyomyositis in our patients.
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Affiliation(s)
- L Ansaloni
- Ambrosoli Memorial Hospital, Kalongo, Kitgum District, Uganda
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34
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Abstract
A panel of monoclonal antibodies specific for macrophage subtypes appearing in early (27E10), down-regulatory (RM3/1) and late (25F9) stages of inflammation had been applied to 20 endometriotic implants of 14 women. Of those patients 9 were in the follicular phase of the cycle, two on danazol, one on LHRH-analogue (buserelin) and another two on oral contraceptives. Beside the macrophage subsets, antibodies against T4, T8 lymphocytes as well as proliferating cells (EN7/44 and Ki67) were examined. In all specimens immunologically competent cells could be detected to a varying degree and within the same implant different stages of inflammation were discernible. Endometriosis presented with signs of early inflammation indicated by 27E10+ macrophages and CD4+ lymphocytes (15 specimens) and with down-regulatory, late inflammatory reactions as shown by RM3/1+, 25F9+ macrophages and CD8+ lymphocytes (19 biopsies). Additionally, in 14 specimens cells of the EN7/44+ and Ki67+ type was detected. These preliminary results showed no significant correlation to either extension of endometriotic implants or adhesions or concomitant therapy and clearly indicate, that there is an immunological dynamic process within the lesion itself in addition to that one of the peritoneal fluid.
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Affiliation(s)
- U Cirkel
- Department of Obstetrics and Gynecology, University of Münster, Germany
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35
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Abstract
The successful development of an anti-fertility vaccine necessitates overcoming obstacles in eliciting an immune response to self species body constituents. The feasibility of accomplishing this task has been demonstrated for certain antigens described in this workshop; however, additional vaccine candidate antigens may yet be revealed from the application of recent advances in molecular biology. Improvements in vaccine design are likely to occur from discovery of more appropriate epitopes on targeting antigens, new carrier molecules for terminating immunological tolerance, expression of vaccine antigens in suitable live vectors, the co-immunization with more than one antigen, the use of safer and/or more effective adjuvants and vehicles, more efficient immunization by targeting antigens to specific lymphoid cells, and the development of superior vaccine delivery systems. Research directed to restricting the immune response to the genital tract and to intentionally reverse the effects of immunization will likely be pursued in the future. All of these areas need to be addressed if vaccines are to be developed that are not only safe and effective but also highly acceptable as birth control methods.
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Affiliation(s)
- V C Stevens
- Department of Obstetrics and Gynecology, Ohio State University, Columbus 43210-1228
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36
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Chaulet P. Epidemiology of tuberculosis in children. Child Trop 1992:7-19. [PMID: 12345144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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37
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Mentlein R, Staves R, Rix-Matzen H, Tinneberg HR. Influence of pregnancy on dipeptidyl peptidase IV activity (CD 26 leukocyte differentiation antigen) of circulating lymphocytes. Eur J Clin Chem Clin Biochem 1991; 29:477-80. [PMID: 1683260 DOI: 10.1515/cclm.1991.29.8.477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Dipeptidyl peptidase IV (CD 26 leukocyte differentiation antigen) is an enzymic surface marker of a human T lymphocyte subpopulation which has been shown to be associated with their capacity to produce large amounts of interleukin 2 and proliferate strongly in response to mitogenic stimulation. The peptidase activity on the surface of purified human peripheral mononuclear cells was determined spectrophotometrically with the substrate glycyl-L-proline-4-nitroanilide. The peripheral mononuclear cells of pregnant women exhibited depressed mean dipeptidyl peptidase IV activity when compared with the activity of peripheral mononuclear cells from non-pregnant or male individuals. The gestational age (7 to 20 weeks) of the pregnant collective had no effects on peptidase levels. Women taking oral contraceptives had a slightly lower mean activity than the non-pregnant group not using contraceptives. Thus, reduced dipeptidyl peptidase IV activity of peripheral mononuclear cells might reflect impairement of cellular immunity during pregnancy.
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Affiliation(s)
- R Mentlein
- Anatomisches Institut, Universität Kiel, Germany
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38
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Witt CS, Alpers MP. Impaired cell-mediated immunity in Papua New Guinean infants. P N G Med J 1991; 34:90-7. [PMID: 1750259] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Immune function was studied in Papua New Guinea highland infants with pneumonia, healthy highland controls and expatriate controls under the age of 15 months. Delayed-type hypersensitivity to tuberculin was depressed in highland pneumonia patients and highland controls as were CD4/CD8 T-lymphocyte ratios. The differences between highland and expatriate infants were more pronounced after 6 months of age, suggesting an environmental effect. Serum immunoglobulin and complement concentrations were higher in highland infants than in expatriate controls. Indices of nutritional status were similar in highland and expatriate infants but iron deficiency was more common in the highland infants in the study.
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Affiliation(s)
- C S Witt
- Papua New Guinea Institute of Medical Research, Goroka
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39
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McDonald SW, al Saffar R, Scothorne RJ. The response of the regional lymph node to epididymal sperm granulomas after vasectomy. J Anat 1991; 176:35-44. [PMID: 1917673 PMCID: PMC1260311] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The cause of the variable immune response in the regional testicular lymph node of inbred Albino Swiss rats after vasectomy was investigated in two experiments. In the first, the ductus deferens was transected at its junction with the epididymis so that, in every case, sperm granulomas developed in the epididymis, from which lymph is known to drain invariably to the testicular node. In spite of this, not all testicular nodes showed histological signs of an immune response at 12 weeks after vasectomy. In the second experiment the contents of epididymal lymphatics were compared in vasectomised rats and sham-operated controls at intervals of up to 18 months after operation. Lymphatics in animals with an 'active' epididymal granuloma invariably contained numbers of macrophages and lymphocytes, thought to be involved in antigen transport, while those of controls contained none. It is concluded that variations in the lymphatic drainage of vasal granulomas were not primarily responsible for the variable lymph node response to vasectomy previously reported.
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Affiliation(s)
- S W McDonald
- Department of Anatomy, University of Glasgow, Scotland
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40
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Abstract
The etiology of Kaposi's sarcoma remains somewhat obscure. While lesions of classic Kaposi's sarcoma, African Kaposi's sarcoma, and immunosuppressed Kaposi's sarcoma have been found to be indistinguishable from one another, the reasons for the variations in type and severity have not been established. The origin of the spindle cell is yet to be agreed on. Geographic variation does not seem as important as ethnic variation. The very young and the very old, perhaps two ages of weakened immunity, tend to have a higher incidence of Kaposi's sarcoma. Children and AIDS patients tend to develop more virulent disease. Males tend to get Kaposi's sarcoma at higher rates than do females. Jewish and Mediterranean males have the highest incidence of classic Kaposi's sarcoma, and African Bantu have the highest incidence of African Kaposi's sarcoma, classifications which do not apply to the Kaposi's sarcoma population in the United States. Male homosexuals have much higher incidence of Kaposi's sarcoma than do male heterosexuals, but since the early 1980s, its incidence as the presenting manifestation of AIDS has decreased dramatically. There is no unequivocal association with HLA haplotype (though DR5 carriers may be at especially high risk) or evidence of family clustering. There is an impressive but not always consistent association between Kaposi's sarcoma development and immunodeficiency. Environmental factors, such as nitrite use, immunosuppression, and repeated cytomegalovirus infection, are associated with Kaposi's sarcoma, but the exact mechanism is unclear and the associations remain inconsistent. Finally, it is still unclear if there is a causative infectious agent for Kaposi's sarcoma. While cytomegalovirus has been linked to Kaposi's sarcoma, there are weaknesses in its hypothetical role as an etiologic agent as is the case for HIV itself.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- A Wahman
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015
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41
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Affiliation(s)
- G W Hoffmann
- Department of Microbiology and Physics, University of British Columbia, Vancouver, Canada
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42
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Abstract
Mother-to-child infection with HIV-2 is thought to be rare, and there have been few previous reports of transmission by this route. Reports of morbidity associated with HIV-2 infection in children are also rare. We describe eight children born to mothers who were infected with HIV-2; five developed AIDS, and three were still seropositive at 17-49 months of age. The only apparent route of HIV-2 transmission was from mother to child, except for one child who had been transfused. Three of the children with AIDS died, all having decreased CD4+ lymphocytes and mitogen responses. Further studies are needed to determine the prevalence and natural history of mother-to-child transmission of HIV-2.
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43
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Mazumder DN, Ghose N, Mitra J, Dutta G, Santra A. Immunological status of women with prolonged oral contraceptives and occurrence of giardiasis. J Indian Med Assoc 1990; 88:129-31. [PMID: 2280071] [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] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Immunological status of 14 women taking oral contraceptive for prolonged period (more than 6 months, low dose pill) was studied. Phytohaemagglutinin induced lymphocytes stimulation (PILT) was found to be significantly depressed in these subjects though T-lymphocyte subpopulation was found to be normal. Serum IgA and IgG levels in these cases were found to be normal but IgM level was increased. Though incidence of G lamblia infection was reported to be high in immunocompromised subjects, it was found only one out of 14 subjects taking oral contraceptive harboured the protozoa.
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Affiliation(s)
- D N Mazumder
- Department of Medicine, Institute of Postgraduate Medical Education and Research, Calcutta
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44
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Repina MA, Blagoslovenskiĭ GS, Gnilevskaia ZU, Ivanova LV. [The effect of specific trophoblastic beta 1-glycoprotein on changes in the cellular link of immunity in infected abortion]. Akush Ginekol (Mosk) 1989:47-50. [PMID: 2629524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Effects of specific trophoblastic beta-1-glycoprotein (TBG) on T- and B-cell immunity have been explored in 107 patients with purulent septic complications of abortion. TBG showed a marked suppressor effect on T lymphocytes. Persistence of TBG in blood of patients with infection complicated abortion maintains immunodeficient states. The presence of TBG in serum may increase the risk of severe septic complications of illegal abortion.
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45
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Kapeliushnik NL, Osipov RA, Tukhvatullina LM, Mal'tseva LI, Chernovskaia RT. [Analysis of the sequelae of induced abortion (based on the clinical data of the V.I. Lenin Kazan Institute for the Training of Physicians)]. Akush Ginekol (Mosk) 1988:52-3. [PMID: 2977274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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46
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Affiliation(s)
- D B Cundall
- Department of Paediatrics and Child Health, St James's University Hospital, Leeds
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47
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Abstract
Sixteen adults presented with lymphadenopathy which was tuberculous on biopsy; they were all seropositive for human immunodeficiency virus (HIV-1), but none had the clinical criteria of the acquired immunodeficiency syndrome (AIDS). The biopsy specimen showed caseating tuberculosis, with scanty or no visible acid fast bacilli in seven cases; the remaining nine had a poor cellular reactivity with numerous bacilli. Antituberculous chemotherapy for two months reduced the lymphadenopathy. Two patients subsequently developed AIDS. Mycobacterial cultures were not performed, but the infection was almost certainly Mycobacterium tuberculosis. The space-time clustering of tuberculous lymphadenitis now seen in Kampala, and the unusual non-reactive histopathology, are typical of the impairment of cellular immunity induced by HIV infection.
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Affiliation(s)
- A Nambuya
- Department of Medicine, Makarere University School of Medicine, Kampala
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48
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Harada S, Yamamoto N. AIDS studies in Japan. Jpn J Cancer Res 1987; 78:415-27. [PMID: 3112053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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49
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50
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Fleming AF, Akintunde EA, Harrison KA, Dunn D. Leucocyte counts during pregnancy and the puerperium and at birth in Nigerians. East Afr Med J 1985; 62:175-84. [PMID: 4017917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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