Immuntherapie mit allogenen Natürlichen Killerzellen bei pädiatrischen Patienten nach Stammzelltransplantation: In-vivo-Monitoring und Einfluss immunsuppressiver Therapie

Zelluläre Immuntherapien mit hochaufgereinigten allogenen NK-Zellen sind eine mögliche Therapieoption um den GvL/T-Effekt nach haploidenter SZT bei pädiatrischen Hochrisikopatienten mit malignen Erkrankungen zu verstärken. Im Rahmen der in Frankfurt a. M. laufenden klinischen Phase I/II NK-Zell-Studie wurden 16 pädiatrische Patienten sowohl mit unstimulierten (NK-DLI(unstim), 9 Patienten) als auch mit zehn Tage ex vivo IL-2 (1000 U/ml) stimulierten Spender-NK-Zellen (NK DLI(IL-2 stim), 9 Patienten) an den Tagen (+3), +40 und +100 nach haploidenter SZT behandelt. Bisher gibt es kaum Daten über den Verbleib der transfundierten Zellen und den Einfluss der NK-DLI Immuntherapie auf sowohl zelluläre als auch humorale Komponenten des Immunsystems der Patienten. Da die Patienten zudem nach haploidenter SZT zur GvHD-Prophylaxe das immunsuppressive Medikament Mycophenolat-Mofetil (MMF) erhalten, sind Untersuchungen zum Einfluss von MMF auf die Funktionalität der Spender-NK-Zellen von großem Interesse. In der vorliegenden Arbeit wurde mit Hilfe eines studienbegleitenden, nichtinvasiven in vivo Immunmonitorings erstmalig ein unterschiedlicher Einfluss von NK-DLI(unstim) im Vergleich zu NK-DLI(IL-2 stim) auf zelluläre Bestandteile und auf die Zytokin/Chemokin-Spiegel des peripheren Blutes der Patienten vor und 10 min, 1 h, 4 h und 24 h nach der Zelltherapie beschrieben. Mittels durchflusszytometrischen single platform Analysen konnten sowohl Spender-NK-Zellen als auch patienteneigene NK-Zellen phänotypisch und funktionell charakterisiert und unterschieden werden. So wurden neben einer gesteigerten zytotoxischen Aktivität IL-2 stimulierter NK-Zellen auch Unterschiede hinsichtlich der Expression des Oberflächenmoleküls CD56, des Aktivierungsmarkers CD69, des Natürlichen Zytotoxizitäts-Rezeptors (NCR) NKp44 und des Lymphknoten Homing Moleküls CD62L beobachtet. Des Weiteren führte die Applikation von NK-DLI(IL-2 stim) zu einer signifikanten Zellmigration in der peripheren Blutzirkulation der Patienten. Während sich die Zahl der neutrophilen Granulozyten innerhalb von 4 h im peripheren Blut vervierfachte wurde unmittelbar 10 min nach NK-DLI(IL-2 stim) ein massiver Zellverlust von eosinophilen Granulozyten, Monozyten, dendritischen Zellen und vor allem der NK-Zellen beobachtet. Eine ausgeprägtere Reduktion der immunregulatorischen CD56(bright)CD16(dim/-) NK-Zellen hatte zudem eine Verschiebung in der prozentualen Verteilung der NK-Zell-Subpopulationen zur Folge. In den folgenden 24 h normalisierten sich alle Zellzahlen wieder zu den Werten vor NK-DLI. Anhand der beschriebenen phänotypischen Unterscheidungsmerkmale konnte gezeigt werden, dass dabei nur patienteneigene NK-Zellen in die periphere Blutbahn zurückkehrten. Die Zellmigration war zudem in vivo von einem signifikanten Anstieg der proinflammatorisch- und chemotaktisch-wirkenden Zytokine/Chemokine IL-2, IL-6, IL-8, IFN-γ, MCP-1 und MIP-1β im peripheren Blut der Patienten 10 min nach NK-DLI(IL-2 stim) Applikation begleitet. Die Applikationen von NK-DLI(unstim) zeigten im Gegensatz dazu keine vergleichbaren Effekte. Ein weiteres Ziel dieser Arbeit war herauszufinden, ob eine Therapie mit dem Immunsuppressivum MMF nach haploidenter SZT die Funktionalität dieser hochaktivierten Spender-NK-Zellen beeinträchtigt und somit die Effektivität der Immuntherapie gefährdet. Es konnten Einschränkungen in der ex vivo Funktionalität der NK-Zellen durch therapeutisch relevante Konzentrationen (1 bis 10 µM) des aktiven Metaboliten Mycophenolsäure (MPA) gezeigt werden. Die MPA-Inkubation führte zu einer dosisabhängigen aber reversiblen Inhibition der IL-2 bedingten ex vivo NK-Zell-Proliferation. Auch die während des ex vivo Expansionsprozesses induzierte Zytokin/Chemokin-Sekretion wurde signifikant gehemmt. Eine 24-stündige MPA-Inkubation der IL-2 stimulierten NK-Zellen führte zudem zu einer eingeschränkten Mobilität der NK-Zellen. Dies korrelierte mit einer signifikant reduzierten zytotoxischen Aktivität gegen K-562 Tumorzellen, was jedoch nicht mit einer Oberflächenreduktion der NCRs und des NKG2D Rezeptors assoziiert war. Auch die durch die IL-2 Stimulation verursachte Hochregulierung der in Aktivierung und Migration involvierten Oberflächenmoleküle CD25, LFA-1, ICAM-1, CCR5, CXCR7, DNAM-1 und CD62L wurde durch MPA inhibiert. Im Gegensatz dazu hatte eine 24-stündige oder 4-tägige MPA-Behandlung bereits vorstimulierter NK-Zellen keinen Einfluss. Zudem konnte im Rahmen dieser Arbeit erstmalig gezeigt werden, dass die IL-2 induzierte intrazelluläre Signaltransduktion durch MPA beeinflusst wird. Dies äußerte sich in einer partiell bis vollständig inhibierten Phosphorylierung zentraler Signalmoleküle wie STAT-3, -4 und -5, der MAP-Kinase ERK1/2 und der Proteinkinase AKT. Dadurch wurden die durch IL-2 geförderten Zellprozesse wie das Überleben, die Proliferation und die zytotoxische Aktivität der NK-Zellen drastisch gehemmt. Dies steht vermutlich im Zusammenhang mit einer reduzierten Expression der IL-2R Untereinheit (CD25), wodurch die Ausbildung des hochaffinen IL-2-Rezeptors auf der Zelloberfläche verhindert wurde. Demzufolge scheint die eingeschränkte NK-Zell-Effektorfunktion Ursache einer durch MPA gestörten IL-2 Signaltransduktion zu sein. Zusammenfassend scheinen NK-DLI(IL-2 stim) durch die gesteigerte Zytotoxizität, die geringere Sensitivität gegenüber der MPA-Exposition sowie durch die mutmaßliche Extravasation der stimulierten NK-Zellen aus der peripheren Blutbahn einen Vorteil gegenüber NK-DLI(unstim) zu haben. Ob dies auch in einer Steigerung der Effektivität der Immuntherapie resultiert und damit die Prognose der Patienten verbessert werden kann, werden jedoch erst zukünftige Studien mit größeren Patientenkohorten abschließend zeigen können

Gene expression of tendon markers in mesenchymal stromal cells derived from different sources

Background: Multipotent mesenchymal stromal cells (MSC) can be recovered from a variety of tissues in the body. Yet, their functional properties were shown to vary depending on tissue origin. While MSC have emerged as a favoured cell type for tendon regenerative therapies, very little is known about the influence of the MSC source on their properties relevant to tendon regeneration. The aim of this study was to assess and compare the expression of tendon extracellular matrix proteins and tendon differentiation markers in MSC derived from different sources as well as in native tendon tissue. MSC isolated from equine bone marrow, adipose tissue, umbilical cord tissue, umbilical cord blood and tendon tissue were characterized and then subjected to mRNA analysis by real-time polymerase chain reaction. Results: MSC derived from adipose tissue displayed the highest expression of collagen 1A2, collagen 3A1 and decorin compared to MSC from all other sources and native tendon tissue (p < 0.01). Tenascin-C and scleraxis expressions were highest in MSC derived from cord blood compared to MSC derived from other sources, though both tenascin-C and scleraxis were expressed at significantly lower levels in all MSC compared to native tendon tissue (p < 0.01). Conclusions: These findings demonstrate that the MSC source impacts the cell properties relevant to tendon regeneration. Adipose derived MSC might be superior regarding their potential to positively influence tendon matrix reorganization

Establishment and application of unbiased in vitro drug screening assays for the identification of compounds against Echinococcus granulosus sensu stricto.

Echinococcus multilocularis and E. granulosus s.l. are the causative agents of alveolar and cystic echinococcosis, respectively. Drug treatment options for these severe and neglected diseases are limited to benzimidazoles, which are not always efficacious, and adverse side effects are reported. Thus, novel and improved treatments are needed. In this study, the previously established platform for E. multilocularis in vitro drug assessment was adapted to E. granulosus s.s. In a first step, in vitro culture protocols for E. granulosus s.s. were established. This resulted in the generation of large amounts of E. granulosus s.s. metacestode vesicles as well as germinal layer (GL) cells. In vitro culture of these cells formed metacestode vesicles displaying structural characteristics of metacestode cysts generated in vivo. Next, drug susceptibilities of E. multilocularis and E. granulosus s.s. protoscoleces, metacestode vesicles and GL cells were comparatively assessed employing established assays including (i) metacestode vesicle damage marker release assay, (ii) metacestode vesicle viability assay, (iii) GL cell viability assay, and (iv) protoscolex motility assay. The standard drugs albendazole, buparvaquone, mefloquine, MMV665807, monepantel, niclosamide and nitazoxanide were included. MMV665807, niclosamide and nitazoxanide were active against the parasite in all four assays against both species. MMV665807 and monepantel were significantly more active against E. multilocularis metacestode vesicles, while albendazole and nitazoxanide were significantly more active against E. multilocularis GL cells. Albendazole displayed activity against E. multilocularis GL cells, but no effects were seen in albendazole-treated E. granulosus s.s. GL cells within five days. Treatment of protoscoleces with albendazole and monepantel had no impact on motility. Similar results were observed for both species with praziquantel and its enantiomers against protoscoleces. In conclusion, in vitro culture techniques and drug screening methods previously established for E. multilocularis were successfully implemented for E. granulosus s.s., allowing comparisons of drug efficacy between the two species. This study provides in vitro culture techniques for the reliable generation of E. granulosus s.s. metacestode vesicles and GL cell cultures and describes the validation of standardized in vitro drug screening methods for E. granulosus s.s

Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy

Background Development of incisional complications following ventral median celiotomy might depend on suture pattern for skin closure. Methods In this prospective study, 21 healthy male horses underwent celiotomy. Skin closure was either performed via a continuous percutaneous pattern (CO group; 5 warmbloods/5 ponies) or an intradermal pattern (ID group; 5 warmbloods/6 ponies). Follow-up examination of the incisional site included daily monitoring for edema, dehiscence, and drainage. Transcutaneous ultrasound was performed at Days 3, 6, and 10 as well as on Week 8 and 12 to evaluate size of edema and presence or absence of sinus formation, and hernia formation. Prevalence of incisional infection on base of positive microbiological analysis at any time up to Day 10 was evaluated and compared between ID and CO group. Furthermore, edema size was analysed by a linear mixed-effect model for group and time dependency. Results Observed incisional complications included edema (9/10 in CO, 10/11 in ID), suture sinus formation (2/10 in CO, 1/11 in ID), surgical site infection (2/10 in CO, 0/11 in ID), and incisional hernia (1/10 in CO, 0/11 in ID). The overall prevalence of incisional infection was 9.5% without significant differences between both groups (20% in CO, 0% in ID; p = 0.214). Edema size was not dependent on time or group (p = 0.545 and p = 0.627, respectively). Discussion CO and ID suture pattern are appropriate for skin closure following ventral median celiotomy in horses. None of the animals in the continuous ID group developed surgical site infections, even without the use of antibiotics

In Vivo Magic Angle Magnetic Resonance Imaging for Cell Tracking in Equine Low-Field MRI.

The magic angle effect increases the MRI signal of healthy tendon tissue and could be used for more detailed evaluation of tendon structure. Furthermore, it could support the discrimination of hypointense artefacts induced by contrast agents such as superparamagnetic iron oxide used for cell tracking. However, magic angle MRI of the equine superficial digital flexor tendon has not been accomplished in vivo in standing low-field MRI so far. The aim of this in vivo study was to evaluate the practicability of this magic angle technique and its benefit for tracking superparamagnetic iron oxide-labelled multipotent mesenchymal stromal cells. Six horses with induced tendinopathy in their forelimb superficial digital flexor tendons were injected locally either with superparamagnetic iron oxide-labelled multipotent mesenchymal stromal cells or serum. MRI included standard and magic angle image series in T1- and T2∗-weighted sequences performed at regular intervals. Image analysis comprised blinded evaluation and quantitative assessment of signal-to-noise ratio. The magic angle technique enhanced the tendon signal-to-noise ratio (P < 0.001). Hypointense artefacts were observable in the cell-injected superficial digital flexor tendons over 24 weeks and artefact signal-to-noise ratio differed significantly from tendon signal-to-noise ratio in the magic angle images (P < 0.001). Magic angle imaging of the equine superficial digital flexor tendon is feasible in standing low-field MRI. The current data demonstrate that the technique improves discrimination of superparamagnetic iron oxide-induced artefacts from the surrounding tendon tissue.Peer Reviewe

IL-2 Stimulated but Not Unstimulated NK Cells Induce Selective Disappearance of Peripheral Blood Cells: Concomitant Results to a Phase I/II Study

In an ongoing clinical phase I/II study, 16 pediatric patients suffering from high risk leukemia/tumors received highly purified donor natural killer (NK) cell immunotherapy (NK-DLI) at day (+3) +40 and +100 post haploidentical stem cell transplantation. However, literature about the influence of NK-DLI on recipient's immune system is scarce. Here we present concomitant results of a noninvasive in vivo monitoring approach of recipient's peripheral blood (PB) cells after transfer of either unstimulated (NK-DLI(unstim)) or IL-2 (1000 U/ml, 9–14 days) activated NK cells (NK-DLI(IL-2 stim)) along with their ex vivo secreted cytokine/chemokines. We performed phenotypical and functional characterizations of the NK-DLIs, detailed flow cytometric analyses of various PB cells and comprehensive cytokine/chemokine arrays before and after NK-DLI. Patients of both groups were comparable with regard to remission status, immune reconstitution, donor chimerism, KIR mismatching, stem cell and NK-DLI dose. Only after NK-DLI(IL-2 stim) was a rapid, almost complete loss of CD56(bright)CD16(dim/−) immune regulatory and CD56(dim)CD16(+) cytotoxic NK cells, monocytes, dendritic cells and eosinophils from PB circulation seen 10 min after infusion, while neutrophils significantly increased. The reduction of NK cells was due to both, a decrease in patients' own CD69(−) NCR(low)CD62L(+) NK cells as well as to a diminishing of the transferred cells from the NK-DLI(IL-2 stim) with the CD56(bright)CD16(+/−)CD69(+)NCR(high)CD62L(−) phenotype. All cell counts recovered within the next 24 h. Transfer of NK-DLI(IL-2 stim) translated into significantly increased levels of various cytokines/chemokines (i.e. IFN-γ, IL-6, MIP-1β) in patients' PB. Those remained stable for at least 1 h, presumably leading to endothelial activation, leukocyte adhesion and/or extravasation. In contrast, NK-DLI(unstim) did not cause any of the observed effects. In conclusion, we assume that the adoptive transfer of NK-DLI(IL-2 stim) under the influence of ex vivo and in vivo secreted cytokines/chemokines may promote NK cell trafficking and therefore might enhance efficacy of immunotherapy

FMD vaccine matching: Inter laboratory study for improved understanding of r1 values

Foot-and-mouth disease virus (FMDV) is a highly variable RNA virus existing as seven different serotypes. The antigenic variability between and within serotypes can limit the cross-reactivity and therefore the in vivo cross-protection of vaccines. Selection of appropriate vaccine strains is crucial in the control of FMD. Determination of indirect relationships (r1-value) between potential vaccine strains and field strains based on antibody responses against both are routinely used for vaccine matching purposes. Aiming at the investigation of the repeatability, reproducibility and comparability of r1-value determination within and between laboratories and serological tests, a small scale vaccine matching ring test for FMDV serotype A was organized. Well-characterized serum pools from cattle vaccinated with a monovalent A24/Cruzeiro/Brazil/55 (A24) FMD vaccine with known in vivo protection status (homologous and heterologous) were distributed to four laboratories to determine r1-values for the heterologous FMD strains A81/Argentina/87, A/Argentina/2000 and A/Argentina/2001 using the virus neutralization tests (VNT) and liquid phase blocking ELISA (LPBE). Within laboratories, the repeatability of r1-value determination was high for both antibody assays. VNT resulted in reproducible and comparable r1-values between laboratories, indicative of a lack of antigenic relatedness between the A24 strain and the heterologous strains tested in this work, thus corresponding to some of the in vivo findings with these strains. Using LPBE, similar trends in r1-values were observed in all laboratories, but the overall reproducibility was lower than with VNT. Inconsistencies between laboratories may at least in part be attributed to differences in LPBE protocols as well as the in preexisting information generated in each laboratory (such as antibody titer-protection correlation curves). To gain more insight in the LPBE-derived r1-values standard bovine control sera were included in the antibody assays performed in each laboratory and a standardization exercise was performed.Fil: Willems, Tom. No especifíca;Fil: De Vleeschauwer, Annebel. No especifíca;Fil: Pérez Filgueira, Daniel Mariano. Instituto Nacional de Tecnologia Agropecuaria. Centro de Investigacion En Ciencias Veterinarias y Agronomicas. Instituto de Virologia E Innovaciones Tecnologicas. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Pque. Centenario. Instituto de Virologia E Innovaciones Tecnologicas.; ArgentinaFil: Li, Yanmin. No especifíca;Fil: Ludi, Anna. No especifíca;Fil: Lefebvre, David. No especifíca;Fil: Wilsden, Ginette. No especifíca;Fil: Statham, Bob. No especifíca;Fil: Haas, Bernd. Federal Research Institute for Animal Health; AlemaniaFil: Mattion, Nora Marta. Ministerio de Produccion y Trabajo. Secretaria de Gobierno de Agroindustria. Servicio Nacional de Sanidad y Calidad Agroalimentaria. Centro de Virologia Animal. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Ciudad Universitaria. Centro de Virologia Animal.; ArgentinaFil: Robiolo, Blanca. Ministerio de Produccion y Trabajo. Secretaria de Gobierno de Agroindustria. Servicio Nacional de Sanidad y Calidad Agroalimentaria. Centro de Virologia Animal. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Ciudad Universitaria. Centro de Virologia Animal.; ArgentinaFil: Beascoechea Perez, Claudia. Ministerio de Agricultura, Ganadería, Pesca y Alimento. Servicio Nacional de Sanidad y Calidad Agroalimentaria; ArgentinaFil: Maradei, Eduardo. Ministerio de Agricultura, Ganadería, Pesca y Alimento. Servicio Nacional de Sanidad y Calidad Agroalimentaria; ArgentinaFil: Smitsaart, Eliana. Biogénesis Bagó; ArgentinaFil: la Torre, Jose Leonardo. Ministerio de Produccion y Trabajo. Secretaria de Gobierno de Agroindustria. Servicio Nacional de Sanidad y Calidad Agroalimentaria. Centro de Virologia Animal. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Ciudad Universitaria. Centro de Virologia Animal.; ArgentinaFil: De Clercq, Kris. No especifíca

NF-Y Dependent Epigenetic Modifications Discriminate between Proliferating and Postmitotic Tissue

The regulation of gene transcription requires posttranslational modifications of histones that, in concert with chromatin remodeling factors, shape the structure of chromatin. It is currently under intense investigation how this structure is modulated, in particular in the context of proliferation and differentiation. Compelling evidence suggests that the transcription factor NF-Y acts as a master regulator of cell cycle progression, activating the transcription of many cell cycle regulatory genes. However, the underlying molecular mechanisms are not yet completely understood. Here we show that NF-Y exerts its effect on transcription through the modulation of the histone “code”. NF-Y colocalizes with nascent RNA, while RNA polymerase II is I phosphorylated on serine 2 of the YSPTSPS repeats within its carboxyterminal domain and histones are carrying modifications that represent activation signals of gene expression (H3K9ac and PAN-H4ac). Comparing postmitotic muscle tissue from normal mice and proliferating muscles from mdx mice, we demonstrate by chromatin immunoprecipitation (ChIP) that NF-Y DNA binding activity correlates with the accumulation of acetylated histones H3 and H4 on promoters of key cell cycle regulatory genes, and with their active transcription. Accordingly, p300 is recruited onto the chromatin of NF-Y target genes in a NF-Y-dependent manner, as demonstrated by Re-ChIP. Conversely, the loss of NF-Y binding correlates with a decrease of acetylated histones, the recruitment of HDAC1, and a repressed heterochromatic state with enrichment of histones carrying modifications known to mediate silencing of gene expression (H3K9me3, H3K27me2 and H4K20me3). As a consequence, NF-Y target genes are downregulated in this context. In conclusion, our data indicate a role of NF-Y in modulating the structure and transcriptional competence of chromatin in vivo and support a model in which NF-Y-dependent histone “code” changes contribute to the proper discrimination between proliferating and postmitotic cells in vivo and in vitro

Histone hyperacetylation induced by histone deacetylase inhibitors is not sufficient to cause growth inhibition in human dermal fibroblasts

Use of specific histone deacetylase inhibitors has revealed critical roles for the histone deacetylases (HDAC) in controlling proliferation. Although many studies have correlated the function of HDAC inhibitors with the hyperacetylation of histones, few studies have specifically addressed whether the accumulation of acetylated histones, caused by HDAC inhibitor treatment, is responsible for growth inhibition. In the present study we show that HDAC inhibitors cause growth inhibition in normal and transformed keratinocytes but not in normal dermal fibroblasts, This was despite the observation that the HDAC inhibitor, suberic bishydroxamate (SBHA), caused a kinetically similar accumulation of hyperacetylated histones, This cell type-specific response to SBHA was not due to the inactivation of SBHA by fibroblasts, nor was it due to differences in the expression of specific HDAC family members. Remarkably, overexpression of HDACs 1, 4, and 6 in normal human fibroblasts resulted in cells that could be growth-inhibited by SBHA. These data suggest that, although histone acetylation is a major target for HDAC inhibitors, the accumulation of hyperacetylated histones is not sufficient to cause growth inhibition in all cell types, This suggests that growth inhibition, caused by HDAC inhibitors, may be the culmination of histone hyperacetylation acting in concert with other growth regulatory pathways