Progressive multifocal leukoencephalopathy in a patient post allo-HCT successfully treated with JC virus specific donor lymphocytes

Background: Progressive multifocal leukoencephalopathy is a demyelinating CNS disorder. Reactivation of John Cunningham virus leads to oligodendrocyte infection with lysis and consequent axonal loss due to demyelination. Patients usually present with confusion and seizures. Late diagnosis and lack of adequate therapy options persistently result in permanent impairment of brain functions. Due to profound T cell depletion, impairment of T-cell function and potent immunosuppressive factors, allogeneic hematopoietic cell transplantation recipients are at high risk for JCV reactivation. To date, PML is almost universally fatal when occurring after allo-HCT. Methods: To optimize therapy specificity, we enriched JCV specific T-cells out of the donor T-cell repertoire from the HLA-identical, anti-JCV-antibody positive family stem cell donor by unstimulated peripheral apheresis [1]. For this, we selected T cells responsive to five JCV peptide libraries via the Cytokine Capture System technology. It enables the enrichment of JCV specific T cells via identification of stimulus-induced interferon gamma secretion. Results: Despite low frequencies of responsive T cells, we succeeded in generating a product containing 20 000 JCV reactive T cells ready for patient infusion. The adoptive cell transfer was performed without complication. Consequently, the clinical course stabilized and the patient slowly went into remission of PML with JCV negative CSF and containment of PML lesion expansion. Conclusion: We report for the first time feasibility of generating T cells with possible anti-JCV activity from a seropositive family donor, a variation of virus specific T-cell therapies suitable for the post allo transplant setting. We also present the unusual case for successful treatment of PML after allo-HCT via virus specific T-cell therapy

Human Cytomegalovirus Impairs the Function of Plasmacytoid Dendritic Cells in Lymphoid Organs

Human dendritic cells (DCs) are the main antigen presenting cells (APC) and can be divided into two main populations, myeloid and plasmacytoid DCs (pDCs), the latter being the main producers of Type I Interferon. The vast majority of pDCs can be found in lymphoid organs, where the main pool of all immune cells is located, but a minority of pDCs also circulate in peripheral blood. Human cytomegalovirus (HCMV) employs multiple mechanisms to evade the immune system. In this study, we could show that pDCs obtained from lymphoid organs (tonsils) (tpDCs) and from blood (bpDCs) are different subpopulations in humans. Interestingly, these populations react in opposite manner to HCMV-infection. TpDCs were fully permissive for HCMV. Their IFN-α production and the expression of costimulatory and adhesion molecules were altered after infection. In contrast, in bpDCs HCMV replication was abrogated and the cells were activated with increased IFN-α production and upregulation of MHC class I, costimulatory, and adhesion molecules. HCMV-infection of both, tpDCs and bpDCs, led to a decreased T cell stimulation, probably mediated through a soluble factor produced by HCMV-infected pDCs. We propose that the HCMV-mediated impairment of tpDCs is a newly discovered mechanism selectively targeting the host's major population of pDCs residing in lymphoid organs

Targeted delivery of CD40L promotes restricted activation of antigen-presenting cells and induction of cancer cell death

Background: Stimulation of CD40 can augment anti-cancer T cell immune responses by triggering effective activation and maturation of antigen-presenting cells (APCs). Although CD40 agonists have clinical activity in humans, the associated systemic activation of the immune system triggers dose-limiting side-effects. Methods: To increase the tumor selectivity of CD40 agonist-based therapies, we developed an approach in which soluble trimeric CD40L (sCD40L) is genetically fused to tumor targeting antibody fragments, yielding scFv: CD40L fusion proteins. We hypothesized that scFv: CD40L fusion proteins would have reduced CD40 agonist activity similar to sCD40L but will be converted to a highly agonistic membrane CD40L-like form of CD40L upon anchoring to cell surface exposed antigen via the scFv domain. Results: Targeted delivery of CD40L to the carcinoma marker EpCAM on carcinoma cells induced dose-dependent paracrine maturation of DCs similar to 20-fold more effective than a non-targeted control scFv: CD40L fusion protein. Similarly, targeted delivery of CD40L to the B cell leukemia marker CD20 induced effective paracrine maturation of DCs. Of note, the CD20-selective delivery of CD40L also triggered loss of cell viability in certain B cell leukemic cell lines as a result of CD20-induced apoptosis. Conclusions: Targeted delivery of CD40L to cancer cells is a promising strategy that may help to trigger cancer-localized activation of CD40 and can be modified to exert additional anti-cancer activity via the targeting domain

Temperature dependence of collisional energy transfer in highly excited aromatics studied by classical trajectory calculations.

The temperature dependence of the gas-phase collisional relaxation of highly vibrationally excited aromatic molecules has been studied using large scale classical trajectory calculations. The investigations have focused on azulene collisions with different colliders (He, Ar and N-2) as well as pyrazine self-collisions providing the moments of energy transfer (Delta E) and (Delta E-2) in the temperature range 50-1500 K. The interaction well depth epsilon(eff)/k(B) is found to be the key factor controlling the observed T dependence of collisional energy transfer. Systems with a relatively deep interaction well (pyrazine + pyrazine, azulene + Ar, azulene + N-2) show a pronounced negative dependence of - (Delta E) when T 300-400 K) - when the temperature is well above epsilon(eff)/k(B) - all systems behave qualitatively similar, showing only a very weak, slightly negative T dependence, as long as one is still far away from thermal equilibrium

Collisional energy transfer of highly vibrationally excited toluene and pyrazine: Transition probabilities and relaxation pathways from KCSI experiments and trajectory calculations.

New experimental results for the collisional energy transfer of highly vibrationally excited toluene and pyrazine employing the method of "kinetically controlled selective ionization (KCSI)" are presented. By means of a master equation approach we determine complete and detailed collisional transition probabilities P(E',E) for energies up to 50 000 cm(-1). The same monoexponential representation P(E',E) proportional to exp[ - ((E - E')/alpha (1)(E))(Y)] (for E' less than or equal to E) with a parametric exponent Y in the argument and linearly energy dependent alpha (1)(E) = C-0 + C1E successfully used in our earlier investigation [T. Lenzer, K. Luther, K. Reihs and A. C. Symonds, J. Chem. Phys., 2000, 112, 4090] can reproduce the toluene and pyrazine results for the whole range of bath gases studied. The parameters Y, C-0 and C-1 of P(E',E) show a smooth increase with the size of the collider. An approximately linear energy dependence of the first moment of energy transfer [DeltaE] is observed for all bath gases. Literature data from infrared fluorescence (IRF) experiments in general show significantly smaller - [DeltaE] values outside the uncertainty limits of the KCSI results. It is shown that this can mainly be traced back to the critical dependence of the IRF data on small uncertainties in the calibration curve. Some of the trends with respect to the energy transfer efficiencies of different colliders observed in the KCSI experiments are easily rationalized on the basis of accompanying trajectory calculations on the deactivation of highly vibrationally excited pyrazine by n-propane and CO2. The negligible influence of the V-V relaxation channel in the pyrazine + CO2 system observed in earlier IR diode laser studies is confirmed