Patient-tailored adoptive immunotherapy with EBV-specific T cells from related and unrelated donors

BACKGROUND: Adoptive transfer of EBV-specific T cells can restore specific immunity in immunocompromised patients with EBV-associated complications. METHODS: We provide results of a personalized T-cell manufacturing program evaluating donor, patient, T-cell product and outcome data. Patient-tailored clinical-grade EBV-specific cytotoxic T-lymphocyte (EBV-CTL) products from stem cell donors (SCD), related third party donors (TPD) or unrelated TPD from the allogeneic T-cell donor registry (alloCELL) established at Hannover Medical School were manufactured by immunomagnetic selection using CliniMACS Plus or Prodigy device and EBV PepTivators EBNA-1 and Select. Consecutive manufacturing processes were evaluated and patient outcome and side effects were retrieved by retrospective chart analysis. RESULTS: Forty clinical-grade EBV-CTL products from SCDs, related or unrelated TPDs were generated for 37 patients with and without transplantation (Tx) history within 5 days (median) after donor identification. 34 patients received 1-14 EBV-CTL products (fresh and cryopreserved). EBV-CTL transfer led to complete response in 20 of 29 patients who were evaluated for clinical response. No infusion-related toxicity was reported. EBV-specific T cells in patients' blood were detectable in 16/18 monitored patients (89 %) after transfer and correlated with clinical response. CONCLUSION: In conclusion, personalized clinical-grade manufacturing of EBV-CTL products via immunomagnetic selection from SCD, related or unrelated TPD is feasible in a timely manner. Overall, EBV-CTL were clinically effective and well-tolerated. Our data suggest EBV-CTL as promising therapeutic approach for immunocompromised patients with refractory EBV-associated diseases beyond HSCT as well as patients with pre-existing organ dysfunction

Promoting system-level learning from project-level lessons. An analysis of donor-driven 'indirect' learning about EIA systems in Ghana and the Maldives

A growing number of low and middle income nations (LMCs) have adopted some sort of system for environmental impact assessment (EIA). However, generally many of these EIA systems are characterised by a low performance in terms of timely information dissemination, monitoring and enforcement after licencing. Donor actors (such as the World Bank) have attempted to contribute to a higher performance of EIA systems in LMCs by intervening at two levels: the project level (e.g. by providing scoping advice or EIS quality review) and the system level (e.g. by advising on EIA legislation or by capacity building). The aims of these interventions are environmental protection in concrete cases and enforcing the institutionalisation of environmental protection, respectively. Learning by actors involved is an important condition for realising these aims. A relatively underexplored form of learning concerns learning at EIA system-level via project level donor interventions. This ‘indirect’ learning potentially results in system changes that better fit the specific context(s) and hence contribute to higher performances. Our exploratory research in Ghana and the Maldives shows that thus far, ‘indirect’ learning only occurs incidentally and that donors play a modest role in promoting it. Barriers to indirect learning are related to the institutional context rather than to individual characteristics. Moreover, ‘indirect’ learning seems to flourish best in large projects where donors achieved a position of influence that they can use to evoke reflection upon system malfunctions. In order to enhance learning at all levels donors should thereby present the outcomes of the intervention elaborately (i.e. discuss the outcomes with a large audience), include practical suggestions about post-EIS activities such as monitoring procedures and enforcement options and stimulate the use of their advisory reports to generate organisational memory and ensure a better information disseminatio

metal-dependent versatility of the oxidation state and related co oxidation performance of noble metal nanoparticles in interaction with ceria

SSCI-VIDE+ATARI:ECI2D:ING+LPI:TSN:FMO:GPOInternational audienceDue to its excellent redox properties, ceria is extensively used in heterogeneous catalysis, where it can act as an oxygen buffer in oxidation reactions or prevent coking of metal phases in hydrocarbon reforming reactions. In this work, ceria-supported platinum-group metal (Pt, Pd, Ir, Rh, Ru) nanoparticles were prepared in a single step by solution combustion synthesis, a simple and inexpensive method favoring metal-oxide interaction and thermal stability [1-3]. The powders were characterized by a variety of techniques (HRTEM, SEM, XRD, XPS, Raman spectroscopy, etc.) and systematically compared for CO oxidation and preferential CO oxidation in excess of hydrogen (PROX) in a flow-fixed-bed reactor. Ceria-supported Rh and Pt appear as the most efficient catalysts in CO oxidation (CO:O2 = 2:2 mol% of 1 atm) and PROX (CO:O2:H2 = 2:2:48 mol%), respectively [3]. These two systems, as well as pristine ceria, were further selected for a comparative operando DRIFTS-MS study, with particular focus on the effect of CO+O2 conditions on the nature of the adsorbed species. Whereas the reaction starts above 150 °C on CeO2 and RhâCeO2, and does not depend on the state of the surface (i.e. pre-exposed to CO:O2 4:4 mol% or 7:1 mol% mixture), PtâCeO2 shows strong dependency on the initial state and substantial activity is achieved at much lower temperatures with the CO-rich feed. On the basis of IR data, this result was related to a change in Pt oxidation state via strong interaction with ceria [4].[1]T.S. Nguyen et al., J. Mater. Chem. A 2, 19822 (2014).[2]G. Postole et al., Appl. Catal. B 166-167, 580 (2015).[3]T.S. Nguyen et al., Catal. Today 253, 106 (2015).[4]A. Kaftan et al., Catal. Sci. Technol., in press (DOI: 10.1039/c5cy00827a

The influence of actor capacities on EIA system performance in low and middle income countries -Cases from Georgia and Ghana

In this paper, we aim to better understand the factors that contribute to the substantive performance of EIA systems in low and middle income countries. Substantive performance is defined as the extent to which the EIA process contributes to the EIA objectives for the long term, namely environmental protection or, even more ambitious, sustainable development. We have therefore developed a conceptual model in which we focus on the key actors in the EIA system, the proponent and the EIA authority and their level of ownership as a key capacity to measure their performance, and we distinguish procedural performance and some contextual factors. This conceptual model is then verified and refined for the EIA phase and the EIA follow-up phase (permitting, monitoring and enforcement) by means of 12 case studies from Ghana (four cases) and Georgia (eight cases), both lower-middle income countries. We observe that in most cases the level of substantive performance increases during the EIA phase but drops during the EIA follow-up phase, and as a result only five out of 12 operational cases are in compliance with permit conditions or national environmental standards. We conclude, firstly that ownership of the proponent is the most important factor explaining the level of substantive performance; the higher the proponent's level of ownership the higher the level of substantive performance. The influence of the EIA authority on substantive performance is limited. Secondly, the influence of procedural performance on substantive performance seems less important than expected in the EIA phase but more important during the EIA follow-up phase.In order to improve substantive performance we learned two lessons. Firstly, increasing the proponent's level of ownership seems obvious, but direct change is probably difficult. However, where international finance institutes are involved they can increase ownership. Despite the limited influence of the EIA authority, a proactive strategy of, for example, working together with international finance institutes has a slightly larger influence than a reactive strategy

Inhibition of Heme Oxygenase-1 Activity Enhances Wilms Tumor-1-Specific T-Cell Responses in Cancer Immunotherapy

Wilms tumor protein-1 (WT1) is an attractive target for adoptive T-cell therapy due to its expression in solid tumors and hematologic malignancies. However, T cells recognizing WT1 occur in low frequencies in the peripheral blood of healthy donors, limiting potential therapeutic possibilities. Tin mesoporphyrin (SnMP) is known to inhibit heme oxygenase-1 (HO-1), which has been shown to boost the activation and proliferation of human virus-specific T cells. We analyzed the influence of this effect on the generation of WT1-specific T cells and developed strategies for generating quantities of these cells from healthy donors, sufficient for adoptive T-cell therapies. HO-1 inhibition with SnMP increased WT1-specific T-cell frequencies in 13 (26%) of 50 healthy donors. To assess clinical applicability, we measured the enrichment efficiency of SnMP-treated WT1-specific T cells in response to a WT1-specific peptide pool and a HLA-A*02:01-restricted WT1 peptide by cytokine secretion assay. SnMP treatment resulted in a 28-fold higher enrichment efficacy with equal functionality. In conclusion, pharmacological inhibition of HO-1 activity with SnMP results in more efficient generation of functionally active WT1-specific T cells. This study demonstrates the therapeutic potentials of inhibiting HO-1 with SnMP to enhance antigen-specific T-cell responses in the treatment of cancer patients with WT1-positive disease

Plerixafor combined with standard regimens for hematopoietic stem cell mobilization in pediatric patients with solid tumors eligible for autologous transplants: two-arm phase I/II study (MOZAIC).

This study (NCT01288573) investigated plerixafor's safety and efficacy in children with cancer. Stage 1 investigated the dosage, pharmacokinetics (PK), pharmacodynamics (PD), and safety of plerixafor + standard mobilization (G-CSF ± chemotherapy). The stage 2 primary endpoint was successful mobilization (doubling of peripheral blood CD34+ cell count in the 24 h prior to first apheresis) in patients treated with plerixafor + standard mobilization vs. standard mobilization alone. In stage 1, three patients per age group (2-<6, 6-<12, and 12-<18 years) were treated at each dose level (160, 240, and 320 µg/kg). Based on PK and PD data, the dose proposed for stage 2 was 240 µg/kg (patients 1-<18 years), in which 45 patients were enrolled (30 plerixafor arm, 15 standard arm). Patient demographics and characteristics were well balanced across treatment arms. More patients in the plerixafor arm (24/30, 80%) met the primary endpoint of successful mobilization than in the standard arm (4/14, 28.6%, p = 0.0019). Adverse events reported as related to study treatment were mild, and no new safety concerns were identified. Plerixafor + standard G-CSF ± chemotherapy mobilization was generally well tolerated and efficacious when used to mobilize CD34+ cells in pediatric cancer patients

Dissecting Epstein-Barr virus-specific T-cell responses after allogeneic EBV-specific T-cell transfer for central nervous system posttransplant lymphoproliferative disease

Epstein–Barr virus (EBV)-associated posttransplant lymphoproliferative disease (PTLD) with central nervous system (CNS) involvement is a severe complication after solid organ transplantation. Standard treatment with reduction of immunosuppression and anti-CD20 antibody application often fails leading to poor outcome. Here, we report the case of an 11-year-old boy with multilocular EBV-positive CNS PTLD 10 years after liver transplantation. Complete remission was achieved by repeated intravenous and intrathecal anti-CD20 antibody rituximab administration combined with intrathecal chemotherapy (methotrexate, cytarabine, prednisone) over a time period of 3 months. Due to the poor prognosis of CNS PTLD and lack of EBV-specific T-cells (EBV-CTLs) in patient’s blood, we decided to perform EBV-directed T-cell immunotherapy as a consolidating treatment. The patient received five infusions of allogeneic EBV-CTLs from a 5/10 HLA-matched unrelated third-party donor. No relevant acute toxicity was observed. EBV-CTLs became detectable after first injection and increased during the treatment course. Next-generation sequencing (NGS) TCR-profiling verified the persistence and expansion of donor-derived EBV-specific clones. After two transfers, epitope spreading to unrelated EBV antigens occurred suggesting onset of endogenous T-cell production, which was supported by detection of recipient-derived clones in NGS TCR-profiling. Continuous complete remission was confirmed 27 months after initial diagnosis