Les lymphomes primitifs oculo-cérébraux (diagnostic différentiel avec les uvéites et étude de l effet thérapeutique d un anticorps anti-CD20 et du CpG-DNA)

Les lymphomes primitifs du SNC (PCNSL : Primary Central Nervous System Lymphoma) sont génotypiquement associés aux lymphomes diffus à larges cellules B (DLBCL). Ce sont des affectations multifocales pouvant toucher les méninges, la moelle épinière mais plus fréquemment l œil et le cerveau. Le lymphome primaire de l œil (PIOL) et le lymphome primaire du cerveau (PCL) sont des atteintes agressives, avec un pronostic vital sombre, et sans thérapie spécifique. Malgré les avancées considérables découvertes sur la pathogenèse de ces atteintes, leur physiopathologie reste encore mal connue. Le diagnostic est aujourd hui basé sur les techniques modernes d imagerie et sur l étude des marqueurs moléculaires, cependant il reste parfois difficile, notamment pour le PIOL qui peut être considéré comme une pseudo-uvéite . Par ailleurs, en dépit des progrès réalisés dans la thérapie de ces tumeurs (chimiothérapie, radiothérapie), le traitement actuel entraîne une grande toxicité et une rechute est notée en quelques années. En vue de définir de nouveaux biomarqueurs d orientation diagnostique précoce et en perspective d amélioration de la thérapie actuelle des lymphomes oculo-cérébraux, nous avons d abord identifié une nouvelle combinaison cytokinique (les ratios IL-10/IL-6 and IL-10/IFNg) différentielle du PIOL et de l uvéite, à partir de dosages moléculaires sur des échantillons de vitré et d humeur aqueuse. Par la suite, nous avons montré un effet thérapeutique d un nouvel anticorps anti-hCD20 optimisé, testé dans nos modèles murins de PIOL et de PCL, et un effet intéressant du CpG-DNA sur les cellules lymphomateuses B, dépendant de leur microenvironnement moléculaire.Primary central nervous system lymphoma (PCNSL) belongs to the systemic diffuse large B-cell lymphoma family. It can affect meninges as well as cranial, spinal, and peripheral nerves, but most frequently, it develops into the brain and/or eye. Primary cerebral lymphoma (PCL) and primary intraocular lymphoma (PIOL) are highly aggressive malignancies with a dark prognosis. Although the important advances founded from the pathogenesis of extraneural non-Hodgkin's lymphoma, the unique organotropism of PCL/PIOL remains poorly understood. Diagnosis now is facilitated by modern imaging techniques and molecular markers, but remains difficult in particular with PIOL as it is a uveitis masquerade syndrom . Moreover, in spite of remarkable progress through methotrexate-based chemotherapy, the majority of patients experience relapses within a few years. Better diagnostic tools are required for earlier diagnosis and monitoring of treatment response, and a deeper understanding of the pathogenesis of primary nervous system lymphoma may reveal new therapeutic targets. My PhD project was first to find new cytokine combinations as diagnostic and prognostic markers and then to explore new immunotherapeutic strategies on PIOL and PCL preclinical mouse models. Using vitreous and aqueous humor samples from French and Tunisian patients, we define a new highly discriminative combination of the IL-10/IL-6 and IL-10/IFNg ratios between PIOL and uveitis patients. Besides, we show an encouraging therapeutic effect of a novel glycoengineered anti-hCD20 antibody in PCL and PIOL murine lymphomas, and intriguing differences in B-cell lymphoma responsiveness to CpG.PARIS-BIUSJ-Biologie recherche (751052107) / SudocSudocFranceF

Bioluminescence-Based Tumor Quantification Method for Monitoring Tumor Progression and Treatment Effects in Mouse Lymphoma Models

Although bioluminescence imaging (BLI) shows promise for monitoring tumor burden in animal models of cancer, these analyses remain mostly qualitative. Here we describe a method for bioluminescence imaging to obtain a semi-quantitative analysis of tumor burden and treatment response. This method is based on the calculation of a luminoscore, a value that allows comparisons of two animals from the same or different experiments. Current BLI instruments enable the calculation of this luminoscore, which relies mainly on the acquisition conditions (back and front acquisitions) and the drawing of the region of interest (manual markup around the mouse). Using two previously described mouse lymphoma models based on cell engraftment, we show that the luminoscore method can serve as a noninvasive way to verify successful tumor cell inoculation, monitor tumor burden, and evaluate the effects of in situ cancer treatment (CpG-DNA). Finally, we show that this method suits different experimental designs. We suggest that this method be used for early estimates of treatment response in preclinical small-animal studies

Lymphoma B-cell responsiveness to CpG-DNA depends on the tumor microenvironment

International audienceToll-like receptor (TLR) agonists have important properties that can be exploited for immunotherapy against tumors. Locally injected immunostimulatory oligodeoxynucleotides containing CpG motifs (CpG-ODNs), which are TLR9 agonists, have shown promise in cancer models. Several studies have demonstrated that these motifs have immunologic effects similar to those of bacterial DNA and can stimulate monocytes, macrophages, dendritic, and B cells, which then produce several proinflammatory cytokines. However, these CpG-ODNs appear to produce opposite effects on tumor B cells. METHODS: In this study, we investigated the direct effects of a murine class B CpG (1826) ODNs on lymphoma B cells in vitro and in vivo, using mouse models of non-Hodgkin B lymphomas developing in immunoprivileged sites, specifically the brain and the eye, and in subcutaneous sites. RESULTS: In vitro, CpG-ODNs produced antiproliferative and proapoptotic effects on lymphoma B cells. In vivo, it had an antitumor effect when injected into tumors in murine models of subcutaneous lymphoma (SCL) and primary cerebral lymphoma (PCL). However, its intravitreal administration into a primary intraocular lymphoma (PIOL) mouse model did not produce an antitumor effect. In vitro experiments using supernatant from mouse PIOL samples demonstrated that the PIOL molecular microenvironment inhibits the antiproliferative effect of CpG-ODNs on lymphoma B-cells. CONCLUSIONS: Responsiveness to CpG stimulation differs in subcutaneous, cerebral, and ocular tumors, according to the tumoral and molecular microenvironment, and this should be considered for further therapeutic approaches

Enhanced Macrophage M1 Polarization and Resistance to Apoptosis Enable Resistance to Plague

International audienceBackground. Susceptibility to infection is in part genetically driven, and C57BL/6 mice resist various pathogens through the proinflammatory response of their M1 macrophages (MPs). However, they are susceptible to plague. It has been reported elsewhere that Mus spretus SEG mice resist plague and develop an immune response characterized by a strong recruitment of MPs. Methods. The responses of C57BL/6 and SEG MPs exposed to Yersinia pestis in vitro were examined. Results. SEG MPs exhibit a stronger bactericidal activity with higher nitric oxide production, a more proinflammatory polarized cytokine response, and a higher resistance to Y. pestis-induced apoptosis. This response was not specific to Y. pestis and involved a reduced sensitivity to M2 polarization/signal transducer and activator of transcription 6 activation and inhibition of caspase 8. The enhanced M1 profile was inducible in C57BL/6 MPs in vitro, and when transferred to susceptible C57BL/6 mice, these MPs significantly increased survival of bubonic plague. Conclusions. MPs can develop an enhanced functional profile beyond the prototypic M1, characterized by an even more potent proinflammatory response coordinated with resistance to killing. This programming plays a key role in the plague-resistance phenotype and may be similarly significant in other highly lethal infections, suggesting that orienting the MP response may represent a new therapeutic approach

Cytokine profile in human eyes: contribution of a new cytokine combination for differential diagnosis between intraocular lymphoma or uveitis.

Primary intraocular lymphoma (PIOL), also called primary vitreoretinal lymphomas, often masquerades as uveitis. This misdiagnosis can result in subsequent brain involvement and oculocerebral lymphoma (OCL). In this study, we sought to characterize the helper T-cell type 1 (Th1)/Th2 cytokine profile in vitreous samples from patients with PIOL, OCL, uveitis and controls with non-inflammatory disease. Vitreous and aqueous humor samples from 87 patients with PIOL (n = 30), OCL (n = 12), uveitis (n = 34), and retinal detachment (RD) without hemorrhage (n = 11) were analyzed and their concentrations of interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were determined by flow cytometric bead arrays (CBA). The IL-10 levels determined by CBA were compared with those by ELISA. IL-10 concentrations measured by CBA and ELISA were highly correlated. IL-2, IL-4, and TNFα were not detected in any sample. The only cytokine detected at a significant level in samples from RD vitreous was IL-6. The IL-10/IL-6 ratio, as previously reported, was slightly higher in PIOL than in uveitis samples, but not for all patients. Cytokine profiles from PIOL and OCL samples did not differ. The combination of the IL-10/IL-6 and IL-10/IFNγ ratios was highly informative for discriminating PIOL/OCL from uveitis samples and for therapeutic follow up of PIOL. This strategy might be very helpful as an initial screening to rule out PIOL in patients thought to have uveitis

Correlation of vitreal IL-10 concentrations measured by CBA and by ELISA.

<p>IL-10 concentration from 30 frozen vitreous samples (13 PIOL, 8 OCL and 9 uveitis patients) were analyzed at the same time. The horizontal and vertical dashed lines indicate the sensitivity thresholds for ELISA (8 pg/ml) and CBA (2.8 pg/ml), respectively.</p

Combination of the Logarithmic conversion of IL-10/IL-6 ratio and IL-10/IFNγ ratios for vitreous samples from PIOL, OCL and uveitis patients.

<p>The black triangles represent PIOL patients (n = 17), the gray diamonds OCL patients (n = 9), and the white squares the uveitis patients (n = 23).</p

Combination of the Logarithmic conversion of IL-10/IL-6 and IL-10/IFNγ ratios in aqueous humor samples from PIOL, OCL and uveitis patients.

<p>(A) The black triangles represent PIOL patients (n = 11), the gray diamonds OCL patients (n = 3), and the white squares uveitis patients (n = 11). Kinetics follow-up after intravitreous methotrexate treatment of a remitting patient (B) and of a patient undergoing an initial phase of remission and then a relapse (C). For (B) and (C) size and gray intensity of the marks are correlated to the dates of analyses; the large black circle is the first time-point. Relapse is represented by black diamonds.</p

Cytokine Profile in Human Eyes: Contribution of a New Cytokine Combination for Differential Diagnosis between Intraocular Lymphoma or Uveitis

Primary intraocular lymphoma (PIOL), also called primary vitreoretinal lymphomas, often masquerades as uveitis. This misdiagnosis can result in subsequent brain involvement and oculocerebral lymphoma (OCL). In this study, we sought to characterize the helper T-cell type 1 (Th1)/Th2 cytokine profile in vitreous samples from patients with PIOL, OCL, uveitis and controls with non-inflammatory disease. Vitreous and aqueous humor samples from 87 patients with PIOL (n = 30), OCL (n = 12), uveitis (n = 34), and retinal detachment (RD) without hemorrhage (n = 11) were analyzed and their concentrations of interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were determined by flow cytometric bead arrays (CBA). The IL-10 levels determined by CBA were compared with those by ELISA. IL-10 concentrations measured by CBA and ELISA were highly correlated. IL-2, IL-4, and TNFα were not detected in any sample. The only cytokine detected at a significant level in samples from RD vitreous was IL-6. The IL-10/IL-6 ratio, as previously reported, was slightly higher in PIOL than in uveitis samples, but not for all patients. Cytokine profiles from PIOL and OCL samples did not differ. The combination of the IL-10/IL-6 and IL-10/IFNγ ratios was highly informative for discriminating PIOL/OCL from uveitis samples and for therapeutic follow up of PIOL. This strategy might be very helpful as an initial screening to rule out PIOL in patients thought to have uveitis