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1.
Nature ; 578(7795): 397-402, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32076218

RESUMEN

Simultaneously optimizing many design parameters in time-consuming experiments causes bottlenecks in a broad range of scientific and engineering disciplines1,2. One such example is process and control optimization for lithium-ion batteries during materials selection, cell manufacturing and operation. A typical objective is to maximize battery lifetime; however, conducting even a single experiment to evaluate lifetime can take months to years3-5. Furthermore, both large parameter spaces and high sampling variability3,6,7 necessitate a large number of experiments. Hence, the key challenge is to reduce both the number and the duration of the experiments required. Here we develop and demonstrate a machine learning methodology  to efficiently optimize a parameter space specifying the current and voltage profiles of six-step, ten-minute fast-charging protocols for maximizing battery cycle life, which can alleviate range anxiety for electric-vehicle users8,9. We combine two key elements to reduce the optimization cost: an early-prediction model5, which reduces the time per experiment by predicting the final cycle life using data from the first few cycles, and a Bayesian optimization algorithm10,11, which reduces the number of experiments by balancing exploration and exploitation to efficiently probe the parameter space of charging protocols. Using this methodology, we rapidly identify high-cycle-life charging protocols among 224 candidates in 16 days (compared with over 500 days using exhaustive search without early prediction), and subsequently validate the accuracy and efficiency of our optimization approach. Our closed-loop methodology automatically incorporates feedback from past experiments to inform future decisions and can be generalized to other applications in battery design and, more broadly, other scientific domains that involve time-intensive experiments and multi-dimensional design spaces.

2.
PLoS Biol ; 18(6): e3000726, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32497046

RESUMEN

Why does poor-quality sleep lead to atherosclerosis? In a diverse sample of over 1,600 individuals, we describe a pathway wherein sleep fragmentation raises inflammatory-related white blood cell counts (neutrophils and monocytes), thereby increasing atherosclerosis severity, even when other common risk factors have been accounted for. Improving sleep quality may thus represent one preventive strategy for lowering inflammatory status and thus atherosclerosis risk, reinforcing public health policies focused on sleep health.


Asunto(s)
Vasos Sanguíneos/patología , Privación de Sueño/complicaciones , Actigrafía , Anciano , Aterosclerosis/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Índice de Severidad de la Enfermedad
3.
Nano Lett ; 19(8): 5140-5148, 2019 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-31322896

RESUMEN

The stability of modern lithium-ion batteries depends critically on an effective solid-electrolyte interphase (SEI), a passivation layer that forms on the carbonaceous negative electrode as a result of electrolyte reduction. However, a nanoscopic understanding of how the SEI evolves with battery aging remains limited due to the difficulty in characterizing the structural and chemical properties of this sensitive interphase. In this work, we image the SEI on carbon black negative electrodes using cryogenic transmission electron microscopy (cryo-TEM) and track its evolution during cycling. We find that a thin, primarily amorphous SEI nucleates on the first cycle, which further evolves into one of two distinct SEI morphologies upon further cycling: (1) a compact SEI, with a high concentration of inorganic components that effectively passivates the negative electrode; and (2) an extended SEI spanning hundreds of nanometers. This extended SEI grows on particles that lack a compact SEI and consists primarily of alkyl carbonates. The diversity in observed SEI morphologies suggests that SEI growth is a highly heterogeneous process. The simultaneous emergence of these distinct SEI morphologies highlights the necessity of effective passivation by the SEI, as large-scale extended SEI growths negatively impact lithium-ion transport, contribute to capacity loss, and may accelerate battery failure.

4.
Nat Mater ; 17(10): 915-922, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30224783

RESUMEN

Phase transformations driven by compositional change require mass flux across a phase boundary. In some anisotropic solids, however, the phase boundary moves along a non-conductive crystallographic direction. One such material is LiXFePO4, an electrode for lithium-ion batteries. With poor bulk ionic transport along the direction of phase separation, it is unclear how lithium migrates during phase transformations. Here, we show that lithium migrates along the solid/liquid interface without leaving the particle, whereby charge carriers do not cross the double layer. X-ray diffraction and microscopy experiments as well as ab initio molecular dynamics simulations show that organic solvent and water molecules promote this surface ion diffusion, effectively rendering LiXFePO4 a three-dimensional lithium-ion conductor. Phase-field simulations capture the effects of surface diffusion on phase transformation. Lowering surface diffusivity is crucial towards supressing phase separation. This work establishes fluid-enhanced surface diffusion as a key dial for tuning phase transformation in anisotropic solids.

5.
Alzheimers Dement ; 15(12): 1588-1602, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31677936

RESUMEN

INTRODUCTION: Multidomain intervention for Alzheimer's disease (AD) risk reduction is an emerging therapeutic paradigm. METHODS: Patients were prescribed individually tailored interventions (education/pharmacologic/nonpharmacologic) and rated on compliance. Normal cognition/subjective cognitive decline/preclinical AD was classified as Prevention. Mild cognitive impairment due to AD/mild-AD was classified as Early Treatment. Change from baseline to 18 months on the modified Alzheimer's Prevention Cognitive Composite (primary outcome) was compared against matched historical control cohorts. Cognitive aging composite (CogAging), AD/cardiovascular risk scales, and serum biomarkers were secondary outcomes. RESULTS: One hundred seventy-four were assigned interventions (age 25-86). Higher-compliance Prevention improved more than both historical cohorts (P = .0012, P < .0001). Lower-compliance Prevention also improved more than both historical cohorts (P = .0088, P < .0055). Higher-compliance Early Treatment improved more than lower compliance (P = .0007). Higher-compliance Early Treatment improved more than historical cohorts (P < .0001, P = .0428). Lower-compliance Early Treatment did not differ (P = .9820, P = .1115). Similar effects occurred for CogAging. AD/cardiovascular risk scales and serum biomarkers improved. DISCUSSION: Individualized multidomain interventions may improve cognition and reduce AD/cardiovascular risk scores in patients at-risk for AD dementia.


Asunto(s)
Enfermedad de Alzheimer/terapia , Disfunción Cognitiva/prevención & control , Educación en Salud , Cooperación del Paciente , Síntomas Prodrómicos , Conducta de Reducción del Riesgo , Anciano , Biomarcadores/sangre , Enfermedades Cardiovasculares , Cognición , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
7.
Data Brief ; 55: 110614, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39015254

RESUMEN

Battery technology is increasingly important for global electrification efforts. However, batteries are highly sensitive to small manufacturing variations that can induce reliability or safety issues. An important technology for battery quality control is computed tomography (CT) scanning, which is widely used for non-destructive 3D inspection across a variety of clinical and industrial applications. Historically, however, the utility of CT scanning for high-volume manufacturing has been limited by its low throughput as well as the difficulty of handling its large file sizes. In this work, we present a dataset of over one thousand CT scans of as-produced commercially available batteries. The dataset spans various chemistries (lithium-ion and sodium-ion) as well as various battery form factors (cylindrical, pouch, and prismatic). We evaluate seven different battery types in total. The manufacturing variability and the presence of battery defects can be observed via this dataset. This dataset may be of interest to scientists and engineers working on battery technology, computer vision, or both.

8.
ACS Nano ; 18(3): 2210-2218, 2024 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-38189239

RESUMEN

Mechanistic understanding of phase transformation dynamics during battery charging and discharging is crucial toward rationally improving intercalation electrodes. Most studies focus on constant-current conditions. However, in real battery operation, such as in electric vehicles during discharge, the current is rarely constant. In this work we study current pulsing in LiXFePO4 (LFP), a model and technologically important phase-transforming electrode. A current-pulse activation effect has been observed in LFP, which decreases the overpotential by up to ∼70% after a short, high-rate pulse. This effect persists for hours or even days. Using scanning transmission X-ray microscopy and operando X-ray diffraction, we link this long-lived activation effect to a pulse-induced electrode homogenization on both the intra- and interparticle length scales, i.e., within and between particles. Many-particle phase-field simulations explain how such pulse-induced homogeneity contributes to the decreased electrode overpotential. Specifically, we correlate the extent and duration of this activation to lithium surface diffusivity and the magnitude of the current pulse. This work directly links the transient electrode-level electrochemistry to the underlying phase transformation and explains the critical effect of current pulses on phase separation, with significant implication on both battery round-trip efficiency and cycle life. More broadly, the mechanisms revealed here likely extend to other phase-separating electrodes, such as graphite.

9.
Sci Eng Ethics ; 19(3): 1007-16, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23224702

RESUMEN

As rapid advances in nanotechnology are made, we must set guidelines to balance the interests of both human beneficiaries and the environment by combining nanoethics and environmental ethics. In this paper, I reject Leopoldian holism as a practical environmental ethic with which to gauge nanotechnologies because, as a nonanthropocentric ethic, it does not value the humans who will actually use the ethic. Weak anthropocentrism is suggested as a reasonable alternative to ethics without a substantial human interest, as it treats nonhuman interests as human interests. I also establish the precautionary principle as a useful situational guideline for decision makers. Finally, I examine existing and potential applications of nanotechnology, including water purification, agriculture, mining, energy, and pollutant removal, from the perspective of weak anthropocentrism using the precautionary principle.


Asunto(s)
Ambiente , Salud Ambiental , Nanotecnología/ética , Responsabilidad Social , Toma de Decisiones/ética , Guías como Asunto , Humanos , Industrias , Medición de Riesgo
10.
Artículo en Inglés | MEDLINE | ID: mdl-38370009

RESUMEN

Introduction: Opioid use disorder (OUD) and obesity are two pressing public health concerns in the United States (US). However, the relationship between these two epidemics has not been well-studied. Our study aims to describe the prevalence rates of obesity in individuals with OUD from a cohort study and compare that to the expected prevalence that would be observed based upon New Jersey state and US population survey data. Additionally, we sought to study whether Body Mass Index (BMI) distribution in this cohort varied by race/ethnicity, gender, and age. Methods: Our subjects (N=151) are part of a drug user cohort study of persons enrolled in medication-assisted treatment (MAT) programmes in New Jersey. Using the New Jersey Behavioral Risk Factor Survey (NJBRFS) and the National Health Interview Survey (NHIS), we generated expected BMI distributions based on race/ethnicity, age, and sex. Expected rates were compared to observed BMI. Standardized prevalence ratios were calculated, and 95% confidence intervals were constructed. Results: Among females, obesity was more prevalent in those with OUD than in the general US population. Among persons ≤50 years old, overweight and obesity were more prevalent in those with OUD than in NJBRFS. Persons who did not inject drugs were more likely to be overweight. The prevalence of underweight was significantly higher among Black non-Hispanic minorities, males, older subjects (aged 66-85), and persons who inject drugs. Conclusion: In our study, the trends in BMI vary based on race/ethnicity, gender and age in these patients with OUD. These varying trends highlight the need for tailored screening and prevention strategies. Primary care providers should be aware that their patients with OUD have multiple health problems that need to be addressed beyond their OUD condition itself. Providers are in a pivotal role to screen and implement interventions to improve their health outcomes.

11.
Front Aging Neurosci ; 10: 96, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29706884

RESUMEN

Alzheimer's disease (AD) is a neurodegenerative dementia that affects nearly 50 million people worldwide and is a major source of morbidity, mortality, and healthcare expenditure. While there have been many attempts to develop disease-modifying therapies for late-onset AD, none have so far shown efficacy in humans. However, the long latency between the initial neuronal changes and onset of symptoms, the ability to identify patients at risk based on family history and genetic markers, and the emergence of AD biomarkers for preclinical disease suggests that early risk-reducing interventions may be able to decrease the incidence of, delay or prevent AD. In this review, we discuss six mechanisms-dysregulation of glucose metabolism, inflammation, oxidative stress, trophic factor release, amyloid burden, and calcium toxicity-involved in AD pathogenesis that offer promising targets for risk-reducing interventions. In addition, we offer a blueprint for a multi-modality AD risk reduction program that can be clinically implemented with the current state of knowledge. Focused risk reduction aimed at particular pathological factors may transform AD to a preventable disorder in select cases.

12.
J Clin Oncol ; 23(25): 6043-53, 2005 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-16087944

RESUMEN

PURPOSE: Previously, we reported our experience treating 14 patients with metastatic melanoma using a fully human antibody to cytotoxic T-lymphocyte antigen-4 (anti-CTLA-4) in conjunction with peptide vaccination. We have now treated 56 patients to evaluate two different dose schedules of anti-CTLA-4 and to explore the relationship between autoimmunity and tumor regression. PATIENTS AND METHODS: A total of 56 patients with progressive stage IV melanoma were enrolled onto the study. All had Karnofsky performance status > or = 60% with no prior history of autoimmunity. Twenty-nine patients received 3 mg/kg anti-CTLA-4 every 3 weeks, whereas 27 received 3 mg/kg as their initial dose with subsequent doses reduced to 1 mg/kg every 3 weeks. In both cohorts patients received concomitant vaccination with two modified HLA-A*0201-restricted peptides from the gp100 melanoma-associated antigen, gp100:209-217(210M) and gp100:280-288(288V). RESULTS: Two patients achieved a complete response (ongoing at 30 and 31 months, respectively) and five patients achieved a partial response (durations of 4, 6, 25+, 26+, and 34+ months, respectively), for an overall objective response rate of 13%. Tumor regression was seen in lung, liver, brain, lymph nodes, and subcutaneous sites. Of 14 patients with grade 3/4 autoimmune toxicity, five (36%) experienced a clinical response compared with only two responses in the 42 patients (5%) with no autoimmune toxicity (P = .008). There were no significant differences in response rate or toxicity between the two dose schedules. CONCLUSION: Administration of anti-CTLA-4 monoclonal antibody plus peptide vaccination can cause durable objective responses, which correlate with the induction of autoimmunity, in patients with metastatic melanoma.


Asunto(s)
Antígenos de Diferenciación/inmunología , Autoinmunidad , Vacunas contra el Cáncer/inmunología , Vacunas contra el Cáncer/uso terapéutico , Inmunosupresores/inmunología , Melanoma/tratamiento farmacológico , Melanoma/inmunología , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/inmunología , Adulto , Anciano , Antígenos CD , Antígenos de Diferenciación/administración & dosificación , Antígeno CTLA-4 , Esquema de Medicación , Femenino , Humanos , Inmunosupresores/administración & dosificación , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Pronóstico , Resultado del Tratamiento
13.
Am J Clin Oncol ; 26(1): 42-5, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12576923

RESUMEN

Hypercalcemia associated with malignancy has been attributed to osteolytic processes secondary to bony metastases and to humoral factors causing increased bone resorption and decreased renal excretion of calcium. Parathyroid hormone-related protein (PTH-rP) is a humoral factor that has been associated with hypercalcemia in renal cell carcinoma, squamous cell carcinoma, and bladder carcinoma. Hypercalcemia does occur in patients with melanoma; however, few studies have reported on hypercalcemia in these patients, and even fewer have described a direct connection to PTH-rP. We here report a patient with stage IV malignant melanoma presenting with severe hypercalcemia associated with elevated PTH-rP levels. Immunohistochemistry showed strong expression of PTH-rP in biopsy of the patient's subcutaneous masses. In addition, we found a 4.9% incidence of hypercalcemia in 1,146 consecutive patients treated for metastatic melanoma at the Surgery Branch of the National Cancer Institute between January 1, 1988 and March 31, 2000. Thus, PTH-rP may play a significant role in severe hypercalcemia in patients with metastatic melanoma. The discovery of PTH-rP and relevant literature will also be reviewed.


Asunto(s)
Hipercalcemia/etiología , Melanoma/complicaciones , Melanoma/metabolismo , Melanoma/secundario , Hormona Paratiroidea/metabolismo , Adulto , Resultado Fatal , Femenino , Humanos , Hipercalcemia/sangre , Inmunohistoquímica , Inmunoterapia , Interleucina-2/uso terapéutico , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/terapia , Metástasis Linfática , Melanoma/patología , Melanoma/terapia , Hormona Paratiroidea/sangre , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapia , Neoplasias de la Columna Vertebral/secundario , Neoplasias de la Columna Vertebral/terapia
14.
J Immunother ; 31(2): 189-98, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18481388

RESUMEN

The regulation of tolerance to self-proteins and the suppression of T-cell responses have in part been attributed to the activity of CD25+CD4+ T regulatory (Treg) cells. Further, Treg cells can inhibit the antitumor effectiveness of adoptive immunotherapy and active immunization approaches in preclinical models. In an effort to selectively eliminate Treg cells from human peripheral blood mononuclear cell to potentially bolster antitumor responses, we have evaluated the Treg-cell depleting capacity of the CD25-directed immunotoxin, RFT5-SMPT-dgA. In preclinical studies, incubation of human peripheral blood mononuclear cell with RFT5-SMPT-dgA mediated a partial reduction in the levels of CD25+, Foxp3-expressing CD4+ T cells in vitro. Administration of RFT5-SMPT-dgA to 6 patients with metastatic melanoma induced a transient but robust reduction in the number of CD25high CD4 T cells in vivo (a 97.5% mean reduction at nadir; from 69.4 +/- 12.4 cells/miroL to 1.7 +/- 0.3 cells/microL). The reduction in FOXP3+ CD4 T-cell number was less comprehensive (a 71.3% mean reduction at nadir; from 66.6 +/- 16.5 cells/microL to 14.2 +/- 3.9 cells/tL). This resulted in the selective persistence of a stable number of CD25(low/neg) FOXP3+ CD4+ T cells in vivo. No objective antitumor responses were seen in any patient. Our results indicate that the CD25-directed, RFT5-SMPT-dgA immunotoxin can mediate a transient, partial reduction in Treg-cell frequency and number in vitro and in vivo and suggest that comprehensive eradication of human Treg cells in vivo may require the ability to target and eliminate FOXP3+ CD4+ T cells expressing both high and low levels of CD25.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Factores de Transcripción Forkhead/análisis , Subunidad alfa del Receptor de Interleucina-2/inmunología , Ricina/uso terapéutico , Linfocitos T Reguladores/efectos de los fármacos , Adulto , Anticuerpos/sangre , Anticuerpos/inmunología , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales/inmunología , Recuento de Linfocito CD4 , Linfocitos T CD8-positivos/química , Linfocitos T CD8-positivos/citología , Linfocitos T CD8-positivos/efectos de los fármacos , Recuento de Células , Femenino , Humanos , Inmunoconjugados , Inmunoterapia/efectos adversos , Inmunoterapia/métodos , Subunidad alfa del Receptor de Interleucina-2/análisis , Leucocitos Mononucleares/citología , Leucocitos Mononucleares/efectos de los fármacos , Recuento de Linfocitos , Depleción Linfocítica/métodos , Masculino , Melanoma/inmunología , Melanoma/patología , Melanoma/terapia , Persona de Mediana Edad , Metástasis de la Neoplasia , Ricina/administración & dosificación , Ricina/inmunología , Subgrupos de Linfocitos T/química , Subgrupos de Linfocitos T/citología , Subgrupos de Linfocitos T/efectos de los fármacos , Linfocitos T Reguladores/química , Linfocitos T Reguladores/citología , Resultado del Tratamiento
15.
J Immunother ; 29(2): 208-14, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16531821

RESUMEN

CD4(+)CD25(+) T-regulatory cells (T(reg)) can inhibit the proliferation and cytokine secretion of CD4(+)CD25(-) helper T cells in mice and humans. In murine tumor models, the presence of these T(reg) cells can inhibit the antitumor effectiveness of T-cell transfer and active immunization approaches. We have thus initiated efforts to eliminate T(reg) cells selectively from human peripheral blood mononuclear cells (PBMCs) to potentially bolster antitumor responses. LMB-2 is a recombinant immunotoxin that is a fusion of a single-chain Fv fragment of the anti-Tac anti-CD25 monoclonal antibody to a truncated form of the bacterial Pseudomonas exotoxin A. In vitro incubation of human PBMCs with LMB-2 reduced the levels of CD4(+)CD25(+) and Foxp3-expressing cells without impairing the function of the remaining lymphocytes. The short in vivo half-life of LMB-2 makes it an attractive candidate for reducing human T(reg) cells in vivo before the administration of cancer vaccine or cell transfer immunotherapy approaches.


Asunto(s)
Anticuerpos Monoclonales/administración & dosificación , Inmunotoxinas/administración & dosificación , Linfocitos T Reguladores/inmunología , Animales , Anticuerpos Monoclonales/inmunología , Antígenos CD4/inmunología , Vacunas contra el Cáncer , Muerte Celular/inmunología , Células Cultivadas , Exotoxinas/administración & dosificación , Exotoxinas/inmunología , Humanos , Inmunoterapia , Inmunotoxinas/inmunología , Depleción Linfocítica/métodos , Ratones , Receptores de Interleucina-2/inmunología , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/inmunología , Linfocitos T Reguladores/patología
16.
J Immunother ; 29(4): 455-63, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16799341

RESUMEN

We previously reported our experience in treating 56 patients with metastatic melanoma using a human anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) antibody. Durable tumor regressions were seen that correlated with the induction of autoimmune toxicities. In this study, we treated 46 additional patients using an intrapatient dose escalation schema to test whether higher doses of anti-CTLA-4 antibody would induce increased autoimmunity and concomitant tumor regression. Twenty-three patients started anti-CTLA-4 antibody administration at 3 mg/kg and 23 patients started treatment at 5 mg/kg, receiving doses every 3 weeks. Patients were dose-escalated every other dose to a maximum of 9 mg/kg or until objective clinical responses or grade III/IV autoimmune toxicity were seen. Escalating doses of antibody resulted in proportionally higher plasma concentrations. Sixteen patients (35%) experienced a grade III/IV autoimmune toxicity. Five patients (11%) achieved an objective clinical response. Two of the responses are ongoing at 13 and 16 months, respectively. Flow cytometric analysis of peripheral blood revealed significant increases in both T-cell surface markers of activation and memory phenotype. Thus, higher serum levels and prolonged administration of anti-CTLA-4 antibody resulted in a trend toward a greater incidence of grade III/IV autoimmune toxicity than previously reported, but did not seem to increase objective response rates.


Asunto(s)
Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Antineoplásicos/administración & dosificación , Antígenos de Diferenciación/inmunología , Melanoma/terapia , Adulto , Anciano , Anticuerpos Monoclonales/inmunología , Anticuerpos Antineoplásicos/inmunología , Antígenos CD , Antígenos de Neoplasias , Autoinmunidad , Antígeno CTLA-4 , Terapia Combinada , Relación Dosis-Respuesta Inmunológica , Femenino , Humanos , Masculino , Melanoma/secundario , Persona de Mediana Edad
17.
J Immunol ; 175(11): 7746-54, 2005 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-16301685

RESUMEN

We have demonstrated previously that the administration of CTLA-4 blockade has mediated objective cancer regression and autoimmunity in patients with metastatic melanoma. To explore the mechanism of these in vivo effects, we have studied the changes in lymphocyte phenotype and function in patients receiving anti-CTLA-4 Ab (MDX-010). Patients with stage IV melanoma or renal cell cancer were treated every 3 wk with an anti-CTLA-4 Ab with or without peptide immunization. Pheresis samples were analyzed using flow cytometry to determine lymphocyte cell surface markers. Gene expression analyses and proliferation assays were conducted on purified T cell subsets. Anti-CTLA-4 Ab did not inhibit the suppressive activity of CD4+CD25+ cells in vitro or in vivo. In addition, there was no decrease in the expression of CD4+CD25+ cells in whole PBMC, nor a decrease in Foxp3 gene expression in the CD4+ or CD4+CD25+ purified cell populations posttreatment. The percentage of CD4+, CD8+, CD4+CD25+, and CD4+CD25- T cells in PBMC expressing the activation marker HLA-DR increased following anti-CTLA-4 Ab administration. Therefore, our results suggest that the antitumor effects of CTLA-4 blockade are due to increased T cell activation rather than inhibition or depletion of T regulatory cells.


Asunto(s)
Anticuerpos Monoclonales/farmacología , Antígenos de Diferenciación/inmunología , Autoinmunidad , Neoplasias Renales/inmunología , Melanoma/inmunología , Linfocitos T/efectos de los fármacos , Antígenos CD , Antígenos CD4/inmunología , Antígenos CD4/metabolismo , Antígenos CD8/inmunología , Antígenos CD8/metabolismo , Antígeno CTLA-4 , Relación Dosis-Respuesta a Droga , Citometría de Flujo , Factores de Transcripción Forkhead/genética , Factores de Transcripción Forkhead/metabolismo , Expresión Génica , Perfilación de la Expresión Génica , Antígenos HLA-DR/inmunología , Antígenos HLA-DR/metabolismo , Humanos , Activación de Linfocitos/efectos de los fármacos , Activación de Linfocitos/inmunología , Fenotipo , Receptores de Interleucina-2/inmunología , Receptores de Interleucina-2/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Neoplasias Cutáneas/inmunología , Linfocitos T/inmunología
18.
J Immunother ; 28(6): 582-92, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16224276

RESUMEN

Elimination of regulatory T lymphocytes may provide a way to break self-tolerance and unleash the anti-tumor properties of circulating lymphocytes. The use of fusion proteins, which link cytotoxic molecules to receptor targets, provides one approach to this problem. This study examined the ability of a fusion protein of interleukin-2 (IL-2) and diphtheria toxin (Denileukin Diftitox, DAB389IL-2, ONTAK) to eliminate regulatory T lymphocytes based on their expression of high-affinity IL-2 receptors. Thirteen patients (12 with metastatic melanoma, 1 with metastatic renal cell carcinoma) were treated at one of the two Food and Drug Administration-approved doses of Denileukin Diftitox (seven patients at 9 microg/kg, six patients at 18 microg/kg). None of the patients experienced an objective clinical response. Foxp3 expression did not decrease significantly overall, although it did decrease minimally among patients receiving 18 microg/kg (-2.01+/-0.618 copies of Foxp3/10(3) copies of beta-actin; P=0.031). Denileukin Diftitox did not decrease the suppressive ability of CD4CD25 cells as quantified by an in vitro co-culture suppression assay. Furthermore, the increased numbers of lymphocytes in patients resulting from treatment with IL-2 were not susceptible to Denileukin Diftitox. Administration of Denileukin Diftitox does not appear to eliminate regulatory T lymphocytes or cause regression of metastatic melanoma.


Asunto(s)
Antineoplásicos/uso terapéutico , Toxina Diftérica/uso terapéutico , Interleucina-2/uso terapéutico , Melanoma/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Linfocitos T Reguladores/efectos de los fármacos , Adulto , Antineoplásicos/administración & dosificación , Linfocitos T CD8-positivos/efectos de los fármacos , Linfocitos T CD8-positivos/inmunología , Carcinoma de Células Renales/tratamiento farmacológico , Carcinoma de Células Renales/inmunología , Carcinoma de Células Renales/secundario , Línea Celular Tumoral , Femenino , Factores de Transcripción Forkhead/genética , Factores de Transcripción Forkhead/metabolismo , Regulación Neoplásica de la Expresión Génica , Humanos , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/inmunología , Neoplasias Renales/patología , Masculino , Melanoma/inmunología , Melanoma/secundario , Persona de Mediana Edad , Metástasis de la Neoplasia , ARN Mensajero/metabolismo , Receptores de Interleucina-2/inmunología , Proteínas Recombinantes de Fusión/uso terapéutico , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/secundario , Linfocitos T Reguladores/inmunología
19.
Ann Surg Oncol ; 12(12): 1005-16, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16283570

RESUMEN

BACKGROUND: Cytotoxic T lymphocyte-associated antigen (CTLA)-4 can inhibit T-cell responses and is involved in tolerance against self antigens. We previously reported autoimmune manifestations and objective cancer regressions in patients with metastatic melanoma treated with CTLA-4 blockade. The possibility of activating tumor-reactive T cells while removing inhibitory activity with CTLA-4 blockade has stimulated interest in using anti-CTLA-4 antibodies in combination with other cancer immunotherapies to improve clinical outcomes. In this study, we assessed the antitumor activity and autoimmune toxicity of CTLA-4 blockade in combination with an immune-activating stimulus, interleukin (IL)-2, in patients with metastatic melanoma. METHODS: Thirty-six patients received anti-CTLA-4 antibody every 3 weeks. Three patients per cohort received doses of .1, .3, 1.0, and 2.0 mg/kg. Twenty-four patients received 3.0 mg/kg. All patients received IL-2 therapy (720,000 IU/kg every 8 hours to a maximum of 15 doses). RESULTS: Eight patients (22%) experienced objective tumor responses (three complete and five partial), including metastases in the lungs, lymph nodes, mediastinum, and subcutaneous tissues. Six of the eight patients have ongoing objective responses at 11 to 19 months. Five patients (14%) developed grade III/IV autoimmune toxicities secondary to anti-CTLA-4 administration, including four patients with enterocolitis and one with arthritis and uveitis. CONCLUSIONS: There is not evidence to support a synergistic effect of CTLA-4 blockade plus IL-2 administration, because the 22% objective response rate is that expected from the sum of these two agents administered alone. Durable cancer regressions were seen in patients treated with this combination.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Antígenos de Diferenciación/uso terapéutico , Inmunosupresores/uso terapéutico , Inmunoterapia/métodos , Interleucina-2/uso terapéutico , Melanoma/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Adulto , Anticuerpos Monoclonales/farmacocinética , Antígenos CD , Autoinmunidad , Antígeno CTLA-4 , Quimioterapia Combinada , Femenino , Citometría de Flujo , Humanos , Ipilimumab , Masculino , Melanoma/diagnóstico por imagen , Melanoma/inmunología , Melanoma/secundario , Persona de Mediana Edad , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/secundario , Tomografía Computarizada por Rayos X
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