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2.
J Immunother Cancer ; 7(1): 95, 2019 04 02.
Article in English | MEDLINE | ID: mdl-30940183

ABSTRACT

BACKGROUND: Notch intercellular communication instructs tissue-specific T-cell development and function. In this study, we explored the roles of dendritic cell (DC)-expressed Notch ligands in the regulation of T-cell effector function. METHODS: We generated mice with CD11c lineage-specific deletion of Notch Delta-like ligand (Dll)1 and Jagged (Jag)2. Using these genetically-ablated mice and engineered pharmacological Notch ligand constructs, the roles of various Delta-like and Jagged ligands in the regulation of T-cell-mediated immunity were investigated. We assessed tumor growth, mouse survival, cytokine production, immunophenotyping of myeloid and lymphoid populations infiltrating the tumors, expression of checkpoint molecules and T-cell function in the experimental settings of murine lung and pancreatic tumors and cardiac allograft rejection. Correlative studies were also performed for the expression of NOTCH ligands, NOTCH receptors and PD-1 on various subsets of myeloid and lymphoid cells in tumor-infiltrating immune cells analyzed from primary human lung cancers. RESULTS: Mice with CD11c lineage-specific deletion of Notch ligand gene Dll1, but not Jag2, exhibited accelerated growth of lung and pancreatic tumors concomitant with decreased antigen-specific CD8+T-cell functions and effector-memory (Tem) differentiation. Increased IL-4 but decreased IFN-γ production and elevated populations of T-regulatory and myeloid-derived suppressor cells were observed in Dll1-ablated mice. Multivalent clustered DLL1-triggered Notch signaling overcame DC Dll1 deficiency and improved anti-tumor T-cell responses, whereas the pharmacological interference by monomeric soluble DLL1 construct suppressed the rejection of mouse tumors and cardiac allograft. Moreover, monomeric soluble JAG1 treatment reduced T-regulatory cells and improved anti-tumor immune responses by decreasing the expression of PD-1 on CD8+Tem cells. A significant correlation was observed between DC-expressed Jagged and Delta-like ligands with Tem-expressed PD-1 and Notch receptors, respectively, in human lung tumor-infiltrates. CONCLUSION: Our data show the importance of specific expression of Notch ligands on DCs in the regulation of T-cell effector function. Thus, strategies incorporating selectively engineered Notch ligands could provide a novel approach of therapeutics for modulating immunity in various immunosuppressive conditions including cancer.


Subject(s)
Calcium-Binding Proteins/metabolism , Dendritic Cells/metabolism , Jagged-2 Protein/metabolism , Lung Neoplasms/immunology , T-Lymphocytes, Cytotoxic/immunology , 3T3 Cells , Animals , Calcium-Binding Proteins/agonists , Calcium-Binding Proteins/antagonists & inhibitors , Calcium-Binding Proteins/genetics , Cell Communication/immunology , Cell Differentiation/immunology , Dendritic Cells/immunology , Disease Models, Animal , Female , Graft Rejection/immunology , Heart Transplantation/adverse effects , Humans , Jagged-2 Protein/agonists , Jagged-2 Protein/antagonists & inhibitors , Jagged-2 Protein/genetics , Lung/immunology , Lung/pathology , Lung Neoplasms/pathology , Lymphocytes, Tumor-Infiltrating , Male , Membrane Proteins/metabolism , Mice , Mice, Knockout , Receptors, Notch/metabolism , Signal Transduction/drug effects , Signal Transduction/immunology
3.
Adv Ther ; 35(10): 1698-1712, 2018 10.
Article in English | MEDLINE | ID: mdl-30128642

ABSTRACT

INTRODUCTION: The objective of this study was to assess the impact of a single-pill combination (SPC) of perindopril/indapamide (PER/IND) at full doses (10/2.5 mg) on endothelial and cognitive function as a clinical intermediate marker of vascular improvement. METHODS: This open-label, uncontrolled, observational study enrolled 30 patients (20 females and 10 males) with grade II-III uncontrolled arterial hypertension (SBP/DBP ≥ 160/100 mmHg) and no evidence of cerebrovascular disease. All patients underwent assessment of macro- and microvascular endothelial function parameters at baseline and after 12 months of treatment with SPC PER/IND using photoplethysmography and video capillaroscopy. Cognitive function was assessed using the Montreal Cognitive Assessment scale (MoCA). RESULTS: All patients (mean age 60.06 ± 10.19 years) were at high risk for cardiovascular events: mean body mass index (BMI) 31.2 ± 3.9 kg/m2, 33% diagnosed with coronary artery disease angina class I, 30% with impaired glucose tolerance, and 7% with type 2 diabetes. Impaired endothelial function was observed at the both micro- and macrovascular levels. Endothelial function parameters improved after 12-month treatment with SPC PER/IND with an increase in occlusion index from 1.4 to 1.8 (P < 0.00005) and phase shift from 5.0 to 10.8 (P < 0.00001); all values achieved levels in the normal range. Resting capillary network density (CND) increased from 44.8 to 52 cap/mm2 (P < 0.00007), and CND after a venous occlusion test increased from 55 to 61 cap/mm2 (P < 0.006). Signs of cognitive impairment were present at baseline with a mean MoCA score of 23 (normal cognitive function score ≥ 26), but improved after 12-month treatment with a mean MoCA score of 27 (P< 0.0001). Treatment was well tolerated. CONCLUSION: SPC PER/IND at full doses for 12 months improves endothelial function, structural and functional parameters of the microcirculation, as well as cognitive function in patients with arterial hypertension at high cardiovascular risk. FUNDING: Les Laboratoires Servier.


Subject(s)
Cognition/drug effects , Endothelium, Vascular/drug effects , Essential Hypertension , Indapamide , Microcirculation/drug effects , Perindopril , Aged , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/pharmacokinetics , Blood Pressure/drug effects , Dose-Response Relationship, Drug , Drug Combinations , Essential Hypertension/diagnosis , Essential Hypertension/drug therapy , Essential Hypertension/epidemiology , Essential Hypertension/psychology , Female , Humans , Indapamide/administration & dosage , Indapamide/pharmacokinetics , Male , Middle Aged , Perindopril/administration & dosage , Perindopril/pharmacokinetics , Russia/epidemiology , Treatment Outcome
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