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1.
Proc Natl Acad Sci U S A ; 117(1): 285-291, 2020 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-31871161

RESUMEN

The impact of ultrasmall nanoparticles (<10-nm diameter) on the immune system is poorly understood. Recently, ultrasmall silica nanoparticles (USSN), which have gained increasing attention for therapeutic applications, were shown to stimulate T lymphocytes directly and at relatively low-exposure doses. Delineating underlying mechanisms and associated cell signaling will hasten therapeutic translation and is reported herein. Using competitive binding assays and molecular modeling, we established that the T cell receptor (TCR):CD3 complex is required for USSN-induced T cell activation, and that direct receptor complex-particle interactions are permitted both sterically and electrostatically. Activation is not limited to αß TCR-bearing T cells since those with γδ TCR showed similar responses, implying that USSN mediate their effect by binding to extracellular domains of the flanking CD3 regions of the TCR complex. We confirmed that USSN initiated the signaling pathway immediately downstream of the TCR with rapid phosphorylation of both ζ-chain-associated protein 70 and linker for activation of T cells protein. However, T cell proliferation or IL-2 secretion were only triggered by USSN when costimulatory anti-CD28 or phorbate esters were present, demonstrating that the specific impact of USSN is in initiation of the primary, nuclear factor of activated T cells-pathway signaling from the TCR complex. Hence, we have established that USSN are partial agonists for the TCR complex because of induction of the primary T cell activation signal. Their ability to bind the TCR complex rapidly, and then to dissolve into benign orthosilicic acid, makes them an appealing option for therapies targeted at transient TCR:CD3 receptor binding.


Asunto(s)
Activación de Linfocitos/efectos de los fármacos , Nanopartículas/química , Complejo Receptor-CD3 del Antígeno de Linfocito T/efectos de los fármacos , Complejo Receptor-CD3 del Antígeno de Linfocito T/metabolismo , Dióxido de Silicio/química , Dióxido de Silicio/farmacología , Antígenos CD28/metabolismo , Complejo CD3/química , Complejo CD3/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Humanos , Interleucina-2/metabolismo , Modelos Moleculares , Fosforilación , Complejo Receptor-CD3 del Antígeno de Linfocito T/química , Complejo Receptor-CD3 del Antígeno de Linfocito T/genética , Transducción de Señal/inmunología , Linfocitos T/efectos de los fármacos , Linfocitos T/inmunología , Linfocitos T/metabolismo
2.
Medicine (Baltimore) ; 98(41): e17525, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31593126

RESUMEN

To assess the intra-individual and inter-individuals biological variation and the effect of aging on lymphocyte T-cells subsets.We assessed lymphocyte phenotypes (CD3, CD4, and CD8 T-cells) in 89 HIV-1-infected and 88 uninfected white non-Hispanic men every 6 months, to examine the biological variation for those measurements, and the average change in lymphocyte phenotype over 34 years.The markers showed significant intra-individuality in HIV-infected and uninfected individuals with index of individuality of <1.4. No mean changes were seen over the 34 years, with the exception of percentage CD4T-cells in HIV-uninfected individuals.In the pre-HAART era, HIV-infected individuals experienced an increase in mean absolute CD3 T-cell numbers (11.21 cells/µL, P = 0.02) and absolute CD8 T-cell numbers (34.57 cell/µl, P < .001), and in the percentage of CD8 T-cells (1.45%, P < .001) per year and a significant decrease in mean absolute CD4 T-cell numbers (23.68 cells/µl, P < .001) and in the percentage of CD4 T-cells (1.49%, P < .001) per year.In the post-HAART era, no changes in mean levels were observed in absolute CD3 T-cell count (P = .15) or percentage (P = .99). Significant decreases were seen in mean count (8.56 cells/µl, P < .001) and percentage (0.59%, P < .001) of CD8 T-cells, and increases in mean absolute count (10.72 cells/µl, P < .001) and percentage (0.47%, P < .001) of CD4 T-cells.With the exception of CD4 (%), no average changes per year were seen in lymphocyte phenotype of HIV-uninfected men. The results of coefficients of variation of intra and inter-individuals of this study can be useful for HIV-1 infection monitoring and in addition the observation could be a useful guide for intra- and inter-individual coefficient variations, and establishing quality goal studies of different blood biomarkers in healthy and other diseases.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/inmunología , Variación Biológica Poblacional/inmunología , Infecciones por VIH/inmunología , Subgrupos de Linfocitos T/inmunología , Síndrome de Inmunodeficiencia Adquirida/etnología , Adulto , Anciano , Anciano de 80 o más Años , Terapia Antirretroviral Altamente Activa/estadística & datos numéricos , Variación Biológica Poblacional/etnología , Biomarcadores/sangre , Complejo CD3/efectos de los fármacos , Complejo CD3/inmunología , Complejo CD3/metabolismo , Antígenos CD4/inmunología , Antígenos CD4/metabolismo , Linfocitos T CD8-positivos/efectos de los fármacos , Linfocitos T CD8-positivos/inmunología , Linfocitos T CD8-positivos/metabolismo , Senescencia Celular/inmunología , Estudios de Cohortes , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/metabolismo , Humanos , Los Angeles/epidemiología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Fenotipo , Subgrupos de Linfocitos T/metabolismo
3.
Acta Cir Bras ; 33(7): 556-564, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30110057

RESUMEN

PURPOSE: To investigate the effects of baicalin on inflammatory reaction, oxidative stress and protein kinase D1 (PKD1) and nuclear factor-kappa B (NF-κB) protein expressions in severe acute pancreatitis (SAP) rats. METHODS: Sixty rats were divided into sham operation, model, and low-, medium- and high-dose baicalin group. SAP model was established in later 4 groups. The later 3 groups were injected with 0.1, 0.2 and 0.4 ml/100 g 5% baicalin injection, respectively. At 12 h, the serum SAP related indexes and inflammatory factors, peripheral blood CD3 and γδT cell percentages, wet/dry ratio and pancreas ascites volume, oxidative stress indexes and PKD1 and NF-κB protein expressions in pancreatic tissue were determined. RESULTS: Compared with model group, in high-dose baicalin group the wet/dry ratio and ascites volume, serum amylase level, phospholipase A2 activity, TNF-α, IL-1 and IL-6 levels, and pancreatic malondialdehyde level and PKD1 and NF-κB protein expression were significantly decreased (P < 0.05), and peripheral blood CD3 and γδT cell percentages and pancreatic superoxide dismutase and glutathione peroxidase levels were significantly increased (P < 0.05). CONCLUSION: Baicalin can resist the inflammatory reaction and oxidative stress, and down-regulate protein kinase D1 and nuclear factor-kappa B protein expressions, thus exerting the protective effects on severe acute pancreatitis in rats.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Flavonoides/farmacología , FN-kappa B/metabolismo , Estrés Oxidativo/efectos de los fármacos , Pancreatitis/tratamiento farmacológico , Proteína Quinasa C/metabolismo , Amilasas/sangre , Amilasas/efectos de los fármacos , Animales , Complejo CD3/sangre , Complejo CD3/efectos de los fármacos , Regulación hacia Abajo/efectos de los fármacos , Glutatión Peroxidasa/efectos de los fármacos , Glutatión Peroxidasa/metabolismo , Interleucina-1/sangre , Interleucina-6/sangre , Malondialdehído/metabolismo , FN-kappa B/efectos de los fármacos , Pancreatitis/metabolismo , Proteína Quinasa C/efectos de los fármacos , Distribución Aleatoria , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Superóxido Dismutasa/efectos de los fármacos , Superóxido Dismutasa/metabolismo , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/sangre , Factor de Necrosis Tumoral alfa/efectos de los fármacos
4.
Acta cir. bras ; 33(7): 556-564, July 2018. tab, graf
Artículo en Inglés | LILACS | ID: biblio-949368

RESUMEN

Abstract Purpose: To investigate the effects of baicalin on inflammatory reaction, oxidative stress and protein kinase D1 (PKD1) and nuclear factor-kappa B (NF-κB) protein expressions in severe acute pancreatitis (SAP) rats. Methods: Sixty rats were divided into sham operation, model, and low-, medium- and high-dose baicalin group. SAP model was established in later 4 groups. The later 3 groups were injected with 0.1, 0.2 and 0.4 ml/100 g 5% baicalin injection, respectively. At 12 h, the serum SAP related indexes and inflammatory factors, peripheral blood CD3 and γδT cell percentages, wet/dry ratio and pancreas ascites volume, oxidative stress indexes and PKD1 and NF-κB protein expressions in pancreatic tissue were determined. Results: Compared with model group, in high-dose baicalin group the wet/dry ratio and ascites volume, serum amylase level, phospholipase A2 activity, TNF-α, IL-1 and IL-6 levels, and pancreatic malondialdehyde level and PKD1 and NF-κB protein expression were significantly decreased (P < 0.05), and peripheral blood CD3 and γδT cell percentages and pancreatic superoxide dismutase and glutathione peroxidase levels were significantly increased (P < 0.05). Conclusion: Baicalin can resist the inflammatory reaction and oxidative stress, and down-regulate protein kinase D1 and nuclear factor-kappa B protein expressions, thus exerting the protective effects on severe acute pancreatitis in rats.


Asunto(s)
Animales , Pancreatitis/tratamiento farmacológico , Flavonoides/farmacología , Proteína Quinasa C/metabolismo , Antiinflamatorios no Esteroideos/farmacología , FN-kappa B/metabolismo , Estrés Oxidativo/efectos de los fármacos , Pancreatitis/metabolismo , Superóxido Dismutasa/efectos de los fármacos , Proteína Quinasa C/efectos de los fármacos , Distribución Aleatoria , Regulación hacia Abajo/efectos de los fármacos , Reproducibilidad de los Resultados , FN-kappa B/efectos de los fármacos , Interleucina-6/sangre , Interleucina-1/sangre , Factor de Necrosis Tumoral alfa/sangre , Resultado del Tratamiento , Ratas Sprague-Dawley , Complejo CD3/efectos de los fármacos , Complejo CD3/sangre , Glutatión Peroxidasa/efectos de los fármacos , Glutatión Peroxidasa/metabolismo , Amilasas/efectos de los fármacos , Amilasas/sangre , Malondialdehído/metabolismo
6.
J Clin Oncol ; 34(10): 1104-11, 2016 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-26884582

RESUMEN

PURPOSE: Blinatumomab is a CD19/CD3 BiTE (bispecific T-cell engager) antibody construct for the treatment of Philadelphia chromosome-negative acute B-lymphoblastic leukemia. We evaluated blinatumomab in relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). PATIENTS AND METHODS: This 3 + 3 design, phase I dose-escalation study determined adverse events and the maximum tolerated dose (MTD) of continuous intravenous infusion blinatumomab in patients with relapsed/refractory NHL. Blinatumomab was administered over 4 or 8 weeks at seven different dose levels (0.5 to 90 µg/m(2)/day). End points were incidence of adverse events, pharmacokinetics, pharmacodynamics, and overall response rate. RESULTS: Between 2004 and 2011, 76 heavily pretreated patients with relapsed/refractory NHL, who included 14 with diffuse large B-cell lymphoma, were enrolled; 42 received treatment in the formal dose-escalation phase. Neurologic events were dose limiting, and 60 µg/m(2)/day was established as the MTD. Thirty-four additional patients were recruited to evaluate antilymphoma activity and strategies for mitigating neurologic events at a prespecified MTD. Stepwise dosing (5 to 60 µg/m(2)/day) plus pentosan polysulfate SP54 (n = 3) resulted in no treatment discontinuations; single-step (n = 5) and double-step (n = 24) dosing entailed two and seven treatment discontinuations due to neurologic events, respectively. Grade 3 neurologic events occurred in 22% of patients (no grade 4/5). Among patients treated at 60 µg/m(2)/day (target dose; n = 35), the overall response rate was 69% across NHL subtypes and 55% for diffuse large B-cell lymphoma (n = 11); median response duration was 404 days (95% CI, 207 to 1,129 days). CONCLUSION: In this phase I study of relapsed/refractory NHL, continuous infusion with CD19-targeted immunotherapy blinatumomab at various doses and schedules was feasible, with an MTD of 60 µg/m(2)/day. Single-agent blinatumomab showed antilymphoma activity.


Asunto(s)
Anticuerpos Biespecíficos/uso terapéutico , Antineoplásicos/uso terapéutico , Inmunoterapia/métodos , Activación de Linfocitos/efectos de los fármacos , Linfoma no Hodgkin/tratamiento farmacológico , Linfoma no Hodgkin/inmunología , Terapia Molecular Dirigida/métodos , Linfocitos T/efectos de los fármacos , Linfocitos T/inmunología , Adulto , Anticuerpos Biespecíficos/administración & dosificación , Anticuerpos Biespecíficos/efectos adversos , Antígenos CD19/efectos de los fármacos , Antígenos CD19/inmunología , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Complejo CD3/efectos de los fármacos , Complejo CD3/inmunología , Esquema de Medicación , Femenino , Alemania , Humanos , Infusiones Intravenosas , Activación de Linfocitos/inmunología , Linfoma de Células B/tratamiento farmacológico , Linfoma de Células B/inmunología , Linfoma Folicular/tratamiento farmacológico , Linfoma Folicular/inmunología , Linfoma de Células del Manto/tratamiento farmacológico , Linfoma de Células del Manto/inmunología , Masculino , Dosis Máxima Tolerada , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/inducido químicamente , Recurrencia , Inducción de Remisión , Resultado del Tratamiento
7.
Inflamm Bowel Dis ; 21(9): 2026-38, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26002542

RESUMEN

BACKGROUND: Chorioamnionitis results from an infection of the fetal membranes and is associated with fetal adverse outcomes notably in the intestine. Using a translational ovine model, we showed that intra-amniotic exposure to inflammatory stimuli decreased the regulatory/effector T (Treg/Teff) cell balance in the gut, which was accompanied by intestinal inflammation and mucosal injury. We thus aimed to augment the Treg/Teff cell ratio in the fetal gut by prophylactic IL-2 treatment and evaluate whether it is sufficient to prevent chorioamnionitis-induced intestinal inflammation and mucosal injury. METHODS: Fetal sheep (122 d of gestation) were intra-amniotically exposed to lipopolysaccharide for 2 or 7 days with or without prophylactic IL-2 treatment (4 d). We evaluated the infiltration of inflammatory cells in the ileum and mesenteric lymph nodes. Cytokine gene expression was analyzed in fetal ileum and the inflammatory changes were correlated with gut wall integrity. RESULTS: IL-2 administration preferentially increased intestinal Treg cells and thus the Treg/Teff cell ratio. Prophylactic IL-2 treatment reduced the lipopolysaccharide-induced influx of neutrophils and CD3(+) T cells and decreased the messenger RNA levels of proinflammatory cytokines including IL-6 and IL-17 in the fetal ileum. Importantly, prophylactic IL-2 treatment prevented mucosal damage without inducing fetal adverse treatment outcomes. CONCLUSIONS: Our data show that prophylactic IL-2 treatment prevents fetal intestinal inflammation and mucosal injury in the context of experimental chorioamnionitis. Modulation of the Treg/Teff cell balance may contribute to the protective effects of IL-2.


Asunto(s)
Analgésicos no Narcóticos/administración & dosificación , Corioamnionitis/patología , Enteritis/prevención & control , Interleucina-2/administración & dosificación , Lesiones Prenatales/prevención & control , Analgésicos no Narcóticos/farmacología , Animales , Complejo CD3/efectos de los fármacos , Corioamnionitis/sangre , Citocinas/genética , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Íleon/inmunología , Íleon/patología , Interleucina-2/farmacología , Mucosa Intestinal/lesiones , Mucosa Intestinal/patología , Lipopolisacáridos , Ganglios Linfáticos/metabolismo , Mesenterio , Neutrófilos/efectos de los fármacos , Embarazo , Lesiones Prenatales/etiología , Sustancias Protectoras/administración & dosificación , Sustancias Protectoras/farmacología , ARN Mensajero/efectos de los fármacos , Distribución Aleatoria , Ovinos , Linfocitos T Reguladores/metabolismo
8.
Int J Oncol ; 45(6): 2446-54, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25242665

RESUMEN

Targeting HER2 overexpressed breast cancer cells with anti­HER2 monoclonal antibodies inhibits tumor growth. Here we investigated whether HER2 can serve as a target for T cell-mediated immunotherapy of human colorectal carcinoma. Specific cytolytic activity of activated T cells (ATCs) armed with anti­CD3 x anti­HER2 bispecific antibody (HER2Bi-Ab) against HER2+ tumor cells was evaluated by bioluminescent signal generated by luciferase reporter on tumor cells in vitro and in vivo. In contrast to unarmed ATCs, increased cytotoxic activity of HER2Bi-armed ATCs against HER2+ tumor cells was observed. Moreover, HER2Bi-armed ATCs expressed higher level of activation marker CD69 and secreted significantly higher levels of IFN-γ than the unarmed ATC counterpart. In addition, compared with anti­HER2 mAb (Herceptin®) or unarmed ATC, HER2Bi-armed ATCs showed significant suppression against colorectal carcinoma cells. In colorectal tumor cell xenograft mice, infusion of HER2Bi-armed ATCs successfully inhibited the growth of Colo205-luc cells. The HER2Bi-armed ATCs with anti-tumor effects may provide a promising immunotherapy for colorectal carcinoma in the future.


Asunto(s)
Anticuerpos Biespecíficos/administración & dosificación , Neoplasias Colorrectales/tratamiento farmacológico , Inmunoterapia , Receptor ErbB-2/biosíntesis , Animales , Anticuerpos Biespecíficos/inmunología , Complejo CD3/efectos de los fármacos , Complejo CD3/inmunología , Línea Celular Tumoral , Neoplasias Colorrectales/inmunología , Neoplasias Colorrectales/patología , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Regulación Neoplásica de la Expresión Génica/inmunología , Humanos , Activación de Linfocitos/efectos de los fármacos , Activación de Linfocitos/inmunología , Ratones , Receptor ErbB-2/inmunología , Linfocitos T Citotóxicos/efectos de los fármacos , Linfocitos T Citotóxicos/inmunología
9.
J Natl Cancer Inst ; 106(11)2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25255802

RESUMEN

BACKGROUND: Sipuleucel-T is a US Food and Drug Administration-approved immunotherapy for asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC). Its mechanism of action is not fully understood. This prospective trial evaluated the direct immune effects of systemically administered sipuleucel-T on prostatic cancer tissue in the preoperative setting. METHODS: Patients with untreated localized prostate cancer were treated on an open-label Phase II study of sipuleucel-T prior to planned radical prostatectomy (RP). Immune infiltrates in RP specimens (posttreatment) and in paired pretreatment biopsies were evaluated by immunohistochemistry (IHC). Correlations between circulating immune response and IHC were assessed using Spearman rank order. RESULTS: Of the 42 enrolled patients, 37 were evaluable. Adverse events were primarily transient, mild-to-moderate and infusion related. Patients developed T cell proliferation and interferon-γ responses detectable in the blood following treatment. Furthermore, a greater-than-three-fold increase in infiltrating CD3(+), CD4(+) FOXP3(-), and CD8(+) T cells was observed in the RP tissues compared with the pretreatment biopsy (binomial proportions: all P < .001). This level of T cell infiltration was observed at the tumor interface, and was not seen in a control group consisting of 12 concurrent patients who did not receive any neoadjuvant treatment prior to RP. The majority of infiltrating T cells were PD-1(+) and Ki-67(+), consistent with activated T cells. Importantly, the magnitude of the circulating immune response did not directly correlate with T cell infiltration within the prostate based upon Spearman's rank order correlation. CONCLUSIONS: This study is the first to demonstrate a local immune effect from the administration of sipuleucel-T. Neoadjuvant sipuleucel-T elicits both a systemic antigen-specific T cell response and the recruitment of activated effector T cells into the prostate tumor microenvironment.


Asunto(s)
Vacunas contra el Cáncer/uso terapéutico , Inmunoterapia/métodos , Interferón gamma/efectos de los fármacos , Activación de Linfocitos/efectos de los fármacos , Terapia Neoadyuvante/métodos , Prostatectomía , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Neoplasias de la Próstata Resistentes a la Castración/inmunología , Linfocitos T/efectos de los fármacos , Extractos de Tejidos/uso terapéutico , Anciano , Complejo CD3/efectos de los fármacos , Linfocitos T CD4-Positivos/efectos de los fármacos , Linfocitos T CD8-positivos/efectos de los fármacos , Vacunas contra el Cáncer/administración & dosificación , Vacunas contra el Cáncer/efectos adversos , Factores de Transcripción Forkhead/efectos de los fármacos , Humanos , Inmunohistoquímica , Interferón gamma/inmunología , Activación de Linfocitos/inmunología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Prostatectomía/métodos , Neoplasias de la Próstata Resistentes a la Castración/patología , Neoplasias de la Próstata Resistentes a la Castración/cirugía , Linfocitos T/inmunología , Extractos de Tejidos/administración & dosificación , Extractos de Tejidos/efectos adversos , Resultado del Tratamiento , Microambiente Tumoral/efectos de los fármacos , Microambiente Tumoral/inmunología
10.
Immunotherapy ; 5(11): 1173-6, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24188671

RESUMEN

Goto R, You S, Zaitsu M, Chatenoud L, Wood KJ. Delayed anti-CD3 therapy results in depletion of alloreactive T cells and the dominance of Foxp3(+) CD4(+) graft infiltrating cells. Am. J. Transplant. 13(7), 1655-1664 (2013). Humanized Fc receptor nonbinding anti-CD3 monoclonal antibodies have been tested in patients with autoimmune diseases with the goal of inducing immune tolerance. However, the timing of drug administration may be an important determinant of the biologic effects, since not all T cells are equally affected, and there may be different subsets of cells involved during the evolution of immune responses. The study by Goto et al. showed that delayed administration of anti-CD3 therapy was more effective in depleting alloreactive T cells than administration at the time of transplant, and resulted in long-term survival of the graft by promoting infiltration of CD4 Tregs into the graft.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Complejo CD3/efectos de los fármacos , Linfocitos T CD4-Positivos/inmunología , Factores de Transcripción Forkhead/inmunología , Rechazo de Injerto/prevención & control , Supervivencia de Injerto/efectos de los fármacos , Trasplante de Corazón/inmunología , Proteínas Represoras/inmunología , Animales , Femenino , Masculino
11.
Am J Transplant ; 13(7): 1655-64, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23750800

RESUMEN

The engineered Fc-nonbinding (crystallizable fragment-nonbinding) CD3 antibody has lower mitogenicity and a precise therapeutic window for disease remission in patients with type 1 diabetes. Before anti-CD3 can be considered for use in transplantation, the most effective timing of treatment relative to transplantation needs to be elucidated. In this study anti-CD3F(ab')2 fragments or saline were administered intravenously for 5 consecutive days (early: d1-3 or delayed: d3-7) to mice transplanted with a cardiac allograft (H2(b)-to-H2(k); d0). Survival of allografts was prolonged in mice treated with the early protocol (MST = 48 days), but most were rejected by d100. In contrast, in mice treated with the delayed protocol allografts continued to survive long term. The delayed protocol significantly inhibited donor alloreactivity at d30 as compared to the early protocol. A marked increase in Foxp3(+) T cells (50.3 ± 1.6%) infiltrating the allografts in mice treated with the delayed protocol was observed (p < 0.0001 vs. early (24.9 ± 2.1%)) at d10; a finding that was maintained in the accepted cardiac allografts at d100. We conclude that the timing of treatment with anti-CD3 therapy is critical for inducing long-term graft survival. Delaying administration effectively inhibits the alloreactivity and promotes the dominance of intragraft Foxp3(+) T cells allowing long-term graft acceptance.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Complejo CD3/efectos de los fármacos , Linfocitos T CD4-Positivos/inmunología , Factores de Transcripción Forkhead/inmunología , Rechazo de Injerto/prevención & control , Supervivencia de Injerto/efectos de los fármacos , Trasplante de Corazón/inmunología , Proteínas Represoras/inmunología , Animales , Complejo CD3/inmunología , Linfocitos T CD4-Positivos/efectos de los fármacos , Linfocitos T CD4-Positivos/patología , Células Cultivadas , Modelos Animales de Enfermedad , Ensayo de Immunospot Ligado a Enzimas , Femenino , Citometría de Flujo , Estudios de Seguimiento , Factores de Transcripción Forkhead/efectos de los fármacos , Rechazo de Injerto/inmunología , Rechazo de Injerto/patología , Supervivencia de Injerto/inmunología , Trasplante de Corazón/patología , Inmunohistoquímica , Terapia de Inmunosupresión/métodos , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos CBA , Ratones Transgénicos , Proteínas Represoras/efectos de los fármacos , Factores de Tiempo , Trasplante Homólogo
12.
Diabetes Technol Ther ; 15 Suppl 2: S2-13-S2-20, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23786294

RESUMEN

Type 1 diabetes (T1D) results from the autoimmune destruction of pancreatic ß-cells, and as such it should respond to immunotherapy. George Eisenbarth gave many significant contributions to this field. He has been involved at some level in most immunotherapy trials during the past three decades. He was among the pioneers who attempted immunotherapy approaches in patients with recent-onset T1D. In the early 1980s he began studying relatives of those with the disease, leading to the concept that T1D was a chronic autoimmune disease, in which islet autoimmune responses would silently destroy ß-cells and cause progressive impairment of insulin secretion, years to months before a diagnosis was made. Consequently, he was one of the first to attempt immune intervention in people at high risk of T1D. Throughout his career he developed autoantibody assays and predictive models (which included metabolic testing and later genetics) to identify individuals at risk of T1D. He provided seminal intellectual contributions and critical tools for prevention trials. His focus on insulin as a critical autoantigen led to multiple prevention trials, including the Diabetes Prevention Trial-Type 1 (DPT-1), which studied both parenteral and oral insulin. In the DPT-1 Oral Insulin Trial, a cohort with higher levels of insulin autoantibodies was identified that appeared to have delayed disease progression. Type 1 Diabetes TrialNet is conducting a new trial to verify or refute this observation. Moreover, George identified and tested in the mouse small molecules that block or modulate presentation of a key insulin peptide and in turn prevent the activation of insulin-specific T-lymphocytes. Thus, we believe his greatest contribution is yet to come, as in the near future we should see this most recent work translate into clinical trials.


Asunto(s)
Autoanticuerpos/efectos adversos , Diabetes Mellitus Tipo 1/inmunología , Hipoglucemiantes/uso terapéutico , Inmunoterapia , Insulina/uso terapéutico , Abatacept , Animales , Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Autoanticuerpos/sangre , Autoantígenos/inmunología , Autoantígenos/uso terapéutico , Enfermedades Autoinmunes/tratamiento farmacológico , Enfermedades Autoinmunes/inmunología , Autoinmunidad/inmunología , Complejo CD3/efectos de los fármacos , Ensayos Clínicos como Asunto , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/prevención & control , Modelos Animales de Enfermedad , Femenino , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Inmunoconjugados/uso terapéutico , Inmunoterapia/métodos , Inmunoterapia/tendencias , Insulina/metabolismo , Anticuerpos Insulínicos/inmunología , Secreción de Insulina , Células Secretoras de Insulina/inmunología , Masculino , Ratones , Rituximab
13.
Lancet ; 378(9790): 487-97, 2011 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-21719095

RESUMEN

BACKGROUND: Findings of small studies have suggested that short treatments with anti-CD3 monoclonal antibodies that are mutated to reduce Fc receptor binding preserve ß-cell function and decrease insulin needs in patients with recent-onset type 1 diabetes. In this phase 3 trial, we assessed the safety and efficacy of one such antibody, teplizumab. METHODS: In this 2-year trial, patients aged 8-35 years who had been diagnosed with type 1 diabetes for 12 weeks or fewer were enrolled and treated at 83 clinical centres in North America, Europe, Israel, and India. Participants were allocated (2:1:1:1 ratio) by an interactive telephone system, according to computer-generated block randomisation, to receive one of three regimens of teplizumab infusions (14-day full dose, 14-day low dose, or 6-day full dose) or placebo at baseline and at 26 weeks. The Protégé study is still underway, and patients and study staff remain masked through to study closure. The primary composite outcome was the percentage of patients with insulin use of less than 0·5 U/kg per day and glycated haemoglobin A(1c) (HbA(1C)) of less than 6·5% at 1 year. Analyses included all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, number NCT00385697. FINDINGS: 763 patients were screened, of whom 516 were randomised to receive 14-day full-dose teplizumab (n=209), 14-day low-dose teplizumab (n=102), 6-day full-dose teplizumab (n=106), or placebo (n=99). Two patients in the 14-day full-dose group and one patient in the placebo group did not start treatment, so 513 patients were eligible for efficacy analyses. The primary outcome did not differ between groups at 1 year: 19·8% (41/207) in the 14-day full-dose group; 13·7% (14/102) in the 14-day low-dose group; 20·8% (22/106) in the 6-day full-dose group; and 20·4% (20/98) in the placebo group. 5% (19/415) of patients in the teplizumab groups were not taking insulin at 1 year, compared with no patients in the placebo group at 1 year (p=0·03). Across the four study groups, similar proportions of patients had adverse events (414/417 [99%] in the teplizumab groups vs 98/99 [99%] in the placebo group) and serious adverse events (42/417 [10%] vs 9/99 [9%]). The most common clinical adverse event in the teplizumab groups was rash (220/417 [53%] vs 20/99 [20%] in the placebo group). INTERPRETATION: Findings of exploratory analyses suggest that future studies of immunotherapeutic intervention with teplizumab might have increased success in prevention of a decline in ß-cell function (measured by C-peptide) and provision of glycaemic control at reduced doses of insulin if they target patients early after diagnosis of diabetes and children. FUNDING: MacroGenics, the Juvenile Diabetes Research Foundation, and Eli Lilly.


Asunto(s)
Complejo CD3/efectos de los fármacos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/inmunología , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Muromonab-CD3/uso terapéutico , Adolescente , Adulto , Anticuerpos Monoclonales Humanizados , Péptido C/sangre , Complejo CD3/inmunología , Canadá , Niño , Diabetes Mellitus Tipo 1/sangre , Esquema de Medicación , Erupciones por Medicamentos/etiología , Europa (Continente) , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/efectos adversos , Hipoglucemiantes/inmunología , India , Insulina/administración & dosificación , Células Secretoras de Insulina/efectos de los fármacos , Células Secretoras de Insulina/inmunología , Israel , Masculino , México , Muromonab-CD3/administración & dosificación , Muromonab-CD3/efectos adversos , Muromonab-CD3/inmunología , Resultado del Tratamiento , Estados Unidos , Adulto Joven
16.
Immunology ; 130(1): 103-13, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20059577

RESUMEN

It has been established that a total of 250 microg of monoclonal anti-mouse CD3 F(ab')(2) fragments, administered daily (50 microg per dose), induces remission of diabetes in the non-obese diabetic (NOD) mouse model of autoimmune diabetes by preventing beta cells from undergoing further autoimmune attack. We evaluated lower-dose regimens of monoclonal anti-CD3 F(ab')(2) in diabetic NOD mice for their efficacy and associated pharmacodynamic (PD) effects, including CD3-T-cell receptor (TCR) complex modulation, complete blood counts and proportions of circulating CD4(+), CD8(+) and CD4(+) FoxP3(+) T cells. Four doses of 2 microg (total dose 8 microg) induced 53% remission of diabetes, similarly to the 250 microg dose regimen, whereas four doses of 1 microg induced only 16% remission. While the 250 microg dose regimen produced nearly complete and sustained modulation of the CD3 -TCR complex, lower doses, spaced 3 days apart, which induced similar remission rates, elicited patterns of transient and partial modulation. In treated mice, the proportions of circulating CD4(+) and CD8(+) T cells decreased, whereas the proportions of CD4(+) FoxP3(+) T cells increased; these effects were transient. Mice with greater residual beta-cell function, estimated using blood glucose and C-peptide levels at the initiation of treatment, were more likely to enter remission than mice with more advanced disease. Thus, lower doses of monoclonal anti-CD3 that produced only partial and transient modulation of the CD3-TCR complex induced remission rates comparable to higher doses of monoclonal anti-CD3. Accordingly, in a clinical setting, lower-dose regimens may be efficacious and may also improve the safety profile of therapy with monoclonal anti-CD3, potentially including reductions in cytokine release-related syndromes and maintenance of pathogen-specific immunosurveillance during treatment.


Asunto(s)
Anticuerpos Monoclonales/administración & dosificación , Complejo CD3/efectos de los fármacos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Animales , Anticuerpos Monoclonales/farmacocinética , Linfocitos T CD4-Positivos/efectos de los fármacos , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/efectos de los fármacos , Linfocitos T CD8-positivos/inmunología , Separación Celular , Diabetes Mellitus Tipo 1/inmunología , Relación Dosis-Respuesta a Droga , Femenino , Citometría de Flujo , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos NOD , Páncreas/efectos de los fármacos , Páncreas/patología , Inducción de Remisión , Subgrupos de Linfocitos T/efectos de los fármacos , Subgrupos de Linfocitos T/inmunología
17.
J Immunol ; 183(8): 4843-7, 2009 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-19801510

RESUMEN

MHC class II expression identifies an effector subset of human CD4(+)CD25(high)FoxP3(high) natural regulatory T cells (DR(+) Tregs) that induces more rapid suppression and exhibits higher FoxP3 expression than the remaining Treg population. Although Tregs are known to be highly sensitive to apoptosis, in this study we demonstrate that this sensitivity is primarily a feature of DR(+) Tregs. Granzyme B (GzmB) is strongly expressed by nonregulatory responder CD4 T cells, whereas effector DR(+) Tregs express little GzmB. Strong TCR stimulation markedly increases the expression of GzmB in all dividing responder CD4 T cells and mitigates the suppression by DR(+) Tregs. DR(+) Treg suppressive activity reemerges if GzmB is neutralized. We show that responder cells actively kill effector Tregs by producing GzmB in response to strong TCR stimulation. Thus, the production of GzmB by strongly activated CD4 T cells represents a mechanism by which CD4 T cells resist Treg suppression.


Asunto(s)
Granzimas/metabolismo , Tolerancia Inmunológica , Receptores de Antígenos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/inmunología , Linfocitos T Reguladores/inmunología , Anticuerpos Monoclonales/inmunología , Apoptosis/efectos de los fármacos , Apoptosis/inmunología , Antígenos CD2/efectos de los fármacos , Antígenos CD2/inmunología , Antígenos CD2/metabolismo , Complejo CD3/efectos de los fármacos , Complejo CD3/inmunología , Complejo CD3/metabolismo , Células Cultivadas , Granzimas/efectos de los fármacos , Granzimas/inmunología , Humanos , Factores Inmunológicos/farmacología , Activación de Linfocitos/efectos de los fármacos , Activación de Linfocitos/inmunología , ARN Interferente Pequeño/inmunología , ARN Interferente Pequeño/metabolismo , Receptores de Antígenos de Linfocitos T/efectos de los fármacos , Receptores de Antígenos de Linfocitos T/metabolismo , Subgrupos de Linfocitos T/efectos de los fármacos , Subgrupos de Linfocitos T/enzimología , Linfocitos T Reguladores/efectos de los fármacos , Linfocitos T Reguladores/enzimología
18.
J Immunol ; 183(8): 4895-903, 2009 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-19801514

RESUMEN

The definitions of tolerogenic vs immunogenic dendritic cells (DC) remain controversial. Immature DC have been shown to induce T regulatory cells (Treg) specific for foreign and allogeneic Ags. However, we have previously reported that mature DC (mDC) prevented the onset of autoimmune diabetes, whereas immature DC (iDC) were therapeutically ineffective. In this study, islet-specific CD4(+) T cells from BDC2.5 TCR-transgenic mice were stimulated in the absence of exogenous cytokine with iDC or mDC pulsed with high- or low-affinity antigenic peptides and examined for Treg induction. Both iDC and mDC presenting low peptide doses induced weak TCR signaling via the Akt/mammalian target of rapamycin (mTOR) pathway, resulting in significant expansion of Foxp3(+) Treg. Furthermore, unpulsed mDC, but not iDC, also induced Treg. High peptide doses induced strong Akt/mTOR signaling and favored the expansion of Foxp3(neg) Th cells. The inverse correlation of Foxp3 and Akt/mTOR signaling was also observed in DO11.10 and OT-II TCR-transgenic T cells and was recapitulated with anti-CD3/CD28 stimulation in the absence of DC. IL-6 production in these cultures correlated positively with Ag dose and inversely with Treg expansion. Studies with T cells or DC from IL-6(-/-) mice revealed that IL-6 production by T cells was more important in the inhibition of Treg induction at low Ag doses. These studies indicate that the strength of Akt/mTOR signaling, a critical T cell-intrinsic determinant for Treg vs Th induction, can be controlled by adjusting the dose of antigenic peptide. Furthermore, this operates in a dominant fashion over DC phenotype and cytokine production.


Asunto(s)
Antígenos/inmunología , Linfocitos T CD4-Positivos/inmunología , Células Dendríticas/inmunología , Diabetes Mellitus Tipo 1/inmunología , Interleucina-6/metabolismo , Linfocitos T Reguladores/inmunología , Animales , Anticuerpos/inmunología , Antígenos CD28/efectos de los fármacos , Antígenos CD28/inmunología , Antígenos CD28/metabolismo , Complejo CD3/efectos de los fármacos , Complejo CD3/inmunología , Complejo CD3/metabolismo , Linfocitos T CD4-Positivos/metabolismo , Proteínas Portadoras/inmunología , Proteínas Portadoras/metabolismo , Técnicas de Cocultivo , Citocinas/biosíntesis , Citocinas/inmunología , Células Dendríticas/metabolismo , Relación Dosis-Respuesta Inmunológica , Factores de Transcripción Forkhead/inmunología , Interleucina-6/genética , Interleucina-6/inmunología , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Endogámicos NOD , Ratones Noqueados , Proteína Oncogénica v-akt/inmunología , Proteína Oncogénica v-akt/metabolismo , Ovalbúmina/inmunología , Péptidos/inmunología , Fosfotransferasas (Aceptor de Grupo Alcohol)/inmunología , Fosfotransferasas (Aceptor de Grupo Alcohol)/metabolismo , Receptores de Antígenos de Linfocitos T/inmunología , Receptores de Antígenos de Linfocitos T/metabolismo , Transducción de Señal/inmunología , Linfocitos T Reguladores/metabolismo , Serina-Treonina Quinasas TOR
19.
J Immunol ; 183(8): 4853-7, 2009 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-19786544

RESUMEN

We report that OX40 stimulation drives all lineages of CD4 T cell development, including regulatory T cells (Tregs), and the plasticity of the response is dependant on local cytokines. In TGF-beta1-treated cultures, an OX40 agonist increased IFN-gamma and IL-4 production and diverted T cells from the Treg lineage. However, cytokine blockade in the context of OX40 stimulation promoted enhanced Treg accumulation. This observation was evident in naive mice, as OX40 engagement enhanced Treg proliferation and accumulation in vivo. Lastly, OX40 agonist administration influenced experimental autoimmune encephalomyelitis disease severity in opposing directions, depending on the timing of administration. Given during Ag priming, the OX40 agonist drove Treg expansion and inhibited disease, whereas given later it enhanced T cell effector cytokine production in the CNS and exacerbated disease. Hence, OX40 signaling can augment the accumulation of all CD4 T cell lineages; however, its accentuation of immune responses may have vastly different biologic outcomes depending upon the local cytokine milieu.


Asunto(s)
Citocinas/inmunología , Encefalomielitis Autoinmune Experimental/inmunología , Receptores OX40/agonistas , Linfocitos T Reguladores/efectos de los fármacos , Traslado Adoptivo , Animales , Anticuerpos/administración & dosificación , Anticuerpos/inmunología , Antígenos CD28/efectos de los fármacos , Antígenos CD28/inmunología , Antígenos CD28/metabolismo , Complejo CD3/efectos de los fármacos , Complejo CD3/inmunología , Complejo CD3/metabolismo , Diferenciación Celular/efectos de los fármacos , Diferenciación Celular/inmunología , Encefalomielitis Autoinmune Experimental/metabolismo , Femenino , Interferón gamma/antagonistas & inhibidores , Interferón gamma/inmunología , Interferón gamma/metabolismo , Interferón gamma/farmacología , Interleucina-4/antagonistas & inhibidores , Interleucina-4/inmunología , Interleucina-4/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Receptores OX40/inmunología , Linfocitos T Reguladores/inmunología , Factor de Crecimiento Transformador beta1/farmacología
20.
Scand J Immunol ; 70(3): 206-15, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19703010

RESUMEN

CD25 monoclonal antibody binding to the alpha-chain of the Interleukin-2 (IL-2) receptor, blocks high-affinity IL-2 binding, thereby preventing complete T-cell activation and being of ample importance in transplantation medicine and potentially the treatment of autoimmune disease. However, CD25 antibodies do not only block T-cell activation but also prevent activation-induced cell death (AICD) attributing a dual function to IL-2. In this study, the modulation of the genomic expression profile of human peripheral blood mononuclear cells (PBMC) with therapeutic concentrations of humanized anti-CD25 mAb was investigated. PBMC were stimulated with CD3 antibody OKT-3 together with recombinant IL-2 in the absence or presence of anti-CD25 mAb. RNA was extracted and subjected to microarray analysis on U133A microarrays (Affymetrix). Anti-CD25 treatment inhibited several genes typically expressed during T-cell activation including granzyme B, signalling lymphocyte activation molecule, family member 1 (SLAMF1), CD40-Ligand (CD40-L), IL-9 and interferon (IFN)-gamma. Interestingly, anti-CD25 mAb also blocked the expression of several genes important for susceptibility to apoptosis, such as death receptor 6 (DR6) or reversed IL-2-mediated repression of anti-apoptotic genes, such as Fas apoptotic inhibitory molecule 3 (FAIM3)/TOSO. Functional significance of DR6 and TOSO expression in IL-2-dependent T-cell activation was subsequently evaluated by RNA interference in AICD: While siRNA specifically directed against DR6 did not modulate FAS-L-mediated apoptosis induction in primary T cells, down-regulation of TOSO significantly increased susceptibility to apoptosis, emphasizing an important role for TOSO in IL-2-mediated AICD.


Asunto(s)
Proteínas Reguladoras de la Apoptosis/biosíntesis , Apoptosis/inmunología , Complejo CD3/inmunología , Subunidad alfa del Receptor de Interleucina-2/antagonistas & inhibidores , Proteínas de la Membrana/biosíntesis , Linfocitos T/inmunología , Anticuerpos Monoclonales/inmunología , Antineoplásicos/farmacología , Proteínas Reguladoras de la Apoptosis/genética , Complejo CD3/efectos de los fármacos , Complejo CD3/metabolismo , Regulación hacia Abajo/efectos de los fármacos , Regulación hacia Abajo/inmunología , Perfilación de la Expresión Génica , Silenciador del Gen/inmunología , Humanos , Interleucina-2/farmacología , Subunidad alfa del Receptor de Interleucina-2/inmunología , Activación de Linfocitos/efectos de los fármacos , Activación de Linfocitos/inmunología , Proteínas de la Membrana/genética , Análisis de Secuencia por Matrices de Oligonucleótidos , ARN Interferente Pequeño/inmunología , ARN Interferente Pequeño/metabolismo , Receptores del Factor de Necrosis Tumoral/genética , Receptores del Factor de Necrosis Tumoral/inmunología , Receptores del Factor de Necrosis Tumoral/metabolismo , Linfocitos T/efectos de los fármacos , Linfocitos T/metabolismo
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