Frontline and Relapsed Rhabdomyosarcoma (FAR-RMS) Clinical Trial: A Report from the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG).

The Frontline and Relapsed Rhabdomyosarcoma (FaR-RMS) clinical trial is an overarching, multinational study for children and adults with rhabdomyosarcoma (RMS). The trial, developed by the European Soft Tissue Sarcoma Study Group (EpSSG), incorporates multiple different research questions within a multistage design with a focus on (i) novel regimens for poor prognostic subgroups, (ii) optimal duration of maintenance chemotherapy, and (iii) optimal use of radiotherapy for local control and widespread metastatic disease. Additional sub-studies focusing on biological risk stratification, use of imaging modalities, including [18F]FDG PET-CT and diffusion-weighted MRI imaging (DWI) as prognostic markers, and impact of therapy on quality of life are described. This paper forms part of a Special Issue on rhabdomyosarcoma and outlines the study background, rationale for randomisations and sub-studies, design, and plans for utilisation and dissemination of results.

Enhanced susceptibility of T lymphocytes to oxidative stress in the absence of the cellular prion protein.

The cellular prion glycoprotein (PrP(C)) is ubiquitously expressed but its physiologic functions remain enigmatic, particularly in the immune system. Here, we demonstrate in vitro and in vivo that PrP(C) is involved in T lymphocytes response to oxidative stress. By monitoring the intracellular level of reduced glutathione, we show that PrP(-/-) thymocytes display a higher susceptibility to H(2)O(2) exposure than PrP(+/+) cells. Furthermore, we find that in mice fed with a restricted diet, a regimen known to increase the intracellular level of ROS, PrP(-/-) thymocytes are more sensitive to oxidative stress. PrP(C) function appears to be specific for oxidative stress, since no significant differences are observed between PrP(-/-) and PrP(+/+) mice exposed to other kinds of stress. We also show a marked evolution of the redox status of T cells throughout differentiation in the thymus. Taken together, our results clearly ascribe to PrP(C) a protective function in thymocytes against oxidative stress.

Cell penetration properties of maurocalcine, a natural venom peptide active on the intracellular ryanodine receptor.

Maurocalcine (MCa) is a 33-amino acid residue peptide toxin initially isolated from the scorpion Scorpio maurus maurus. Its structural and functional features make it resembling many Cell Penetrating Peptides. In particular, MCa exhibits a characteristic positively charged face that may interact with membrane lipids. External application of MCa is known to produce Ca2+-release from intracellular stores within seconds. MCa binds directly to the skeletal muscle isoform of the ryanodine receptor, an intracellular channel target of the endoplasmic reticulum, and induces long-lasting channel openings in a mode of smaller conductance. The binding sites for MCa have been mapped within the cytoplasmic domain of the ryanodine receptor. In this manuscript, we further investigated how MCa proceeds to cross biological membranes in order to reach its target. A biotinylated derivative of MCa (MCab) was chemically synthesized, coupled to a fluorescent streptavidin indicator (Cy3 or Cy5) and the cell penetration of the entire complex followed by confocal microscopy and FACS analysis. The data provide evidence that MCa allows the penetration of the macro proteic complex and therefore may be used as a vector for the delivery of proteins in the cytoplasm as well as in the nucleus. Using both FACS and confocal analysis, we show that the cell penetration of the fluorescent complex is observed at concentrations as low as 10 nM, is sensitive to membrane potential and is partly inhibited by heparin. We also show that MCa interacts with the disialoganglioside GD3, the most abundant charged lipid in natural membranes. Despite its action on ryanodine receptor, MCa showed no sign of cell toxicity on HEK293 cells suggesting that it may have a wider application range. These data indicate that MCa may cross the plasma membrane directly by cell translocation and has a promising future as a carrier of various drugs and agents of therapeutic, diagnostic and technological value.

Fibroblasts inhibit the production of interleukin-12p70 by murine dendritic cells.

Interleukin-12 p70 (IL-12p70) is a key cytokine produced by dendritic cells (DC) able to drive the development of T helper type 1 (Th1) lymphocytes. We showed that thymic and other fibroblasts strongly inhibit IL-12p70 production by splenic DC stimulated by lipopolysaccharide plus either anti-CD40 or interferon-gamma (IFN-gamma) and by purified splenic DC stimulated by Pansorbin plus IFN-gamma. This IL-12p70 inhibitory activity is secreted in the conditioned medium of primary fibroblasts and fibroblast cell lines but not by haematopoietic cell lines. As IL-10 was the unique factor able to inhibit IL-12p70 produced by cultured splenic DC, we showed that a neutralizing antibody to IL-10 did not suppress the IL-12p70 inhibitory activity of thymic fibroblast-conditioned medium (FCM). This FCM potently inhibits the maturation and expression of major histocompatibility complex class II and co-stimulatory molecules induced by stimulation of spleen-derived DC. While thymic FCM suppressed the IL-12p70 expression by stimulated spleen-derived DC, tumour necrosis factor-alpha production is not affected. This inhibitory activity is able to down-regulate the IL-12p35 subunit transcription and expression, resulting in the impaired assembly of IL-12p70 heterodimer. As fibroblasts are present in the tissue microenvironment and are active players in the establishment of an immune response, the nature and role of the fibroblastic inhibitory activity remain to be established.

T lymphocytes potentiate murine dendritic cells to produce IL-12.

IL-12 is mainly produced by CD8alpha(+) dendritic cells (DCs) and induces Th1 polarization of the immune response. We investigated the influence of lymphocytes on splenic DC (SDC) and thymic DC (TDC) development and on their IL-12 production capacity. First, CD3epsilon(-/-) mice, lacking T cells, and RAG-2(-/-) mice, lacking T and B cells, possess numbers of SDCs, TDCs, and CD8alpha(+) SDCs similar to wild-type (WT) mice. Second, SDCs and TDCs from CD3epsilon(-/-) mice do not secrete IL-12 in vitro after different stimulations, whereas DCs from pTalpha(-/-) mice, possessing reduced T cell number, and RAG-2(-/-) mice, produce an IL-12 level similar to that of WT DCs. We show that T lymphocytes restore the capacity of DCs to produce IL-12 after stimulation in vivo by reconstitution of CD3epsilon(-/-) mice with WT T cells and in vitro by coculture of CD3epsilon(-/-) DCs with WT T cells. The regulation of IL-12 production occurred at the transcriptional level, with an increase of IL-12p35 transcripts and a decrease of IL-12p40 transcripts. Although IL-4 restores IL-12 production by CD3epsilon(-/-) SDCs, anti-IL-4 Abs inhibited only partially the IL-12 production in coculture of CD3epsilon(-/-) DCs and WT T cells. Taken together, these data show that T lymphocytes potentiate IL-12 production by DCs and that IL-4 is not solely involved in this regulation. In conclusion, B and T cells exert balanced actions on DCs by respectively inhibiting or promoting IL-12 production.