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Huang JW, Kuo CL, Wang LT, Ma KSK, Huang WY, Liu FC, Yang KD, Yang BH. Case Report: In Situ Vaccination by Autologous CD16 + Dendritic Cells and Anti-PD-L 1 Antibody Synergized With Radiotherapy To Boost T Cells-Mediated Antitumor Efficacy In A Psoriatic Patient With Cutaneous Squamous Cell Carcinoma. Front Immunol 2022; 12:752563. [PMID: 35003064 PMCID: PMC8733210 DOI: 10.3389/fimmu.2021.752563] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/22/2021] [Indexed: 01/30/2023] Open
Abstract
The combination of radiotherapy and immunotherapy improves the survival rate of patients with malignancies developed through escape from T-cell-mediated immune surveillance. Immune checkpoint inhibitors, such as anti-programmed cell death protein-ligand 1 (anti-PD-L1) antibody, are used to rescue exhausted T cells. Simultaneously, dendritic cells (DCs) which are antigen-presenting cells that can initiate T-cell activation, are used to induce a tumor-specific immune response. However, the synergistic antitumor efficacy of the aforementioned combinational immunotherapy with intratumoral injection of low-dose DCs has not been reported, and the underlying therapeutic mechanism requires further investigation. Herein, we present the special case of a psoriatic patient with cutaneous squamous cell carcinoma (cSCC) in the right inguinal region, these two diseases characterized by opposing contradiction, further complicating treatments and side-effect management efforts. To treat the intractable SCC without exaggerating psoriasis, we developed the triple-regimen therapy (TRT) with the intratumoral injection of low-dose autologous DCs and anti-PD-L1 combined with radiotherapy. The injected DCs were obtained simply through leukapheresis without prior G-CSF administration for mobilization nor tumor-antigen loading for expansion. The patient received three radiation doses (24, 18, and 18 Gy) combined with three intratumoral injections of anti-PD-L1 antibody (40, 60, and 120 mg) plus autologous DCs (80% of the DC subpopulation being CD16+ myeloid DC with approximate amounts of 7.3 × 104, 2.5 × 106, and 1.7 × 107) within 10 weeks. The efficacy of the TRT was encouraging in shrinking tumor mass with remarkable SUVmax reduction (approximately 42%) on FDG PET-Scan despite relatively low-dose DCs were available. The low-dose intratumoral immunotherapy induced mild cutaneous side effects as expected. The transcriptomes were compared between pre-TRT and post-TRT biopsies to analyze underlying mechanical pathways of the TRT protocol. Over 10 highly significantly enriched T-cell-related pathways (P <0.0001) were identified in post-TRT biopsies. In addition, the activation of both innate and adaptive immunity was significantly enriched in post-TRT peripheral blood samples. We develop the easily accessible TRT which produces both local anti-tumor T-cell responses and systemic antitumor immunity for treating cSCC patients, especially for those with autoimmune disease.
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Affiliation(s)
- Jun-Wei Huang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Chun-Lin Kuo
- Department of General Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Li-Tzu Wang
- Department of Obstetrics & Gynecology, National Taiwan University Hospital & College of Medicine, Taipei, Taiwan
| | - Kevin Sheng-Kai Ma
- Department of Life Science, National Taiwan University, Taipei, Taiwan.,Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Wen-Yen Huang
- Department of Radiation Oncology, Tri-Service General Hospital, Taipei, Taiwan
| | - Feng-Cheng Liu
- Division of Rheumatology/Immunology and Allergy, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Kuender D Yang
- Department of Microbiology & Immunology, National Defense Medical Center, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Allergy, Immunology & Rheumatology, Mackay Children's Hospital, Taipei, Taiwan
| | - Bing-Heng Yang
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan.,Trace Element Research Center, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
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Lu J, Sun K, Yang H, Fan D, Huang H, Hong Y, Wu S, Zhou H, Fang F, Li Y, Meng L, Huang J, Bai Z. Sepsis Inflammation Impairs the Generation of Functional Dendritic Cells by Targeting Their Progenitors. Front Immunol 2021; 12:732612. [PMID: 34566996 PMCID: PMC8458800 DOI: 10.3389/fimmu.2021.732612] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/23/2021] [Indexed: 12/29/2022] Open
Abstract
Background Sepsis is a complex systemic immune dysfunction syndrome induced by infection. Sepsis has a high mortality rate, with most patients dying due to systemic organ failure or secondary infection. Dendritic cells (DCs) are professional antigen-presenting cells. Upon infection with microbes, DCs are activated to induce adaptive immune responses for controlling infection. DC generation and function are impaired during sepsis; however, the underlying mechanisms remain largely unknown. Methods Peripheral blood samples from sepsis patients were collected to examine DC subsets, DC progenitors, and apoptosis of DCs by flow cytometer. In vitro induction of DCs from hematopoietic stem/progenitor cells were established and a variety of sepsis-associated inflammatory mediators [e.g., interferon-gamma (IFN-γ), interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and granulocyte-colony stimulating factor (G-CSF)] and Lipopolysaccharide (LPS) were determined for the impact on DC generation and function in vitro. Results Our results demonstrate that sepsis-induced systemic inflammation impairs the capacity of hematopoietic stem and progenitor cells (HSPCs) to produce DCs, including conventional DCs (cDCs) and plasmacytoid DCs (pDCs). We investigated peripheral blood (PB) samples from 34 pediatric patients on days 1 to 7 following diagnosis. Compared to healthy donors (n = 18), the sepsis patients exhibited a significantly fewer percentage and number of pDCs and cDCs, and a lower expression of antigen presenting molecule HLD-DR and co-stimulatory molecules (e.g., CD86) on the surface of DCs. This sepsis-induced DC impairment was associated with significantly increased apoptotic death of DCs and marked decreases of progenitor cells that give rise to DCs. Furthermore, we observed that among the tested sepsis-associated cytokines (e.g., IFN-γ, IL-1β, TNF-α, and G-CSF), G-CSF and IFN-γ impaired DC development from cultured HSPCs. G-CSF also markedly decreased the expression of HLA-DR on HSPC-derived DCs and their cytokine production, including IL-12 and IFN-β. Conclusions Collectively, these findings indicate that sepsis impairs the survival of functional DCs and their development from HSPCs. Strategies for improving DC reconstitution following sepsis may restore DC progenitors and their associated function.
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Affiliation(s)
- Jie Lu
- Department of Pediatric Intensive Care Unit, Children Hospital of Soochow University, Suzhou, China
| | - Kun Sun
- Department of Emergency, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Huiping Yang
- Department of Pediatric Intensive Care Unit, Children Hospital of Soochow University, Suzhou, China
| | - Dan Fan
- Department of Pediatric Intensive Care Unit, Children Hospital of Soochow University, Suzhou, China
| | - He Huang
- Department of Emergency, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Yi Hong
- Department of Pediatrics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Shuiyan Wu
- Department of Pediatric Intensive Care Unit, Children Hospital of Soochow University, Suzhou, China
| | - HuiTing Zhou
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China
| | - Fang Fang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China
| | - YanHong Li
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China.,Department of Nephrology, Children's Hospital of Soochow University, Suzhou, China
| | - Lijun Meng
- Department of Pediatric Intensive Care Unit, Children Hospital of Soochow University, Suzhou, China
| | - Jie Huang
- Department of Cardiovascular Medicine, Children Hospital of Soochow University, Suzhou, China
| | - Zhenjiang Bai
- Department of Pediatric Intensive Care Unit, Children Hospital of Soochow University, Suzhou, China
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Liu X, Shi GP, Guo J. Innate Immune Cells in Pressure Overload-Induced Cardiac Hypertrophy and Remodeling. Front Cell Dev Biol 2021; 9:659666. [PMID: 34368120 PMCID: PMC8343105 DOI: 10.3389/fcell.2021.659666] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
Pressure overload and heart failure are among the leading causes of cardiovascular morbidity and mortality. Accumulating evidence suggests that inflammatory cell activation and release of inflammatory mediators are of vital importance during the pathogenesis of these cardiac diseases. Yet, the roles of innate immune cells and subsequent inflammatory events in these processes remain poorly understood. Here, we outline the possible underlying mechanisms of innate immune cell participation, including mast cells, macrophages, monocytes, neutrophils, dendritic cells, eosinophils, and natural killer T cells in these pathological processes. Although these cells accumulate in the atrium or ventricles at different time points after pressure overload, their cardioprotective or cardiodestructive activities differ from each other. Among them, mast cells, neutrophils, and dendritic cells exert detrimental function in experimental models, whereas eosinophils and natural killer T cells display cardioprotective activities. Depending on their subsets, macrophages and monocytes may exacerbate cardiodysfunction or negatively regulate cardiac hypertrophy and remodeling. Pressure overload stimulates the secretion of cytokines, chemokines, and growth factors from innate immune cells and even resident cardiomyocytes that together assist innate immune cell infiltration into injured heart. These infiltrates are involved in pro-hypertrophic events and cardiac fibroblast activation. Immune regulation of cardiac innate immune cells becomes a promising therapeutic approach in experimental cardiac disease treatment, highlighting the significance of their clinical evaluation in humans.
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Affiliation(s)
- Xin Liu
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Guo-Ping Shi
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Junli Guo
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- Hainan Provincial Key Laboratory for Tropical Cardiovascular Diseases Research & Key Laboratory of Emergency and Trauma of Ministry of Education, Institute of Cardiovascular Research of the First Affiliated Hospital, Hainan Medical University, Haikou, China
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Liu G, Fan X, Cai Y, Fu Z, Gao F, Dong J, Li K, Cai J. Efficacy of dendritic cell-based immunotherapy produced from cord blood in vitro and in a humanized NSG mouse cancer model. Immunotherapy 2020; 11:599-616. [PMID: 30943862 DOI: 10.2217/imt-2018-0103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AIM To produce dendritic cells (DCs) from CD34+ stem cells from cord blood and explore their prophylactic and curative effect against tumors by vaccinating humanized NSG mice. MATERIALS & METHODS Separated CD34+ stem cells from cord blood were cultured for 30 days, and the resultant DCs (CD34-DCs) were collected. The basic function of the CD34-DCs and the cytotoxicity of CD34-cytotoxic-T lymphocytes (CTLs) were tested in vitro, and tumor inhibition in a humanized NSG mouse tumor model was observed. RESULTS The number of CD34-DCs reached approximately 9 log. These cells performed functions similar to those of DCs derived from monocytes from peripheral blood (PBMC-DCs). The CTLs of the CD34-DCs (CD34-CTLs) presented a better antitumor effect in vitro. The obvious prophylactic and therapeutic antitumor effects of the CD34-DC vaccine were observed in the humanized NSG mouse models. CONCLUSION CD34-DCs from cord blood were sufficient in quantity and quality as a vaccine agent against tumors in vitro and in vivo.
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Affiliation(s)
- Gang Liu
- Department of Surgery, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China.,Department of Surgery, Hebei General Hospital, 348 Heping West Road, Shijiazhuang 050051, China
| | - Xiaoyan Fan
- Department of Oncology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang 050051, China
| | - Ying Cai
- Department of Research and Development, Hebei Engineering Technology Research Center for Cell Therapy, Hebei HOFOY Biotech Corporation Ltd, 238 Changjiang Aveneu, Shijiazhuang 500350, China
| | - Zexian Fu
- Department of Surgery, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Fei Gao
- Department of Surgery, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Jiantao Dong
- Department of Surgery, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China.,Department of Surgery, Hebei General Hospital, 348 Heping West Road, Shijiazhuang 050051, China
| | - Kang Li
- Department of Surgery, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China
| | - Jianhui Cai
- Department of Surgery, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang 050017, China.,Department of Surgery, Hebei General Hospital, 348 Heping West Road, Shijiazhuang 050051, China.,Department of Oncology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang 050051, China
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In Vivo Administration of Recombinant Human Granulocyte Colony-Stimulating Factor Increases the Immune Effectiveness of Dendritic Cell-Based Cancer Vaccination. Vaccines (Basel) 2019; 7:vaccines7030120. [PMID: 31546936 PMCID: PMC6789603 DOI: 10.3390/vaccines7030120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 09/12/2019] [Accepted: 09/17/2019] [Indexed: 01/01/2023] Open
Abstract
Significant recent advances in cancer immunotherapeutics include the vaccination of cancer patients with tumor antigen-associated peptide-pulsed dendritic cells (DCs). DC vaccines with homogeneous, mature, and functional activities are required to achieve effective acquired immunity; however, the yield of autologous monocyte-derived DCs varies in each patient. Priming with a low dose of recombinant human granulocyte colony-stimulating factor (rhG-CSF) 16-18 h prior to apheresis resulted in 50% more harvested monocytes, with a significant increase in the ratio of CD11c+CD80+ DCs/apheresed monocytes. The detection of antigen-specific cytotoxic T lymphocytes after Wilms' tumor 1-pulsed DC vaccination was higher in patients treated with rhG-CSF than those who were not, based on immune monitoring using tetramer analysis. Our study is the first to report that DC vaccines for cancer immunotherapy primed with low-dose rhG-CSF are expected to achieve higher acquired immunogenicity.
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Fidyk W, Mitrus I, Ciomber A, Smagur A, Chwieduk A, Głowala-Kosińska M, Giebel S. Evaluation of proinflammatory and immunosuppressive cytokines in blood and bone marrow of healthy hematopoietic stem cell donors. Cytokine 2017; 102:181-186. [PMID: 28927758 DOI: 10.1016/j.cyto.2017.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/17/2017] [Accepted: 09/02/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Cytokine composition of bone marrow microenvironment in comparison to blood is poorly explored. The goal of this study was to investigate the levels of cytokines present in peripheral blood and bone marrow of healthy hematopoietic stem cells donors. The data obtained on this subject with addition to cytometric analysis can provide new insight into the hematopoietic stem cells microenvironment. METHODOLOGY Study consisted of cytokine concentration analysis performed by ELISA tests of peripheral blood of healthy peripheral blood stem cells donors and bone marrow of healthy bone marrow donors. Additionally we have tested the expression of CD47 and CD274 proteins on the surface of hematopoietic stem cells by the flow cytometry analysis. RESULTS The results has shown different composition of analyzed cytokines (IL-1 β, IL-2, IL-4, IL-6, IL-10, IL-17A, TGF-β1, IFN-γ and TNF-α) present in bone marrow and blood of stem cells donors. The hematopoietic stem cells in peripheral blood are subjected to higher levels of proinflammatory cytokines whilst the lower level of those cytokines in bone marrow with a very high level of TGF-β1 which possibly creates a more immunosuppressive environment. The IL-10 level was significantly higher in peripheral blood of PBSC donors after the administration of mobilizing factor (G-CSF). The percentage of CD47+HSCs was significantly higher in bone marrow compared to peripheral blood of mobilized donors.
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Affiliation(s)
- Wojciech Fidyk
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute Oncology Center, Gliwice Branch, 44-101 Gliwice, Wybrzeże Armii Krajowej 15 Street, Poland.
| | - Iwona Mitrus
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute Oncology Center, Gliwice Branch, 44-101 Gliwice, Wybrzeże Armii Krajowej 15 Street, Poland
| | - Agnieszka Ciomber
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute Oncology Center, Gliwice Branch, 44-101 Gliwice, Wybrzeże Armii Krajowej 15 Street, Poland
| | - Andrzej Smagur
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute Oncology Center, Gliwice Branch, 44-101 Gliwice, Wybrzeże Armii Krajowej 15 Street, Poland
| | - Agata Chwieduk
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute Oncology Center, Gliwice Branch, 44-101 Gliwice, Wybrzeże Armii Krajowej 15 Street, Poland
| | - Magdalena Głowala-Kosińska
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute Oncology Center, Gliwice Branch, 44-101 Gliwice, Wybrzeże Armii Krajowej 15 Street, Poland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute Oncology Center, Gliwice Branch, 44-101 Gliwice, Wybrzeże Armii Krajowej 15 Street, Poland
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Abstract
Vaccination, the revolutionary prophylactic immunotherapy developed in the eighteenth century, has become the most successful and cost-effective of medical remedies available to modern society. Due to the remarkable accomplishments of the past century, the number of diseases and pathogens for which a traditional vaccine approach might reasonably be employed has dwindled to unprecedented levels. While this happy scenario bodes well for the future of public health, modern immunologists and vaccinologists face significant challenges if we are to address the scourge of recalcitrant pathogens like HIV and HCV and well as the significant obstacles to immunotherapy imposed by neoplastic self. Here, the authors review the clinical and preclinical literature to highlight the manner by which the host immune system can be successfully manipulated by cytokine adjuvants, thereby significantly enhancing the efficacy of a wide variety of vaccination platforms.
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Eksioglu EA, Kielbasa J, Eisen S, Reddy V. Granulocyte-macrophage colony-stimulating factor increases the proportion of circulating dendritic cells after autologous but not after allogeneic hematopoietic stem cell transplantation. Cytotherapy 2011; 13:888-96. [PMID: 21609205 DOI: 10.3109/14653249.2011.579956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AIMS Granulocyte-macrophage (GM) colony-stimulating factor (CSF) has been used as an adjuvant in cancer immunotherapy. We tested the hypothesis that GM-CSF (Leukine(®); sargramostim) improves immune reconstitution after hematopoietic stem cell transplantation (HSCT) based on our prior in vitro work that demonstrated the pro-inflammatory effects of GM-CSF on dendritic cells (DC). METHODS GM-CSF was administered to donors, along with standard granulocyte (G) CSF, during stem cell mobilization, and to recipients from the day prior to transplant until engraftment. Eighteen patients consented to the GM-CSF(+) protocol and were compared with 17 matched controls undergoing HSCT during the same time period (GM-CSF(-)). RESULTS Numbers of white blood cells (WBC) and CD34(+) stem cells in the graft were comparable to controls. Surprisingly, contrary to our hypothesis, the allogeneic donor graft had significantly decreased numbers of CD3(+) T cells and their subsets (CD4(+), CD4(+) CD45RA(+), CD4(+) CD45RO(+), CD8(+) and CD8(+) CD45RO(+)), DC (both myeloid and plasmacytoid) and natural killer (NK) cells (CD16(+) CD56(+)). In the GM-CSF arm, following allogeneic transplantation, the levels of DC, T cells and NK cells did not increase with treatment. Conversely, autologous transplant patients receiving GM-CSF had a higher proportion of DC at the time of engraftment. CONCLUSIONS These findings demonstrate that administration of GM-CSF improves DC reconstitution after autologous rather than allogeneic HSCT.
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Affiliation(s)
- Erika Adriana Eksioglu
- University of Florida, College of Medicine, Division of Hematology-Oncology, Gainesville, Florida, USA
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Serrano-López J, Sanchez-Garcia J, Serrano J, Alvarez-Rivas MA, Garcia-Castellano JM, Roman-Gomez J, Rosa ODL, Herrera-Arroyo C, Torres-Gomez A. Nonleukemic myeloid dendritic cells obtained from autologous stem cell products elicit antileukemia responses in patients with acute myeloid leukemia. Transfusion 2011; 51:1546-55. [DOI: 10.1111/j.1537-2995.2010.03042.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sobrino T, Millán M, Castellanos M, Blanco M, Brea D, Dorado L, Rodríguez-González R, Rodríguez-Yáñez M, Serena J, Leira R, Dávalos A, Castillo J. Association of growth factors with arterial recanalization and clinical outcome in patients with ischemic stroke treated with tPA. J Thromb Haemost 2010; 8:1567-74. [PMID: 20456746 DOI: 10.1111/j.1538-7836.2010.03897.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY BACKGROUND Growth factors (GF) such as vascular endothelial growth factor (VEGF), angiopoietin-1 (Ang-1) and granulocyte-colony stimulating factor (G-CSF) have been associated with greater efficacy of tissue plasminogen activator (tPA) in experimental studies. OBJECTIVES To study the association of these GF with arterial recanalization and clinical outcome in patients with acute ischemic stroke treated with tPA. METHODS We prospectively studied 79 patients with ischemic stroke attributable to MCA occlusion treated with i.v. tPA within the first 3 h from onset of symptoms. Continuous transcranial color-coded sonography (TCCS) was performed during the first 2 h after tPA bolus to assess early MCA recanalization. Hemorrhagic transformation (HT) was classified according to ECASS II definitions. Good functional outcome was defined as a Rankin scale score of 0-2 at 90 days. GF levels were determined by ELISA. RESULTS Mean serum levels of VEGF, G-CSF and Ang-1 at baseline were significantly higher in patients with early MCA recanalization (n = 30) (all P < 0.0001). In the multivariate analysis, serum levels of VEGF (OR, 1.03), G-CSF (OR, 1.02) and Ang-1 (OR, 1.07) were independently associated with early MCA recanalization (all P < 0.0001). On the other hand, patients with parenchymal hematoma (PH) (n = 20) showed higher levels of Ang-1 (P < 0.0001). Ang-1 (OR, 1.12; P < 0.0001) was independently associated with PH, whereas patients with good outcome (n = 38) had higher levels of G-CSF (P < 0.0001). G-CSF was independently associated with good outcome (OR, 1.12; P = 0.036). CONCLUSIONS These findings suggest that GF may enhance arterial recanalization in patients with ischemic stroke treated with t-PA, although they might increase the HT.
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Affiliation(s)
- T Sobrino
- Clinical Neuroscience Research Laboratory, Department of Neurology, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
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Hosing C, Munsell MF, Reuben JM, Popat U, Lee BN, Gao H, Körbling M, Shpall EJ, Kebriaei P, Alousi A, De Lima M, McMannis J, Qazilbash M, Anderlini P, Giralt S, Champlin RE, Khouri I. A randomized study comparing chemotherapy followed by G-CSF alone or in combination with GM-CSF for mobilization of peripheral blood stem cells in patients with non-Hodgkin's lymphomas. J Blood Med 2010; 1:49-55. [PMID: 22282683 PMCID: PMC3262333 DOI: 10.2147/jbm.s9846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) are the two most commonly used cytokines for mobilization of stem cells in patients undergoing high dose chemotherapy with stem cell support. Both cytokines increase the peripheral blood white blood cell count and the stem cell count but there are other differences in the stem cell products mobilized by G-CSF versus those mobilized with GM-CSF. Generally higher numbers of dendritic cells are mobilized with GM-CSF than by G-CSF. The primary objective of this randomized study was to evaluate the safety and efficacy of chemotherapy plus G-CSF versus chemotherapy plus G-CSF and GM-CSF in patients with B-cell non-Hodgkin's lymphoma (NHL) who were undergoing chemo-mobilization. Secondary objectives were to determine the expression of various dendritic cell subsets in the two groups and to determine the incidence of disease progression or relapse at 12 months. METHODS We prospectively evaluated 84 patients with relapsed NHL who were candidates for high dose therapy (HDT). All patients underwent chemo-mobilization using ifosfamide, etoposide, and rituximab. All patients were randomized in an adaptive manner to receive either G-CSF or G-CSF plus GM-CSF (G+GM) starting 24 hours after completion of chemotherapy and continuing until completion of apheresis. The stem cell yield/kg, the number of apheresis procedures needed in the two groups, and the toxicity were recorded. We also enumerated dendritic cell subsets, myeloid DCs (mDC) and plasmacytoid DCs (pDC), in apheresis products and in peripheral blood (PB) samples collected pre-chemotherapy. The data were expressed as a percentage of peripheral blood mononuclear cells. RESULTS A total of 84 patients were treated. Forty-three patients received G-CSF and 41 received G+GM. Both regimens were well tolerated. The median CD34+ cell dose collected was similar in the two groups. A total of 54 (G-CSF N = 25 and G+GM N = 29) paired samples from baseline and post-apheresis were available for analysis of dendritic cell subsets. There was no significant difference in the percentages of mDC subsets between baseline and post-apheresis collected with G-CSF or G+GM mobilization. However, there was a significant increase in the percentage of pDC subsets in the G-CSF alone when compared to the G+GM arm (P = 0.002). Furthermore, the ratio of mDC and pDC was significantly lower after mobilization with G-CSF versus G+GM (P = 0.029). CONCLUSION Addition of GM-CSF to G-CSF to the mobilization regimen resulted in lower percentages of pDC in the apheresis products when compared to those with G-CSF alone. This shifts the mDC/pDC ratio in the apheresis grafts in favor of mDC in the combination arm. However, these differences did not seem to impact the clinical outcomes in the two groups. (ClinicalTrials.gov Identifier: NCT00499343).
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Decker WK, Safdar A. Bioimmunoadjuvants for the treatment of neoplastic and infectious disease: Coley's legacy revisited. Cytokine Growth Factor Rev 2009; 20:271-81. [DOI: 10.1016/j.cytogfr.2009.07.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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13
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Mannon PJ, Leon F, Fuss IJ, Walter BA, Begnami M, Quezado M, Yang Z, Yi C, Groden C, Friend J, Hornung RL, Brown M, Gurprasad S, Kelsall B, Strober W. Successful granulocyte-colony stimulating factor treatment of Crohn's disease is associated with the appearance of circulating interleukin-10-producing T cells and increased lamina propria plasmacytoid dendritic cells. Clin Exp Immunol 2008; 155:447-56. [PMID: 19094118 DOI: 10.1111/j.1365-2249.2008.03799.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Granulocyte-colony stimulating factor (G-CSF) has proved to be a successful therapy for some patients with Crohn's disease. Given the known ability of G-CSF to exert anti-T helper 1 effects and to induce interleukin (IL)-10-secreting regulatory T cells, we studied whether clinical benefit from G-CSF therapy in active Crohn's disease was associated with decreased inflammatory cytokine production and/or increased regulatory responses. Crohn's patients were treated with G-CSF (5 microg/kg/day subcutaneously) for 4 weeks and changes in cell phenotype, cytokine production and dendritic cell subsets were measured in the peripheral blood and colonic mucosal biopsies using flow cytometry, enzyme-linked immunosorbent assay and immunocytochemistry. Crohn's patients who achieved a clinical response or remission based on the decrease in the Crohn's disease activity index differed from non-responding patients in several important ways: at the end of treatment, responding patients had significantly more CD4(+) memory T cells producing IL-10 in the peripheral blood; they also had a greatly enhanced CD123(+) plasmacytoid dendritic cell infiltration of the lamina propria. Interferon-gamma production capacity was not changed significantly except in non-responders, where it increased. These data show that clinical benefit from G-CSF treatment in Crohn's disease is accompanied by significant induction of IL-10 secreting T cells as well as increases in plasmacytoid dendritic cells in the lamina propria of the inflamed gut mucosa.
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Affiliation(s)
- P J Mannon
- Mucosal Immunity Section, Laboratory of Host Defense, NIAID, NIH, Bethesda, MD, USA.
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Naito K, Anzai T, Sugano Y, Maekawa Y, Kohno T, Yoshikawa T, Matsuno K, Ogawa S. Differential effects of GM-CSF and G-CSF on infiltration of dendritic cells during early left ventricular remodeling after myocardial infarction. THE JOURNAL OF IMMUNOLOGY 2008; 181:5691-701. [PMID: 18832728 DOI: 10.4049/jimmunol.181.8.5691] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Several lines of evidence suggest that the immune activation after myocardial infarction (MI) induces secondary myocardial injury. Although dendritic cells (DC) are potent regulators of immunity, their role in MI is still undetermined. We investigated the effect of DC modulation by CSF on left ventricular (LV) remodeling after MI. MI was induced by ligation of the left coronary artery in male Wistar rats. G-CSF (20 microg/kg/day, MI-G, n = 33), a GM-CSF inducer (romurtide, 200 microg/kg/day, MI-GM, n = 28), or saline (MI-C, n = 55) was administered for 7 days. On day 14, MI-G animals had higher LV max dP/dt and smaller LV dimensions, whereas MI-GM animals had lower LV max dP/dt and larger LV dimensions than did MI-C animals, despite similar infarct size. In MI-C, OX62(+) DC infiltrated the infarcted and border areas, peaking on day 7. Bromodeoxyuridine-positive DC were observed in the border area during convalescence. Infiltration by DC was decreased in MI-G animals and increased in MI-GM animals compared with MI-C (p < 0.05). In the infarcted area, the heat shock protein 70, TLR2 and TLR4, and IFN-gamma expression were reduced in MI-G, but increased in MI-GM in comparison with those in MI-C animals. IL-10 expression was higher in MI-G and lower in MI-GM than in MI-C animals. In conclusion, G-CSF improves and GM-CSF exacerbates early postinfarction LV remodeling in association with modulation of DC infiltration. Suppression of DC-mediated immunity could be a new strategy for the treatment of LV remodeling after MI.
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Affiliation(s)
- Kotaro Naito
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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15
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Chen YK, Jiang XM, Gong JP. Recombinant human granulocyte colony-stimulating factor enhanced the resolution of venous thrombi. J Vasc Surg 2008; 47:1058-65. [PMID: 18358673 DOI: 10.1016/j.jvs.2007.12.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Revised: 12/12/2007] [Accepted: 12/16/2007] [Indexed: 11/17/2022]
Abstract
BACKGROUND Bone marrow-derived cells are recruited into the thrombus during resolution. This study explored whether mobilization of bone marrow cells with recombinant human granulocyte colony-stimulating factor (rhG-CSF) could enhance the resolution of venous thrombi and the accumulation of macrophages in thrombi and explored the effect of rhG-CSF on cysteine-cysteine chemokine receptor 2 (CCR2) expression. METHODS The Sprague-Dawley adult rats were randomly divided into four groups: control, sham-operated, thrombus, and treatment groups. Thrombi were induced in the thrombus and treatment group, which received a subcutaneous injection of rhG-CSF once daily for 6 days postoperatively. The thrombus, sham-operated, and control groups received equal volumes of 0.9% saline. The mononuclear cells in peripheral blood were analyzed by an automated hematology analyzer and counted under microscope. The cell marker CD68 was used to determine the number of macrophages in thrombi tissue sections. Levels of monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1alpha (MIP1alpha) in the peripheral blood were detected by enzyme-linked immunosorbent assay. Real-time reverse transcriptase-polymerase chain reaction and Western blot were used to analyze, respectively, the expression of CCR2 messenger RNA in the peripheral blood and CCR2 protein of THP-1 monocyte. RESULTS At postoperative days 3 (P < .05) and 7 (P < .01), mononuclear cells significantly increased in treatment group (2.1 +/- 0.3, 4.4 +/- 0.3 x 10(6)/L) vs the thrombus group (1.7 +/- 0.2, 1.3 +/- 0.4 x 10(6)/L). The organization and recanalization of thrombi in treatment group progressed more quickly compared with the thrombus group (P < .01). The macrophage number of the thrombus in the treatment group (338 +/- 26 cells/15 high-power fields) increased significantly vs the thrombus group (125 +/- 11 cells/15 high-power fields, P < .01). No statistical difference was observed between the thrombus and treatment group in the MCP-1 and MIP-1alpha level in peripheral blood. Expressions of the CCR2 gene in the peripheral blood of the treatment group significantly increased compared with the thrombus group (P < .05). Recombinant human G-CSF induced higher expression of CCR2 protein of human monocytic cell line THP-1. CONCLUSIONS Bone marrow mobilization enhanced the resolution and recanalization of venous thrombi. This process was associated with increased macrophage accumulation in thrombi, which might be the result of higher CCR2 expression of monocytes. CLINICAL RELEVANCE The classic treatment of venous thrombi is anticoagulation. Anticoagulant therapy and thrombolysis both have limited effects on existing thrombi and have a small but significant risk of severe hemorrhage. In clinical practice, we lack specific treatment for patients with venous thrombosis combined with brain hemorrhage or a gastrointestinal activated ulcer, which are contraindicated for anticoagulation and thrombolytic therapy. Enhancing the resolution of venous thrombi would contribute to its therapy. Bone marrow-derived cells are recruited into the thrombus during resolution. Many of these cells express a macrophage phenotype and may represent a population of plastic stem cells that orchestrate thrombus recanalization. Recombinant human granulocyte colony stimulating factor (rhG-CSF) can mobilize monocytic lineage cells into peripheral blood and may contribute to this cell in the thrombi. If rhG-CSF enhances the resolution of venous thrombi and recanalization, it might be used to treat patients with venous thrombi, especially those who have contraindication for anticoagulation and thrombolytic therapy.
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MESH Headings
- Animals
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Bone Marrow Cells/drug effects
- Bone Marrow Cells/immunology
- Bone Marrow Cells/pathology
- Cell Line
- Cell Movement/drug effects
- Chemokine CCL2/blood
- Chemokine CCL3/blood
- Disease Models, Animal
- Granulocyte Colony-Stimulating Factor/administration & dosage
- Hematopoietic Stem Cell Mobilization/methods
- Humans
- Injections, Subcutaneous
- Macrophages/drug effects
- Macrophages/immunology
- Male
- Monocytes/drug effects
- Monocytes/immunology
- RNA, Messenger/blood
- Rats
- Rats, Sprague-Dawley
- Receptors, CCR2/blood
- Receptors, CCR2/genetics
- Receptors, CCR2/metabolism
- Recombinant Proteins
- Stem Cells/drug effects
- Stem Cells/immunology
- Time Factors
- Venae Cavae/drug effects
- Venae Cavae/immunology
- Venous Thrombosis/drug therapy
- Venous Thrombosis/pathology
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Affiliation(s)
- Yi-kuan Chen
- Department of General Surgery, Second Affiliated Hospital, Chongqing University of Medical Science, Chongqing, Peoples Republic of China
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16
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Gazitt Y, Freytes CO, Akay C, Badel K, Calandra G. Improved mobilization of peripheral blood CD34+ cells and dendritic cells by AMD3100 plus granulocyte-colony-stimulating factor in non-Hodgkin's lymphoma patients. Stem Cells Dev 2007; 16:657-66. [PMID: 17784839 DOI: 10.1089/scd.2006.0087] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AMD3100 is a drug capable of mobilizing peripheral blood stem cells (PBSCs) in donors and in cancer patients as a single agent or in combination with granulocyte-colony-stimulating factor (G-CSF). We initiated a phase II study of 11 refractory or relapsed non-Hodgkin's lymphoma (NHL) patients, receiving 16 microg/kg daily of G-CSF for 4 days followed by 240 microg/kg of AMD3100 given subcutaneously on a new schedule of 9-10 h before apheresis collection on day 5. Our aims were to assess the effect of AMD3100 on the mobilization of CD34+ cells, dendritic cells (DCs) and lymphoma cells. Administration of G-CSF and AMD3100 were continued daily until >or=2 x 10(6) CD34+ cells/kg were collected. Adequate collection of the target of CD34+ cells was achieved in all but 1 patient within 2 days, and 10/11 patients were transplanted within 2 months. All transplanted patients engrafted with a mean of 10 and 12 days for neutrophils and platelets, respectively. Addition of AMD3100 to G-CSF resulted with >2.5-fold increase in CD34+ cells/microl (p = 0.0001) and in a >2-fold increase in pDC1 and pDC2 cells/microl (p = 0.003). Adverse events related to AMD3100 were minimal. AMD3100 was generally safe and improved PBSC and DC cell mobilization with no apparent contamination of lymphoma cells.
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Affiliation(s)
- Yair Gazitt
- The University of Texas Health Science Center at San Antonio and Audie L Murphy Memorial Veterans Hospital, San Antonio, TX 78284, USA.
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17
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Abstract
During inflammation and cytopenia, increased levels of hematopoietic growth factors (HPGFs) induce mobilization and proliferation of hematopoietic stem cells and hematopoietic progenitor cells (HPCs), resulting in spatial and quantitative in vivo expansion of the hematopoietic tissue. Exogenous administration of recombinant HPGFs, particularly granulocyte colony-stimulating factor (G-CSF), is routine for mobilization of stem cells, followed by collection and transplantation of autologous or allogeneic stem cells. In this review, we summarize experience using different HPGFs and HPGF combinations for stem cell mobilization, such as G-CSF, granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-3 (IL-3), stem cell factor (SCF), and others. Preclinical and clinical studies of so-called early- and late-acting HPGFs for ex vivo expansion of HPCs are discussed, also with respect to the unresolved question whether expansion of repopulating stem cells can be achieved in vitro.
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Affiliation(s)
- Robert Möhle
- Department of Medicine II, University of Tübingen, Tübingen, Germany.
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