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Grivas P, Loriot Y, Morales-Barrera R, Teo MY, Zakharia Y, Feyerabend S, Vogelzang NJ, Grande E, Adra N, Alva A, Necchi A, Rodriguez-Vida A, Gupta S, Josephs DH, Srinivas S, Wride K, Thomas D, Simmons A, Loehr A, Dusek RL, Nepert D, Chowdhury S. Efficacy and safety of rucaparib in previously treated, locally advanced or metastatic urothelial carcinoma from a phase 2, open-label trial (ATLAS). BMC Cancer 2021; 21:593. [PMID: 34030643 PMCID: PMC8147008 DOI: 10.1186/s12885-021-08085-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND ATLAS evaluated the efficacy and safety of the PARP inhibitor rucaparib in patients with previously treated locally advanced/unresectable or metastatic urothelial carcinoma (UC). METHODS Patients with UC were enrolled independent of tumor homologous recombination deficiency (HRD) status and received rucaparib 600 mg BID. The primary endpoint was investigator-assessed objective response rate (RECIST v1.1) in the intent-to-treat and HRD-positive (loss of genome-wide heterozygosity ≥10%) populations. Key secondary endpoints were progression-free survival (PFS) and safety. Disease control rate (DCR) was defined post-hoc as the proportion of patients with a confirmed complete or partial response (PR), or stable disease lasting ≥16 weeks. RESULTS Of 97 enrolled patients, 20 (20.6%) were HRD-positive, 30 (30.9%) HRD-negative, and 47 (48.5%) HRD-indeterminate. Among 95 evaluable patients, there were no confirmed responses. However, reductions in the sum of target lesions were observed, including 6 (6.3%) patients with unconfirmed PR. DCR was 11.6%; median PFS was 1.8 months (95% CI, 1.6-1.9). No relationship was observed between HRD status and efficacy endpoints. Median treatment duration was 1.8 months (range, 0.1-10.1). Most frequent any-grade treatment-emergent adverse events were asthenia/fatigue (57.7%), nausea (42.3%), and anemia (36.1%). Of 64 patients with data from tumor tissue samples, 10 (15.6%) had a deleterious alteration in a DNA damage repair pathway gene, including four with a deleterious BRCA1 or BRCA2 alteration. CONCLUSIONS Rucaparib did not show significant activity in unselected patients with advanced UC regardless of HRD status. The safety profile was consistent with that observed in patients with ovarian or prostate cancer. TRIAL REGISTRATION This trial was registered in ClinicalTrials.gov (NCT03397394). Date of registration: 12 January 2018. This trial was registered in EudraCT (2017-004166-10).
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Affiliation(s)
- P Grivas
- Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, 98109, USA.
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA.
- Seattle Cancer Care Alliance, 1144 Eastlake Avenue E, LG- 465, Seattle, WA, 98109, USA.
| | - Y Loriot
- Department of Medicine, Gustave Roussy Cancer Campus, INSERM U981, Université Paris-Saclay, 39 Rue Camille Desmoulins, 94800, Villejuif, France
| | | | - M Y Teo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Y Zakharia
- Division of Hematology, Oncology, and Blood and Marrow Transplant, University of Iowa and Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - S Feyerabend
- Studienpraxis Urologie, Steinengrabenstraße 17, 72622, Nürtingen, Germany
| | - N J Vogelzang
- Division of Hematology/Oncology, Comprehensive Cancer Centers of Nevada, 3730 S Eastern Avenue, Las Vegas, NV, 89169, USA
| | - E Grande
- Department of Medical Oncology, MD Anderson Cancer Center, Calle de Arturo Soria, 270 28033, Madrid, Spain
| | - N Adra
- Department of Medicine, Indiana University Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - A Alva
- Department of Internal Medicine, University of Michigan Comprehensive Cancer Center, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - A Necchi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - A Rodriguez-Vida
- Medical Oncology Department, Hospital del Mar, Passeig Maritim 25-29, 08003, Barcelona, Spain
| | - S Gupta
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, 1950 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - D H Josephs
- Department of Medical Oncology, Guy's and St. Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK
| | - S Srinivas
- Division of Medical Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA
| | - K Wride
- Clovis Oncology, Inc., 5500 Flatiron Parkway, Boulder, CO, 80301, USA
| | - D Thomas
- Clovis Oncology, Inc., 5500 Flatiron Parkway, Boulder, CO, 80301, USA
| | - A Simmons
- Clovis Oncology, Inc., 5500 Flatiron Parkway, Boulder, CO, 80301, USA
| | - A Loehr
- Clovis Oncology, Inc., 5500 Flatiron Parkway, Boulder, CO, 80301, USA
| | - R L Dusek
- Clovis Oncology, Inc., 5500 Flatiron Parkway, Boulder, CO, 80301, USA
| | - D Nepert
- Clovis Oncology, Inc., 5500 Flatiron Parkway, Boulder, CO, 80301, USA
| | - S Chowdhury
- Department of Medical Oncology, Guy's and St. Thomas' NHS Foundation Trust & Sarah Cannon Research Institute, Great Maze Pond, London, SE1 9RT, UK
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2
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Ferastraoaru D, Bax HJ, Bergmann C, Capron M, Castells M, Dombrowicz D, Fiebiger E, Gould HJ, Hartmann K, Jappe U, Jordakieva G, Josephs DH, Levi-Schaffer F, Mahler V, Poli A, Rosenstreich D, Roth-Walter F, Shamji M, Steveling-Klein EH, Turner MC, Untersmayr E, Karagiannis SN, Jensen-Jarolim E. AllergoOncology: ultra-low IgE, a potential novel biomarker in cancer-a Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI). Clin Transl Allergy 2020; 10:32. [PMID: 32695309 PMCID: PMC7366896 DOI: 10.1186/s13601-020-00335-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022] Open
Abstract
Elevated serum IgE levels are associated with allergic disorders, parasitosis and specific immunologic abnormalities. In addition, epidemiological and mechanistic evidence indicates an association between IgE-mediated immune surveillance and protection from tumour growth. Intriguingly, recent studies reveal a correlation between IgE deficiency and increased malignancy risk. This is the first review discussing IgE levels and links to pathological conditions, with special focus on the potential clinical significance of ultra-low serum IgE levels and risk of malignancy. In this Position Paper we discuss: (a) the utility of measuring total IgE levels in the management of allergies, parasitosis, and immunodeficiencies, (b) factors that may influence serum IgE levels, (c) IgE as a marker of different disorders, and d) the relationship between ultra-low IgE levels and malignancy susceptibility. While elevated serum IgE is generally associated with allergic/atopic conditions, very low or absent IgE may hamper anti-tumour surveillance, indicating the importance of a balanced IgE-mediated immune function. Ultra-low IgE may prove to be an unexpected biomarker for cancer risk. Nevertheless, given the early stage of investigations conducted mostly in patients with diseases that influence IgE levels, in-depth mechanistic studies and stratification of malignancy risk based on associated demographic, immunological and clinical co-factors are warranted.
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Affiliation(s)
- D Ferastraoaru
- Department of Internal Medicine/Allergy and Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY USA
| | - H J Bax
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, 9th Floor, Guy's Tower, London, SE1 9RT UK.,School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - C Bergmann
- ENT Research Institute for Clinical Studies, Essen, Germany
| | - M Capron
- LIRIC-Unite Mixte de Recherche 995 INSERM, Universite de Lille 2, CHRU de Lille, Lille, France
| | - M Castells
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - D Dombrowicz
- Recepteurs Nucleaires, Maladies Cardiovasculaires et Diabete, Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, 59000 Lille, France
| | - E Fiebiger
- Division of Gastroenterology, Hepatology and Nutrition Research, Department of Medicine Research, Children's University Hospital Boston, Boston, MA USA
| | - H J Gould
- Randall Centre for Cell and Molecular Biophysics, School of Basic & Medical Biosciences, King's College London, New Hunt's House, London, SE1 1UL UK.,Medical Research Council & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - K Hartmann
- Department of Dermatology, University of Luebeck, Luebeck, Germany
| | - U Jappe
- Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, Luebeck, Germany.,Division of Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - G Jordakieva
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - D H Josephs
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, 9th Floor, Guy's Tower, London, SE1 9RT UK.,School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - F Levi-Schaffer
- Pharmacology and Experimental Therapeutics Unit, The Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - V Mahler
- Division of Allergology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - A Poli
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-Sur-Alzette, Luxembourg
| | - D Rosenstreich
- Department of Internal Medicine/Allergy and Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY USA
| | - F Roth-Walter
- The Interuniversity Messerli Research Inst, Univ. of Vet. Medicine Vienna, Med. Univ. Vienna, Univ. Vienna, Vienna, Austria
| | - M Shamji
- Immunomodulation and Tolerance Group, Imperial College London, and Allergy and Clinical Immunology, Imperial College London, London, UK
| | - E H Steveling-Klein
- Department of Dermatology, Allergy Division, University Hospital Basel, Basel, Switzerland
| | - M C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - E Untersmayr
- Institute of Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria
| | - S N Karagiannis
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, 9th Floor, Guy's Tower, London, SE1 9RT UK.,NIHR Biomedical Research Centre at Guy's and St. Thomas' Hospitals and King's College London, Guy's Hospital, King's College London, London, UK
| | - E Jensen-Jarolim
- The Interuniversity Messerli Research Inst, Univ. of Vet. Medicine Vienna, Med. Univ. Vienna, Univ. Vienna, Vienna, Austria.,Institute of Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria
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3
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Josephs DH, Nakamura M, Bax HJ, Dodev TS, Muirhead G, Saul L, Karagiannis P, Ilieva KM, Crescioli S, Gazinska P, Woodman N, Lombardelli C, Kareemaghay S, Selkirk C, Lentfer H, Barton C, Canevari S, Figini M, Downes N, Dombrowicz D, Corrigan CJ, Nestle FO, Jones PS, Gould HJ, Blower PJ, Tsoka S, Spicer JF, Karagiannis SN. An immunologically relevant rodent model demonstrates safety of therapy using a tumour-specific IgE. Allergy 2018; 73:2328-2341. [PMID: 29654623 PMCID: PMC6492130 DOI: 10.1111/all.13455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Designing biologically informative models for assessing the safety of novel agents, especially for cancer immunotherapy, carries substantial challenges. The choice of an in vivo system for studies on IgE antibodies represents a major impediment to their clinical translation, especially with respect to class-specific immunological functions and safety. Fcε receptor expression and structure are different in humans and mice, so that the murine system is not informative when studying human IgE biology. By contrast, FcεRI expression and cellular distribution in rats mirror that of humans. METHODS We are developing MOv18 IgE, a human chimeric antibody recognizing the tumour-associated antigen folate receptor alpha. We created an immunologically congruent surrogate rat model likely to recapitulate human IgE-FcεR interactions and engineered a surrogate rat IgE equivalent to MOv18. Employing this model, we examined in vivo safety and efficacy of antitumour IgE antibodies. RESULTS In immunocompetent rats, rodent IgE restricted growth of syngeneic tumours in the absence of clinical, histopathological or metabolic signs associated with obvious toxicity. No physiological or immunological evidence of a "cytokine storm" or allergic response was seen, even at 50 mg/kg weekly doses. IgE treatment was associated with elevated serum concentrations of TNFα, a mediator previously linked with IgE-mediated antitumour and antiparasitic functions, alongside evidence of substantially elevated tumoural immune cell infiltration and immunological pathway activation in tumour-bearing lungs. CONCLUSION Our findings indicate safety of MOv18 IgE, in conjunction with efficacy and immune activation, supporting the translation of this therapeutic approach to the clinical arena.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/metabolism
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Cell Line, Tumor
- Folate Receptor 1/immunology
- Humans
- Immunoglobulin E/administration & dosage
- Immunoglobulin E/adverse effects
- Immunoglobulin E/immunology
- Immunoglobulin E/therapeutic use
- Immunoglobulin G/immunology
- Immunoglobulin G/metabolism
- Immunotherapy/methods
- Mice
- Models, Animal
- Neoplasms/pathology
- Neoplasms/therapy
- Protein Binding
- Rats
- Receptors, IgE/metabolism
- Statistics, Nonparametric
- Treatment Outcome
- Tumor Necrosis Factor-alpha/blood
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Affiliation(s)
- D. H. Josephs
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - M. Nakamura
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
| | - H. J. Bax
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - T. S. Dodev
- Randall Centre for Cell and Molecular BiophysicsKing's College LondonLondonUK
| | - G. Muirhead
- Department of InformaticsFaculty of Natural and Mathematical SciencesKing's College LondonLondonUK
| | - L. Saul
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - P. Karagiannis
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - K. M. Ilieva
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
| | - S. Crescioli
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
| | - P. Gazinska
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - N. Woodman
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - C. Lombardelli
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - S. Kareemaghay
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - C. Selkirk
- Biotherapeutics Development UnitCancer Research UKSouth MimmsUK
| | - H. Lentfer
- Biotherapeutics Development UnitCancer Research UKSouth MimmsUK
| | - C. Barton
- Centre for Drug DevelopmentCancer Research UKLondonUK
| | - S. Canevari
- Department of Applied Research and Technology DevelopmentFondazione IRCCS Istituto Nazionale dei TumouriMilanItaly
| | - M. Figini
- Department of Applied Research and Technology DevelopmentFondazione IRCCS Istituto Nazionale dei TumouriMilanItaly
| | | | - D. Dombrowicz
- CHU LilleInstitut Pasteur de LilleInsermUniv. LilleLilleFrance
| | - C. J. Corrigan
- Medical Research Council & Asthma UK Centre in Allergic Mechanisms of AsthmaKing's College LondonLondonUK
| | - F. O. Nestle
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Immunology and Inflammation Therapeutic Research AreaSanofi USCambridgeMAUSA
| | - P. S. Jones
- Centre for Drug DevelopmentCancer Research UKLondonUK
| | - H. J. Gould
- Randall Centre for Cell and Molecular BiophysicsKing's College LondonLondonUK
| | - P. J. Blower
- Imaging Chemistry & BiologyDivision of Imaging Sciences and Biomedical EngineeringSt. Thomas's HospitalKing's College LondonLondonUK
| | - S. Tsoka
- Department of InformaticsFaculty of Natural and Mathematical SciencesKing's College LondonLondonUK
| | - J. F. Spicer
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - S. N. Karagiannis
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
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4
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Jensen-Jarolim E, Bax HJ, Bianchini R, Crescioli S, Daniels-Wells TR, Dombrowicz D, Fiebiger E, Gould HJ, Irshad S, Janda J, Josephs DH, Levi-Schaffer F, O'Mahony L, Pellizzari G, Penichet ML, Redegeld F, Roth-Walter F, Singer J, Untersmayr E, Vangelista L, Karagiannis SN. AllergoOncology: Opposite outcomes of immune tolerance in allergy and cancer. Allergy 2018; 73:328-340. [PMID: 28921585 PMCID: PMC6038916 DOI: 10.1111/all.13311] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2017] [Indexed: 12/11/2022]
Abstract
While desired for the cure of allergy, regulatory immune cell subsets and nonclassical Th2-biased inflammatory mediators in the tumour microenvironment can contribute to immune suppression and escape of tumours from immunological detection and clearance. A key aim in the cancer field is therefore to design interventions that can break immunological tolerance and halt cancer progression, whereas on the contrary allergen immunotherapy exactly aims to induce tolerance. In this position paper, we review insights on immune tolerance derived from allergy and from cancer inflammation, focusing on what is known about the roles of key immune cells and mediators. We propose that research in the field of AllergoOncology that aims to delineate these immunological mechanisms with juxtaposed clinical consequences in allergy and cancer may point to novel avenues for therapeutic interventions that stand to benefit both disciplines.
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Affiliation(s)
- E Jensen-Jarolim
- The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University Vienna, Vienna, Austria
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - H J Bax
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - R Bianchini
- The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University Vienna, Vienna, Austria
| | - S Crescioli
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
| | - T R Daniels-Wells
- Division of Surgical Oncology, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - D Dombrowicz
- INSERM, CHU Lille, European Genomic Institute of Diabetes, Institut Pasteur de Lille, U1011 - Recepteurs Nucleaires, Maladies Cardiovasculaires et Diabete, Universite de Lille, Lille, France
| | - E Fiebiger
- Division of Gastroenterology, Hepatology and Nutrition Research, Department Medicine Research, Childrens' University Hospital Boston, Boston, MA, USA
| | - H J Gould
- Randall Division of Cell and Molecular Biophysics, King's College London, London, UK
| | - S Irshad
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- Breast Cancer Now Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London, UK
| | - J Janda
- Faculty of Science, Charles University, Prague, Czech Republic
| | - D H Josephs
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - F Levi-Schaffer
- Faculty of Medicine, Pharmacology and Experimental Therapeutics Unit, The Institute for Drug Research, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - L O'Mahony
- Molecular Immunology, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| | - G Pellizzari
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - M L Penichet
- Division of Surgical Oncology, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Centre, University of California, Los Angeles, CA, USA
| | - F Redegeld
- Faculty of Science, Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - F Roth-Walter
- The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University Vienna, Vienna, Austria
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - J Singer
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - E Untersmayr
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - L Vangelista
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - S N Karagiannis
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- Breast Cancer Now Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London, UK
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5
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Jensen‐Jarolim E, Bax HJ, Bianchini R, Capron M, Corrigan C, Castells M, Dombrowicz D, Daniels‐Wells TR, Fazekas J, Fiebiger E, Gatault S, Gould HJ, Janda J, Josephs DH, Karagiannis P, Levi‐Schaffer F, Meshcheryakova A, Mechtcheriakova D, Mekori Y, Mungenast F, Nigro EA, Penichet ML, Redegeld F, Saul L, Singer J, Spicer JF, Siccardi AG, Spillner E, Turner MC, Untersmayr E, Vangelista L, Karagiannis SN. AllergoOncology - the impact of allergy in oncology: EAACI position paper. Allergy 2017; 72:866-887. [PMID: 28032353 PMCID: PMC5498751 DOI: 10.1111/all.13119] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 12/19/2022]
Abstract
Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both antitumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveillance, immunomodulation and the functions of IgE-mediated immune responses against cancer, to derive novel insights into more effective treatments. Coincident with rapid expansion in clinical application of cancer immunotherapies, here we review the current state-of-the-art and future translational opportunities, as well as challenges in this relatively new field. Recent developments include improved understanding of Th2 antibodies, intratumoral innate allergy effector cells and mediators, IgE-mediated tumour antigen cross-presentation by dendritic cells, as well as immunotherapeutic strategies such as vaccines and recombinant antibodies, and finally, the management of allergy in daily clinical oncology. Shedding light on the crosstalk between allergic response and cancer is paving the way for new avenues of treatment.
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Affiliation(s)
- E. Jensen‐Jarolim
- The Interuniversity Messerli Research InstituteUniversity of Veterinary Medicine ViennaMedical University of ViennaViennaAustria
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - H. J. Bax
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
| | - R. Bianchini
- The Interuniversity Messerli Research InstituteUniversity of Veterinary Medicine ViennaMedical University of ViennaViennaAustria
| | - M. Capron
- LIRIC‐Unité Mixte de Recherche 995 INSERMUniversité de Lille 2CHRU de LilleLilleFrance
| | - C. Corrigan
- Division of Asthma, Allergy and Lung BiologyMedical Research Council and Asthma UK Centre in Allergic Mechanisms in AsthmaKing's College LondonLondonUK
| | - M. Castells
- Division of Rheumatology, Immunology and AllergyDepartment of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - D. Dombrowicz
- INSERMCHU LilleEuropean Genomic Institute of DiabetesInstitut Pasteur de LilleU1011 – récepteurs nucléaires, maladies cardiovasculaires et diabèteUniversité de LilleLilleFrance
| | - T. R. Daniels‐Wells
- Division of Surgical OncologyDepartment of SurgeryDavid Geffen School of Medicine at UCLALos AngelesCAUSA
| | - J. Fazekas
- The Interuniversity Messerli Research InstituteUniversity of Veterinary Medicine ViennaMedical University of ViennaViennaAustria
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - E. Fiebiger
- Division of Gastroenterology, Hepatology and Nutrition ResearchDepartment of Medicine ResearchChildren's University Hospital BostonBostonMAUSA
| | - S. Gatault
- LIRIC‐Unité Mixte de Recherche 995 INSERMUniversité de Lille 2CHRU de LilleLilleFrance
| | - H. J. Gould
- Division of Asthma, Allergy and Lung BiologyMedical Research Council and Asthma UK Centre in Allergic Mechanisms in AsthmaKing's College LondonLondonUK
- Randall Division of Cell and Molecular BiophysicsKing's College LondonLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
| | - J. Janda
- Center PigmodInstitute of Animal Physiology and GeneticsAcademy of Sciences of Czech RepublicLibechovCzech Republic
| | - D. H. Josephs
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
| | - P. Karagiannis
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
| | - F. Levi‐Schaffer
- Pharmacology and Experimental Therapeutics UnitFaculty of MedicineSchool of PharmacyThe Institute for Drug ResearchThe Hebrew University of JerusalemJerusalemIsrael
| | - A. Meshcheryakova
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - D. Mechtcheriakova
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - Y. Mekori
- Sackler Faculty of MedicineTel‐Aviv UniversityTel‐AvivIsrael
| | - F. Mungenast
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - E. A. Nigro
- IRCCS San Raffaele Scientific InstituteMilanItaly
| | - M. L. Penichet
- Division of Surgical OncologyDepartment of SurgeryDavid Geffen School of Medicine at UCLALos AngelesCAUSA
- Department of Microbiology, Immunology, and Molecular GeneticsDavid Geffen School of Medicine at UCLALos AngelesCAUSA
- Jonsson Comprehensive Cancer CenterUniversity of CaliforniaLos AngelesCAUSA
| | - F. Redegeld
- Division of PharmacologyFaculty of ScienceUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - L. Saul
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
| | - J. Singer
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - J. F. Spicer
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
| | | | - E. Spillner
- Immunological EngineeringDepartment of EngineeringAarhus UniversityAarhusDenmark
| | - M. C. Turner
- ISGlobalCentre for Research in Environmental Epidemiology (CREAL)BarcelonaSpain
- Universitat Pompeu Fabra (UPF)BarcelonaSpain
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
- McLaughlin Centre for Population Health Risk AssessmentUniversity of OttawaOttawaONCanada
| | - E. Untersmayr
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - L. Vangelista
- Department of Biomedical SciencesNazarbayev University School of MedicineAstanaKazakhstan
| | - S. N. Karagiannis
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
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6
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Rudman SM, Josephs DH, Cambrook H, Karagiannis P, Gilbert AE, Dodev T, Hunt J, Koers A, Montes A, Taams L, Canevari S, Figini M, Blower PJ, Beavil AJ, Nicodemus CF, Corrigan C, Kaye SB, Nestle FO, Gould HJ, Spicer JF, Karagiannis SN. Harnessing engineered antibodies of the IgE class to combat malignancy: initial assessment of FcɛRI-mediated basophil activation by a tumour-specific IgE antibody to evaluate the risk of type I hypersensitivity. Clin Exp Allergy 2011; 41:1400-13. [PMID: 21569129 DOI: 10.1111/j.1365-2222.2011.03770.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND IgE antibodies, sequestered into tissues and retained locally by the high-affinity IgE receptor, FcɛRI, on powerful effector cells such as mast cells, macrophages and eosinophils, may offer improvements in the therapy of solid tumours. The chimeric antibody, MOv18 IgE, against the human ovarian carcinoma antigen, folate receptor α (FRα), is more effective than its IgG1 counterpart in xenograft models of ovarian cancer. Although MOv18 IgE binds to a single epitope on FRα and cannot cross-link IgE receptors on basophils, there remains a risk that components in the circulation of ovarian cancer patients might cross-link FRα-MOv18-IgE-receptor-FcɛRI complexes on basophils to cause type I hypersensitivity. OBJECTIVE To assess the propensity for MOv18 used in a therapeutic setting to cause FcɛRI-mediated type I hypersensitivity. METHODS As validated readouts of the potential for MOv18 to cause FcɛRI-mediated type I hypersensitivity we measured release of a granule-stored mediator from a rat basophilic leukaemia cell line RBL SX-38 stably transfected with human tetrameric (αβγ2) FcɛRI, and induction of CD63 on blood basophils from patients with ovarian carcinoma and healthy controls ex vivo. RESULTS Serum FRα levels were increased in ovarian cancer patients compared with healthy controls. MOv18 IgE alone, or in the presence of its antigen recombinant human FRα, or of healthy volunteer (n=14) or ovarian carcinoma patient (n=32) sera, did not induce RBL SX-38 cell degranulation. Exposure to FRα-expressing ovarian tumour cells at target-to-effector ratios expected within tumours induced degranulation. MOv18 IgE did not induce expression of CD63 in blood basophils from either healthy volunteers (n=6), or cancer patients, despite detectable levels of circulating FRα (n=5). CONCLUSION AND CLINICAL RELEVANCE These encouraging data are compatible with the hypothesis that, when ovarian carcinoma patients are treated with MOv18, FcɛRI-mediated activation of effector cells occurs within the tumour mass but not in the circulation mandating, with due caution, further pre-clinical studies.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/genetics
- Antibodies, Monoclonal, Murine-Derived/immunology
- Antibody Specificity
- Antigens, Neoplasm/immunology
- Basophils/immunology
- Carcinoma/immunology
- Carcinoma/therapy
- Cell Degranulation
- Cell Line, Tumor
- Female
- Folate Receptor 1/blood
- Folate Receptor 1/immunology
- Folate Receptor 1/metabolism
- Humans
- Hypersensitivity, Immediate/etiology
- Hypersensitivity, Immediate/immunology
- Immunoglobulin E/genetics
- Immunoglobulin E/immunology
- Ovarian Neoplasms/immunology
- Ovarian Neoplasms/therapy
- Protein Engineering
- Rats
- Receptors, IgE/immunology
- Tetraspanin 30/metabolism
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Affiliation(s)
- S M Rudman
- NIHR Biomedical Research Centre at Guy's and St Thomas's Hospitals and King's College London, Cutaneous Medicine & Immunotherapy Unit, St John's Institute of Dermatology, Division of Genetics & Molecular Medicine, King's College London School of Medicine, Guy's Hospital, King's College London, London, UK
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7
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Josephs DH, Hutson TE, Pickering LM, Larkin JM, Choueiri TK, Patel TV, Mcdermott DF, Powles T, Harper PG, Chowdhury S. Efficacy and toxicity of sunitinib in patients with metastatic renal cell carcinoma (mRCC) with severe renal impairment or on haemodialysis. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5109 Background: Sunitinib is currently a standard of care for the treatment of mRCC. Due to the inclusion criteria of clinical trials, no studies of sunitinib have enrolled patients with severe renal impairment or those undergoing haemodialysis, and thus further investigation of the effect of sunitinib in this population is required. Methods: Clinical databases were used to identify all patients with mRCC treated with sunitinib in five institutions internationally. Medical records were searched to identify only those patients with a creatinine clearance (CLcr) of <30ml/min or who had end stage renal disease (ESRD) requiring haemodialysis. Baseline characteristics, toxicity data and progression free survival (PFS) were collected. Results: 21 patients met inclusion criteria with 9 (43%) undergoing haemodialysis. Baseline characteristics include a median age of 62 years (range 44–80); 90% of patients had ECOG PS of 0 or 1; 38% of patients had > 2 metastatic sites and 86% had prior nephrectomy. The estimated median PFS of this cohort was 38 weeks (range 2–120) although progression has not yet been reached in 8 (38%) patients. PR or SD was observed as best response in 17 (81%) patients. The most common treatment-related adverse events (AEs) included fatigue, diarrhoea, hand foot skin reaction (HFSR), nausea and vomiting and rash. Grade 3 treatment related AEs including fatigue, HFSR, diarrhoea and rash occurred in a total of 7 (33%) of patients. Only one patient experienced grade IV toxicity (HFSR). Conclusions: These data suggest that patients treated with sunitinib who have severe renal impairment, or ESRD on haemodialysis, have a PFS that is comparable to patients with normal renal function. In addition sunitinib appears to be reasonably well tolerated in this group of patients. These preliminary results warrant confirmation in a larger cohort of patients. [Table: see text]
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Affiliation(s)
- D. H. Josephs
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - T. E. Hutson
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - L. M. Pickering
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - J. M. Larkin
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - T. K. Choueiri
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - T. V. Patel
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - D. F. Mcdermott
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - T. Powles
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - P. G. Harper
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
| | - S. Chowdhury
- Guy's Hospital, London, United Kingdom; Baylor Sammons Cancer Center, Dallas, TX; The Royal Marsden Hospital, London, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Barts and The London Hospital, London, United Kingdom
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8
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Abstract
OBJECTIVES To determine the in vitro effects of unfractionated heparin, fractionated heparin and direct thrombin inhibition on platelet-monocyte aggregation, and to establish the in vivo effects of unfractionated heparin and direct thrombin inhibition on platelet-monocyte aggregates in patients scheduled for percutaneous coronary intervention (PCI). DESIGN Platelet-monocyte aggregates were assessed in whole blood from 18 healthy volunteers after the addition of unfractionated heparin (1 U/ml), enoxaparin (0.8 U/ml) or lepirudin (5.6 microg/ml), and in 28 patients scheduled for elective PCI before and after administration of 100 U/kg of unfractionated heparin or 0.75 mg/kg bivalirudin. The influence of P-selectin-mediated platelet-monocyte aggregation was assessed with specific blocking antibodies. RESULTS Addition of unfractionated heparin in vitro was associated with a higher level of platelet-monocyte aggregates than in controls (20.1 (1.9)% v 16.2 (1.6)%, respectively, p < 0.001). However, platelet-monocyte aggregation was not affected by enoxaparin or lepirudin (16.9 (2.0)% and 17.0 (2.2)%, respectively, NS). Intravenous unfractionated heparin in vivo also resulted in an increase in platelet-monocyte aggregates (absolute Delta 7.1 (2.7)%, p < 0.01), whereas intravenous bivalirudin had no effect (absolute Delta -1.5 (2.4)%, NS). The addition of P-selectin blockade abolished any increase in platelet-monocyte aggregates associated with heparin. CONCLUSIONS In vitro and in vivo unfractionated heparin is associated with increased platelet-monocyte aggregation through a P-selectin-dependent mechanism. These findings provide a potential explanation for the superior cardiovascular outcomes associated with fractionated heparins and direct thrombin inhibitors.
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Affiliation(s)
- S A Harding
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
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9
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Harding SA, Sarma J, Josephs DH, Cruden NL, Din JN, Twomey PJ, Fox KAA, Newby DE. Upregulation of the CD40/CD40 Ligand Dyad and Platelet-Monocyte Aggregation in Cigarette Smokers. Circulation 2004; 109:1926-9. [PMID: 15078798 DOI: 10.1161/01.cir.0000127128.52679.e4] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Smoking is a potent cardiovascular risk factor and is associated with proinflammatory and prothrombotic responses. The CD40/CD40 ligand (CD40L) dyad and platelet-monocyte aggregation mediate a range of proinflammatory and prothrombotic processes thought to be important in atherothrombosis. We investigated whether expression of the CD40/CD40L dyad and platelet-monocyte aggregation are altered in cigarette smokers. METHODS AND RESULTS C-reactive protein (CRP), soluble (s) CD40L, and surface expression of CD40L on platelets and T cells and of CD40 on monocytes and platelet-monocyte aggregates were compared in 25 cigarette smokers and 25 age- and gender-matched nonsmokers. Cigarette smokers had increased serum CRP (2.47+/-2.60 versus 0.94+/-0.96 mg/L, P=0.008) and appeared to have elevated plasma sCD40L (0.8+/-1.09 versus 0.37+/-0.21 ng/mL, P=0.07) concentrations. Smokers also had increased surface expression of CD40 on monocytes (45.9+/-7.7% versus 39.9+/-6.5%, P=0.006), of CD40L on platelets (2.9+/-1.0% versus 2.3+/-0.6%, P=0.03), and of platelet-monocyte aggregates (26.6+/-10.9% versus 19.7+/-8.6%, P=0.02). Plasma cotinine concentrations correlated with monocyte CD40 expression, platelet CD40L expression, and platelet-monocyte aggregates. CONCLUSIONS Cigarette smokers have upregulation of the CD40/CD40L dyad and platelet-monocyte aggregation that may account for the atherothrombotic consequences of this major cardiovascular risk factor.
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Affiliation(s)
- S A Harding
- Centre for Cardiovascular Sciences, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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