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Aloè T, Novelli F, Puppo G, Pinelli V, Barisione E, Trucco E, Costanzo R, Covesnon MG, Grillo F, Zoccali P, Milanese M, Maniscalco S, Tagliabue E, Piroddi IMG, Venturi S, Serra M, Scordamaglia F, Ferrari M, Serafini A. Prevalence of Long COVID Symptoms Related to SARS-CoV-2 Strains. Life (Basel) 2023; 13:1558. [PMID: 37511933 PMCID: PMC10381360 DOI: 10.3390/life13071558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Few studies have assessed the differences of patterns of Long COVID (L-COVID) with regards to the pathogenetic SARS-CoV-2 strains. OBJECTIVES To investigate the relationship between demographic and clinical characteristics of acute phase of infection and the persistence of L-COVID symptoms and clinical presentation across different SARS-CoV-2 strains. METHODS In this observational-multicenter study we recorded all demographic and clinical characteristics, severity of infection, presence/persistence of symptoms of fatigue, dyspnoea and altered quality of life (QoL) at baseline and after 6 months, in a sample of Italian patients from Liguria between March 2020 and March 2022. RESULTS 308 patients (mean age 63.2 years; 55.5% men) with previous COVID were enrolled. Obese patients were 21.2% with a significant difference in obesity prevalence across the second and third wave (p = 0.012). Treatment strategies differed between waves (p < 0.001): more patients required invasive mechanical ventilation in the first wave, more patients were treated with high-flow nasal cannula/non-invasive ventilation in the in the second and more patients were treated with oxygen-therapy in the fourth wave. At baseline, a high proportion of patients were symptomatic (dyspnoea and fatigue), with impairment in some QoL indicators. A higher prevalence of patients with pain, were seen in the first wave compared to later infections (p = 0.01). At follow-up, we observed improvement of dyspnoea, fatigue and some dimensions of QoL scale evaluation such as mobility, usual activities, pain evaluations; instead there was no improvement in remaining QoL scale indicators (usual care and anxiety-depression). CONCLUSIONS There were no significant differences in the prevalence of the most frequent L-COVID symptoms, except for QoL pain domain that was especially associated with classical variant. Our results show substantial impact on social and professional life and usual care activities. These findings highlight the importance of multidisciplinary post COVID follow-up care including mental health support and rehabilitation program.
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Affiliation(s)
- Teresita Aloè
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | | | | | | | - Emanuela Barisione
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Elisa Trucco
- Pulmonology Unit, Ospedale Civile, 18100 Imperia, Italy
| | - Roberta Costanzo
- Pulmonology Unit, Ospedale Villa Scassi, ASL3 Genovese, 16100 Genoa, Italy
| | | | - Federica Grillo
- Anatomic Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16100 Genoa, Italy
- Anatomic Pathology Unit, Università degli Studi di Genova, 16100 Genoa, Italy
| | | | - Manlio Milanese
- Pulmonology Unit, Ospedale S.Corona, 17027 Pietra Ligure, Italy
| | - Sara Maniscalco
- Pulmonology Unit, Ospedale S.Corona, 17027 Pietra Ligure, Italy
| | - Elena Tagliabue
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Ines Maria Grazia Piroddi
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Simonetta Venturi
- Pulmonology Unit, Ospedale Villa Scassi, ASL3 Genovese, 16100 Genoa, Italy
| | - Maria Serra
- Pulmonology Unit, Ospedale Villa Scassi, ASL3 Genovese, 16100 Genoa, Italy
| | | | - Marta Ferrari
- Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, 16100 Genoa, Italy
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Tumino N, Besi F, Martini S, Di Pace AL, Munari E, Quatrini L, Pelosi A, Fiore PF, Fiscon G, Paci P, Scordamaglia F, Covesnon MG, Bogina G, Mingari MC, Moretta L, Vacca P. Polymorphonuclear Myeloid-Derived Suppressor Cells Are Abundant in Peripheral Blood of Cancer Patients and Suppress Natural Killer Cell Anti-Tumor Activity. Front Immunol 2022; 12:803014. [PMID: 35116033 PMCID: PMC8805733 DOI: 10.3389/fimmu.2021.803014] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/28/2021] [Indexed: 12/25/2022] Open
Abstract
Tumor microenvironment (TME) includes a wide variety of cell types and soluble factors capable of suppressing immune-responses. While the role of NK cells in TME has been analyzed, limited information is available on the presence and the effect of polymorphonuclear (PMN) myeloid-derived suppressor cells, (MDSC). Among the immunomodulatory cells present in TME, MDSC are potentially efficient in counteracting the anti-tumor activity of several effector cells. We show that PMN-MDSC are present in high numbers in the PB of patients with primary or metastatic lung tumor. Their frequency correlated with the overall survival of patients. In addition, it inversely correlated with low frequencies of NK cells both in the PB and in tumor lesions. Moreover, such NK cells displayed an impaired anti-tumor activity, even those isolated from PB. The compromised function of NK cells was consequent to their interaction with PMN-MDSC. Indeed, we show that the expression of major activating NK receptors, the NK cytolytic activity and the cytokine production were inhibited upon co-culture with PMN-MDSC through both cell-to-cell contact and soluble factors. In this context, we show that exosomes derived from PMN-MDSC are responsible of a significant immunosuppressive effect on NK cell-mediated anti-tumor activity. Our data may provide a novel useful tool to implement the tumor immunoscore. Indeed, the detection of PMN-MDSC in the PB may be of prognostic value, providing clues on the presence and extension of both adult and pediatric tumors and information on the efficacy not only of immune response but also of immunotherapy and, possibly, on the clinical outcome.
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Affiliation(s)
- Nicola Tumino
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
| | - Francesca Besi
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
| | - Stefania Martini
- Unità Operativa (UO) Immunology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Laura Di Pace
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
| | - Enrico Munari
- Pathology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Linda Quatrini
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
| | - Andrea Pelosi
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
| | - Piera Filomena Fiore
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
| | - Giulia Fiscon
- Institute for Systems Analysis and Computer Science “Antonio Ruberti”, National Research Council, Rome, Italy
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Rome, Italy
| | - Paola Paci
- Institute for Systems Analysis and Computer Science “Antonio Ruberti”, National Research Council, Rome, Italy
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Rome, Italy
| | | | - Maria Grazia Covesnon
- Struttura Complessa (SC) Pneumologia Ospedale Villa Scassi, ASL3 Genovese, Genoa, Italy
| | - Giuseppe Bogina
- Pathology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Maria Cristina Mingari
- Unità Operativa (UO) Immunology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
- Experimental Medicine Department (DIMES), University of Genoa, Genoa, Italy
| | - Lorenzo Moretta
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
- *Correspondence: Lorenzo Moretta,
| | - Paola Vacca
- Immunology Research Area, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Children’s Hospital, Rome, Italy
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Mencoboni M, Ceppi M, Bruzzone M, Taveggia P, Cavo A, Scordamaglia F, Gualco M, Filiberti RA. Effectiveness and Safety of Immune Checkpoint Inhibitors for Patients with Advanced Non Small-Cell Lung Cancer in Real-World: Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13061388. [PMID: 33808533 PMCID: PMC8003199 DOI: 10.3390/cancers13061388] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary The benefit of programmed death-1/programmed death ligand-1 (PD-1/PD-L1) immunotherapy, particularly of nivolumab, pembrolizumab and atezolizumab, in the second-line setting of patients with non-small cell lung cancer has been documented in randomized clinical trials, showing improvements in global survival and in the overall response rate. Nevertheless, patients enrolled in these studies met strict eligibility criteria, allowing for the treatment of patients that do not reflect the broader oncology patient population. Experiences from real-world data are useful in providing further evidence of the benefit of treatment in a wider range of patients, including those underrepresented in clinical trials. We performed a meta-analysis to evaluate the outcomes in non-small cell lung cancer patients treated in everyday practice with these drugs as the second line, and more generally with immunotherapy with checkpoint inhibitors (ICIs), showing that the efficacy and safety were comparable to those in selected studies. Results may encourage to treat patients excluded from randomized studies. Abstract Immunotherapy based on anti PD-1/PD-L1 inhibitors is the new standard of advanced non-small cell lung cancers. Pembrolizumab, nivolumab and atezolizumab are used in clinical practice. The strict eligibility criteria of clinical trials do not allow researchers to fully represent treatment effects in the patients that will ultimately use these drugs. We performed a systematic review and a meta-analysis to evaluate the effectiveness and safety of these drugs, and more generally of ICIs, as second-line therapy in NSCLC patients in real world practice. MEDLINE, PubMed, Scopus and Web of Science were searched to include original studies published between January 2015 and April 2020. A total of 32 studies was included in the meta-analysis. The overall radiological response rate (ORR), disease control rate (DCR), median progression-free survival (PFS) and overall survival (OS) were 21%, 52%, 3.35 months and 9.98 months, respectively. The results did not change when analysis was adjusted for Eastern Cooperative Oncology Group performance status (ECOG PS) and age. A unitary increase in the percent of patients with liver and CNS metastases reduced the occurrence of DCR by 7% (p < 0.001) and the median PFS by 2% (p = 0.010), respectively. The meta-analysis showed that the efficacy and safety of immunotherapy in everyday practice is comparable to that in clinical trials.
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Affiliation(s)
- Manlio Mencoboni
- SSD Oncologia Ospedale Villa Scassi, ASL 3 Genovese, 16149 Genova, Italy; (M.M.); (P.T.); (A.C.)
| | - Marcello Ceppi
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.C.); (M.B.)
| | - Marco Bruzzone
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.C.); (M.B.)
| | - Paola Taveggia
- SSD Oncologia Ospedale Villa Scassi, ASL 3 Genovese, 16149 Genova, Italy; (M.M.); (P.T.); (A.C.)
| | - Alessia Cavo
- SSD Oncologia Ospedale Villa Scassi, ASL 3 Genovese, 16149 Genova, Italy; (M.M.); (P.T.); (A.C.)
| | | | - Marina Gualco
- SC Anatomia Patologica Ospedale Villa Scassi, ASL 3 Genovese, 16149 Genova, Italy;
| | - Rosa Angela Filiberti
- Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.C.); (M.B.)
- Correspondence:
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Quatrini L, Vacca P, Tumino N, Besi F, Di Pace AL, Scordamaglia F, Martini S, Munari E, Mingari MC, Ugolini S, Moretta L. Glucocorticoids and the cytokines IL-12, IL-15, and IL-18 present in the tumor microenvironment induce PD-1 expression on human natural killer cells. J Allergy Clin Immunol 2020; 147:349-360. [PMID: 32417134 DOI: 10.1016/j.jaci.2020.04.044] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/28/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Programmed cell death protein 1 (PD-1)-immune checkpoint blockade has provided significant clinical efficacy across various types of cancer by unleashing both T and natural killer (NK) cell-mediated antitumor responses. However, resistance to immunotherapy occurs for many patients, rendering the identification of the mechanisms that control PD-1 expression extremely important to increase the response to the therapy. OBJECTIVE We sought to identify the stimuli and the molecular mechanisms that induce the de novo PD-1 expression on human NK cells in the tumor setting. METHODS NK cells freshly isolated from peripheral blood of healthy donors were stimulated with different combinations of molecules, and PD-1 expression was studied at the mRNA and protein levels. Moreover, ex vivo analysis of tumor microenvironment and NK cell phenotype was performed. RESULTS Glucocorticoids are indispensable for PD-1 induction on human NK cells, in cooperation with a combination of cytokines that are abundant at the tumor site. Mechanistically, glucocorticoids together with IL-12, IL-15, and IL-18 not only upregulate PDCD1 transcription, but also activate a previously unrecognized transcriptional program leading to enhanced mRNA translation and resulting in an increased PD-1 amount in NK cells. CONCLUSIONS These results provide evidence of a novel immune suppressive mechanism of glucocorticoids involving the transcriptional and translational control of an important immune checkpoint.
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Affiliation(s)
- Linda Quatrini
- Department of Immunology, Istituto di Ricovero e Cura a Carattere Scientifico Bambino Gesù Children's Hospital, Rome, Italy.
| | - Paola Vacca
- Department of Immunology, Istituto di Ricovero e Cura a Carattere Scientifico Bambino Gesù Children's Hospital, Rome, Italy
| | - Nicola Tumino
- Department of Immunology, Istituto di Ricovero e Cura a Carattere Scientifico Bambino Gesù Children's Hospital, Rome, Italy
| | - Francesca Besi
- Department of Immunology, Istituto di Ricovero e Cura a Carattere Scientifico Bambino Gesù Children's Hospital, Rome, Italy
| | - Anna Laura Di Pace
- Department of Immunology, Istituto di Ricovero e Cura a Carattere Scientifico Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Stefania Martini
- Immunology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Enrico Munari
- Department of Pathology, Sacro Cuore Don Calabria, Negrar, Italy
| | - Maria Cristina Mingari
- Immunology Unit, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy; Department of Experimental Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - Sophie Ugolini
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Istitut National de la Santé et de la Recherche Médicale, Centre d'Immunologie de Marseille-Luminy, Marseille, France
| | - Lorenzo Moretta
- Department of Immunology, Istituto di Ricovero e Cura a Carattere Scientifico Bambino Gesù Children's Hospital, Rome, Italy.
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Tumino N, Martini S, Munari E, Scordamaglia F, Besi F, Mariotti FR, Bogina G, Mingari MC, Vacca P, Moretta L. Presence of innate lymphoid cells in pleural effusions of primary and metastatic tumors: Functional analysis and expression of PD-1 receptor. Int J Cancer 2019; 145:1660-1668. [PMID: 30856277 PMCID: PMC6767381 DOI: 10.1002/ijc.32262] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/22/2019] [Accepted: 02/28/2019] [Indexed: 01/01/2023]
Abstract
The tumor microenvironment (TM) contains a wide variety of cell types and soluble factors capable of suppressing immune responses. While the presence of NK cells in pleural effusions (PE) has been documented, no information exists on the presence of other innate lymphoid cell (ILC) subsets and on the expression of programmed cell death‐1 (PD‐1) in NK and ILC. The presence of ILC was assessed in PE of 54 patients (n = 33 with mesothelioma, n = 15 with adenocarcinoma and n = 6 with inflammatory pleural diseases) by cell staining with suitable antibody combinations and cytofluorimetric analysis. The cytokine production of ILC isolated from both PE and autologous peripheral blood was analyzed upon cell stimulation and intracytoplasmic staining. We show that, in addition to NK cells, also ILC1, ILC2 and ILC3 are present in malignant PE and that the prevalent subset is ILC3. PE‐ILC subsets produced their typical sets of cytokines upon activation. In addition, we analyzed the PD‐1 expression on NK/ILC by multiparametric flow‐cytometric analysis, while the expression of PD‐1 ligand (PD‐L1) was evaluated by immunohistochemical analysis. Both NK cells and ILC3 expressed functional PD‐1, moreover, both tumor samples and malignant PE‐derived tumor cell lines were PD‐L1+ suggesting that the interaction between PD‐1+ILC and PD‐L1+tumor cells may hamper antitumor immune responses mediated by NK and ILC. What's new? Pleural tumors result in effusions that are not well characterized. In this study, the authors found that pleural effusions from patients with primary mesothelioma or metastatic adenocarcinoma contain NK cells and other innate lymphoid cells (ILC). These immune cells were capable of expressing normal cytokines, including the checkpoint protein PD‐1. However, the tumor cells were found to express the ligand PD‐L1. These results suggest a PD‐1‐mediated inhibitory effect on lymphoid cells with potential anti‐tumor activity. Better understanding of this inhibition in the tumor microenvironment may lead to new targets for checkpoint‐inhibitor therapies.
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Affiliation(s)
- Nicola Tumino
- Department of Immunology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Stefania Martini
- UOC Immunologia, IRCCS Ospedale Policlinico San Martino Genova, Genoa, Italy
| | - Enrico Munari
- Department of Pathology, Sacro Cuore Don Calabria, Negrar VR, Italy.,Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Francesca Besi
- Department of Immunology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Giuseppe Bogina
- Department of Pathology, Sacro Cuore Don Calabria, Negrar VR, Italy
| | - Maria Cristina Mingari
- UOC Immunologia, IRCCS Ospedale Policlinico San Martino Genova, Genoa, Italy.,Department of Experimental Medicine (DIMES) and Centre of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Paola Vacca
- Department of Immunology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Lorenzo Moretta
- Department of Immunology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
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Mariotti FR, Petrini S, Ingegnere T, Tumino N, Besi F, Scordamaglia F, Munari E, Pesce S, Marcenaro E, Moretta A, Vacca P, Moretta L. PD-1 in human NK cells: evidence of cytoplasmic mRNA and protein expression. Oncoimmunology 2018; 8:1557030. [PMID: 30723590 PMCID: PMC6350684 DOI: 10.1080/2162402x.2018.1557030] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/30/2018] [Accepted: 12/05/2018] [Indexed: 01/01/2023] Open
Abstract
Under physiological conditions, PD-1/PD-L1 interactions regulate unwanted over-reactions of immune cells and contribute to maintain peripheral tolerance. However, in tumor microenvironment, this interaction may greatly compromise the immune-mediated anti-tumor activity. PD-1+ NK cells have been detected in high percentage in peripheral blood and ascitic fluid of ovarian carcinoma patients. To acquire information on PD-1 expression and physiology in human NK cells, we analyzed whether PD-1 mRNA and protein are present in resting, surface PD-1−, NK cells from healthy donors. Both different splicing isoforms of PD-1 mRNA and a cytoplasmic pool of PD-1 protein were detected. Similar results were obtained also from both in vitro-activated and tumor-associated NK cells. PD-1 mRNA and protein were higher in CD56dim than in CD56bright NK cells. Confocal microscopy analyses revealed that PD-1 protein is present in virtually all NK cells analyzed. The present findings are compatible with a rapid surface expression of PD-1 in NK cells in response to appropriate, still undefined, stimuli.
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Affiliation(s)
| | - Stefania Petrini
- Confocal Microscopy Core Facility, Research Center, IRCSS Bambino Gesù Children's Hospital, Rome, Italy
| | - Tiziano Ingegnere
- Department of Immunology, IRCSS Bambino Gesù Children's Hospital, Rome, Italy
| | - Nicola Tumino
- Department of Immunology, IRCSS Bambino Gesù Children's Hospital, Rome, Italy
| | - Francesca Besi
- Department of Immunology, IRCSS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Enrico Munari
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy.,Department of Pathology AOUI, University of Verona, Verona, Italy
| | - Silvia Pesce
- Department of Experimental Medicine (DIMES), University of Genova, Genoa, Italy
| | - Emanuela Marcenaro
- Department of Experimental Medicine (DIMES), University of Genova, Genoa, Italy.,Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Alessandro Moretta
- Department of Experimental Medicine (DIMES), University of Genova, Genoa, Italy.,Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Paola Vacca
- Department of Immunology, IRCSS Bambino Gesù Children's Hospital, Rome, Italy
| | - Lorenzo Moretta
- Department of Immunology, IRCSS Bambino Gesù Children's Hospital, Rome, Italy
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Croxatto D, Martini S, Chiossone L, Scordamaglia F, Simonassi CF, Moretta L, Mingari MC, Vacca P. IL15 induces a potent antitumor activity in NK cells isolated from malignant pleural effusions and overcomes the inhibitory effect of pleural fluid. Oncoimmunology 2017; 6:e1293210. [PMID: 28507797 DOI: 10.1080/2162402x.2017.1293210] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/03/2017] [Accepted: 02/04/2017] [Indexed: 12/14/2022] Open
Abstract
Natural Killer (NK) cells are capable of recognizing and killing cancer cells and play an important role in tumor immunosurveillance. However, tumor-infiltrating NK cells are frequently impaired in their functional capability. A remarkable exception is represented by NK cells isolated from malignant pleural effusions (PE) that are not anergic and, upon IL2-induced activation, efficiently kill tumor cells. Although IL2 is used in various clinical trials, severe side effects may occur in treated patients. In this study, we investigated whether also other clinical-grade cytokines could induce strong cytotoxicity in NK cells isolated from pleural fluid of patients with primary or metastatic tumors of different origins. We show that PE-NK cells, cultured for short-time intervals with IL15, maintain the CD56bright phenotype, a high expression of the main activating receptors, produce cytokines and kill tumor cells in vitro similarly to those treated with IL2. Moreover, IL15-activated PE-NK cells could greatly reduce the growth of established tumors in mice. This in vivo antitumor effect correlated with the ability of IL15-activated PE-NK cells to traffic from periphery to the tumor site. Finally, we show that IL15 can counteract the inhibitory effect of the tumor pleural microenvironment. Our study suggests that IL15-activated NK cells isolated from pleural fluid (otherwise discarded after thoracentesis) may represent a suitable source of effector cells to be used in adoptive immunotherapy of cancer.
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Affiliation(s)
- D Croxatto
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - S Martini
- IRCCS AOU San Martino-IST, Genoa, Italy
| | - L Chiossone
- Centre d'Immunologie de Marseille-Luminy, Université d'Aix-Marseille UM2, Inserm, U1104, CNRS UMR7280, Marseille, France
| | | | - C F Simonassi
- Department of Pneumology, AO Villa Scassi, Genoa, Italy
| | - L Moretta
- Department of Immunology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - M C Mingari
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy.,IRCCS AOU San Martino-IST, Genoa, Italy
| | - P Vacca
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy.,IRCCS AOU San Martino-IST, Genoa, Italy
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8
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Balsamo M, Scordamaglia F, Pietra G, Manzini C, Cantoni C, Boitano M, Queirolo P, Vermi W, Facchetti F, Moretta A, Moretta L, Mingari MC, Vitale M. Effect of Melanoma-derived Fibroblasts on NK Cell Phenotype and Functions. Clin Immunol 2010. [DOI: 10.1016/j.clim.2010.03.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Della Chiesa M, Falco M, Parolini S, Bellora F, Petretto A, Romeo E, Balsamo M, Gambarotti M, Scordamaglia F, Tabellini G, Facchetti F, Vermi W, Bottino C, Moretta A, Vitale M. GPR56 as a novel marker identifying the CD56dull CD16+ NK cell subset both in blood stream and in inflamed peripheral tissues. Int Immunol 2009; 22:91-100. [DOI: 10.1093/intimm/dxp116] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Balsamo M, Scordamaglia F, Pietra G, Manzini C, Cantoni C, Boitano M, Queirolo P, Vermi W, Facchetti F, Moretta A, Moretta L, Mingari MC, Vitale M. Melanoma-associated fibroblasts modulate NK cell phenotype and antitumor cytotoxicity. Proc Natl Acad Sci U S A 2009; 106:20847-52. [PMID: 19934056 PMCID: PMC2791633 DOI: 10.1073/pnas.0906481106] [Citation(s) in RCA: 251] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Indexed: 12/21/2022] Open
Abstract
Although the role of the tumor microenvironment in the process of cancer progression has been extensively investigated, the contribution of different stromal components to tumor growth and/or evasion from immune surveillance is still only partially defined. In this study we analyzed fibroblasts derived from metastatic melanomas and provide evidence for their strong immunosuppressive activity. In coculture experiments, melanoma-derived fibroblasts sharply interfered with NK cell functions including cytotoxicity and cytokine production. Thus, both the IL-2-induced up-regulation of the surface expression of NKp44, NKp30, and DNAM-1 triggering receptors and the acquisition of cytolytic granules were inhibited in NK cells. This resulted in an impairment of the NK cell-mediated killing of melanoma target cells. Transwell cocultures and the use of specific inhibitors suggested that cell-to-cell contact was required for inducing DNAM-1 modulation. In contrast, modulation of NKp44 and NKp30 was due to PGE(2) released by fibroblasts during coculture. Normal skin fibroblasts could also partially affect NK cell phenotype and function. However, the inhibitory effect of tumor-derived fibroblasts was far stronger and directly correlated with their ability to produce PGE(2) either constitutively or upon induction by NK cells.
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Affiliation(s)
- Mirna Balsamo
- Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, 16132 Genova and Centro di Eccellenza per la Ricerca Biomedica 16132 Genova, Italy
| | - Francesca Scordamaglia
- Clinica Malattie dell'Apparato Respiratorio e Allergologia, Dipartimento di Medicina Interna, Università di Genova, 16132 Genova, Italy
| | - Gabriella Pietra
- Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, 16132 Genova and Centro di Eccellenza per la Ricerca Biomedica 16132 Genova, Italy
| | - Claudia Manzini
- Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, 16132 Genova and Centro di Eccellenza per la Ricerca Biomedica 16132 Genova, Italy
| | - Claudia Cantoni
- Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, 16132 Genova and Centro di Eccellenza per la Ricerca Biomedica 16132 Genova, Italy
- Istituto Giannina Gaslini 16147 Genova Italy
| | - Monica Boitano
- Istituto Nazionale per la Ricerca sul Cancro (IST) 16132 Genova, Italy; and
| | - Paola Queirolo
- Istituto Nazionale per la Ricerca sul Cancro (IST) 16132 Genova, Italy; and
| | - William Vermi
- Servizio di Anatomia Patologica, Spedali Civili di Brescia, 25123, Brescia, Italy
| | - Fabio Facchetti
- Servizio di Anatomia Patologica, Spedali Civili di Brescia, 25123, Brescia, Italy
| | - Alessandro Moretta
- Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, 16132 Genova and Centro di Eccellenza per la Ricerca Biomedica 16132 Genova, Italy
| | - Lorenzo Moretta
- Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, 16132 Genova and Centro di Eccellenza per la Ricerca Biomedica 16132 Genova, Italy
- Istituto Giannina Gaslini 16147 Genova Italy
| | - Maria Cristina Mingari
- Dipartimento di Medicina Sperimentale (DIMES), Università di Genova, 16132 Genova and Centro di Eccellenza per la Ricerca Biomedica 16132 Genova, Italy
- Istituto Nazionale per la Ricerca sul Cancro (IST) 16132 Genova, Italy; and
| | - Massimo Vitale
- Istituto Nazionale per la Ricerca sul Cancro (IST) 16132 Genova, Italy; and
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Abstract
BACKGROUND Levocetirizine, the R-enantiomer of cetirizine dihydrochloride, is a new molecule with a potent and selective antihistamine activity. OBJECTIVE To investigate the evidence that levocetirizine is an effective therapy for allergic disease. METHODS Evaluation of published articles in English, or having an English abstract. RESULTS Clinical trials indicate that levocetirizine is safe and effective for the treatment of allergic rhinitis and chronic idiopathic urticaria. The compound shows a rapid onset of action, high bioavailability and affinity for the H1 receptor. Moreover, this molecule demonstrates many anti-inflammatory effects that enhance the clinical therapeutic benefit not only in short-term but also in long-term treatments, as reported in recent trials utilizing levocetirizine for several months. CONCLUSION Levocetirizine confirms its safe effective activity for treatment of allergic disease in both adults and children.
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Affiliation(s)
- Francesca Scordamaglia
- Genoa University, Department of Internal Medicine, Allergy and Respiratory Diseases, Genoa, Italy
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12
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Balsamo M, Zambello R, Teramo A, Pedrazzi M, Sparatore B, Scordamaglia F, Pende D, Mingari MC, Moretta L, Moretta A, Semenzato G, Vitale M. Analysis of NK cell/DC interaction in NK-type lymphoproliferative disease of granular lymphocytes (LDGL): role of DNAM-1 and NKp30. Exp Hematol 2009; 37:1167-75. [PMID: 19580844 DOI: 10.1016/j.exphem.2009.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 06/25/2009] [Accepted: 06/29/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Natural killer (NK) cells and dendritic cells (DC) can give rise to reciprocal functional interactions resulting in promotion of DC maturation, killing of immature DC (iDC), and proliferation of NK cells. In this study, we analyze whether, in NK-lymphoproliferative disease of granular lymphocytes (LDGL) patients, this function could be altered and contribute to the persistence of the disease. MATERIALS AND METHODS Freshly isolated peripheral blood NK granular lymphocytes (GL) and NK cell lines derived from 13 different NK-LDGL patients were analyzed in coculture experiments to evaluate their ability to interact with monocyte-derived DCs (Mo-DC). RESULTS As compared to NK cells isolated from healthy donors, NK-GLs displayed, in most cases, a reduced capability of promoting Mo-DC maturation and of killing iDC. These findings could be explained, at least in part, by the low expression levels of NKp30: an activating receptor involved in the molecular interactions occurring between NK cells and DC. We also show that, in the presence of DC-derived cytokines such as interleukin-12, in both patients and healthy individuals, DNAM-1 can cooperate with NKp30 to induce NK cells to kill DC, release tumor necrosis factor-alpha, and promote DC maturation. This contribution, however, is not sufficient to compensate for the defect in patients' NK cells. CONCLUSION Besides expanding knowledge of the molecular basis of the NK/DC cross-talk, our study demonstrates that NK cells from NK-LDGL patients are impaired in their ability to interact with Mo-DC. The possible relationship between such abnormal NK cell/DC interactions and chronic NK cell proliferation are discussed.
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Affiliation(s)
- Mirna Balsamo
- DI.ME.S. Dipartimento di Medicina Sperimentale, Università di Genova, Genova, Italy
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Descalzi D, Folli C, Scordamaglia F, Riccio AM, Gamalero C, Canonica GW. Importance of fibroblasts-myofibroblasts in asthma-induced airway remodeling. ACTA ACUST UNITED AC 2009; 1:237-41. [PMID: 19075987 DOI: 10.2174/187221307782418847] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Asthma is a chronic airway disorder principally characterized by bronchial hyperreactivity and airflow obstruction. Increased epithelial and smooth muscle thickness, goblet cell hyperplasia, increased mucus secretion, abnormal deposition of extracellular matrix (ECM) components in the basement membrane (BM) layer and angiogenesis are all events which occur in asthma and are defined with the general term of remodeling. This is an important feature whose repetition and regeneration may bring to an abnormal or exaggerated response to airway insults. One of the characteristic aspects of asthma is an alteration in structural cell function. Airway smooth muscle cells (ASM), myofibroblasts and fibroblasts have the ability to secrete immunomodulatory cytokines and chemokines and to express cell surface receptors. These elements are all important for cell adhesion and leukocyte activation and may be integral components of the inflammatory response as well. In particular cells such as fibroblasts and myofibroblasts, important regulators in the development and maintenance of allergic airway inflammation, have been studied in depth by our group and several studies regarding their role in asthma therapy have been analyzed.
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Affiliation(s)
- Desideria Descalzi
- Allergy and Respiratory Diseases, Department of Internal Medicine, Genova, University of Genova, Italy
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Folli C, Descalzi D, Bertolini S, Riccio AM, Scordamaglia F, Gamalero C, Barbieri M, Passalacqua G, Canonica GW. Effect of statins on fibroblasts from human nasal polyps and turbinates. Eur Ann Allergy Clin Immunol 2008; 40:84-89. [PMID: 19334372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Statins are serum cholesterol-lowering agents used for the prevention and treatment of atherosclerotic vascular disease. There is, however, growing evidence that statins have immunomodulatory and anti-inflammatory activities and may prove invaluable in the treatment of immunological and inflammatory disorders. OBJECTIVE On these basis we evaluated the effect of statins on the proliferation of fibroblasts derived from human nasal polyps and turbinates and determined their ability to modulate airway remodelling. METHODS Fluvastatin (0.01-0.1-1 microM), Atorvastatin (0.1-1-10 microM) and Simvastatin (0.1-1-10 microM) were tested on cultured fibroblasts derived from human nasal polyps and turbinates stimulated or not with Fibroblast Growth Factor beta (10 ng/ml). All cultures were treated with 3H-Thymidine (1 microCi/ml) to test cell proliferation. RESULTS Our results show that proliferation of turbinate-derived fibroblasts is significantly inhibited by the three statins. Fluvastatin is already effective at the lowest dose (0.01 microM), whereas Atorvastatin and Simvastatin act at the plasmatic peak concentration (1 microM). No significant effect was found on fibroblasts derived from nasal polyps, except for Simvastatin which was effective after 144 hours of stimulation. CONCLUSIONS These drugs show a remarkable antiprolhferative effect and their different outcome depending on the different kind of fibroblasts in vitro is prompting news in the studies about statin use for the treatment of chronic inflammatory diseases.
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Affiliation(s)
- C Folli
- Allergy and Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy
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Descalzi D, Folli C, Nicolini G, Riccio AM, Gamalero C, Scordamaglia F, Canonica GW. Anti-proliferative and anti-remodelling effect of beclomethasone dipropionate, formoterol and salbutamol alone or in combination in primary human bronchial fibroblasts. Allergy 2008; 63:432-7. [PMID: 18076728 DOI: 10.1111/j.1398-9995.2007.01582.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Bronchial asthma is characterized by lower airway inflammation and remodelling. Anti-inflammatory treatment with inhaled corticosteroids (ICS) provides the mainstay of asthma therapy together with bronchodilation induced by short- and long-acting inhaled beta(2)-agonists. Lower airway fibroblasts may play a critical role in airway inflammation and remodelling, suggesting that they might represent an important target for the major anti-asthmatic drugs. The aim of our study was to investigate the effects of beclomethasone dipropionate (BDP), salbutamol and formoterol either alone or in combination on in vitro cultures of human bronchial fibroblasts. METHODS Fibroblasts were cultured in the presence of pro-inflammatory and proliferative stimuli, BDP, salbutamol and formoterol. The effects of drugs on cell proliferation were ascertained by (3)H-thymidine incorporation. CD90 and CD44 expression were detected by flow cytometry and fibronectin secretion using the enzyme-linked immunosorbent assay technique. RESULTS This study showed that BDP alone has significant anti-proliferative effects on lung fibroblasts treated with basic fibroblast growth factor and the combination of BDP with formoterol or salbutamol strengthen these effects. Short-acting beta(2)-agonist (SABA) or long-acting beta(2)-agonist (LABA) by themselves did not show any significant effect on the different cultures. CD44 and CD90 expression and fibronectin production were modulated by pro-inflammatory and proliferative stimuli; the addition of the drugs brought them back near to the basal level. CONCLUSIONS From this in vitro study, we can conclude that BDP, when combined with salbutamol or formoterol, exhibits enhanced anti-remodelling activity in bronchial fibroblasts, providing new insights on the additive effects of ICS and SABAs and LABAs for asthma therapy.
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Affiliation(s)
- D Descalzi
- Allergy and Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy
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Scordamaglia F, Balsamo M, Scordamaglia A, Moretta A, Mingari MC, Canonica GW, Moretta L, Vitale M. Perturbations of natural killer cell regulatory functions in respiratory allergic diseases. J Allergy Clin Immunol 2007; 121:479-85. [PMID: 18061653 DOI: 10.1016/j.jaci.2007.09.047] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2007] [Revised: 08/20/2007] [Accepted: 09/27/2007] [Indexed: 01/21/2023]
Abstract
BACKGROUND Allergic diseases are characterized by abnormal responses to allergens favored by an inappropriate regulation of the T(H)1-T(H)2 polarization. Natural killer (NK) cells give rise to a complex NK/dendritic cell (DC) cross-talk that would help T(H)1 responses. OBJECTIVE By analyzing peripheral blood NK cells from 12 patients with either allergic rhinitis or rhinitis and intermittent asthma, we evaluated whether these cells were impaired in their ability to interact with DCs. METHODS Different circulating NK cell subsets were analyzed by flow cytofluorimetry. Mixed NK/DC cultures were performed to assess the reciprocal functional interactions. NK cells were analyzed for their ability to induce DC maturation and cytokine production, and to kill immature DCs. In addition, DCs were assessed for their ability to induce cytokine production by NK cells. RESULTS We first analyzed the CD56++CD16+/- cells, a subset of circulating NK cells that is able to respond to DCs by proliferating and producing IFN-gamma. Our analysis revealed that this NK cell subpopulation was significantly reduced in most patients. This was reflected by reduced NK cell-mediated IFN-gamma production in response to DCs. Also, the capability of promoting DC maturation and/or killing immature DCs, a function sustained by CD56+CD16+ NK cells, was reduced in most patients. CONCLUSIONS We suggest that allergic diseases are accompanied by a partial impairment of the NK cell capability of promoting and maintaining appropriate T(H)1 responses.
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Affiliation(s)
- Francesca Scordamaglia
- Clinica Malattie dell'Apparato Respiratorio e Allergologia, Dipartimento di Medicina Interna, Università di Genova, Genoa, Italy
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Scordamaglia F, Canonica G, Scordamaglia A. Natural Killer (NK) Cell Subsets in Allergic Patients. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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