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Santegoets SJ, Duurland CL, Jordanova ES, van Ham JJ, Ehsan I, van Egmond SL, Welters MJP, van der Burg SH. Tbet-positive regulatory T cells accumulate in oropharyngeal cancers with ongoing tumor-specific type 1 T cell responses. J Immunother Cancer 2019; 7:14. [PMID: 30658697 PMCID: PMC6339415 DOI: 10.1186/s40425-019-0497-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 10/11/2018] [Accepted: 01/01/2019] [Indexed: 01/13/2023] Open
Abstract
Regulatory T cells (Tregs) may comprise different subsets allowing them to efficiently suppress different types of effector T cells. In this study, we show that high numbers of both conventional and Tbet co-expressing Foxp3hi Tregs accumulate in human papilloma virus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC). The infiltration of Tbet+ Foxp3+ Tregs was strongly correlated with a concomitant tumor-specific and conventional type 1-oriented intratumoral T cell infiltrate. Both conventional CD4+CD25+CD127–Foxp3hi Tregs and their Tbethi counterparts exhibited an activated phenotype, co-expressed high levels of CTLA4 and Helios and exhibited a maximally demethylated Foxp3 gene locus TSDR, indicating their full capacity to impede a type 1 effector T cell response. Interestingly, while the prognostic value of conventional Tregs was neutral, a high intratumoral frequency of Tbet+ Tregs was associated with prolonged disease-specific survival, most likely because their presence reflected high numbers of effector T cells. The presence of these Tbet+ Tregs may in part explain why a dense type 1-oriented immune infiltrate in OPSCC is not enough to fully control tumor growth.
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Affiliation(s)
- S J Santegoets
- Departments of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - C L Duurland
- Departments of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - E S Jordanova
- Department of Obstetrics and Gynecology, Center for Gynecological Oncology Amsterdam (CGOA) Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J J van Ham
- Departments of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - I Ehsan
- Departments of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - S L van Egmond
- Departments of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - M J P Welters
- Departments of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - S H van der Burg
- Departments of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
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2
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Santegoets SJAM, de Groot AF, Dijkgraaf EM, Simões AMC, van der Noord VE, van Ham JJ, Welters MJP, Kroep JR, van der Burg SH. The blood mMDSC to DC ratio is a sensitive and easy to assess independent predictive factor for epithelial ovarian cancer survival. Oncoimmunology 2018; 7:e1465166. [PMID: 30221063 PMCID: PMC6136880 DOI: 10.1080/2162402x.2018.1465166] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 02/28/2018] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 12/26/2022] Open
Abstract
Epithelial ovarian cancer (EOC) may cause abnormal blood levels of leukocytes. This paraneoplastic manifestation is associated with a worse response to therapy and shorter survival. To understand the complexity and nature of these leukocytes, we dissected the different populations of myeloid cells and analyzed their relation to clinical outcome. Therefore, baseline blood samples of 36 EOC patients treated either with carboplatin/doxorubucin or with gemcitabine were analyzed for different subsets of monocytes/macrophages, myeloid derived suppressor cells (MDSC) and dendritic cells (DC) using multiparameter flow cytometry as well as functional assays for myeloid cell mediated suppression of antigen-specific T cell reactivity. Healthy donor blood served as control. EOC patients displayed an increase in monocytes/macrophages, monocytic MDSC (mMDSC) and CD33-CD11b+CD14-CD15- double-negative MDSC (CD33- dnMDSC) and a decrease in the frequency of DC, across all EOC subtypes. A low frequency of DC and high frequencies of monocytes/macrophages and mMDSC, but not CD33- dnMDSC, were associated with poor overall survival. Patient's monocytes/macrophages and mMDSC, but not CD33- dnMDSC, were shown to suppress T cell reactivity in vitro. The mMDSC and DC frequencies were not altered upon treatment. Importantly, the mMDSC to DC ratio was the strongest independent, highly sensitive and specific, predictive factor for survival. This was irrespective of the type of chemotherapy or disease stage and outperformed classical parameters as WHO status or time from last chemotherapy. Thus, the baseline blood mMDSC to DC ratio is a robust, independent and easy to analyze predictive factor for EOC survival, and may assist patient selection for immunotherapy.
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Affiliation(s)
- S J A M Santegoets
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - A F de Groot
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - E M Dijkgraaf
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - A M Carnaz Simões
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - V E van der Noord
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - J J van Ham
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - M J P Welters
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - J R Kroep
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - S H van der Burg
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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3
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Koskimaa HM, Paaso A, Welters MJP, Grénman S, Syrjänen K, van der Burg SH, Syrjänen S. The presence of human papillomavirus (HPV) in placenta and/or cord blood might result in Th2 polarization. Eur J Clin Microbiol Infect Dis 2017; 36:1491-1503. [PMID: 28324192 PMCID: PMC5524867 DOI: 10.1007/s10096-017-2958-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 01/16/2017] [Accepted: 03/02/2017] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to evaluate if an early exposure to human papillomavirus (HPV) during the prenatal period or infancy could result in HPV16-specific T helper (Th) responses resembling those of adults with HPV-induced lesions. We tested HPV16-specific cell-mediated immunity (CMI) in children born with HPV-positive umbilical cord blood and/or placenta or having persistent oral HPV infection and in constantly oral HPV-negative controls. Peripheral blood mononuclear cells from 33 children from the Finnish HPV Family Study cohort (mean age 14.7 years) were stimulated with peptide pools covering the amino acid sequence of the HPV16 E2, E6, and E7 proteins. Lymphocyte proliferation, secretion of cytokines (IFN-γ, TNF-α, IL-2, IL-4, IL-5, IL-10, IL-17A), and the frequency of Foxp3+ regulatory T-cells were determined in relation to the HPV DNA status during a 14-year follow-up. 73.6% of cases and 85.7% of controls responded against HPV16 E2, while reactivity against E6 was found in 10.5 and 35.7%, respectively. The proliferative response against E6 and E7 was more frequent in controls than in cases (p = 0.047). No HPV16-specific CMI response or antibodies were detected in two children with persistent oral HPV16. The profiles of induced cytokines indicated higher levels of IL-5, IL-10, and IL-17A in children with HPV DNA in placenta and/or cord blood than in other children. HPV16-specific CMI is common in HPV DNA-negative children. The cytokine profile in children infected with HPV16 during early life suggests that the viral dose and/or specific environment created by the placenta may have significant impact on the type of HPV-specific immunity.
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Affiliation(s)
- H-M Koskimaa
- Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Lemminkäisenkatu 2, 20540, Turku, Finland.
| | - A Paaso
- Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Lemminkäisenkatu 2, 20540, Turku, Finland
| | - M J P Welters
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - S Grénman
- Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland
| | - K Syrjänen
- Department of Clinical Research, Biohit Oyj, Helsinki, Finland
| | - S H van der Burg
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - S Syrjänen
- Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Lemminkäisenkatu 2, 20540, Turku, Finland
- Department of Pathology, Turku University Hospital, University of Turku, Turku, Finland
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4
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Van Meir H, du Burck IJ, de Kam ML, Welters MJP, van der Burg SH, Trimbos JBMZ, de Kroon CD, van Poelgeest MIE. The identification of patients at high risk for recurrent disease after treatment for early-stage cervical cancer. EUR J GYNAECOL ONCOL 2017; 38:25-32. [PMID: 29767860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate prognostic factors in patients with recurrent cervical cancer after treatment of early-stage disease in order to identify high-risk patients who might benefit from alternative treatment strategies. STUDY DESIGN The authors retrospectively analyzed clinical and pathology data from 130 recurrent cervical cancer patients after surgical treatment for early-stage disease. Patients were compared with a recurrence-free control group matched for age, FIGO Stage, and adjuvant treatment. Univariate and multivariate Cox regression analyses were performed to determine prognostic factors for recurrence and survival. RESULTS Of 889 patients, 130 (14.6%) developed recurrent disease after primary treatment for early-stage cervical cancer. Local or loco-regional metastasis was observed in 45%, distant metastasis in 31%, and combined pelvic and distant metastasis in 24%. Median survival after recurrence was 12 months (range 1-107 months). Median five-year survival was 96% in the control group and 29% in the recurrence group. Tumor size ≥ 40 mm and lymph node metastasis were independent unfavorable prognostic factors for overall survival (OS) and disease-free survival (DFS). The number of positive lymph nodes (≥ one) and bilateral occurrence of pelvic lymph node metastasis were associated with adverse clinical outcome. CONCLUSIONS Tumor size ≥ 40 mm and lymph node metastasis were independent unfavorable prognostic factors in surgically treated, early-stage cervical cancer patients. The combination of these factors was particularly associated with recurrence. Future trials should focus on the role of alternative adjuvant treatment strategies in patients at high risk of recurrent disease (e.g., by chemotherapy, immunotherapy or combinations thereof).
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5
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van Meir H, Nout RA, Welters MJP, Loof NM, de Kam ML, van Ham JJ, Samuels S, Kenter GG, Cohen AF, Melief CJM, Burggraaf J, van Poelgeest MIE, van der Burg SH. Impact of (chemo)radiotherapy on immune cell composition and function in cervical cancer patients. Oncoimmunology 2016; 6:e1267095. [PMID: 28344877 PMCID: PMC5353924 DOI: 10.1080/2162402x.2016.1267095] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [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: 10/14/2016] [Revised: 11/22/2016] [Accepted: 11/24/2016] [Indexed: 11/13/2022] Open
Abstract
New treatments based on combinations of standard therapeutic modalities and immunotherapy are of potential use, but require a profound understanding of immune modulatory properties of standard therapies. Here, the impact of standard (chemo)radiotherapy on the immune system of cervical cancer patients was evaluated. Thirty patients with cervical cancer were treated with external beam radiation therapy (EBRT), using conventional three-dimensional or intensity modulated radiation therapy without constraints for bone marrow sparing. Serial blood sampling for immunomonitoring was performed before, midway and at 3, 6 and 9 weeks after EBRT to analyze the composition of lymphocyte and myeloid-cell populations, the expression of co-stimulatory molecules, T-cell reactivity and antigen presenting cell (APC) function. Therapy significantly decreased the absolute numbers of circulating leukocytes and lymphocytes. Furthermore, the capacity of the remaining T cells to respond to antigenic or mitogenic stimulation was impaired. During treatment the frequency of both CD4+ and CD8+ T cells dropped and CD4+ T cells displayed an increased expression of programmed cell death-1 (PD-1). In vitro blocking of PD-1 successfully increased T-cell reactivity in all five samples isolated before radiotherapy but was less successful in restoring reactivity in samples isolated at later time points. Moreover, (chemo)radiotherapy was associated with an increase in both circulating monocytes and myeloid-derived suppressor cells (MDSCs) and an impaired capacity of APCs to stimulate allogeneic T cells. T-cell reactivity was slowly restored at 6–9 weeks after cessation of therapy. We conclude that conventional (chemo)radiotherapy profoundly suppresses the immune system in cervical cancer patients, and may restrict its combination with immunotherapy.
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Affiliation(s)
- H van Meir
- Department of Gynecology, Leiden University Medical Center, Leiden, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands
| | - R A Nout
- Department of Radiation Oncology, Leiden University Medical Center , Leiden, the Netherlands
| | - M J P Welters
- Department of Medical Oncology, Leiden University Medical Center , Leiden, the Netherlands
| | - N M Loof
- Department of Medical Oncology, Leiden University Medical Center , Leiden, the Netherlands
| | - M L de Kam
- Centre for Human Drug Research , Leiden, the Netherlands
| | - J J van Ham
- Department of Medical Oncology, Leiden University Medical Center , Leiden, the Netherlands
| | - S Samuels
- Center Gynecological Oncology Amsterdam , NKI-AvL , Amsterdam, the Netherlands
| | - G G Kenter
- Center Gynecological Oncology Amsterdam , NKI-AvL , Amsterdam, the Netherlands
| | - A F Cohen
- Centre for Human Drug Research , Leiden, the Netherlands
| | | | - J Burggraaf
- Centre for Human Drug Research , Leiden, the Netherlands
| | - M I E van Poelgeest
- Department of Gynecology, Leiden University Medical Center , Leiden, the Netherlands
| | - S H van der Burg
- Department of Medical Oncology, Leiden University Medical Center , Leiden, the Netherlands
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6
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Dijkgraaf EM, Santegoets SJAM, Reyners AKL, Goedemans R, Wouters MCA, Kenter GG, van Erkel AR, van Poelgeest MIE, Nijman HW, van der Hoeven JJM, Welters MJP, van der Burg SH, Kroep JR. A phase I trial combining carboplatin/doxorubicin with tocilizumab, an anti-IL-6R monoclonal antibody, and interferon-α2b in patients with recurrent epithelial ovarian cancer. Ann Oncol 2015. [PMID: 26216383 DOI: 10.1093/annonc/mdv309] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
MESH Headings
- Adenocarcinoma, Clear Cell/blood
- Adenocarcinoma, Clear Cell/drug therapy
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Mucinous/blood
- Adenocarcinoma, Mucinous/drug therapy
- Adenocarcinoma, Mucinous/pathology
- Adult
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- CA-125 Antigen/blood
- Carboplatin/administration & dosage
- Cystadenocarcinoma, Serous/blood
- Cystadenocarcinoma, Serous/drug therapy
- Cystadenocarcinoma, Serous/pathology
- Dose-Response Relationship, Drug
- Doxorubicin/administration & dosage
- Doxorubicin/analogs & derivatives
- Endometrial Neoplasms/blood
- Endometrial Neoplasms/drug therapy
- Endometrial Neoplasms/pathology
- Enzyme-Linked Immunosorbent Assay
- Female
- Follow-Up Studies
- Humans
- Interferon alpha-2
- Interferon-alpha/administration & dosage
- Interferon-gamma/blood
- Interleukin-6/blood
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/blood
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Ovarian Neoplasms/blood
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/pathology
- Polyethylene Glycols/administration & dosage
- Prognosis
- Receptors, Interleukin-6/antagonists & inhibitors
- Recombinant Proteins/administration & dosage
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Affiliation(s)
- E M Dijkgraaf
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - S J A M Santegoets
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | | | - R Goedemans
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - M C A Wouters
- Department of Gynecologic Oncology, University Medical Center Groningen, Groningen
| | - G G Kenter
- Department of Gynecologic Oncology, Center for Gynecological Oncology Amsterdam, Amsterdam
| | | | - M I E van Poelgeest
- Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - M J P Welters
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - S H van der Burg
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - J R Kroep
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
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7
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Dijkgraaf EM, Santegoets SJAM, Reyners AKL, Goedemans R, Wouters MCA, Kenter GG, van Erkel AR, van Poelgeest MIE, Nijman HW, van der Hoeven JJM, Welters MJP, van der Burg SH, Kroep JR. A phase I trial combining carboplatin/doxorubicin with tocilizumab, an anti-IL-6R monoclonal antibody, and interferon-α2b in patients with recurrent epithelial ovarian cancer. Ann Oncol 2015. [PMID: 26216383 DOI: 10.1093/annonc/mdv309.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The immune system is important in epithelial ovarian cancer (EOC). Interleukin-6 is associated with chemoresistance and an immune-suppressive tumor microenvironment. We investigated whether a combination of chemotherapeutics, blockade of interleukin 6 (IL-6) receptor (IL-6R; tocilizumab), and immune enhancer interferon-α (Peg-Intron) is feasible, safe, and able to enhance immunity in patients with recurrent EOC. PATIENTS AND METHODS In this dose-escalation study, patients received tocilizumab 1, 2, 4, or 8 mg/kg i.v., q4 weeks during the first three cycles of carboplatin (AUC5) plus doxorubicin [pegylated liposomal doxorubicin (PLD) 30 mg/m(2) or doxorubicin 50 mg/m(2) i.v., day 1, q4 weeks, for six cycles]. At the highest tocilizumab dose (8 mg/kg), Peg-Intron (1 µg/kg s.c.) was added. Peripheral blood mononuclear cells were collected for immunomonitoring at baseline, after three and six cycles. Dose-limiting toxicity (DLT), CA-125, and radiologic response were evaluated. RESULTS In the 23 patients enrolled, no DLT was established. The most frequent grade 3/4 adverse events (CTCAE v4.03) were neutropenia (23%), febrile neutropenia (19%), and ileus (19%). No treatment-related deaths occurred. Using CT evaluation, 11 of 21 assessable patients responded, 6 had stable disease and 3 progressive disease. Patients receiving highest dose tocilizumab showed a functional blockade of IL-6R with increased levels of serum IL-6 (P = 0.02) and soluble IL-6R (P = 0.008). Consequently, immune cells displayed decreased levels of pSTAT3, myeloid cells produced more IL-12 and IL-1β while T cells were more activated and secreted higher amounts of effector cytokines interferon-γ and tumor necrosis factor-α. An increase in sIL-6R was potentially associated with a survival benefit (P = 0.03). CONCLUSIONS Functional IL-6R blocking is feasible and safe in EOC patients treated with carboplatin/(pegylated liposomal)doxorubicin, using 8 mg/kg tocilizumab. This combination is recommended for phase II evaluation based on immune parameters. CLINICAL TRIAL REGISTER NCT01637532.
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Affiliation(s)
- E M Dijkgraaf
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - S J A M Santegoets
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | | | - R Goedemans
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - M C A Wouters
- Department of Gynecologic Oncology, University Medical Center Groningen, Groningen
| | - G G Kenter
- Department of Gynecologic Oncology, Center for Gynecological Oncology Amsterdam, Amsterdam
| | | | - M I E van Poelgeest
- Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - M J P Welters
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - S H van der Burg
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - J R Kroep
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
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8
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Moodie Z, Price L, Gouttefangeas C, Mander A, Janetzki S, Löwer M, Welters MJP, Ottensmeier C, van der Burg SH, Britten CM. Response definition criteria for ELISPOT assays revisited. Cancer Immunol Immunother 2010; 59:1489-501. [PMID: 20549207 PMCID: PMC2909425 DOI: 10.1007/s00262-010-0875-4] [Citation(s) in RCA: 159] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Accepted: 05/31/2010] [Indexed: 11/28/2022]
Abstract
No consensus has been reached on how to determine if an immune response has been detected based on raw data from an ELISPOT assay. The goal of this paper is to enable investigators to understand and readily implement currently available methods for response determination. We describe empirical and statistical approaches, identifying the strengths and limitations of each approach to allow readers to rationally select and apply a scientifically sound method appropriate to their specific laboratory setting. Five representative approaches were applied to data sets from the CIMT Immunoguiding Program and the response detection and false positive rates were compared. Simulation studies were also performed to compare empirical and statistical approaches. Based on these, we recommend the use of a non-parametric statistical test. Further, we recommend that six medium control wells or four wells each for both medium control and experimental conditions be performed to increase the sensitivity in detecting a response, that replicates with large variation in spot counts be filtered out, and that positive responses arising from experimental spot counts below the estimated limit of detection be interpreted with caution. Moreover, a web-based user interface was developed to allow easy access to the recommended statistical methods. This interface allows the user to upload data from an ELISPOT assay and obtain an output file of the binary responses.
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Affiliation(s)
- Z Moodie
- Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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9
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Mander A, Gouttefangeas C, Ottensmeier C, Welters MJP, Low L, van der Burg SH, Britten CM. Serum is not required for ex vivo IFN-gamma ELISPOT: a collaborative study of different protocols from the European CIMT Immunoguiding Program. Cancer Immunol Immunother 2010; 59:619-27. [PMID: 20052465 PMCID: PMC2813523 DOI: 10.1007/s00262-009-0814-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [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: 08/24/2009] [Accepted: 12/21/2009] [Indexed: 02/04/2023]
Abstract
The Cancer Immunotherapy Immunoguiding Program has conducted an IFN-γ ELISPOT proficiency panel to examine the influence of serum supplementation of test media on assay performance. Sixteen European laboratories analyzed the same PBMC samples using different locally established protocols. Participants generated two simultaneous data sets—one using medium supplemented with serum and one without serum. Performances of the two test conditions were compared by quantifying: (1) the number of viable cells, (2) background spot formation induced in the medium only control and (3) the ability to detect antigen-specific T cell responses. The study demonstrated that the number of viable cells recovered and the overall background spot production were not significantly different between the two conditions. Furthermore, overall laboratory performance was equivalent for the two test conditions; 11 out of 16 laboratories reported equal or greater detection rates using serum-free medium, while 5 laboratories reported decreased detections rates under serum-free conditions. These results show that good performance of the IFN-γ ELISPOT assay can be achieved under serum-free conditions. Optimization of the protocol for serum-free conditions should result in excellent detection rates and eliminate the requirement of serum batch and stability testing, allowing further harmonization of the assay.
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Affiliation(s)
- A. Mander
- Cancer Sciences Division, Southampton University Hospitals, Southampton, UK
| | - C. Gouttefangeas
- Department of Immunology, University of Tübingen, Tübingen, Germany
| | - C. Ottensmeier
- Cancer Sciences Division, Southampton University Hospitals, Southampton, UK
| | - M. J. P. Welters
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - L. Low
- Cancer Sciences Division, Southampton University Hospitals, Southampton, UK
| | - S. H. van der Burg
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - C. M. Britten
- Division of Experimental and Translational Oncology, Department of Internal Medicine III, Johannes Gutenberg-University, Mainz, Germany
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10
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Britten CM, Gouttefangeas C, Welters MJP, Pawelec G, Koch S, Ottensmeier C, Mander A, Walter S, Paschen A, Müller-Berghaus J, Haas I, Mackensen A, Køllgaard T, thor Straten P, Schmitt M, Giannopoulos K, Maier R, Veelken H, Bertinetti C, Konur A, Huber C, Stevanović S, Wölfel T, van der Burg SH. The CIMT-monitoring panel: a two-step approach to harmonize the enumeration of antigen-specific CD8+ T lymphocytes by structural and functional assays. Cancer Immunol Immunother 2008; 57:289-302. [PMID: 17721783 PMCID: PMC2150627 DOI: 10.1007/s00262-007-0378-0] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Accepted: 07/17/2007] [Indexed: 01/08/2023]
Abstract
The interpretation of the results obtained from immunomonitoring of clinical trials is a difficult task due to the variety of methods and protocols available to detect vaccine-specific T-cell responses. This heterogeneity as well as the lack of standards has led to significant scepticism towards published results. In February 2005, a working group was therefore founded under the aegis of the Association for Immunotherapy of Cancer ("CIMT") in order to compare techniques and protocols applied for the enumeration of antigen-specific T-cell responses. Here we present the results from two consecutive phases of an international inter-laboratory testing project referred to as the "CIMT monitoring panel". A total of 13 centers from six European countries participated in the study in which pre-tested PBMC samples, synthetic peptides and PE-conjugated HLA-tetramers were prepared centrally and distributed to participants. All were asked to determine the number of antigen-specific T-cells in each sample using tetramer staining and one functional assay. The results of the first testing round revealed that the total number of cells analyzed was the most important determinant for the sensitive detection of antigen-specific CD8(+) T-cells by tetramer staining. Analysis by ELISPOT was influenced by a combination of cell number and a resting phase after thawing of peripheral blood mononuclear cells. Therefore, the experiments were repeated in a second phase but now the participants were asked to change their protocols according to the new guidelines distilled from the results of the first phase. The recommendations improved the number of antigen-specific T-cell responses that were detected and decreased the variability between the laboratories. We conclude that a two-step approach in inter-laboratory testing allows the identification of distinct variables that influence the sensitivity of different T-cell assays and to formally show that a defined correction to the protocols successfully increases the sensitivity and reduces the inter-center variability. Such "two-step" inter-laboratory projects could define rational bases for accepted international guidelines and thereby lead to the harmonization of the techniques used for immune monitoring.
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Affiliation(s)
- C. M. Britten
- Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - C. Gouttefangeas
- Department of Immunology, University of Tuebingen, Tuebingen, Germany
| | - M. J. P. Welters
- Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - G. Pawelec
- Centre for Medical Research, University of Tuebingen, Tuebingen, Germany
| | - S. Koch
- Centre for Medical Research, University of Tuebingen, Tuebingen, Germany
| | - C. Ottensmeier
- Cancer Sciences Division, Southampton University Hospitals, Southampton, UK
| | - A. Mander
- Cancer Sciences Division, Southampton University Hospitals, Southampton, UK
| | - S. Walter
- Immatics Biotechnologies, Tuebingen, Germany
| | - A. Paschen
- Skin Cancer Unit of the German Cancer Research Centre, University Clinics of Mannheim, Mannheim, Germany
| | | | - I. Haas
- Department of Haematology and Oncology, University of Regensburg, Regensburg, Germany
| | - A. Mackensen
- Department of Haematology and Oncology, University of Regensburg, Regensburg, Germany
| | - T. Køllgaard
- Department of Haematology, Centre for Cancer Immune Therapy, Herlev, Denmark
| | - P. thor Straten
- Department of Haematology, Centre for Cancer Immune Therapy, Herlev, Denmark
| | - M. Schmitt
- Third Department of Internal Medicine, University of Ulm, Ulm, Germany
| | - K. Giannopoulos
- Clinical Immunology Department, Medical University of Lublin, Lublin, Poland
| | - R. Maier
- Research Department, Kantonal Hospital St Gallen, St Gallen, Switzerland
| | - H. Veelken
- Department of Haematology and Oncology, Freiburg University Medical Centre, Freiburg, Germany
| | - C. Bertinetti
- Department of Haematology and Oncology, Freiburg University Medical Centre, Freiburg, Germany
| | - A. Konur
- Third Medical Department, University Mainz, Mainz, Germany
| | - C. Huber
- Third Medical Department, University Mainz, Mainz, Germany
| | - S. Stevanović
- Department of Immunology, University of Tuebingen, Tuebingen, Germany
| | - T. Wölfel
- Third Medical Department, University Mainz, Mainz, Germany
| | - S. H. van der Burg
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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