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Chew N, Ng CH, Kong G, Chin YH, Lim O, Lim WH, Dalakoti M, Khoo CM, Kong W, Poh KK, Foo R, Lee CH, Chan MY, Muthiah M, Loh PH. Metabolic associated fatty liver disease increases risk of adverse events after acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1414] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Metabolic Associated Fatty Liver Disease (MAFLD) was recently introduced as an alternative definition for fatty liver, that has been linked to an increased risk of systemic end-organ damage. However, current studies have not examined the impact of MAFLD on patients presenting with acute coronary syndrome (ACS). Here, we present a retrospective analysis on the short and long-term outcomes of ACS patients with MAFLD.
Methods
A retrospective analysis was conducted in a tertiary care centre. Hepatic steatosis and fibrosis was examined with hepatic steatosis index and fibrosis-4 (FIB-4) index. The primary and secondary outcomes of the analysis were long term all-cause mortality, and in-hospital all-cause mortality, stroke, heart failure and cardiogenic shock respectively. Adjusted analysis was conducted for primary and secondary outcomes with covariates including age, sex, race, type of ACS and previous myocardial infarction.
Results
A total of 5770 patients were included in the analysis, and 21% of ACS patients had concomitant MAFLD. MAFLD resulted in a 23% increase in long-term all-cause mortality compared to non-MAFLD (HR: 1.230, CI: 1.065 to 1.420, p=0.005). MAFLD increased the risk of in-hospital mortality, stroke, heart failure and cardiogenic shock compared to non-MAFLD. A sensitivity analysis conducted based on MAFLD with advance fibrosis, chronic kidney disease and diabetes also demonstrated significantly increased effect size magnitude of all-cause mortality, compared to non-MAFLD.
Conclusion
MAFLD represents an encapsulation of metabolism dysregulation and has been associated with increased risk of systematic disease. The present study shows that MAFLD is associated with significantly increased adverse prognostic outcomes after ACS compared to non-MAFLD. An increase in awareness of MAFLD is required beyond the field of hepatology for improvements in multidisciplinary care and management.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Chew
- National University Heart Centre , Singapore , Singapore
| | - C H Ng
- National University Health System , Singapore , Singapore
| | - G Kong
- National University Health System , Singapore , Singapore
| | - Y H Chin
- National University Health System , Singapore , Singapore
| | - O Lim
- National University of Singapore , Singapore , Singapore
| | - W H Lim
- National University of Singapore , Singapore , Singapore
| | - M Dalakoti
- National University of Singapore , Singapore , Singapore
| | - C M Khoo
- National University Health System , Singapore , Singapore
| | - W Kong
- National University Heart Centre , Singapore , Singapore
| | - K K Poh
- National University Heart Centre , Singapore , Singapore
| | - R Foo
- National University Heart Centre , Singapore , Singapore
| | - C H Lee
- National University Heart Centre , Singapore , Singapore
| | - M Y Chan
- National University Heart Centre , Singapore , Singapore
| | - M Muthiah
- National University Health System , Singapore , Singapore
| | - P H Loh
- National University Heart Centre , Singapore , Singapore
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Chew NWS, Zhang A, Koh S, Ong JL, Kong G, Lim O, Kuntjoro I, Kong W, Low A, Lee CH, Chan MY, Yeo TC, Tan HC, Poh KK, Loh PH. Higher long-term mortality in patients with concomitant acute coronary syndrome and aortic stenosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1417] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Aortic stenosis (AS) and acute coronary syndrome (ACS) share similar cardiovascular risk factors, and their concomitant presentation is increasing in incidence with the aging population. Yet literature regarding the prognosis of patients with concomitant ACS and AS remains scarce.
Methods
This retrospective cohort study examined consecutive patients presenting with ACS (ST-segment elevation myocardial infarction [STEMI] and non-STEMI [NSTEMI]) and concomitant AS between 1 January 2011 and 31 March 2021 in a tertiary hospital. The cohort was divided into mild, moderate and severe AS based on index echocardiogram. The primary outcome was all-cause mortality. Kaplan-Meier curves were constructed to compare all-cause mortality among the three groups of patients, based on ACS type and left ventricular ejection fraction (LVEF). Multivariable Cox regression was performed to identify independent predictors of all-cause mortality.
Results
Of a total of 563 patients, 264 had mild (46.9%), 193 moderate (34.3%) and 106 severe AS (18.8%). The mean follow-up duration was 2.5 (± 2.4) years. Majority of patients (72.5%) presented with NSTEMI. Patients with moderate and severe AS had higher rates of all-cause mortality compared to those with mild AS (49.7% vs. 51.4% vs. 35.6% respectively, p=0.002). Concomitant moderate (HR 1.439, 95% CI 1.012–2.048, p=0.043) and severe AS (HR 1.844, 95% CI 1.159–2.933, p=0.010) were independent predictors of all-cause mortality after adjusting for age, gender, LVEF, ACS type, chronic kidney disease, diabetes, hypertension, coronary artery bypass grafting and aortic valve replacement as a time-dependent variable. The Kaplan-Meier curves demonstrated excess mortality in moderate and severe AS, compared to the mild AS group (p<0.001), with similar survival trends observed in the STEMI and the NSTEMI groups, as well as those with preserved LVEF.
Conclusion
Regardless of the ACS presentation type, long-term excess mortality in those with concomitant moderate or severe AS was observed. The adverse prognosis typically observed in patients with concomitant severe AS, in the setting of ACS, extends to patients with moderate AS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N W S Chew
- National University Heart Centre , Singapore , Singapore
| | - A Zhang
- National University Heart Centre , Singapore , Singapore
| | - S Koh
- National University Heart Centre , Singapore , Singapore
| | - J L Ong
- National University Heart Centre , Singapore , Singapore
| | - G Kong
- National University Heart Centre , Singapore , Singapore
| | - O Lim
- National University Heart Centre , Singapore , Singapore
| | - I Kuntjoro
- National University Heart Centre , Singapore , Singapore
| | - W Kong
- National University Heart Centre , Singapore , Singapore
| | - A Low
- National University Heart Centre , Singapore , Singapore
| | - C H Lee
- National University Heart Centre , Singapore , Singapore
| | - M Y Chan
- National University Heart Centre , Singapore , Singapore
| | - T C Yeo
- National University Heart Centre , Singapore , Singapore
| | - H C Tan
- National University Heart Centre , Singapore , Singapore
| | - K K Poh
- National University Heart Centre , Singapore , Singapore
| | - P H Loh
- National University Heart Centre , Singapore , Singapore
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Kim JM, Cho SY, Rhu J, Jung M, Her JH, Lim O, Choi GS, Shin EC, Hwang YK, Joh JW. Adjuvant therapy using ex vivo-expanded allogenic natural killer cells in hepatectomy patients with hepatitis B virus related solitary hepatocellular carcinoma: MG4101 study. Ann Hepatobiliary Pancreat Surg 2021; 25:206-214. [PMID: 34053923 PMCID: PMC8180393 DOI: 10.14701/ahbps.2021.25.2.206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/10/2020] [Accepted: 10/11/2020] [Indexed: 12/12/2022] Open
Abstract
Backgrounds/Aims Fewer reports have been published regarding hepatectomy patients with solitary hepatocellular carcinoma (HCC) who received immunotherapeutic agents as adjuvant therapy. We evaluated the safety and efficacy of ex vivo-expanded allogenic natural killer (NK) cells in those patients with modified International Union Against Cancer (UICC) stage T3. Methods From August 2014 to October 2015, five patients who underwent hepatic resection received ex vivo-expanded allogenic NK cells. Patients received five rounds of NK cells (2-3×107 cells/kg) at postoperative 4, 6, 8, 12, and 16 weeks. This study is registered with ClinicalTrials.gov, number NCT02008929. Results The median age of the five patients (three men and two women) was 44.8 years (range, 36-54 years). All had hepatitis B virus-related HCC, and the median tumor size was 2.2 cm (range, 2.1-8.2 cm). None of the patients had any adverse events. HCC recurrence developed in two patients at one year after hepatic resection, but four patients were alive at 3 years. The two recurrence-free patients showed a higher ratio of CD8+ T lymphocyte populations before and after administration of ex vivo-expanded allogenic NK cells compared with the three patients who experienced recurrence. Conclusions Immunotherapy using ex vivo-expanded allogenic NK cells in hepatectomy patients can be used safely. Further studies should be investigated for efficacy.
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Affiliation(s)
- Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yoo Cho
- Cell Therapy Research Center, GC LabCell, Yongin, Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Miyoung Jung
- Cell Therapy Research Center, GC LabCell, Yongin, Korea
| | - Jung Hyun Her
- Cell Therapy Research Center, GC LabCell, Yongin, Korea
| | - Okjae Lim
- Cell Therapy Research Center, GC LabCell, Yongin, Korea
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eui-Cheol Shin
- Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | | | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee J, Sheen JH, Lim O, Lee Y, Ryu J, Shin D, Kim YY, Kim M. Abrogation of HLA surface expression using CRISPR/Cas9 genome editing: a step toward universal T cell therapy. Sci Rep 2020; 10:17753. [PMID: 33082438 PMCID: PMC7576162 DOI: 10.1038/s41598-020-74772-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 09/24/2020] [Indexed: 12/26/2022] Open
Abstract
As recent advancements in the chimeric antigen receptor-T cells have revolutionized the way blood cancers are handled, potential benefits from producing off-the-shelf, standardized immune cells entail the need for development of allogeneic immune cell therapy. However, host rejection driven by HLA disparity in adoptively transferred allogeneic T cells remains a key obstacle to the universal donor T cell therapy. To evade donor HLA-mediated immune rejection, we attempted to eliminate T cell’s HLA through the CRISPR/Cas9 gene editing system. First, we screened 60 gRNAs targeting B2M and multiple sets of gRNA each targeting α chains of HLA-II (DPA, DQA and DRA, respectively) using web-based design tools, and identified specific gRNA sequences highly efficient for target deletion without carrying off-target effects. Multiplex genome editing of primary human T cells achieved by the newly discovered gRNAs yielded HLA-I- or HLA-I/II-deficient T cells that were phenotypically unaltered and functionally intact. The overnight mixed lymphocyte reactions demonstrated the HLA-I-negative cells induced decreased production of IFN-γ and TNF-α in alloreactive T cells, and deficiency of HLA-I/II in T cells further dampened the inflammatory responses. Taken together, our approach will provide an efficacious pathway toward the universal donor cell generation by manipulating HLA expression in therapeutic T cells.
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Affiliation(s)
- Jeewon Lee
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea
| | - Joong Hyuk Sheen
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea
| | - Okjae Lim
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea
| | - Yunjung Lee
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea
| | - Jihye Ryu
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea
| | - Duckhyang Shin
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea
| | - Yu Young Kim
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea
| | - Munkyung Kim
- MOGAM Institute for Biomedical Research, 93, 30beon-gil, Ihyeon-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16924, South Korea.
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Lee YJ, Lim O, Kim M, Lee J, Kim K, Jung J, Lee S, Kim SK, Kwon H, Lim Y, Park YY, Won J. Abstract 5768: MG1122, a whole IgG-like bispecific antibody targeting mesothelin and CD3, induces T cell-mediated killing of MSLN-expressing tumor cells. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5768] [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: 11/16/2022]
Abstract
Abstract
Mesothelin (MSLN) is an antigen overexpressed in several malignancies, including mesothelioma and ovarian and pancreatic adenocarcinoma. It has been studied as a marker for diagnosis and a target for immunotherapy. Here, we adopted a bispecific antibody format for recruiting cytotoxic T cells to kill tumor cells. MG1122 is a novel, whole IgG-like bispecific antibody which recognizes CD3 on T cells and MSLN on tumor cells. MG1122 induced effective killing of MSLN-expressing tumor cells. This response was associated with robust activation of T cells as shown by nuclear factor of activated T cells (NFAT) activation, CD25 and CD69 upregulation and increased cytokine release. In addition, using a live cell analysis system, we found that levels of activated caspase 3/7 were amplified in the tumor cells by MG1122 treatment. Although MSLN is a surface antigen, it also exists as a secreted isoform, which can lead to tumor evasion against MSLN targeting antibodies. However, despite the high concentration of soluble MSLN, MG1122 still effectively bound and showed strong killing effects against MSLN-expressing tumor cells. Taken together, our MSLN/CD3 bispecific antibody, MG1122 offers a promising opportunity to redirect T cells to kill MSLN-expressing cancer cells.
Citation Format: Yun-Jung Lee, Okjae Lim, Munkyung Kim, Jeewon Lee, Kisu Kim, Junhong Jung, SuA Lee, Sung Keun Kim, Haenaem Kwon, Yangmi Lim, Yong Yea Park, Jonghwa Won. MG1122, a whole IgG-like bispecific antibody targeting mesothelin and CD3, induces T cell-mediated killing of MSLN-expressing tumor cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5768.
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Affiliation(s)
| | - Okjae Lim
- Mogam Institute, Yongin-si, Republic of Korea
| | | | - Jeewon Lee
- Mogam Institute, Yongin-si, Republic of Korea
| | - Kisu Kim
- Mogam Institute, Yongin-si, Republic of Korea
| | | | - SuA Lee
- Mogam Institute, Yongin-si, Republic of Korea
| | | | | | - Yangmi Lim
- Mogam Institute, Yongin-si, Republic of Korea
| | | | - Jonghwa Won
- Mogam Institute, Yongin-si, Republic of Korea
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Lim O, Chung H, Min B, Her J, Hwang Y. Post-transfusion kinetics of allogeneic natural killer cells in patients with malignant lymphoma or advanced solid tumors. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.316] [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: 10/17/2022]
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7
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Lim O, Choi H, Chung H, Min B, Her J, Cho S, Hwang Y. Clinical efficacy of killer cell immunoglobulin-like receptor ligand-mismatched allogeneic natural killer cells in patients with malignant lymphoma or advanced solid tumors. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.089] [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: 11/27/2022]
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Yang Y, Lim O, Kim TM, Ahn YO, Choi H, Chung H, Min B, Her JH, Cho SY, Keam B, Lee SH, Kim DW, Hwang YK, Heo DS. Phase I Study of Random Healthy Donor-Derived Allogeneic Natural Killer Cell Therapy in Patients with Malignant Lymphoma or Advanced Solid Tumors. Cancer Immunol Res 2016; 4:215-24. [PMID: 26787822 DOI: 10.1158/2326-6066.cir-15-0118] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 12/02/2015] [Indexed: 11/16/2022]
Abstract
Natural killer (NK) cells with mismatched killer cell immunoglobulin-like receptor-ligand pairs have shown efficacy and been proven safe in treatment of cancer patients. Ex vivo-expanded and highly activated NK cells (MG4101) had been generated under good manufacturing practice conditions, which demonstrated potent anticancer activity in vitro and in vivo in preclinical studies. The current phase I clinical trial was designed to evaluate safety and possible clinical efficacy of repetitive administrations of MG4101 derived from random unrelated healthy donors into patients with malignant lymphoma or advanced, recurrent solid tumors. The maximum dose (3 × 10(7) cells/kg, triple infusion) was tolerable without significant adverse events. Of 17 evaluable patients, 8 patients (47.1%) showed stable disease and 9 (52.9%) showed progressive disease. We also evaluated the capacity of MG4101 to influence host immune responses. Administration of MG4101 augmented NKG2D expression on CD8(+) T cells and upregulated chemokines that recruit T cells. In contrast, administration of MG4101 reduced regulatory T cells and myeloid-derived suppressor cells and suppressed TGFβ production. In conclusion, administration of a large number of MG4101 cells was not only safe and feasible, but also exhibited efficacy in maintaining the effector arm of the host immune response.
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Affiliation(s)
- Yaewon Yang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Okjae Lim
- Cell Therapy Team, MOGAM Biotechnology Institute, Yongin, Gyeonggi-do, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
| | - Yong-Oon Ahn
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hana Choi
- Cell Therapy Team, MOGAM Biotechnology Institute, Yongin, Gyeonggi-do, Korea
| | - Hyejin Chung
- Cell Therapy Team, MOGAM Biotechnology Institute, Yongin, Gyeonggi-do, Korea
| | - Bokyung Min
- Cell Therapy Team, MOGAM Biotechnology Institute, Yongin, Gyeonggi-do, Korea
| | - Jung Hyun Her
- Cell Therapy Team, MOGAM Biotechnology Institute, Yongin, Gyeonggi-do, Korea
| | - Sung Yoo Cho
- Cell Therapy Team, MOGAM Biotechnology Institute, Yongin, Gyeonggi-do, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Wan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yu Kyeong Hwang
- Cell Therapy Team, MOGAM Biotechnology Institute, Yongin, Gyeonggi-do, Korea.
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Abstract
Natural killer (NK) cells are innate lymphocytes that are capable of eliminating tumor cells and are therefore used for cancer therapy. Although many early investigators used autologous NK cells, including lymphokine-activated killer cells, the clinical efficacies were not satisfactory. Meanwhile, human leukocyte antigen (HLA)-haploidentical hematopoietic stem cell transplantation revealed the antitumor effect of allogeneic NK cells, and HLA-haploidentical, killer cell immunoglobulin-like receptor ligand-mismatched allogeneic NK cells are currently used for many protocols requiring NK cells. Moreover, allogeneic NK cells from non-HLA-related healthy donors have been recently used in cancer therapy. The use of allogeneic NK cells from non-HLA-related healthy donors allows the selection of donor NK cells with higher flexibility and to prepare expanded, cryopreserved NK cells for instant administration without delay for ex vivo expansion. In cancer therapy with allogeneic NK cells, optimal matching of donors and recipients is important to maximize the efficacy of the therapy. In this review, we summarize the present state of allogeneic NK cell therapy and its future directions.
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Affiliation(s)
- Okjae Lim
- Virology and Immunology Team, MOGAM Biotechnology Institute , Yongin , South Korea
| | - Mi Young Jung
- Virology and Immunology Team, MOGAM Biotechnology Institute , Yongin , South Korea
| | - Yu Kyeong Hwang
- Cell Therapy Center, GreenCross LabCell , Yongin , South Korea
| | - Eui-Cheol Shin
- Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST , Daejeon , South Korea
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Lim O, Her J, Kang S, Hwang Y. Therapeutic efficacy of ex vivo expanded allogeneic natural killer cells in mouse neuroblastoma model. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.060] [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: 11/28/2022]
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Lim O, Lee Y, Chung H, Her JH, Kang SM, Jung MY, Min B, Shin H, Kim TM, Heo DS, Hwang YK, Shin EC. GMP-compliant, large-scale expanded allogeneic natural killer cells have potent cytolytic activity against cancer cells in vitro and in vivo. PLoS One 2013; 8:e53611. [PMID: 23326467 PMCID: PMC3543306 DOI: 10.1371/journal.pone.0053611] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 11/29/2012] [Indexed: 12/27/2022] Open
Abstract
Ex vivo-expanded, allogeneic natural killer (NK) cells can be used for the treatment of various types of cancer. In allogeneic NK cell therapy, NK cells from healthy donors must be expanded in order to obtain a sufficient number of highly purified, activated NK cells. In the present study, we established a simplified and efficient method for the large-scale expansion and activation of NK cells from healthy donors under good manufacturing practice (GMP) conditions. After a single step of magnetic depletion of CD3(+) T cells, the depleted peripheral blood mononuclear cells (PBMCs) were stimulated and expanded with irradiated autologous PBMCs in the presence of OKT3 and IL-2 for 14 days, resulting in a highly pure population of CD3(-)CD16(+)CD56(+) NK cells which is desired for allogeneic purpose. Compared with freshly isolated NK cells, these expanded NK cells showed robust cytokine production and potent cytolytic activity against various cancer cell lines. Of note, expanded NK cells selectively killed cancer cells without demonstrating cytotoxicity against allogeneic non-tumor cells in coculture assays. The anti-tumor activity of expanded human NK cells was examined in SCID mice injected with human lymphoma cells. In this model, expanded NK cells efficiently controlled lymphoma progression. In conclusion, allogeneic NK cells were efficiently expanded in a GMP-compliant facility and demonstrated potent anti-tumor activity both in vitro and in vivo.
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Affiliation(s)
- Okjae Lim
- BioMedical Science and Engineering Interdisciplinary Program, KAIST, Daejeon, Republic of Korea
- Cell Therapy Team, Mogam Biotechnology Research Institute, Yongin, Gyeonggi-do, Republic of Korea
- Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea
| | - Yuna Lee
- Cell Therapy Team, Mogam Biotechnology Research Institute, Yongin, Gyeonggi-do, Republic of Korea
| | - Hyejin Chung
- Cell Therapy Team, Mogam Biotechnology Research Institute, Yongin, Gyeonggi-do, Republic of Korea
| | - Jung Hyun Her
- Cell Therapy Team, Mogam Biotechnology Research Institute, Yongin, Gyeonggi-do, Republic of Korea
| | - Sang Mi Kang
- Cell Therapy Team, Mogam Biotechnology Research Institute, Yongin, Gyeonggi-do, Republic of Korea
| | - Mi-young Jung
- Cell Therapy Division, Green Cross LabCell Corp., Yongin, Gyeonggi-do, Republic of Korea
| | - Bokyung Min
- Cell Therapy Team, Mogam Biotechnology Research Institute, Yongin, Gyeonggi-do, Republic of Korea
| | - Hyejin Shin
- Cell Therapy Division, Green Cross LabCell Corp., Yongin, Gyeonggi-do, Republic of Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yu Kyeong Hwang
- Cell Therapy Team, Mogam Biotechnology Research Institute, Yongin, Gyeonggi-do, Republic of Korea
| | - Eui-Cheol Shin
- BioMedical Science and Engineering Interdisciplinary Program, KAIST, Daejeon, Republic of Korea
- Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea
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Noël G, Bauer N, Clavier JB, Guihard S, Lim O, Jastaniah Z. [Stereotactic radiotherapy of intracranial benign tumors]. Cancer Radiother 2012; 16:410-7. [PMID: 22921979 DOI: 10.1016/j.canrad.2012.07.179] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 06/22/2012] [Accepted: 07/05/2012] [Indexed: 11/25/2022]
Abstract
Stereotactic radiotherapy can be delivered in one fraction or in multiple fractions schedule. It is used in benign tumours such as meningiomas, mainly localized in the base of the skull, for acoustic schwannoma and pituitary tumours. Whatever the tumour, results with the Gamma Knife(®) are the most numerous, but those obtained by linear accelerators, adapted or dedicated, are comparable. The peripheral dose is preferred to the dose delivered to the isocentre. One fraction stereotactic irradiation should be proposed in small lesions and fractionated treatment for tumours larger. Whatever the tumour, the results are satisfactory with a control rate of 90%. However, this value reflects a disparity assessment, radiological stability for meningiomas, radiological stability and preservation of useful hearing in schwannoma and radiological stability and a decrease in hormonal secretions for pituitary adenomas. Overall complication rates are low. In total, the treatment of benign lesions with stereotactic irradiation gives satisfactory results with few complications.
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Affiliation(s)
- G Noël
- Département universitaire de radiothérapie, centre de lutte contre le cancer Paul-Strauss, Strasbourg, France.
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