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Amiri Souri E, Chenoweth A, Karagiannis SN, Tsoka S. Drug repurposing and prediction of multiple interaction types via graph embedding. BMC Bioinformatics 2023; 24:202. [PMID: 37193964 DOI: 10.1186/s12859-023-05317-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/30/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Finding drugs that can interact with a specific target to induce a desired therapeutic outcome is key deliverable in drug discovery for targeted treatment. Therefore, both identifying new drug-target links, as well as delineating the type of drug interaction, are important in drug repurposing studies. RESULTS A computational drug repurposing approach was proposed to predict novel drug-target interactions (DTIs), as well as to predict the type of interaction induced. The methodology is based on mining a heterogeneous graph that integrates drug-drug and protein-protein similarity networks, together with verified drug-disease and protein-disease associations. In order to extract appropriate features, the three-layer heterogeneous graph was mapped to low dimensional vectors using node embedding principles. The DTI prediction problem was formulated as a multi-label, multi-class classification task, aiming to determine drug modes of action. DTIs were defined by concatenating pairs of drug and target vectors extracted from graph embedding, which were used as input to classification via gradient boosted trees, where a model is trained to predict the type of interaction. After validating the prediction ability of DT2Vec+, a comprehensive analysis of all unknown DTIs was conducted to predict the degree and type of interaction. Finally, the model was applied to propose potential approved drugs to target cancer-specific biomarkers. CONCLUSION DT2Vec+ showed promising results in predicting type of DTI, which was achieved via integrating and mapping triplet drug-target-disease association graphs into low-dimensional dense vectors. To our knowledge, this is the first approach that addresses prediction between drugs and targets across six interaction types.
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Affiliation(s)
- E Amiri Souri
- Department of Informatics, Faculty of Natural, Mathematical and Engineering Sciences, King's College London, Bush House, London, WC2B 4BG, UK
| | - A Chenoweth
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, Guy's Hospital, King's College London, London, SE1 9RT, UK
- Breast Cancer Now Research Unit, School of Cancer and Pharmaceutical Sciences, Guy's Cancer Centre, King's College London, London, SE1 9RT, UK
| | - S N Karagiannis
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, Guy's Hospital, King's College London, London, SE1 9RT, UK
- Breast Cancer Now Research Unit, School of Cancer and Pharmaceutical Sciences, Guy's Cancer Centre, King's College London, London, SE1 9RT, UK
| | - S Tsoka
- Department of Informatics, Faculty of Natural, Mathematical and Engineering Sciences, King's College London, Bush House, London, WC2B 4BG, UK.
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Amiri Souri E, Laddach R, Karagiannis SN, Papageorgiou LG, Tsoka S. Novel drug-target interactions via link prediction and network embedding. BMC Bioinformatics 2022; 23:121. [PMID: 35379165 PMCID: PMC8978405 DOI: 10.1186/s12859-022-04650-w] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As many interactions between the chemical and genomic space remain undiscovered, computational methods able to identify potential drug-target interactions (DTIs) are employed to accelerate drug discovery and reduce the required cost. Predicting new DTIs can leverage drug repurposing by identifying new targets for approved drugs. However, developing an accurate computational framework that can efficiently incorporate chemical and genomic spaces remains extremely demanding. A key issue is that most DTI predictions suffer from the lack of experimentally validated negative interactions or limited availability of target 3D structures. RESULTS We report DT2Vec, a pipeline for DTI prediction based on graph embedding and gradient boosted tree classification. It maps drug-drug and protein-protein similarity networks to low-dimensional features and the DTI prediction is formulated as binary classification based on a strategy of concatenating the drug and target embedding vectors as input features. DT2Vec was compared with three top-performing graph similarity-based algorithms on a standard benchmark dataset and achieved competitive results. In order to explore credible novel DTIs, the model was applied to data from the ChEMBL repository that contain experimentally validated positive and negative interactions which yield a strong predictive model. Then, the developed model was applied to all possible unknown DTIs to predict new interactions. The applicability of DT2Vec as an effective method for drug repurposing is discussed through case studies and evaluation of some novel DTI predictions is undertaken using molecular docking. CONCLUSIONS The proposed method was able to integrate and map chemical and genomic space into low-dimensional dense vectors and showed promising results in predicting novel DTIs.
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Affiliation(s)
- E Amiri Souri
- Department of Informatics, Faculty of Natural, Mathematical and Engineering Sciences, King's College London, Bush House, London, WC2B 4BG, UK
| | - R Laddach
- Department of Informatics, Faculty of Natural, Mathematical and Engineering Sciences, King's College London, Bush House, London, WC2B 4BG, UK
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, Guy's Hospital, London, SE1 9RT, UK
| | - S N Karagiannis
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, Guy's Hospital, London, SE1 9RT, UK
- Breast Cancer Now Research Unit, School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London, SE1 9RT, UK
| | - L G Papageorgiou
- Centre for Process Systems Engineering, Department of Chemical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK
| | - S Tsoka
- Department of Informatics, Faculty of Natural, Mathematical and Engineering Sciences, King's College London, Bush House, London, WC2B 4BG, UK.
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3
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Ferastraoaru D, Bax HJ, Bergmann C, Capron M, Castells M, Dombrowicz D, Fiebiger E, Gould HJ, Hartmann K, Jappe U, Jordakieva G, Josephs DH, Levi-Schaffer F, Mahler V, Poli A, Rosenstreich D, Roth-Walter F, Shamji M, Steveling-Klein EH, Turner MC, Untersmayr E, Karagiannis SN, Jensen-Jarolim E. AllergoOncology: ultra-low IgE, a potential novel biomarker in cancer-a Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI). Clin Transl Allergy 2020; 10:32. [PMID: 32695309 PMCID: PMC7366896 DOI: 10.1186/s13601-020-00335-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022] Open
Abstract
Elevated serum IgE levels are associated with allergic disorders, parasitosis and specific immunologic abnormalities. In addition, epidemiological and mechanistic evidence indicates an association between IgE-mediated immune surveillance and protection from tumour growth. Intriguingly, recent studies reveal a correlation between IgE deficiency and increased malignancy risk. This is the first review discussing IgE levels and links to pathological conditions, with special focus on the potential clinical significance of ultra-low serum IgE levels and risk of malignancy. In this Position Paper we discuss: (a) the utility of measuring total IgE levels in the management of allergies, parasitosis, and immunodeficiencies, (b) factors that may influence serum IgE levels, (c) IgE as a marker of different disorders, and d) the relationship between ultra-low IgE levels and malignancy susceptibility. While elevated serum IgE is generally associated with allergic/atopic conditions, very low or absent IgE may hamper anti-tumour surveillance, indicating the importance of a balanced IgE-mediated immune function. Ultra-low IgE may prove to be an unexpected biomarker for cancer risk. Nevertheless, given the early stage of investigations conducted mostly in patients with diseases that influence IgE levels, in-depth mechanistic studies and stratification of malignancy risk based on associated demographic, immunological and clinical co-factors are warranted.
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Affiliation(s)
- D Ferastraoaru
- Department of Internal Medicine/Allergy and Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY USA
| | - H J Bax
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, 9th Floor, Guy's Tower, London, SE1 9RT UK.,School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - C Bergmann
- ENT Research Institute for Clinical Studies, Essen, Germany
| | - M Capron
- LIRIC-Unite Mixte de Recherche 995 INSERM, Universite de Lille 2, CHRU de Lille, Lille, France
| | - M Castells
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - D Dombrowicz
- Recepteurs Nucleaires, Maladies Cardiovasculaires et Diabete, Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, 59000 Lille, France
| | - E Fiebiger
- Division of Gastroenterology, Hepatology and Nutrition Research, Department of Medicine Research, Children's University Hospital Boston, Boston, MA USA
| | - H J Gould
- Randall Centre for Cell and Molecular Biophysics, School of Basic & Medical Biosciences, King's College London, New Hunt's House, London, SE1 1UL UK.,Medical Research Council & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - K Hartmann
- Department of Dermatology, University of Luebeck, Luebeck, Germany
| | - U Jappe
- Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, Luebeck, Germany.,Division of Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - G Jordakieva
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - D H Josephs
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, 9th Floor, Guy's Tower, London, SE1 9RT UK.,School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - F Levi-Schaffer
- Pharmacology and Experimental Therapeutics Unit, The Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - V Mahler
- Division of Allergology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - A Poli
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-Sur-Alzette, Luxembourg
| | - D Rosenstreich
- Department of Internal Medicine/Allergy and Immunology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY USA
| | - F Roth-Walter
- The Interuniversity Messerli Research Inst, Univ. of Vet. Medicine Vienna, Med. Univ. Vienna, Univ. Vienna, Vienna, Austria
| | - M Shamji
- Immunomodulation and Tolerance Group, Imperial College London, and Allergy and Clinical Immunology, Imperial College London, London, UK
| | - E H Steveling-Klein
- Department of Dermatology, Allergy Division, University Hospital Basel, Basel, Switzerland
| | - M C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - E Untersmayr
- Institute of Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria
| | - S N Karagiannis
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, 9th Floor, Guy's Tower, London, SE1 9RT UK.,NIHR Biomedical Research Centre at Guy's and St. Thomas' Hospitals and King's College London, Guy's Hospital, King's College London, London, UK
| | - E Jensen-Jarolim
- The Interuniversity Messerli Research Inst, Univ. of Vet. Medicine Vienna, Med. Univ. Vienna, Univ. Vienna, Vienna, Austria.,Institute of Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria
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4
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Urwyler P, Earnshaw I, Bermudez M, Perucha E, Wu W, Ryan S, Mcdonald L, Karagiannis SN, Taams LS, Powell N, Cope A, Papa S. Mechanisms of checkpoint inhibition-induced adverse events. Clin Exp Immunol 2020; 200:141-154. [PMID: 31989585 DOI: 10.1111/cei.13421] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 12/14/2022] Open
Abstract
Immune checkpoint inhibition has revolutionized the treatment of several solid cancers, most notably melanoma and non-small-cell lung cancer (NSCLC). Drugs targeting cytotoxic T lymphocyte antigen (CTLA)-4 and programmed cell death 1 (PD-1) have made their way into routine clinical use; however, this has not been without difficulties. Stimulation of the immune system to target cancer has been found to result in a reduction of self-tolerance, leading to the development of adverse effects that resemble autoimmunity. These adverse effects are erratic in their onset and severity and can theoretically affect any organ type. Several mechanisms for immune-related toxicity have been investigated over recent years; however, no consensus on the cause or prediction of toxicity has been reached. This review seeks to examine reported evidence for possible mechanisms of toxicity, methods for prediction of those at risk and a discussion of future prospects within the field.
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Affiliation(s)
- P Urwyler
- Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - I Earnshaw
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - M Bermudez
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - E Perucha
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - W Wu
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - S Ryan
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - L Mcdonald
- Oncology and Haematology Clinical Trials, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S N Karagiannis
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - L S Taams
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - N Powell
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - A Cope
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammatory Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - S Papa
- Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,ImmunoEngineering, School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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5
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Josephs DH, Nakamura M, Bax HJ, Dodev TS, Muirhead G, Saul L, Karagiannis P, Ilieva KM, Crescioli S, Gazinska P, Woodman N, Lombardelli C, Kareemaghay S, Selkirk C, Lentfer H, Barton C, Canevari S, Figini M, Downes N, Dombrowicz D, Corrigan CJ, Nestle FO, Jones PS, Gould HJ, Blower PJ, Tsoka S, Spicer JF, Karagiannis SN. An immunologically relevant rodent model demonstrates safety of therapy using a tumour-specific IgE. Allergy 2018; 73:2328-2341. [PMID: 29654623 PMCID: PMC6492130 DOI: 10.1111/all.13455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Designing biologically informative models for assessing the safety of novel agents, especially for cancer immunotherapy, carries substantial challenges. The choice of an in vivo system for studies on IgE antibodies represents a major impediment to their clinical translation, especially with respect to class-specific immunological functions and safety. Fcε receptor expression and structure are different in humans and mice, so that the murine system is not informative when studying human IgE biology. By contrast, FcεRI expression and cellular distribution in rats mirror that of humans. METHODS We are developing MOv18 IgE, a human chimeric antibody recognizing the tumour-associated antigen folate receptor alpha. We created an immunologically congruent surrogate rat model likely to recapitulate human IgE-FcεR interactions and engineered a surrogate rat IgE equivalent to MOv18. Employing this model, we examined in vivo safety and efficacy of antitumour IgE antibodies. RESULTS In immunocompetent rats, rodent IgE restricted growth of syngeneic tumours in the absence of clinical, histopathological or metabolic signs associated with obvious toxicity. No physiological or immunological evidence of a "cytokine storm" or allergic response was seen, even at 50 mg/kg weekly doses. IgE treatment was associated with elevated serum concentrations of TNFα, a mediator previously linked with IgE-mediated antitumour and antiparasitic functions, alongside evidence of substantially elevated tumoural immune cell infiltration and immunological pathway activation in tumour-bearing lungs. CONCLUSION Our findings indicate safety of MOv18 IgE, in conjunction with efficacy and immune activation, supporting the translation of this therapeutic approach to the clinical arena.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/metabolism
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Cell Line, Tumor
- Folate Receptor 1/immunology
- Humans
- Immunoglobulin E/administration & dosage
- Immunoglobulin E/adverse effects
- Immunoglobulin E/immunology
- Immunoglobulin E/therapeutic use
- Immunoglobulin G/immunology
- Immunoglobulin G/metabolism
- Immunotherapy/methods
- Mice
- Models, Animal
- Neoplasms/pathology
- Neoplasms/therapy
- Protein Binding
- Rats
- Receptors, IgE/metabolism
- Statistics, Nonparametric
- Treatment Outcome
- Tumor Necrosis Factor-alpha/blood
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Affiliation(s)
- D. H. Josephs
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - M. Nakamura
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
| | - H. J. Bax
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - T. S. Dodev
- Randall Centre for Cell and Molecular BiophysicsKing's College LondonLondonUK
| | - G. Muirhead
- Department of InformaticsFaculty of Natural and Mathematical SciencesKing's College LondonLondonUK
| | - L. Saul
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - P. Karagiannis
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - K. M. Ilieva
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
| | - S. Crescioli
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
| | - P. Gazinska
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - N. Woodman
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - C. Lombardelli
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - S. Kareemaghay
- King's Health Partners Cancer BiobankSchool of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - C. Selkirk
- Biotherapeutics Development UnitCancer Research UKSouth MimmsUK
| | - H. Lentfer
- Biotherapeutics Development UnitCancer Research UKSouth MimmsUK
| | - C. Barton
- Centre for Drug DevelopmentCancer Research UKLondonUK
| | - S. Canevari
- Department of Applied Research and Technology DevelopmentFondazione IRCCS Istituto Nazionale dei TumouriMilanItaly
| | - M. Figini
- Department of Applied Research and Technology DevelopmentFondazione IRCCS Istituto Nazionale dei TumouriMilanItaly
| | | | - D. Dombrowicz
- CHU LilleInstitut Pasteur de LilleInsermUniv. LilleLilleFrance
| | - C. J. Corrigan
- Medical Research Council & Asthma UK Centre in Allergic Mechanisms of AsthmaKing's College LondonLondonUK
| | - F. O. Nestle
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Immunology and Inflammation Therapeutic Research AreaSanofi USCambridgeMAUSA
| | - P. S. Jones
- Centre for Drug DevelopmentCancer Research UKLondonUK
| | - H. J. Gould
- Randall Centre for Cell and Molecular BiophysicsKing's College LondonLondonUK
| | - P. J. Blower
- Imaging Chemistry & BiologyDivision of Imaging Sciences and Biomedical EngineeringSt. Thomas's HospitalKing's College LondonLondonUK
| | - S. Tsoka
- Department of InformaticsFaculty of Natural and Mathematical SciencesKing's College LondonLondonUK
| | - J. F. Spicer
- School of Cancer & Pharmaceutical SciencesGuy's HospitalKing's College LondonLondonUK
| | - S. N. Karagiannis
- St. John's Institute of DermatologySchool of Basic & Medical BiosciencesKing's College LondonLondonUK
- Breast Cancer Now Research UnitSchool of Cancer & Pharmaceutical SciencesGuy's Cancer CentreKing's College LondonLondonUK
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6
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Jensen-Jarolim E, Bax HJ, Bianchini R, Crescioli S, Daniels-Wells TR, Dombrowicz D, Fiebiger E, Gould HJ, Irshad S, Janda J, Josephs DH, Levi-Schaffer F, O'Mahony L, Pellizzari G, Penichet ML, Redegeld F, Roth-Walter F, Singer J, Untersmayr E, Vangelista L, Karagiannis SN. AllergoOncology: Opposite outcomes of immune tolerance in allergy and cancer. Allergy 2018; 73:328-340. [PMID: 28921585 PMCID: PMC6038916 DOI: 10.1111/all.13311] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2017] [Indexed: 12/11/2022]
Abstract
While desired for the cure of allergy, regulatory immune cell subsets and nonclassical Th2-biased inflammatory mediators in the tumour microenvironment can contribute to immune suppression and escape of tumours from immunological detection and clearance. A key aim in the cancer field is therefore to design interventions that can break immunological tolerance and halt cancer progression, whereas on the contrary allergen immunotherapy exactly aims to induce tolerance. In this position paper, we review insights on immune tolerance derived from allergy and from cancer inflammation, focusing on what is known about the roles of key immune cells and mediators. We propose that research in the field of AllergoOncology that aims to delineate these immunological mechanisms with juxtaposed clinical consequences in allergy and cancer may point to novel avenues for therapeutic interventions that stand to benefit both disciplines.
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Affiliation(s)
- E Jensen-Jarolim
- The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University Vienna, Vienna, Austria
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - H J Bax
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - R Bianchini
- The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University Vienna, Vienna, Austria
| | - S Crescioli
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
| | - T R Daniels-Wells
- Division of Surgical Oncology, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - D Dombrowicz
- INSERM, CHU Lille, European Genomic Institute of Diabetes, Institut Pasteur de Lille, U1011 - Recepteurs Nucleaires, Maladies Cardiovasculaires et Diabete, Universite de Lille, Lille, France
| | - E Fiebiger
- Division of Gastroenterology, Hepatology and Nutrition Research, Department Medicine Research, Childrens' University Hospital Boston, Boston, MA, USA
| | - H J Gould
- Randall Division of Cell and Molecular Biophysics, King's College London, London, UK
| | - S Irshad
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- Breast Cancer Now Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London, UK
| | - J Janda
- Faculty of Science, Charles University, Prague, Czech Republic
| | - D H Josephs
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - F Levi-Schaffer
- Faculty of Medicine, Pharmacology and Experimental Therapeutics Unit, The Institute for Drug Research, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - L O'Mahony
- Molecular Immunology, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| | - G Pellizzari
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
| | - M L Penichet
- Division of Surgical Oncology, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Centre, University of California, Los Angeles, CA, USA
| | - F Redegeld
- Faculty of Science, Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - F Roth-Walter
- The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University Vienna, Vienna, Austria
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - J Singer
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - E Untersmayr
- Centre of Pathophysiology, Infectiology & Immunology, Institute of Pathophysiology & Allergy Research, Medical University Vienna, Vienna, Austria
| | - L Vangelista
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - S N Karagiannis
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London, UK
- Breast Cancer Now Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London, UK
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Jensen‐Jarolim E, Bax HJ, Bianchini R, Capron M, Corrigan C, Castells M, Dombrowicz D, Daniels‐Wells TR, Fazekas J, Fiebiger E, Gatault S, Gould HJ, Janda J, Josephs DH, Karagiannis P, Levi‐Schaffer F, Meshcheryakova A, Mechtcheriakova D, Mekori Y, Mungenast F, Nigro EA, Penichet ML, Redegeld F, Saul L, Singer J, Spicer JF, Siccardi AG, Spillner E, Turner MC, Untersmayr E, Vangelista L, Karagiannis SN. AllergoOncology - the impact of allergy in oncology: EAACI position paper. Allergy 2017; 72:866-887. [PMID: 28032353 PMCID: PMC5498751 DOI: 10.1111/all.13119] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 12/19/2022]
Abstract
Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both antitumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveillance, immunomodulation and the functions of IgE-mediated immune responses against cancer, to derive novel insights into more effective treatments. Coincident with rapid expansion in clinical application of cancer immunotherapies, here we review the current state-of-the-art and future translational opportunities, as well as challenges in this relatively new field. Recent developments include improved understanding of Th2 antibodies, intratumoral innate allergy effector cells and mediators, IgE-mediated tumour antigen cross-presentation by dendritic cells, as well as immunotherapeutic strategies such as vaccines and recombinant antibodies, and finally, the management of allergy in daily clinical oncology. Shedding light on the crosstalk between allergic response and cancer is paving the way for new avenues of treatment.
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Affiliation(s)
- E. Jensen‐Jarolim
- The Interuniversity Messerli Research InstituteUniversity of Veterinary Medicine ViennaMedical University of ViennaViennaAustria
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - H. J. Bax
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
| | - R. Bianchini
- The Interuniversity Messerli Research InstituteUniversity of Veterinary Medicine ViennaMedical University of ViennaViennaAustria
| | - M. Capron
- LIRIC‐Unité Mixte de Recherche 995 INSERMUniversité de Lille 2CHRU de LilleLilleFrance
| | - C. Corrigan
- Division of Asthma, Allergy and Lung BiologyMedical Research Council and Asthma UK Centre in Allergic Mechanisms in AsthmaKing's College LondonLondonUK
| | - M. Castells
- Division of Rheumatology, Immunology and AllergyDepartment of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - D. Dombrowicz
- INSERMCHU LilleEuropean Genomic Institute of DiabetesInstitut Pasteur de LilleU1011 – récepteurs nucléaires, maladies cardiovasculaires et diabèteUniversité de LilleLilleFrance
| | - T. R. Daniels‐Wells
- Division of Surgical OncologyDepartment of SurgeryDavid Geffen School of Medicine at UCLALos AngelesCAUSA
| | - J. Fazekas
- The Interuniversity Messerli Research InstituteUniversity of Veterinary Medicine ViennaMedical University of ViennaViennaAustria
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - E. Fiebiger
- Division of Gastroenterology, Hepatology and Nutrition ResearchDepartment of Medicine ResearchChildren's University Hospital BostonBostonMAUSA
| | - S. Gatault
- LIRIC‐Unité Mixte de Recherche 995 INSERMUniversité de Lille 2CHRU de LilleLilleFrance
| | - H. J. Gould
- Division of Asthma, Allergy and Lung BiologyMedical Research Council and Asthma UK Centre in Allergic Mechanisms in AsthmaKing's College LondonLondonUK
- Randall Division of Cell and Molecular BiophysicsKing's College LondonLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
| | - J. Janda
- Center PigmodInstitute of Animal Physiology and GeneticsAcademy of Sciences of Czech RepublicLibechovCzech Republic
| | - D. H. Josephs
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
| | - P. Karagiannis
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
| | - F. Levi‐Schaffer
- Pharmacology and Experimental Therapeutics UnitFaculty of MedicineSchool of PharmacyThe Institute for Drug ResearchThe Hebrew University of JerusalemJerusalemIsrael
| | - A. Meshcheryakova
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - D. Mechtcheriakova
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - Y. Mekori
- Sackler Faculty of MedicineTel‐Aviv UniversityTel‐AvivIsrael
| | - F. Mungenast
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - E. A. Nigro
- IRCCS San Raffaele Scientific InstituteMilanItaly
| | - M. L. Penichet
- Division of Surgical OncologyDepartment of SurgeryDavid Geffen School of Medicine at UCLALos AngelesCAUSA
- Department of Microbiology, Immunology, and Molecular GeneticsDavid Geffen School of Medicine at UCLALos AngelesCAUSA
- Jonsson Comprehensive Cancer CenterUniversity of CaliforniaLos AngelesCAUSA
| | - F. Redegeld
- Division of PharmacologyFaculty of ScienceUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - L. Saul
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
| | - J. Singer
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - J. F. Spicer
- Division of Cancer StudiesFaculty of Life Sciences & MedicineKing's College LondonGuy's HospitalLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
| | | | - E. Spillner
- Immunological EngineeringDepartment of EngineeringAarhus UniversityAarhusDenmark
| | - M. C. Turner
- ISGlobalCentre for Research in Environmental Epidemiology (CREAL)BarcelonaSpain
- Universitat Pompeu Fabra (UPF)BarcelonaSpain
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
- McLaughlin Centre for Population Health Risk AssessmentUniversity of OttawaOttawaONCanada
| | - E. Untersmayr
- Institute of Pathophysiology & Allergy ResearchCenter of Pathophysiology, Infectiology & ImmunologyMedical University ViennaViennaAustria
| | - L. Vangelista
- Department of Biomedical SciencesNazarbayev University School of MedicineAstanaKazakhstan
| | - S. N. Karagiannis
- Division of Genetics & Molecular MedicineFaculty of Life Sciences and MedicineSt. John's Institute of DermatologyKing's College LondonLondonUK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ Hospitals and King's College LondonKing's College LondonGuy's HospitalLondonUK
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Rudman SM, Josephs DH, Cambrook H, Karagiannis P, Gilbert AE, Dodev T, Hunt J, Koers A, Montes A, Taams L, Canevari S, Figini M, Blower PJ, Beavil AJ, Nicodemus CF, Corrigan C, Kaye SB, Nestle FO, Gould HJ, Spicer JF, Karagiannis SN. Harnessing engineered antibodies of the IgE class to combat malignancy: initial assessment of FcɛRI-mediated basophil activation by a tumour-specific IgE antibody to evaluate the risk of type I hypersensitivity. Clin Exp Allergy 2011; 41:1400-13. [PMID: 21569129 DOI: 10.1111/j.1365-2222.2011.03770.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND IgE antibodies, sequestered into tissues and retained locally by the high-affinity IgE receptor, FcɛRI, on powerful effector cells such as mast cells, macrophages and eosinophils, may offer improvements in the therapy of solid tumours. The chimeric antibody, MOv18 IgE, against the human ovarian carcinoma antigen, folate receptor α (FRα), is more effective than its IgG1 counterpart in xenograft models of ovarian cancer. Although MOv18 IgE binds to a single epitope on FRα and cannot cross-link IgE receptors on basophils, there remains a risk that components in the circulation of ovarian cancer patients might cross-link FRα-MOv18-IgE-receptor-FcɛRI complexes on basophils to cause type I hypersensitivity. OBJECTIVE To assess the propensity for MOv18 used in a therapeutic setting to cause FcɛRI-mediated type I hypersensitivity. METHODS As validated readouts of the potential for MOv18 to cause FcɛRI-mediated type I hypersensitivity we measured release of a granule-stored mediator from a rat basophilic leukaemia cell line RBL SX-38 stably transfected with human tetrameric (αβγ2) FcɛRI, and induction of CD63 on blood basophils from patients with ovarian carcinoma and healthy controls ex vivo. RESULTS Serum FRα levels were increased in ovarian cancer patients compared with healthy controls. MOv18 IgE alone, or in the presence of its antigen recombinant human FRα, or of healthy volunteer (n=14) or ovarian carcinoma patient (n=32) sera, did not induce RBL SX-38 cell degranulation. Exposure to FRα-expressing ovarian tumour cells at target-to-effector ratios expected within tumours induced degranulation. MOv18 IgE did not induce expression of CD63 in blood basophils from either healthy volunteers (n=6), or cancer patients, despite detectable levels of circulating FRα (n=5). CONCLUSION AND CLINICAL RELEVANCE These encouraging data are compatible with the hypothesis that, when ovarian carcinoma patients are treated with MOv18, FcɛRI-mediated activation of effector cells occurs within the tumour mass but not in the circulation mandating, with due caution, further pre-clinical studies.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/genetics
- Antibodies, Monoclonal, Murine-Derived/immunology
- Antibody Specificity
- Antigens, Neoplasm/immunology
- Basophils/immunology
- Carcinoma/immunology
- Carcinoma/therapy
- Cell Degranulation
- Cell Line, Tumor
- Female
- Folate Receptor 1/blood
- Folate Receptor 1/immunology
- Folate Receptor 1/metabolism
- Humans
- Hypersensitivity, Immediate/etiology
- Hypersensitivity, Immediate/immunology
- Immunoglobulin E/genetics
- Immunoglobulin E/immunology
- Ovarian Neoplasms/immunology
- Ovarian Neoplasms/therapy
- Protein Engineering
- Rats
- Receptors, IgE/immunology
- Tetraspanin 30/metabolism
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Affiliation(s)
- S M Rudman
- NIHR Biomedical Research Centre at Guy's and St Thomas's Hospitals and King's College London, Cutaneous Medicine & Immunotherapy Unit, St John's Institute of Dermatology, Division of Genetics & Molecular Medicine, King's College London School of Medicine, Guy's Hospital, King's College London, London, UK
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Karagiannis SN, Warrack JK, Jennings KH, Murdock PR, Christie G, Moulder K, Sutton BJ, Gould HJ. Endocytosis and recycling of the complex between CD23 and HLA-DR in human B cells. Immunology 2001; 103:319-31. [PMID: 11454061 PMCID: PMC1783243 DOI: 10.1046/j.1365-2567.2001.01238.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [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: 11/20/2022] Open
Abstract
The presentation of extremely low doses of antigen to T cells is enhanced by immunoglobulin E (IgE)-dependent antigen focusing to CD23, the low-affinity receptor for IgE, expressed on activated B cells. CD23 contains a C-type lectin domain in its extracellular sequence and a targeting signal for coated pits, required for endocytosis, in its cytoplasmic sequence. CD23 is non-covalently associated with the major histocompatibility complex class II antigen, human leucocyte antigen HLA-DR, on the surface of human B cells, but the fate of this complex following endocytosis is unknown. To answer this question we have labelled these proteins on the surface of RPMI 8866 B cells and traced their route through the cytoplasm. Endocytosis mediated by anti-CD23 antibodies (BU38 and MHM6) led to the loss of CD23 from the cells. Endocytosis mediated by an antibody to HLA-DR (CR3/43) or an antigen-IgE complex (NP-BSA-anti-NP IgE), however, led to recycling of the HLA-DR-CD23 complex to the cell surface on a time scale (3-6 hr) consistent with the recycling of HLA-DR in antigen presentation. Along the latter pathway CD23 label was observed in cytoplasmic organelles that resembled the 'compartments for peptide loading' or 'class II vesicles' described by previous authors. Two features of the recycling process may contribute to the efficiency of antigen presentation. Peptide exchange may be facilitated by the proximity of HLA-DR and antigen in peptide loading compartments of the endosomal network. The return of CD23 with HLA-DR to the cell surface may then help to stabilize specific B-cell-T-cell interactions, contributing to T-cell activation.
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Affiliation(s)
- S N Karagiannis
- The Randall Centre for Molecular Mechanisms of Cell Function, King's College London, UK.
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Gould HJ, Mackay GA, Karagiannis SN, O'Toole CM, Marsh PJ, Daniel BE, Coney LR, Zurawski VR, Joseph M, Capron M, Gilbert M, Murphy GF, Korngold R. Comparison of IgE and IgG antibody-dependent cytotoxicity in vitro and in a SCID mouse xenograft model of ovarian carcinoma. Eur J Immunol 1999; 29:3527-37. [PMID: 10556807 DOI: 10.1002/(sici)1521-4141(199911)29:11<3527::aid-immu3527>3.0.co;2-5] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Allergic reactions are mediated by IgE antibodies bound to high-affinity receptors on mast cells in peripheral tissues and are characterized by their immediacy and hypersensitivity. These properties could also be advantageous in immunotherapy against cancer growth in peripheral tissues. We have constructed chimeric IgE and IgG1 antibodies with murine V regions and human C regions corresponding to the MOv18 monoclonal antibody against the human ovarian tumor-associated antigen, folate binding protein. The antibodies exhibited the expected binding affinities for antigen and Fc receptors, and effector activities with human basophils and platelets in vitro. The protective activities of MOv18-IgE and MOv18-IgG1 were compared in a SCID mouse xenograft model of ovarian carcinoma. The beneficial effects of MOv18-IgE were greater and of longer duration than those of MOv18-IgG1. Our results suggest that the allergic reaction could be harnessed for the suppression of ovarian tumors.
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Affiliation(s)
- H J Gould
- The Randall Institute King's College London, London, GB.
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Abstract
Peripheral sensory and autonomic neurons are known to possess insulin receptors. These have been considered to be of the peripheral type, i.e. similar to those of hepatic and fat cells rather than of the brain type which show dual specificity for both insulin and insulin-like growth factor (IGF-1). We have examined the localisation of insulin and IGF-1 receptors in cultured sensory and sympathetic ganglion cells using confocal microscopy and indirect labelling with FITC (fluorescein isothiocyanate) and TRITC (tetramethyl rhodamine isothiocyanate) respectively. We have shown that in cultured U266B1 multiple myeloma cells these receptors display separate localisation, whereas they are colocalised in IM-9 lymphocytes which are known to possess hybrid receptors. We have confirmed the sequestration of insulin and IGF-1 receptors in the cytoplasm of sensory and sympathetic neurons, consistent with a brain-type receptor. The colocalisation of insulin and IGF-1 receptors in sensory and sympathetic ganglion cells is consistent with the view that they are hybrid receptors, similar to those present in the CNS. The function of these receptors, as suggested for the CNS, may be related to trophic support for neurons.
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MESH Headings
- Animals
- Cell Line
- Cells, Cultured
- Fluorescent Antibody Technique, Indirect
- Ganglia, Sensory/chemistry
- Ganglia, Sensory/cytology
- Ganglia, Sympathetic/chemistry
- Ganglia, Sympathetic/cytology
- Humans
- Microscopy, Confocal
- Rats
- Rats, Sprague-Dawley
- Receptor, IGF Type 1/analysis
- Receptor, Insulin/analysis
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Affiliation(s)
- S N Karagiannis
- Department of Clinical Neurosciences, Royal Free Hospital School of Medicine, London, UK
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