Abstract A111: Effects of ionizing radiation on brain metastasis-associated inflammation and its implication for immunotherapy

Brain metastases represent the most common intracranial tumor in adults associated with poor prognosis and median survival of only a few months. Despite current success in the development of targeted or immuno-therapies against different cancer entities, those strategies are ineffective against brain metastases. Hence, treatment options for brain metastasis patients largely remain limited to surgical resection and radio- and/or chemotherapy. This paucity can in part be attributed to the immune-privileged status of the brain where the blood brain-barrier restricts the entry of blood-borne immune cells. However, recent insights into the immune landscape of primary brain cancers indicate that tumor progression leads to an infiltration of blood-borne immune cells into the brain. We employ a comprehensive set of experimental brain metastasis models to characterize the immune landscape of brain metastases from different primary cancer entities at distinct disease stages and in response to radiotherapy. Our data indicate that brain metastases induce massive infiltration of myeloid and lymphoid cell populations into the central nervous system. This leads to the establishment of a dynamic and highly complex tumor microenvironment that affects tumor progression and therapy response. Fractionated whole-brain radiotherapy leads to enhanced infiltration of blood-borne myeloid and lymphoid cells. Transcriptome analysis of brain-resident and recruited myeloid cells indicate a switch from a proinflammatory towards an immune-suppressive environment at advanced disease stages. Importantly, radiotherapy was found to induce gene signatures that are associated with proinflammatory innate immune responses that could revert the establishment of an immune-suppressive environment. Consequently, radiotherapy might sensitize brain metastases towards immuno-therapies. Our goal is to identify pathways or molecular targets that are induced by radiotherapy in the tumor microenvironment to overcome resistance against immuno-therapy. In this project, we seek to test strategies to maintain or induce proinflammatory immune responses for improved targeted or immuno-therapies against brain metastasis.

Citation Format: Michael Schulz, Katja Niesel, Anna Salamero Boix, Woon Hyung Chae, Birgitta Michels, Alexander Schaeffer, Maja Strecker, Tijna Alekseeva, Stefan Stein, Henner Farin, Franz Roedel, Patrick Harter, Karlheinz Plate, and Lisa Sevenich. Effects of ionizing radiation on brain metastasis-associated inflammation and its implication for immunotherapy [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr A111.

Oxidative stress-driven pulmonary inflammation and fibrosis in a mouse model of human ataxia-telangiectasia

Lung failure is responsible for significant morbidity and is a frequent cause of death in ataxia-telangiectasia (A-T). Disturbance in the redox balance of alveolar epithelial cells must be considered as a causal factor for respiratory disease in A-T. To investigate bronchoalveolar sensitivity to reactive oxygen species (ROS) and ROS-induced DNA damage, we used bleomycin (BLM) to induce experimental inflammation and fibrotic changes in the Atm-deficient mouse model.

BLM or saline was administered by oropharyngeal instillation into the lung of Atm-deficient mice and wild-type mice. Mice underwent pulmonary function testing at days 0, 9, and 28, and bronchoalveolar lavage (BAL) was analysed for cell distribution and cytokines. Lung tissue was analysed by histochemistry.

BLM administration resulted in a tremendous increase in lung inflammation and fibrotic changes in the lung tissue of Atm-deficient mice and was accompanied by irreversible deterioration of lung function. ATM (ataxia telangiectasia mutated) deficiency resulted in reduced cell viability, a delay in the resolution of γH2AX expression and a significant increase in intracellular ROS in pulmonary epithelial cells after BLM treatment. This was confirmed in the human epithelial cell line A549 treated with the ATM-kinase inhibitor KU55933.

Our results demonstrate high bronchoalveolar sensitivity to ROS and ROS-induced DNA damage in the Atm-deficient mouse model and support the hypothesis that ATM plays a pivotal role in the control of oxidative stress-driven lung inflammation and fibrosis.

Trafficking of the exported P. falciparum chaperone PfHsp70x

Plasmodium falciparum extensively modifies its chosen host cell, the mature human erythrocyte. This remodelling is carried out by parasite-encoded proteins that are exported into the host cell. To gain access to the human red blood cell, these proteins must cross the parasitophorous vacuole, a membrane bound compartment surrounding the parasite that is generated during the invasion process. Many exported proteins carry a so-called PEXEL/HT signal that directs their transport. We recently reported the unexpected finding of a species-restricted parasite-encoded Hsp70, termed PfHsp70x, which is exported into the host erythrocyte cytosol. PfHsp70x lacks a classical PEXEL/HT motif, and its transport appears to be mediated by a 7 amino acid motif directly following the hydrophobic N-terminal secretory signal. In this report, we analyse this short targeting sequence in detail. Surprisingly, both a reversed and scrambled version of the motif retained the capacity to confer protein export. Site directed mutagenesis of glutamate residues within this region leads to a block of protein trafficking within the lumen of the PV. In contrast to PEXEL-containing proteins, the targeting signal is not cleaved, but appears to be acetylated. Furthermore we show that, like other exported proteins, trafficking of PfHsp70x requires the vacuolar translocon, PTEX.

High power narrow-band fiber-based ASE source

In this paper we describe a high power narrow-band amplified spontaneous emission (ASE) light source at 1030 nm center wavelength generated in an Yb-doped fiber-based experimental setup. By cutting a small region out of a broadband ASE spectrum using two fiber Bragg gratings a strongly constrained bandwidth of 12±2 pm (3.5±0.6 GHz) is formed. A two-stage high power fiber amplifier system is used to boost the output power up to 697 W with a measured beam quality of M2≤1.34. In an additional experiment we demonstrate a stimulated Brillouin scattering (SBS) suppression of at least 17 dB (theoretically predicted ~20 dB), which is only limited by the dynamic range of the measurement and not by the onset of SBS when using the described light source. The presented narrow-band ASE source could be of great interest for brightness scaling applications by beam combination, where SBS is known as a limiting factor.

[Morphological diagnosis of spinal diseases. Current technical possibilities and challenges for the histological preparation of transpedicular biopsies]

The spine is the central component for the mobility of the human body. Both locally limited and diffuse pathologies of the spine are a challenge for the treating physician due to the difficult anatomy. The biopsy of a pathologically altered vertebral body is a fast and reliable basis for further therapy but until now this has not regularly been made use of as a diagnostic standard for spinal diseases, since the tissue gained was often microfractured because of the difficult anatomical position. Our own experience with transpedicular vertebral biopsies of 70 patients with different diseases is reported because of the considerable improvement in the biopsy technique and the methodical possibilities for processing the bony tissue. Methods which have proven particularly valuable are contact radiographs, embedding in plastic, careful decalcifying with EDTA and immunohistological procedures. In this way a definite diagnosis can be made in 97% of the cases. A close cooperation with the clinician carrying out the biopsy and a greater use of methods other than just fast decalcification is recommended.

Endogenous and exogenous factors modifying the activity of human liver cytochrome P-450 enzymes

Cytochrome P-450 dependent monooxygenases play a dual role for xenobiotic metabolism. On one hand they initiate the primary rate limiting step for the elimination of a bulk of drugs and organic chemicals. On the other hand they catalyze the formation of toxic metabolites from chemical carcinogens and many other toxic chemicals. Numerous studies have shown that their activity in animals is subject to the influence of various modifying factors, such as strain, species, sex, age, diurnal rhythm and the effect of enzyme inducers. Less is known about the influence of these factors on human cytochrome P-450 enzymes. Here we report the results of an extended study on human liver cytochrome P-450 performed with liver biopsies of 178 individuals taken for diagnostic purposes. The enzymatic activity was determined by the aldrin epoxidase assay indicating a variety of enzymes inducible by phenobarbital and by glucocorticoid and androgenic hormones. The frequency histogram of individual aldrin epoxidase activities showed a unimodal distribution and a variation factor of 100 between maximal and minimal activity. Individuals with severe liver diseases, such as cirrhosis and fatty liver, exhibited a 50% loss of enzyme activity. Age and sex did not significantly influence the enzyme activity. No significant correlation was observable between the rate of aldrin epoxidation and debrisoquine 4-hydroxylation, a prototype of a genetically controlled cytochrome P-450 reaction. We assume that the broad interindividual variation of epoxidase activities is more likely due to the influence of exogenous and endogenous inducers rather than to a genetic polymorphism.(ABSTRACT TRUNCATED AT 250 WORDS)

Lipopeptides containing 2-(palmitoylamino)-6,7-bis(palmitoyloxy) heptanoic acid: synthesis, stereospecific stimulation of B-lymphocytes and macrophages, and adjuvanticity in vivo and in vitro

Lipopeptides, carrying the N-terminal lipoamino acid 2-(palmitoylamino)-6,7-bis(palmitoyloxy) heptanoic acid (Pam3Adh-OH, 1), were obtained by solid-phase synthesis and by synthesis in solution. 2-Amino-6,7-dihydroxyheptanoic acid (Adh) can be regarded as a methylene analogue of S-glycerylcysteine, the N-terminal amino acid of lipoprotein from the outer cell membrane of Escherichia coli (a methylene group substitutes for the sulfur atom). The lipopeptides Pam3Adh-Ser-Ser-Asn-Ala 2a-d, in which the four possible stereoisomers of Pam3Adh-OH (2S,6S)-1 (1a), (2S,6R)-1 (1b), (2R,6S)-1 (1c), and (2R,6R)-1 (1d) are linked to the naturally occurring sequence Ser-Ser-Asn-Ala of the N-terminus of lipoprotein, and also Pam3Adh-Ser-(Lys)4 [2S,6S)-3), with a peptide part rendering the molecule water soluble, were capable of stimulating murine splenocytes polyclonally in vitro, as determined in a proliferation assay and in a hemolytic plaque assay against trinitrophenylated sheep erythrocytes. The diastereomers (2S,6S)-2 and (2R,6S)-2 with S-configurated C-6 were more active than the diastereomers (2S,6R)-2 and (2R,6R)-2 with R-configurated C-6; a change of the configuration at C-2 had less effect on the stimulatory activity. (2S,6S)-2 and (2S,6S)-3 are potent immunoadjuvants. A significantly enhanced primary immune response against trinitrophenylated sheep erythrocytes was obtained in vitro at lipopeptide concentrations of about 5 micrograms/mL and an immunization dose of 10(7) sheep erythrocytes/mL. Balb/c mice, which were immunized with a mixture of ovalbumin and (2S,6S)-2 or (2S,6S)-3, respectively, had a substantially higher antiovalbumin titer 28 days after immunization than mice which had received ovalbumin, (2S,6S)-2 or (2S,6S)-3 alone. Finally, the novel lipopeptides constitute potent macrophage activators: (2S,6S)-3 was able to induce tumor cytotoxicity against the tumor cell line L929 in bone marrow derived macrophages.

Biological activity of bacterial surface components. Immunogenicity and immunomodulatory properties of a bacterial extract from Escherichia coli

The immunogenic and immunomodulatory properties of a lysed fraction from selected E. coli strains (OM-89, Uro-Vaxom) were determined in vivo and in vitro. It could be demonstrated that OM-89 constitutes an active immunogen in mice. Maximum OM-89-specific antibody titers were obtained after 4-5 i.p. immunizations; the titers could be further enhanced by the simultaneous injection of lipopeptide adjuvants. It was shown by ELISA that the antibodies obtained bound to the bacterial strains used for the preparation of the OM-89 extract. Immunogenicity was observed both after intraperitoneal and oral application of the extract. Besides being active as an immunogen. OM-89 was able to act in vitro as a polyclonal lymphocyte activator, as determined in splenocyte cultures of different inbred murine strains, and in cultures of human peripheral blood lymphocytes. Our results show that the B lymphocyte stimulating activity of the bacterial extract OM-89 was comparable to that of lipopeptide adjuvants. In conclusion, the bacterial extract both an active immunogen in vivo, and a polyclonal B cell activator in vitro. These findings may be of importance for the understanding of the therapeutic effect of OM-89.

Conjugates of synthetic lymphocyte-activating lipopeptides with segments from HIV proteins induce protein-specific antibody formation

Lipopeptide analogues of bacterial lipoprotein activate macrophages and B lymphocytes. The products formed by coupling these lipopeptides to low molecular mass antigens can be used to induce antigen-specific antibodies in mice. In the present work, it is shown that HIV-1 gp160-derived synthetic oligopeptides coupled to the synthetic lipodipeptide N-palmitoyl-S-[2,3-bis(palmitoyloxy)-(2RS)-propyl]-(R)-cysteinyl-s eryl- serine (P3CSS) induce peptide-specific antibodies in mice without adding further adjuvants. Depending on the peptides applied, the conjugates exhibited different lymphocyte stimulatory activity, immunoglobulin isotype patterns, and boost reactions; lipopeptide conjugates inducing a pronounced secondary immune response are considered to possess both B- and T-cell epitopes. Antibodies induced by the lipopeptide-HIV-1-peptide conjugates were also reactive against the recombinant gp160 of HIV-1.

[Significance of echocardiography for the diagnosis and strategy in infectious endocarditis]

The echocardiographic results of 29 patients--clinically suspected of infective endocarditis--were compared with clinical, intraoperative, histologic, autoptic data and the available outcome of cardiac catheterization. The purpose of this retrospective study was to define the potential valence of echocardiography for planning of therapy and success. Valvular vegetations of different histological ages were established on 35 valves. The sensitivity was 96.3%, the specificity 100% considering this topic. Following visual assessed sonographical intensity of such vegetations echographical floridity was postulated. In 26 vegetations the sensitivity--considering this floridity statement--was 92% and the specificity 86% compared with the results of histology and intraoperative assessment. The type of pathogens and the time interval between beginning of the clinical symptomatic and the echocardiographic procedure were important for the prognosis in this study. In the case of longer latency time prevailed bivalvular vegetations (n = 6) combined with a high mortality. No patient died in the case of univalvular vegetations. The whole group had a mortality of 17.2%. Considering these results using echocardiographic methods an exact identification of vegetations (infective and noninfective) and additional a quantification of subsequent valvular damaging and actual ventricular function is possible. A qualified sonographical technique permits an earlier diagnosis of bacterial endocarditis (especially in the absence of bacteriaemia) and in the followings a more opportune indication for prosthetic valve replacement.

Biological activity of bacterial surface components: bacterial extracts and defined bacterial cell wall components as immunomodulators

Bacterial extracts obtained from pathogenic strains occurring in lung infections (Broncho Vaxom) or urogenital infections (Urovaxom) as well as defined surface components of Gram-negative bacteria purified from bacteria or obtained by chemical synthesis were tested for their immunomodulatory properties in a murine system. The bacterial extracts were able to act as immunogens inducing an antigen-specific response. Both the bacterial extracts and the purified bacterial cell wall components constituted polyclonal activators of murine splenic B cells, as demonstrated by proliferation assays measuring the incorporation of [3H]thymidine into DNA. They were also able to act as immunoadjuvants increasing the SRBC and the BSA-TNP specific immune response, and could induce tumor cytotoxicity in bone marrow-derived macrophages. The results show that bacterial extracts and defined bacterial surface components constitute immunogens as well as immunomodulators in vitro and in vivo.

Monohydroperoxides of linoleic acid in endoplasmic lipids of rats exposed to tetrachloromethane

An accurate method for the quantitative determination of hydroperoxy and hydroxy fatty acids in liver microsomes is presented which involves the use of 18O-labeled internal standards. The method is employed for the determination of hydroperoxides in rat liver microsomes after aerobic incubation with Fe2+/ADP and in microsomes from animals exposed to 75 mg tetrachloromethane/kg body weight. The amounts found after artificial microsomal "lipid peroxidation" are almost two orders of magnitude larger than those in microsomes from tetrachloromethane-exposed animals.

Lack of relationship between debrisoquine 4-hydroxylation and other cytochrome P-450 dependent reactions in rat and human liver

The effect of various inhibitors and inducers of cytochrome P-450 on the activity of microsomal debrisoquine 4-hydroxylation (DQH) was investigated in rat liver. DQH was strongly inhibited by SKF 525-A, 7,8-benzoflavone, and metyrapone. Pretreatment of animals with common inducers, such as phenobarbital, 3-methylcholanthrene, the commercial PCB mixture, Clophen A-50, dexamethasone and pregenenolone-16 alpha-carbonitrile did not lead to induction of DQH, while most reference reactions, i.e. aldrin epoxidation, ethylmorphine demethylation, and benzo(a)-pyrene hydroxylation were induced under these conditions. DQH likewise was not induced by pretreatment of animals with the enzyme substrate DQ. The relationship between DQH and other cytochrome P-450 functions was also studied in untreated animals. Both genders of Wistar rats exhibited similar rates of DQH, but different activities of the reference reactions. DQH activity in Wistar females however, was 10 times higher than in females of the DA-strain, whereas the reference activities were similar in both strains. The studies were also extended to human liver. DQH activity in homogenates of various biopsy samples was neither correlated to the activity of aldrin epoxidation nor to AHH activity. The results indicate that DQH in the rat and in man reflects the activity of a cytochrome P-450 species not related to various other known cytochrome P-450 functions.