变应性鼻炎舌下特异性免疫治疗前后主客观指标、生活质量改变及疗效影响因素分析

目的:分析舌下特异性免疫治疗变应性鼻炎(AR)临床疗效及其影响因素。方法:以我院2012年1月~2014年1月诊治的100例变应性鼻炎患者为研究对象,均接受舌下特异性免疫治疗,以治疗2年为研究终点,比较治疗前、治疗2年后症状及体征评分、视觉模拟量表(VAS)评分及生活质量变化,评价治疗2年疗效及不良反应,同时对可能影响舌下特异性免疫治疗2年疗效的相关因素行多元线性回归分析。结果:治疗2年总有效率高达72.00%;与治疗前比较,治疗2年后症状及体征积分、VAS评分、鼻结膜炎生存质量调查问卷(RQLQ)中文版各项评分均显著下降,差异有统计学意义(P0.05)。多元线性回归分析显示舌下特异性免疫治疗AR 2年疗效的影响因素为病程、治疗前VAS评分及患者用药依从性。结论:舌下特异性免疫治疗AR疗效明确,不良反应少,能有效缓解患者症状及体征,改善其生活质量。同时其疗效与AR患者病程长、治疗前VAS评分高、用药依从性差有关。     

The effect of vaccination with the lysate of heat-shocked tumor cells on nitric oxide production in BALB/c mice with fibrosarcoma tumor

The aim of this study was to investigate the effect of heat shock protein-70 (HSP-70) on splenocyte proliferation and nitric oxide (NO) production in the BALB/c mice fibrosarcoma tumor model. To do so, HSP-70 was induced in the lysate of heat-shocked tumor cells and WEHI-164 cells (mouse fibrosarcoma cell line) were injected subcutaneously into the right flank of inbred BALB/c mice to establish a tumor model. Three animal bearing tumor groups were applied: the test group; vaccinated with HSP-70 enriched tumor lysate; control group I, vaccinated with tumor lysate only; and control group II, which received PBS. Using immunoblot analysis, an increase of HSP-70 expression was detected in the lysate of heat-shocked cells in comparison with non-heat-shocked cells. The effect of the test lysate on NO production was measured both in vitro and in vivo in the peritoneal macrophages and splenocytes of tumor bearing mice, respectively. The result showed a significant increase in NO production both in vitro by peritoneal macrophages and in vivo after immunization with HSP-70 enriched tumor lysate. In addition, tumor growth was significantly postponed and the proliferation of splenocytes was increased in the test group. Our results indicate that the lysate of heat-shocked tumor cells was more potent than that of non-heat-shocked tumor cells in inducing anti-tumor immunity. Since production of NO by HSP-activated antigen presenting cells (APCs) is likely to affect innate immunity and tumor growth, the probable mechanism of postponing tumor growth would be NO production by innate immune cells. These findings provide a useful therapeutic model for developing novel approaches to cancer treatments.     

A WT1 protein‐derived,naturally processed 16‐mer peptide,WT1332, is a promiscuous helper peptide for induction of WT1‐specific Th1‐type CD4+ T cells

The Wilms' tumor gene WT1 is overexpressed in various tumors, and the WT1 protein has been demonstrated to be an attractive target antigen for cancer immunotherapy. A WT1 protein‐derived 16‐mer peptide, WT1₃₃₂ (KRYFKLSHLQMHSRKH), which was naturally generated through processing in cells and could elicit Th1‐type CD4⁺ helper T cell responses with an HLA‐DRB1*0405‐restriction has previously been identified by us. In the present study, it has been demonstrated that WT1₃₃₂ can induce WT1₃₃₂‐specific CD4⁺ T cell responses with the restriction of not only HLA‐DRB1*0405 but also HLA‐DRB1*1501, ‐DRB1*1502, or ‐DPB1*0901. These HLA class II‐restricted WT1₃₃₂‐specific CD4⁺ T cell lines produced IFN‐γ but neither IL‐4 nor IL‐10 with WT1₃₃₂ stimulation, thus showing a Th1‐type cytokine profile. Furthermore, HLA‐DRB1*1501 or ‐DRB1*1502‐restricted WT1₃₃₂‐specific CD4⁺ T cell lines responded to WT1‐expressing transformed cells in an HLA‐DRB1‐restricted manner, which is consistent with our previous finding that WT1₃₃₂ is a naturally processed peptide. These results indicate that the natural peptide, WT1₃₃₂, is a promiscuous WT1‐specific helper epitope. WT1₃₃₂ is expected to apply to cancer patients with various types of HLA class II as a WT1‐specific helper peptide in combination with HLA class I‐restricted WT1 peptides.     

重组腺相关病毒2型转导人外周血单核细胞来源树突状细胞的研究

To find out the infection efficiency of recombinant adeno-as sociated virus 2-mediated exogenou s genes in human peripheral blood monocyte-derived dendritic cells(D Cs),the process of transfection wa s investigated by FITC-labeled rAA V2,and observed under confocal mic roscope.Newly separated dendritic cells were tranfected by rAAV2-luc and rAAV2-GFP at different MOI,and transfection efficiency were detec ted by luminometer for rAAV2-luc a nd flow cytometry for rAAV2-GFP.Th e results were elucidated in four different assay systems:(1)60min w as needed for rAAV2 to bind on den dritic cells,and got into cells in the following 10min;(2)the express ion of luc could be detected at th e MOI as low as 1×10~5v.g/cell,and the expression plateau was reached by the MOI of 10~6～10~7v.g/cell,furt her increase of MOI had no functio n on expression level;(3)transgene expression was detected after 48h, and maintained a higher expression level from 96h to 240h after infec tion;(4)7days postinfection of rAA V2-GFP,5%～18% dendritic cells were GFP positive. These data suggest th at rAAV2 vector can efficiently in fect monocyte-derived dendritic ce lls and mediate exogenous gene exp ression,and that the application o f rAAV2 as vector may be useful fo r gene transfer to dendritic cells in ex vivo immunotherapy.     

Incubation of antigen-sensitized T lymphocytes activated with bryostatin 1 + ionomycin in IL-7 + IL-15 increases yield of cells capable of inducing regression of melanoma metastases compared to culture in IL-2

Regression of established tumors can be induced by adoptive immunotherapy (AIT) with tumor draining lymph node (DLN) lymphocytes activated with bryostatin and ionomycin (B/I). We hypothesized that B/I-activated T cells cultured in IL-7 + IL-15 might proliferate and survive in culture better than cells cultured in IL-2, and that these cells would have equal or greater anti-tumor activity in vivo. Tumor antigen-sensitized DLN lymphocytes from either wild-type or T cell receptor transgenic mice were harvested, activated with B/I, and expanded in culture with either IL-2, IL-7 + IL-15 or a regimen of alternating cytokines. Cell yields, proliferation, apoptosis, phenotypes, and in vitro responses to tumor antigen were compared for cells grown in different cytokines. These T cells were also tested for anti-tumor activity against melanoma lung metastases established by prior i.v. injection of B16 melanoma cells. IL-7 + IL-15 or alternating cytokines resulted in much faster and prolonged proliferation and much less apopotosis of B/I-activated T cells than culturing the same cells in IL-2. This resulted in approximately tenfold greater yields of viable cells. Culture in IL-7 + IL-15 yielded higher proportions of CD8+ T cells and a higher proportion of cells with a central memory phenotype. Despite this, T cells grown in IL-7 + IL-15 had higher IFN-γ release responses to tumor antigen than cells grown in IL-2. Adoptive transfer of B/I-activated T cells grown in IL-7 + IL-15 or the alternating regimen had equal or greater efficacy on a “per-cell” basis against melanoma metastases. Activation of tumor antigen-sensitized T cells with B/I and culture in IL-7 + IL-15 is a promising modification of standard regimens for production of T cells for use in adoptive immunotherapy of cancer.     

Modified peptides in anti-cancer vaccines: are we eventually improving anti-tumour immunity?

The discovery of tumour antigens recognized by T cells and the features of immune responses directed against them has paved the way to a multitude of clinical studies aimed at boosting anti-tumour T cell immunity as a therapeutic tool for cancer patients. One of the different strategies explored to ameliorate the immunogenicity of tumour antigens in vaccine protocols is represented by the use of optimized peptides or altered peptide ligands, whose amino acid sequence has been modified for improving HLA binding or TCR interaction with respect to native epitopes. However, despite the promising results achieved with preclinical studies, the clinical efficacy of this approach has not yet met the expectations. Although multiple reasons could explain the relative failure of altered peptide ligands as more effective cancer vaccines, the possibility that T cells primed by modified tumour peptides might may be unable to effectively cross-recognize tumour cells has not been sufficiently addressed. Indeed, the introduction of conservative amino acid substitutions may still produce diverse and unpredictable changes in the HLA/peptide interface, with consequent modifications of the TCR repertoire that can interact with the complex. This could lead to the expansion of a broad array of T cells whose TCRs may not necessarily react with equivalent affinity with the original antigenic epitope. Considering the results presently achieved with this vaccine approach, and the emerging availability of alternative strategies for boosting anti-tumour immunity, the use of modified tumour peptides could be reconsidered. This article is a symposium paper from the conference “Immunotherapy—From Basic Research to Clinical Applications”, Symposium of the Collaborative Research Center (SFB) 685, held in Tübingen, Germany, 6–7 March 2008.     

PLAC1特异性TCR基因修饰T细胞对乳腺癌的抗肿瘤作用

目的研究胎盘特异性基因1（PLAC1）特异性T细胞受体（TCR）基因修饰T细胞对乳腺癌的抗肿瘤作用。 方法磁珠分选人类白细胞抗原分型为A2（HLA-A2）的志愿者外周血单个核细胞（PBMC）中的CD8⁺ T细胞,流式检测CD8⁺ T细胞的表型。通过慢病毒载体构建、包装,将可识别乳腺癌肿瘤抗原PLAC1的HLA-A2限制性的TCR基因导入CD8⁺ T细胞（称为TCR-T细胞）,以慢病毒空载体包装、感染的CD8⁺ T细胞（NC-T细胞）作为对照细胞,通过流式细胞术检测PLAC1特异性TCR的表达效率。免疫荧光和流式细胞术检测乳腺癌细胞MCF-7和MDA-MB-231（三阴性乳腺癌细胞）的PLAC1和HLA-A2血清型的表达。WST-1法检测不同效靶比（5?:?1、10?:?1和20?:?1）TCR-T细胞或NC-T细胞与乳腺癌细胞MCF-7或MDA-MB-231作用后的细胞毒性,并通过ELISA检测共培养后T细胞IFN-γ的释放量。通过裸鼠皮下人乳腺癌移植瘤模型检测TCR-T细胞以及NC-T细胞的抗肿瘤作用。采用单因素方差分析及独立t检验进行统计学分析。 结果磁珠分选出的CD8⁺ T细胞CD3⁺ CD8⁺比例达到（98.89±0.30）%。经慢病毒感染、五聚体检测,TCR-T细胞中PLAC1特异性TCR的正确表达率为（24.58±0.82）%,NC-T细胞不表达PLAC1特异性TCR。免疫荧光和流式结果显示乳腺癌细胞MCF-7和MDA-MB-231为HLA-A2和PLAC1双阳性表达细胞。其中流式检测结果显示,MCF-7和MDA-MB-231细胞中HLA-A2的表达效率分别为（93.04±1.36）%和（98.72±0.12）%。在效靶比为20?:?1时,TCR-T细胞对MCF-7杀伤率为（51.5±1.37）%,高于NC-T细胞对MCF-7的杀伤率（5.93±2.40）%,t = 15.507,P < 0.01;TCR-T细胞对MDA-MB-231杀伤率为（44.34±2.20）%,高于NC-T细胞对MDA-MB-231杀伤率（5.15±2.40）% （t?= 10.694,P < 0.01）。在相同效靶比情况下,TCR-T细胞对MCF-7或MDA-MB-231细胞的细胞毒性高于NC-T细胞,且随着效靶比的增加杀伤效果增强。在效靶比为20?:?1时,与MCF-7共培养后TCR-T细胞IFN-γ的分泌水平[（347.49±4.10）pg/ml]高于NC-T细胞[（18.14±6.22）pg/ml]（t = -76.638,P < 0.01）;与MDA-MB-231共培养后TCR-T细胞IFN-γ的分泌水平为（255.25±6.85）pg/ml,高于NC-T细胞[（14.70±6.38）pg/ml] （t = -44.526,P < 0.01）,且随着效靶比的增加分泌量升高。在裸鼠皮下人乳腺癌移植瘤实验中,生理盐水组和NC-T细胞移植组小鼠的肿瘤生长迅速,TCR-T细胞治疗组小鼠肿瘤生长相对缓慢,在移植后第35天,生理盐水组、NC-T细胞组和TCR-T细胞组小鼠肿瘤的平均体积分别为（5?636.96±2?879.55）mm³、（5?522.12±3?391.48）mm³和（1?403.85±1?394.31）mm³,TCR-T细胞治疗组小鼠肿瘤体积明显小于生理盐水组（F = 0.1813,P < 0.05）和NC-T细胞组（F = 0.1307,P?< 0.05）。 结论PLAC1特异性TCR基因修饰T细胞对乳腺癌细胞具有较强的抗肿瘤作用,PLAC1可作为乳腺癌治疗的潜在靶标;PLAC1特异性TCR基因修饰T细胞治疗是PLAC1表达阳性的乳腺癌治疗的新策略。