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Construction and characterization of a recombinant vaccinia virus expressing murine intercellular adhesion molecule-1: induction and potentiation of antitumor responses.

The intercellular adhesion molecule-1 (ICAM-1) has been associated with cellular migration into inflammatory sites and with facilitating interactions between lymphocytes and tumor targets in the pathway of cell-mediated cytotoxicity. More recently, ICAM-1 has become increasingly implicated in the costimulation of T cell functions, such as antigen-dependent T cell proliferation. Previous murine studies have shown that the introduction of the ICAM-1 gene into tumor cells using retroviral vectors led to enhanced antitumor responses. In this study, we report the construction, characterization, and immunological consequences of a recombinant vaccinia virus expressing murine ICAM-1. Vaccinia virus represents an attractive vector for the delivery of molecules such as ICAM-1 due to its wide host range, rapid infection, and functional expression of inserted gene products. The infection of tumor cells with this recombinant virus resulted in the expression of functional ICAM-1. Infected tumors provide accessory or secondary signals to lymphoblasts in vitro, resulting in enhanced cytokine production or alloreactive cytotoxic T lymphocyte (CTL) activity. In vivo, we demonstrated that weakly immunogenic syngeneic tumors, infected with and expressing rV-ICAM-1, were rejected by immunocompetent hosts. Furthermore, immunization with rV-ICAM-1-infected tumors resulted in the rejection of subsequent tumor challenge, providing evidence for recall response and immunological memory. These studies demonstrated the utility of a recombinant vaccinia virus to deliver and efficiently express ICAM-1 molecules on tumor cells for potential gene therapy and recombinant approaches to cancer immunotherapy.

Adenocarcinoma↗

Gene therapy for metastatic brain tumors by vaccination with granulocyte-macrophage colony-stimulating factor-transduced tumor cells.

We have developed an ex vivo gene therapy paradigm for the treatment of brain tumors using granulocyte-macrophage colony-stimulating factor (GM-CSF). Murine B16 melanoma cells were infected with MFG recombinant retrovirus containing the mouse GM-CSF cDNA. Subcutaneous vaccination of syngeneic mice with irradiated GM-CSF-secreting B16 melanoma cells was capable of completely protecting animals against subsequent intracranial B16 tumor inoculation, with up to 5 x 10(3) cells. Histologic evaluation revealed the presence of neutrophils, eosinophils, and lymphocytes, including CD4+, CD8+, and CD45R+ cells, in the intracerebral inoculation site, peaking 4 days after intracranial inoculation. In contrast, nonvaccinated animals or animals vaccinated with irradiated, nontransduced B16 cells succumbed to intracranial tumor within 3 weeks after inoculation. Treatment of established intracranial B16 melanoma tumors with subcutaneous injection of irradiated GM-CSF-secreting B16 cells significantly delayed death, as compared to injection of irradiated nontransduced B16 cells or no treatment. In addition, treatment of established intracerebral GL261 gliomas by vaccination with irradiated GM-CSF-secreting B16 cells mixed with irradiated, transduced, or nontransduced GL261 cells also extended survival. These B16/GL261 co-vaccinations also improved outcome and, in some cases, induced immunological memory that protected survivors from subsequent intracranial challenge with GL261 tumor cells. These findings indicate that peripheral vaccination with irradiated tumor cells in the presence of GM-CSF-producing cells can initiate a potent antitumor immune response against intracranial neoplasms.

Animals↗

Production of interferon-gamma by in vivo tumor-sensitized T cells: association with active antitumor immunity.

The state of active immunity to Meth A fibrosarcoma in mice immunized with an admixture of Meth A cells and Propionibacterium acnes is associated with possession by the host of spleen cells capable of producing interferon-gamma (IFN-gamma) upon in vitro restimulation with irradiated tumor cells. The ability of spleen cells from immunized mice to produce IFN-gamma in response to irradiated Meth A cells decays as active antitumor immunity is replaced by a state of immunological memory. The IFN-producing cells are L3T4+Ly2+, cyclophosphamide-sensitive and radiosensitive T cells, as determined by their sensitivity to corresponding monoclonal antibodies and complement. The induction of IFN-gamma production by in vivo tumor-sensitized T cells is tumor specific, in that spleen cells from mice immunized against Meth A fibrosarcoma can produce IFN in response to irradiated Meth A cells but not in response to another syngeneic tumor M109 lung carcinoma.

Animals↗

Coadministration of IL-12 or IL-10 expression cassettes drives immune responses toward a Th1 phenotype.

Cytokines are important regulators of the immune response. They influence immune expression, the development of immunologic memory, and regulation of antigen-specific and nonspecific immune activation as well as allergic responses. In a model system in mice, we have studied the effect of plasmids expressing interleukin (IL)-10 or IL-12 on the modulation of antigen-specific responses. Coadministration of IL-12 or IL-10 genes with DNA immunogens directed the antigen-specific immune response toward a T helper (Th1)-type immunity. In addition to the modulation of antigen-specific immune responses, we studied the induction of delayed-type hypersensitivity (DTH) to contact allergens as an in vivo model of the Th1 response. We found that IL-12 and IL-10 gene-containing plasmids, and not the bacterial plasmid alone, upregulate this response. Our cytokine gene delivery technique demonstrates an important level of control of the magnitude and direction of induced immune responses and could be advantageous in a wide variety of immunotherapeutic strategies.

Animals↗

Immune function in rural Gambian children is not related to season of birth, birth size, or maternal supplementation status.

BACKGROUND: We previously showed that mortality from infectious diseases among young adults in rural Gambia is strongly correlated with the season of their birth. This suggests that early life insults that involve fetal malnutrition, exposure to natural toxins, or highly seasonal infections affecting the infant or pregnant mother cause permanent damage to the immune system. Excess mortality begins after puberty and has a maximal odds ratio of >10 for deaths between ages 25 and 50 y. OBJECTIVE: We investigated the immune function of children according to birth weight, season of birth, and exposure to maternal dietary supplementation during pregnancy. DESIGN: Immune function was measured in 472 prepubertal children aged 6.5-9.5 y from 28 villages in rural Gambia. The mothers of these children had been randomly assigned to a high-energy prenatal supplementation program, which significantly increased birth weight. This permitted supplementation status, birth weight, and season of birth to be investigated as exposure variables. The outcome variables tested were naive responses to rabies and pneumococcus vaccines, delayed-type hypersensitivity skin reactions, and mucosal defense (secretory immunoglobulin A and dual-sugar permeability). RESULTS: Immune responses were strongly related to current age and sex, suggesting a high level of sensitivity, but were not consistently related to birth weight, season of birth, or maternal supplementation (control compared with intervention). CONCLUSION: Events in early life did not predict a measurable defect in immune response within this cohort of rural Gambian children. It is possible that the early programming of immune function may be mediated through a defect in immunologic memory or early senescence rather than through impairment of early responses.

Adult↗

Intravenous immune globulin for prevention of bacterial infections in pediatric AIDS patients.

The immunologic and clinical abnormalities associated with pediatric human immunodeficiency virus (HIV) infection are reviewed, the rationale for using intravenous immune globulin (IVIG) to prevent serious bacterial infections is described, and clinical experience with IVIG for this indication is summarized. Immunologic and clinical abnormalities seen in pediatric HIV-infected patients differ from those seen in adult HIV-infected patients. In pediatric patients, impaired B-cell activity is an early and prominent manifestation of HIV infection. Infants infected with HIV do not develop the antigen-specific B- and T-cell clones required for immunologic memory, amplification, and production of specific antibodies. B-cell defects and lack of memory B cells result in a high rate of serious bacterial infections in HIV-infected children compared with adults. Natural killer cell dysfunction may also increase HIV-infected children's susceptibility to secondary infections. IVIG therapy in HIV-infected pediatric patients is based on evidence of impaired antibody function in these patients, although this use remains controversial. Case reports and one unblinded comparative study published during the 1980s suggest that IVIG may decrease morbidity and improve cellular and humoral immune response. One recent large-scale, double-blind, placebo-controlled study showed that IVIG 400 mg/kg every 28 days can decrease the morbidity associated with serious bacterial infections in HIV-infected children with CD4 cell counts of > 200 cells/cu mm. Another study involving HIV-infected children receiving concurrent zidovudine demonstrated that IVIG helped prevent serious bacterial infections in children who were not concurrently receiving trimethoprim-sulfamethoxazole but not in those who were. Although IVIG has not been shown to alter mortality in HIV-infected children, regular use may decrease the morbidity associated with serious bacterial infections.

AIDS-Related Opportunistic Infections↗

Pneumococcal polysaccharide vaccines.

Pneumococcal infections are major causes of morbidity and mortality in children throughout the world. For this reason and because of the increasingly frequent isolation of multiply resistant pneumococci of the serotypes most often causing infection in childhood, prophylactic immunization offers the best prospect of reducing the incidence of such infections in the future. Studies of the immune system of humans have shown that immunologic maturation continues throughout the first decade of life and that responsiveness to some purified bacterial polysaccharides may be delayed until several years after birth. Vaccines of such capsular polysaccharides conjugated chemically to protein have been found to be immunogenic at an earlier age and to stimulate the development of IgM and IgG antibodies and of "immunologic memory." Current investigations suggest that administration of polyvalent vaccines of polysaccharide-protein conjugates in infancy followed by the administration of vaccines of purified polysaccharides after the age of 10 years offers the prospect of reducing significantly the incidence of pneumococcal infections.

Bacterial Vaccines↗

Modes of action of poliovirus vaccines and relation to resulting immunity.

Parenteral inactivated poliovirus vaccine (IPV) chiefly induces formation of serum antibody. Infection, with oral poliovirus vaccine ( OPV ) or wild poliovirus, also induces development of secretory IgA antibody. In addition, infection results in virus shedding and, hence, in possible spread of virus to contacts (more likely with wild than with vaccine virus). IPV induces a high level (90%-95%) of protection against disease, which presumably is mediated by serum antibody that prevents CNS invasion resulting from viremia. IPV induces little protection against infection but does modify the related virus shedding--chiefly that from the oropharynx. Infection, whether by OPV or wild virus, induces a high level of protection against disease. It also results in appreciable prevention or modification of infection because of the development of secretory IgA antibody. This effect is directly protective for the vaccinee and also benefits the community, since the exposed vaccinee can play little or no part in the spread of wild virus. One major question remaining concerns the maintenance of immunity. Lifelong immunologic memory assures an enhanced serum antibody response to any infection that occurs, but will it be sufficiently rapid that when preinfection antibody cannot be detected newly formed antibody will block blood-borne viral invasion of the CNS? If not, booster doses of vaccine are indicated. OPV boosters might be indicated in any case to reinforce protection against infection and so maintain herd immunity.

Central Nervous System↗

Development of antigen-specific cell-mediated immune responses after infection of cynomolgus monkeys (Macaca fascicularis) with Rickettsia tsutsugamushi.

Cynomolgus monkeys were evaluated for cellular immune responses after infection with the Karp strain of Rickettsia tsutsugamushi. Antibody and clinical signs of localized and systemic infection were also evaluated. Animals challenged with homologous or heterologous strains at various times after a primary infection were also followed up. Naive monkeys developed eschars, lymphadenopathy, rickettsemia, and elevated body temperatures. Antibody in these animals was IgM followed by IgG. Lymphocyte proliferation and production of gamma-interferon by peripheral blood mononuclear leukocytes also were demonstrated. If challenged six years after the initial infection, clinical signs and cellular responses were indistinguishable from naive animals but an anamnestic IgG antibody response was noted. If challenged eight months after the initial infection, complete resistance was noted, but if challenged at one year, a localized cutaneous lesion developed. The majority of animals infected previously had preexisting lymphocyte activity, a characteristic suggesting long-term immunologic memory that was not protective against rechallenge.

Animals↗

The C(H)1 domain of IgG is not essential for C3 covalent binding: importance of the other constant domains as targets for C3.

The covalent binding of C3 to antigen-antibody complexes [immune complexes (IC)] plays a pivotal role in the elimination of antigens. C3 prevents the formation of large IC lattices promoting their solubilization. Subsequently, bound C3 fragments determine the efficacy of antigen presentation, and the generation of antibody responses and immunological memory. C3 binding to IgG-IC generates IgG-C3b-C3b complexes which are detected by SDS-PAGE as two major bands: C3alpha65-heavy chain and C3alpha65-C3alpha43 covalent complexes. Using human heat-aggregated IgG1 as a model of IC, a C3b binding site was localized only in the Cgamma1 domain. However, with true IC of ovalbumin and rabbit IgG anti-ovalbumin, C3b binds to both the Fab and Fc regions of IgG. To study the binding of C3b to the different domains of IgG and particularly to evaluate the involvement of the Cgamma1 domain, we have constructed recombinant single-chain antibodies without Cgamma1, which have the structure: V(H)-linker-V(L)-hinge-Cgamma2-Cgamma3 (scAb). The variable domains were from a mouse mAb anti-HSA and the constant region (hinge-C(H)2-C(H)3) from human IgG1 or rabbit IgG. C3 binds very efficiently to IC formed with human (h-scAb) or rabbit (r-scAb) recombinant antibodies (scAb-HSA) and generates also two bands on SDS-PAGE (C3alpha65-scAb and C3alpha65-C3alpha43), which are the counterparts of those of the complete antibody. In addition, IC formed with scAb activate the alternative pathway to a similar extent as IC of the entire IgG. These data indicate that the Cgamma1 domain is a dispensable region for C3b binding and that the remaining constant domains are as efficient as Cgamma1 in C3b binding. Overall these results support the view that C3 does not specifically recognize a unique site in the Cgamma1 domain. Rather it seems to be able to attach along the antibody molecule. Probably this implies an advantage for effective processing of C3b-IC and elimination of antigens in vivo.

Animals↗

Stress as an endogenous adjuvant: augmentation of the immunization phase of cell-mediated immunity.

Stress is thought to be immunosuppressive but paradoxically exacerbates inflammatory and autoimmune diseases. We initially showed that acute stress enhances skin immunity. Such immunoenhancement could promote immunoprotection in case of wounding, infection or vaccination but could also exacerbate immunopathological diseases. Here we identify the molecular and cellular mediators of the immunoenhancing effects of acute stress. Compared with non-stressed mice, acutely stressed animals showed significantly greater pinna swelling and leukocyte infiltration, and up-regulated macrophage chemoattractant protein-1, macrophage inflammatory protein-3alpha, IL-1alpha, IL-1beta, IL-6, tumor necrosis factor-alpha and IFN-gamma, but not IL-4 gene expression at the site of primary antigen exposure. Stressed animals also showed enhanced maturation and trafficking of dendritic cells (DCs) from skin to lymph nodes (LNs), higher numbers of activated macrophages in skin and LNs, increased T cell activation in LNs, and enhanced recruitment of surveillance T cells to skin. These findings show that important interactive components of innate (DCs and macrophages) and adaptive (surveillance T cells) immunity are mediators of the stress-induced enhancement of a primary immune response. Such enhancement during primary immunization may induce a long-term increase in immunologic memory resulting in subsequent augmentation of the immune response during secondary antigen exposure. Thus, the evolutionarily adaptive fight-or-flight stress response may protectively prepare the immune system for impending danger (e.g. infection and wounding by a predator), but may also contribute to stress-induced exacerbation of inflammatory and autoimmune diseases.

Animals↗

Cycling of human dendritic cell effector phenotypes in response to TNF-alpha: modification of the current 'maturation' paradigm and implications for in vivo immunoregulation.

Dendritic cells (DCs) are potent antigen presenting cells reported to undergo irreversible functional 'maturation' in response to inflammatory signals such as TNF-alpha. The current paradigm holds that this DC maturation event is required for full functional capacity and represents terminal differentiation of this cell type, culminating in apoptotic cell death. This provides a possible mechanism for avoiding dysregulated immunostimulatory activity, but imposes constraints on the capacity of DCs to influence subsequent immune responses and to participate in immunological memory. We report that the cell surface and functional effects induced by TNF-alpha are reversible and reinducible. These effects are accompanied by a concordant modulation of cytokine mRNA expression that includes the induction of proinflammatory factors (IL-15, IL-12, LT-alpha, LT-beta, TNF-alpha, RANTES) which is coincident with the down-regulation of counter-regulatory cytokines (IL-10, TGF-beta1, TGF-beta2, IL-1 RA, MCP-1). The resultant net effect is a dendritic cell activation state characterized by a transient proinflammatory posture. These results demonstrate that 1) human DCs do not undergo terminal 'maturation' in response to TNF-alpha, 2) DC phenotypes are more pleiotropic than previously thought, and 3) DCs are potential immunoregulatory effector cells with implications for control of immune responses in both in vivo and in vitro systems.

Antigens, CD↗

Antigen presentation in acquired immunological tolerance.

In acquired tolerance, previous exposure to antigen under certain conditions induces specific unresponsiveness instead of specific immunological memory. It has been studied as an approach to the mechanisms of self-tolerance that operate on immunocompetent T and B lymphocytes once they leave their sites of origin in the thymus and the bone marrow. Possible mechanisms involve induction of specific suppressor cells or inactivation of antigen-specific lymphocytes (clonal anergy) as a consequence of abortive antigen presentation, in which the antigen receptor is effectively engaged but certain poorly defined accessory signals the T lymphocytes require are lacking. We propose that small, resting B lymphocytes, which lack these accessory signals, are the inactivating antigen-presenting cells in acquired tolerance to proteins and to the class II transplantation antigens. B lymphocytes, which can use their antigen receptors to gather and process antigens that are present at very low concentrations, may play a role in self-tolerance. In addition, B lymphocytes and T lymphocytes rendered anergic by encounter with self antigens could persist as self-specific suppressor cells to block an autoimmune response of autoreactive clones that had escaped deletion or anergy.

Animals↗

Vitamin A status and immunoglobulin G subclasses in rats immunized with tetanus toxoid.

Vitamin A deficiency severely compromises the magnitude of the primary and secondary antibody response to tetanus toxoid (TT) but does not impair the development of immunologic memory. To further characterize this immunodeficiency in antibody production, we have quantified the immunoglobulin G (IgG) subclasses (IgG1, IgG2a, IgG2b, and IgG2c) during the primary and secondary response to TT in normal, vitamin A-deficient, and retinol-repleted rats. In the primary response in normal rats, anti-TT IgG1 and IgG2b predominated. In vitamin A-deficient rats the production of anti-TT IgG2b was severely impaired, with little change in either IgG1 or IgG2a. In the secondary response vitamin A-deficient rats produced low levels of all anti-TT IgG subclasses. However, when vitamin A-deficient rats were repleted with retinol 2 days before reimmunization their secondary anti-TT IgG response was normal both in magnitude and IgG subclass distribution. This result implies that although vitamin A deficiency during the primary antibody response impaired anti-TT IgG2b production, it did not inhibit Ig heavy chain recombination or the differentiation of lymphocytes that formed memory B cells for each subclass; furthermore, these cells were activated in the secondary response after vitamin A status was improved. Thus, these experiments further support the concept that memory cell formation remains normal during vitamin A deficiency despite low levels of antibody production.

Animals↗

The role of colostral antibodies in prevention of microbial infections.

Mammalian colostrum offers passive protection to the newborn against a variety of microbial pathogens, in the form of specific immunoglobulin A, G and M antibodies. Sharing maternal immunological memory is in many cases vital for the infant, but may have disastrous consequences, such as involuntary transfer of disease and disturbance of the developing immune system. In most published studies, immune milk preparations are reported to be effective in the prevention of various gastroenteric infections, but not in the treatment of an established infection.

Animals↗

Lymphocyte activation in HIV-1 infection. I. Predominant proliferative defects among CD45R0+ cells of the CD4 and CD8 lineages.

OBJECTIVES AND DESIGN: The proliferative defects of CD4 and CD8 cells taken from 474 HIV-1-seropositive individuals during various stages of disease were quantitated. Phytohaemagglutinin (PHA) and soluble anti-CD3 were used in optimal mitogenic concentrations in the presence of recombinant interleukin-2 (rIL-2) and conditioned medium, and the proliferation of cells from HIV-1-seropositive donors was assessed in co-culture with HIV-1-seronegative cells in order to exclude effects of cytokine deficiency. Defects within the CD45RA+ ('unprimed') and CD45R0+ ('primed') T-cell populations were also investigated. METHODS: Quantitative immunofluorescence and double and triple labelling in flow cytometry were performed for (1) CD25 (IL-2 receptor alpha chain) expression, (2) lymphocyte and T-cell survival, and (3) blast transformation and proliferation--in relation to the original input of cells for each subpopulation. RESULTS: T cells from normal and HIV-1-seropositive donors were CD25+ at day 1. In HIV-1-seropositive patients a variable number of CD4 and CD8 lymphocytes failed to further increase CD25, and died as a sign of activation-associated lymphocyte death (AALD). Forty-two per cent of asymptomatic subjects, including 32% of those with CD4 cell counts > 400 x 10(6)/l, showed a poor blast transformation (< 30% blasts). Cells from HIV-1-seropositive donors showed poor blast responses when co-cultured with HIV-1-seronegative cells; both CD4 and CD8 cells were handicapped. In asymptomatic HIV-1-seropositive people T cells with the CD45R0+ RA- ('primed') phenotype were three to five times more vulnerable to AALD than the CD45RA+ RO- ('unprimed') cells. In patients in Centers for Disease Control and Prevention (CDC) disease stage IV both CD45R0+ and -RA+ populations were severely affected. CONCLUSIONS: This is the first quantitative analysis to demonstrate that in HIV-1 infection mitogen-stimulated CD45R0+ ('primed') T cells preferentially die upon activation. Both the CD4 and CD8 lineages are affected, as seen in animal models of graft versus host disease. AALD may explain defects of immunological memory. The analysis of AALD may be a suitable assay for studying whether antiviral drugs influence the proliferative responses of lymphocytes.

CD3 Complex↗

Cytokine-modified tumor vaccines: an antitumor strategy revisited in the age of molecular medicine.

Technological advances and improved understanding of the biology of the immune response have resulted in a resurgence of interest in the use of tumor vaccination as a means to control cancer. Tumor vaccines genetically modified with cytokine genes comprise the greatest proportion of gene therapy approaches to cancer. Tumor cells obtained at resection of the primary tumor are grown in tissue culture and genetically modified with cytokine genes such that the vaccine cells, after injection, may stimulate immune recognition of tumor cells and generate immunologic memory to prevent future tumor recurrence. There are many unanswered questions regarding tumor vaccination including the optimal dose, optimal cytokine, injection technique including route and site of vaccine delivery, and methods of evaluating the immune response. Oncology nurses have an integral role in these areas as well as in evaluating patients for as yet undetermined side effects. As tumor vaccines receive increasing attention by the lay media, oncology nurses, especially those in the clinical research setting, must learn new terminology and concepts relevant to this new treatment approach in order to effectively translate the information to patients.

Cancer Vaccines↗