抗原致敏DC联合CIK在原发性肝癌治疗中的应用

目的:探讨负载自身肝癌裂解物的树突状细胞(DC)与细胞因子诱导杀伤细胞(CIK)共培养对CIK体外杀伤活性的影响,并观察抗原致敏DC(Ag-DC)联合CIK治疗原发性肝癌后患者的免疫状态、临床疗效及毒副反应.方法:选择24例原发性肝癌患者,分离外周血单个核细胞,其中贴壁细胞经GM-CSF和IL-4诱导产生DC,并负载自体肿瘤裂解物;悬浮细胞经IFN-γ、IL-2、抗CD3单抗、IL-1α体外诱导产生CIK.将Ag-Dc与CIK共培养,观察CIK在体外对肝癌细胞株SMMC-7721的杀伤活性;24例患者接受Ag-DC+CIK的过继免疫治疗,观察疗效.结果:1)Ag-DC与CIK共培养后,CIK体外肿瘤杀伤活性明显提高;2)Ag-Dc联合C1K治疗原发性肝癌可明显改善患者细胞免疫功能,提高临床疗效;3)除一过性发热、畏寒外未见其它不良反应.结论:负载自体肿瘤细胞裂解物的DC疫苗联合CIK可作为原发性肝癌常规治疗的有效辅助手段.     

自体肿瘤抗原致敏的树突状细胞联合细胞因子诱导杀伤细胞应用于肺腺癌治疗的临床研究

目的:探讨负载自身肿瘤裂解物的树突状细胞(dendritic cells, DCs)联合细胞因子诱导杀伤 (cytokine induced killer, CIK) 细胞治疗肺腺癌的临床疗效及安全性.方法:选择30例肺腺癌患者,分离获得外周血单个核细胞(peripheral blood mononuclear cells, PBMCs),其中贴壁细胞经重组人粒细胞巨噬细胞集落刺激因子(recombinant human granulocyte-macrophage colony stimulating factor, rhGM-CSF)和重组人白细胞介素- 4(recombinant human interleukin-4, rhIL-4)诱导产生DCs,并负载自体肺腺癌细胞裂解物,培养获得Ag-DCs;悬浮细胞经干扰素-α(interferon,IFN-α)、白细胞介素-2(interleukin-2,IL-2)、抗CD3单克隆抗体和白细胞介素-1α(interleukin-1α,IL-1α)体外诱导产生CIK细胞; 将Ag-DCs与CIK细胞共培养,观察CIK细胞体外对肺腺癌细胞株A549和自体肿瘤细胞的杀伤活性;30 例患者接受Ag-DCs+CIK细胞过继免疫治疗,观察疗效.结果: Ag-DCs与CIK细胞共培养后,提高了CIK细胞对A549细胞和自体肿瘤细胞的杀伤活性;Ag-DCs联合CIK细胞治疗肺腺癌,可增强患者细胞免疫功能,改善生活质量,提高临床疗效;除一过性发热和畏寒外,未见其他不良反应.结论:Ag-DCs联合CIK细胞可作为中晚期肺腺癌的一种有效治疗手段.     

树突状细胞与肾癌融合细胞疫苗诱导抗肿瘤免疫

目的探讨自体树突状细胞(DC)与肾癌融合细胞疫苗诱导特异性抗肿瘤免疫应答。方法利用肿瘤细胞纯化技术,从手术切除的肾癌组织中分离出高纯度的肾癌细胞,用10%胎牛血清(FCS)的RPMI-1640进行原代培养。分离外周血单核细胞(PBMCs),在含重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)和白细胞介素4(rhIL-4)的培养条件下,诱导分化为DC。用细胞融合技术将DC与肾癌细胞融合制备DC与肾癌融合细胞疫苗。用流式细胞仪检测肾癌细胞、DC和融合细胞的表型;用噻唑盐(MTT)比色法检测融合细胞刺激自体T细胞的增殖能力,乳酸脱氢酶(LDH)释放的细胞毒实验检测融合细胞刺激的细胞毒性T淋巴细胞(CTLs)的杀瘤活性。结果DC高表达主要组织相融性复合体(MHC)Ⅰ类分子、MHCⅡ类分子和共刺激分子(CD86,CD80);原代肾癌细胞高表达一种高分子量的糖蛋白(MUC-1);自体DC与肾癌融合细胞疫苗同时表达肾癌细胞和DC细胞的表面抗原,并能有效刺激自体T细胞增殖,诱导产生的CTLs对自体肾癌细胞具有显著的杀伤活性。结论自体DC与肾癌融合细胞疫苗能诱导特异性抗自体肾癌细胞的免疫应答,为自体DC与肾癌融合细胞疫苗在治疗肾癌的临床应用中提供了实验依据。     

树突状细胞联合CIK细胞应用于晚期恶性实体瘤治疗的临床疗效观察

目的:研究树突状细胞(dendritic cells, DCs)和细胞因子诱导的杀伤细胞(cytokine induced killer, CIK)联合治疗晚期实体瘤的临床疗效.方法:选择110例晚期实体瘤患者,分离外周血单个核细胞(peripheral blood mononuclear cells,PBMCs),其中贴壁细胞用粒细胞巨噬细胞集落刺激因子(granulocyte-macrophage colony-stimulating factor,GM-CSF)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及白细胞介素-4 (interleukin-4,IL-4)等诱导产生DCs,并用自体肿瘤细胞或外源性肿瘤细胞抗原致敏,获得Ag-DCs;悬浮细胞经干扰素-γ(interferon-γ,IFN-γ)、IL-2和CD3单克隆抗体(CD3 monoclonal antibody,CD3mAb)等诱导产生CIK细胞,将DCs与CIK细胞共同培养;采用FCM法检测DCs及CIK细胞表型,并回输患者进行治疗.结果: 42 例可评价病灶的患者中,2 例完全缓解(complete response,CR),9 例部分缓解(partial response, PR),15 例疾病稳定(stable disease, SD);37 例不可评价病灶的患者中,25例患者有效,与治疗前相比,治疗后免疫功能及肿瘤标志物有一定程度改善.结论:DCs-CIK细胞联合治疗晚期恶性实体瘤安全有效,具有一定的临床应用前景.     

DC-CIK细胞治疗对晚期恶性肿瘤患者免疫功能及生活质量的影响

目的:探讨自体树突状细胞(DC细胞)及细胞因子诱导的杀伤细胞(CIK细胞)治疗对晚期恶性肿瘤患者T细胞免疫功能及生活质量的影响.方法:用流式细胞仪检测52例晚期恶性肿瘤患者DC/CIK细胞治疗前后T细胞亚群并观察该治疗对患者生活质量的影响.结果:52例接受DC/CIK治疗的患者CD3、CD4、CD4/CD8比例均较治疗前上升,差异有统计学意义(P＜0.05).Kamofsky评分等级有明显提高,差异有统计学意义(P＜0.05).结论:自体DC-CIK细胞治疗可提高晚期恶性肿瘤患者的免疫功能,改善其生活质量.     

多肽负载DC联合CIK治疗激素难治性前列腺癌的疗效

目的:研究多肽负载树突状细胞(dendritic cell,DC)联合细胞因子诱导的杀伤细胞(cytokine-induced killer cell,CIK)对激素难治性前列腺癌(hormone refractory metastatic prostate cancer,HRPC)患者免疫治疗的效果。方法:选择无锡市第四人民医院中西医结合科收治的HLA-A2+HRPC患者26例,分离外周血单个核细胞,其中贴壁细胞经GM-CSF、IL-4联合诱导培养为成熟DC,负载前列腺癌特异性抗原(prostate specific antigen,PSA)、前列腺酸性磷酸酶(prostatic acid phosphatase,PAP)、前列腺特异性膜抗原(prostate specific membrane antigen,PSMA)三个多肽,制备成DC疫苗,经患者腹股沟皮内注射;未贴壁细胞经IFN-γ、IL-2、抗CD3单抗、IL-1体外诱导培养成CIK,经静脉回输给患者。在治疗后1周进行迟发型超敏反应(delayed type hypersensitivity,DTH)检测,在患者治疗前后进行血清中细胞因子和PSA检测,治疗结束后4周进行短期疗效评价。结果:26例HRPC患者对DC联合CIK治疗的耐受良好。治疗后患者血清中IL-2、IL-12、IFN-γ水平较治疗前显著升高(上升幅度分别为65.07%、67.69%和125.38%,P<0.05或P<0.01),TNF-α和IL-10水平变化不大;DTH的阳性率为43.5%(10/23);7例患者的CD8+IFN-γ+T细胞比例较治疗前显著提高[(8.95±2.74)%vs(0.39±0.15)%,P<0.01];8/26例患者的PSA下降,降幅为13%～66%。26例患者短期疗效评价,3例PR、4例PD、19例SD,所有患者治疗中未出现明显不良反应。结论:多肽负载DC联合CIK治疗HRPC能激发患者的免疫应答、诱导Th1型细胞因子的分泌,近期疗效良好,是一种安全的治疗方法。     

DC活化淋巴细胞对自体乳腺癌细胞的杀伤作用

 目的探讨负载自体抗原DC诱导的CTLs对自体乳腺癌细胞的杀伤作用。方法以负载自体癌细胞抗原的DCs体外诱导CTLs,用ELISA法检测IFN-γ和IL-12的表达水平,用LDH法检测CTL对自体癌细胞的杀伤作用。结果负载自体抗原DC组IFN-γ和IL-12的浓度高于未致敏DC组、抗原组及单核细胞对照组(P<0.05),且负载抗原DC组所刺激的CTLs的杀伤作用也强于未致敏DC组、抗原组及单核细胞组(P<0.01)及对照的MCF-7组和HT-29组(P<0.01)。结论肿瘤裂解物致敏DC可持续刺激特异性CTLs从而可在体外杀伤乳腺癌患者的自体肿瘤细胞,说明肿瘤抗原致敏的DC疫苗对于治疗残留的和(或)对化疗耐药乳腺癌可能是适合的,因而有可能成为标准的补救措施。     

DC-CIK治疗对肾癌患者淋巴细胞亚群的影响

目的:观察自体树突状细胞(dendritic cell,DC)联合细胞因子诱导的杀伤细胞(cytokine-induced kill cell,CIK)(DC-CIK)免疫疗法治疗肾癌的近期临床疗效和不良反应,及其对患者外周血淋巴细胞亚群的影响。方法:采集10例肾癌患者外周血单个核细胞,经体外诱导产生DC和CIK细胞,分次回输给患者,随访3～12个月,观察患者临床疗效和不良反应。分别于第1次治疗前1周和每次治疗后1个月取患者外周血,流式细胞仪检测其淋巴细胞亚群变化。结果:本研究中6例晚期肾癌患者接受1～3疗程DC-CIK细胞免疫治疗后,完全缓解1例,部分缓解3例,病情稳定1例,疾病进展1例;近期有效率为60%,临床反应率为90%。治疗前及1～3疗程治疗后患者外周血的CD3+CD4+CD8-、CD3+CD4-CD8+、CD3+CD19-、CD3-CD19+、CD3-CD16+CD56+、CD3+CD16+CD56+、CD3+HLA-DR-、CD3+HLA-DR+、CD3+CD28+CD8+细胞无明显变化(P>0.05),CD4+CD25+T细胞(Treg细胞)治疗后有降低趋势(P<0.05)。除1例患者出现一过性发热外,余患者无不良反应。结论:DC-CIK免疫治疗肾癌能改善患者免疫抑制状态,提高机体的抗肿瘤免疫效应,有较好的近期疗效,无明显不良反应。     

人结肠癌主动特异性免疫治疗的初步研究

目的:探讨自体肿瘤疫苗的作用机制及临床意义。方法:50例进展期结肠癌病人术后,以自体肿瘤细胞疫苗辅助主动免疫治疗。术后第4周开始免疫接种(共4次,每次间隔7~10天);接种前3天及第4次接种后1周,采集外周血。采集血清监测血清IFN-γ、IL-10水平;用PPD及自体肿瘤抗原做皮肤迟发型过敏试验(DTH),48小时后测量红斑、硬结大小(mm);对DTH反应部位皮肤活检,用免疫组化染色,了解局部免疫活性细胞浸润;临床随访。结果:自体肿瘤细胞疫苗治疗后:血清IFN-γ水平升高,由(6.01±2.30)pg/ml升至(12.98±4.65)pg/ml;而IL-10水平由(19.80±10.15)pg/ml降至(8.92±4.60)pg/ml,差异有非常显著性(P<0.05);治疗前后病人对自体肿瘤抗原的特异性DTH反应明显增强(P<0.01);DTH反应部位,CD8 T细胞、CD4 T细胞及DC细胞浸润明显增多;病人耐受性良好,无溃疡等严重副作用发生;随访结果显示:术后辅助自体肿瘤疫苗主动特异性免疫治疗,可延长结肠癌病人的无瘤生存时间,降低复发率及死亡率。结论:自体肿瘤疫苗可激发病人特异性细胞介导的免疫反应;可改善肿瘤病人的抗瘤免疫反应;自体肿瘤疫苗主动特异性免疫治疗,对于杀灭残留癌细胞、抗转移及复发有重要作用。     

热休克自体胃癌细胞负载DC疫苗对患者术后细胞免疫功能的影响

目的 探讨热休克自体胃癌细胞负载的树突状细胞(DC)疫苗对胃癌术后细胞免疫功能的影响。方法 从胃癌患者外周血单个核细胞中诱导DC,并用重组人粒细胞-巨噬细胞集落刺激因子 (rhGM-CSF)和白介素4(rhIL-4)刺激活化,经负载热休克凋亡的自体胃癌细胞制备DC疫苗。将32例胃癌术后化疗患者随机分为DC疫苗治疗组16例,另16例作为对照组,仅作常规化疗。对两组病例治疗前后T细胞亚群及自然杀伤（NK）细胞进行观察比较。结果 DC疫苗治疗后外周血CD3+、CD3+CD4+、CD3+CD8+及NK细胞比率较治疗前明显升高(P<0.05),且明显高于对照组化疗后的相应指标(P<0.05)。结论 胃癌术后化疗时行热休克凋亡自体胃癌细胞负载的DC疫苗治疗,可改善患者的细胞免疫水平。     

Presentation of renal tumor antigens by human dendritic cells activates tumor-infiltrating lymphocytes against autologous tumor: implications for live kidney cancer vaccines.

The clinical impact of dendritic cells (DCs) in the treatment of human cancer depends on their unique role as the most potent antigen-presenting cells that are capable of priming an antitumor T-cell response. Here, we demonstrate that functional DCs can be generated from peripheral blood of patients with metastatic renal cell carcinoma (RCC) by culture of monocytes/macrophages (CD14+) in autologous serum containing medium (RPMI) in the presence of granulocyte macrophage colony-stimulating factor and interleukin (IL) 4. For testing the capability of RCC-antigen uptake and processing, we loaded these DCs with autologous tumor lysate (TuLy) using liposomes, after which cytometric analysis of the DCs revealed a markedly increased expression of HLA class I antigen and a persistent high expression of class II. The immunogenicity of DC-TuLy was further tested in cultures of renal tumor infiltrating lymphocytes (TILs) cultured in low-dose IL-2 (20 Biologic Response Modifier Program units/ml). A synergistic effect of DC-TuLy and IL-2 in stimulating a T cell-dependent immune response was demonstrated by: (a) the increase of growth expansion of TILs (9.4-14.3-fold; day 21); (b) the up-regulation of the CD3+ CD56- TcR+ (both CD4+ and CD8+) cell population; (c) the augmentation of T cell-restricted autologous tumor lysis; and (d) the enhancement of IFN-gamma, tumor necrosis factor-alpha, granulocyte macrophage colony-stimulating factor, and IL-6 mRNA expression by TILs. Taken together, these data implicate that DC-TuLy can activate immunosuppressed TIL via an induction of enhanced antitumor CTL responses associated with production of Thl cells. This indicates a potential role of DC-TuLy vaccines for induction of active immunity in patients with advanced RCC.     

Enhanced antitumor effects by the coculture of allotumor RNA-pulsed dendritic cells with autologous cytokine-induced killer cells on hormone-refractory prostate cancer

In this study, we evaluated antitumor effects of allotumour RNA-transfected dendritic cells (DCs) cocultured with autologous cytokine-induced killer cells (CIKs) on hormone-refractory prostate cancer. The cocultured cells enhanced prostate cancer cytolysis from 26% (CIKs-induced cytolysis) to 80.8%. They also increased the productions of CD4⁺ Th1 (IFN-γ⁺IL-4^-, 55.52%) and CD8⁺ T (IFN-γ⁺, 69.59%) cells determined by intracellular cytokines IFN-γ /IL-4 staining and reduced the rate of CD4⁺ CD25⁺ cells from 18.72% (in CIKs) to 9.72%. The cocultured cells significantly inhibited tumor growth in SCID mouse and induced cancer cells necrosis and apoptosis. Our study indicates that tumor RNA-pulsed DCs cocultured with autologous CIKs significantly enhance antitumor immunity, which can be induced by increased CD4⁺ Th1 and CD8⁺ T cells and decreased CD4⁺CD25⁺ regulatory T (T_reg) cells. This provides a potential immunotherapy strategy for HRPC.     

Induction of G250-targeted and T-cell-mediated antitumor activity against renal cell carcinoma using a chimeric fusion protein consisting of G250 and granulocyte/monocyte-colony stimulating factor.

Immunotherapy targeting for the induction of a T-cell-mediated antitumor response in patients with renal cell carcinoma (RCC) appears to hold significant promise. Here we describe a novel RCC vaccine strategy that allows for the concomitant delivery of dual immune activators: G250, a widely expressed RCC associated antigen; and granulocyte/macrophage-colony stimulating factor (GM-CSF), an immunomodulatory factor for antigen-presenting cells. The G250-GM-CSF fusion gene was constructed and expressed in Sf9 cells using a baculovirus expression vector system. The Mr 66,000 fusion protein (FP) was subsequently purified through a 6xHis-Ni2+-NTA affinity column and SP Sepharose/fast protein liquid chromatography. The purified FP retains GM-CSF bioactivity, which is comparable, on a molar basis, to that of recombinant GM-CSF when tested in a GM-CSF-dependent cell line. When combined with interleukin 4 (IL-4; 1000 units/ml), FP (0.34 microg/ml) induces differentiation of monocytes (CD14+) into dendritic cells (DCs) expressing surface markers characteristic for antigen-presenting cells. Up-regulation of mature DCs (CD83+CD19-; 17% versus 6%) with enhanced expression of HLA class I and class II antigens was detected in FP-cultured DCs as compared with DCs cultured with recombinant GM-CSF. Treatment of peripheral blood mononuclear cells (PBMCs) with FP alone (2.7 microg/10(7) cells) augments both T-cell helper 1 (Th1) and Th2 cytokine mRNA expression (IL-2, IL-4, GM-CSF, IFN-gamma, and tumor necrosis factor-alpha). Comparison of various immune manipulation strategies in parallel, bulk PBMCs treated with FP (0.34 microg/ml) plus IL-4 (1000 units/ml) for 1 week and restimulated weekly with FP plus IL-2 (20 IU/ml) induced maximal growth expansion of active T cells expressing the T-cell receptor and specific anti-RCC cytotoxicity, which could be blocked by the addition of anti-HLA class I, anti-CD3, or anti-CD8 antibodies. In one tested patient, an augmented cytotoxicity against lymph node-derived RCC target was determined as compared with that against primary tumor targets, which corresponded to an 8-fold higher G250 mRNA expression in lymph node tumor as compared with primary tumor. The replacement of FP with recombinant GM-CSF as an immunostimulant completely abrogated the selection of RCC-specific killer cells in peripheral blood mononuclear cell cultures. All FP-modulated peripheral blood mononuclear cell cultures with antitumor activity showed an up-regulated CD3+CD4+ cell population. These results suggest that GM-CSF-G250 FP is a potent immunostimulant with the capacity for activating immunomodulatory DCs and inducing a T-helper cell-supported, G250-targeted, and CD8+-mediated antitumor response. These findings may have important implications for the use of GM-CSF-G250 FP as a tumor vaccine for the treatment of patients with advanced kidney cancer.     

IL-4 prevents the blockade of dendritic cell differentiation induced by tumor cells

Malignant cells may escape from the immune response in vivo because of a defective differentiation of professional antigen-presenting cells (APCs), i.e., dendritic cells (DCs). We recently reported that tumor cells release interleukin (IL)-6 and macrophage colony stimulating factor (M-CSF), which inhibit the differentiation of CD34+ cells into DCs and promote their commitment toward monocytic lineage with a poor APC function. The results presented here show that both IL-4 and IL-13 reverse the inhibitory effects of renal cell carcinoma conditioned media (RCC CM) or IL-6+M-CSF on the phenotypic and functional differentiation of CD34+ into DCs. IL-4 was found to act through a rapid blockade of the expression of M-CSF and the IL-6 receptor-transducing chain (gp130), along with a decrease of the secondary production of M-CSF, thereby preventing the loss of granulocyte macrophage colony stimulating factor (GM-CSF) receptor alpha chain expression on differentiating CD34+ cells. Consistent with these observations, the differentiation of DCs from monocytes cultured with GM-CSF and IL-4 was also impaired by RCC CM, but the minimal inhibitory concentrations of RCC CM were 10-fold higher than for CD34+ cells. In these conditions, monocytes cultured with GM-CSF and IL-4 also exhibited profound phenotypic changes (CD14+ D32+ CD86+ HLA-DR+ CD115(low) CD23(low) CD1a-) and a poor APC function. These alterations were overcome in a dose-dependent manner by IL-4 (5-500 IU/ml), although not beyond a 40% final concentration of RCC CM. The capacity of RCC CM to block DC differentiation from monocytes strongly correlated with IL-6 and M-CSF concentrations in medium. Taken together, these results demonstrate that IL-4 and IL-13 reverse the inhibitory effect of tumor cells on DC differentiation.     

Role of low nuclear grading of renal carcinoma cells in the functional profile of tumor-infiltrating T cells

Tumor-infiltrating lymphocytes (TILs) from biopsies of 9 selected patients with pT1pN0M0 renal cell carcinoma (RCC) were analyzed at the clonal level for phenotypic distribution, cytokine secretion profile and antitumor cell proliferation and cytotoxicity. T-cell clones generated from RCCs were able to produce higher amounts of interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) than the corresponding clones derived from peripheral blood mononuclear cells, thus suggesting a recruitment into tumors of T cells with peculiar functions. Moreover, CD4+ T-cell clones generated from TILs of nuclear grading 2 (G2)-type RCC patients produced significantly higher amounts of IL-4 and IL-10 and lower amounts of IFN-gamma than the corresponding clones generated from G1-type RCC and 2 renal angiomyolipoma (AML) patients. In addition, T-cell clones generated from lymphocytes infiltrating the peritumoral areas of G2-type, but not those from G1-type, RCC patients produced higher and lower amounts of IL-4 and IFN-gamma, respectively, than the corresponding clones derived from intratumoral T cells of the same patients. The proportion of T-cell clones derived from G2-type tumors and proliferating to autologous tumor cells (ATCs) was significantly lower than that of clones generated from G1-type RCC or AML patients. However, irrespective of their source, they exhibited similar cytokine profiles and produced comparable amounts of IL-4, IL-10 and IFN-gamma. Furthermore, the proportion and the production of both IL-4 and IFN-gamma of G2-type RCC-derived T-cell clones with cytotoxic activity against ATC were significantly lower than those of cytolytic clones generated from AML and G1-type RCCs. The concentrations of IL-4, IL-10 and IFN-gamma produced by the cytolytic clones from G2-type RCC were also lower than those produced by their noncytolytic counterparts obtained from the same patients. These data address the association of the nuclear grading of neoplastic cells with different local tumor-specific T-cell responses in RCC.     

Tumor infiltrating dendritic cells predict treatment response to immmunotherapy in patients with metastatic renal cell carcinoma

BACKGROUND: Although renal cell carcinoma (RCC) is considered to be an immunogenic tumor, the role of immunogenicity in this tumor for predicting treatment response has been little investigated. PATIENTS AND METHODS: Resected RCC specimens from 25 patients who received cytokine treatment for metastases were investigated using immunohistochemistry for CD83+ or S100+ dendritic cells (DCs), CD8+ T-cells, HLA-DR+ tumor cells, CD68+ tumor associated macrophages, microvascular density and vascular endotherial growth factor. RESULTS: Among the examined parameters, DCs status showed predictive value, that is, higher numbers of CD83+ or S100+ cells in tumors were associated with favorable treatment response. However, only higher CD83 status, which indicates mature and activated DCs, contributed to better survival (p = 0.0339). CONCLUSION: Increased tumor infiltration of mature DCs would be a predictor of treatment response and outcome in metastatic RCC patients, who receive immunotherapy.     

肺癌肿瘤全溶物脉冲自体树突状细胞体外诱生T细胞抗肿瘤反应的研究

目的　探讨非小细胞肺癌 (NSCLC)患者全瘤溶解物 (WTL)冲击的自体树突状细胞 (DCs)瘤苗体外诱生T细胞介导的抗肿瘤反应。方法　在含重组人粒细胞 巨噬细胞 集落刺激因子 (rhGM CSF)和重组人白细胞介素 4 (rhIL 4 )的培养条件下 ,以 10例患者的贴壁外周血单核细胞 (PBMCs)衍生不成熟的树突状细胞 (imDCs) ,分别添加肿瘤坏死因子 (TNFα)、自体WTL或WTL TNFα诱导成熟 ,即分别为DCs/TNF、DCs/WTL和 DCs/WTL ,用流式细胞仪和混合淋巴细胞反应 (MLR) ,检测细胞表面分子的表达变化及其刺激异基因或同基因的T细胞增殖能力。将 DCs/WTL和自体T细胞共培养1～ 2周 ,以诱导细胞毒性T淋巴细胞 (CTL) ,用计数γ 干扰素 (IFN γ)释放的酶联免疫斑点 (ELISPOT)试验和乳酸脱氢酶 (LDH)释放的细胞毒试验 ,分别检测该CTL中识别自体肿瘤细胞释放特异性IFN γ的T细胞数和溶瘤活性。结果　以 30 μg/ml蛋白的WTL体外冲击自体 10 6imDCs,可导致上调DC表型 ,包括CD1a、CD83和CD86以及HLA DR的分子表达 ,与常规TNFα诱导成熟的DCs表型相似。虽然两者均能显著刺激异基因T细胞的增殖 ,但其刺激自体T淋巴细胞的增殖能力 ,DCs/WTL却显著高于DCs/TNF(P <0 .0 5 )。将体外与 DCs/WTL共培养的自体T细胞作为反应或效应细胞 ,再次     

Fusion cell vaccination of patients with metastatic breast and renal cancer induces immunological and clinical responses.

PURPOSE: Dendritic cells (DCs) are potent antigen-presenting cells that are uniquely capable of inducing tumor-specific immune responses. We have conducted a Phase I trial in which patients with metastatic breast and renal cancer were treated with a vaccine prepared by fusing autologous tumor and DCs. EXPERIMENTAL DESIGN: Accessible tumor tissue was disrupted into single cell suspensions. Autologous DCs were prepared from adherent peripheral blood mononuclear cells that were obtained by leukapheresis and cultured in granulocyte macrophage colony-stimulating factor, interleukin 4, and autologous plasma. Tumor cells and DCs were cocultured in the presence of polyethylene glycol to generate the fusions. Fusion cells were quantified by determining the percentage of cells that coexpress tumor and DC markers. Patients were vaccinated with fusion cells at 3-week intervals and assessed weekly for toxicity, and tumor response was assessed at 1, 3, and 6 months after completion of vaccination. RESULTS: The vaccine was generated for 32 patients. Twenty-three patients were vaccinated with 1 x 10(5) to 4 x 10(6) fusion cells. Fusion cells coexpressed tumor and DC antigens and stimulated allogeneic T-cell proliferation. There was no significant treatment-related toxicity and no clinical evidence of autoimmunity. In a subset of patients, vaccination resulted in an increased percentage of CD4 and CD8+ T cells expressing intracellular IFN-gamma in response to in vitro exposure to tumor lysate. Two patients with breast cancer exhibited disease regressions, including a near complete response of a large chest wall mass. Five patients with renal carcinoma and one patient with breast cancer had disease stabilization. CONCLUSIONS: Our findings demonstrate that fusion cell vaccination of patients with metastatic breast and renal cancer is a feasible, nontoxic approach associated with the induction of immunological and clinical antitumor responses.     

Monitoring peri-operative immune suppression in renal cancer patients

The aim of this study was the identification of surrogate markers of host immunity in renal cell carcinoma (RCC) patients. Using 4-color flow cytometry the immunophenotype of blood immune cells of RCC patients was compared to that of healthy volunteers and correlated with staging and grading of patients. Furthermore, the time course of these immune markers was compared in RCC patients undergoing either open surgery or laparoscopy. Compared to the healthy control group, blood of RCC patients contained more granulocytes and higher percentages of CTLA4+CD8+ T lymphocytes, but reduced numbers of dendritic cells (DCs) and of CD28+ CD8+ T cells. Tumor progression was associated with a higher white blood cell count, a reduced frequency of blood DCs and increased numbers of CD57+ T and NK cells. Monocytes of patients with advanced RCC showed a reduced HLA-DR surface expression associated with higher aminopeptidase N(APN)/CD13 expression. Tumor surgery caused an increase of granulocytes and a decrease of all lymphocytic and DC subpopulations within 24 h, whereas the number of HLA-DR low monocytes was up-regulated. As demonstrated by time kinetic analysis, laparoscopic intervention caused a more moderate immunosuppression and an enhanced restoration of immune activity than open surgery. These results suggest that the composition and the phenotype of innate immune cells reflect well the differences in the cellular immunity of RCC patients associated with tumor disease as well as surgery. The monocytic HLA-DR intensity represents a suitable marker for monitoring tumor stage and surgery-associated immunosuppression in RCC patients.