Targeting OX40 and OX40L for the treatment of autoimmunity and cancer

The optimal activation of na?ve T cells requires TCR-mediated recognition of cognate peptide-MHC complexes on antigen presenting cells in the presence of costimulatory signals. Although signals provided via CD28-B7 interactions are important for enhancing the initial T-cell response, other costimulatory signals are required for sustaining the response and promoting both T-cell differentiation and survival. In particular, engagement of OX40 (CD134) by its natural ligand OX40L (CD134L) or OX40 agonists has been shown to provide key signals that can augment CD4 and CD8 T-cell responses. Importantly, numerous studies have highlighted the ability of OX40-specific agonists or antagonists to enhance antitumor immunity or ameliorate autoimmune disease, respectively. On the basis of these studies, the development of OX40- and OX40L-specific reagents has been pursued for clinical use. Given the emerging role of OX40 and OX40L as novel therapeutic targets, this review will focus on the cellular and molecular mechanisms of OX40-mediated T-cell costimulation with a special emphasis on the role of OX40-OX40L interactions in the etiology and treatment of autoimmunity and cancer.     

The significance of OX40 and OX40L to T-cell biology and immune disease

Summary:  OX40 (CD134) and its binding partner, OX40L (CD252), are members of the tumor necrosis factor receptor/tumor necrosis factor superfamily and are expressed on activated CD4⁺ and CD8⁺ T cells as well as on a number of other lymphoid and non-lymphoid cells. Costimulatory signals from OX40 to a conventional T cell promote division and survival, augmenting the clonal expansion of effector and memory populations as they are being generated to antigen. OX40 additionally suppresses the differentiation and activity of T-regulatory cells, further amplifying this process. OX40 and OX40L also regulate cytokine production from T cells, antigen-presenting cells, natural killer cells, and natural killer T cells, and modulate cytokine receptor signaling. In line with these important modulatory functions, OX40–OX40L interactions have been found to play a central role in the development of multiple inflammatory and autoimmune diseases, making them attractive candidates for intervention in the clinic. Conversely, stimulating OX40 has shown it to be a candidate for therapeutic immunization strategies for cancer and infectious disease. This review provides a broad overview of the biology of OX40 including the intracellular signals from OX40 that impact many aspects of immune function and have promoted OX40 as one of the most prominent costimulatory molecules known to control T cells.     

Relative Expression of OX40, OX40L mRNA,and OX40L Serum Levels in Women with Recurrent Spontaneous Abortion

This study determined the roles of OX40 and OX40L in women with recurrent spontaneous abortion (RSA). We compared the expression of OX40 and OX40L genes in peripheral blood mRNA levels and serum levels of OX40L in women with a history of RSA to the control group. In this case-control study, 40 women with a history of RSA (case group), and 40 others with no history of abortion (control group) were investigated. The expressions of OX40 mRNA and OX40L mRNA were determined in the two groups using the quantitative polymerase chain reaction. Also, the enzyme-linked immunosorbent assay was used to determine the levels of serum OX40L in the two groups. There were no significant differences in the maternal age of women in the two groups (30.1 ± 4.28 years in the case vs. 30.03 ± 4.23 years in the control group). There was no difference in terms of the levels of OX40 and OX40L mRNA between the groups (p = 0.08 and p = 0.56, respectively). In addition, there was no significant correlation between the expression of OX40 and OX40L mRNA levels with age or the number of abortions. The correlation between OX40 and OX40L mRNA levels was not significant. RSA history group turned to show a higher level of serum OX40L than the control group (p = 0.03). In conclusion, our findings demonstrated that the expression of OX40 mRNA and OX40L mRNA was similar between women with a history of RSA and the control group. The elevation of serum OX40L level may be considered as a risk factor for RSA.     

Contribution of OX40/OX40 ligand interaction to the pathogenesis of rheumatoid arthritis

OX40 ligand (OX40L) and OX40 (CD134) are a pair of cell surface molecules belonging to the TNF/TNF receptor family. Interaction of OX40L with its receptor OX40 is thought to be important in T cell activation through T cell/antigen-presenting cell interaction. However, involvement of these molecules in the pathogenesis of rheumatoid arthritis (RA) remains unclear. To explore the contribution of OX40/OX40L interaction to the pathogenesis of RA in vivo, we evaluated the effect of a neutralizing anti-OX40L monoclonal antibody (mAb) on the development of collagen-induced arthritis (CIA) in DBA/1 mice as an animal model for RA. Administration of anti-OX40L mAb into type II collagen (CII) -immunized DBA/1 mice dramatically ameliorated the disease severity. In vivo treatment with anti-OX40L mAb did not inhibit the expansion of CII-reactive T cells, but suppressed IFN-gamma and anti-CII IgG2a production. Therefore, OX40/OX40L interaction appears to play a critical role in the development of CIA by enhancing Th1-type autoimmune response. In addition, T lymphocytes in synovial fluid and synovial tissue from RA patients expressed OX40, while OX40L was expressed on sublining cells in synovial tissue. These results indicate that OX40/OX40L interaction may play a critical role in the development of RA.     

Prevention of diabetes in NOD mice at a late stage by targeting OX40/OX40 ligand interactions

Autoreactive T cells play a major role in the development of insulin-dependent diabetes mellitus, suggesting that costimulatory molecules that regulate T cell responses might be essential for disease progression. In NOD mice, CD28/B7 and CD40/CD40 ligand (L) interactions control the onset of diabetes from 2 to 4 weeks of age, but blocking these molecules has little effect after this time. Hence, it is possible that other ligand/receptor pairs control a later phase of disease. We now show that OX40 is expressed on CD4 and CD8 T cells several weeks prior to islet destruction, which is initiated around weeks 12-14, and that OX40L is present on dendritic cells in both secondary lymphoid organs and the pancreas from 11 to 13 weeks of age. Blocking OX40L at 6, 9, or 15 weeks after birth had little effect on disease; however, inhibiting OX40/OX40L interactions at week 12, or continuous treatment from week 12 onwards, significantly reduced the incidence of diabetes. Histological examination showed that islet destruction was prevented and insulitis reduced by targeting OX40L. These studies show that OX40/OX40L interactions form a late checkpoint in diabetes development and suggest that these molecules are realistic targets for therapeutic intervention.     

Graves病患者外周血OX40和OX40L分子表达的研究

探讨OX40和OX40L分子在Graves病患者外周血T淋巴细胞和单核细胞上的表达及其在Graves病发病机制中的可能作用。采用流式细胞仪检测技术对50例初发Graves病患者和30例健康志愿者外周血T细胞上OX40和单核细胞上OX40L的表达水平进行分析,并对28例治疗前后病人淋巴细胞上OX40/OX40L的表达进行了比较。结果:与正常对照组比,初发Graves病患者外周血CD4+T细胞上OX40表达水平明显升高,而CD8+T细胞上OX40表达水平无显著变化;同时,还检测到单核细胞上OX40L表达水平也明显增加。治疗后,FT3(游离三碘甲腺原氨酸)值恢复至健康对照组表达范围的Graves病患者其CD4+T细胞上OX40和单核细胞上OX40L的表达均显著降低至正常水平;而FT3值仍偏高的患者单核细胞上OX40L的表达降低,但未降至健康对照组表达范围,CD4+T细胞上OX40的表达则无显著变化。Graves病患者外周血T细胞和单核细胞上分别存在OX40和OX40L的异常表达,且与治疗效果密切相关,提示OX40/OX40L信号在T细胞与单核细胞相互作用过程中可能有助于自身反应性T细胞的持续活化,从而参与Graves病的免疫发生发展。     

Consequences of OX40-OX40 ligand interactions in langerhans cell function: enhanced contact hypersensitivity responses in OX40L-transgenic mice

Langerhans cells (LC) represent the dominant antigen-presenting cells (APC) in the epidermis and thus play an important role in cutaneous immune responses to approaching pathogens. These responses are mediated by several costimulatory molecules after antigenic challenge. OX40 ligand (OX40L), a member of TNF superfamily, is expressed on several APC such as splenic dendritic cells (DC) and activated B cells. This molecule has been reported to provide potent costimulation in APC-T cell interactions upon binding to its cognate receptor, OX40, on activated T cells. Little is known, however, regarding OX40L expression and function on LC. In the present study, we report the expression of both OX40L and OX40 on differentiated LC derived from draining lymph nodes in the FITC-sensitized mice. During contact hypersensitivity responses, OX40L-deficient mice demonstrated a significant reduction in both hapten-induced ear swelling and hapten-specific T cell responses despite intact migratory responses. Conversely, these responses were markedly increased in two different OX40L-transgenic strains with variations in OX40L overexpression. In the LC-induced MLR, OX40L-deficient and OX40L-overexpressing LC were capable of reducing and elevating the responses of allogeneic CD4+ T cells, respectively. Thus the requirement of OX40L during the antigen presentation function of LC in T cell priming is here demonstrated.     

Expression and function of the OX40/OX40L costimulatory pair during herpes stromal keratitis

Herpes stromal keratitis (HSK) is an immunopathological disease regulated by Th1 CD4 T cells, which require APC and costimulation within the infected cornea to mediate disease. Recent studies suggest the OX40:OX40 ligand (OX40L) interaction enhances effector cell cytokine secretion at inflammatory sites. OX40(+) cells were detected in HSV-1-infected mouse corneas as early as 3 days postinfection (dpi), prior to the onset of HSK, and their frequency increased through 15 dpi, when all mice exhibited severe HSK. OX40L(+) cells were first detected at 7 dpi, coincident with the initiation of HSK. It is interesting that the OX40L(+) cells did not coexpress MHC Class II or the dendritic cell (DC) marker CD11c. Our findings demonstrate rapid infiltration of activated (OX40(+)) CD4(+) T cells into HSV-1-infected corneas and expression of OX40L on MHC Class II-negative cells but surprisingly, not on MHC Class II(+) CD11c(+) DC, which are present in the infected corneas and required for HSK. Moreover, neither local nor systemic treatment of mice with a blocking antibody to OX40L or with a blocking fusion protein altered the course of HSK significantly, possibly as a result of a lack of OX40L expression on functional APC.     

OX40:OX40L axis: emerging targets for improving poxvirus-based CD8(+) T-cell vaccines against respiratory viruses

The human respiratory tract is an entry point for over 200 known viruses that collectively contribute to millions of annual deaths worldwide. Consequently, the World Health Organization has designated respiratory viral infections as a priority for vaccine development. Despite enormous advances in understanding the attributes of a protective mucosal antiviral immune response, current vaccines continue to fail in effectively generating long-lived protective CD8(+) T-cell immunity. To date, the majority of licensed human vaccines afford protection against infectious pathogens through the generation of specific immunoglobulin responses. In recent years, the selective manipulation of specific costimulatory pathways, which are critical in regulating T cell-mediated immune responses, has generated increasing interest. Impressive results in animal models have shown that the tumor necrosis factor receptor (TNFR) family member OX40 (CD134) and its binding partner OX40L (CD252) are key costimulatory molecules involved in the generation of protective CD8(+) T-cell responses at mucosal surfaces, such as the lung. In this review, we highlight these new findings with a particular emphasis on their potential as immunological adjuvants to enhance poxvirus-based CD8(+) T-cell vaccines.     

Science gone translational: the OX40 agonist story

OX40 (CD134) is a tumor necrosis factor (TNF) receptor expressed primarily on activated CD4(+) and CD8(+) T cells and transmits a potent costimulatory signal when engaged. OX40 is transiently expressed after T-cell receptor engagement and is upregulated on the most recently antigen-activated T cells within inflammatory lesions (e.g. sites of autoimmune destruction and on tumor-infiltrating lymphocytes). Hence, it is an attractive target to modulate immune responses: OX40 blocking agents to inhibit undesirable inflammation or OX40 agonists to enhance immune responses. In regards to this review, OX40 agonists enhance anti-tumor immunity, which leads to therapeutic effects in mouse tumor models. A team of laboratory and clinical scientists at the Providence Cancer Center has collaborated to bring the preclinical observations in cancer models from the bench to the bedside. This review describes the journey from in vitro experiments through preclinical mouse models to the successful translation of the first OX40 agonist to the clinic for the treatment of patients with cancer.     

Identification and characterization of a MBP isoform specific to hypothalamus in orange-spotted grouper (Epinephelus coioides)

Myelin basic protein (MBP), as a major component of the myelin sheath, has been revealed to play an important role in forming and maintaining myelin structure in vertebrate nervous system. In teleost, hypothalamus is an instinctive brain center and plays significant roles in many physiological functions, such as energy metabolism, growth, reproduction, and stress response. In comparison with other MBP identified in vertebrates, a smallest MBP is cloned and identified from the orange-spotted grouper hypothalamic cDNA plasmid library in this study. RT-PCR analysis and Western blot detection indicate that the EcMBP is specific to hypothalamus, and expresses mainly in the tuberal hypothalamus in adult grouper. Immunofluorescence localization suggests that EcMBP should be expressed by oligodendrocytes, and the expressing cells should be concentrated in hypothalamus and the area surrounding hypothalamus, such as NPOpc, VC, DP, NLTm, and NDLI. The studies on EcMBP expression pattern and developmental behaviour in the brains of grouper embryos and larvae reveal that the EcMBP-expressing cells are only limited in a defined set of cells on the border of hypothalamus, and suggest that the EcMBP-expressing cells might be a subpopulation of oligodendrocyte progenitor cells. This study not only identifies a smallest MBP isoform specific to hypothalamus that can be used as a molecular marker of oligodendrocytes in fish, but also provides new insights for MBP evolution and cellular distribution.     

OX40: targeted immunotherapy--implications for tempering autoimmunity and enhancing vaccines

OX40 (CD134), a membrane-bound member of the tumor-necrosis-factor-receptor superfamily, is expressed primarily on activated CD4+ T cells. Recently, several groups have reduced clinical signs of autoimmunity in animal models by blocking the OX40-OX40-ligand interaction or depleting OX40+ T cells. By contrast, engagement of OX40 in the setting of active immunization has potent adjuvant properties, leading to enhanced cytokine production and increased numbers of antigen-specific memory T cells. These potent adjuvant effects lead to an enhancement of anti-tumor responses. OX40 has several unique features that make it a clinically relevant target. They include: (1) T cells isolated from a site of inflammation that express OX40 are T cells that have been stimulated recentlythrough the T-cell receptor in vivo; (2) OX40 is only expressed on T cells found at the site of inflammation, therefore, targeting this receptor does not interfere with the peripheral T-cell repertoire; and (3) the biological function of OX40 is limited primarily to effector CD4+ T cells, which are a major source of cytokines to induce and maintain ongoing immune responses.     

胸腺基质淋巴细胞生成素、OX40和OX40受体在过敏性腹泻小鼠大肠黏膜中表达的关系

目的 建立小鼠过敏性腹泻模型,检测其大肠黏膜中胸腺基质淋巴细胞生成素(TSLP)、OX40、OX40受体(OX40L)的表达和肠系膜淋巴结细胞培养上清中IL-4、IFN-γ的水平,分析其之间的关系,探讨TSLP、OX40、OX40L在过敏性腹泻中的作用.方法 雌性BALB/c小鼠20只随机分成两组即对照组和实验组.采用酶联免疫吸附法(ELISA)检测肠系膜淋巴结细胞培养上清中IL-4和IFN-γ的水平,取大肠组织HE染色观察大肠组织病理改变,SP免疫组织化学技术检测TSLP、OX40、OX40L的表达.结果 ①HE染色结果显示:实验组比对照组小鼠结肠黏膜组织非特异性炎症反应显著,上皮排列不规则,有大量炎性细胞浸润,固有层可见大量嗜酸性粒细胞浸润;②TSLP、OX40、OX40L在过敏性腹泻小鼠大肠黏膜中的表达水平高于对照组的表达水平(t=7.07,t =7.81,t =7.79,P均＜0.01);③Spearman等级相关分析发现TSLP、OX40、0X40L三者间表达强度存在正相关(r=0.889,r=0.932,r=0.943,P均＜0.01),同时三者与肠系膜淋巴结细胞培养上清中IL-4水平呈正相关(r=0.891,r =0.936,r=0.886,P均＜0.05),而与IFN-γ水平呈负相关(r=-0.829,r=-0.881,r=-0.937,P均＜0.05).结论 TSLP、OX40、OX40L三者间表达存在正相关,并诱导了Th1/Th2轴向Th2轴漂移,促进了过敏性腹泻的发生发展.     

Costimulatory molecule OX40/OX40L expression in ductal carcinoma in situ and invasive ductal carcinoma of breast: An immunohistochemistry-based pilot study

OX40, a membrane-bound member of the tumor-necrosis-factor-receptor (TNFR) superfamily, plays an important role in proliferation, survival and infiltration of activated T cells via binding to OX40L. Recent studies indicate that OX40/OX40L system mediates the adhesion and infiltration of adult T cell leukemia (ATL). Previously, we detected OX40 expression in breast carcinoma cell lines and tissues. The correlation of expression of OX40 and OX40L and clinical features in breast carcinogenesis, however, has not been well characterized. The expression of OX40 and OX40L in 107 invasive ductal carcinomas (IDCa), 9 ductal carcinomas in situ (DCIS), and 31 fibroadenomas from breast tissues and its relationship with the clinical features were determined using immunohistochemistry (peroxidase-conjugated polymer method, ChemMate™ Envision™ Detection kit). The positive immunostaining rates for OX40 in IDCa, DCIS and fibroadenomas from breast tissues were 85.0%, 66.7% and 38.7% respectively, showing a significant difference in OX40 expression among IDCa, DCIS and fibroadenoma of breast (z = 5.206, P = 0.001). Increased staining intensity of OX40 was associated with TNM stages (z = 2.112, P = 0.017). Meanwhile, a relation of OX40 expression with lymph node metastatic status in IDCa was found (P = 0.041). The expression of OX40L did not show any obvious difference among IDCa, DCIS and fibroadenomas from breast tissues. OX40L expression was also not related to histopathological parameters in IDCa except for progesterone receptor (PR) being positive (P = 0.005). However, a high coincidental positive rate for OX40 and OX40L was observed in biopsy samples with IDCa (P = 0.017, Kappa = 0.231). The present results suggest that high OX40 expression may be associated with malignant transformation, progression, invasion and metastasis in breast cancer biology.     

OX40 (CD134) and OX40 ligand interaction plays an adjuvant role during in vivo Th2 responses

The role of OX40-OX40 ligand (OX40L) interaction in Th cell differentiation remains contentious. In vitro studies have revealed a Th2-biased effect by OX40 signals in T cells. However, in vivo studies demonstrated that OX40-OX40L interaction is involved in responses either Th1 or Th2, or both, which appears to be dependent on the experimental conditions used. We document in our report Th cell differentiation in OX40L-deficient and OX40L-transgenic (Tg) mice in response to protein antigens (Ag) and to Leishmania major (L. major) infection. Upon immunization with protein Ag, we demonstrate the adjuvant effect of OX40 signals during in vivo Th2 responses. However, adjuvant treatment to mice ameliorates the Th2-specific effect of OX40-OX40L interaction and rather induces concurrent promotion of both Th1 and Th2 responses via OX40 signals. Thus, previous reports showing promotion of Th1 response by OX40-OX40L interaction may in actual fact be affected by the adjuvant effects mediated by the various experimental conditions. Indeed, constitutive OX40-OX40L interactions in OX40L-Tg mice converted the normally resistant C57BL/6 strain, into a susceptible status following L. major infection due to an extraordinary elevated Th2 response. These results provide convincing evidence demonstrating that the OX40-OX40L interaction is paramount in the development of Th2 responses in vivo.     

Sandwich immunoassay of small molecules. II. Effects of heterology and development of a highly sensitive and specific enzyme immunoassay for testosterone.

The effect of dimer heterology in the sandwich immunoassay of testosterone was studied using symmetrical and asymmetrical dimers prepared from testosterone-3-(O-carboxymethyl)oxime and 4-(carboxymethyl-mercapto)testosterone. The effect of antibody heterology was studied using antibodies against 3-carboxymethyl oxime and 17-hemisuccinate derivatives of the steroid and an asymmetrical dimer prepared from the same two derivatives. Using antibody against the 3-carboxymethyl oxime and the dimer of 4-(carboxymethylmercapto)testosterone, the sensitivity of direct enzyme immunoassay of testosterone in serum by this method was 0.5 pg/well and the cross-reactivity of 5 alpha-dihydrotestosterone was 5%.     

OX40和OX40L在原发性干燥综合征患者外周血中的表达及临床意义

目的 检测原发性干燥综合征(pSS)患者外周血单个核细胞表面共刺激分子OX40和OX40L的表达,并探讨其临床意义.方法 采用免疫荧光标记流式细胞技术检测51例pSS患者及36例健康志愿者外周血T细胞表面OX40的表达及CD14+单核细胞和CD19+B细胞表面OX40L分子表达,比较11例初诊pSS患者治疗前后OX40和OX40L表达水平变化,分析其临床意义.结果 与健康志愿者相比,pSS患者外周血CD4+T细胞表面OX40表达显著增高(8.65％ ±3.51％ vs 5.68％ ±1.68％,P＜0.01),而CD8+T细胞表面OX40的表达无统计学差异.pSS患者表面OX40L的表达,在外周血中CD14+单核细胞(6.76％±3.60％ vs 3.15％±1.89％,P＜0.01)和CD19+B细胞(4.69％ ±2.40％ vs 2.76％ ±1.33％,P＜0.01)中均高于健康志愿者.活动期的pSS患者外周血OX40和OX40L的表达高于非活动期患者,伴发多系统损伤pSS患者外周血OX40和OX40L分子的表达显著高于单纯外分泌腺损伤患者.治疗后CD4+T细胞表面OX40的表达及CD14+单核细胞和CD19+B细胞表面OX40L的表达显著下降.结论 pSS患者外周血单个核细胞表面OX40和OX40L异常高表达,且与疾病活动度、组织损伤及治疗密切相关.