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Biomedical subjects

C Renner

Publications and source records attributed to C Renner.

At least 91 records · Page 5Linked to original sources

Monoclonal antibodies in the treatment of non-Hodgkin's lymphoma: recent results and future prospects.

The availability of monoclonal antibodies with well-defined specificities to lymphoma-associated antigens promises to open new therapeutic opportunities in the treatment of patients with non-Hodgkin's lymphoma. Monoclonal antibodies against lineage-specific surface markers such as CD19, CD20 or CD22 have been generated and employed in native or modified forms in clinical phase I/II trials. Modified versions such as toxin-conjugated antibodies or antibodies with dual specificities (bispecific antibodies) were introduced to enhance the cytotoxicity of monoclonal antibodies since native antibodies were not able to induce long-lasting remissions in patients with advanced disease although responses were seen and side-effects were usually mild. Future efforts should concentrate on patients with minimal residual disease employing genetically engineered antibody fragments.

Antibodies, Monoclonal↗

T cells from patients with Hodgkin's disease have a defective T-cell receptor zeta chain expression that is reversible by T-cell stimulation with CD3 and CD28.

To investigate the mechanisms underlying the deficiency of T lymphocytes from patients with Hodgkin's disease, we investigated the expression of the T-cell receptor (TCR) zeta chain in patients with Hodgkin's disease. By flow cytometry using an anti-zeta chain monoclonal antibody, peripheral blood T lymphocytes from patients with untreated Hodgkin's disease were shown to express decreased levels of the TCR zeta chain. After stimulation by combined CD3 and CD28 cross-linking, T cells from Hodgkin's disease patients upregulated zeta chain protein expression to normal values within 48 hours and achieved a cytolytic potential and levels of interleukin (IL)-2 secretion that were not different from T cells obtained from healthy controls. These results show that downregulation of the TCR zeta chain in Hodgkin's T lymphocytes is a reversible event. Costimulation of CD3 and CD28 is a novel approach for overcoming the T-cell deficiency in Hodgkin's disease and might be exploited clinically. As upregulation of the zeta chain can also be achieved using bispecific monoclonal antibodies (BI-MoAbs) with specificity for tumor antigens and CD3 and CD28, respectively, an immunotherapy with CD3/CD30 and CD28/CD30 Bi-MoAbs may overcome and should therefore, not be jeopardized by the inherent T-cell deficiency in patients with Hodgkin's disease.

Adolescent↗

Cure of disseminated xenografted human Hodgkin's tumors by bispecific monoclonal antibodies and human T cells: the role of human T-cell subsets in a preclinical model.

Cure of a single established human Hodgkin's tumor growing subcutaneously in severe combined immunodeficient (SCID) mice can be achieved with a complex protocol using two bispecific monoclonal antibodies (Bi-MoAb) directed against the Hodgkin's associated CD30 antigen and the T-cell triggering molecules CD3 and CD28, respectively, together with human T cells prestimulated in vitro with Bi-MoAbs in the presence of CD30+ cells. To adapt this model to the clinical situation, disseminated tumors were established in SCID mice by intravenous injection of 2 x 10(7) cells of the Hodgkin's derived cell line L540CY. Treatment of SCID mice bearing disseminated CD30+ Hodgkin's tumors with the combination of CD3/CD30 and CD28/CD30 Bi-MoAbs and naive (ie, not in vitro prestimulated) human T cells resulted in the cure of all appropriately treated animals. T lymphocytes obtained from patients with advanced stage untreated Hodgkin's disease were as effective as lymphocytes from healthy controls. Treatment was effective even when delayed until 2 weeks after tumor inoculation, and application of Bi-MoAbs into SCID mice with circulating human T cells was as effective as injecting the Bi-MoAbs before the lymphocytes. Treatment results with isolated CD4+ and CD8+ human T cells suggest that both subsets are necessary for the Bi-MoAb mediated cure of xenografted human tumors in vivo. The efficacy and practicability of this preclinical immunotherapy protocol support and form the basis for the clinical evaluation of this approach in patients with Hodgkin's disease resistant to standard therapy.

Animals↗

NMR characterization of structure, backbone dynamics, and glutathione binding of the human macrophage migration inhibitory factor (MIF).

Human macrophage migration inhibitory factor is a 114 amino acid protein that belongs to the family of immunologic cytokines. Assignments of 1H, 15N, and 13C resonances have enabled the determination of the secondary structure of the protein, which consists of two alpha-helices (residues 18-31 and 89-72) and a central four-stranded beta-sheet. In the beta-sheet, two parallel beta-sheets are connected in an antiparallel sense. From the total of three cysteines present in the primary structure of MIF, none was found to form disulfide bridges. 1H-15N heteronuclear T1, T2, and steady-state NOE measurements indicate that the backbone of MIF exists in a rigid structure of limited conformational flexibility (on the nanosecond to picosecond time scale). Several residues located in the loop regions and at the N termini of two helices exhibit internal motions on the 1-3 ns time scale. The capacity to bind glutathione was investigated by titration of a uniform 15N-labeled sample and led us to conclude that MIF has, at best, very low affinity for glutathione.

Amino Acid Sequence↗

Pulmonary hypertension in patients with chronic pulmonary thromboembolism: chest radiograph and CT evaluation before and after surgery.

The purpose of this study was to assess the value of morphometric data on conventional radiography and CT predicting the presence and degree of pulmonary hypertension and to assess the reversibility after surgery. On preoperative X-ray films and CT scans of 50 patients with pulmonary hypertension secondary to chronic thromboembolism, we measured the cardiothoracic ratio, basal diameter, length of cardiac contact to sternum, pulmonary trunk, right and left descending pulmonary artery, and the septum angle. These data were correlated with pulmonary arterial pressure. In 14 X-ray patients and 18 CT patients, with follow-up after surgical thromboendarterectomy the reversibility of these changes was assessed. A dilated pulmonary trunk was the most common abnormality (96% each on X-ray and CT). Pulmonary arteries were dilated on X-ray in 40% (right) and 14% (left), and on CT in 92% (right) and 96% (left). The best correlation with mean arterial pressure was found measuring the pulmonary trunk on CT (r = 0.43, p < 0.01). After surgery, reversibility was most significant for the pulmonary trunk on CT (p < 0.0001). In patients with chronic pulmonary embolism, pulmonary hypertension can best be predicted by assessing the diameter of the pulmonary trunk both on X-ray and CT. No close correlation is present between the extent of any parameter and the level of pulmonary pressure.

Adult↗

Interleukin-12 increases bispecific-antibody-mediated natural killer cell cytotoxicity against human tumors.

The combination of CD16/CD30 bispecific monoclonal antibodies (bi-mAb) and unstimulated human resting natural killer (NK) cells can cure about 50% of mice with severe combined immunodeficiency (SCID) bearing subcutaneously growing established Hodgkin's lymphoma. As interleukin-2 (IL-2) and IL-12 have been shown to increase NK cell activity, we tested the capacity of these cytokines to increase bi-mAb-mediated NK cell cytotoxicity against two types of human tumors (Hodgkin's disease and colorectal carcinoma). Unstimulated NK cells needed a three- to five-times higher antibody concentration than cytokine-stimulated NK cells to exert similar levels of bi-mAb-mediated cytotoxicity. The augmented tumor cell lysis was achieved with IL-12 at considerably lower concentrations than with IL-2 and was associated with a significantly increased bi-mAb-mediated intracellular Ca2+ mobilization. The efficiency of IL-12 in this setting together with its low toxicity make it the ideal candidate for a combination therapy with NK-cell-activating bi-mAb in human tumors that are resistant to standard treatment.

Antibodies, Bispecific↗

VEP and ERP abnormalities in children and adolescents with prepubertal onset of insulin-dependent diabetes mellitus.

Visual evoked sensory (VEP) and event-related potentials (ERP) were assessed in 29 adolescents with insulin-dependent diabetes mellitus (IDDM) and in 29 controls matched for age and gender. Data were compared with clinical and psychometric measures, age at onset, duration of disease, and metabolic control. Analysis revealed no latency differences for the first cortical VEP component (P50) but a steadily increasing latency delay for subsequent VEP (N80, P100, N150, P200) and ERP components (P300) in the IDDM group compared to healthy controls. IDDM subjects showed highly significant latency prolongations (p < 0.001) for P100, N150 and P200 and P300 compared with healthy controls. A pathological VEP/ERP latency delay of more than 3 SD above the reference value range was observed in 21 IDDM patients (72.4%). Psychometric outcome measures in IDDM subjects showed no significant performance deficits on the Raven SPMs relative to non-diabetic controls. In contrast to VEP and ERP anomalies, which were highly interrelated, there was no tendency for neurophysiological and psychometric abnormalities to be contemporarily present. Neither electrophysiological nor psychometric measures were correlated with age at onset, IDDM duration, quality of metabolic control, or the presence of peripheral neuropathy. These findings give evidence that 1) higher cognitive functions are frequently affected in adolescents even with prepubertal IDDM onset, 2) neurophysiological ERP analysis seems to detect minor neurocognitive restrictions, presently not affecting psychometric outcome, 3) altered neurophysiological parameters were present in more than 70% of IDDM subjects studied, and 4) functional CNS disturbances affecting neurocognition are apparently not correlated with metabolic parameters previously thought to be important predictors of CNS outcome, suggesting the presence of multifactorial influences affecting neurocognition in IDDM subjects.

Adolescent↗

Treatment of Hodgkin's disease with bispecific antibodies.

Bispecific monoclonal antibodies (Bi-MAbs) with dual specificity for tumor-associated antigens (TAA) and a triggering molecule of an immunologic effector cell, respectively, open the possibility to specifically target to and activate cytotoxic effector cells (macrophages, T-cells, NK cells) at the tumor site. Using appropriately designed Bi-MAbs and unstimulated human NK cells and T-cells, respectively, we were able to cure SCID mice xenografted with human Hodgkin's tumors. This approach was also effective in disseminated tumors and when treatment was delayed until three weeks after the inoculation of the tumor, thus establishing this approach as the most effective model of an immunomodulating therapy of human neoplasms. Early observations with an ongoing phase I/II study with CD16/CD30 Bi-MAb in patients with refractory Hodgkin's disease confirm the expected low toxicity. If these observations can be confirmed in larger clinical studies, effector cell activating Bi-MAbs could become an important weapon in the remaining fight for the conquest of Hodgkin's disease.

Animals↗

The role of lymphocyte subsets and adhesion molecules in T cell-dependent cytotoxicity mediated by CD3 and CD28 bispecific monoclonal antibodies.

The cure of human Hodgkin's tumors heterotransplanted into SCID mice can be achieved by two bispecific monoclonal antibodies (Bi-mAb) directed against the tumor-associated CD30 antigen and CD3 and CD28, respectively, and normal peripheral human blood T cells. We investigated the role of lymphocyte subsets and adhesion molecules in this Bi-mAb-mediated cytolysis. CD4+ lymphocytes were the most rapidly expanding subpopulation, but Bi-mAb-directed cytotoxicity was mediated preferentially by CD8+ lymphocytes and effector cells belonging to the CD45RO+ "memory" pool. Blocking of the LFA-1/ICAM-1 or CD2/LFA-3 adhesion pathways by mAb decreased Bi-mAb-mediated cytotoxicity. This was not due to inhibition of aggregate formation between Bi-mAb-coated T lymphocytes and target cells. Cross-linking of LFA-1 or CD2 molecules on lymphocytes prestimulated with Bi-mAb bound to CD3 and CD28 antigen lead to a more pronounced and prolonged rise in the intracellular concentration of free Ca2+. Additional CD2 cross-linking resulted in the tyrosine phosphorylation of distinct proteins. These findings indicate that adhesion molecules play a critical role and function as co-stimulatory signals rather than as cellular contact mediators in CD3 and CD28 Bi-mAb-stimulated T lymphocytes.

Antibodies, Bispecific↗

Sodium citrate supplementation in inborn argininosuccinate lyase deficiency: a study in a 5-year-old patient under total parenteral nutrition.

The effects of sodium citrate supplementation to improve aspartic acid supply in a 5-year-old girl with argininosuccinate lyase deficiency were studied over a period of 5 years under constant and total parenteral nutrition. Daily increasing doses of sodium citrate (0-8 mmol/kg) were continuously infused i.v.. Her standard therapy with arginine hydrochloride (4 mmol/kg/day) and sodium benzoate (200 mg/kg/day) was continued. Serum citrulline concentrations were reduced by citrate supplementation (161.8-41.7 mumol/l). Correspondingly serum concentrations of argininosuccinate and its anhydrides rose (270-458 mumol/l), positively correlated with the doses of sodium citrate. Renal elimination of argininosuccinate did not change measurably. There was no improvement in plasma ammonia concentration, which remained between 88 and 136 mumol/l. A long-standing hepatomegaly did not improve. The patient developed a significant alkalosis with blood pH-values increasing up to 7.55. The alkalosis lead to a reduction in renal ammonium elimination by at least 5.3 mmol/kg per day; the portion of ammonium-nitrogen decreased from 54.2% to finally 9% of total urinary nitrogen. Nevertheless total urinary nitrogen elimination, as measured by pyrochemiluminescence, improved by 24.5% during the 5 days and rose from 2065 mg nitrogen/day to 2570 mg/day. This improvement could not be explained by the metabolites determined and corresponded with an increase in chemically undefined nitrogen excretion, which rose from 0% to 65.9% of total urinary nitrogen. Further investigations are necessary to elucidate the nature of these unexplained nitrogen-containing compounds. CONCLUSION. Sodium citrate supplementation improved renal nitrogen elimination in a patient with argininosuccinate lyase deficiency in the observation period of 5 days by up to 24.5%.

Alkalosis↗

Treatment of heterotransplanted Hodgkin's tumors in SCID mice by a combination of human NK or T cells and bispecific antibodies.

To test the feasibility and efficacy of a new immunotherapeutic approach in Hodgkin's disease, bispecific monoclonal antibodies (BsmAb) were established with specificity for the Hodgkin's-associated CD30 antigen and for CD16 (on NK cells) or CD3 and CD28 (on T lymphocytes), respectively. These BsmAb induced a specific and efficient NK cell or T cell-mediated cytotoxicity in vitro. The treatment of severe combined immunodeficiency (SCID) mice with the NK (anti-CD16/CD30) or T cell (anti-CD3/CD30 and anti-CD28/CD30) activating BsmAb followed by administration of resting human lymphocytes led to complete remission of established heterotransplanted human Hodgkin's tumors. Even disseminated tumors were cured. Studies on the mechanism responsible for tumor destruction revealed that treatment efficacy depended on lymphocyte activation at the tumor site. Localization of human lymphocytes in mice was BsmAb mediated and antigen specific as activated lymphocytes were only detected in CD30+ tumors but not in CD30- colorectal carcinomas co-established as a control in the same animal.

Animals↗

Tumor therapy by immune recruitment with bispecific antibodies.

Many strategies for experimental immunotherapy of cancers aim at inducing and expanding tumor-specific cytotoxic T-lymphocytes. One of the most promising approaches uses bispecific monoclonal antibodies (Bi-MAbs) which are able to accumulate and activate human effector cells at the tumor site. Human resting peripheral NK- or T cells targeted by appropriate Bi-MAbs to tumor cells expressing a tumor-associated antigen display multiple signs of activation including proliferation, cytokine secretion, upregulation of cytotoxic peptides and enzymes and induce an efficient tumor cell lysis in vivo. Moreover, tumor-bearing SCID which were treated by effector cell-triggering Bi-MAbs and human peripheral blood lymphocytes had complete regressions of established tumors and most or all animals were cured by human NK-cell or T-cell cytotoxicity, respectively. Local tumor site-specific activation of T-cells was demonstrated, and enhanced granzyme and perforin expression together with the results of inhibition experiments suggest both mechanisms as the major contributors to the cytolytic machinery of Bi-MAb-mediated T-cell cytotoxicity in vivo. The encouraging results of this approach, which is able to cure animals with even advanced disseminated tumors, together with the local site-specific effector cell activation, which suggests minimal side effects, warrant the clinical evaluation of this Bi-MAb approach. As lymphocytes from tumor patients can be adequately activated by the respective Bi-MAbs, the clinical application of Bi-MAbs promises to become a safe, efficient and simple approach which should be readily applicable to the treatment of human malignancies that cannot be cured by standard regimens.

Antibodies, Bispecific↗

Cure of xenografted human tumors by bispecific monoclonal antibodies and human T cells.

Tumor immunotherapy should increase both the number of T cells that kill the tumor and the likelihood that those cells are activated at the tumor site. Bispecific monoclonal antibodies (Bi-mAbs) were designed that bound to a Hodgkin's tumor-associated antigen (CD30) on the tumor and to either CD3 or CD28 on the T cell. Immunodeficient mice were cured of established human tumors when mice were treated with both the CD3-CD30 and the CD28-CD30 Bi-mAbs and then given human peripheral blood lymphocytes that had been incubated with the CD3-CD30 Bi-mAb and cells that expressed CD30. The enrichment of human T cells within the tumor and the fact that established tumors can be cured may indicate in situ activation of both the T cell receptor and the costimulatory pathway.

Animals↗

Opposite effects of the CD30 ligand are not due to CD30 mutations: results from cDNA cloning and sequence comparison of the CD30 antigen from different sources.

CD30L, the ligand for the activation antigen CD30, is a member of the tumor necrosis factor family of cytokines. Binding of CD30L to CD30, which is a member of the nerve growth factor/tumor necrosis factor receptor family, induces proliferation in peripheral blood lymphocytes and Hodgkin's derived cell lines with a T-cell phenotype such as HDLM-2 and L540, while cell lines derived from anaplastic large cell lymphomas, such as Karpas 299, undergo cell death. In order to investigate whether mutations of the CD30 antigen are responsible for these opposite effects, we cloned the open reading frame of CD30 cDNAs from the cell lines L540 and Karpas 299 and from peripheral blood lymphocytes by reverse transcriptase polymerase chain reaction. Sequencing of independent plasmid clones revealed that these cells have a silent transition (A-->G) at position 771 of the open reading frame compared to the published sequence derived from the HTLV-1+ cell line HUT-102. As published data have shown that crosslinking of CD30 induces an elevation of cytosolic free calcium ([Ca2+]i) in TCR positive Jurkat cells, we have analysed the effect of crosslinking of CD30 on L540 and Karpas 299 cells. No elevations of [Ca2+]i have been observed in these cell lines after crosslinking of CD30 with HRS-4. We conclude (i) that the different functional effects of CD30 in PBL, L540 and Karpas 299 are not due to differences in the primary structure of the receptor; and (ii) that the different responses observed upon engagement with CD30L for the cell lines L540 and Karpas 299 do not correlate with differences in mobilization of [Ca2+]i after crosslinking of CD30.

Base Sequence↗