krn-7000 and Acute-Disease

Regulatory T (Treg) cells play a central role in immune tolerance and prevention of aberrant immune responses. Several studies have suggested that the risk of graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation (HCT) can be ameliorated by increasing Tregs. We have developed an approach of in vivo expansion of Tregs with RGI-2001, a novel liposomal formulation of a synthetic derivative of alpha-galactosylceramide, a naturally occurring ligand that binds to CD1 and activates and expands invariant natural killer cells. In preclinical studies, a single intravenous infusion of RGI-2001 expanded Treg and could ameliorate GVHD in a mouse model of allogeneic HCT. To explore the role of RGI-2001 in clinical HCT, we initiated a phase 2A clinical trial (n = 29), testing 2 different doses of RGI-2001 administered as a single infusion on day 0 of allogeneic HCT. RGI-2001 was well tolerated and without infusion reactions or cytokine release syndrome. A subset of patients (8 of 29, 28%) responded to RGI-2001 by inducing a markedly increased number of cells with a Treg phenotype. The Treg had a high Ki-67 index and were almost exclusively Helios

Topics: Acute Disease; Adult; Aged; Bone Marrow Transplantation; Cell Proliferation; Drug Synergism; Forkhead Transcription Factors; Galactosylceramides; Graft vs Host Disease; Humans; Ikaros Transcription Factor; Middle Aged; Natural Killer T-Cells; Sirolimus; T-Lymphocytes, Regulatory; Transplantation, Homologous; Young Adult

Invariant natural killer T (iNKT) cells are capable of rapid activation and production of cytokines upon recognition of antigenic lipids presented by CD1d molecules. They have been shown to play a significant role in many viral infections and were observed to be highly activated in patients with acute dengue infection. In order to characterize further their role in dengue infection, we investigated the proportion of iNKT cells and their phenotype in adult patients with acute dengue infection. The functionality of iNKT cells in patients was investigated by both interferon (IFN)-γ and interleukin (IL)-4 ex-vivo enzyme-linked immunospot (ELISPOT) assays following stimulation with alpha-galactosyl-ceramide (αGalCer). We found that circulating iNKT cell proportions were significantly higher (P = 0·03) in patients with acute dengue when compared to healthy individuals and were predominantly of the CD4(+) subset. iNKT cells of patients with acute dengue had reduced proportions expressing CD8α and CD161 when compared to healthy individuals. The iNKT cells of patients were highly activated and iNKT activation correlated significantly with dengue virus-specific immunoglobulin (Ig)G antibody levels. iNKT cells expressing Bcl-6 (P = 0·0003) and both Bcl-6 and inducible T cell co-stimulator (ICOS) (P = 0·006) were increased significantly in patients when compared to healthy individuals. Therefore, our data suggest that in acute dengue infection there is an expansion of highly activated CD4(+) iNKT cells, with reduced expression of CD161 markers.

Topics: Acute Disease; Adult; Antibodies, Viral; CD8 Antigens; Dengue; Dengue Virus; Enzyme-Linked Immunospot Assay; Female; Galactosylceramides; Humans; Immunoglobulin G; Inducible T-Cell Co-Stimulator Protein; Interferon-gamma; Interleukin-4; Lymphocyte Activation; Lymphocyte Count; Male; Natural Killer T-Cells; NK Cell Lectin-Like Receptor Subfamily B; Phenotype; Proto-Oncogene Proteins c-bcl-6; Severe Dengue

Acute leukemias with adverse prognostic features carry a high relapse rate without allogeneic stem cell transplantation (allo-SCT). Allo-SCT has a high morbidity and is precluded for many patients because of advanced age or comorbidities. Postremission therapies with reduced toxicities are urgently needed. The murine acute leukemia model C1498 was used to study the efficacy of an intravenously administered vaccine consisting of irradiated leukemia cells loaded with the natural killer T (NKT)-cell agonist α-galactosylceramide (α-GalCer). Prophylactically, the vaccine was highly effective at preventing leukemia development through the downstream activities of activated NKT cells, which were dependent on splenic langerin(+)CD8α(+) dendritic cells and which led to stimulation of antileukemia CD4(+) and CD8(+) T cells. However, hosts with established leukemia received no protective benefit from the vaccine, despite inducing NKT-cell activation. Established leukemia was associated with increases in regulatory T cells and myeloid-derived suppressor cells, and the leukemic cells themselves were highly suppressive in vitro. Although this suppressive environment impaired both effector arms of the immune response, CD4(+) T-cell responses were more severely affected. When cytarabine chemotherapy was administered prior to vaccination, all animals in remission posttherapy were protected against rechallenge with viable leukemia cells.

Topics: Acute Disease; Animals; Antimetabolites, Antineoplastic; Cancer Vaccines; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Combined Modality Therapy; Cytarabine; Dendritic Cells; Galactosylceramides; Green Fluorescent Proteins; Killer Cells, Natural; Leukemia, Myeloid; Mice, Inbred C57BL; Mice, Transgenic; Prognosis; Secondary Prevention; Transplantation, Autologous

Invariant natural killer T cells (iNKT cells) may suppress graft-versus-host disease (GVHD) after allogeneic transplantation. The purpose of this study was to investigate the therapeutic potential of iNKT cells from major histocompatibility complex (MHC)-mismatched donors for preventing GVHD after allogeneic bone marrow transplantation (BMT).. In vitro, mouse iNKT cells were expanded with alpha-galactosylceramide and interleukin (IL)-2 treatment. In the NKT-treated group, lethally irradiated DBA/2(H-2K(d)) mice were adoptively transferred with expanded iNKT, bone marrow (BM), and spleen cells (SCs) from C57BL/6 (H-2K(b)) mice. Recipients in the control group were transferred only BM and SCs. The two groups were compared in survival, weight, histopathologic specimens, and serum cytokine analysis.. In the iNKT-treated group, 80% of mice survived past Day 60 after BMT, but all died within 38 days in the control group. The mice treated with iNKT did not exhibit signs of GVHD after Day 42 except for a change in fur color. There were higher IL-4 levels by Day 7 in serum of mice that received iNKT compared to those without iNKT treatment, while the interferon-gamma levels showed no significant difference between two groups. Levels of IL-2 and IL-5 increased by Day 21 only in iNKT-treated mice.. The results suggest that donor iNKT cells could alleviate GVHD symptoms and prolong survival after MHC-mismatched allogeneic BMT, which may be associated with the maintenance in IL-4 levels. These findings indicate that the therapy based on iNKT cells from MHC-mismatched donors has great potential in protection against GVHD after allogeneic hematopoietic stem cell transplantation.

Topics: Acute Disease; Animals; Bone Marrow Transplantation; Cells, Cultured; Galactosylceramides; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; Graft vs Host Disease; Hair Color; Immunotherapy, Adoptive; Interferon-gamma; Interleukin-2; Interleukin-4; Interleukin-5; Male; Mice; Mice, Inbred C57BL; Mice, Inbred DBA; Natural Killer T-Cells; Radiation Chimera; Spleen; Transplantation, Homologous

Mouse natural killer T cells with an invariant Valpha14-Jalpha18 TCR rearrangement (Valpha14i NKT cells) are able to regulate immune responses through rapid and large amounts of Th1 and Th2 cytokine production. It has been reported that in vivo administration of the Valpha14i NKT cell ligand, alpha-galactosylceramide (alpha-GalCer) significantly reduced morbidity and mortality of acute graft-versus-host disease (GVHD) in mice. In this study, we examined whether adoptive transfer of in vitro-expanded Valpha14i NKT cells using alpha-GalCer and IL-2 could modulate acute GVHD in the transplantation of spleen cells of C57BL/6 mice into (B6xDBA/2) F(1) mice. We found that the adoptive transfer of cultured spleen cells with a combination of alpha-GalCer and IL-2, which contained many Valpha14i NKT cells, modulated acute GVHD by exhibiting long-term mixed chimerism and reducing liver damage. Subsequently, the transfer of Valpha14i NKT cells purified from spleen cells cultured with alpha-GalCer and IL-2 also inhibited acute GVHD. This inhibition of acute GVHD by Valpha14i NKT cells was blocked by anti-IL-4 but not by anti-IFN-gamma monoclonal antibody. Therefore, the inhibition was dependent on IL-4 production by Valpha14i NKT cells. Our findings highlight the therapeutic potential of in vitro-expanded Valpha14i NKT cells for the prevention of acute GVHD after allogeneic hematopoietic stem cell transplantation.

Topics: Acute Disease; Adoptive Transfer; Animals; Antigens, Differentiation, B-Lymphocyte; Cell Separation; Cells, Cultured; Chimerism; Female; Galactosylceramides; Graft vs Host Disease; Histocompatibility Antigens Class II; Interferon-gamma; Interleukin-2; Interleukin-4; Mice; Mice, Inbred C57BL; Spleen; T-Lymphocytes, Regulatory

The protective immune response against Trypanosoma cruzi is improved by treatment with the natural killer (NK) T-cell glycolipid antigen alpha-galactosylceramide (alpha-GalCer). A single alpha-GalCer treatment of mice before T. cruzi infection decreases parasitaemia and prolongs survival. This protection is dependent on CD1d-restricted NKT cells and interferon-gamma (IFN-gamma) suggesting that alpha-GalCer-activated NKT cells produce IFN-gamma, which stimulates the cells of the innate and adaptive immune responses to provide protection. To learn which cells provide protection we investigate here alpha-GalCer treatment of mice deficient in different immune cells. Surprisingly, although NK cells provide protection against T. cruzi, and are a major source of IFN-gamma following alpha-GalCer treatment, NK cells are not required for the alpha-GalCer-induced protection. The alpha-GalCer treatment of NK-cell-depleted mice controlled parasitaemia and prevented death. In contrast, phagocytes, helper T cells and cytotoxic T cells are required. Furthermore, alpha-GalCer treatment of MHC II(-/-) or CD8alpha(-/-) mice exacerbated the infection, demonstrating that alpha-GalCer treatment induces some responses that favour the parasite. In summary alpha-GalCer protection against T. cruzi required multiple cellular responses, but not the response of NK cells. These results provide useful information because alpha-GalCer is being developed as therapy for infections, autoimmune diseases, allergy and cancers.

Topics: Acute Disease; Animals; CD8 Antigens; CD8-Positive T-Lymphocytes; Chagas Disease; Female; Galactosylceramides; Killer Cells, Natural; Lymphocyte Activation; Mice; Mice, Inbred C57BL; Parasitemia; T-Lymphocyte Subsets; Trypanocidal Agents; Weight Loss

We demonstrated in this study the critical role of NKT cells in the lethal ileitis induced in C57BL/6 mice after infection with Toxoplasma gondii. This intestinal inflammation is caused by overproduction of IFN-gamma in the lamina propria. The implication of NKT cells was confirmed by the observation that NKT cell-deficient mice (Jalpha281(-/-)) are more resistant than C57BL/6 mice to the development of lethal ileitis. Jalpha281(-/-) mice failed to overexpress IFN-gamma in the intestine early after infection. This detrimental effect of NKT cells is blocked by treatment with alpha-galactosylceramide, which prevents death in C57BL/6, but not in Jalpha281(-/-), mice. This protective effect is characterized by a shift in cytokine production by NKT cells toward a Th2 profile and correlates with an increased number of mesenteric Foxp3 lymphocytes. Using chimeric mice in which only NKT cells are deficient in the IL-10 gene and mice treated with anti-CD25 mAb, we identified regulatory T cells as the source of the IL-10 required for manifestation of the protective effect of alpha-galactosylceramide treatment. Our results highlight the participation of NKT cells in the parasite clearance by shifting the cytokine profile toward a Th1 pattern and simultaneously to immunopathological manifestation when this Th1 immune response remains uncontrolled.

Topics: Acute Disease; Animals; Female; Galactosylceramides; Ileitis; Interferon-gamma; Interleukin-10; Interleukin-4; Intestinal Mucosa; Killer Cells, Natural; Lymphocyte Activation; Mice; Mice, Inbred C57BL; Mice, Inbred CBA; Mice, Knockout; T-Lymphocyte Subsets; Toxoplasma; Toxoplasmosis, Animal

Pulmonary fibrosis is an end-stage disorder for which efficacious therapeutic options are not readily available. Although its pathogenesis is poorly understood, pulmonary fibrosis occurs as a result of various inflammations. NKT cells modulate inflammation because of their ability to produce large amounts of cytokines by stimulation with their glycolipid ligand. In the present study, we investigated the effects of alpha-galactosylceramide (alpha-GalCer), a selective NKT cell ligand, on the development of bleomycin-induced pulmonary fibrosis. Treatment of mice with alpha-GalCer prolonged their survival under bleomycin administration by attenuating the development of pulmonary fibrosis. The protective effects of alpha-GalCer were associated with an increase in the pulmonary level of IFN-gamma and a decrease in the pulmonary level of fibrogenic cytokines such as TGF-beta and connective tissue growth factor. The initial pulmonary inflammation caused by bleomycin was also attenuated by alpha-GalCer with the reduction of the macrophage inflammatory protein-2 level. The protective effects of alpha-GalCer were markedly reduced in mice lacking NKT cells or as a result of treatment with anti-IFN-gamma Ab. These results suggest that alpha-GalCer suppresses bleomycin-induced acute pulmonary inflammation and thus attenuates the development of pulmonary fibrosis possibly by regulating several cytokine levels.

Topics: Acute Disease; Adjuvants, Immunologic; Animals; Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Monoclonal; Bleomycin; Chemokine CXCL2; Chemokines; Connective Tissue Growth Factor; Disease Models, Animal; Galactosylceramides; Immediate-Early Proteins; Injections, Intraperitoneal; Intercellular Signaling Peptides and Proteins; Interferon-gamma; Intubation, Intratracheal; Killer Cells, Natural; Lung; Mice; Mice, Inbred C57BL; Mice, Knockout; Pulmonary Fibrosis; T-Lymphocyte Subsets