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1.
Mol Ther ; 31(10): 2914-2928, 2023 Oct 04.
Article in English | MEDLINE | ID: mdl-37641405

ABSTRACT

Fibroblast activation protein (FAP) is a cell surface serine protease that is highly expressed on reactive stromal fibroblasts, such as cancer-associated fibroblasts (CAFs), and generally absent in healthy adult tissues. FAP expression in the tumor stroma has been detected in more than 90% of all carcinomas, rendering CAFs excellent target cells for a tumor site-specific adenoviral delivery of cancer therapeutics. Here, we present a tropism-modified human adenovirus 5 (Ad5) vector that targets FAP through trivalent, designed ankyrin repeat protein-based retargeting adapters. We describe the development and validation of these adapters via cell-based screening assays and demonstrate adapter-mediated Ad5 retargeting to FAP+ fibroblasts in vitro and in vivo. We further show efficient in vivo delivery and in situ production of a therapeutic payload by CAFs in the tumor microenvironment (TME), resulting in attenuated tumor growth. We thus propose using our FAP-Ad5 vector to convert CAFs into a "biofactory," secreting encoded cancer therapeutics into the TME to enable a safe and effective cancer treatment.

2.
Mol Ther Methods Clin Dev ; 29: 120-132, 2023 Jun 08.
Article in English | MEDLINE | ID: mdl-37007608

ABSTRACT

Clinical success in T cell therapy has stimulated widespread efforts to increase safety and potency and to extend this technology to solid tumors. Yet progress in cell therapy remains restricted by the limited payload capacity, specificity of target cell transduction, and transgenic gene expression efficiency of applied viral vectors. This renders complex reprogramming or direct in vivo applications difficult. Here, we developed a synergistic combination of trimeric adapter constructs enabling T cell-directed transduction by the human adenoviral vector serotype C5 in vitro and in vivo. Rationally chosen binding partners showed receptor-specific transduction of otherwise non-susceptible human T cells by exploiting activation stimuli. This platform remains compatible with high-capacity vectors for up to 37 kb DNA delivery, increasing payload capacity and safety because of the removal of all viral genes. Together, these findings provide a tool for targeted delivery of large payloads in T cells as a potential avenue to overcome current limitations of T cell therapy.

3.
Sci Transl Med ; 14(653): eabm9043, 2022 07 13.
Article in English | MEDLINE | ID: mdl-35857639

ABSTRACT

T cell-directed cancer immunotherapy often fails to generate lasting tumor control. Harnessing additional effectors of the immune response against tumors may strengthen the clinical benefit of immunotherapies. Here, we demonstrate that therapeutic targeting of the interferon-γ (IFN-γ)-interleukin-12 (IL-12) pathway relies on the ability of a population of natural killer (NK) cells with tissue-resident traits to orchestrate an antitumor microenvironment. In particular, we used an engineered adenoviral platform as a tool for intratumoral IL-12 immunotherapy (AdV5-IL-12) to generate adaptive antitumor immunity. Mechanistically, we demonstrate that AdV5-IL-12 is capable of inducing the expression of CC-chemokine ligand 5 (CCL5) in CD49a+ NK cells both in tumor mouse models and tumor specimens from patients with cancer. AdV5-IL-12 imposed CCL5-induced type I conventional dendritic cell (cDC1) infiltration and thus increased DC-CD8 T cell interactions. A similar observation was made for other IFN-γ-inducing therapies such as Programmed cell death 1 (PD-1) blockade. Conversely, failure to respond to IL-12 and PD-1 blockade in tumor models with low CD49a+ CXCR6+ NK cell infiltration could be overcome by intratumoral delivery of CCL5. Thus, therapeutic efficacy depends on the abundance of NK cells with tissue-resident traits and, specifically, their capacity to produce the DC chemoattractant CCL5. Our findings reveal a barrier for T cell-focused therapies and offer mechanistic insights into how T cell-NK cell-DC cross-talk can be enhanced to promote antitumor immunity and overcome resistance.


Subject(s)
Integrin alpha1 , Neoplasms , Animals , Dendritic Cells , Immunotherapy , Integrin alpha1/metabolism , Interleukin-12/metabolism , Killer Cells, Natural , Mice , Neoplasms/pathology , Programmed Cell Death 1 Receptor/metabolism , Tumor Microenvironment
4.
Skin Health Dis ; 2(1): e70, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35665207

ABSTRACT

Background: Bullous pemphigoid (BP) is the most frequent autoimmune blistering disease of the skin affecting the elderly. BP is immunopathologically characterized by autoantibodies against BP180 and BP230. With the growing evidence of cell-mediated autoimmunity in the pathogenesis of BP, it still remains unclear whether mast cells (MCs) are involved, due to conflicting data obtained from Kit-dependent MC-deficient mouse models. Objectives: To clarify the role of MCs in experimental BP; the dynamics in cutaneous MC numbers, associated immune cells and the development of disease in Kit-independent MC-deficient mouse model. Methods: Employing a recently established murine adult passive transfer model of BP induced by the transfer of pathogenic immunoglobulin G (IgG), lesional skin biopsies were investigated histologically and immunohistochemically for the time-dependent MC accumulation and dermal infiltration. Results: The numbers of cutaneous MCs increased following the induction of BP, in part, maintained by MC proliferation. Numbers of T cells, neutrophils and eosinophils in the skin also increased after BP induction, with eosinophils showing a preferential co-localization with MCs. Furthermore, clinical disease manifestation in MC-deficient Mcpt5Cre/Dicer fl/fl mice remained unchanged compared to MC-sufficient Dicer fl/fl mice. The composition of the immune cell infiltration including as T cells, neutrophils and eosinophils was largely unaffected by the absence of MCs. Conclusion: MCs do not play a pivotal role in the pathogenesis of passive IgG-transfer mediated BP model. Their increase in number may be a bystander effect following tissue injury. We therefore suggest caution regarding the selection of MCs as sole targets for the development of novel drugs for BP.

7.
J Neural Eng ; 19(3)2022 05 09.
Article in English | MEDLINE | ID: mdl-35421857

ABSTRACT

Objective.Functional specialization is fundamental to neural information processing. Here, we study whether and how functional specialization emerges in artificial deep convolutional neural networks (CNNs) during a brain-computer interfacing (BCI) task.Approach.We trained CNNs to predict hand movement speed from intracranial electroencephalography (iEEG) and delineated how units across the different CNN hidden layers learned to represent the iEEG signal.Main results.We show that distinct, functionally interpretable neural populations emerged as a result of the training process. While some units became sensitive to either iEEG amplitude or phase, others showed bimodal behavior with significant sensitivity to both features. Pruning of highly sensitive units resulted in a steep drop of decoding accuracy not observed for pruning of less sensitive units, highlighting the functional relevance of the amplitude- and phase-specialized populations.Significance.We anticipate that emergent functional specialization as uncovered here will become a key concept in research towards interpretable deep learning for neuroscience and BCI applications.


Subject(s)
Brain-Computer Interfaces , Algorithms , Brain , Electroencephalography/methods , Neural Networks, Computer
8.
Front Cell Dev Biol ; 10: 1036917, 2022.
Article in English | MEDLINE | ID: mdl-36619863

ABSTRACT

Introduction: Ovarian follicle development requires tight coordination between several factors to initiate folliculogenesis to generate a mature and fertile egg. Studies have shown that cell cycle factors might contribute to follicle development, hover specific knowledge on individual CDKs and follicle activation has not been investigated. Among cell cycle regulators, CDK6 is a key player through binding to cyclin D resulting DNA synthesis and genome duplication. Interestingly, the CDK6 gene is differentially expressed in oocytes and granulosa cells from human primordial and primary follicles, which suggest a potential role of CDK6 in the primordial-to-primary transition. In this study, we investigated the potential regulatory role of CDK6 in progression of primordial to primary follicle transition using BSJ-03-123 (BSJ), a CDK6-specific degrader. Methods: In mouse ovarian in vitro culture, BSJ reduced the activation of primordial follicles, and reduced follicle development. As a next step, we examined the egg maturation read-out and found that BSJ-treated follicles matured to competent MII eggs with resumption of first meiosis, comparable with the control group. Results: Noteworthy, it appears that inhibition of CDK6 did increase number of apotoptic cells, articular in the granulosa cells, but had no impact on ROS level of cultured ovaries compared to control group, indicating that the cells were not stressed. Oocyte quality thus appeared safe. Discussion: The results of this study indicate that CDK6 plays a role in the primordial-to-primary transition, suggesting that cell cycle regulation is an essential part of ovarian follicle development.

11.
Emerg Microbes Infect ; 10(1): 2313-2325, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34792436

ABSTRACT

Lassa virus (LASV), a Risk Group-4 zoonotic haemorrhagic fever virus, affects sub-Saharan African countries. Lassa fever, caused by LASV, results in thousands of annual deaths. Although decades have elapsed since the identification of the Natal multimammate mouse (Mastomys natalensis) as a natural reservoir of LASV, little effort has been made to characterize LASV infection in its reservoir. The natural route of infection and transmission of LASV within M. natalensis remains unknown, and the clinical impact of LASV in M. natalensis is mostly undescribed. Herein, using an outbred colony of M. natalensis, we investigate the replication and dissemination dynamics of LASV in this reservoir following various inoculation routes. Inoculation with LASV, regardless of route, resulted in a systemic infection and accumulation of abundant LASV-RNA in many tissues. LASV infection in the Natal multimammate mice was subclinical, however, clinical chemistry values were transiently altered and immune infiltrates were observed histologically in lungs, spleens and livers, indicating a minor disease with coordinated immune responses are elicited, controlling infection. Intranasal infection resulted in unique virus tissue dissemination dynamics and heightened LASV shedding, compared to subcutaneous inoculation. Our study provides important insights into LASV infection in its natural reservoir using a contemporary infection system, demonstrating that specific inoculation routes result in disparate dissemination outcomes, suggesting intranasal inoculation is important in the maintenance of LASV in the natural reservoir, and emphasizes that selection of the appropriate inoculation route is necessary to examine aspects of viral replication, transmission and responses to zoonotic viruses in their natural reservoirs.


Subject(s)
Disease Reservoirs/veterinary , Lassa Fever/veterinary , Lassa virus/physiology , Murinae/virology , Rodent Diseases/virology , Viral Zoonoses/virology , Virus Shedding , Animals , Disease Reservoirs/virology , Female , Humans , Lassa Fever/transmission , Lassa Fever/virology , Lassa virus/genetics , Male , Murinae/physiology , Rodent Diseases/transmission , Viral Zoonoses/transmission
12.
Int J Legal Med ; 135(6): 2625-2635, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34570269

ABSTRACT

Estimating the age of the developmental stages of the blow fly Calliphora vicina (Diptera: Calliphoridae) is of forensic relevance for the determination of the minimum post-mortem interval (PMImin). Fly eggs and larvae can be aged using anatomical and morphological characters and their modification during development. However, such methods can only hardly be applied for aging fly pupae. Previous study described age estimation of C. vicina pupae using gene expression, but just when reared at constant temperatures, but fluctuating temperatures represent a more realistic scenario at a crime scene. Therefore, age-dependent gene expression of C. vicina pupae were compared at 3 fluctuating and 3 constant temperatures, the latter representing the mean values of the fluctuating profiles. The chosen marker genes showed uniform expression patterns during metamorphosis of C. vicina pupae bred at different temperature conditions (constant or fluctuating) but the same mean temperature (e.g. constant 10 °C vs. fluctuating 5-15 °C). We present an R-based statistical tool, which enables estimation of the age of the examined pupa based on the analysed gene expression data.


Subject(s)
Calliphoridae/growth & development , Calliphoridae/genetics , Gene Expression , Metamorphosis, Biological , Pupa/growth & development , Pupa/genetics , Temperature , Animals , Forensic Entomology , Gene Expression Profiling
13.
Vet J ; 276: 105740, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34416401

ABSTRACT

Trilostane is the recommended medical treatment for dogs with hyperadrenocorticicm (HAC). The objective of this study was to investigate the association between ACTH stimulation test (ACTHST) results, and relevant clinical signs, in dogs treated with trilostane. A disease-specific questionnaire was developed, which included the owner's assessment of polydipsia, polyuria, polyphagia, panting, and satisfaction with the treatment, based on a 5-response category rating scale. Forty-nine dogs with HAC were prospectively enrolled. Dogs were grouped according to their recheck appointment (first recheck, 710 days after commencement of treatment or change of trilostane dose; second recheck, 4 weeks after the first recheck; third recheck, performed at 3-6 months intervals once the dog was well controlled). At the recheck appointment, the owner's questionnaire responses were recorded, and an ACTHST was performed, along with urine specific gravity measurement. Linear mixed effects models were used to assess differences among the three recheck time points and to test possible associations between ACTHST results and clinical signs. Significant differences between rechecks were present for stimulated cortisol (first to third recheck, P < 0.001; second to third recheck, P < 0.01), polydipsia (first to second recheck, P = 0.001), polyuria (first to second recheck, P < 0.001; first to third recheck, P = 0.001), and owner satisfaction (first to second recheck, P < 0.001; first to third recheck, P < 0.001). Backward stepwise variable elimination did not identify any significant associations between ACTHST results and clinical signs. Therefore, clinical signs of HAC were not predicted based on the ACTHST results.


Subject(s)
Adrenocortical Hyperfunction , Dog Diseases , Adrenocortical Hyperfunction/diagnosis , Adrenocortical Hyperfunction/drug therapy , Adrenocortical Hyperfunction/veterinary , Adrenocorticotropic Hormone , Animals , Dihydrotestosterone/analogs & derivatives , Dog Diseases/diagnosis , Dog Diseases/drug therapy , Dogs
15.
Neuroimage ; 238: 118251, 2021 09.
Article in English | MEDLINE | ID: mdl-34116147

ABSTRACT

Evidence from language, visual and sensorimotor learning suggests that training early in life is more effective. The present work explores the hypothesis that learning during sensitive periods involves distinct brain networks in addition to those involved when learning later in life. Expert pianists were tested who started their musical training early (<7 years of age; n = 21) or late (n = 15), but were matched for total lifetime practice. Motor timing expertise was assessed using a musical scale playing task. Brain activity at rest was measured using fMRI and compared with a control group of nonmusicians (n = 17). Functional connectivity from seeds in the striatum revealed a striatal-cortical-sensorimotor network that was observed only in the early-onset group. In this network, higher connectivity correlated with greater motor timing expertise, which resulted from early/late group differences in motor timing expertise. By contrast, networks that differentiated musicians and nonmusicians, namely a striatal-occipital-frontal-cerebellar network in which connectivity was higher in musicians, tended to not show differences between early and late musicians and not be correlated with motor timing expertise. These results parcel musical sensorimotor neuroplasticity into a set of musicianship-related networks and a distinct set of predominantly early-onset networks. The findings lend support to the possibility that we can learn skills more easily early in development because during sensitive periods we recruit distinct brain networks that are no longer implicated in learning later in life.


Subject(s)
Corpus Striatum/diagnostic imaging , Learning/physiology , Nerve Net/diagnostic imaging , Neuronal Plasticity/physiology , Adult , Age Factors , Brain Mapping , Female , Humans , Magnetic Resonance Imaging , Male , Music , Young Adult
16.
Vet J ; 273: 105693, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34148608

ABSTRACT

Pre-vaccination antibody testing to determine dogs' immunity against canine distemper virus (CDV) is increasingly used. Four point-of-care tests (POC A-D) are available in Europe, but their diagnostic accuracy has not been compared. The study evaluated the diagnostic accuracy and usability of these tests. Sera of client-owned dogs (n = 198; healthy n = 22; unhealthy dogs n = 176) and specific pathogen-free (SPF) dogs (n = 40) were included. Virus neutralisation (VN) was performed as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy (OA) were determined. McNemar's test was used to determine significant differences between specificity and sensitivity of the tests and Cohen's kappa was used to assess agreement. The prevalence of anti-CDV antibodies by VN was 80% in client-owned dogs overall, with 100% prevalence in healthy dogs, and 0% in SPF dogs. POC-C and POC-D were considered easiest to perform. Specificity of all tests was high using sera from SPF dogs (88-100%). In healthy dogs, sensitivity was variable (45-98%). Specificity was low in all four POC tests when using sera from acutely ill dogs (6-53%) and clinically healthy dogs with chronic disease (5-77%). In client-owned dogs, including healthy and unhealthy dogs, agreement was poor between tests. All POC tests had a low specificity when investigating sera from ill client-owned dogs and usefullness of these tests especially in dogs that are acutely ill or have chronic disease is not supported by this study.


Subject(s)
Antibodies, Viral/immunology , Dog Diseases/diagnosis , Point-of-Care Testing , Animals , Antibodies, Viral/blood , Distemper/immunology , Distemper Virus, Canine , Dog Diseases/immunology , Dogs , Female , Male , Predictive Value of Tests , Reagent Kits, Diagnostic/veterinary , Reagent Kits, Diagnostic/virology , Sensitivity and Specificity , Specific Pathogen-Free Organisms
17.
J Eur Acad Dermatol Venereol ; 35(2): 486-492, 2021 Feb.
Article in English | MEDLINE | ID: mdl-32596926

ABSTRACT

BACKGROUND: Bullous pemphigoid (BP) and pemphigus vulgaris (PV) are common autoimmune bullous dermatoses (AIBD) characterized by blisters and erosions. Treatment options are limited and often insufficient. Immune checkpoint receptors play critical roles in immune homoeostasis and self- tolerance. Targeting checkpoint receptors is highly efficient in treatment of various cancers, but often also associated with autoimmune side effects. OBJECTIVES: We therefore aimed to investigate the expression of immune checkpoint receptors in patients with BP and PV. METHODS: We analysed expression of the checkpoint receptors programmed cell death protein 1 (PD-1), T-cell immunoglobulin and mucin domain 3 (Tim-3) and lymphocyte activation gene 3 (Lag-3) in lesional skin of patients with BP and PV compared to healthy control skin as well as the expression patterns of PD-1 and Tim-3 on various infiltrating immune cells in skin sections of AIBD by immunohistochemistry and immunofluorescence. We also measured serum levels of soluble PD-1, Tim-3 and Lag-3 in AIBD patients by ELISA. RESULTS: We report on increased expression of PD-1 and Tim-3, but not Lag-3, in lesional skin of patients with BP and PV. Investigating the expression pattern of PD-1 and Tim-3 on different cutaneous immune cells, we observed significant upregulation of PD-1 predominantly on infiltrating CD8 T cells and upregulation of Tim-3 on CD8 T cells as well as macrophages. CONCLUSIONS: Our results suggest exploring immune checkpoint receptors as novel therapeutic targets using an agonistic approach in autoimmune bullous diseases.


Subject(s)
Autoimmune Diseases , Hepatitis A Virus Cellular Receptor 2 , Pemphigoid, Bullous , Pemphigus , Programmed Cell Death 1 Receptor , Humans
18.
Sci Rep ; 10(1): 14180, 2020 08 25.
Article in English | MEDLINE | ID: mdl-32843655

ABSTRACT

Na+/K+-ATPase is a transmembrane ion pump that is essential for the maintenance of ion gradients and regulation of multiple cellular functions. Na+/K+-ATPase has been associated with nuclear factor kappa B (NFκB) signalling, a signal associated with lipopolysaccharides (LPSs)-induced immune response in connection with activated Toll-like receptor 4 (TLR4) signalling. However, the contribution of Na+/K+-ATPase to regulating inflammatory responses remains elusive. We report that mice haploinsufficient for the astrocyte-enriched α2Na+/K+-ATPase isoform (α2+/G301R mice) have a reduced proinflammatory response to LPS, accompanied by a reduced hypothermic reaction compared to wild type litter mates. Following intraperitoneal injection of LPS, gene expressions of Tnf-α, Il-1ß, and Il-6 was reduced in the hypothalamus and hippocampus from α2+/G301R mice compared to α2+/+ littermates. The α2+/G301R mice experienced increased expression of the gene encoding an antioxidant enzyme, NRF2, in hippocampal astrocytes. Our findings indicate that α2Na+/K+-ATPase haploinsufficiency negatively modulates LPS-induced immune responses, highlighting a rational pharmacological target for reducing LPS-induced inflammation.


Subject(s)
Hippocampus/pathology , Hypothalamus/pathology , Lipopolysaccharides/toxicity , Migraine with Aura/enzymology , Sodium-Potassium-Exchanging ATPase/physiology , Animals , Astrocytes/metabolism , Cells, Cultured , Female , Gene Expression Regulation/drug effects , Gene Knock-In Techniques , Heterozygote , Hippocampus/metabolism , Hypothalamus/metabolism , Hypothermia/chemically induced , Hypothermia/enzymology , Hypothermia/genetics , Interleukin-1beta/biosynthesis , Interleukin-1beta/blood , Interleukin-1beta/genetics , Interleukin-6/biosynthesis , Interleukin-6/blood , Interleukin-6/genetics , Macrophages/enzymology , Mice , Mice, Inbred C57BL , Migraine with Aura/genetics , Mutation, Missense , NF-E2-Related Factor 2/biosynthesis , NF-E2-Related Factor 2/genetics , Sodium-Potassium-Exchanging ATPase/deficiency , Sodium-Potassium-Exchanging ATPase/genetics , Tumor Necrosis Factor-alpha/biosynthesis , Tumor Necrosis Factor-alpha/blood , Tumor Necrosis Factor-alpha/genetics
19.
BMC Vet Res ; 16(1): 285, 2020 Aug 12.
Article in English | MEDLINE | ID: mdl-32787842

ABSTRACT

BACKGROUND: An increased risk for glomerulonephritis and a higher prevalence of antibodies to Borrelia (B.) burgdorferi sensu lato have been reported in Bernese mountain dogs (BMDs). The aim of the study was to determine the prevalence of laboratory abnormalities suggestive of kidney disease in clinically healthy BMDs compared to a control population and to investigate if there is a correlation with the occurrence of antibodies to B. burgdorferi sensu lato, Ehrlichia canis, and Anaplasma (A.) spp. and with the occurrence of Dirofilaria (D.) immitis antigen. A total of 197 BMDs and 57 control dogs were included in the study. Laboratory evidence of kidney disease was defined as renal azotemia and/or proteinuria with a urine protein creatinine ration of more than 0.5 in an inactive urine sediment. A SNAP®4Dx® ELISA (IDEXX, Laboratories, Inc., Westbrook, ME, USA) was used to detect antibodies to B. burgdorferi sensu lato, E. canis and Anaplasma spp. and antigen of D. immitis. RESULTS: Laboratory evidence of kidney disease was significantly more common in BMDs than in control dogs (17.8% versus 1.8%) (p = 0.005). The proportion of BMDs with anti-B. burgdorferi sensu latu antibodies and anti-A. phagocytophilum antibodies was significantly higher in BMDs (p <  0.001). However, an association between these findings could not be identified. CONCLUSION: BMDs are more often affected by kidney disease and have a higher prevalence of antibodies to bacterial pathogens transmitted by Ixodes ticks than control dogs. However, a causal relationship between these two variables could not be established due to a lack of association between these two findings.


Subject(s)
Azotemia/veterinary , Dog Diseases/epidemiology , Proteinuria/veterinary , Tick-Borne Diseases/veterinary , Anaplasma/immunology , Animals , Antibodies, Bacterial/blood , Antigens, Helminth/blood , Asymptomatic Infections , Borrelia burgdorferi/immunology , Dirofilaria immitis/immunology , Dog Diseases/microbiology , Dog Diseases/parasitology , Dogs , Ehrlichia canis/immunology , Female , Genetic Predisposition to Disease , Male , Tick-Borne Diseases/epidemiology , Tick-Borne Diseases/immunology
20.
Clin Transl Allergy ; 10: 32, 2020.
Article in English | MEDLINE | ID: mdl-32695309

ABSTRACT

Elevated serum IgE levels are associated with allergic disorders, parasitosis and specific immunologic abnormalities. In addition, epidemiological and mechanistic evidence indicates an association between IgE-mediated immune surveillance and protection from tumour growth. Intriguingly, recent studies reveal a correlation between IgE deficiency and increased malignancy risk. This is the first review discussing IgE levels and links to pathological conditions, with special focus on the potential clinical significance of ultra-low serum IgE levels and risk of malignancy. In this Position Paper we discuss: (a) the utility of measuring total IgE levels in the management of allergies, parasitosis, and immunodeficiencies, (b) factors that may influence serum IgE levels, (c) IgE as a marker of different disorders, and d) the relationship between ultra-low IgE levels and malignancy susceptibility. While elevated serum IgE is generally associated with allergic/atopic conditions, very low or absent IgE may hamper anti-tumour surveillance, indicating the importance of a balanced IgE-mediated immune function. Ultra-low IgE may prove to be an unexpected biomarker for cancer risk. Nevertheless, given the early stage of investigations conducted mostly in patients with diseases that influence IgE levels, in-depth mechanistic studies and stratification of malignancy risk based on associated demographic, immunological and clinical co-factors are warranted.

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