Reversing the Inflammatory Process-25 Years of Tumor Necrosis Factor-α Inhibitors.

Immune-mediated inflammatory diseases, such as rheumatoid arthritis, psoriatic arthritis, peripheral and/or axial spondyloarthritis, Crohn's disease, and ulcerative colitis, are characterized by molecular and cellular changes in the immune system. Due to the systemic nature of these diseases, organs such as the liver or cardiovascular system are often affected by the inflammatory process. Tumor necrosis factor-α inhibitor therapy reduces the activation of pro-inflammatory signaling cascades, mitigates the chronic inflammatory process by restoring cellular balance, and alleviates clinical consequences, such as pain and tissue damage.

Real-world use and acceptance of rituximab biosimilars in non-Hodgkin lymphoma in an oncologist network in Germany.

Aim: Present real-world data for rituximab (biosimilar and reference)-containing regimens in extrapolated indications in non-Hodgkin lymphoma (NHL)/chronic lymphocytic leukemia (CLL). Patients & methods: Data collected from office-based oncologic practices in Germany (July 2017-June 2019). Results: Of 1741 patients, 1241 had NHL; 500 had CLL. Of 7595 therapy cycles, 28.3% used reference rituximab; 55.2% used rituximab biosimilars; 2.0% used subcutaneous rituximab; 14.5% used rituximab, not otherwise specified. Rituximab biosimilars were used across all indications; 57.3% of cycles were administered in extrapolated indications. Over 24 months, the proportion of rituximab prescriptions that were for biosimilars increased from 12.0 to 83.0%. Conclusion: Our real-world data in NHL and CLL depicts increasing use of rituximab biosimilars across multiple treatment protocols, including extrapolated indications.

Modular multiantigen T cell epitope-enriched DNA vaccine against human leishmaniasis.

The leishmaniases are protozoal diseases that severely affect large populations in tropical and subtropical regions. There are only limited treatment options and preventative measures. Vaccines will be important for prevention, control and elimination of leishmaniasis, and could reduce the transmission and burden of disease in endemic populations. We report the development of a DNA vaccine against leishmaniasis that induced T cell-based immunity and is a candidate for clinical trials. The vaccine antigens were selected as conserved in various Leishmania species, different endemic regions, and over time. They were tested with T cells from individuals cured of leishmaniasis, and shown to be immunogenic and to induce CD4(+) and CD8(+) T cell responses in genetically diverse human populations of different endemic regions. The vaccine proved protective in a rodent model of infection. Thus, the immunogenicity of candidate vaccine antigens in human populations of endemic regions, as well as proof of principle for induction of specific immune responses and protection against Leishmania infection in mice, provides a viable strategy for T cell vaccine development.

Therapeutic vaccination with recombinant adenovirus reduces splenic parasite burden in experimental visceral leishmaniasis.

Therapeutic vaccines, when used alone or in combination therapy with antileishmanial drugs, may have an important place in the control of a variety of forms of human leishmaniasis. Here, we describe the development of an adenovirus-based vaccine (Ad5-KH) comprising a synthetic haspb gene linked to a kmp11 gene via a viral 2A sequence. In nonvaccinated Leishmania donovani-infected BALB/c mice, HASPB- and KMP11-specific CD8(+) T cell responses were undetectable, although IgG1 and IgG2a antibodies were evident. After therapeutic vaccination, antibody responses were boosted, and IFNγ(+)CD8(+) T cell responses, particularly to HASPB, became apparent. A single vaccination with Ad5-KH inhibited splenic parasite growth by ∼66%, a level of efficacy comparable to that observed in early stage testing of clinically approved antileishmanial drugs in this model. These studies indicate the usefulness of adenoviral vectors to deliver leishmanial antigens in a potent and host protective manner to animals with existing L. donovani infection.

Therapeutic vaccination for cancer immunotherapy: antigen selection and clinical responses.

BACKGROUND: Because of its high specificity and low toxicity therapeutic vaccination is considered a desirable treatment for cancer. So far, however, the results of cancer vaccination trials have been disappointing, which is often attributed to the problem identifying appropriate vaccine antigens. Tumorassociated antigens are mostly autoantigens and therefore expected to be subject to immunosuppressive mechanisms. Cancer-testis antigens are the most prominent exception as, still being self, they are physiologically only expressed in immunopriviledged tissues and should therefore not induce autotolerance. This leads to the widely accepted hypothesis that cancer-testis antigens should be more efficient inducers of anti-tumor cellular immune responses than differentiation antigens. Aim of the study was to test this hypothesis by evaluating the published reports on clinical therapeutic vaccination trials for the objective clinical response rates to vaccination with cancer testis antigen vs. differentiation antigens. APPROACH: The results of vaccination clinical trials with cancer testis and/or differentiation antigens published in literature and databanks were analyzed for clinical outcome versus vaccine antigens. 21 publications on cancer testis antigen-based trials in which clinical outcome was reported according to WHO or RECIST were identified and analyzed. RESULTS: The rate of objective responses to cancer testis antigen vaccines in 239 patients was 3.8% and for the 235 patients vaccinated with cancer testis plus 3 differentiation antigens 4.3% compared to 2.6% for the 496 patients vaccinated with differentiation antigens alone. CONCLUSIONS: Cancer testis antigen-based vaccines seem slightly superior over vaccines based on differentiation antigens providing support for the hypothesis.

MHC I stabilizing potential of computer-designed octapeptides.

Experimental results are presented for 180 in silico designed octapeptide sequences and their stabilizing effects on the major histocompatibility class I molecule H-2K(b). Peptide sequence design was accomplished by a combination of an ant colony optimization algorithm with artificial neural network classifiers. Experimental tests yielded nine H-2K(b) stabilizing and 171 nonstabilizing peptides. 28 among the nonstabilizing octapeptides contain canonical motif residues known to be favorable for MHC I stabilization. For characterization of the area covered by stabilizing and non-stabilizing octapeptides in sequence space, we visualized the distribution of 100,603 octapeptides using a self-organizing map. The experimental results present evidence that the canonical sequence motives of the SYFPEITHI database on their own are insufficient for predicting MHC I protein stabilization.

Attractors in Sequence Space: Agent-Based Exploration of MHC I Binding Peptides.

Ant Colony Optimization (ACO) is a meta-heuristic that utilizes a computational analogue of ant trail pheromones to solve combinatorial optimization problems. The size of the ant colony and the representation of the ants' pheromone trails is unique referring to the given optimization problem. In the present study, we employed ACO to generate novel peptides that stabilize MHC I protein on the plasma membrane of a murine lymphoma cell line. A jury of feedforward neural network classifiers served as fitness function for peptide design by ACO. Bioactive murine MHC I H-2K(b) stabilizing as well as nonstabilizing octapeptides were designed, synthesized and tested. These peptides reveal residue motifs that are relevant for MHC I receptor binding. We demonstrate how the performance of the implemented ACO algorithm depends on the colony size and the size of the search space. The actual peptide design process by ACO constitutes a search path in sequence space that can be visualized as trajectories on a self-organizing map (SOM). By projecting the sequence space on a SOM we visualize the convergence of the different solutions that emerge during the optimization process in sequence space. The SOM representation reveals attractors in sequence space for MHC I binding peptides. The combination of ACO and SOM enables systematic peptide optimization. This technique allows for the rational design of various types of bioactive peptides with minimal experimental effort. Here, we demonstrate its successful application to the design of MHC-I binding and nonbinding peptides which exhibit substantial bioactivity in a cell-based assay.

Coordinated expression of clustered cancer/testis genes encoded in a large inverted repeat DNA structure.

Cancer/testis antigens (CTA) are expressed in cancers and testis or placenta only and, therefore are considered promising targets for cancer immunotherapy and diagnosis. One family of CTA is the MAGEA family which comprises 13 members and was shown to be expressed synchronously with members from the CSAG (TRAG-3) family of CTA. The MAGEA genes are arranged in 4 subclusters located on the X chromosome. Subcluster III exposes a remarkable gene organization with an inverted repeat (IR) DNA structure of a triplicated couplet of a MAGEA gene and a CSAG gene. Analyzing the mRNA expression pattern of all genes of the MAGEA and CSAG family of cancer/testis genes, we show that the MAGEA and CSAG genes encoded in the large IR are expressed coordinately and independent from the MAGEAs encoded outside the IR. These results reinforce our hypothesis that the large MAGEA/CSAG-IR DNA structure has an impact on the regulation of gene expression.

Evidence for a large double-cruciform DNA structure on the X chromosome of human and chimpanzee.

The human X chromosome consists of a high number of large inverted repeat (IR) DNA sequences which fulfill all requirements for formation of cruciform DNA structures. Such alternative DNA structures are suggested to have a great impact in altering the chromatin architecture and function. Our comprehensive analysis of the corresponding orthologous nucleotide sequences of an IR sequence from Homo sapiens and Pan troglodytes revealed that most of the nucleotide differences between the two species are symmetrical to the apex of the IR, and that the spacer region of the orthologous IRs are in reverse orientation. We provide evidence that this IR forms a large non-B DNA structure containing two Holliday junctions, allowing intrastrand nucleotide pairing of the arms and interstrand pairing of the spacer region of the IR. This structure would extrude into a large double-cruciform DNA structure providing the molecular basis of translocation events and regulation of gene expression.

Design of MHC I stabilizing peptides by agent-based exploration of sequence space.

Identification of molecular features that determine peptide interaction with major histocompatibility complex I (MHC I) is essential for vaccine development. We have developed a concept for peptide design by combining an agent-based artificial ant system with artificial neural networks. A jury of feedforward networks classifies octapeptides that are recognized by mouse MHC I protein H-2K(b). Prediction accuracy yielded a correlation coefficient of 0.94. Peptides were designed in machina by the artificial ant system and tested in vitro for their MHC I stabilizing effect. The behavior of the search agents during the design process was controlled by the jury network. The experimentally determined prediction accuracy was 89% for the designed stabilizing and 95% for the non-stabilizing peptides. Novel H-2K(b) stabilizing peptides were conceived that reveal extensions of known residue motifs. The combined network-agent system recognized context dependencies of residue positions. A diverse set of novel sequences exhibiting substantial activity was generated.

Identification of noncanonical melanoma-associated T cell epitopes for cancer immunotherapy.

The identification of tumor-associated T cell epitopes has contributed significantly to the understanding of the interrelationship of tumor and immune system and is instrumental in the development of therapeutic vaccines for the treatment of cancer. Most of the known epitopes have been identified with prediction algorithms that compute the potential capacity of a peptide to bind to HLA class I molecules. However, naturally expressed T cell epitopes need not necessarily be strong HLA binders. To overcome this limitation of the available prediction algorithms we established a strategy for the identification of T cell epitopes that include suboptimal HLA binders. To this end, an artificial neural network was developed that predicts HLA-binding peptides in protein sequences by taking the entire sequence context into consideration rather than computing the sum of the contribution of the individual amino acids. Using this algorithm, we predicted seven HLA A*0201-restricted potential T cell epitopes from known melanoma-associated Ags that do not conform to the canonical anchor motif for this HLA molecule. All seven epitopes were validated as T cell epitopes and three as naturally processed by melanoma tumor cells. T cells for four of the new epitopes were found at elevated frequencies in the peripheral blood of melanoma patients. Modification of the peptides to the canonical sequence motifs led to improved HLA binding and to improved capacity to stimulate T cells.

Activation of T cells via tumor antigen specific chimeric receptors: the role of the intracellular signaling domain.

T cells engineered to express hybrid receptors with antibody defined specificity can successfully be targeted to tumor cells. In order to select intracellular domains of chimeric receptors capable of efficiently activate T cells in vitro and in vivo, we compared the function of receptors, which share the same extracellular antigen-binding part, joined to different intra-cellular signal transduction units. The antigen binding domain of the receptors was a single-chain fragment of a monoclonal antibody, which recognize a High Molecular Weight Melanoma-Associated Antigen with high affinity. The intracellular tails were derived from the T-cell receptor zeta chain (TCR-zeta), from the B-cell receptor Ig-alpha molecule and from a mutated Ig-alpha molecule able of stronger signal transduction. We compared the activity of the different chimeric receptors at a single-cell level by using a T-cell line that expressed an activation-dependent EGFP-reporter gene. Upon cross-linking with immobilized antibodies, all receptors were able to induce EGFP expression in the majority of the T cells. In contrast, EGFP expression was induced by contact to melanoma cells in vitro only in T cells that expressed the chimeric receptor that contained the TCR-zeta intracellular tail. In these T cells, the co-expression of chimeric receptors that contain a mutated Ig-alpha tail lowers the threshold of T-cell activation and facilitates tumor recognition in vitro and in vivo. Given their specificity and efficiency, T cells grafted with these type of receptors may represent potential candidates for cancer passive immunotherapy.