KIR3DL2 (CD158k) is a potential therapeutic target in primary cutaneous anaplastic large-cell lymphoma.

BACKGROUND: KIR3DL2, an inhibitory receptor expressed by natural killer cells and a subset of normal CD8(+) T cells, is aberrantly expressed in neoplastic cells in transformed mycosis fungoides and Sézary syndrome. Anti-KIR3DL2 targeted antibody therapy has shown potent activity in preclinical models for these diseases. OBJECTIVES: To examine the expression of KIR3DL2 and its potential use as a therapeutic target in patients with primary cutaneous anaplastic large-cell lymphoma (pcALCL), the most aggressive cutaneous CD30(+) lymphoproliferative disease. METHODS: Samples from 11 patients with pcALCL and three CD30(+) lymphoproliferative disease cell lines - Mac1, Mac2a and Mac2b - were used in KIR3DL2 expression studies using immunohistochemistry, flow cytometry and reverse-transcriptase quantitative polymerase chain reaction. The effect of IPH4102, a monoclonal humanized IgG1 targeting KIR3DL2, was assessed by in vitro cytotoxicity assays against Mac1, Mac2a and Mac2b using allogeneic peripheral blood mononuclear cells as effectors. RESULTS: KIR3DL2 mRNA and protein were found in all human samples of pcALCL, and in the Mac2a and Mac2b cell lines. KIR3DL2 protein expression was present on 85·8 ± 14·0% of CD30(+) skin-infiltrating tumour cells. In vitro functional studies showed that KIR3DL2(+) Mac2a and Mac2b pcALCL lines are sensitive to antibody-derived cytotoxicity mediated by IPH4102, through activation of natural killer cells, in a concentration-dependent manner. CONCLUSIONS: pcALCL tumour cells express KIR3DL2, and we provide preclinical proof of concept for the use of IPH4102, a humanized anti-KIR3DL2 antibody, to treat patients with primary cutaneous CD30(+) ALCL.

Diagnosis of cypress pollen allergy: in vivo and in vitro standardization of a Juniperus ashei pollen extract.

BACKGROUND: Cypress pollen allergy is a major cause of rhinoconjunctivitis and asthma in the Mediterranean area. The nonstandardized cypress allergen extracts currently available for the diagnosis of cypress allergy have a low level of activity. The search for an active material has led to the selection of Juniperus ashei (Ja) pollen because of its very high cross-reactivity with cypress extracts and its superior allergenic activity. The aim of this study was to characterize in vitro and calibrate in vivo an in-house reference extract (IHRS) of J. ashei pollen and determine the specificity and sensitivity of a standardized Ja extract for the prick test diagnosis of cypress allergy. METHODS: Juniperus ashei pollen extract was analysed by 2-D electrophoresis. The IHRS Ja extract was calibrated by skin prick testing in 28 cypress-allergic patients. The sensitivity and specificity of cypress allergy diagnosis using a standardized Ja extract was studied by skin prick test in 42 cypress-allergic patients and 53 nonallergic patients. Jun a 1 content of the IHRS was determined by a monoclonal antibody-based electrophoretic technique. RESULTS: The Jun a 1 content of the 100 IR/ml Ja IHRS extract was 180 microg/ml. For in vivo diagnosis of cypress allergy, Ja pollen extract demonstrated a sensitivity of 95%, a specificity of 100%, a negative predictive value of 96%, and a positive predictive value of 100%. CONCLUSION: Standardized Ja pollen extract is therefore a very appropriate tool for the in vivo diagnosis of cypress pollen allergy and good candidate for specific immunotherapy.

Synthetic phosphoantigens enhance human Vgamma9Vdelta2 T lymphocytes killing of non-Hodgkin's B lymphoma.

BACKGROUND: Non-Hodgkin's B lymphomas (NHL) are often resistant to conventional treatments and, until now, immunotherapeutic approaches against NHL only aimed at inducing anti-tumor effectors. Nevertheless, human blood Vgamma9Vdelta2 T lymphocytes represent an abundant pool of cytotoxic tumor-reactive cells. Vgamma9Vdelta2 T cells are strongly activated by natural compounds, from which powerful synthetic ligands have been derived. These synthetic antigens induce efficient Vgamma9Vdelta2 T cell responses in vitro. MATERIALS AND METHODS: We set up a series of Vgamma9Vdelta2 T cell-activation experiments, including cytotoxic activity and amplification from whole blood cells. Several types of Vgamma9Vdelta2 effectors were challenged against a panel of 16 B lymphoma cell lines. These tests have been performed in the absence and presence of -specific synthetic ligands to evaluate the effect of such molecules on anti-tumor activity. RESULTS: We report here that Vgamma9Vdelta2 T cells recognize B lymphomas. This recognition is associated with the cytotoxic activity against B-lymphoma cells and/or proliferative responses, and appears to be T-cell antigen receptor (TCR)-dependent. Because few B lymphoma induce a complete set of Vgamma9Vdelta2 cell responses, a chemical ligand of Vgamma9Vdelta2 T cells was used to enhance both proliferation and cytotoxic activity of anti-B lymphoma effectors. We show that such synthetic compound improves Vgamma9Vdelta2 CTL numbers and lysis of B lymphoma lines, especially when the targets are already spontaneously recognized by these effectors. CONCLUSIONS: We report here that human Vgamma9Vdelta2 T cells anti-B lymphoma response can be improved by use of specific synthetic ligands, which enhance their cytotoxic activity and allows their rapid expansion ex vivo.

Y2K+1 state-of-the-art on non-peptide phosphoantigens, a novel category of immunostimulatory molecules.

Some human T cells are activated in vivo and in vitro by small non-peptide antigens, so-called phosphoantigens. Since their discovery in 1994, several reports have continuously documented novel members of this category of immunostimulatory molecules. This article reviews the current knowledge on their biochemical properties.

[Conjunctival provocation test with Dermatophagoides pteronyssinus in the diagnosis of allergic conjunctivitis from house mites]. / Test de provocation conjonctival au Dermatophagoïdes pteronyssinus dans le diagnostic des conjonctivites allergiques aux acariens domestiques.

INTRODUCTION: Perennial conjunctivitis due to house dust mites is the most frequent form of allergic conjunctivitis in urban environments. However, its diagnosis remains difficult for ophthalmologists. In this study, we evaluated a conjunctival provocation test (CPT) using standardized extracts of Dermatophagoides pteronyssinus (Dpt) and compared it to the diagnostic methods commonly performed in allergology: prick tests with dust and house dust mites and specific and IgE assay. MATERIALS AND METHODS: We performed a CPT on 60 volunteer patients, between the ages of 8 and 64 years, corresponding to 30 patients sensitized to house dust mites with the presence of specific IgE and chronic conjunctivitis, 21 patients not sensitized to house dust mites but presenting features of chronic conjunctivitis, and 9 asymptomatic patients. A house dust mite desensitizing treatment was not an exclusion criterion for a number of allergic patients. CPTs were prepared from Dpt allergenic extracts (Laboratoires Stallergènes, Antony, France) with 5 progressive concentrations by dilution in a nonphenolic physiological solution: 1.2 RI, 3.7 RI, 11 RI, 33 RI, and 100 RI. CPTs were performed in only one eye and asymmetry of the ocular response was evaluated by the cumulative clinical score of Abelson Chambers and Smith. The correlation between the 2 diagnostic tests was established by calculating the Cohen correlation coefficient or kappa. We also evaluated the sensitivity and diagnostic specificity for each test. RESULTS: The statistical correlation between specific IgE and the other allergological tests in for allergic conjunctivitis to house dust mites was 0.93 for the CPT, 0.46 for the prick test to Dpt, and 0.33 for the prick test to dust. The diagnostic sensitivities and specificities for each test were 90% and 100% for the CPT, 60% and 70% for the prick test to dust, 70% and 76% for prick test to Dpt, respectively. Beyond an antigenic cut-off value of 11 RI, we also observed greater hypersensitivity reactions for patients with lacrimal IgE or elevated specific IgE levels. CONCLUSION: The results obtained with the CPT confirm its high antigenic quality. It is a particularly useful, rapid, and perfectly safe clinical test. It is the only test able to establish a relationship between ocular manifestations and specific I(8)E.

[Juniperus ashei: the gold standard of the Cuppressaceae]. / Juniperus ashei: le golden standard des cupressacées.

The non-standardized Cupressus sempervirens allergen extract currently available for the diagnosis of cypress allergy has a low level of activity. The search for an active material consisted of in vitro and in vivo comparison of three Cupressaceae pollen extracts: Cupressus sempervirens (Cs), Cupressus arizonica (Ca) and Juniperus ashei (Ja) (synonyms: Juniperus sabinoides and Mountain Cedar). These 3 trees belong to the same botanical family of Cupressaceae. While Cs and Ca are commonly encountered in Mediterranean regions, Ja is only present in Europe in the Balkans, but is a major cause of allergy in the USA. In vitro, with a similar protein content, the allergenic properties of Ja extract are 20-Fold higher than those of Cs and 11-fold higher than those of Ca. IgE immunoblotting revealed 14, 42 and 70 kDa allergens common to all 3 extracts. The inhibition curves of the 3 extracts were more than 88% parallel. A significant correlation was observed between serum specific IgE titres for Ja and Cs in 23 patients (r = 0.916; p < 0.001). In vivo, in 23 patients with cypress allergy, the mean diameter of the prick test papule at 1/20 W/V of Ja (8.3 mm) was greater than that of the Cs papule (6.3 mm) (p = 0.001) and the Ca papule (6.7 mm) (p < 0.001). Correlations between cutaneous responses to Cs and Ja (r = 0.629; p = 0.002), and to Cs and Ca (r = 0.75; p = 0.001) were significant. These results demonstrate the intense cross-reactivity between Cs, Ca and Ja. The allergenic potency of the Ja extract is superior to that of Cs and Ca extracts, both in vitro and in vivo. This superiority is correlated with a high concentration of the major allergen, Jun a 1. The non-standardized The now standardized extract of in vitro ashei pollen therefore represents an effective and documented solution for identification, and probably for treatment, of Cupressaceae pollen allergy.

Safety of sublingual-swallow immunotherapy in children and adults.

BACKGROUND: Immunotherapy is an established treatment of allergic diseases. The safety of this treatment, particularly when administered without direct medical surveillance, as in the case of the sublingual-swallow route needs to be established. The aim of this paper is to review the safety of the sublingual-swallow immunotherapy as reported in eight double-blind, placebo-controlled trials carried out in France, Italy and Greece. METHODS: Six hundred and ninety subjects, 472 adults and 218 children, took part in trials of specific immunotherapy (SIT) for the treatment of rhinoconjunctivitis and/or asthma. Three hundred and forty-seven patients received SIT and 343 patients received placebo. Treatment with specific immunotherapy with allergen extracts or placebo was administered using the sublingual-swallow technique. The allergens administered were grass, ambrosia, parietaria and olive pollens, and mites. The daily dose taken during maintenance therapy ranged from 100 to 300 IR (index of reactivity) and cumulative doses ranged from 4,500 to 104,000 IR. Treatment duration ranged from 4 months to 2 years. Adverse events reported either spontaneously by the patient or on direct questioning by the investigator were analysed. RESULTS: One hundred and forty-five unusual events were reported in the subjects receiving active SIT and 79 in those receiving placebo (p < 0.001). Of these 85 were children aged 15 years or less (50 received active SIT, 35 placebo) and 139 were adults (95 received SIT, 44 placebo). Unusual events involving the buccal cavity (61 SIT, 13 placebo) and the gastro-intestinal tract (47 SIT, 15 placebo) were significantly more frequent in the SIT-treated patients (p < 0.001). Wheezing (9 SIT, 21 placebo) was more frequent in the placebo-treated patients (p < 0.05). There were no differences in the frequency of unusual events between adults and children and in the frequency of events involving other body systems. No event was reported as serious. Two events reported as laryngeal oedema were not considered to be accurate descriptions. CONCLUSIONS: No serious adverse event was reported in the studies monitored, confirming the good safety profile of the sublingual-swallow method both in children and adults with rhinitis or moderate asthma.

Structure and functions of nucleolin.

Nucleolin is an abundant protein of the nucleolus. Nucleolar proteins structurally related to nucleolin are found in organisms ranging from yeast to plants and mammals. The association of several structural domains in nucleolin allows the interaction of nucleolin with different proteins and RNA sequences. Nucleolin has been implicated in chromatin structure, rDNA transcription, rRNA maturation, ribosome assembly and nucleo-cytoplasmic transport. Studies of nucleolin over the last 25 years have revealed a fascinating role for nucleolin in ribosome biogenesis. The involvement of nucleolin at multiple steps of this biosynthetic pathway suggests that it could play a key role in this highly integrated process.

The role of the Schizosaccharomyces pombe gar2 protein in nucleolar structure and function depends on the concerted action of its highly charged N terminus and its RNA-binding domains.

Nonribosomal nucleolar protein gar2 is required for 18S rRNA and 40S ribosomal subunit production in Schizosaccharomyces pombe. We have investigated the consequences of the absence of each structural domain of gar2 on cell growth, 18S rRNA production, and nucleolar structure. Deletion of gar2 RNA-binding domains (RBDs) causes stronger inhibition of growth and 18S rRNA accumulation than the absence of the whole protein, suggesting that other factors may be titrated by its remaining N-terminal basic/acidic serine-rich domain. These drastic functional defects correlate with striking nucleolar hypertrophy. Point mutations in the conserved RNP1 motifs of gar2 RBDs supposed to inhibit RNA-protein interactions are sufficient to induce severe nucleolar modifications but only in the presence of the N-terminal domain of the protein. Gar2 and its mutants also distribute differently in glycerol gradients: gar2 lacking its RBDs is found either free or assembled into significantly larger complexes than the wild-type protein. We propose that gar2 helps the assembly on rRNA of factors necessary for 40S subunit synthesis by providing a physical link between them. These factors may be recruited by the N-terminal domain of gar2 and may not be released if interaction of gar2 with rRNA is impaired.

Ultrastructural changes in the Schizosaccharomyces pombe nucleolus following the disruption of the gar2+ gene, which encodes a nucleolar protein structurally related to nucleolin.

The nucleolar protein gar2, from the fission yeast Schizosaccharomyces pombe, is the functional homolog of NSR1 from Saccharomyces cerevisiae, and is structurally related to nucleolin from vertebrates. By immunocytochemistry at the electron microscope level, we show that gar2 co-localizes with RNA polymerase I and the gar1 protein along the dense fibrillar component of the nucleolus in a wild-type strain of S. pombe, suggesting that gar2 is involved in the transcription and/or in the early steps of maturation of the ribosomal RNAs. Since the effects of disruption of the gar2+ gene might also shed light on the role of the gar2 protein, we analyzed the ultrastructure of the nucleolus of a gar2-disruption mutant. The nucleolus of the gar2- mutant is dramatically reorganized when compared with that of the wild-type gar2+ strain: a truncated protein containing the NH2-terminus of the gar2 protein is accumulated in an unusual nucleolar "dense body". Our results also suggest that the NH2-terminus might be sufficient for nucleolar localization via interaction with specific nucleolar components and support the hypothesis that gar2 in wild-type S. pombe interacts with nascent pre-rRNA via its two RNA-binding domains in combination with the glycine/arginine-rich domain. We also report that disruption of the gar2+ gene results in a mutant that is defective in cytokinesis and nuclear division.

Mitosis-specific phosphorylation of gar2, a fission yeast nucleolar protein structurally related to nucleolin.

The nucleolar protein gar2 of fission yeast is structurally related to the multifunctional nucleolar protein nucleolin from vertebrates and has been shown to be implicated in production of 18S rRNA. gar2 contains several potential casein kinase 2 (CK2) phosphorylation sites and a single putative p34(cdc2 )phosphorylation site in the consensus S50PKK. Here, we show that, like nucleolin, gar2 is phosphorylated in vitro by both highly purified CK2 from CHO cells and p34(cdc2 )from starfish oocytes. Moreover, the substitution of alanine for the N-terminal serine 50 abolishes phosphorylation by p34(cdc2 )in vitro. We also provide evidence that gar2 is phosphorylated in vitro by a p13(suc1)-Sepharose-bound kinase from Schizosaccharomyces pombe extracts that displays cell cycle-regulated activity similar to that of the p34(cdc2(kinase. In vivo 32P labeling of cells indicates that gar2 is a phosphoprotein and that incorporation of phosphate on residue 50 occurs specifically at mitosis. Taken together, these results lead us to propose that gar2 is likely to be an in vivo substrate for the mitotic p34(cdc2 )kinase. However, this posttranslational modification of the gar2 protein does not appear to be essential for normal production of 18S rRNA.

Latex allergy diagnosis: in vivo and in vitro standardization of a natural rubber latex extract.

For the diagnosis of IgE-mediated (immediate) hypersensitivity to natural rubber latex (NRL), skin prick testing with extracts of latex gloves has been widely used, but such extracts are difficult to standardize. The present study aimed to produce on an industrial scale an NRL extract from freshly collected NRL and to evaluate, calibrate, and standardize the extract by both in vivo and in vitro testing. The source material, latex of the rubber tree, Hevea brasiliensis (clone RRIM 600), was frozen immediately after collection in Malaysia and shipped in dry ice to Stallergènes SA, France. Protein and allergen profiles were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting, isoelectric focusing (IEF), crossed immunoelectrophoresis (CIE), and crossed radioimmunoelectrophoresis (CRIE). Allergen quantification was effected by RAST inhibition. The capacity of the preparation to elicit immediate hypersensitivity reactions in vivo was measured by skin prick testing in 46 latex-allergic patients and 76 nonallergic control subjects. SDS-PAGE and immunoblot profiles of the extract and an NRL standard (E8) provided by the US Food and Drug Administration were almost identical, disclosing several distinct IgE-binding proteins with apparent molecular weights of 14, 20, 27, 30, and 45 kDa, conforming to reported molecular weights of several significant NRL allergens. An arbitrary index of reactivity (IR) of 100 was assigned to the extract at 1:200 dilution (w/v), having a protein content of 22 micrograms/ml. Skin prick testing of latex-allergic patients and controls using the extract at 100 IR revealed 93% sensitivity, 100% specificity, 100% negative predictive value, and 96% positive predictive value. In conclusion, a skin prick test reagent for diagnosis of type I NRL allergy was successfully standardized. The reagent was demonstrated to contain most, if not all, of the currently known clinically significant NRL allergens, and it showed high sensitivity and specificity.

A double-blind, placebo-controlled trial by the sublingual route of immunotherapy with a standardized grass pollen extract.

Fifty-eight patients with well-documented history of seasonal rhinoconjunctivitis caused by grass pollens were allocated randomly on a double-blind basis to receive either sublingual therapy with a solution of purified, standardized allergen preparation (Stallergènes) or a matched placebo for 17 weeks. The assessment of the effect of oral immunotherapy, done with drops of five-grass allergen extract, was on the clinical symptoms and on the medication score of the authorized rescue treatments. The actively treated patients had significantly (P < 0.05 to P < 0.01) fewer symptoms of rhinitis (sneezing and rhinorrhea) and of conjunctivitis (redness and tears) during the pollen season than the placebo group. Consumption of nasal solution of sodium cromoglycate and of betamethasone and dexchlorpheniramine was significantly less in the desensitized group (P < 0.01). Side-effects were negligible. This study concludes that perlingual immunotherapy with grass pollen extract in grass-pollen-sensitive seasonal hay fever and conjunctivitis patients is effective, easy to perform, inexpensive, and safe.

[Sublingual specific immunotherapy for rhinoconjunctivitis caused by grass pollens]. / Immunothérapie spécifique par voie sublinguale de la rhinoconjonctivite aux pollens de graminées.

Fifty eight patients with rhino-conjunctivitis caused by grass pollen were included in a double-blind study in which they received, by the sub-lingual route over 5 months, either a solution of purified and standardised allergen or a placebo. Assessment of the effect of this immunotherapy, which was done with drops of Stallergenes "5-grass pollen" was by clinical symptoms and the use of authorized drugs and treatments. Compared with the placebo group, the patients on active treatment showed significantly less (P = 0.05 to P = 0.01) rhinitis symptoms (sneezing and rhinorrhea) and conjunctivitis (reddening and tears) during the pollen season. Consumption of nasal cromoglycate solution, of betamethasone and dexchlorpheniramine was significantly lower (p = 0.01) in the desensitised group. Secondary effects were negligible. From this study, it can be concluded that immunotherapy with grass pollen extract, by the sub-lingual route, of patients with rhino-conjunctivitis who were sensitive to these allergens, is efficacious, easy to do, economic and sure.