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  • 1
    In: Blood, American Society of Hematology, Vol. 120, No. 21 ( 2012-11-16), p. 4221-4221
    Abstract: Abstract 4221 Background & Purpose: Recent findings regarding leukemia stem cell (LSC) have emphasized the importance of suppression of LSC for the achievement of durable remission, the first requisite to establish cure of leukemia. For this subject, successful graft-vs.-leukemia (GvL) effect in allogeneic hematopoietic stem cell transplantation (allo-HSCT) against human leukemias has strongly illustrated the importance of anti-leukemia immunity. Additionally, WT1, one of well-known leukemia-associated antigens, has been obviously demonstrated to be expressed by LSCs in bone marrow niche (Saito Y et al, Sci Transl Med.2010). On the other hand, cell-cycle quiescence of LSCs in bone marrow niche is importantly implicated in their chemoresistance. Taking all above, in this study, we set out to answer questions whether therapeutically adopted T-cell immunity towards WT1 enabled to suppress LSC in vivo, and whether cell-cycle status of leukemia cells affected the sensitivity to cyotocidal activity mediated by WT1-specific cytotoxic T cells (CTLs). Methods: Approval for this study was obtained from the Institutional Review Board of Ehime University Hospital. Written informed consent was given by all patients, healthy volunteers in accordance with the Declaration of Helsinki. Peripheral CD8+ T cells obtained from AML or ALL patients in complete remission (CR) or healthy individuals were gene-modified to express HLA-A*2402-restricted and WT1235–243 nonamer -specific T-cell receptor (TCR) using our unique TCR-a/b gene expression vector carrying silencers for endogenous TCRs (WT1-siTCR vector) were generated as effector cells. Bone marrow CD34+ leukemia (L-BMCD34+) cells isolated using immunomagnetic beads from HLA-A*2402 positive or negative patients with AML or ALL were serially transplanted into NOD/scid/γcnull (NOG) mice as previously reported (Ochi T et al. Blood, 2011). 12 weeks later, engrafted leukemia cells in murine bone marrow were examined using a flowcytometry. In some experiments, after engrafted, first transplanted mice were treated with intraperitoneal administration of high dose (150mg/kg) of cytosine arabinoside (Ara-C). A week later, those mice received intravenous administration of gene-modified autologous CD8+ T cells to express WT1-specific TCR or non-gene-modified (NGM) ones in combination with intraperioneal administration of 500u of IL-2 every 2 days. A week after therapeutic T-cell infusion, bone marrow cells were harvested, and transplantation into second mice. 12 weeks later, engrafted human leukemia cells in murine bone marrow were assessed. Next, using a time-lapse photo assay and fluorescent ubiqutination-based cell-cycle indicator (Fucci)-labeled K562-A24 cells which are known to produce high amounts of WT1 mRNA and are positive for HLA-A*2402, we directly assessed the impact of cell-cycle status of leukemia cells on their sensitivity to redirected CTL towards WT1 in vitro. Results: Using isolated L-BMCD34+ cells, LSCs were detectable as leukemia initiating cell in serially transplanted NOG mice. High dose of Ara-C treatment alone was unable to eradicate LSCs. An experiment using samples from a patient with HLA-A*2402+ ALL revealed that intravenously infused gene-modified autologous peripheral CD8+ T cells in CR successfully reduced leukemia burden in bone marrow which were refractory to high dose of Ara-C. In serial transplantation experiments using samples from AML patients, therapeutic infusion of redirected CD8+ T cells to express WT1-specific TCR, but not NGM ones in nadir state successfully eradicated LSCs out of murine bone marrow. In vitro time-lapse photo assay directly illustrated that retargeted CD8+T cells towards WT1 killed fucci-labeled K562-A24 cells irrelevantly to cell-cycle status of target leukemia cells. Summary: In this study, when leukemia mass burden was reduced, therapeutically infused gene-modified CD8+ T cells targeting WT1 successfully enabled to inhibit LSCs in vivo. Furthermore cell-cycle status of leukemia cells which is importantly implicated in their chemoresistance in bone marrow niche, did not affect WT1-specific cytocidal activity mediated by genetically redirected CTLs at all. Although it is preliminary, our observation encourages us to actively introduce redirected T cell-based antileukemia adoptive immunotherapy, aiming at a cure of leukemias. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2012
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 2
    In: Blood, American Society of Hematology, Vol. 121, No. 24 ( 2013-06-13), p. 4894-4901
    Abstract: The efficacy and safety of a novel redirected T-cell–based adoptive immunotherapy targeting hTERT for patients with adult T-cell leukemia. hTERT-specific T-cell receptor gene-transduced CD8+ T cells lyse ATL cells, but not normal cells, both in vitro and in vivo.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 3
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 144-144
    Abstract: In the context of redirected T-cell based antitumor adoptive immunotherapy, the therapeutic roles played by co-infused CD4+ T cells genetically redirected to the predefined HLA class I-restricted epitope which had been originally recognized by effector CD8+ T cells has not yet been fully discussed. In this study, using an HLA class I-restricted WT1 -specific T-cell receptor (TCR) gene transfer, we in detail examined antileukemia functionality mediated by these gene-modified CD4+ T cells co-infused with similarly gene-modified effector CD8+ T cells as the redirected T cell-based adoptive immunotherapy. Methods Using our unique retroviral vector expressing HLA-A*2402-restricted and WT1235-243-specific TCR a/b genes and shRNAs for endogenous TCRs (WT1-siTCR vector), we genetically modified both CD4+ and CD8+ T cells from the same healthy donor or leukemia patients (termed WT1-siTCR/CD4 and WT1-siTCR/CD8, respectively). First, target-responsive cellular outputs mediated by WT1-siTCR/CD4 was thoroughly examined using flowcytometry, ELISA, 51Cr-release assay, CFSE dilution assay and bioluminescence assay. Next we similarly assessed impacts of WT1-siTCR/CD4 on the antileukemia functionality mediated by concurrentWT1-siTCR/CD8 both in vitro and in vivo. Eventually, we assessed the in vivo therapeutic efficacy of combined administration of WT1-siTCR/CD8 with WT1-siTCR/CD4 using a xenografted mouse model. Results The transcription factor profile demonstrated that WT1-siTCR/CD4 turned a terminal effector, but not regulatory phenotype. Activated WT1-siTCR/CD4 expressed cell-surface CD40L. Target-responsive cytokine production profile of WT1-siTCR/CD4 represented the Th1 helper function in the context of HLA-A*2402. HLA class II molecules expressed by leukemia cells facilitated the recognition of leukemia cells by WT1-siTCR/CD4 in the context of HLA-A*2402. WT1-siTCR/CD4 displayed the delayed cytocidal activity determined by 51Cr release assay. WT1-siTCR/CD4 could produce IFN-g in response to freshly isolated leukemia cells. WT1-siTCR/CD4 displayed the leukemia trafficking activity in vivo. WT1-siTCR/CD4 represented the potential to migrate into bone marrow via CXCR4/CXCL12 axis both in vitro and in vivo. Concurrent WT1-siTCR/CD4 augmented IFN-g production and cytotoxic degranulation mediated by WT1-siTCR/CD8 in response to the cognate epitope via humoral factors. Consequently, the cytocidal activity against autologous leukemia cells mediated by WT1-siTCR/CD8 was augmented in the presence of WT1-siTCR/CD4, both of them generated from normal lymphocytes of the same patient with leukemia in a complete remission. Upon the target recognition, activated WT1-siTCR/CD4 recruited WT1-siTCR/CD8 via CCL3/4-CCR5 axis. Proliferative response and differentiation into central memory T-cell subset mediated by WT1-siTCR/CD8 in response to the cognate epitope and leukemia cells were enhanced in the presence of autologousWT1-siTCR/CD4, but not gene-modified CD4+ T cells (NGM-CD4). CD127 expression on activated WT1-siTCR/CD8 also increased in parallel to this differentiation. Co-infused WT1-siTCR/CD4 augmented the tumor trafficking and persistence of WT1-siTCR/CD8 in vivo, resulting in the greater suppression of leukemia cells in a xenografted mouse model. Finally, in the therapeutic mouse model, co-infusion of WT1-siTCR/CD8 with of WT1-siTCR/CD4 significantly suppressed the growth of inoculated leukemia cells compared to that in mice received co-infusion of WT1-siTCR/CD8 with NGM-CD4 (Fig.1). Correlation between the therapeutic efficacy and survival of infused gene-modified T cells was also observed. Conclusion In results, the combined infusion of WT1-siTCR/CD8 with WT1-siTCR/CD4, but not NGM-CD4 obviously demonstrates the enhanced antileukemia efficacy via diverse mechanisms. Now we have just started a clinical trial using gene-modified T cells with WT1-siTCR vector for the treatment of patients with refractory acute myeloid leukemia and myeloid dysplastic syndrome. Because redirected T cells employed in this trial encompassed both WT1-siTCR/CD4 and WT1-siTCR/CD8, we are planning to clinically verify the significance of WT1-siTCR/CD4 in the redirected T cell-based antileukemia adoptive immunotherapy. (Fig.1) Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 4
    In: Journal of Hematology & Oncology, Springer Science and Business Media LLC, Vol. 7, No. 1 ( 2014-12)
    Type of Medium: Online Resource
    ISSN: 1756-8722
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 2429631-4
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  • 5
    In: Endocrine Journal, Japan Endocrine Society, Vol. 60, No. 4 ( 2013), p. 431-439
    Type of Medium: Online Resource
    ISSN: 0918-8959 , 1348-4540
    Language: English
    Publisher: Japan Endocrine Society
    Publication Date: 2013
    detail.hit.zdb_id: 2133773-1
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  • 6
    In: Diabetes Research and Clinical Practice, Elsevier BV, Vol. 108, No. 2 ( 2015-05), p. 342-349
    Type of Medium: Online Resource
    ISSN: 0168-8227
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 2004910-9
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  • 7
    In: Case Reports in Transplantation, Hindawi Limited, Vol. 2019 ( 2019-05-21), p. 1-5
    Abstract: The authors describe the high effectiveness of human mesenchymal stem cell (hMSC) therapy to treat steroid-refractory gastrointestinal acute graft-versus-host Disease (aGVHD) in a 15-year-old boy with acute lymphoblastic leukemia (ALL). He received allogeneic hematopoietic stem cell transplantation due to high-risk hypodiploid ALL. Around the time of engraftment, he developed severe diarrhea following high-grade fever and erythema. Although methylprednisolone pulse therapy was added to tacrolimus and mycophenolate mofetil, diarrhea progressed up to 5000~6000 ml/day and brought about hypocalcemia, hypoalbuminemia, and edema. Daily fresh frozen plasma (FFP), albumin, and calcium replacements were required to maintain blood circulation. After aGVHD was confirmed by colonoscopic biopsy, MSC therapy was administered. The patient received 8 biweekly intravenous infusions of 2×10 6 hMSCs/kg for 4 weeks, after which additional 4 weekly infusions were performed. A few weeks after initiation, diarrhea gradually resolved, and at the eighth dose of hMSC, lab data improved without replacements. MSC therapy successfully treated steroid-refractory gastrointestinal GVHD without complications. Despite life-threatening diarrhea, the regeneration potential of children and adolescents undergoing SMC therapy successfully supports restoration of gastrointestinal damage. Even with its high treatment costs, SMC therapy should be proactively considered in cases where young patients suffer from severe gastrointestinal GVHD.
    Type of Medium: Online Resource
    ISSN: 2090-6943 , 2090-6951
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2019
    detail.hit.zdb_id: 2627657-4
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  • 8
    Online Resource
    Online Resource
    Hindawi Limited ; 2021
    In:  Case Reports in Pediatrics Vol. 2021 ( 2021-09-13), p. 1-4
    In: Case Reports in Pediatrics, Hindawi Limited, Vol. 2021 ( 2021-09-13), p. 1-4
    Abstract: Rothia mucilaginosa is a Gram-positive coccus and an opportunistic pathogen in immunocompromised hosts. The microorganism has been implicated in serious infections, including bacteremia meningitis or endocarditis. However, there is a dearth of investigations on meningitis, especially in children. As this infection is rare and only a few cases have been recorded, evidence-based guidelines for adequate infection treatment are lacking. We herein report the case of a 12-year-old boy with myelodysplastic syndromes (MDS) presenting with a change in mental status who was diagnosed as having febrile neutropenia and bacterial meningitis caused by R. mucilaginosa at 23 days after unrelated cord blood transplant. In our case, the minimum inhibitory concentrations (MICs) of meropenem and vancomycin (VCM) were both ≤1 μg/mL, whereas the MIC of daptomycin (DAP) was 4 μg/mL. The patient was treated with intravenous antimicrobial therapy due to meropenem for 43 days because he had febrile neutropenia. During follow-up, the patient had no neurological complications. We retrospectively reviewed the antimicrobial susceptibility of all R. mucilaginosa isolates (n = 5) from blood or cerebrospinal fluid cultures at our hospital. The MIC of VCM was 〈 0.5 μg/mL for all strains, whereas the MIC of DAP was ≥2 μg/mL for all strains. The MIC of MEPM was 〉 1 μg/mL for one strain. We recommend choosing VCM as the primary treatment for invasive R. mucilaginosa infections until antimicrobial susceptibility results are known, especially in immunocompromised children.
    Type of Medium: Online Resource
    ISSN: 2090-6811 , 2090-6803
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2659094-3
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  • 9
    In: Physical Review E, American Physical Society (APS), Vol. 66, No. 1 ( 2002-7-12)
    Type of Medium: Online Resource
    ISSN: 1063-651X , 1095-3787
    RVK:
    Language: English
    Publisher: American Physical Society (APS)
    Publication Date: 2002
    detail.hit.zdb_id: 2844562-4
    SSG: 12
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  • 10
    In: Blood, American Society of Hematology, Vol. 120, No. 21 ( 2012-11-16), p. 1902-1902
    Abstract: Abstract 1902 Background and Purpose: Adult T-cell leukemia (ATL) is one of the most refractory forms of T-cell malignancy that preferentially affects aged population that constrains clinical efficacy of chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, objective responses in a small part of patients who received allo-HSCT evidently emphasize the therapeutic potential of immune-mediated approaches. While, some previous studies described that activation of human telomerase reverse transcriptase (hTERT), one of tumor antigens was detected in ATL tumor cells. Collectively, in this study, we examined the feasibility of redirected T-cell based immunotherapy targeting hTERT to explore a novel treatment strategy for ATL. Methods: Approval for this study was obtained from our institutional review board. Written informed consent was obtained from all patients, healthy volunteers, and parents of cord blood donors in accordance with the Declaration of Helsinki. HLA-A*2402-restricted and hTERT461–469 epitope (VYGFVRACL)-specific TCR-α/β genes were newly cloned into a novel retroviral vector encoding siRNAs for endogenous TCR-α/β genes (hTERT-siTCR vector). Using hTERT-siTCR vector, hTERT-siTCRR-α/β genes were transduced into normal peripheral CD8+ T cells (hTERT-siTCR/CD8+), employed as effectors. HLA-A*2402+ or HLA-A*2402− ATL cell lines, freshly isolated patients' ATL cells, normal peripheral blood mononuclear cells (PBMCs) from healthy volunteers, and CD34+ cells isolated from cord blood mononuclear cells (CBMCs) were employed as target cells. Anti-tumor reactivity mediated by hTERT-siTCR/CD8+ was assessed using standard 51Cr release assay. Expressions of hTERT mRNA and hTERT protein in ATL cell lines, freshly isolated ATL cells and normal CD4+ T cells were assessed by quantitative real-time PCR (QRT-PCR) and Western blotting. Frequencies of hTERT461–469–specific cytotoxic T-lymphocyte (CTL) precursors in periphery of ATL patients or healthy donors were measured by hTERT461–469/HLA-A*2402 tetramer assay. Finally, NOD/scid/γcnull (NOG) mice subcutaneously inoculated with luciferase-gene-modified HLA-A*2402+ ATL cell line, ATN-1 cells were treated with intravenous infusion of hTERT-siTCR/CD8+or non-gene-modified (NGM) ones, respectively. Thereafter, these mice were serially monitored for tumor growth using bioluminescence imaging and survival. Results: QRT-PCR and Western blotting revealed that hTERT was markedly overexpressed in both ATL cell lines and freshly isolated ATL cells, while less than undetectable in normal cells. hTERT461–469-specific CTL precursors were variably detectable in periphery of HLA-A*2402+ ATL patients, but not HLA-A*2402− ATL patients or HLA-A*2402+ healthy individuals. hTERT-siTCR/CD8+ were 30–50% positive for hTERT461–469/HLA-A*2402 tetramer and displayed HLA-A*2402-restricted and hTERT461–469–specific cytocidal activity against peptide-loaded K562-A24 cells. Those hTERT-siTCR/CD8+ successfully displayed tumoricidal activity against HLA-A*2402+ ATL cell line cells and freshly isolated HLA-A*2402+ ATL cells, but not HLA-A*2402− ones or HLA-A*2402+ normal cells including CD34+ CBMCs. Moreover, hTERT-siTCR/CD8+ generated from HLA-A*2402+ ATL patients also lysed autologous ATL tumor cells. Finally, using xenografted NOG mouse models, therapeutically infused hTERT-siTCR/CD8+, but not NGM ones from the identical donor successfully suppressed growth of inoculated ATL cells in vivo. Furthermore, NOG mice bearing advanced ATL tumor masses were also successfully treated with hTERT-siTCR/CD8+ in combination with bortezomib. Summary: In this study, we newly demonstrated that hTERT is a promising therapeutic tumor antigen for ATL. Moreover, redirected CD8+ T cells to express hTERT-specific TCR displayed antitumor activity against ATL tumor cells both in vitro and in vivo. Furthermore, our preliminary data represented antitumor activity against advanced ATL, in combination with bortezomib. Collectively, redirected T cell-based immunotherapy targeting hTERT seems clinically feasible and promising for the treatment of almost all ATL patients who are ineligible for allo-HSCT. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2012
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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