Monday, April 8, 2013

Monoclonal Antibody Targets, Kills Leukemia Cells

Monoclonal Antibody Targets, Kills Leukemia Cells

 Researchers at the University of California, San Diego Moores Cancer Center have identified a humanized monoclonal antibody that targets and directly kills chronic lymphocytic leukemia (CLL) cells
The findings, published in the online Early Edition of the Proceedings of the National Academy of Sciences on March 25, 2013 represent a potential new therapy for treating at least some patients with CLL, the most common type of blood cancer in the United States.
CLL cells express high levels of a cell-surface glycoprotein receptor called CD44. Principal investigator Thomas Kipps, MD, PhD, Evelyn and Edwin Tasch Chair in Cancer Research, and colleagues identified a monoclonal antibody called RG7356 that specifically targeted CD44 and was directly toxic to cancer cells, but had little effect on normal B cells.
Moreover, they found RG7356 induced CLL cells that expressed the protein ZAP-70 to undergo apoptosis or programmed cell death. Roughly half of CLL patients have leukemia cells that express ZAP-70. Such patients typically have a more aggressive form of the disease than patients with CLL cells that do not express that specific protein.

Previous research by Kipps and others has shown that CLL cells routinely undergo spontaneous or drug-induced cell death when removed from the body and cultured in the laboratory. They found that CLL cells receive survival signals from surrounding non-tumor cells that are present in the lymph nodes and bone marrow of patients with CLL. One of these survival signals appears to be transmitted through CD44. However, when CD44 is bound by the RG7356 monoclonal antibody, it seems to instead convey a death signal to the leukemia cell.
"By targeting CD44, it may be possible to kill CLL cells regardless of whether there are sufficient numbers of so-called 'effector cells,' which ordinarily are required by other monoclonal antibodies to kill tumor cells," said Kipps. "We plan to initiate clinical trials using this humanized anti-CD44 monoclonal antibody in the not-too-distant future."
Co-authors were Suping Zhang, Christina C.N. Wu, Jessie-Farah Fecteau, Bing Cui, Liguang Chen, Ling Zhang, Rongrong Wu, Laura Rassenti, and Fitzgerald S. Lao, Department of Medicine, UCSD Moores Cancer Center; and Stefan Weigand, Roche Diagnostics GmbH, Germany.
Funding for this study came, in part, from the National Institutes of Health (grant PO1-CA081534) and the UC San Diego Moores Cancer Blood Center Research Fund.

Story Source:
The above story is reprinted from materials provided by University of California, San Diego Health Sciences.

Journal Reference:
  1. Suping Zhang, Christina C. N. Wu, Jessie-F. Fecteau, Bing Cui, Liguang Chen, Ling Zhang, Rongrong Wu, Laura Rassenti, Fitzgerald Lao, Stefan Weigand, and Thomas J. Kipps. Targeting chronic lymphocytic leukemia cells with a humanized monoclonal antibody specific for CD44. PNAS, March 25, 2013 DOI: 10.1073/pnas.1221841110

Stem Cell Treatment May Become Option to Treat Nonhealing Bone Fractures

Stem Cell Treatment May Become Option to Treat Non healing Bone Fractures


Stem cell therapy enriched with a bone-regenerating hormone, insulin-like growth factor-I (IGF-I), can help mend broken bones in fractures that are not healing normally, a new animal study finds.
The results are being presented at The Endocrine Society's 93rd Annual Meeting in Boston.
A deficiency of fracture healing is a common problem affecting an estimated 600,000 people annually in North America, according to the principal investigator, Anna Spagnoli, MD, associate professor of pediatrics and biomedical engineering at the University of North Carolina at Chapel Hill.
"This problem is even more serious," Spagnoli said, "in children with osteogenesis imperfecta, or brittle bone disease, and in elderly adults with osteoporosis, because their fragile bones can easily and repeatedly break, and bone graft surgical treatment is often not successful or feasible"
Fractures that do not heal within the normal timeframe are called non-union fractures. Using an animal model of a non-union fracture, a "knockout" mouse that lacks the ability to heal broken bones, Spagnoli and her colleagues studied the effects of transplanting adult stem cells enriched with IGF-I. They took mesenchymal stem cells (adult stem cells from the bone marrow) of mice and engineered the cells to express IGF-1. Then they transplanted the treated cells into knockout mice with a fracture of the tibia, the long bone of the leg.
Using computed tomography (CT) scanning, the researchers showed that the treated mice had better fracture healing than did control mice either left untreated or treated only with stem cells. They found that the stem cells enriched with IGF-I became bone cells and helped the cells in the broken bones to repair the fracture, speeding the healing. Compared with controls left to heal on their own, treated mice had more bone bridging the fracture gap, and that new bone was three to four times stronger, according to Spagnoli.
"More excitingly, we found that stem cells empowered with IGF-I restored the formation of new bone in a mouse lacking the ability to repair broken bones. This is the first evidence that stem cell therapy can address a deficiency of fracture repair," she said.
This success in an animal model of fracture non-union, Spagnoli said, "is a crucial step toward developing a stem cell-based treatment for patients with fracture non-unions."
"We envision a clinical use of combined mesenchymal stem cells and IGF-1 similar to the approach employed in bone marrow transplant, in which stem cell therapy is combined with growth factors to restore blood cells," she said. "I think this treatment will be feasible to start testing in patients in a few years."
IGF-I is approved for treatment of children with a deficiency of this hormone, causing growth failure.
The National Institutes of Health supported this study through a NIDDK-NIH R01 grant.

STEM CELL THERAPY.....

Stem Cells Fill Gaps in Bones




 For many patients the removal of several centimetres of bone from the lower leg following a serious injury or a tumour extraction is only the beginning of a long-lasting ordeal. Autologous stem cells have been found to accelerate and boost the healing process. Surgeons at the RUB clinic Bergmannsheil have achieved promising results: without stem cells, it takes on average 49 days for one centimetre of bone to regrow; with stem cells, that period has been reduced to 37 days.
In the past, large bone defect inevitably led to an amputation. Today, the arm or leg is stabilised in an external support, and a transport wire is pulled through the marrow of the intact part of the injured bone. Once the soft tissue surrounding the injury is healed, the surgeons cut the healthy part of the bone into two. The transport wire is affixed to the winches of a ring fixator that is attached around the leg. Using a sophisticated cable-pull system, the previously detached part of the bone is slowly pulled either downwards or upwards along the gap in the bone until it arrives and docks at the other end. During the pulling stage, the periosteum of the bone that had been pulled apart had been continuously stretched. Thus, a periosteum tube is created in the gap behind the relocated portion of the bone. Inside that tube, the new bone can regenerate. This process, however, is extremely tedious and the treatment fails in every firth case.

Processing autologous stem cells in the operating theatre
Surgeons at the RUB clinic Bergmannsheil attempt to optimise the healing process by applying autologous stem cells therapy. Depending on the requirements, stem cells are capable of evolving into different types of tissue cells, including so-called osteoblasts -- cells that are responsible for bone formation. Adult stem cells such as are deployed in the process can be found in the bone marrow of adults. "We harvest them by inserting a hollow needle into the iliac crest," explains PD Dr Dominik Seybold, managing consultant at the clinic.
The stem cells are prepared for application directly on location. Under x-ray control, the surgeons inject six to eight millilitres of the concentrated fluid into the centre of the periosteum tube. X-ray controls are routinely performed to monitor the recovery progress. To date, the RUB physicians have applied this therapy in 20 cases. "This is not enough to be statistically relevant," admits Dr Seybold. Nevertheless, the researchers find the results very encouraging: whilst the bone regeneration process without stem cells used to take 49 days on average, it has been reduced to 37 days on average thanks to the new therapy method. So far, RUB scientists have been treating bone defects with an average length of eight centimetres -- consequently, the patients thus recovered, on average, three months sooner.

Story Source:
The above story is reprinted from materials provided by Ruhr-Universitaet-Bochum, via AlphaGalileo.

Sunday, April 7, 2013

Natural killer cell = The wonder creation , may be a mutation of WBC......

Natural killer cell


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Natural killer cells (or NK cells) are a type of cytotoxic lymphocyte critical to the innate immune system. The role NK cells play is analogous to that of cytotoxic T cells in the vertebrate adaptive immune response. NK cells provide rapid responses to virally infected cells and respond to tumor formation, acting at around 3 days after infection. Typically immune cells detect MHC presented on infected cell surfaces, triggering cytokine release causing lysis or apoptosis. NK cells are unique, however, as they have the ability to recognize stressed cells in the absence of antibodies and MHC, allowing for a much faster immune reaction. They were named “natural killers” because of the initial notion that they do not require activation in order to kill cells that are missing “self” markers of major histocompatibility complex (MHC) class 1 .[1]
NK cells are defined as large granular lymphocytes (LGL) and constitute the third kind of cells differentiated from the common lymphoid progenitor generating B and T lymphocytes.[2] NK cells are known to differentiate and mature in the bone marrow, lymph node, spleen, tonsils and thymus where they then enter into the circulation. .[3] NK cells differ from Natural Killer T cells (NKT) phenotypically, by origin and by respective effector functions; often NKT cell activity promotes NK cell activity by secreting IFNγ. In contrast to NKT cells, NK cells do not express T-cell antigen receptors (TCR) or Pan T marker CD3 or surface immunoglobulins (Ig) B cell receptors, but they usually express the surface markers CD16 (FcγRIII) and CD56 in humans, NK1.1 or NK1.2 in C57BL/6 mice. Up to 80% of human NK cells also express CD8.
In addition to the knowledge that natural killer cells are effectors of innate immunity, recent research has uncovered information on both activating and inhibitory NK cell receptors which play important function roles including self tolerance and sustaining NK cell activity. NK cell also play a role in adaptive immune response ,[4] numerous experiments have worked to demonstrate their ability to readily adjust to the immediate environment and formulate antigen-specific immunological memory, fundamental for responding to secondary infections with the same antigen. The ability for NK cells to act in both the innate and adaptive immune response is becoming increasingly important in research utilizing NK cell activity and potential cancer therapies.
 
NK cell receptors :
NK cell receptors can also be differentiated based on function. Natural cytotoxicity receptors directly induce apoptosis after binding to ligands that directly indicate infection of a cell. The MHC dependent receptors (described above) use an alternate pathway to induce apoptosis in infected cells. Natural killer cell activation is determined by the balance of inhibitory and activating receptor stimulation i.e. if the inhibitory receptor signaling is more prominent then NK cell activity will be inhibited, similarly if the activating signal is dominant then NK cell activation will result .[5]

Protein Structure of NKG2D
NK cell receptor types (with inhibitory as well as some activating members) are differentiated by structure, with a couple of examples to follow:
Activating receptors
  • Ly49 (homodimers) — a relatively ancient, C-type lectin family receptor; are of multigenic presence in mice, while humans have only one pseudogenic Ly49; the receptor for classical (polymorphic) MHC I molecules.
  • NCR (natural cytotoxicity receptors), upon stimulation, mediate NK killing and release of IFNϒ.
  • CD94 : NKG2 (heterodimers) — a C-type lectin family receptor, conserved in both rodents and primates and identifies non-classical (also non-polymorphic) MHC I molecules like HLA-E. Expression of HLA-E at the cell surface is dependent on the presence of nonamer peptide epitope derived from the signal sequence of classical MHC class I molecules, which is generated by the sequential action of signal peptide peptidase and the proteasome. Though indirect, this is a way to survey the levels of classical (polymorphic) HLA molecules.
  • CD16 (FcγIIIA) play a role in antibody-dependent cell-mediated cytotoxicity (ADCC), in particular they bind IgG.

Function :

Cytolytic granule mediated cell apoptosis

NK cells are cytotoxic; small granules in their cytoplasm contain proteins such as perforin and proteases known as granzymes. Upon release in close proximity to a cell slated for killing, perforin forms pores in the cell membrane of the target cell, creating an aqueous channel through which the granzymes and associated molecules can enter, inducing either apoptosis or osmotic cell lysis. The distinction between apoptosis and cell lysis is important in immunology: lysing a virus-infected cell could potentially only release the virions, whereas apoptosis leads to destruction of the virus inside. αdefensins, an antimicrobial is also secreted by NK cells, it directly kills bacteria by disrupting their cell walls analogous to neutrophils.[3]

Antibody-dependent cell-mediated cytotoxicity (ADCC)

Infected cells are routinely opsonised with antibodies for detection by immune cells. Antibodies that bind to antigens can be recognised by FcϒRIII (CD16) receptors expressed on NK cells resulting in NK activation, release of cytolytic granules and consequent cell apoptosis .[6]

Cytokine induced NK and CTL activation

Cytokines play a crucial role in NK cell activation. As these are stress molecules released by cells upon viral infection, they serve to signal to the NK cell the presence of viral pathogens. Cytokines involved in NK activation include IL-12, IL-15, IL-18, IL-2, and CCL5. NK cells are activated in response to interferons or macrophage-derived cytokines. They serve to contain viral infections while the adaptive immune response is generating antigen-specific cytotoxic T cells that can clear the infection. NK cells work to control viral infections by secreting IFNγ and TNFα, IFNγ activates macrophages for phagocytosis and lysis and TNFα acts promote direct NK tumor cells killing. Patients deficient in NK cells prove to be highly susceptible to early phases of herpes virus infection.

Missing 'self' hypothesis


Schematic diagram indicating the complementary activities of cytotoxic T-cells and NK cells.
In order for NK cells to defend the body against viruses and other pathogens, they require mechanisms that enable the determination of whether a cell is infected or not. The exact mechanisms remain the subject of current investigation, but recognition of an "altered self" state is thought to be involved. To control their cytotoxic activity, NK cells possess two types of surface receptors: activating receptors and inhibitory receptors. Most of these receptors are not unique to NK cells and can be present in some T cell subsets as well.
These inhibitory receptors recognize MHC class I alleles, which could explain why NK cells kill cells possessing low levels of MHC class I molecules. This inhibition is crucial to the role played by NK cells. MHC class I molecules are the main mechanism by which cells display viral or tumor antigens to cytotoxic T-cells. A common evolutionary adaptation to this seen in both intracellular microbes and tumours, the chronic down-regulation of MHC I molecules, rendering the cell impervious to T-cell mediated immunity. It is believed that NK cells, evolved as an evolutionary response to this adaptation (the loss of the MHC deprives CD4/CD8 action so another immune cell evolved to fulfil the requirement). .[7]

Tumor cell surveillance

Natural Killer Cells (NK) often lack antigen specific cell surface receptors and therefore are part of innate immunity i.e. able to react immediately with no prior exposure to the pathogen. In both mice and humans NKs can be seen to play a role in tumor immuno-surveillance by directly inducing the death of tumor cells (NKs act as cytolytic effector lymphocytes) even with the absence of surface adhesion molecules and antigenic peptides, this role of NK cells is critical for immune success particularly because T cells are unable to recognize pathogens in the absence of surface antigens.[1] Tumor cell detection results in activation of NK cells and consequent cytokine production and release.
If the tumor cells do not cause inflammation they will also be regarded as self and therefore will not induce a T cell response. A number of cytokines are produced by NKs including Tumor Necrosis Factor α (TNFα), IFNγ and Interleukin (IL-10); TNFα and IL-10 act as pro-inflammatory and immuno-suppressors respectively. The activation of NK cells and subsequent production of cytolytic effector cells impacts macrophages, dendritic cells and neutrophils which subsequently affects antigen specific T and B cell responses. Instead of acting via antigen specific receptors, lysis of tumor cells by NK cells is mediated by alternative receptors including NKG2D, NKp44, NKp46, NKp30 and DNAM.[5] NKG2D is a disulphide linked homodimer which recognizes a number of ligands, including ULBP and MICA, which are typically expressed on tumor cells.
NK cells, along with macrophages and several other cell types, express the Fc receptor (FcR) molecule (FC-gamma-RIII = CD16), an activating biochemical receptor that binds the Fc portion of antibodies. This allows NK cells to target cells against which a humoral response has been mobilized and to lyse cells through Antibody-dependent cellular cytotoxicity (ADCC).NK cells promote the expression of FAS on cancer cells, FAS is not normally expressed on tumor cells, and it therefore aids FAS-dependent apoptosis upon binding with FASL expressing NK cells.[6]

NK cell function in adaptive response

The ability to generate memory cells following a primary infection and the consequent rapid immune activation and response to succeeding infections by the same antigen is fundamental to the role T and B cells play in the adaptive immune response. Despite prior belief that NK cells play no role in the adaptive immune responses, they have since been found to undergo expansion, contraction, memory maintenance and recall .[8]

NK cell function in pregnancy
As the majority of pregnancies involve two parents who are not tissue matched, successful pregnancy requires the mother's immune system to be suppressed. NK cells are thought to be an important cell type in this process.[9] These cells are known as "uterine NK cells" (uNK cells) and they differ from peripheral NK cells. They are in the CD56bright NK cell subset, potent at cytokine secretion, but with low cytotoxic ability and relatively similar to peripheral CD56bright NK cells, with a slightly different receptor profile.[9] These uNK cells are the most abundant leukocytes present in the uterus in early pregnancy, representing approximately 70% of leukocytes here, however where they originate from remains controversial.[10]
These NK cells have been shown to have the ability to elicit cell cytotoxicity in vitro, however at a lower level than peripheral NK cells, despite containing perforin.[11] Lack of cytotoxicity in vivo may be due to the presence of ligands for their inhibitory receptors. Trophoblast cells downregulate HLA-A and HLA-B in order to defend against cytotoxic T cell-mediated death. This would normally trigger NK cells by missing self recognition, however these cells survive. It is thought that the selective retention of HLA-E (which is a ligand for NK cell inhibitory receptor NKG2A) and HLA-G (which is a ligand for NK cell inhibitory receptor KIR2DL4) by the trophoblast defends it against NK cell-mediated death.[9]
NK cells secrete a high level of cytokines which help mediate their function. Some important cytokines they secrete include TNF-α, IL-10, IFN-γ and TGF-β, among others.[9] For example, IFN-γ dilates and thins the walls of maternal spiral arteries to enhance blood flow to the implantation site. [12]

NK cell evasion by tumor cells

By shedding decoy NKG2D soluble ligands tumor cells have evolved a process by which they are able to avoid immune responses. These soluble NKG2D ligands bind to NK cell NKG2D receptors activating a false NK response and consequently creating competition for the receptor site.[1] This method of evasion occurs in prostate cancer. In addition, prostate cancer tumors can evade CD8 cell recognition due to the ability to lose expression of MHC class 1 molecules. This example of immune evasion actually highlights NK cell importance in tumor surveillance and response as CD8 cells can consequently only act on tumor cells in response to NK initiated cytokine production (adaptive immune response) .[13]

History

In early experiments on cell-mediated cytotoxicity against tumor target cells, both in cancer patients and animal models, investigators consistently observed what was termed a "natural" reactivity, that is, a certain population of cells seemed to be able to lyse tumor cells without having been previously sensitized to them. As these discoveries were incompatible with the established model at the time, many initially considered that these observations were artifacts.[14] However, by 1973, 'natural killing' activity was established across a wide variety of species, and the existence of a separate lineage of cells possessing this ability was postulated.
The discovery that a unique type of lymphocyte was responsible for “natural” or spontaneous cytotoxicity was made in the early 1970s by doctoral student Rolf Kiessling and post-doctoral fellow Hugh Pross, in the mouse,[15] and by Hugh Pross and doctoral student Mikael Jondal in the human.[16][17] The mouse and human work was carried out under the supervision of professors Eva Klein and Hans Wigzell, respectively, of the Karolinska Institute, Stockholm. Kiessling’s research involved the well-characterized ability of T-lymphocytes to lyse tumor cells against which they had been previously immunized. Pross and Jondal were studying cell-mediated cytotoxicity in normal human blood and the effect of the removal of various receptor-bearing cells on this cytotoxicity. Later that same year Ronald Herberman published similar data with respect to the unique nature of the mouse effector cell.[18] The human data were confirmed, for the most part, by West et al.[19] using similar techniques and the same erythroleukemic target cell line, K562. K562 is highly sensitive to lysis by human NK cells and, over the decades, the K562 51Chromium-release assay has become the most commonly used assay to detect human NK functional activity.[20] Its almost universal use has meant that experimental data can be compared easily by different laboratories around the world.
Using discontinuous density centrifugation and, later, monoclonal antibodies, natural killing ability was mapped to the subset of large, granular lymphocytes known today as NK cells. The demonstration that density gradient-isolated large granular lymphocytes were responsible for human NK activity, made by Timonen and Saksela in 1980,[21] was the first time that NK cells had been visualized microscopically and was a major breakthrough in the field.

New findings

Anti-cancer therapy

Tumor specific antibodies are being used to target and destroy tumors with specific antigens. These antibodies employ effector cells such as NK cells activating them via their FC regions to target and lyse the specific pathogen. This has proven successful in treatment against breast cancer. Also trialed is combining monoclonal antibodies with KIR on NK cells in human cancer patients, the success of this has not yet been confirmed but studies are aimed in myeloid leukemia and multiple myeloma.[4] Understanding the importance of NK cells in tumor-immuno-surveillance is key to advancing and finding new cancer therapies.
NK cells in a study at Children's Hospital Boston in coordination with Dana-Farber Cancer Institute, whereby immunocompromised mice had contracted lymphomas from EBV infection, an NK activating receptor called NKG2D was fused with a stimulatory Fc portion of the EBV antibody. The NKG2D-Fc fusion proved capable of reducing tumor growth and prolonging survival of the recipients.[22]
In autologous immune enhancement therapy (AIET) the in vitro expanded NK cells are used along with T cells taken from the patients own peripheral blood and cultured without using feeder layers or animal serum.[23] These cells intravenously injected to the patient have been documented to provide additional survival benefits to cancer victims.[24][25][26]

Innate resistance to HIV?

Recent research suggests that specific KIR-MHC class 1 gene interactions could control innate genetic resistance to certain viral infections including HIV and its consequent development of AIDS.[3] Certain HLA allotypes have been found to determine the progression of HIV to AIDS; an example is the HLA-B57 and HLA-B27 alleles, which have been found to defer progression of HIV to AIDS. This is evident because patients expressing these HLA alleles are observed to have lower viral loads and a more gradual decline in CD4+ T cells numbers. Despite considerable research and data collected measuring the genetic correlation of HLA alleles and KIR allotypes, a firm conclusion has not yet been drawn as to what combination provides decrease HIV and AIDS susceptibility. Future research would aim to pinpoint relevant KIR/HLA interactions with aim to produce a vaccine against HIV/AIDS. NK cells can impose immune pressure on HIV, something that had previously been described only for T cells and antibodies [27] and that HIV mutates to avoid NK cell activity.[27]

 

Literature

  • Cellular and Molecular Immunology by Abbul K. Abbas & Andrew Lichtman Saunders Copyright 2003
  • How the Immune System Works, 2nd edition, by Lauren Sompayrac, PhD Blackwell Publishing 2003
  • Immunobiology: The Immune System In Health And Disease by Janeway, Travers, Walport & Shlomchik Churchchill Livingstone Copyright 2005
  • Kuby Immunology, 6th edition, by Thomas J. Kindt, Richard A. Goldsby,and Barbara A.OsborneW.H. Freeman and Company,New York
  • Tsuda Y, Cygler M, Gibbs BF, et al. (December 1994). "Design of potent bivalent thrombin inhibitors based on hirudin sequence: incorporation of nonsubstrate-type active site inhibitors". Biochemistry 33 (48): 14443–51. doi:10.1021/bi00252a010. PMID 7981204.

Baldness as a Signal of Heart Disease Risk

Baldness as a Signal of Heart Disease Risk


Courtesy : NY Times and BMJ online.

Baldness may indicate an increased risk for coronary heart disease.
The risk is associated only with male pattern baldness, the kind that starts at the top or back of the head, and not with a receding hairline, according to researchers who reviewed six studies that included 37,000 participants.
The analysis, published online in BMJ Open, found that baldness increased the risk for heart disease by between 30 and 40 percent compared with men with a full head of hair. They found the association among men 55 to 60 as well as among older men, and the more severe the baldness, the greater the risk.
The reason for the association is unclear, but the authors suggest that known risk factors for heart disease — hypertension, high cholesterol, smoking and others — may affect both conditions, and that baldness may be a marker of atherosclerosis. In previous studies, baldness has been linked to an increased risk of prostate cancer, diabetes and high blood pressure.
“It may be premature to confirm this relationship on the basis of only six studies,” said a co-author, Dr. Kazuo Hara, an associate professor of medicine at the University of Tokyo. “But the ultimate aim is to be able to predict the risk for heart disease more precisely in clinical practice.”