Modulation der Strahlen- und Chemosensitivität menschlicher Tumorzellen durch Interferon

Pankreaskarzinome und maligne Melanome weisen eine hohe Resistenz gegenüber Zytostatika und Bestrahlung in der Therapie auf. Die Behandlung eines metastasierenden Pankreaskarzinoms besteht aus einer Kombination aus 5-FU, CDDP und IR. Für die Behandlung des malignen Melanoms ist das methylierende Agenz DTIC das Mittel erster Wahl. Das ebenfalls methylierende Agenz TMZ, welches jedoch in Deutschland noch nicht für die Behandlung von malignen Melanomen zugelassen ist, erlangt immer größere Bedeutung. Die Ansprechrate der Tumore kann durch Kombination mit IFNs erhöht werden. In der vorliegenden Arbeit wurde an Pankreaskarzinom- bzw. Melanomzelllinien untersucht, ob IFNs einen radio- bzw. chemosensibilisierender Effekt ausüben und, wenn ja, welcher Mechanismus hierfür verantwortlich ist. Es wurden zehn Pankreaskarzinom-Zelllinien (Panc-1, Su8686, Capan-1, Capan-2, Bxpc-3, PA-TU 8988T, Aspc-1, HS 766T, Mia-PaCa-2 und PA-TU 8902) untersucht. Diese zeigten eine hohe Variabilität in ihrer intrinsischen Radiosensitivität sowie in ihrer Sensitivität gegenüber IFN-alpha und IFN-beta. IFN-beta erwies sich als toxischer im Vergleich zu IFN-alpha. Die radiosensibilisierende Wirkung der IFNs an Pankreaskarzinom-Zelllinien war moderat, wobei IFN-beta im Vergleich zu IFN-alpha effektiver war. Der radiosensibilisierende Effekt ging mit einer deutlichen Erhöhung der alpha-Komponente, der Überlebenskurven einher und kam durch eine IFN-beta vermittelte Verstärkung der IR-induzierten Apoptoserate zustande. Dies wurde sowohl durch SubG1 als auch durch Annexin V / PI Messungen gezeigt. Einen Einfluss von IFN-beta auf den Zellzyklus und die DSB-Reparatur konnte durch funktionelle Untersuchungen sowie durch PCR bzw. Western-Blot-Analysen als Grund für den sensibilisierdenen Effekt ausgeschlossen werden. Ein sensibilisierender Effekt von IFN-beta auf die durch TMZ-induzierte Zytotoxizität war für die Pankreaskarzinom-Zelllinien weder in MGMT-profizientem noch –depletiertem Zustand zu beobachten. Zur Untersuchung der sensibilisierenden Eigenschaften von IFNs gegenüber TMZ in malignen Melanomzelllinien wurden p53-Wildtyp (D05 und A375) und mutierte Zelllinien (D14 und RPMI 7951) untersucht. Gegenüber alleiniger TMZ-Behandlung reagierten die untersuchten p53-Wildtyp Melanomzelllinien nicht sensitiver auf eine Behandlung mit TMZ als p53-mutierte Zelllinien. Der Nachweis des Spaltprodukts der Caspase-9 lieferte einen Hinweis darauf, dass in den Melanomzelllinien unabhängig vom p53-Status nach alleiniger TMZ-Behandlung der mitochondriale Apoptoseweg aktiviert wird. Durch eine Vorbehandlung der Zellen mit IFN-alpha oder IFN-beta konnte die TMZ-induzierte Apoptoserate in malignen Melanomzellen deutlich gesteigert werden. In p53-Wildtyp Melanomzellen war der chemosensibilisierende Effekt der IFNs besonders ausgeprägt. IFN-beta erwies sich hierbei als effektiver, weshalb es für die folgenden Versuche verwendet wurde. Durch stabile Transfektion der Zelllinie D05 mit MGMT konnte das durch TMZ-induzierte Addukt O6MeG als für den sensibilisieredenen Effekt ausschlaggebende DNA-Schädigung charakterisiert werden. Western-Blot-Analysen und gamma-H2AX-Immunfluoreszenz Untersuchungen konnten einen Einfluss von IFN-beta auf die Prozessierung der Läsion O6MeG sowie einen Einfluss von IFN-beta auf die Induktion und Reparatur von TMZ verursachten DSBs ausschließen. Durch Experimente mit einem Fas-aktivierenden Antikörper und durch eine stabile Transfektion der Zelllinien D05 und A375 mit DN-FADD konnte gezeigt werden, dass p53-Wildtyp Melanomzellen nicht oder nur eingeschränkt in der Lage sind, nach TMZ-Behandlung über den Fas-Rezeptor Signalweg Apoptose zu induzieren. Ausschlaggebend hierfür ist die geringe Pro-Caspase-8 Expression dieser Zelllinien. Eine IFN-beta Vorbehandlung bewirkte eine Reaktivierung des Fas-Rezeptor Signalweges, was mit einer verstärkten Expression der Pro-Caspase-8 einherging. Durch Experimente mit Caspase-8 siRNA konnte diese IFN-beta induzierte Verstärkung der Pro-Caspase-8 Expression als entscheidender Faktor für den sensibilisierenden Effekt ausgemacht werden. Zum ersten Mal konnte damit in dieser Arbeit gezeigt werden, dass p53-Wildtyp Melanomzellen durch eine IFN-beta vermittelte Hochregulation der Pro-Caspase-8 ihre Fähigkeit wiedererlangen, nach TMZ-Behandlung über den Fas-Rezeptor Signalweg Apoptose auszulösen. Diese Arbeiten weisen einen Weg, auf welchem die hohe Resistenz von malignen Melanomzellen, welche zu 80 % das nicht mutierte p53 Gen beherbergen, über eine IFN-beta induzierte Reaktivierung der Fas-Rezeptor vermittelten Apoptosekaskade überwunden werden kann.

An interferon regulatory factor element controls the major immune modulator of murine cytomegalovirus

Immune modulation by herpesviruses, such as cytomegalovirus, is critical for the establishment of acute and persistent infection confronting a vigorous antiviral immune response of the host. Therefore, the action of immune-modulatory proteins has long been the subject of research, with the final goal to identify new strategies for antiviral therapy.rnIn the case of murine cytomegalovirus (mCMV), the viral m152 protein has been identified to play a major role in targeting components of both the innate and the adaptive immune system in terms of infected host-cell recognition in the effector phase of the antiviral immune response. On the one hand, it inhibits cell surface expression of RAE-1 and thereby prevents ligation of the activating natural killer (NK)-cell receptor NKG2D. On the other hand, it decreases cell surface expression of peptide-loaded MHC class I molecules thereby preventing antigen presentation to CD8 T cells. Ultimately, the outcome of CMV infection is determined by the interplay between viral and cellular factors.rnIn this context, the work presented here has revealed a novel and intriguing connection between viral m152 and cellular interferon (IFN), a key cytokine of the immune system: rnthe m152 promoter region contains an interferon regulatory factor element (IRFE) perfectly matching the consensus sequence of cellular IRFEs.rnThe biological relevance of this regulatory element was first suggested by sequence comparisons revealing its evolutionary conservation among various established laboratory strains of mCMV and more recent low-passage wild-derived virus isolates. Moreover, search of the mCMV genome revealed only three IRFE sites in the complete sequence. Importantly, the functionality of the IRFE in the m152 promoter was confirmed with the use of a mutant virus, representing a functional deletion of the IRFE, and its corresponding revertant virus. In particular, m152 gene expression was found to be inhibited in an IRFE-dependent manner in infected cells. Essentially, this inhibition proved to have a severe impact on the immune-modulatory function of m152, first demonstrated by a restored direct antigen presentation on infected cells for CD8 T-cell activation. Even more importantly, this effect of IRFE-mediated IFN signaling was validated in vivo by showing that the protective antiviral capacity of adoptively-transferred, antigen-specific CD8 T cells is also significantly restored by the IRFE-dependent inhibition of m152. Somewhat curious and surprising, the decrease in m152 protein simultaneously prevented an enhanced activation of NK cells in acute-infected mice, apparently independent of the RAE-1/NKG2D ligand/receptor interaction but rather due to reduced ‘missing-self’ recognition.rnTaken together, this work presents a so far unknown mechanism of IFN signaling to control mCMV immune modulation in acute infection.rnrn

Serum anti-interferon alpha antibodies in chronic hepatitis C patients treated with pegylated interferon alpha containing therapy

The development of anti-IFNα antibodies is an occurrence described in chronic hepatitis C patients during treatment with Interferonα/PEG-Interferonα. However, its relevance, especially in difficult-to treat patients, has not been defined. Methods: We retrospectively measured the serum levels of anti-IFNα antibodies (baseline and week 12) and IFNα levels (week 12) by ELISA in 76 previous non-responders, and in 14 naive patients treated with Pegylated-IFNα and Ribavirin. A group of 57 healthy donors (HD) was also assessed as control. Positivity to anti-IFNα antibodies was established on the values of HD. Results: Baseline anti-IFNα antibodies were detected in 15.5% of patients and in 7% of HD, with significantly higher concentrations in patients than HD (181.5±389.9 vs 95.9±143.0 ng mL−1, p=0.0023). All positive patients were IFNα-experienced. At week 12, the prevalence of positivity increased to 22.3 and 28.5% in experienced and naïve patients, respectively, and the levels of anti-IFNα antibodies did not differ between the two groups (391±792.3 vs 384.7±662.6 ng mL−1, respectively). IFNα concentrations were significantly lower in antibody-positive patients than in antibody-negatives (988.2±1402 vs 3462±830.8 pg mL−1, p≤0.0001) and the levels of antibodies and IFNα were inversely correlated (r=-0.405, p=0.0001). The antibody-positive population clustered in null responders (67%) and 19/21 patients (90%) did not achieve SVR. Conclusions: The development of anti-IFNα antibodies is a non-negligible occurrence in patients treated with PEG-IFNα, is stable over time, and has a relevant clinical impact when associated with low levels of circulating PEG-IFNα. It should be considered in patients undergoing treatments including PEG-IFNα.

The Combination of Interferon-Beta and HMG-CoA Reductase Inhibition in Multiple Sclerosis: Enthusiasm Lost too Soon?

Recent studies support the notion that statins, widely prescribed cholesterol-lowering agents, may target key elements in the immunological cascade leading to inflammation and tissue damage in the pathogenesis of multiple sclerosis (MS). Compelling experimental and observational clinical studies highlighted the possibility that statins may also exert immunomodulatory synergy with approved MS drugs, resulting in several randomized clinical trials testing statins in combination with interferon-beta (IFN-?). Some data, however, suggest that this particular combination may not be clinically beneficial, and might actually have a negative effect on the disease course in some patients with MS. In this regard, a small North American trial indicated that atorvastatin administered in combination with IFN-? may increase disease activity in relapsing-remitting MS. Although other trials did not confirm this finding, the enthusiasm for studies with statins dwindled. This review aims to provide a comprehensive overview of the completed clinical trials and reports of the interim analyses evaluating the combination of IFN-? and statins in MS. Moreover, we try to address the evident question whether usage of this combination routinely requires caution, since the number of IFN-?-treated MS patients receiving statins for lowering of cholesterol is expected to grow.

Dose-response effect of interleukin (IL)-1beta, tumour necrosis factor (TNF)-alpha, and interferon-y on the in vitro production of epithelial neutrophil activating peptide-78 (ENA-78), IL-8, and IL-6 by human endometrial stromal cells

The production of epithelial neutrophil activating peptide-78 (NA-78) and the interleukins IL-8 and IL-6 by endometrial stromal cells is stimulated by pro-inflammatory interleukin-1 (IL-1) and tumour necrosis factor-α (TNF-α). IL-8 is suggested to play a role in the pathogenesis of endometriosis, and in these women the peritoneal fluid concentrations of ENA-78 and IL-8 are increased. TNF-α has been tested together with interferon-γ because of their cooperative stimulation of IL-6. The release of IL-8, however, is inhibited with increasing interferon levels. The aim of the study was the analysis of the production of ENA-78, IL-6 and IL-8 by cultured human endometrial stromal cells in the presence of varying concentrations of IL-1β, TNF-α, and interferon-γ.

Atorvastatin added to interferon beta for relapsing multiple sclerosis: a randomized controlled trial

Statins have anti-inflammatory and immunomodulatory properties in addition to lipid-lowering effects. The present study evaluated the effect of atorvastatin added to interferon beta-1b in multiple sclerosis (MS) in a multicenter, randomized, parallel-group, rater-blinded study performed in eight Swiss hospitals. Seventy-seven patients with relapsing-remitting MS started interferon beta-1b every other day. After 3 months, they were randomized 1:1 to receive atorvastatin 40 mg/day or not in addition to interferon beta-1b until month 15. The primary endpoint was the proportion of patients with new lesions on T2-weighted images at month 15 compared to baseline at month three. At study end, the proportion of patients with new lesions on T2-weighted images was equal in both groups (odds ratio 1.14; 95 % CI 0.36-3.56; p = 0.81). All predefined secondary endpoints including number of new lesions and total lesion volume on T2-weighted images, total number of new Gd-enhancing lesions on T1-weighted images, total brain volume, volume of grey matter, volume of white matter, EDSS, MSFC, relapse rate, time to first relapse, number of relapse-free patients and neutralizing antibodies did not show any significant differences (all p values >0.1). Transient elevations of liver enzymes were more frequent with atorvastatin (p = 0.02). In conclusion, atorvastatin 40 mg/day in addition to interferon beta-1b did not have a beneficial effect on relapsing-remitting MS compared to interferon beta-1b monotherapy over a 12-month period.

Improved sensitivity of an interferon-gamma release assay (T-SPOT.TB™) in combination with tuberculin skin test for the diagnosis of latent tuberculosis in the presence of HIV co-infection

Background Interferon-gamma release assays (IGRA) are more specific than the tuberculin skin test (TST) for the diagnosis of Mycobacterium tuberculosis infection. Data on sensitivity are controversial in HIV infection. Methods IGRA (T-SPOT.TB) was performed using lymphocytes stored within 6 months before culture-confirmed tuberculosis was diagnosed in HIV-infected individuals in the Swiss HIV Cohort Study. Results 64 individuals (69% males, 45% of non-white ethnicity, median age 35 years (interquartile range [IQR] 31-42), 28% with prior AIDS) were analysed. Median CD4 cell count was 223 cells/μl (IQR 103-339), HIV-RNA was 4.7 log10 copies/mL (IQR 4.3-5.2). T-SPOT.TB resulted positive in 25 patients (39%), negative in 18 (28%) and indeterminate in 21 (33%), corresponding to a sensitivity of 39% (95% CI 27-51%) if all test results were considered, and 58% (95% CI 43-74%) if indeterminate results were excluded. Sensitivity of IGRA was independent of CD4 cell count (p = 0.698). Among 44 individuals with available TST, 22 (50%) had a positive TST. Agreement between TST and IGRA was 57% (kappa = 0.14, p = 0.177), and in 34% (10/29) both tests were positive. Combining TST and IGRA (at least one test positive) resulted in an improved sensitivity of 67% (95% CI 52-81%). In multivariate analysis, older age was associated with negative results of TST and T-SPOT.TB (OR 3.07, 95% CI 1,22-7.74, p = 0.017, per 10 years older). Conclusions T-SPOT.TB and TST have similar sensitivity to detect latent TB in HIV-infected individuals. Combining TST and IGRA may help clinicians to better select HIV-infected individuals with latent tuberculosis who qualify for preventive treatment.

Impaired type I and type III interferon induction and rhinovirus control in human cystic fibrosis airway epithelial cells

Rhinoviruses are important triggers of pulmonary exacerbations and possible contributors to long-term respiratory morbidity in cystic fibrosis (CF), but mechanisms leading to rhinovirus-induced CF exacerbations are poorly understood. It is hypothesised that there is a deficient innate immune response of the airway epithelium towards rhinovirus infection in CF.

Squirrel Monkeys (Saimiri sciureus) Infected with the Agent of Bovine Spongiform Encephalopathy Develop Tau Pathology

Squirrel monkeys (Saimiri sciureus) were infected experimentally with the agent of classical bovine spongiform encephalopathy (BSE). Two to four years later, six of the monkeys developed alterations in interactive behaviour and cognition and other neurological signs typical of transmissible spongiform encephalopathy (TSE). At necropsy examination, the brains from all of the monkeys showed pathological changes similar to those described in variant Creutzfeldt-Jakob disease (vCJD) of man, except that the squirrel monkey brains contained no PrP-amyloid plaques typical of that disease. Constant neuropathological features included spongiform degeneration, gliosis, deposition of abnormal prion protein (PrP(TSE)) and many deposits of abnormally phosphorylated tau protein (p-Tau) in several areas of the cerebrum and cerebellum. Western blots showed large amounts of proteinase K-resistant prion protein in the central nervous system. The striking absence of PrP plaques (prominent in brains of cynomolgus macaques [Macaca fascicularis] with experimentally-induced BSE and vCJD and in human patients with vCJD) reinforces the conclusion that the host plays a major role in determining the neuropathology of TSEs. Results of this study suggest that p-Tau, found in the brains of all BSE-infected monkeys, might play a role in the pathogenesis of TSEs. Whether p-Tau contributes to development of disease or appears as a secondary change late in the course of illness remains to be determined.