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and Granulocyte/Macrophage Colony-Stimulating Factor) Producing Donor Tumor-Infiltrating Lymphocytes1
Laboratory of Biologic Cancer Therapy, Department of Surgery, Division of Surgical Oncology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA 02115
| Abstract |
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and granulocyte/macrophage (GM)-CSF by donor TIL in vitro.
Here, we propose the mechanism through which adoptively transferred
Thy-1.1+ TIL induce a host antitumor response in congenic
Thy-1.2+ tumor-bearing mice. Donor Thy-1.1+ TIL
were detected at the tumor site 12 h after transfer. These
Thy-1.1+ cells produced IFN-
and GM-CSF in situ. The
percentage of Thy-1.1+ TIL at the tumor site increased up
to 16.4 ± 4.9% 24 h after transfer but decreased to
undetectable levels thereafter. In contrast, the percentages of host
cells producing IFN-
and GM-CSF continued to increase at the tumor
site. These increases were significantly higher in TIL +
rIL-2-treated mice compared with untreated mice and rIL-2-treated mice
48 h after TIL transfer. The appearance of IFN-
+
and GM-CSF+ cells was followed by a large influx of host
CD4+, CD8+, and Thy-1.2+ TIL and
eventually by tumor eradication. This response was tumor specific since
TIL obtained from MCA-205 did not induce high levels of IFN-
and
GM-CSF and did not induce tumor eradication of MCA-105 tumor.
Coinjection of Thy-1.1+ TIL and anti-IFN-
or
anti-GM-CSF mAb significantly inhibited antitumor efficacy of the
TIL + rIL-2 treatment. We conclude that successful adoptive
immunotherapy in this model is mediated through cytokine production by
adoptively transferred TIL that induce a host T cell-dependent
antitumor response. | Introduction |
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and TNF-
, than with their cytotoxicity
in vitro (14). Tumor-specific secretion of granulocyte/macrophage
colony-stimulating factor (GM-CSF) by lymph node lymphocytes was also
found to be associated with in vivo therapeutic efficacy (17). In
addition, we have shown not only that the CD3-activated TIL used in
these AIT experiments produced high levels of IFN-
and GM-CSF in
vitro but also that the level of cytokines was associated with the in
vivo efficacy of TIL (18). The controversy whether TIL induce tumor
eradication by direct cytolysis, cytokine secretion, or both is still
ongoing. It is also unknown to what extent a host immune response is
required for tumor eradication during TIL + rIL-2 therapy and
therefore how adoptively transferred TIL contribute to tumor
eradication. In some reports, suppression of host immune cells by
sublethal dose irradiation of the host or administration of
anti-Thy-1.2 Ab before the treatment efficacy did not abrogate the
efficacy of the AIT (14, 16). On the other hand, our group has shown
that host CD8+ T cells are critical in this type of AIT by
CD8+ T cell depletion and normal splenocyte recruitment
study (19). To evaluate the role of adoptively transferred TIL in
inducing a host immune response during TIL + rIL-2 treatment, we
explored the changes in T cell subset concentrations of both donor and
host at the tumor site using FACS analysis and
immunohistochemistry. | Materials and Methods |
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Female 6- to 8-wk-old C57BL/6 (Thy-1.2+) and
B6PL-Thy-1a (Thy-1.1+) mice were obtained from
The Jackson Laboratory, Bar Harbor, ME. C57BL/6 mice were used as
recipients for all AIT experiments, and female B6PL-Thy-1a
mice were used for TIL preparation. SCID mice
(C57BL/6J-prkdcSCID/SzJ) were also used for
recipient in some experiments. IFN-
gene knockout mice
(C57BL/6ifngtmlTs) were used for IFN-
gene knockout (gko) TIL preparation. The animals were housed in the
Dana-Farber Animal Facility under National Institutes of Health/Harvard
Medical School-approved animal subject conditions. All mice received
animal laboratory chow and water ad libitum.
Tumor
The weakly immunogenic syngeneic methylcholanthrene (MCA)-induced fibrosarcomas MCA-105 and MCA-205 were kindly provided by Drs. J. Yang and S. A. Rosenberg (National Cancer Institute, Bethesda, MD). They were maintained in vivo by s.c. passage of 5 x 105 cryopreserved or fresh tumor cells in C57BL/6 syngeneic mice or cultured in vitro (20, 21). MCA-105 and MCA-205 tumors were also used for generating TIL 2 to 3 wk after s.c. injection when tumor had reached a diameter of 1 to 2 cm.
Digestion of tumor and murine lungs
s.c. tumor and murine lungs were dissected, minced, and digested by mechanical stirring in a solution of 0.1% collagenase type IV, 0.01% hyaluronidase type V, and 0.002% DNase type I (Sigma Chemical Co., St. Louis, MO) in 40 ml of HBSS (BioWhittaker, Walkersville, MD) for 2 h at room temperature. The resulting single-cell suspension was filtrated through a sterile Nitex mesh (Lawshe Instrument Co., Rockville, MD) and washed twice in HBSS.
Preparation of TIL
The resulting single-cell suspension recovered from s.c. MCA-105
or MCA-205 tumors of B6PL-Thy-1a
(Thy-1.1+) or C57/6ifngtm1Ts
(IFN-
gko) mice was resuspended at a density of 5 x
105 cells/ml in RPMI 1640 containing 10% FCS, 2 mM
L-glutamine, 1 mM sodium pyruvate, 0.1 mM nonessential
amino acids, 100 IU/ml penicillin, 100 µg/ml streptomycin (all
BioWhittaker), 5 x 10-5 M 2-ME (Sigma), and 100
IU/ml rIL-2 (AMGEN, Thousand Oaks, CA). Then it was placed onto solid
phase anti-CD3 mAb (supernatant from 145-2C11 hybridoma; American
Type Culture Collection, Rockville, MD)-coated flasks (4). After
48 h, the cells were collected with cell scrapers (Costar,
Cambridge, MA). The cells were washed and resuspended in culture medium
as described above. Every 3 to 4 days, cultures were split by cell
redistribution into new flasks with addition of new culture medium. TIL
were expanded for
3 to 4 wk before they were used in in vivo
experiments.
Cytokine release assay
T cells were placed in rIL-2-free medium for 24 h before
experiments. For cytokine release, T cells (106/ml)
were placed in culture medium with or without anti-CD3 mAb coating.
T cells were incubated at 37°C for 24 h; then the supernatant
was collected, centrifuged to remove any cells, and frozen at -20°C.
Aliquots were thawed and tested by ELISA for the presence of IFN-
and GM-CSF.
Adoptive immunotherapy model
Thy-1.2+ mice were injected i.v. with 5 x
105 MCA-105 or MCA-205 tumor cells in 1 ml of HBSS on day
0. Thy-1.1+ or IFN-
gko TIL from s.c. MCA-105 or MCA-205
tumor were transferred i.v. at 5 x 106 cells on day 3
after tumor injection. rIL-2 was given i.p. twice daily at 30,000 IU/ml
from day 3 to day 7. Control groups received no treatment or rIL-2
only. Animals were killed on day 14 (MCA-205 tumor-injected animals) or
day 21 (MCA-105 tumor-injected animals). Murine lungs were insufflated
using a 15% solution of India ink (Farber-Castell Co., Lewisburg, TN),
washed in water, and bleached in Feketes solution (22). The number of
pulmonary metastases in treatment and control groups was counted in a
blinded fashion and reported as the mean ± SEM. Each group
consisted of 5 to 10 animals. Murine lungs were dissected and prepared
for phenotyping and immunohistochemistry at different intervals
following TIL transfer up to day 21.
Flow cytometric analysis
Single-cell suspensions of processed murine lungs were aliquoted
at a concentration of 5 x 105 lymphocytes/ml and
stained by rat anti-mouse CD4/PE, CD8/FITC (both Becton Dickinson
Immunocytometry Systems, Mountain View, CA), mouse anti-mouse
Thy-1.1/PE (PharMingen, San Diego, CA), biotinylated rat anti-mouse
Thy-1.2 (Becton Dickinson), rat anti-mouse Mac-3/FITC,
mouse-anti-mouse NK-1.1/PE, rat anti-mouse IFN-
, and GM-CSF
(all PharMingen) mAb or control murine IgG For staining of
intracellular cytokines (IFN-
and GM-CSF); cells were prefixed with
4% paraformaldehyde (Sigma) for 10 min at 4°C and washed with
staining buffer (BSS with 0.1% sodium azide, 0.1% saponin, and 5%
FCS) twice (23, 24). For indirect staining, cells were incubated with
primary mAb in staining medium (HBSS with 0.1% sodium azide and 5%
FCS) for 30 min at 4°C. After two washings with staining buffer,
cells were stained with FITC-conjugated goat anti-rat IgG (mouse
adsorbed, Life Technologies, Gaithersburg, MD) or FITC-conjugated
avidin (Becton Dickinson) for 30 min at 4°C. The stained cells were
fixed with 1% paraformaldehyde at 4°C. Flow cytometric analysis of
the stained lymphocytes was performed on a Coulter Epics C cytometer
(Coulter Electronics, Hialeah, FL). Percentages of positive cells were
calculated of the total lymphocyte population. Multiple samples were
compared using the same gate settings for lymphocytes. Five to seven
mice were analyzed in each group on each day. Each experiment was
repeated at least three times using newly prepared TIL that showed
efficacy in eradication of pulmonary metastatic tumors in
vivo.
Immunohistochemistry
Specimens were embedded in OCT compound (Miles, Elkhart, IN) and
snap frozen in liquid nitrogen (-170°C). Frozen blocks were stored
at -80°C until used. Frozen serial sections were cut 5 mm thick on a
microtome-cryostat. Sections were fixed in cold acetone for 5 min,
preincubated with rabbit serum at room temperature for 15 min, and
subsequently incubated with primary Abs (rat anti-mouse CD8, CD4,
Thy-1.2, IFN-
, GM-CSF, and biotinylated mouse anti-mouse
Thy-1.1) at 4°C overnight, biotinylated rabbit anti-rat IgG
(mouse adsorbed, Vector Laboratories Inc., Burlingame, CA) at room
temperature for 30 min, and avidin-peroxidase conjugate at room
temperature for 30 min. Then sections were incubated with 0.03%
H2O2 and 0.06% diaminobenzidine
(Vector).
Cytokine depletion
On day 3 at the same time of TIL injection, some mice were
injected with 1.0 ml of HBSS containing
100 µg of rat
anti-mouse IFN-
IgG1 (R4-6A2 hybridoma) obtained from American
Type Culture Collection (ATCC, Rockville, MD) (25). Previous
experiments showed depletion of IFN-
lasting for at least 48 h
(14, 16, 25). Because of the timing, this depletion inhibited the
secretion of IFN-
by the adoptively transferred
Thy-1.1+ cells as well as host Thy-1.2+
cells. Similarly, mice were injected on day 3 with 1.0 ml of HBSS
containing 100 µg of rat anti-mouse GM-CSF IgG2a (clone:
MP1-22E9, PharMingen) (26). Injection of control rat IgG1 (PharMingen)
did not affect the number of pulmonary metastases in TIL + rIL-2
treatment.
Statistical analysis
The statistical significance between treatment and control groups was determined by the nonparametric Wilcoxon rank sum test and was considered significant when the p value was <0.05. All p values are two-sided.
| Results |
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To test the efficacy of tumor eradication using
Thy-1.1+ donor TIL in vivo, the numbers of pulmonary
metastases were counted on day 21 after tumor injection in MCA-105
tumor-bearing mice (Fig. 1
A). Each treatment
group consisted of 5 to 10 mice. Only the TIL-105 + rIL-2
treatment significantly reduced the numbers of pulmonary metastases
compared with control untreated mice (p <
0.01; Fig. 1
A). The number of metastases in
rIL-2-treated mice in the absence of TIL or TIL-105-treated mice in the
absence of rIL-2 was similar to those in control animals. To determine
the specificity of TIL-mediated tumor eradication, TIL obtained from
MCA-205 tumor was used as control. TIL-205 + rIL-2 did not
eradicate MCA-105 tumor. However, in MCA-205 tumor-bearing mice, the
TIL-205 + rIL-2 treatment significantly reduced the numbers of
pulmonary metastases compared with control untreated mice, IL-2
only-treated mice, or TIL-205 only-treated mice (Fig. 1
B). However, TIL-105 + rIL-2 had no effect in
MCA-205 tumor-bearing mice.
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Utilizing the MCA-105 model, we further investigated the
mechanisms of AIT with TIL + rIL-2. Donor
Thy-1.1+ TIL-105 reproducibly contained >95%
CD8+ T cells and 0 to 1% CD4+ T cells at the
time of AIT. The changes in T cell subsets at the tumor sites were
followed by flow cytometric analysis. Percentages of positive cells of
the total lymphocyte population were calculated. Multiple samples were
compared using the same gate settings for lymphocytes. In vivo, donor
Thy-1.1+ cells were detectable in the lungs of TIL-105
+ rIL-2-treated mice for only 72 h. The percentage of donor
Thy-1.1+ cells in the lungs of TIL-105 + rIL-2-treated
mice increased up to 16.4% 24 h after TIL transfer and then
gradually decreased. On day 3 after transfer (day 7 after tumor
injection), donor Thy-1.1+ cells were undetectable (Fig. 3
A). In contrast, the
percentage of host Thy-1.2+ cells rapidly increased in
TIL-105 + rIL-2-treated but not in untreated mice after the
disappearance of donor Thy-1.1+ cells. These
Thy-1.2+ cells consisted of almost equal percentages of
CD8+ and CD4+ T cells. On day 7 after tumor
injection, the percentages of CD8+, CD4+, and
Thy-1.2+ cells in TIL-105 + rIL-2-treated mice had
increased to significantly higher levels compared with those of the
control mice (Thy-1.2+ cells: 83.9% vs 34%,
p < 0.05; CD8+ cells: 16.2% vs 10.1%,
p < 0.05; CD4+ cells: 15.9% vs 8.1%,
p < 0.05, respectively). The high percentages of host
Thy-1.2+, CD8+, and CD4+ T cells
were also seen in lungs of rIL-2-treated mice as well as TIL-205 +
rIL-2-treated mice (Fig. 3
, B and C,
respectively), suggesting that the composition of lymphocytic
infiltrates were similar for all three treatments. After day 7, high
levels of CD8+, CD4+, and Thy-1.2+
T cells were sustained in TIL-105 + rIL-2-treated mice but were
not always significantly different from those of control mice.
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Earlier, we showed that anti-CD3-activated TIL-105 produced
cytokines among which IFN-
and GM-CSF were the most prominent (18).
In addition, phenotype analysis showed that in vitro-activated
Thy-1.1+ TIL-105 consisted of 68.5 ± 10.5%
IFN-
+ cells and 11.5 ± 1.4% GM-CSF+
cells (average ± SE; data not shown). As shown in Figure 3
A, the percentage of Thy-1.1+ cells in lungs of
TIL-105 + rIL-2-treated mice increased up to 16.4 ± 5.0%
after 24 h and decreased to undetectable levels thereafter (Fig. 7
). The rapid increase in the percentages
of IFN-
+ cells and GM-CSF+ cells followed
the appearance of donor Thy-1.1+ cells. The sustained
levels of IFN-
+ cells and GM-CSF+ cells from
day 5 to day 10 could not be due to donor Thy-1.1+ cells
(Fig. 7
). As shown in Figure 8
, the
percentages of IFN-
+ and GM-CSF+ cells in
lungs of TIL-105 + rIL-2-treated mice were higher than those in
lungs of rIL-2-treated or untreated control mice, reaching significance
on day 5 after tumor injection (IFN-
+ cells: 24.7% vs
5.7% and 7.0%, p < 0.01; GM-CSF+ cells:
38.9% vs 17.4% and 21.1%, p < 0.05, Fig. 8
A). Likewise, the increase in percentage of
IFN-
+ and GM-CSF+ cells was significantly
higher in MCA-105 tumor treated with TIL-105 than in MCA-105 tumor
treated with TIL-205 on day 5 (IFN-
+ cells: 24.7% vs
7.7%; GM-CSF+ cells: 38.9% vs 25.9%, p
< 0.05, respectively; Fig. 8
B). Similarly, the
increases in IFN-
+ and GM-CSF+ cells in
MCA-205 tumor treated with TIL-205 were significantly higher than
those treated with TIL-105 on day 5 (IFN-
+ cells: 29.1%
vs 12.9%, p < 0.05; GM-CSF+ cells: 35.1%
vs 18.8%, p < 0.05, respectively; Fig. 8
C).
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and GM-CSF production in lungs of tumor-bearing mice.
Twelve hours after TIL injection, Thy-1.1+
IFN-
+ cells and Thy-1.1+ GM-CSF+
cells were detected in lungs of TIL105 + rIL-2-treated MCA-105
tumor-bearing mice by flow cytometry (Fig. 9
+, and GM-CSF+ cells continued to
increase (Fig. 9
+ cells and GM-CSF+ cells were
still present. This observation confirmed that infiltrating host cells
accounted for the ongoing increases of IFN-
and GM-CSF production
after donor Thy-1.1+ cells were no longer detectable (Fig. 7
+ cells, and
GM-CSF+ cells at the periphery of metastatic foci
(Fig. 10
+
and GM-CSF+ cell areas (Fig. 10
and GM-CSF. Attempts to double stain the
infiltrate at 96 h with anti-Thy-1.2 and anti-IFN-
or
GM-CSF mAb showed <10% double-positive cells. Interestingly, the
percentages of Mac-3+ cells and NK-1.1+ cells
increased after donor Thy-1.1 cells were no longer detectable (Figs. 7
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and GM-CSF depletions
To confirm the importance of IFN-
and GM-CSF in TIL +
rIL-2 treatment, MCA-105 tumor-bearing mice were injected i.p. with
anti-mouse IFN-
or anti-mouse GM-CSF mAbs at the same time
as TIL injection. The numbers of pulmonary metastases in
anti-IFN-
mAb injected animals were similar to those of control
untreated animals (172 metastases), whereas administration of
anti-GM-CSF mAb resulted in 86 metastases (Table I
). Thus, antitumor efficacy of TIL
+ rIL-2 treatment was completely inhibited by depletion of IFN-
and
partially inhibited by depletion of GM-CSF. Because of its timing (day
3, immediately following adoptive transfer of Thy-1.1+
cells), it should be noted that mAbs depleted host- as well as
donor-produced IFN-
and GM-CSF.
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MCA-105 tumor-bearing mice were treated with TIL from IFN-
gko
C57BL/6 mice + rIL-2. Only TIL from w.t. C57BL/6 mice combined
with rIL-2 significantly reduced the numbers of pulmonary metastases
but not gko-TIL; those were deficient in production of IFN-
(rIL-2
alone vs TIL + rIL-2, p < 0.01; TIL + rIL-2
vs IFN-
gko-TIL, p < 0.05, respectively;
Fig. 12
gko-TIL can produce GM-CSF as well as other cytokines such as TNF-
(data not shown) but not IFN-
.
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| Discussion |
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We detected Thy-1.1+ donor TIL at the tumor site
immediately following adoptive transfer. The percentage of
Thy-1.1+ cells actually increased over time. After 96
h, however, no donor Thy-1.1+ cells could be detected in
the lungs by immunohistochemistry or FACS analysis (Figs. 3
, 6
, and 9
).
These findings are consistent with those of Matsumura et al. in the
MCA-106 and MCA-205 model (5): Cloned MCA-106 TIL transferred into
MCA-106 tumor-bearing mice accumulated at the tumor sites. This
accumulation was apparent over a 24-h period after transfer and was
associated with tumor eradication. Apparent from this study was also
that the accumulation and subsequent tumor eradication was tumor
specific. No accumulation of MCA-106 TIL was detected in MCA-205
tumor-bearing animals. Likewise, in our study, TIL-105 used in AIT
induced eradication of MCA-105 tumor but TIL-205 did not (Fig. 1
).
Therefore, tumor eradication induced by adoptively transferred TIL in
vivo seems to be dependent on a transient accumulation of
tumor-specific donor TIL at the tumor site.
The hypothesis that donor TIL induce tumor eradication through cytokine
secretion was based on the observation that noncytolytic TIL could
eradicate murine pulmonary micrometastases in vivo (14, 15, 16, 17). Some
investigators also demonstrated that anti-cytokine Abs inhibited
the antitumor efficacy of TIL in vivo (14, 16). Similarly, our study
showed that Thy-1.1+ TIL cultured in low dose rIL-2 (100
IU/ml) induced in vivo antitumor efficacy in Thy-1.2+ hosts
(Fig. 1
), yet these TIL showed little or no tumor-specific cytotoxic
activity in vitro in 4-h or 6-h chromium release assays (data not
shown) and are detectable in the lungs of the host for only 72 h.
This would imply that by itself the donor T cell-mediated cytolysis of
tumor is insufficient to yield the results observed on day 21 (MCA-105)
or day 14 (MCA-205 (Fig. 1
)).
We previously reported that depletion of host CD8+ T cells
but not CD4+ T cells before TIL transfer abrogated
antitumor efficacy. Additionally, adding back normal splenocytes after
CD8+ cell depletion reconstituted antitumor efficacy (19).
In the current study, we demonstrated that successful AIT with TIL
+ rIL-2 was dependent on an immunocompetent host (Fig. 2
). A
significant infiltration of host Thy-1.2+,
CD8+, and CD4+ T cells at tumor sites was
observed in TIL-105 + rIL-2-treated mice as determined by FACS
analysis and histology (Figs. 3
A and 4C).
Although increased percentages of Thy-1.2+,
CD8+, and CD4+ T cells were also found in
rIL-2-treated and TIL-205 + rIL-2-treated animals (Fig. 3
, B and C),, histologic evaluation showed a
much larger infiltrate in TIL-105 + rIL-2-treated animals compared
with all other groups (Fig. 4
). This suggests that the infiltrate of
host T cells is more a reflection of IL-2 than anything else. However,
only treatment with TIL + rIL-2 caused a massive infiltration of
host CD8+ and CD4+ cells into metastatic foci
and tumor lysis on day 7 (Figs. 4
C, 5, and 6). TIL derived
from MCA-205 tumor caused no tumor lysis or lymphocytic infiltration
even in combination with rIL-2 (data not shown). Perhaps with higher
doses of rIL-2, a larger percentage of CD4+ and
CD8+ T cells would infiltrate into the tumor, consistent
with prior reports that rIL-2 treatment can be effective at very high
doses, but occurs at the expense of host toxicity. We are utilizing
relatively low doses of rIL-2. Thus, recruitment of host immune cells
and infiltration into the tumor in response to adoptive transfer of T
cells in a crucial event in successful eradication.
How does recruitment of host cells occur? The evaluation of
cytokines (IFN-
and GM-CSF) using FACS analysis and
immunohistochemistry over time showed the appearance of
cytokine-producing donor TIL at the periphery of the tumor site within
24 h (Figs. 9
and 10
). Shortly after the increase in
Thy-1.1+ T cells, there was an increase in
IFN-
+ and GM-CSF+ Thy-1.1-negative host
cells (Figs. 7
and 9
B). Only the combination of
tumor-specific TIL and IL-2 induced the significant increase of
IFN-
+ and/or GM-CSF+ host cells on day 2
after TIL transfer (Figs. 7
and 8
). Depletion of these cytokines
completely (IFN-
) or partially (GM-CSF) inhibited tumor eradication
(Table I
). In addition, TIL deficient in production of IFN-
(gko-TIL) failed to induce an effective antitumor response (Fig. 12
).
These data suggest that cytokines produced by the transferred TIL
trigger the initiation of a cascade of events in the host resulting in
recruitment of host immune cells. This may partially explain why
previous LAK cell and TIL therapies in humans had unpredictable
results. Some patients with large amounts of disease responded
completely, and some patients with very little metastatic disease had
no response. It may also explain the observation during these trials of
a "triggering" response; i.e., once switched on, the patient had a
rapid and dramatic antitumor response.
It is controversial to what extent a host immune response is
required for tumor eradication in AIT. There have been some reports
supporting that AIT is independent from host immune response. Sublethal
dose irradiation of host before treatment has been reported not to
affect the efficacy of TIL+ rIL-2 therapy (14, 16). However,
irradiation-resistant host cells such as macrophages may participate in
the tumor eradication. Tuttle et al. reported that IFN-
produced by
adoptively transferred T cells plays a key role in AIT, but depletion
of Thy-1.2+ cells by mAb 24 h before treatment did not
abrogate the effectiveness of AIT in a 14-day protocol (16). These
findings are not necessarily in contrast with our findings if the
depletion of Thy-1.2+ cells lasted for only 24 to 48
h. In our earlier studies (19), we found that depletion of either CD4
or CD8 T cells by mAbs lasted for only 48 h. In addition, our
experiment in C57BL6/SCID mice suggests that an immunocompetent host is
required for successful AIT (Fig. 2
).
It is possible that cytokines other than IFN-
and GM-CSF are
produced locally at the tumor site in this model such as TNF-
(14, 16, 30). Preliminary data show that the percentage of
TNF-
+ cells in the lungs of TIL + rIL-2-treated
mice is significantly higher than in those in untreated and
rIL-2-treated mice in MCA-105 and MCA-205 models (data not shown).
IFN-
and TNF-
are cytokines that may directly exert a cytotoxic
effect on tumor cells. Recombinant murine IFN-
had a significant
antiproliferative effect against MCA-105 tumor cells when tested in a
[3H]TdR uptake assay (16). Nonspecific inflammatory
responses can be mediated by IL-2, IFN-
, GM-CSF, and TNF-
which
can further activate macrophages, dendritic cells, NK cells, and
granulocytes that may produce cytokines such as IL-1
, IL-1ß, IL-2,
IL-6, and IL-12 (14, 25, 31, 32, 33, 34, 35, 36). Macrophages activated by IFN-
had
increased antitumor cytotoxicity in vitro (37, 38, 39). Mule et al.
reported that host macrophages seemed to play an important role in AIT
using splenocytes from tumor-bearing mice (40). Therefore, host immune
cells, such as macrophages and CD8+ T cells, are likely to
play an important role in eradication of tumor. APC such as dendritic
cells and macrophages activated by GM-CSF may participate in the
establishment of an antitumor immune response (17, 41, 42, 43, 44, 45). Our data
demonstrated an enhanced infiltration of macrophages, NK cells, and
dendritic cells at the tumor sites in TIL + rIL-2-treated mice
compared with other treatment groups (Fig. 11
and data not shown).
In spite of the nonspecific infiltration, tumor eradication by TIL
+ rIL-2 was a tumor-specific reaction. Through restimulation by
specific tumor-associated Ags (TAA) (one of which was recently
identified by Itoh et al. (46)) at the tumor site, adoptively
transferred TIL may express cytotoxicity against tumor cells and
release cytokines. The importance of this was indicated by AIT
experiments in which TIL-105 had little efficacy against MCA-205 tumor
and TIL-205 had little efficacy against MCA-105 tumor (Fig. 1
).
However, highly significant tumor eradication and increased levels of
IFN-
and GM-CSF production at the tumor sites were observed when
TIL-105 or TIL-205 were transferred into MCA-105 and MCA-205
tumor-bearing animals, respectively (Fig. 8
, B and
C). Thus, local reactivation of adoptively
transferred TIL by TAA may initiate the cytokine-mediated recruitment
of host cells. Fig. 13
summarizes our proposed
mechanism of AIT. Immediately after TIL transfer, adoptively
transferred T cells migrate to the tumor sites and release cytokines.
This local cytokine production initiates the influx of host immune
cells such as NK cells, macrophages, dendritic cells, CD8+
T cells, and CD4+ T cells to the tumor sites. The
availability of APC may promote Ag presentation, which may induce T
cells to proliferate and exhibit tumor eradication.
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, TNF-
, GM-CSF, etc.) or genetic
modification of tumor cells to produce cytokines, the advantages of AIT
with T cells are: 1) two different mechanisms are activated leading to
tumor eradication; 2) cytokines are concentrated selectively at the
tumor site; 3) there are fewer side effects. The disadvantages,
however, are the expenses associated with ex vivo preparation of TIL
for adoptive transfer and the toxicity associated with systemic rIL-2
administration (47, 48, 49, 50, 51, 52). However, if we could illicit a host immune
response that was specific (i.e., by using a peptide/DNA vaccine), we
could bypass the disadvantages of this expensive, toxic, ex vivo
treatment of metastatic disease. We are currently identifying tumor Ags
(53, 54) and exploring vector design to sensitize the host immune
response to accomplish these goals.
Our findings confirm the hypothesis that the initiation of a
cytokine cascade at the tumor site is triggered by cytokine-producing
adoptively transferred TIL. We conclude that successful AIT is
dependent on the production of cytokines such as IFN-
and GM-CSF at
the tumor site by donor TIL, followed by the infiltration of host
CD8+ and CD4+ T cells into tumor with further
production of these cytokines. The result is specific tumor
eradication.
| Footnotes |
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2 Both authors contributed equally to this work. ![]()
3 Current address: Surgical University Hospital, University of Heidelberg, INF 110, 69120 Heidelberg, Germany. ![]()
4 Address correspondence and reprint requests to Dr. Timothy J. Eberlein, Laboratory of Biologic Cancer Therapy, Department of Surgery, Division of Surgical Oncology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA 02115. E-mail address: ![]()
5 Abbreviations used in this paper: AIT, adoptive immunotherapy; LAK cells, lymphokine-activated killer cells; TIL, tumor-infiltrating lymphocytes; GM-CSF, granulocyte/macrophage colony-stimulating factor; gko,
-interferon gene knockout; w.t., wild-type; TAA, tumor-associated antigens; MCA, methylcholanthrene. ![]()
Received for publication May 27, 1997. Accepted for publication September 19, 1997.
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