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The Jackson Laboratory, Bar Harbor, ME 04609
| Abstract |
|---|
|
|
|---|
ß or 
T cells were
required for an antitumor effect induced by CY + IL-15 therapy.
However, mice lacking in both
ß and 
T cells failed to
respond to combination therapy. Cured B6 and
ß or 
T
cell-deficient mice were immune to rechallenge with 76-9, but not B16LM
tumor. B cell-deficient mice showed a significant improvement in the
survival rate both after CY and combination CY + IL-15 therapy compared
with normal B6 mice. Overall, the data suggest that the interaction of
NK cells with tumor-specific
ß or 
T lymphocytes is
necessary for successful therapy, while B cells appear to suppress the
antitumor effects of CY + IL-15 therapy. | Introduction |
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T cells (5),
and B cells (6). It has been reported recently that IL-15 induces the
production of proinflammatory cytokines from macrophages
(M
)3 (7) and activates
human neutrophils (8). Reports that IL-15 induces the expression of
mRNA for perforin and granzymes in murine lymphocytes (9), activates
human PBL for perforin-mediated lysis of melanoma and lung cancer tumor
cells (10, 11), and induces the generation of CTL (1) and the
maturation/differentiation of cytotoxic NK cells (12, 13) suggest that
this cytokine may play an important role in antitumor immunity. Indeed,
it was shown that administration of IL-15 prolonged survival of
lymphoma-bearing mice (14) and suppressed pulmonary metastases induced
by i.v. injection of sarcoma cells (15).
It was shown previously in this laboratory that IL-15 acted as an
adjuvant when administered in combination with CY, significantly
prolonging the life of mice bearing the i.m. implanted 76-9
rhabdomyosarcoma (16). Combination therapy was seen to induce an
increase in NK cells in vivo. These were shown to be cytotoxic in vitro
against YAC-1 cells, and to exert antitumor effects when adoptively
transferred to CY-treated tumor-bearing (TB) mice. Their lack of
cytotoxic activity in vitro against the 76-9 tumor, together with
little or no evidence for IL-15-induced MHC class I-restricted lysis,
suggested that NK cell involvement in antitumor activity was probably
indirect and mediated via its secretory products. However, the
mechanisms of the combined action of CY and IL-15 on tumors still need
to be clarified. It is established that CY augments delayed-type
sensitivity reactions by eliminating suppressor T cells (17) or by
increasing the production of Th1-related cytokines (18). It has been
reported that CY increases the localization of effector cells in the
tumor mass (19), to augment the antitumor action of adoptively
transferred tumor-infiltrating lymphocytes in clinical trials (20), and
increases therapeutic efficacy of IL-2 (21). In addition, as was shown
in this laboratory, CY injection resulted in an increase in
tumor-associated M
, as well as NK cell and granulocyte precursors
(22, 23). Thus, because of its reported ability to react with NK cells,
M
, granulocytes, T cells, and B cells, as cited above, it seems
plausible to suggest that antitumor adjuvant activity of IL-15 may
be mediated by activation of any or all of these cellular
compartments following CY chemotherapy.
In this study, we examined the impact of IL-15 as an adjuvant to cancer chemotherapy using CY in an experimental pulmonary metastasis model. In addition, we explored the cellular compartments most likely to be involved in successful CY + IL-15 therapy.
| Materials and Methods |
|---|
|
|
|---|
Male C57BL/6J, C57BL/6J-Lystbg (B6.beige),
C57BL/6J-Prkdcscid/SzJ (B6.scid),
C57BL/6J-Hfh11nu (B6.nude), C57BL/6J-TCRbtm1Mom
(B6.TCR-ß-/-), C57BL/6J-TCRdtm1Mom
(B6.TCR-
-/-),
C57BL/6J-TCRbtm1MomTCRdtm1Mom
(B6.TCR-ß
-/-), and C57BL/6-Igh-6tm1Cgn
(B6.IgH-6-/-) mice 810 wk old were obtained from The
Jackson Laboratory Animal Resources Unit (Bar Harbor, ME). The absence
of T cells in the TCR knockout and nude mice, and B cells in the B
cell-deficient mice was confirmed by flow cytometry analyses. The
absence of cytotoxic NK cells in beige mice was confirmed in
cytotoxicity assays against YAC-1 cells.
Tumor cells
76-9 tumor is a syngeneic B6 3-methylcholanthrene-induced, weakly immunogenic rhabdomyosarcoma described previously (24). The tumor was passed in vivo in B6 mice every 23 wk. Tumor cell suspensions were prepared from solid tumor, as previously described (25). Briefly, i.m. tumor nodules were first mechanically dissociated into 24-mm fragments, and then enzymatically digested at 37°C for 1 h in RPMI 1640 containing 1 µg/ml deoxyribonuclease I (Sigma, St. Louis, MO), 250 µg/ml collagenase (Sigma), and 250 µg/ml papain (Sigma). The resulting tumor cell suspensions were washed, resuspended at desired concentrations, and used for i.v. injection into mice.
Preparation of PBL
PBL were obtained by modification of the methods described previously (26). In brief, blood was collected from the tail vein, diluted immediately in serum-free RPMI 1640 containing 50 mM EDTA, and washed by centrifugation for 10 min at 170190 x g. The pellet was lysed using ice-cold lysing buffer (154 mM NH4Cl, 1.5 mM KHCO3, 0.1 mM EDTA, pH 7.2) for 5 min. After centrifugation, cells were washed three times to remove debris that contained red cell ghosts and residual platelets that sedimented above the cell pellet. The remaining white cells were suspended in medium, as required, and used in experiments.
In vivo treatment studies
Preliminary experiments indicated that injection of B6 mice with 105 76-9 tumor cells was a minimal dose that resulted in the development of pulmonary metastases that could not be cured with CY alone, but were sensitive to therapy with CY + IL-15. Pulmonary metastases developed after injection of 5 x 104 or fewer 76-9 cells were curable with CY alone. Thus, in further experiments, we used 105 76-9 tumor cells as a minimal dose for development of pulmonary metastases not sensitive to chemotherapy alone. On day 0, mice were injected i.v. into the tail vein with 76-9 tumor cells (5 x 105) to establish pulmonary tumors. Ten days later, mice were treated i.p. with single dose of 200 mg/kg body weight of CY (Cytoxan; Bristol Myers Squibb, Princeton, NJ). Human rIL-15 (sp. act. of 4.45 x 105 U/mg; Immunex, Seattle, WA) was given by i.p. injection for 20 days at a dose of 10 µg/mouse/day starting 24 h after CY treatment. Survival of TB mice was monitored every day. Mice that became moribund due to lung tumors (usually between 35 and 40 days after tumor inoculation for TB mice treated with CY alone) were killed for humane reasons. Mice surviving longer then 120 days posttumor injection were considered as cured. During the course of therapy, mice were bled (200 µl of blood from mouse) at various time points. PBL were isolated from the combined blood samples and used in cytotoxicity assays and flow cytometry analysis. In one experiment, randomly selected TB mice treated with CY ± IL-15 were killed at day 35 after 76-9 tumor inoculation, and lungs were infused with a 15% solution of india ink and bleached by Feketes solution (27).
Flow cytometry
Biotin-conjugated anti-LGL-1 (clone 4D-11; The Jackson Laboratory), FITC-labeled anti-CD8 (clone 53-6.72; The Jackson Laboratory), phycoerythrin-labeled anti-CD44 (clone IM7.8.1; PharMingen, Los Angeles, CA), and phycoerythrin-labeled anti-NK1.1 (PK136; PharMingen) mAb were used to analyze the phenotype of PBL isolated from normal or TB mice treated with CY + IL-15. For that PBL were incubated at 4°C for 30 min with mAb, washed in PBS containing 5% FBS. Cells treated with biotin-conjugated mAb were cultured for additional 30 min at 4°C with FITC-labeled streptavidin and washed in PBS. Stained cells were analyzed using the Becton Dickinson FACScan.
Cytotoxicity assay
Cytotoxicity of PBL was measured in a standard 4-h 51Cr release assay. The tumor cell targets used were YAC-1 (NK cell sensitive), 76-9 rhabdomyosarcoma (H-2b), C26 colon carcinoma (H-2d), and B16LM melanoma (H-2b). All target cells were maintained in vitro in RPMI 1640 medium (BioWhittaker, Walkersville, MD) supplemented with 2-ME (5 x 10-6 M; Sigma), gentamicin (50 µg/ml; Sigma), and 10% heat-inactivated FBS (Atlanta Biologicals, Norcross, GA). Effector PBL and 51Cr-labeled target cells (4 x 103 cells/well) were combined in 96-well V-bottom plates (Rainin, Wodurn, MA) at various E:T ratios and incubated for 4 h at 37°C and 5% CO2; 100 µl/well of supernatant was then withdrawn, and radioactivity was measured in a gamma counter (Wallac, Gaithersburg, MD). Spontaneous release of 51Cr (incubation of target cells with media alone) was less than 15% of maximum release (incubation of target cells with 5% SDS detergent). There were three replicates for each sample. Data were expressed as percentage of cytotoxicity calculated from the following formula: % cytotoxicity = (test cmp - spontaneous cpm)/(maximum cpm - spontaneous cpm) x 100.
Statistics
All data were analyzed by using the Students t test
(SigmaPlot), or
2 test for survival studies, whereby
p < 0.05 indicated that the value of the test sample
was significantly different from that of the relevant controls.
| Results |
|---|
|
|
|---|
Lung metastases were established in B6 mice, as described. Ten
days later, TB mice received an i.p. injection of CY (200 mg/kg) and
daily i.p. injections of IL-15 (x20 at 10 µg/injection) beginning
24 h after CY. The data in Fig. 1
summarize five independent experiments and show that 32% (8 of 25) of
CY + IL-15 mice were cured, the remaining mice showing significant
prolongation of life compared with mice receiving CY treatment alone,
in which 6.7% (2 of 30) were cured. The difference between groups of
mice treated with CY alone or CY + IL-15 was statistically significant
(p < 0.005), as calculated at 100 days after
tumor inoculation. Fig. 2
shows that by
day 35 after tumor inoculation, there were no visible tumor nodules in
the lungs of mice receiving CY + IL-15 therapy in contrast to lungs
from CY-treated controls. Mice that were cured by either CY alone or
combined CY + IL-15 therapy were resistant to a subsequent i.m.
challenge with 104 76-9 tumor cells, while challenge with
the irrelevant syngeneic B16LM tumor resulted in tumor growth (data not
shown), indicating the presence of immunologic memory.
|
|
PBL from TB mice that had been treated with CY and 20 daily
injections of IL-15 (10 µg/day) were analyzed by flow cytometry for
the expression of multiple Ags, including NK1.1, LGL-1, CD4, CD8, CD44,
B220, Gr-1, MAC-1, and F4/80 as markers of the major types of potential
effector cells. As was shown previously, injection of CY alone
decreased the absolute number of PBL (22). Multiple injections of IL-15
into CY-treated TB mice did not significantly change the absolute
number of PBL, but increased the proportions of NK1.1, LGL-1, CD8, and
CD44 cells. The data presented in Fig. 3
is a typical dot plot of PBL isolated from TB mice injected with CY or
CY + IL-15. Cells were double stained for the expression of NK1.1 and
LGL-1 (upper panel) or CD8 and CD44 (lower
panel). It is seen that 20 daily injections of IL-15 induced
increase in NK1.1+/LGL-1- cells (sixfold) and
NK1.1+/LGL-1+ cells (17-fold). The percentage
of CD8+/CD44+ cells in PBL from CY +
IL-15-treated mice was also five times higher than in control mice
(injected with CY alone), while the percentage of
CD8+/CD44- was the same in both groups of
mice. The above changes in NK1.1, LGL-1, CD8, and CD44 expression were
also seen in non-TB mice after injection with CY + IL-15, indicating
that this was not related to the presence of tumor and depended on
IL-15 administration (data not shown). Administration of IL-15 into
normal or TB mice that did not receive CY treatment resulted in lower
levels of NK1.1+/LGL-1+ and higher levels of
CD8+/CD44+ cells compared with mice treated
with CY + IL-15 (data not shown). The changes in the expression of the
other Ags relative to the appropriate controls were not significant and
are not shown.
|
|
To determine whether the increased levels of IL-15-induced
NK1.1+ and CD8+ cells were associated with
increased cytotoxicity, PBL isolated as above were also tested for
cytotoxicity in a standard 4-h 51Cr release assay. Fig. 5
shows that PBL isolated from TB mice
treated with CY and IL-15 were highly cytotoxic against NK
cell-sensitive targets (YAC-1). Similar to the accumulation of
NK1.1+ cells in PBL, the peak of NK-mediated cytotoxic
activity occurred by 1015 injections of IL-15 and declined
thereafter. Cytotoxicity above background levels was not detectable 7
days after the twentieth injection of IL-15 (data not shown).
|
|
To determine whether NK, T, or B cells were responsible for the
antitumor action of CY + IL-15 therapy, survival studies were conducted
using B6 mice with impaired NK cell activity (B6.beige), T and B cell
deficient (B6.scid), T cell deficient (B6.nude), lacking of B cells
(B6.IgH-6), and induced mutants deficient in
ß T cells
(B6.TCR-ß-/-) or 
T cells
(B6.TCR-
-/-) or both
ß and 
T cells
(TCR-ß
-/-). Mice were inoculated i.v. with 5 x
105 76-9 tumor cells. Ten days later, they were injected
with CY (200 mg/kg), followed 24 h later by 20 daily injections of
IL-15. Fig. 7
summarizes the survival
data. It is seen that IL-15 in combination with CY did not improve the
survival rate in B6.beige, B6.nude, or B6.scid mice, but resulted in
cures in 30% of the B6.TCR-ß-/- mice and in 40% of
the B6.TCR-
-/- mice. In the double knockouts
B6.TCR-ß
-/-, therapy with CY + IL-15 had no effect
on survival compared with treatment with CY alone. The most effective
CY + IL-15 therapeutic effect was seen in the B6.IgH-6-/-
B cell-deficient mice, in which 100% of the mice were cured,
suggesting a suppressor role for B cells toward CY + IL-15 therapy.
Even in the CY control group, 60% of the mice were cured. Those mice
deficient in
ß T cells, 
T cells, or B cells surviving
longer than 120 days were resistant to a challenge with 104
76-9 tumor cells, but not with B16LM tumor cells (data not shown).
Since the cells other than NK cells may be defective in B6.beige mice,
an attempt was made to deplete NK cells in vivo by administration of
NK1.1 Ab to B6 mice before and after injection of tumor cells and the
administration of combination CY + IL-15 therapy. Unfortunately,
although depletion of circulating and splenic NK cells was successful,
the administration of IL-15 resulted in the reappearance of peripheral
NK cells. As reported by Puzanov et al. (12), IL-15 induces
maturation and proliferation of bone marrow-associated NK cell
precursors.
|
-/- mice confirms the
T cell deficiency in these mice. Fig. 9
|
|
| Discussion |
|---|
|
|
|---|
, IL-2, and
TNF-
at the tumor site (24, 30). Since IL-15 has been reported to
induce the production of TNF-
and IFN-
from T and NK cells (2, 31, 32), its administration after CY injection may further promote the
production of Th1-related cytokines. This in turn may augment T cell
immune reactions at the tumor site, including the generation and
activation of CTL and LAK cells. Finally, it has been reported that CY
injection resulted in an increase in M
, NK cells, and
polymorphonuclear precursor at the tumor site (22, 23). In view
of the reports that IL-15 may activate each of these cell types (7, 8, 12, 13), the administration of IL-15 in combination with CY therapy
clearly has the potential to accentuate the antitumor roles that each
or all of these cells express.
The flow cytometry data indicated that when TB mice received
combination CY + IL-15 therapy, there was a substantial increase in the
proportions of NK and CD8+ T lymphocytes. Increases in
peripheral blood CD4+ T lymphocytes, B cells, M
, or
granulocytes were not seen. The question raised was whether the
increased levels of NK cells or CD8+ cells, or both, were
responsible for the observed in vivo antitumor effects. Although high
cytotoxic PBL activity was generated toward YAC-1 cells, only
relatively low cell cytotoxic activity was generated against the 76-9
targets. Moreover, the specific tumor targets were no more susceptible
to cytotoxic cells than the B16LM melanoma or C26 targets, suggesting
LAK but not T cell cytotoxicity in PBL. In some experiments, the data
suggested significantly higher cytotoxic activity toward 76-9 cells
compared with the other two targets, but this was not reproducible over
the full range of experiments. This low level of LAK cell activity
observed in PBL was induced in the various natural and induced mutant
mice and did not correlate with in vivo antitumor effects induced by CY
+ IL-15 therapy. Nevertheless, previous data indicated that
NK1.1+/LGL-1+ cells expanded in vitro with
IL-15 expressed potent antitumor effects in vivo when adoptively
transferred to CY-treated 76-9 TB mice (16). These expanded cells
showed considerable NK cell activity in vitro, but only low LAK cell
activity. Clearly, in vivo activity was not reflected by in vitro
cytotoxicity data. Similarly, it seems unlikely that
CD8+/CD44+ T cells detected in PBL, putative
memory cells (33) played a direct role in the antitumor effects
generated by CY + IL-15 therapy since IL-15 administration induced an
increase in non-TB mice. If within this population there is a
tumor-specific subset of memory T cells, this was not evident based on
the in vitro cytotoxicity data. However, the findings that those
ß
and 
T cell-deficient mice that were cured by CY + IL-15 therapy
were shown to be resistant to a challenge with 76-9 cells, but not to
the syngeneic B16LM melanoma cells, indicated that tumor-specific
effectors had been generated. As discussed previously in the context of
spleen cells (16), to what extent the in vitro activity of PBL reflects
events occurring at the tumor site during the generation of antitumor
activity remains to be elucidated.
In an attempt to determine what cells are required for successful CY +
IL-15 therapy, the survival of mutant mice in response to combination
therapy was evaluated. The overall data suggested that NK cells and T
cells expressing either
ß-TCR or 
-TCR were required for a
positive antitumor effect, while B cells appeared to be antagonistic to
positive antitumor responses. The evidence concerning NK cells based on
the use of B6.beige mice is somewhat equivocal. First, unsuccessful
therapy in B6.beige mice may be explained on the basis that other
defective cells play important roles. For example, it has been reported
that lysis mediated by cytolytic T cells is defective in B6.beige (34).
Second, IL-15 administration resulted in increased numbers of NK cells
and NK cell-mediated cytotoxicity in B6.scid, B6.nude, and
B6.TCR-ß
-/- mice that failed to respond to CY +
IL-15 therapy. This would indicate that if NK cells were required for
antitumor activity, they did not appear to act independently of T cells
and probably did not exert their effects toward 76-9 tumor cells by
direct lytic activity. There is no question that the NK cells are
activated, as measured by increased cytotoxicity and by expression of
the activation marker B220 (16). Thus, as discussed previously (16), it
seems more plausible to suggest that the involvement of activated NK
cells in antitumor effects will be via their secretory products acting
on other cell types, such as T cells or M
. It is proposed that the
therapeutic efficacy of IL-15-expanded NK cells adoptively transferred
to CY-treated 76-9 TB mice is likely to be mediated by their secretory
products orchestrating the generation of antitumor effectors.
On the other hand, the collective data from the experiments involving
B6.scid, B6.nude, and TCR-deficient mice were compelling in that there
was also an absolute requirement for T cells for successful CY + IL-15
therapy. The apparent alternative roles of
ß and 
T cells in
this regard are intriguing, since these two cell populations have
different mechanisms of Ag recognition. It is well documented that
ß T cells can kill tumor cells in an MHC class I-restricted manner
(35). It also has been reported that 
T cells can lysis tumor
target cells in an Ag-specific manner (36, 37). Reports that 
T
cells may localize in the lung, as well as other epithelial tissues
such as skin and intestine (38), suggest that 
T cells might be
important in protecting the host against lung metastases. As cited
above, IL-15 activates both
ß and 
T cells (5, 39, 40). The
findings that cured TB mice deficient in
ß or 
T cells
resisted a challenge with 76-9 cells, but not with the B16LM melanoma
cells, indicated that tumor-specific effectors had been generated in
vivo. As discussed above, the failure of the in vitro cytotoxicity
assays to show the presence of tumor-specific T cells would suggest
that cytolytic T cells are not generated systemically, but only at the
tumor site.
The exciting finding that the most successful antitumor effects induced by CY + IL-15 therapy were seen in the TB B6.IgH-6-/- mice deficient in B lymphocytes provides for the first time a likely pathway by which therapeutic efficacy is regulated. The role of B cells in antitumor immunity is rather controversial. In several mouse models and in melanoma patients, it has been reported that the clinical outcome of immunotherapy was associated with B cell immune responses (41, 42). In addition, it was shown that B cells play an essential role in host protection against virus-induced tumors (43). However, it is evident that depletion of B cells by Abs against mouse IgG or IgM enhanced rejection of allogeneic or chemically induced tumors (44, 45). Our current data indicate that the absence of B cells is associated with enhanced antitumor effects, suggesting that in replete B6 mice, the presence of B cells antagonizes antitumor effects. We can only speculate at this time as to the mechanism of action involved. It was shown that cell-mediated antitumor immunity can be blocked by Ab or Ab-Ag complexes (46, 47), and in the absence of B cells this inhibition did not occur. In view of the proposed dependence of successful CY + IL-15 therapy on NK cells and T cells, a more plausible candidate may be based on reports that B cell-deficient mice are unable to mount significant Th2 responses, while Th1 responses are reported to be enhanced (48, 49). Th2-related cytokines such as IL-4 and IL-10 were shown to suppress IL-15-induced activation of T lymphocytes and NK cells (31, 50). Thus, in the absence of B cells and suppressive Th2 factors, IL-15 may amplify Th1-dependent reactions, including the generation of antitumor cytotoxic effectors.
In conclusion, we have shown that the combined treatment of CY and
IL-15 induced a significant incidence of permanent regression of
experimental metastases of the 76-9 rhabdomyosarcoma. This was
associated with an increase in activated peripheral blood NK cells and
CD8+/CD44+ memory T cells. Successful therapy
required the presence of either
ß or 
T cells, and the
absence of both subsets abrogated the therapeutic efficacy. Of
considerable interest in the context of understanding how the therapy
works was the finding that the most effective therapeutic benefit was
seen in B cell-deficient mice, suggesting that B cells or their
products antagonize potential antitumor effector function. While
neither the positive effects of CY + IL-15 therapy nor the negative
effects of B cells have yet to be fully elucidated, in future
experiments we will test the hypothesis that NK cells mediate their
effects by amplifying the effects of Th1 cells whose products activate
effector
ß or 
T cells. From a practical standpoint, the
antagonistic effect of B cells would suggest that depletion of B cells
may improve the clinical outcome of combination CY + IL-15 therapy.
| Acknowledgments |
|---|
| Footnotes |
|---|
2 Address correspondence and reprint requests to Dr. Andrei I. Chapoval, The Mayo Clinic and Foundation, Department of Immunology, 200 First Street SW, Rochester, MN 55905. E-mail address: ![]()
3 Abbreviations used in this paper: M
, macrophage; CY, cyclophosphamide; LAK, lymphokine-activated killer; TB, tumor-bearing. ![]()
Received for publication May 11, 1998. Accepted for publication August 26, 1998.
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