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IMMUNOBIOLOGY
From the Immunotherapy Laboratory, Department of
Immunology, Department of Internal Medicine and Oncology, Medarex
Europe, and Genmab, University Medical Center Utrecht, The
Netherlands.
Antibody-reliant destruction of tumor cells by immune effector
cells is mediated by antibody-dependent cellular cytotoxicity, in
which Fc receptor (FcR) engagement is crucial. This study documents an
important role for the Antibody (Ab)-dependent cellular
cytotoxicity (ADCC) is considered crucial for Ab-mediated tumor cell
degradation. Specific Ab-Fc receptor (FcR) interactions establish
close contacts between tumor targets and immune effector cells, which
triggers cytotoxicity and cytokine release. Neutrophils, monocytes,
macrophages, and natural killer (NK) cells can mediate ADCC via
activating FcRs, which include Fc Numerous studies in cancer immunology focused on melanoma and
melanoma-specific differentiation antigens that induce immune responses.9 If tolerance is broken, melanosomal proteins
can be recognized by T cells, which may provide B-cell help and
participate in Ab production. Actual tumor rejection seems dependent on
phagocytes, which may be activated by CD4+ or NK
cells.10-12 Improved clinical outcome has, furthermore, been correlated with the presence of melanoma-specific Abs in patients.13 Ab-mediated protection in the murine B16F10
melanoma model is well established. Monoclonal antibody (mAb) TA99,
specific for melanoma differentiation antigen gp75 (brown
locus protein, or TRP-1), is effective in preventing and
eradicating early established metastases.11 Studies with
mice deficient in the FcR Mac-1 (CD11b/CD18) represents the leukocyte
Involvement of Mac-1 in phagocyte FcR-mediated phagocytosis and
respiratory burst activity has been documented.18-20
Phagocytes from leukocyte adhesion deficiency patients lack
Antibodies and peg-G-CSF
Tumor cell lines and gp75 expression
ADCC assay To increase circulating effector cells, mice were injected subcutaneously with 15 µg peg-G-CSF, and blood was collected from the retro-orbital plexus 3 days later. Erythrocytes were removed by hypotonic lysis, followed by washing remaining leukocytes 3 times with RPMI 1640 medium with 10% FCS. Cell viability determined by trypan blue exclusion was always more than 95%. Fluorescence activated cell sorting (FACS) analyses revealed leukocytes to consist of, approximately, 55% neutrophils, 40% lymphocytes, 3% monocytes, and 1% eosinophils. The capacity of leukocytes to lyse tumor cells was evaluated in 51Chromium (51Cr) release assays.30 Briefly, 51Cr-labeled B16F10 or SK-BR-3 cells were plated in round-bottom 96-well plates (5 × 103 cells/well) in RPMI 1640 medium with 10% FCS. Isolated mouse leukocytes were added in the absence or presence of mAb TA99 (concentrations ranging from 1 µg/mL-100 µg/mL) or 2 µg/mL mAb 520C9, giving different effector-to-target ratios, and incubated for 4 hours at 37°C, after which 51Cr release was measured in supernatants.Mice C57BL/6 wild-type (WT) mice were purchased from Harlan (Horst, The Netherlands). CD11b-deficient mice (Mac-1 / ), in the
C57BL/6 background, were kindly provided by Dr T. N. Mayadas
(Harvard Medical School, Boston, MA).25,27,31 Experiments were performed with 8- to 12-week-old female and male mice. Mice were
maintained at the Central Laboratory Animal Institute (Utrecht University) and experiments were approved by the Utrecht University animal ethics committee.
Melanoma model C57BL/6 WT and Mac-1 / mice were injected
intravenously with 1 × 105 B16F10 tumor cells (in 100 µL saline) on day 0. Mice were treated intraperitoneally with 200 µL saline (control), or with 200 µg mAb TA99 (in 200 µL saline)
on days 0, 2, 4, 7, 9, and 11. In other experiments, mice were treated
with peg-G-CSF or with mAb TA99 and peg-G-CSF. Peg-G-CSF was
administered as a subcutaneous injection of 20 µg (in 150 µL
saline) on days 3 and 4. Mice were observed daily and killed when
they became seriously ill (inactive/blurred fur) or paralyzed.
Surviving mice were killed at day 21. Since metastases of B16F10
melanoma are readily visually detected, they were scored at the
macroscopical level by 2 independent investigators, who were blinded
for the treatment. Lungs from all mice were excised and scored for (1)
the number of surface metastases and (2) tumor load. Tumor load was
defined by the sum of the following scores: metastases less than 1 mm
were scored as 1; metastases of 1 mm to 2 mm scored as 3; and
metastases more than 2 mm scored as 10. Tumor load correlated closely
with the number of metastases (Figure 2). Secondary target organs,
including thoracic and abdominal lymph nodes, liver, kidneys, spleen,
and the central nervous system (CNS) were also examined for the
presence of melanoma metastases, and the mean number of metastases per target organ was calculated (n 6 per group). In additional
experiments, mice were killed and lungs were excised at day 7, 11, or
15 after tumor inoculation and frozen in liquid nitrogen for
immunohistochemical analyses. Mean numbers of GR-1-positive cells in
lungs with detectable metastases were quantified by 2 independent
investigators using light microscopy.
Immunohistochemistry Frozen sections of lungs (6 µm thick) were placed on superfrost slides (Menzel, Braunschweig, Germany), air-dried overnight, and fixed in acetone for 10 minutes at 20°C. Slides were incubated with 0.3% H2O2 to quench endogenous peroxidase activity. After fixation, slides were blocked with 10% normal mouse serum, and incubated with mAb GR-1 (1:250) or mAb F4/80 (1:2) for 1 hour. After repeated washing with PBS 0.05% Tween, sections were incubated with peroxidase-labeled rabbit anti-rat IgG (DAKO, Glostrup, Denmark) (1:1200) for 30 minutes at 20°C. Primary antibodies were diluted in 2% normal mouse serum, and a secondary Ab was diluted in 1% normal mouse and 2% normal rabbit serum. Upon washing with PBS 0.05% Tween and with sodium acetate buffer (0.1 M, pH 5.0), peroxidase activity was detected by incubating slides with 0.4 mg/mL 3-amino-9-ethylcarbazole (Sigma) for 15 minutes. Subsequently, slides were rinsed in distilled water, counterstained with Mayer hematoxylin (Merck, Darmstadt, Germany), and mounted in aquamount (BHD, Poole, England).Statistical analysis Unpaired Student t tests and Welch tests were used to determine statistical differences. Significance was accepted at the P < .05 level.
mAb TA99 recognizes gp75 antigen on B16F10 melanoma cells We first examined the binding of mAb TA99 to B16F10 melanoma cells. Low gp75 expression (mean fluorescence intensity [MFI] of 9.94, vs MFI of 3.55 in the control) was found on B16F10 cell membranes, whereas high levels were detectable in permeabilized cells (MFI of 551.3) (Figure 1). Control mIgG2a and FITC-labeled anti-mouse IgG did not bind B16F10 cells. Next, we assessed whether isolated murine leukocytes mediated ADCC of melanoma cells. Leukocytes of WT mice did not mediate Ab-dependent cytotoxicity of B16F10 cells at a range of effector-to-target ratios (data not shown). This was in contrast to breast carcinoma cells (SK-BR-3), which were effectively lysed (56.3% ± 2.5% cytolysis, n = 4) by WT leukocytes in the presence of mAb 520C9. mAb 520C9 recognizes the antigen HER-2/neu on SK-BR-3 cell membranes (MFI of 90.86 vs MFI of 2.9 in the control).
Ab-mediated protection against melanoma is enhanced by G-CSF Previous work indicating that T and NK cells do not play a direct role in Ab-mediated rejection of B16F10 melanoma10-12 prompted us to study the effect of peg-G-CSF on Ab-induced antitumor responses. Peg-G-CSF mediates in vivo activity similar to G-CSF, but has a prolonged half-life.28,29 WT mice were inoculated with 1 × 105 B16F10 cells, treated with either saline, mAb TA99, peg-G-CSF, or both TA99 and peg-G-CSF, and the number of lung metastases (Figure 2A) and tumor load (Figure 2B) were determined after 21 days. TA99 treatment led to protection against melanoma (61% reduction in number of lung metastases and 78% reduced tumor load, compared with controls). Peg-G-CSF, however, enhanced TA99-mediated antitumor activity significantly (95% reduction in number of metastases and 99% reduced tumor load). Upon combination treatment with TA99 and peg-G-CSF, 64% of mice were tumor-free at day 21. In additional experiments, mice were followed up after TA99/peg-G-CSF combination treatment, and were found to be alive without symptoms at the last observation at day 70. Peg-G-CSF treatment, by itself, did not lead to decreased tumor growth (12.9 ± 1.1% metastases and 61 ± 6.6% tumor load; n = 14).
Excitingly, the combination treatment was also protective when started 7 days after tumor cell injection (75% reduction in number of lung metastases and 72% reduced tumor load, compared with controls; n = 6). Moreover, 33% of the treated mice were tumor-free after 21 days in this therapy model. Mac-1 is required for Ab-induced antimelanoma activity To assess the relevance of Mac-1 in FcR-mediated tumor cytotoxicity in vivo, we established the syngeneic B16F10 melanoma model in CD11b-deficient mice, which were of the same background as WT mice (C57Bl/6). B16F10 cells grew well in Mac-1 / mice,
leading to advanced lung metastases after 3 weeks, similar to WT mice
(Figure 3). A striking difference in
melanoma growth was observed, however, between Mac-1 /
and WT mice upon treatment. MAb TA99 combined with peg-G-CSF treatment
resulted in almost complete tumor remission in lungs of WT mice,
whereas Mac-1 / mice still contained clear melanoma
infiltration despite treatment (Figure 3A). Quantification of pulmonary
metastases revealed WT mice to be significantly better protected than
Mac-1 / mice by mAb TA99 therapy (Figure 3Bi), as well
as TA99 combined with peg-G-CSF (Figure 3Bii). Combination treatment
reduced the number of metastases in WT mice by 95%, and in
Mac-1 / mice by only 44%, compared with saline
controls. Similarly, pulmonary tumor load was significantly higher in
treated Mac-1 / mice than in WT mice. Treatment with
TA99 combined with peg-G-CSF resulted in mean tumor loads of 0.79 (± 0.25, n = 14) in WT mice and 21.3 (± 7.5, n = 12) in
Mac-1 / mice (data not shown). In addition, control
experiments revealed peg-G-CSF to increase circulating neutrophil
numbers in WT and Mac-1 / mice with similar kinetics
(data not shown).
To study whether Ab-mediated protection was also diminished in
secondary melanoma target organs of Mac-1
Phagocytic cell migration into melanoma Because our data pointed to a role for phagocytes in immunity to B16F10 melanoma, we examined the capacity of WT and Mac-1 / neutrophils and monocytes/macrophages to
infiltrate tumor sites. Lungs of WT and Mac-1 / mice,
treated with TA99 and peg-G-CSF, were analyzed 7, 11, and 15 days
after tumor challenge. B16F10 cells were distributed as clustered
neoplastic cells on days 11 and 15. Histology of lungs of treated WT
mice revealed close-to-normal alveolar morphology with sporadic
malignant cells and few neutrophils present (Figure 4, lower left). Lungs of WT mice not
receiving TA99 and lungs of Mac-1 / mice (treated with
saline or TA99), on the other hand, contained large metastatic lesions
with occasional neutrophil infiltrates (Figure 4, arrows). We
quantified the number of GR-1-positive cells in lung metastases of WT
and Mac-1 / mice not receiving TA99 11 and 15 days after
tumor inoculation. Comparable neutrophil infiltration (mean number of
cells ± SEM, n = 3) was observed in established tumors of WT
and Mac-1 / mice (26 ± 4.9 vs 40.7 ± 18.7 at day
11, and 118 ± 41.2 vs 115 ± 35.9 at day 15, respectively).
Analyzing effector-target cell interactions in more detail revealed
both WT and Mac-1 / neutrophils to be situated in close
contact with melanoma cells (Figure 4, inserts). On the contrary,
macrophages and monocytes (visualized by F4/80 staining) hardly
infiltrated into metastases of WT or Mac-1 / mice (data
not shown). These data show Mac-1 not to be essential for phagocytic
cell recruitment into metastatic sites and, furthermore, reveal
Mac-1 / neutrophils capable of binding tumor
cells.
Melanoma differentiation antigens serve as a hallmark of tumor
targets for immune cells. Antibodies directed against the gp75 antigen
mediate effective protection in murine melanoma models. The mechanisms
by which antibodies initiate antitumor activity remain incompletely
understood. In the present study we document a requirement for Mac-1,
an important Our data and the data of others6,12 show that the
gp75 glycoprotein is predominantly expressed intracellularly in
cultured B16F10 melanoma cells, making them resistant to ADCC. However, gp75 membrane expression increases upon in vivo growth, and
gp75-specific antibodies induce FcR-dependent melanoma
rejection.6,7 In the present study, Mac-1-deficient mice
proved significantly less protected against B16F10 melanoma
infiltration than WT mice by an antibody targeting gp75, evidenced by
higher tumor loads in lungs and secondary target organs. Since Mac-1
also serves as an adhesion molecule, we hypothesized that effector cell
infiltration of tumor sites possibly depends on Mac-1. However, our
data showed that WT and Mac-1 Mac-1-mediated tumor cytotoxicity was recently shown in therapy models
with A number of earlier studies focused on identification of the effector cells responsible for Ab-mediated melanoma eradication. An important role for phagocytes seems plausible on the following grounds: (1) enhanced Ab-induced melanoma rejection by macrophage colony-stimulating factor,10,41 (2) intact Ab-mediated protection upon T-cell depletion,10,11 and (3) Ab-mediated immunity in both SCID (lacking lymphocytes) and beige (lacking NK cells) mice.12 Establishing a requirement for Mac-1 in Ab immunity to melanoma is in line with this earlier work and may allude to neutrophil involvement. To further support this, peg-G-CSF was found to augment antimelanoma Ab responses in vivo. Peg-G-CSF proved not tumoricidal by itself, underlining FcR-antibody interactions as a prerequisite. Since peg-G-CSF has a documented capacity to increase circulating neutrophil numbers and to enhance their tissue recruitment,29 the present findings support the involvement of neutrophils in Ab-mediated protection against melanoma. Consistent with our data, G-CSF transduction of adenocarcinoma results in antitumor activity mediated by neutrophils.42,43 Furthermore, phagocytes have been shown to infiltrate tumor sites including melanoma,44-47 and neutrophils have earlier been found important for tumor cell elimination in vivo.8,43,48-50 Ab-mediated protection against melanoma was reduced by
approximately 50% in Mac-1 In summary, the data presented here provide evidence for an important role of Mac-1 in Ab-mediated immunity to melanoma. Furthermore, this study implicates neutrophils to be important for Ab-reliant tumor cytotoxicity. Antibody treatment of human tumors has been studied extensively, with a number of clinical successes reported.5,7,52 FcRs play an important role in direct Ab-mediated tumor cytotoxicity and are, furthermore, important in the induction of vaccine responses.8,53,54 Better insight into the mechanisms of FcR-mediated tumor cytotoxicity may well facilitate the design of more effective therapeutic concepts.
We thank Tanya Mayadas for kindly providing the CD11b-deficient mice, Cora Damen for technical assistance, Theo Thepen and Gerard Groenewegen for critically reading the manuscript, and Toon Hesp, Herma Boere, Anja van der Sar, and Ingrid van den Brink for excellent animal care.
Submitted May 4, 2001; accepted August 29, 2002.
A.B. van S. and H.H. van O. contributed equally to this study.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
Reprints: Jan G. J. van de Winkel, Immunotherapy Laboratory, Department of Immunology, University Medical Center Utrecht, Room KC02.085.2, Lundlaan 6, 3584 EA, Utrecht, The Netherlands; e-mail: janvandewinkel{at}aol.com.
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