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IMMUNOBIOLOGY
From the Third Department of Internal Medicine,
Asahikawa Medical College, Hokkaido, Japan.
Heat-shock proteins (HSPs) act as molecular chaperones binding
endogenous antigenic peptides and transporting them to major histocompatibility complexes. HSPs chaperone a broad repertoire of
endogenous peptides including tumor antigens. For the immunotherapy of
tumors, a strategy using HSPs may be more advantageous than other
procedures because the identification of each tumor-specific antigen is
not necessary. In this study, the efficacy of immunotherapy against
minimal residual leukemia cells using HSP preparations was evaluated.
HSP70 and GP96 were purified from syngeneic leukemia cell line A20 and
immunized into BALB/c mice during the reconstitution period of the
immune system after syngeneic bone marrow transplantation. In this
procedure, all mice not immunized were dead within 60 days of A20
inoculation, whereas the survival times of HSP-immunized mice were
significantly prolonged. In addition, the depletion of either
CD4+ or CD8+ T lymphocyte significantly
abrogated this efficacy, indicating that both CD4+ and
CD8+ T lymphocytes were required for tumor cell rejection.
Moreover, the vaccination of HSPs elicited a specific response of
potent CD8+ T lymphocytes cytotoxic against A20 in vitro.
These observations suggest that immunization of the complex of HSPs and
peptides derived from leukemia cells leads to immune responses. These
immune responses are sufficient to reject minimal amounts of leukemia cells for relatively immunocompromised mice after syngeneic bone marrow transplantation.
(Blood. 2001;98:1852-1857) Heat-shock proteins (HSPs) are classified according
to subcellular localization and molecular weight; for example, HSP70
and HSP90 are located in the cytoplasm and GP96 in the endoplasmic reticulum.1 The major role of these proteins is to act as
a molecular chaperone binding immature peptides during their synthesis and assisting their folding. After the peptides are degraded in the
cytoplasm, they are transferred to the endoplasmic reticulum by binding
to HSP70 or HSP90 but not by natural diffusion.2,3 The
peptides are then bound to GP96 and loaded, through a transporter associated with antigen processing (TAP), onto major histocompatibility complex (MHC) class I molecules.4-6 It is known that HSPs
bind antigenic peptides of the tumor cells, and tumor-derived
HSP-antigenic peptide complexes can be purified for vaccination against
cancer.7 The unique features of HSP-based cancer
immunotherapy are as follows: (1) the spectrum of HSPs for binding
peptides is broad; (2) HSPs are able to bind unknown peptides in vitro
and to induce the peptide-specific immune response by vaccination with
these peptide complexes; (3) HSP-peptide complexes lack diversity in
their HSPs and are able to make use of different haplotype
cases.8 Immunotherapy against malignant solid tumor has
been extensively studied. It has been reported that specific immunity
is induced by immunization with tumor-specific
antigens.9,10 Furthermore, several vaccination programs of
tumor-specific antigens for cancer patients are undergoing clinical
trials.11,12 However, it is difficult to determine the
specific antigens of each cancer patient and to identify the peptide
motif presented on individual human leukocyte antigen molecules. For
this reason, HSP-antigenic peptide complexes derived from tumors would
be appropriate materials for the induction of tumor-specific
immunity.7 One of the authors previously reported that
vaccination with autologous cancer-derived HSP-peptide complex leads to
cancer-specific immunity for mice bearing colon cancer without the need
to identify tumor-specific antigenic peptides.13 In light
of the complexities of determining individually specific antigens, this
immunotherapy with an HSP-peptide complex would be a more convenient
form of therapy.
Recently, autologous stem cell transplantations for hematologic
malignancies have been carried out safely and successfully for elderly
patients and for those unable to find donors with the necessary
identical human leukocyte antigen.14-16 However, unlike
allogeneic transplantation, a major problem is frequent relapse after
transplantation because of the presence of minimal residual
leukemia cells even after high-dose chemotherapy and the lack of
graft-versus-leukemia (GVL) effect. In this study, we purified
HSP-peptide complexes from leukemia cells and examined whether
immunotherapy with HSPs is useful after syngeneic bone marrow
transplantation (BMT) in mice with minimal residual leukemia cells.
Experimental animals
Cell lines
Purification of HSP70 and GP96 Purification of HSP70 and GP96 was performed as previously reported.20 Briefly, to purify the HSP70, a pellet of each cell line or liver tissue from healthy mice was homogenized in hypotonic buffer (10 mM NaHCO3, 0.5 mM phenylmethylsulfonyl fluoride [PMSF], pH 7.1) in a Dounce homogenizer and centrifuged at 100 000g for 30 minutes at 4°C. The supernatant was applied to a PD10 column (Pharmacia Biotech, Uppsala, Sweden) to remove low-molecular-weight materials and to change buffer to FPLC buffer D (20 mM Tris acetate, 20 mM NaCl, 15 mM 2-ME, 3 mM MgCl2, 0.5 mM PMSF, pH 7.5). The sample was applied to an adenosine 5'-diphosphate (ADP)-agarose column equilibrated with FPLC buffer D. The column was washed with buffer D containing 0.5 M NaCl and then incubated with buffer D containing 3 mM ADP at room temperature for 30 minutes. Then the sample was eluted with the same buffer and finally resolved on Mono Q system (Pharmacia Biotech) equilibrated with FPLC buffer A (20 mM sodium phosphate, 20 mM NaCl, pH 7.0) and eluted by a 20- to 600-mM NaCl gradient. Two micrograms protein from each fraction was resolved on 10% SDS-PAGE followed by the immunoblots using anti-HSP70 (anti-HSP72/73, clone N27F3-4; Stressgen, Sidney, BC, Canada). Fractions containing HSP70 were collected, and the quantity of HSP70 was determined using the Bradford protein assay (Bio-Rad Laboratories, Hercules, CA). The purity of purified protein was confirmed by silver staining.To purify GP96, a pellet of each cell line and liver tissue from
healthy mice was homogenized in buffer (30 mM
NaHCO3, 1 mM PMSF, pH 7) and was centrifuged at
2000g for 10 minutes at 4°C. The supernatant was further
centrifuged at 100 000g for 30 minutes at 4°C and brought
to 50% ammonium sulfate saturation by adding it slowly while stirring
for 1 hour at 4°C. The solution was centrifuged at 6000 rpm for 30 minutes, and ammonium sulfate of 70% saturation was added slowly to
the supernatant. The solution was stored at 4°C for 1 hour and
centrifuged, and the pellet was suspended in phosphate-buffered saline
(PBS; 137 mM NaCl, 8.1 mM Na2HPO4
12H2O, 2.68 mM KCl, 1.47 mM
KH2PO4), applied to a Con A column
(Pharmacia Biotech), and washed with PBS. The column was incubated with
10% methyl- Endotoxins of each of HSP preparation could not be detected (less than 5 pg/mL) by an endotoxin-specific chromogenic test (ES test; Seikagaku Kogyo, Tokyo, Japan).21 In vitro cytotoxic assay Mixed lymphocyte-tumor cell culture (MLTC) was grown in vitro as previously described.22 Briefly, 8 × 106 spleen cells of HSP-vaccinated mice were cultured for 5 days with 1.3 × 105 irradiated A20 cells in a volume of 1 mL RPMI 1640 medium containing 10% FCS and 0.5% 2-ME. Effector cells from MLTC were cultured with chromium Cr 51-labeled target cells (A20) in a volume of 200 µL RPMI 1640 medium containing 10% FCS and 0.5% 2-ME in 96-well round-bottom plates. After 6 hours of incubation at 37°C on 5% CO2, 100 µL supernatant was harvested, and the radioactivity of each sample was counted on a gamma counter. Results were presented as percentage of specific cytotoxicity calculated from the formula:
For the experiment to determine the subset of effector cells, rat anti-mouse CD4 (clone GK1.5, immunoglobulin (Ig) G2b; ATCC) or anti-CD8 (clone 53-6.7, IgG2a; Pharmingen) was incubated with effector cells before cytotoxic assay. In addition, anti-mouse MHC class I antibodies (anti-mouse H-2Kd, clone SF1-1.1, IgG2a; Pharmingen and anti-mouse H-2Dd, clone 34-5-8S, IgG2a; Pharmingen) were incubated with A20 (target cells) before cytotoxic assay to determine the MHC class I restriction. Conditioning and bone marrow transplantation Syngeneic BMT in mice was performed according to the protocol reported previously.23,24 Briefly, the recipient mice were received a dose of 7.5 Gy total body irradiation (TBI) in a single dose by a cesium 137 source for conditioning regimen. In BALB/c mice, this dose was found to be lethal for 100% of the animals. Donor mice were killed by cervical dislocation under ether anesthesia. Bone marrow cells were aseptically collected from the femurs and tibias and suspended in RPMI 1640 medium. Two hours after TBI, 5 × 108/kg bone marrow mononuclear cells from healthy donor mice were intravenously injected into recipient mice at a constant volume of 0.2 mL through the retro-orbital sinuses.Protocol of immunotherapy with HSPs Ten days after BMT, 2.5 × 104 A20 cells were inoculated to recipient mice through the retro-orbital sinuses to make a model of minimal residual disease. This day was appointed day 0. Inoculated cell number was determined from the clinical results of suspected minimal residual tumor cell numbers of leukemia patients who had undergone chemotherapy and achieved complete response.25 HSP70 (20 µg or 40 µg) or GP96 (2.5 µg or 5 µg) derived from A20 were injected subcutaneously on days 4, 9, 14, and 19. Control groups of mice were treated with PBS (137 mM NaCl, 8.1 mM Na2HPO4 12H2O, 2.68 mM KCl, 1.47 mM KH2PO4), 40 µg HSP70 or 5 µg GP96 from normal liver. Survival times after the A20 cell inoculation were compared using the Kaplan and Meier method. For the experiments to determine the specificity of HSPs derived from A20, 40 µg HSP70 from T27A or colon 26 was injected subcutaneously in the same protocol described above.In vivo depletion of CD4+ or CD8+ T cells from mice was carried out during this protocol of immunotherapy with HSPs, as described previously.13,26 Briefly, 200 µL 1:8 diluted anti-CD4 (clone GK1.5; ATCC) or anti-CD8 (clone 2.43; ATCC) ascites were intravenously injected into the retro-orbital sinus on days 2, 7, 12, and 17, each time 2 days before immunization of HSP. Depletion efficacy was confirmed by flow cytometry, and specific depletion was 90% to 100%. Protocol of in vitro analysis of spleen cells immunized with HSPs After TBI and BMT, 40 µg HSP70 or 5 µg GP96 was injected subcutaneously on days 18 and 25. MLTC was examined on day 32 with spleen cells from mice in these groups, and the specific cytotoxicity was determined by 51Cr release assay on day 37.
Prolongation of survival days in mice injected with HSPs HSP70 or GP96 preparations derived from A20 cells were purified as described in "Materials and methods." As shown in Figure 1, SDS-PAGE of purified HSP70 and GP96 demonstrated a single band by silver staining (lanes 1 and 2), and these bands were reacted with anti-HSP70 and anti-GP96, respectively, by Western blot (lanes 3 and 4). These HSPs were injected into mice, as described in the experimental protocol used for immunotherapy in "Materials and methods." In the syngeneic BMT procedure, the hematopoietic engraftment shown by the recovery of peripheral blood neutrophils was achieved on the 10th day after BMT. All the mice that received TBI without BMT died within 14 days because of bone marrow failure, whereas those that received both TBI and BMT survived (data not shown). As shown in Figure 2A, in the PBS-treated group, the mice inoculated with A20 cells after TBI and BMT died within 60 days because of systemic dissemination of A20 leukemia cells. Although the survival times in both groups of mice immunized with 20 µg or 40 µg HSP70 derived from A20 (A20-HSP70) were significantly prolonged (P < .01, Wilcoxon study), the mice that survived more than 80 days did not show any residual leukemia cells. Similarly, both groups of mice immunized with 2.5 µg or 5 µg GP96 derived from A20 (A20-GP96) had significantly prolonged survival compared to the PBS-treated group (P < .01, Wilcoxon study) (Figure 2B). In contrast, the survival times in the 40 µg HSP70 or the 5 µg GP96 immunized mice derived from healthy mice liver (liver-HSP70 or liver-GP96) did not show a significant difference from that in PBS-treated mice. These data suggested that repeated injection of HSPs derived from A20 (A20-HSPs) to A20-inoculated mice after BMT resulted in both the rejection of A20 and a survival increase.
To investigate whether this survival increase was specific to the
treatment of A20-HSPs, we injected HSPs derived from other syngeneic
tumor cell lines to A20-inoculated mice after BMT. As shown in Figure
3, although subcutaneous injection of 40 µg A20-HSP70 significantly increased survival, administration of the
same amount of HSP70 derived from syngeneic colon adenocarcinoma cell
line (colon 26) or myeloid leukemia cell line (T27A) did not show
prolonged survival times in these mice. These results suggested that
the survival increase induced by the administration of HSP preparations in A20-inoculated mice after syngeneic BMT was specific to HSPs derived
from A20.
Involvement of CD4+ or CD8+ T cells in survival advantage To identify the immune cells mediating the antitumor effects induced by A20-HSPs, we depleted mice CD4+ or CD8+ T lymphocytes in vivo by the intravenous injection of appropriate antibodies, as described in "Materials and methods." As shown in Figure 4A, all the mice without immunization died within 60 days of A20 inoculation, whereas the mice immunized with A20-HSP70 had significantly prolonged survival times (P < .01, Wilcoxon study). In contrast, the depletion of CD4+ or CD8+ T lymphocytes completely abrogated the efficacy of immunization with A20-HSP70 (P < .01, Wilcoxon study), and the survival of mice with depleted CD4+ or CD8+ T lymphocytes was shortened to almost the same degree as that of mice without immunization. Similar to the results of A20-HSP70 immunization, immunization with A20-GP96 significantly prolonged the survival times, and the depletion of either CD4+ or CD8+ T lymphocytes completely abrogated this efficacy of A20-GP96 immunization (P < .01, Wilcoxon study) (Figure 4B). These results demonstrated that the immunity against A20 induced by A20-HSP70 or A20-GP96 administration required both CD4+ and CD8+ T lymphocytes.
Induction of cytotoxic T lymphocyte activities against A20 cells in vitro We next examined cytotoxic activities against A20 cells to investigate the immune response in effector phase of anti-A20 immunity. Mouse spleen cells were cultured with irradiated A20 cells, and the specific cytotoxicity against A20 was determined by 51Cr release assay as described in "Materials and methods." A20 expressed a notable level of MHC class I (Kd and Dd), as detected on the cell surface by flow cytometry (data not shown). As shown in Figure 5, spleen cells derived from both A20-HSP70- and A20-GP96-immunized mice showed significant cytotoxicities against A20 cells at the effector/target cell (E/T) ratio of 200 and 100 (P < .01; t test). However, spleen cells derived from control mice did not show significant cytotoxicities against A20 cells. Therefore, the induction of specific cytotoxicities against A20 cells probably explains the mechanisms of tumor rejection by the administration of A20-HSP70 and A20-GP96. To determine the subset of effector cells in A20, specific killing induced by A20-HSP immunization, effector cells derived from A20-HSP70 or A20-GP96 immunized mice were pretreated with anti-mouse CD4 or anti-CD8 before cytotoxic assay. Cytotoxic activities induced by A20-HSP70 observed at E/T ratios of 200 and 100 were significantly blocked by anti-CD8 pretreatment (P < .01; t test). However, anti-CD4 pretreatment did not block the cytotoxicities against A20 by effector cells in A20-HSP70-immunized mice. Similarly, A20-GP96-induced cytotoxicities against A20 were significantly blocked by anti-CD8 pretreatment but not by anti-CD4 pretreatment (P < .01; t test). Because the CD8+ cells contain not only CTLs but also natural killer (NK) cells, we further analyzed the effector cells to distinguish these 2 cell populations. As shown in Figure 6, pretreatment of A20 cells (target cells) with anti-MHC class I (anti-mouse H-2Kd and anti-mouse H-2Dd) before cytotoxic assay significantly blocked the specific lysis by spleen cells derived from A20-HSP70-immunized mice (P < .01; t test). Similarly, A20-GP96-induced cytotoxicities against A20 were significantly blocked by anti-MHC class I pretreatment (P < .01; t test). In addition, the level of specific lysis blocked by anti-MHC class I was almost equal to the level blocked by anti-CD8 shown in Figure 5. These results suggested that effector cells against A20, induced by A20-HSP immunization, were mainly contributed by CD8+ CTLs.
In the present study, we demonstrated that immunization of leukemia cell-derived HSP70 or GP96 during the reconstitution periods of immune system after syngeneic BMT induced an effective survival advantage in mice with minimal residual leukemia cells. In addition, we revealed that this effect required both CD4+ and CD8+ T lymphocytes. Moreover, HSP70 and GP96 immunization induced the cytotoxic T lymphocyte activity in vitro against leukemia cells, from which HSPs were purified. Our results demonstrating that leukemia cell-derived HSPs induced
specific immunity and that CD4+ and CD8+ T
lymphocytes are involved for this effect are consistent with the
findings of other solid tumors.8,26-28 To confirm the
specific cytotoxicity induced by HSPs, we injected HSPs derived from
other syngeneic tumor cell lines to A20-inoculated mice after BMT.
Because the subcutaneous injection of A20-HSP70 significantly increased survival and the same amount of HSP70, derived from syngeneic colon
adenocarcinoma or myeloid leukemia cell lines, did not show the
prolongation of survival days in these mice, the administration of both
A20-HSP70 and A20-GP96 induced specific immunity against A20 cells. We
also demonstrated that Another concern is the role of CD4+ T lymphocytes on
HSP-induced immunity. We demonstrated that CD4+ lymphocytes
were required for the prolongation of survival by HSP immunization,
whereas effector cells against A20 were CD8+ CTLs in vitro.
Until now, it was unclear whether the peptides associated with HSPs
were recognized by CD4+ T lymphocytes after they were
presented on MHC class II. In the investigation of specific CTLs for
lymphocytic choriomeningitis virus, CD62L+ naive T
lymphocytes were activated and converted to effector-memory T
lymphocytes.30 In addition, a reduced expression of CD62L on T lymphocytes was reported to be induced by immunogenic tumor vaccine, and these CD62 low/ In the previous studies demonstrating the effective induction of tumor-specific immunity by the HSP-peptide complex, the host immune system was relatively intact.8,26-28 In this study, however, the specific immunity by HSP administration was obtained after syngeneic BMT without any support to strengthen the immune system. From quantitative aspects, the immune system generally returns to normal within 3 to 4 months after syngeneic BMT in mice, though the recovery of qualitative immune function is longer.32 Therefore, the immunocompetence in our experimental mice was thought to be impaired. As shown in Figures 5 and 6, the effector-target cell ratio to obtain significant cytotoxicity was relatively high, and the level of cytotoxicity was low probably because of the partially immunocompromised state early after BMT. However, it is noteworthy that we could successfully induce effective cytotoxicities against A20 cells. Recently, exogenous HSPs have been shown to have a function of binding monocytes and stimulating the production of several cytokines.33 Therefore, it is possible that exogenously injected A20-HSPs not only act as a tumor vaccine but also stimulate the monocytes and help to activate the immune system in mice after BMT. Additional adoptive transfer of ex vivo-expanded APCs or stimulation of APCs in vivo with cytokines, such as flt-3 ligand or granulocyte macrophage-colony-stimulating factor, or T-cell activation by cytokines such as IL-2 or IL-7, may produce stronger killing effects in these immature immune conditions. Because HSPs chaperone a broad repertoire of peptides, immunization with endogenous HSP-peptide complexes might elicit abnormal autoimmune responses. In addition, it is reported that mice administered dendritic cells pulsed with A20-derived peptides and fibroblasts expressing CD40 ligand and secreting IL-2 showed a systemic disorder resembling graft-versus-host disease.34 In this regard, mice immunized with A20-HSPs did not show fur loss or weight loss. In addition, we preliminarily analyzed the serum levels of alkaline phosphatase, alanine aminotransferase, and lactate dehydrogenase in the mice treated with A20-HSP70; no elevation of these serum enzyme activities was found (data not shown). Similarly, several hundred mice immunized with tumor or normal liver-derived GP96 show no detectable autoimmune phenomena.13 Contrary to our results, it is shown that the depletion of CD4+ lymphocyte in vivo has no immunologic effect on mice immunized with a combination of A20-derived peptide-pulsed dendritic cells and fibroblasts expressing CD40 ligand and secreting IL-2.34 Therefore it is suggested that the CD4+ lymphocytes in our experimental system might play an important role in the regulation of autoimmune disease development. Furthermore, a pilot study of the immunotherapy against human cancers with HSP-peptide complexes has been carried out for advanced malignancies that became refractory to established therapies. Until now, no unacceptable vaccine-related toxicity or autoimmune reactions were observed.1,35 Therefore, the immunization by HSP preparations is thought to be safe and might be clinically useful after autologous stem cell transplantation against minimal residual leukemia. Recent advances in conventional chemotherapy or high-dose chemotherapy can reduce leukemia cell numbers, even if the initial cell burden is large. Therefore, after appropriate chemotherapeutic treatments supported by autologous hematopoietic stem cell transplantation, it is possible that immunotherapy against a limited number of leukemia cells could extinguish minimal residual disease. We demonstrated in this study that the administration of leukemia cell-derived HSP-peptide complexes led to specific immunity against leukemia cells during the reconstitution period of the immune system after syngeneic BMT in mice. Fortunately, abundant leukemia cells can be obtained from peripheral blood or bone marrow from most patients with leukemia. Therefore, it is possible to prepare sufficient amounts of leukemia cell-derived HSPs from patients, and these purified HSPs might be clinically useful to induce specific immunity. The observations reported in this study will provide the basis for a new generation of vaccines for patients with leukemia.
Submitted December 8, 2000; accepted May 10, 2001.
Supported by a Grant-in Aid for Scientific Research (C) from the Japanese Ministry of Education, Science, Sports and Culture.
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: Yoshihiro Torimoto, The Third Department of Internal Medicine, Asahikawa Medical College, Midorigaoka Higashi 2-1, Asahikawa, Hokkaido, 078-8510 Japan; e-mail: tori{at}asahikawa-med.ac.jp.
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© 2001 by The American Society of Hematology.
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T. Kurotaki, Y. Tamura, G. Ueda, J. Oura, G. Kutomi, Y. Hirohashi, H. Sahara, T. Torigoe, H. Hiratsuka, H. Sunakawa, et al. Efficient Cross-Presentation by Heat Shock Protein 90-Peptide Complex-Loaded Dendritic Cells via an Endosomal Pathway J. Immunol., August 1, 2007; 179(3): 1803 - 1813. [Abstract] [Full Text] [PDF] |
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J. B. Flechtner, K. P. Cohane, S. Mehta, P. Slusarewicz, A. K. Leonard, B. H. Barber, D. L. Levey, and S. Andjelic High-Affinity Interactions between Peptides and Heat Shock Protein 70 Augment CD8+ T Lymphocyte Immune Responses J. Immunol., July 15, 2006; 177(2): 1017 - 1027. [Abstract] [Full Text] [PDF] |
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Z. Li, Y. Qiao, B. Liu, E. J. Laska, P. Chakravarthi, J. M. Kulko, R. D. Bona, M. Fang, U. Hegde, V. Moyo, et al. Combination of Imatinib Mesylate with Autologous Leukocyte-Derived Heat Shock Protein and Chronic Myelogenous Leukemia Clin. Cancer Res., June 15, 2005; 11(12): 4460 - 4468. [Abstract] [Full Text] [PDF] |
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K. Fleischer, B. Schmidt, W. Kastenmuller, D. H. Busch, I. Drexler, G. Sutter, M. Heike, C. Peschel, and H. Bernhard Melanoma-Reactive Class I-Restricted Cytotoxic T Cell Clones Are Stimulated by Dendritic Cells Loaded with Synthetic Peptides, but Fail to Respond to Dendritic Cells Pulsed with Melanoma-Derived Heat Shock Proteins In Vitro J. Immunol., January 1, 2004; 172(1): 162 - 169. [Abstract] [Full Text] [PDF] |
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A. Michils, D. Dutry, V. Z. de Beyl, M. Remmelink, V. de Maertelaer, and P. Rocmans Peripheral Blood Mononuclear Cell Proliferation to Heat Shock Protein-70 Derived from Autologous Lung Carcinoma Am. J. Respir. Crit. Care Med., September 1, 2002; 166(5): 749 - 753. [Abstract] [Full Text] [PDF] |
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