Behrens, Marshall D.

Abstract DRB1*0401 has been associated with predisposition to rheumatoid arthritis while DRB1*0402 is associated with resistance. We have generated transgenic mice lacking endogenous H2-A and E molecules (AEo) but expressing DRB1*0401 or DRB1*0402 molecules. All transgenic mice expressed functional DR molecules which could positively and negatively select various Vβ T cell repertoire profile. Transgenic mice were studied in vivo for induction of arthritis following immunization with type II collagen. DRB1*0401 mice are susceptible to collagen-induced arthritis while DRB1*0402 mice are resistant. Presence of DR4 leads to arthritis predominantly in female mice. CIA susceptible AEo.DQ8 mice have been shown to develop arthritis without a gender bias. However, AEo mice expressing DRB1*0401.DQ8 develop arthritis in female mice with a ratio of 3F:1M, similar to that in humans. DRB1*0402 mice did not show any defect in humoral response though they demonstrated a lower cellular response to CII and an increased activation-induced cell death compared to susceptible mice. In vitro T cell response with superantigen staphylococcal enterotoxin B and Concovalin A showed that DRB1*0402 mice are not defective in generating T cell response. The resistant mice showed an increased cell death in thymus suggesting deletion of autoreactive T cells at thymic level might be one reason for protection. The data suggest that DRB1 polymorphism lead to selection of TCR in thymus thus controlling the selection of autoreactive T cells available in periphery. Thus these transgenic mice may be useful to study the reasons for gender-bias observed in human patients develop therapeutic strategies.

Abstract The PD-1:PD-L1 axis is a major immune regulatory pathway that blunts T cell activation in the tumor microenvironment. We recently identified that PD-1 is also upregulated on ovarian mouse tumor-infiltrating myeloid dendritic cells (TIDCs) that exhibit an immune suppressive phenotype. Extending those observations in this study, we now report that PD-1 is also expressed on human myeloid TIDCs of ovarian cancer patients, on which it suppresses the expression of co-stimulatory molecules (CD40 and CD80) as well as production of inflammatory cytokines. Mechanistic studies revealed that PD-1 on TIDCs is associated with Src homology domain-containing phosphatase-2 (SHP-2) and that PD-1-mediated blockade of NFkB-dependent cytokine release is SHP-2 dependent. PD-1 also inhibits NFkB-mediated antigen presentation which appears, however, to be independent of SHP-2. Thus, suppression of NFkB is critical in mediating PD-1-induced paralysis of ovarian tumor-associated immune TIDCs and is mediated through multiple signaling circuits that are both SHP-2 dependent and independent.

Abstract HLA-DRB1*0401 has been associated with predisposition to develop rheumatoid arthritis (RA) while *0402 has been linked with resistance to develop RA. Using transgenic mice, we showed that *0401 mice are susceptible to develop collagen-induced arthritis (CIA) that mimics human disease in histopathology, production of autoantibodies and sex-bias while *0402 mice are not susceptible. In this study, we determined if *0401 mice have CD4 T cell repertoire that is predetermined to produce proinflammatory cytokines. The data shown here supports that both *0401 and *0402 mice can produce Th1/TH17 cytokines although conditions required for production of Th17 cytokines differ between the 2 strains. In context of CIA, *0402 mice generate a Th2 response that may explain its resistance to develop CIA. Further, our data supports that a significant subset of naïve CD4 T cells when activated in polarizing conditions can generate T regulatory cells in *0402 but not *0401 mice. We hypothesize that *0401 has been evolutionarily selected due to its ability to clear infection. Our data suggests that *0401 generates a storm of cytokines in response to bacterial products and may be more efficient in clearing infection than *0402. Autoimmunity is a bystander effect of the cytokine storm ensuing immune dysregulation along with the presence of lower number of T regulatory cells in *0401 mice.

Abstract HLA-DQB1*0302/DQA1*0301 renders humans and transgenic mice susceptible to develop arthritis while HLA-DQB1*0601/DQA1*0103 has been associated with resistance to arthritis in both. However, some patients of rheumatoid arthritis carry the non-associated alleles. Most of the studies do not take in to account the role of DQA1 alleles. DQB1*0604 generally occurs in linkage with DQA1*0102. To understand the role of trans-heterodimer, we generated DQB1*0604/ DQA1* 0103 transgenic mice lacking endogenous class II molecules. Previous studies have shown that DQB1*0601/DQA1*0103 transgenic mice are resistant to develop collagen-induced arthritis. The DQB1*0604/A1*0103 and DQA1*0103 mice developed severe arthritis and generated antigen-specific response in vitro. The DQB1*0604/ DQA1*0103 could present CII-derived peptides that are not presented by RA resistant DQ6 allele suggesting that trans-heterodimer molecules between two DQB1 and DQA1 molecules may result in presentation of unique antigens and susceptibility to develop arthritis. The data provides a possible explanation for the presence of HLA alleles not associated with arthritis in some patients.

Abstract Glycosphingolipid (GSL) Lactosyl Ceramide (LacCer) is thought to be involved in Pneumocystis interaction with the host. Our previous results show that treatment with glycosphingolipid synthesis inhibitor PDMP reduces the fungus lung burden as well as symptoms of inflammation in mice with Pneumocystis pneumonia (PCP). Experiments were set up to resolve whether anti-inflammatory effects were due to the specific mechanisms involved in innate immune responses to Pneumocystis, or to some general anti-inflammatory property of PDMP. Animals were infected with live organisms, or challenged with either beta-glucan (the pro-inflammatory component of Pneumocystis cell wall) or LPS (inducer of lung inflammation unrelated to Pneumocystis). At the experimental endpoint the following inflammatory parameters were assessed: leukocyte recruitment to the lungs, production of pro-inflammatory cytokines and chemokines, histopathology and lung damage. Results show that glucan-induced acute inflammation partially mimics the inflammation caused by the whole organism, and PDMP suppresses some of the inflammatory parameters affected in PCP. In contrast, although LPS induces comparable intensity of inflammation as live Pneumocystis or glucan, PDMP does not suppress any inflammatory parameters measured in this group. These results suggest that the mechanism of PDMP action is related to the features specific to Pneumocystis and host recognition of the microorganism. Further studies will attempt to determine the role of LacCer in these processes. Supported by NIH-RO1-HL62150 and Mayo Clinic

Abstract The PD-1:PD-L1 immune signaling axis mediates suppression of T-cell–dependent tumor immunity. PD-1 expression was recently found to be upregulated on tumor-infiltrating murine (CD11c+CD11b+CD8−CD209a+) and human (CD1c+CD19−) myeloid dendritic cells (TIDC), an innate immune cell type also implicated in immune escape. However, there is little knowledge concerning how PD-1 regulates innate immune cells. In this study, we examined the role of PD-1 in TIDCs derived from mice bearing ovarian tumors. Similar to lymphocytes, TIDC expression of PD-1 was associated with expression of the adapter protein SHP-2, which signals to NF-κB; however, in contrast to its role in lymphocytes, we found that expression of PD-1 in TIDC tonically paralyzed NF-κB activation. Further mechanistic investigations showed that PD-1 blocked NF-κB–dependent cytokine release in a SHP-2–dependent manner. Conversely, inhibition of NF-κB–mediated antigen presentation by PD-1 occurred independently of SHP-2. Collectively, our findings revealed that PD-1 acts in a distinct manner in innate immune cells compared with adaptive immune cells, prompting further investigations of the signaling pathways controlled by this central mediator of immune escape in cancer. Cancer Res; 76(2); 239–50. ©2015 AACR.

SummaryRheumatoid arthritis (RA) is associated with the presence of certain HLA class II genes. However, why some individuals carrying RA non‐associated alleles develop arthritis is still unexplained. The trans‐heterodimer between two RA non‐associated HLA genes can render susceptibility to develop arthritis in humanized mice, DQA1*0103/DQB1*0604, suggesting a role for DQ α chains in pathogenesis. In this study we determined the role of DQA1 in arthritis by using mice expressing DQA1*0103 and lacking endogenous class II molecules. Proximity ligation assay showed that DQA1*0103 is expressed on the cell surface as a dimer with CD74. Upon immunization with type II collagen, DQA1*0103 mice generated an antigen‐specific cellular and humoral response and developed severe arthritis. Structural modelling suggests that DQA1*0103/CD74 form a pocket with similarity to the antigen binding pocket. DQA1*0103 mice present type II collagen‐derived peptides that are not presented by an arthritis‐resistant DQA1*0103/DQB1*0601 allele, suggesting that the DQA1*0103/CD74 dimer may result in presentation of unique antigens and susceptibility to develop arthritis. The present data provide a possible explanation by which the DQA1 molecule contributes to susceptibility to develop arthritis.

Abstract Purpose: It is well known that the immune system impacts the clinical course of ovarian cancer suggesting that immune-based approaches may effective in treating the disease. This has led to several clinical trials of novel treatments such as antibody, vaccine, and adoptive T cell therapy. PD-1:PD-L1 axis is a major immune regulatory pathway that blunts immune effectors in the tumor microenvironment. It is well known that high surface expression of PD-1 on tumor infiltrating T cells is a sign of their exhaustion. However, the complete mechanism behind the PD-1 regulation of T cell exhaustion is yet to be explored. Recently we identified that PD-1 is also expressed on ovarian tumor-infiltrating myeloid dendritic cells (DCs) that exhibit an immunosuppressive phenotype. Our goal in this study was to understand the mechanism by which PD-1 mediates the paralysis of ovarian cancer infiltrating DCs. Experimental procedures: PD-1+ DCs obtained from ID8 mouse model of ovarian cancer were used in this study. Data from this preclinical model was confirmed by using myeloid DCs obtained from ovarian cancer patient’s samples. Using standard flow cytometry, immunoassays (ELISA, multiplexed cytokine assay), PCR array, western blot and confocal microscopy, PD-1 mediated paralysis of ovarian cancer DCs was determined. Results: Our data shows that blockade of surface PD-1 on ovarian cancer infiltrating DCs results in their activation by, enhancing their surface co-stimulatory molecules expression, increasing their motility, enhancing their antigen presentation capacity, and increasing their production of immunostimulatory cytokines. Also, our results suggest that PD-1 expressed on tumor DCs mediates the suppression of NFkB which occurs through SHP-2 and IKK dependent mechanisms. Conclusion: Our study reveals that blockade of PD-1 on ovarian cancer infiltrating DCs results in the reversal of their paralysis to such an extent that it overrides their B7-H1 mediated suppression of T cells and this occurs through the reversal of PD-1 mediated tonic suppression of NFkB. Citation Format: Lavakumar Karyampudi James Krempski, Purushottam Lamichhane, Kimberly R. Kalli, Marshall D. Behrens, Doris M. Vargas, Lynn C Hartmann, Karen E Hedin, Ellen L. Goode, Keith L. Knutson. PD-1 mediated paralysis of ovarian cancer infiltrating dendritic cells [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr POSTER-THER-1418.

Abstract Background: Ovarian cancer (OC) is the most common cause of death among gynecologic cancers. A key reason for the high lethality of OC is that early detection of OC is uncommon, and the majority of OC patients have advanced stage disease at diagnosis. Current non-invasive tests do not adequately distinguish benign from malignant adnexal masses. Diagnostic tests that reliably distinguish early stage OC from benign conditions may lead to earlier diagnosis of OC and improved survival. Methods: We designed a cohort study of plasma biomarkers in ovarian cancer patients. Specimens were analyzed from 100 patients with advanced OC (AJCC Stage III and IV), 50 patients with early stage OC (Stage I and II), and 50 patients with benign surgical conditions from the Mayo Ovarian SPORE Biospecimens Core. Presurgical plasma samples were assayed for multiple toll-like receptor agonists, cytokines, and vascular growth factors by ELISA and electrochemiluminescence. Biomarkers that were reliably detected in plasma were analyzed for association with OC. Differences in plasma biomarker levels between benign, early, and advanced OC patient groups were assessed using plate-adjusted logistic regression models. Results: Out of 23 biomarkers tested, 7 were excluded due to unreliable plasma detection. Of the remaining 16 biomarkers, 6_including interferon gamma (IFNγ), interleukin 6 (IL-6), IL-8, IL-10, tumor necrosis factor alpha (TNFα), and placental growth factor (PlGF)_were univariately associated with OC (all p<0.005), and one_IL-6_was associated with early stage OC (p < 0.0001). Heat shock protein 90kDa beta member 1 (HSP90B1, gp96) was associated with OC and early stage OC with borderline statistical significance (p = 0.039 and p = 0.026, respectively). However, when adjusted for cancer antigen 125 (CA-125), only HSP90B1 independently predicted OC (p = 0.008), as well as early stage OC (p = 0.014). Conclusions: The plasma cytokines IFNγ, IL-6, IL-8, IL-10, TNFα, and PlGF are associated with OC. However, after adjusting for CA-125, only HSP90B1 independently predicts OC, including early stage OC. These data warrant further investigation to determine whether measuring plasma HSP90B1 can aid in patient evaluation. Citation Format: Matthew S. Block, Matthew J. Maurer, Krista Goergen, Kimberly R. Kalli, Courtney L. Erskine, Marshall D. Behrens, Keith L. Knutson. Plasma heat shock protein 90kDa beta member 1 levels predict both early stage and advanced stage ovarian cancer independently from cancer antigen 125 in patients with an indeterminate adnexal mass. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1873. doi:10.1158/1538-7445.AM2014-1873

Abstract Background: Ovarian cancer (OC) is the leading cause of gynecologic cancer death in the United States. Survival in advanced OC is highly variable and is impacted by the endogenous anti-tumor immune response. Toll-like receptors (TLR) on tumor-infiltrating leukocytes can modulate anti-OC immunity. Heparan sulfate (HS) is an oligosaccharide component of the extracellular matrix that, when released, binds and triggers TLR-4 to induce production of multiple cytokines; HS is liberated from the extracellular matrix by heparanase, which is overexpressed by many ovarian cancers. We therefore explored the association between plasma levels of HS, heparanase, proinflammatory and immunosuppressive cytokines, and survival in patients with advanced OC. Methods: We designed a two stage cohort study of plasma biomarkers in ovarian cancer patients. For the pilot stage, we enrolled 100 patients with advanced OC (AJCC Stage III and IV), 50 patients with early stage OC (Stage I and II), and 50 patients with benign surgical conditions from the Mayo Ovarian SPORE Biospecimens Core. For the expansion stage, 257 patients with advanced OC were enrolled. Presurgical plasma samples were assayed for HS, heparanase, and multiple cytokines by ELISA and electrochemiluminescence. Differences in plasma levels between benign, early, and advanced OC patient groups were assessed using plate-adjusted linear models. Associations between plasma levels of HS and heparanase with overall survival in advanced OC patients were assessed by Cox proportional hazards models using a log2 transformation; total effects across stages were estimated using a meta-analysis approach. Results: In the pilot cohort, soluble HS levels were similar in control (mean +/ STD: 88.26 +/- 32.23), early stage (93.91 +/- 37.77), and advanced OC (93.55 +/- 40.44), with similar values observed in the expansion cohort (129.29 +/- 95.64). There was no correlation between heparanase and HS levels. Higher levels of HS were associated with improved overall survival (log2 HR = 0.62, p = 0.042; HR = 0.84, p = 0.014; HR = 0.82, 95% CI: 0.71-0.93, p = 0.003 for the pilot, expansion, and combined sets, respectively). There was no association between heparanase levels and overall survival (all p > 0.45). Conclusions: Neither soluble HS nor heparanase were elevated in presurgical OC patients relative to controls; however, higher levels of HS were associated with improved survival in patients with advanced OC. These results suggest that HS may play a key role in modulating the innate immune response to OC. Citation Format: Matthew S. Block, Matthew J. Maurer, Krista M. Goergen, Courtney L. Erskine, Marshall D. Behrens, Kimberly R. Kalli, Keith L. Knutson. Higher plasma levels of heparan sulfate are associated with improved survival of patients with advanced ovarian cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3476. doi:10.1158/1538-7445.AM2013-3476