Abstract
Natural killer cells (NK) are essential for the elimination of resistant acute myeloid and acute lymphoblastic leukemia (AML and ALL) cells. NK cell-based immunotherapies have already successfully entered for clinical trials, but limitations due to immune escape mechanisms were identified. Therefore, we extended our established NK cell protocol by integration of the previously investigated powerful trispecific immunoligand ULBP2-aCD19-aCD33 [the so-called triplebodies (TBs)] to improve the anti-leukemic specificity of activated NK cells. IL-2-driven expansion led to strongly elevated natural killer group 2 member D (NKG2D) expressions on donor NK cells which promote the binding to ULBP2+ TBs. Similarly, CD33 expression on these NK cells could be detected. Dual-specific targeting and elimination were investigated against the B-cell precursor leukemia cell line BV-173 and patient blasts, which were positive for myeloid marker CD33 and B lymphoid marker CD19 exclusively presented on biphenotypic B/myeloid leukemia’s. Cytotoxicity assays demonstrated improved killing properties of NK cells pre-coated with TBs compared to untreated controls. Specific NKG2D blocking on those NK cells in response to TBs diminished this killing activity. On the contrary, the observed upregulation of surface CD33 on about 28.0% of the NK cells decreased their viability in response to TBs during cytotoxic interaction of effector and target cells. Similar side effects were also detected against CD33+ T- and CD19+ B-cells. Very preliminary proof of principle results showed promising effects using NK cells and TBs against primary leukemic cells. In summary, we demonstrated a promising strategy for redirecting primary human NK cells in response to TBs against leukemia, which may lead to a future progress in NK cell-based immunotherapies.
Highlights
Natural killer (NK) cells are a subset of lymphoid effector cells within the innate immune response and have been shown to be a suitable tool for adoptive immunotherapy because of their ability of anti-tumor surveillance [1,2,3,4,5,6]
The NK cell-mediated cytotoxicity against BV-173 cells could be further enhanced at increased expansion periods by pre-incubation of NK cells with 1 μg/ml TBs (ULBP2-aCD19-aCD33) (Figure 1B)
The NK cell killing activity in presence of TBs reached a maximum of cytotoxic average value of 33.2 ± 5.1% (E/T: 1:1) and 55.2 ± 8.8% (E/T: 5:1) with IL-2-cultured NK cells expanded for 10–14 days compared to significant lower cytotoxic levels of untreated NK cells [24.8 ± 9.4% (E/T: 1:1) and 26.8 ± 5.0% (E/T: 5:1)] (Figure 1B)
Summary
Natural killer (NK) cells are a subset of lymphoid effector cells within the innate immune response and have been shown to be a suitable tool for adoptive immunotherapy because of their ability of anti-tumor surveillance [1,2,3,4,5,6]. Major histocompatibility complex class I-related chain A and B (MICA/B) and the UL-16 binding protein family are cancer cell surface ligands that interact with NKG2D on NK cells. These specific bindings between NKG2D and their corresponding ligands (NKG2DL) on cancer cells are responsible for improved cytotoxic properties of NK cells against tumor and leukemia cells [10,11,12]. Based on these receptor–ligand bindings between effector and target cells, an increased secretion of granzyme A (GraA) and B (GraB), granulysin, and perforin induced in NK cells could be demonstrated [13,14,15]. Enhanced tumor-shedding and DNAmethylation could contribute to an unhampered proliferation and evasion of immune control in AML patients [21]
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