Interaction Of CD4 Research Articles

SARS-CoV-2 spike protein induces the cytokine release syndrome by stimulating T cells to produce more IL-2.

Cytokine release syndrome (CRS) is one of the leading causes of mortality in patients with COVID-19 caused by the SARS-CoV-2 coronavirus. However, the mechanism of CRS induced by SARS-CoV-2 is vague. Using spike protein combined with IL-2, IFN-γ, and TNF-α to stimulate human peripheral blood mononuclear cells (PBMCs) to secrete CRS-related cytokines, the content of cytokines in the supernatant was detected, and the effects of NK, T, and monocytes were analyzed. This study shows that dendritic cells loaded with spike protein of SARS-CoV-2 stimulate T cells to release much more interleukin-2 (IL-2,) which subsequently cooperates with spike protein to facilitate PBMCs to release IL-1β, IL-6, and IL-8. These effects are achieved via IL-2 stimulation of NK cells to release tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ), as well as T cells to release IFN-γ Mechanistically, IFN-γ and TNF-α enhance the transcription of CD40, and the interaction of CD40 and its ligand stabilizes the membrane expression of toll-like receptor 4 (TLR4) that serves as a receptor of spike protein on the surface of monocytes. As a result, there is a constant interaction between spike protein and TLR4, leading to continuous activation of nuclear factor-κ-gene binding (NF-κB). Furthermore, TNF-α also activates NF-κB signaling in monocytes, which further cooperates with IFN-γ and spike protein to modulate NF-κB-dependent transcription of CRS-related inflammatory cytokines. Targeting TNF-α/IFN-γ in combination with TLR4 may represent a promising therapeutic approach for alleviating CRS in individuals with COVID-19.

ADU-1604, a novel CTLA-4 blocking antibody, to modulate pharmacodynamic markers in patients with PD1 relapse/refractory melanoma.

9552 Background: Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is a negative regulator of T-cell responses, also known as an immune checkpoint. The clinical relevance of CTLA-4 blockade was demonstrated by the approval of ipilimumab for the treatment of melanoma, both in the adjuvant as well as metastatic settings. ADU-1604 is a humanized hIgG1 CTLA-4 antagonist antibody. ADU-1604 binds a unique epitope on CTLA-4 demonstrating, in contrast to ipilimumab full blockade of both CD80 and CD86 interactions. In vitro and in vivo ADU-1604 demonstrates at least as potent efficacy as compared to ipilimumab, was well tolerated in non-human primates and demonstrated enhanced immunogenicity against hepatitis B vaccine in non-human primates. Methods: This is a phase 1, first-in-human (FIH), two-part, open-label clinical trial of intravenous (IV) administration of ADU-1604 given as monotherapy in subjects with advanced-stage, relapsed/refractory melanoma who relapsed or were refractory to a prior anti-PD-1/PD-L1 therapy. Main endpoints are safety of ADU-1604 monotherapy, pharmacokinetics, pharmacodynamics (upregulation of ICOS and Ki-67 on circulation CD4+ T cells and ALC, CD4+ and CD8+ T cells) as well as preliminary clinical efficacy. 20 subjects received escalating doses of ADU-1604 IV (25, 75, 225, 450 mg flat dose) Q3W. In the dose expansion part up to 20 additional patients will be treated with 225 mg dose to confirm recommended Phase 2 dose (RP2D). Safety and preliminary efficacy of ADU-1604 monotherapy in PD1 relapsed/refractory melanoma patients will be evaluated. The study was initiated in June 2022. Results: ADU-1604 was demonstrated to have a typical pharmacokinetic behavior for a human IgG1 antibody and similar exposure was observed as described for ipilimumab. Administration of ADU-1604 in cycle 1 and 2 showed a dose-dependent modulation of ICOS and Ki-67 on circulating CD4+ T cells. Similarly, in cycles 3 and 4 a dose-dependent increase of ALC and CD4+ and CD8+ T cells was detected. Notably, no DLTs across the 25, 75, 225 and 450 mg dose level have occurred. Of the patients treated at 225 and 450 mg dose levels (N=6 at 225 mg and N=6 at 450 mg), two Grade 2 severe adverse events (both immune-related enterocolitis) and two Grade 3 AESIs (ALT elevation and immune-related gastritis) suggesting that ADU-1604 has a relatively mild safety profile. Two patients at 225 mg and one patient at 450 mg demonstrated clinical efficacy. Conclusions: ADU-1604 Phase 1 dose-escalation data indicates clinical activity in line with what has been observed with other CTLA-4 blocking antibodies. Importantly, no DLTs and very limited safety signals were reported during the study. Dose expansion at 225 mg dose is ongoing in subjects with advanced-stage, relapsed/refractory melanoma who relapsed or were refractory to a prior anti-PD-1/PD-L1 therapy. Clinical trial information: 2021-002623-38 .

Abstract 5292: CD28 humanized mouse model for efficacy and safety assessment of CD28-targeting therapies

Abstract Agonist antibodies targeting CD28 have proven to be effective against cancer, but also faced challenges due to severe adverse events triggered by its activation. Human (hCD28) and mouse CD28 (mCD28) have different signaling responses, with CD28 ligands and superagonists inducing pro-inflammatory cytokines upon stimulation in absence of TCR ligation in humans, but not in mice. Expression of CD28i amplifier isoform, which is thought to enhanced the production of cytokines in humans, could partially explain this difference, as it is not expressed in mice. In addition, evidence suggests that the different signaling between hCD28 and mCD28 relies on one amino acid change in the intracellular domain (ICD)[1]. Herein, we describe a CD28 humanized mouse model for assessment of CD28-targeting agents. To improve translatability, we decided to keep the expression of both canonical and CD28i human isoforms to avoid undermining the biological effects of the testing agents. Although keeping the human ICD could favor the evaluation of cytokine production and therefore the safety of the test agents, we decided to keep the mouse ICD to enable a proper interaction of CD28 with its signaling partners, allowing a physiological stimulation of CD28 in efficacy studies. The hCD28 model expresses a chimeric protein, with the whole human extracellular domain, and mouse intracellular domain. Human CD28 is expressed at physiological levels on T cells, and these cells can be activated and proliferate in response to hCD28 ligands and agonist antibodies. Tumor growth inhibition and complete tumor regressions are achieved in a MC38-TAA colorectal cancer model following prophylactic treatment with CD28-TAA bispecific antibody in combination with anti-PD-1. Extension of this study and re-challenged of the tumor-free surviving animals shows that re-challenged hCD28 mice have enhanced survival compared to naïve hCD28 mice inoculated with MC38-TAA, suggesting tumor immunological memory. Furthermore, TGN1412 administration in CD28 mice induces cytokine release, and a slightly body weight loss, but no major change in body temperature. Although the model does not fully reproduce the ability of human CD28 to produce cytokines upon activation due to the mouse ICD, the expression of the amplifier isoform CD28i might contribute to the response to TGN1412. Altogether, data suggest that hCD28 model enables assessment of efficacy and safety of CD28-targeting agents. The hCD28 model was intercrossed with CD3 humanized models to enable assessment of combination therapies and bispecific antibodies targeting both CD3 and CD28. [1] Porciello N, Grazioli P, Campese AF, et al. A non-conserved amino acid variant regulates differential signalling between human and mouse CD28. Nat Commun 2018; 9:1-16 Citation Format: Fabiane Sonego, Angela Pappalardo, Gaëlle Martin, Yacine Cherifi, Patricia Isnard-Petit, Kader Thiam. CD28 humanized mouse model for efficacy and safety assessment of CD28-targeting therapies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5292.

Artificial intelligence-powered discovery of small molecules inhibiting CTLA-4 in cancer

Background/ObjectivesCheckpoint inhibitors, which generate durable responses in many cancer patients, have revolutionized cancer immunotherapy. However, their therapeutic efficacy is limited, and immune-related adverse events are severe, especially for monoclonal antibody treatment directed against cytotoxic T-lymphocyte–associated protein 4 (CTLA-4), which plays a pivotal role in preventing autoimmunity and fostering anticancer immunity by interacting with the B7 proteins CD80 and CD86. Small molecules impairing the CTLA-4/CD80 interaction have been developed; however, they directly target CD80, not CTLA-4.Subjects/MethodsIn this study, we performed artificial intelligence (AI)-powered virtual screening of approximately ten million compounds to identify those targeting CTLA-4. We validated the hits molecules with biochemical, biophysical, immunological, and experimental animal assays.ResultsThe primary hits obtained from the virtual screening were successfully validated in vitro and in vivo. We then optimized lead compounds and obtained inhibitors (inhibitory concentration, 1 micromole) that disrupted the CTLA-4/CD80 interaction without degrading CTLA-4.ConclusionsSeveral compounds inhibited tumor development prophylactically and therapeutically in syngeneic and CTLA–4–humanized mice. Our findings support using AI-based frameworks to design small molecules targeting immune checkpoints for cancer therapy.Schematic representation of AI-assisted anti-CTLA-4 drug discovery. (a) The extracellular domain of CTLA-4 with residues around the binding site is shown in yellow (26PGKAT) and other colors (98MYPPPYY104). (b) The interactions between B7 (CD80 and CD86) and CTLA-4 or CD28 occurring with varying affinities are represented by the thicknesses of the arrows. AI, artificial intelligence; APC, antigen-presenting cell; CTLA-4, cytotoxic T-lymphocyte–associated protein 4; IFN-γ, interferon γ; MHC II-Ag, major histocompatibility class 2 antigen; PD-1, programmed cell death protein-1; PD-L1, programmed death-ligand 1; Tconv, T conventional; TCR, T-cell receptor; Treg, T regulatory cell.

Blockade of PD-L1/CD80 Interactions Augments Function of Activated Donor T Cells Results in Augmenting Gvhd Induced By Donor Naïve CD8 + t Cells and GVL Effect Mediated By Donor Memory CD8 + T Cells

Preventing graft-versus-host disease (GVHD) while preserving graft-versus-leukemia/lymphoma (GVL) activity remains an elusive goal for allogeneic hematopoietic cell transplantation (HCT). It was reported by others that while donor naïve CD8 + T cells mediate both GVHD and GVL activity, donor memory CD8 + T cells could mediate GVL activity without GVHD. We recently reported that in vivo specific blockade of PD-L1/CD80 interactions augment tumor immunity mediated by memory CD8 + T cells (Zhang et al: PNAS 2023). In the current studies, we evaluated the impact of blockade of PD-L1/CD80 on GVHD induced by donor naïve CD8 + T cells and GVL activity-mediated by donor memory CD8 + T cells. Sorted naïve CD8 + T or memory CD8 + T cells and TCD-BM cells from C57BL/6 donors were transplanted into lethal TBI-conditioned BALB/c recipients with or without bearing ALL cancer cells. 4 days after HCT, the recipients were injected I.P. with anti-PD-L1 mAb (43H12) that specifically blocks PD-L1/CD80 interactions without inferring PD-L1/PD-1 interactions or control IgG. We observed that naïve but not memory CD8 + T cells severely infiltrated GVHD target tissues, and the memory CD8 + T cells expanded mainly in the lymphoid tissues. In vivo blockade of PD-L1/CD80 interactions augmented GVHD induced by the naïve T cells and GVL activity mediated by the memory CD8 + T cells. In addition, blockade of PD-L1/CD80 interactions increased production of granzyme B and inflammatory cytokines (IFN-g and TNF-α) of activated donor CD8 + T cells. Since cytolytic activity of effector CD8 + T cell is reported to be associated with its metabolic fitness, we evaluated the effect of blockade PD-L1/CD80 interactions on metabolism of alloreactive donor CD8 + T cells. And blockade of the interactions enhanced the fitness of mitochondria, as indicated by electronic microscopy analysis. The blockade also increased ECAR, OCR, and ATP production of the activated CD8 + T cells, with increased influx of glucose and fatty acids; and the blockade augmented mitophagy of the activated CD8 + T cells, as indicated by reducing mitochondria mass and dysfunctional mitochondria in the CD8 + T cells. The results indicate that 1) PD-L1/CD80 interactions play an important role in regulating the mitochondria function of activated alloreactive CD8 + T cells; 2) Blockade of PD-L1/CD80 interactions can augment GVL activity mediated by donor memory T cells without augmenting GVHD. This is different from blockade of PD-L1/PD-1 interactions that resulted in lethal GVHD. *Zhang and Song are co-first authors of this abstract

CD40 Ligand-CD40 Interaction Is an Intermediary between Inflammation and Angiogenesis in Proliferative Diabetic Retinopathy.

We aimed to investigate the role of the CD40-CD40 ligand (CD40L) pathway in inflammation-mediated angiogenesis in proliferative diabetic retinopathy (PDR). We analyzed vitreous fluids and epiretinal fibrovascular membranes from PDR and nondiabetic patients, cultures of human retinal microvascular endothelial cells (HRMECs) and Müller glial cells and rat retinas with ELISA, immunohistochemistry, flow cytometry and Western blot analysis. Functional tests included measurement of blood-retinal barrier breakdown, in vitro angiogenesis and assessment of monocyte-HRMEC adherence. CD40L and CD40 levels were significantly increased in PDR vitreous samples. We demonstrated CD40L and CD40 expression in vascular endothelial cells, leukocytes and myofibroblasts in epiretinal membranes. Intravitreal administration of soluble (s)CD40L in normal rats significantly increased retinal vascular permeability and induced significant upregulation of phospho-ERK1/2, VEGF, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). sCD40L induced upregulation of VEGF, MMP-9, MCP-1 and HMGB1 in cultured Müller cells and phospo-ERK1/2, p65 subunit of NF-ĸB, VCAM-1 and VEGF in cultured HRMECS. TNF-α induced significant upregulation of CD40 in HRMECs and Müller cells and VEGF induced significant upregulation of CD40 in HRMECs. sCD40L induced proliferation and migration of HRMECs. We provide experimental evidence supporting the involvement of the CD40L-CD40 pathway and how it regulates inflammatory angiogenesis in PDR.

Cis-B7:CD28 interactions at invaginated synaptic membranes provide CD28 co-stimulation and promote CD8+ T cell function and anti-tumor immunity

B7 ligands (CD80 and CD86), expressed by professional antigen-presenting cells (APCs), activate the main co-stimulatory receptor CD28 on Tcells in trans. However, in peripheral tissues, APCs expressing B7 ligands are relatively scarce. This raises the questions of whether and how CD28 co-stimulation occurs in peripheral tissues. Here, we report that CD8+ Tcells displayed B7 ligands that interacted with CD28 in cis at membrane invaginations of the immunological synapse as a result of membrane remodeling driven by phosphoinositide-3-kinase (PI3K) and sorting-nexin-9 (SNX9). cis-B7:CD28 interactions triggered CD28 signaling through protein kinase C theta (PKCθ) and promoted CD8+ Tcell survival, migration, and cytokine production. In mouse tumor models, loss of Tcell-intrinsic cis-B7:CD28 interactions decreased intratumoral Tcells and accelerated tumor growth. Thus, B7 ligands on CD8+ Tcells can evoke cell-autonomous CD28 co-stimulation in cis in peripheral tissues, suggesting cis-signaling as a general mechanism for boosting Tcell functionality.

Blockade of trans PD-L1 interaction with CD80 augments antitumor immunity

PD-L1 has two receptors: PD-1 and CD80. Previous reports assumed that PD-L1 and CD80 interacted in trans, but recent reports showed that only cis PD-L1/CD80 interactions existed, and prevention of cis PD-L1/CD80 interactions on antigen-presenting cells (APCs) reduced antitumor immunity via augmenting PD-L1/PD-1 and CD80/CTLA4 interactions between T and APCs. Here, using tumor-bearing mice capable of cis and trans or trans only PD-L1/CD80 interactions, we show that trans PD-L1/CD80 interactions do exist between tumor and T cells, and the effects of trans PD-L1/CD80 interactions require tumor cell expression of MHC-I and T cell expression of CD28. The blockade of PD-L1/CD80 interactions in mice with both cis and trans interactions or with only trans interactions augments antitumor immunity by expanding IFN-γ-producing CD8+ T cells and IFN-γ-dependent NOS2-expressing tumor-associated macrophages. Our studies indicate that although cis and trans PD-L1/CD80 interactions may have opposite effects on antitumor immunity, the net effect of blocking PD-L1/CD80 interactions invivo augments CD8+ T cell-mediated antitumor immunity.

Abstract 606: Cis-B7:CD28 interactions at invaginated synaptic membranes activate CD28 and promote T cell function

Abstract Absence of adequate CD28 costimulation is a common feature of dysfunctional T cells in cancer. However, although augmentation of CD28 signaling is well known to be essential for restoring dysfunctional T cell immune responses upon immune checkpoint blockade treatment, it is unclear how CD28 in tumor-infiltrated T cells is activated in the absence of corresponding ligands on cancer. In current dogma, the T cell CD28 can be activated in trans by CD80 (B7-1) or CD86 (B7-2) expressed on professional antigen presenting cells (APCs) enriched in secondary lymphoid organs. Notably, besides professional APCs, B7 ligands are also displayed by T cells, but their functions are unclear. Here we report that B7 ligands expressed on T cells interact with CD28 in cis at membrane invaginations of the immunological synapse, as a result of phosphoinositide-3-kinase (PI3K) mediated membrane remodeling. Cis-B7:CD28 interactions triggered CD28 signaling through protein-kinase-C-theta (PKCθ) and promoted T cell survival, migration and cytokine production. In a B7 deficient tumor model grafted with primed CD8+ T cells, blockade of T cell intrinsic B7:CD28 interactions accelerated tumor growth and decreased intratumoral T cells. Thus, B7 ligands on T cells can evoke cell autonomous CD28 costimulation in cis in peripheral tissues, suggesting cis-signaling as a general mechanism for boosting T cell functionality. Citation Format: Yunlong Zhao, Christine Caron, Ya-Yuan Chan, Calvin K. Lee, Xiaozheng Xu, Jack D. Bui, Enfu Hui. Cis-B7:CD28 interactions at invaginated synaptic membranes activate CD28 and promote T cell function [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 606.

Abstract P5-02-34: Single-cell Analysis of KN026 in Combination with KN046 in Treating Patients with Advanced HER2-positive Breast Cancer

Abstract Background: KN026 is a novel bispecific antibody that simultaneously binds to two distinct HER2 epitopes (two different HER2 epitopes shared by trastuzumab and pertuzumab). KN046 is a novel bispecific antibody that blocks both PD-L1 interaction with PD-1/CD80 and CTLA-4 interaction with CD80/CD86. Our on-going multi-centered phase II trial (NCT04521179) demonstrated that in advanced HER2-positive breast cancer (HER2+ BC) patients, who have progressed after prior anti-HER2 combinational therapies, the objective response rate (ORR) of this chemo-free therapy of KN026 in combination of KN046 was about 50.0% (SABCS 2021 poster P5-16-04). To explore the underlying mechanism of this regimen, we collected tumor specimens from patients before and after receiving this combinational treatment for single-cell analysis to provide an in-depth description of the tumor immune microenvironment and its correlation with treatment response. Methods: Paired tumor specimens before and after treatment of patients enrolled in the trial were collected for single-cell transcriptome and TCR sequencing. In addition, to reveal the immune cell characteristics of anti-HER2 resistant patients, we compared our data with previously reported single-cell analysis of treatment-naïve HER2+ BC. Results: We obtained 30 specimens from 17 patients, including 17 of pre-treatment and 13 of post-treatment. TCR expansion did not correlate with clinical efficacy. In-depth analysis of subpopulations revealed that compared to treatment-naive HER2+ BC, these enrolled prior anti-HER2-resistant patients had an additional population of T cells subpopulation characterized by CD4-low and CD8-low in their baseline tumor tissues, and the proportion of this subpopulation was significantly decreased after KN046 plus KN026 treatment in responding patients. Moreover, we found that patients with baseline CD8+ T/naïve T >1 tended to benefit more from this regimen. Conclusion: We identified a subpopulation of CD4-low and CD8-low T cells that may be associated with anti-HER2 resistance. And decreased of this subpopulation of T cells was associated with better ORR of KN046 in combination with KN026 treatment in heavily pretreated advanced HER2+ BC. Baseline CD8+ T/naïve T ratio in tumor is expected to be a predictor of ORR as well. Citation Format: Jieqiong Liu, Jianyou Liao, Zhenluan Tian, Jien Wang, Chuangui Song. Single-cell Analysis of KN026 in Combination with KN046 in Treating Patients with Advanced HER2-positive Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-34.

Novel peptide inhibitors targeting CD40 and CD40L interaction: A potential for atherosclerosis therapy

Atherosclerosis is a chronic inflammatory disease characterized by plaque build-up in the arteries, leading to the obstruction of blood flow. Macrophages are the primary immune cells found in the atherosclerotic lesions and are directly involved in atherosclerosis progression. Macrophages are derived from extravasating blood monocytes. The monocytic CD40 receptor is important for monocyte recruitment on the endothelium expressing the CD40 ligand (CD40L). Thus, targeting monocyte/macrophage interaction with the endothelium by inhibiting CD40-CD40L interaction may be a promising strategy for attenuating atherosclerosis. Monoclonal antibodies have been used against this target but shows various complications. We used an array of computer-aided drug discovery tools and molecular docking approaches to design a therapeutic inhibitory peptide that could efficiently bind to the critical residues (82Y, 84D, and 86N) on the CD40 receptor essential for the receptor's binding to CD40L. The initial screen identified a parent peptide with a high binding affinity to CD40, but the peptide exhibited a positive hepatotoxicity score. We then designed several novel peptidomimetic derivatives with higher binding affinities to CD40, good physicochemical properties, and negative hepatotoxicity as compared to the parent peptide. Furthermore, we conducted molecular dynamics simulations for both the apo and complexed forms of the receptor with ligand, and screened peptides to evaluate their stability. The designed peptidomimetic derivatives are promising therapeutics targeting the CD40-CD40L interaction and may potentially be used to attenuate atherosclerosis.

A Novel CTLA-4 affinity peptide for cancer immunotherapy by increasing the integrin αvβ3 targeting

Immune checkpoint inhibitors (ICIs) are changing all aspects of malignant tumour therapy as an immunotherapy subverter in oncology. However, the current ICIs might induce systemic immune activation in other tissues and organs since they are not tumour-specific, causing the immune system to attack some normal tissues and organs of the human body. The toxicity can also amplify greatly although combined immunotherapy for cancer has increased the curative efficacy. The LC4 peptide was modified to improve its tumour-targeting ability and reduce peripheral immune system activation, which was obtained through phage display peptide library screening and could block the CTLA-4/CD80 interaction. The LC4 peptide as a result, like other ICIs, exerts anti-tumour effects by refreshing T cell function, and also activates the peripheral immune system. We used the PLGLAG peptide as a linker at the C-terminal of LC4 to connect with a tumour-targeting peptide RGD to increase the tumour tissue targeting ability, and obtain LC4-PLG-RGD. Further experiments demonstrated that the anti-tumour LC4-PLG-RGD activity was better than LC4 in vivo, and the ability to activate the peripheral immune system was weakened. In conclusion, LC4-PLG-RGD can increase the ICIs tumour-targeting and reduce excessive peripheral tissue immune activation, thereby reducing the side effects of ICIs, while increasing their anti-tumour efficacy. This study confirmed that enhanced ICI tumour targeting can effectively reduce immune-related adverse reaction occurrence.

The fusion of quantitative molecular proteomics and immune-oncology: a step towards precision medicine in cancer therapeutics.

Innate and adaptive immune systems are built-in homeostatic functions of many multicellular organisms and protect the host against foreign pathogens and infections. Dysregulation of the molecular mechanisms of the immune system can result in autoimmune diseases. The immune system can also be harnessed and manipulated to provide targeted cancer therapies, some of them relying on the blockade of immune-checkpoint receptors. Two prominent immune checkpoints, PD-1/PD-L1 and CTLA-4/CD80, comprise receptor-ligand pairs that prevent the host immune cells from attacking host tissues. However, cancer cells upregulate the respective PD-L1 and CD80 ligands for PD-1 and CTLA-4 and thereby evade the host-immune response. Therapeutic drugs that block PD-1/PD-L1 and CTLA-4/CD80 interactions re-enable the immune system to attack cancer cells, but their prognostic biomarker remains challenging. In this review, we discuss how the use of quantitative molecular imaging can be exploited to predict the response to anti-PD-1/PD-L1 therapies and to identify cancer patients who would benefit from them.

Preclinical anti-tumor activity of small-molecule oral PD-L1 checkpoint inhibitors.

e14558 Background: The PD-1/PD-L1 checkpoint axis is a validated target in oncology, and immunotherapy with antibody approaches have proven efficacy across various tumor types. Oral small-molecule inhibitors of PD-L1 may offer advantages over antibody approaches by enabling tunable on-target engagement and the potential for better tissue penetration and improved efficacy. Here we report the preclinical in vitro activity of small-molecule inhibitors of PD-L1 possessing a novel mechanism of action, favorable pharmacokinetics, and demonstrated in vivo efficacy in a mouse colon adenocarcinoma model. Methods: In vitro activity was assessed in a Jurkat T cell NFAT reporter assay and PD-L1 reduction was confirmed in CHO-K1 cells expressing human PD-L1 (CHO-K1-hPD-L1) and in peripheral blood mononuclear cells (PBMCs) from healthy donors. T cell activation assays were conducted with PBMCs from healthy donors. Non-specific cytokine release was evaluated in human whole blood. Pharmacokinetic (PK) evaluations were conducted in rodents and non-human primates (NHP). In vivo efficacy was evaluated in an MC38 tumor humanized PD-L1 and PD-1 mouse model. Results: Small-molecule inhibitors of PD-L1 were able to disrupt PD-1:PD-L1 and PD-L1:CD80 interactions through the reduction of PD-L1 expression on the cell surface via a novel internalization mechanism, resulting in PD-L1 degradation (EC50s ranged from 1.9 – 24 nM in CHO-K1-hPD-L1 and primary human myeloid cells). Lead PD-L1 inhibitors mediated potent activation of T cells in a NFAT reporter assay (EC50s of 13 and 18 nM) as well as dose responsive elevations in IL-2 production in human PBMCs stimulated with staphylococcal enterotoxin B. Compound treatment did not elicit non-specific cytokine release in human whole blood, supportive of favorable immune safety. PK profiles showed low systemic clearance in rodents and NHP. In an MC38 tumor model, once daily oral administration of compounds at 3, 10, and 30 mg/kg resulted in dose responsive tumor reduction that was associated with T cell activation and infiltration into tumors. Conclusions: Oral small-molecule PD-L1 inhibitors possessing a novel mechanism of action and the ability to mediate T cell activation in primary human immune cell types were identified. These compounds display in vivo anti-tumor efficacy comparable to anti-PD-L1 antibody and possess favorable preclinical profiles for further development, with the potential for all-oral treatment regimens for oncology.

Recall of B cell memory depends on relative locations of prime and boost immunization.

Immunization or microbial infection can establish long-term B cell memory not only systemically but also locally. Evidence has suggested that local B cell memory contributes to early local plasmacytic responses after secondary challenge. However, it is unclear whether locality of immunization plays any role in memory B cell participation in recall germinal centers (GCs), which is essential for updating their B cell antigen receptors (BCRs). Using single B cell culture and fate mapping, we have characterized BCR repertoires in recall GCs after boost immunizations at sites local or distal to the priming. Local boosts with homologous antigen recruit the progeny of primary GC B cells to recall GCs more efficiently than do distal boosts. Recall GCs elicited by local boosts contain significantly more B cells with elevated levels of immunoglobulin (Ig) mutation and higher avidity BCRs. This local preference is unaffected by blocking CD40:CD154 interaction to terminate active, GC responses. Local boosts with heterologous antigens elicit secondary GCs with B cell populations enriched for cross-reactivity to the prime and boost antigens; in contrast, cross-reactive GC B cells are rare after distal boosts. Our results suggest that local B cell memory is retained in the form of memory B cells, GC B cells, and GC phenotype B cells that are independent of organized GC structures and that these persistent "primed B cells" contribute to recall GC responses at local sites. Our findings indicate the importance of locality in humoral immunity and inform serial vaccination strategies for evolving viruses.

Modulation of Regulatory T Cells Activity by Distinct CD80 and CD86 Interactions With CD28/CTLA-4 in Chagas Cardiomyopathy

Chagas cardiomyopathy is the symptomatic cardiac clinical form (CARD) of the chronic phase of Chagas disease caused by Trypanosoma cruzi infection. It was described as the most fibrosing cardiomyopathies, affecting approximately 30% of patients during the chronic phase. Other less frequent symptomatic clinical forms have also been described. However, most patients who progress to the chronic form develop the indeterminate clinical form (IND), may remain asymptomatic for life, or develop some cardiac damage. Some mechanisms involved in the etiology of the clinical forms of Chagas disease have been investigated. To characterize the contribution of CD80 and CD86 co-stimulatory molecules in the activation of different CD4+ (Th1, Th2, Th17, and Treg) and CD8+ T lymphocyte subsets, we used blocking antibodies for CD80 and CD86 receptors of peripheral blood mononuclear cells (PBMC) in cultures with T. cruzi antigens from non-infected (NI), IND, and CARD individuals. We demonstrated a higher frequency of CD8+ CD25+ T lymphocytes and CD8+ Treg cells after anti-CD80 antibody blockade only in the CARD group. In contrast, a lower frequency of CD4+ Treg lymphocytes after anti-CD86 antibody blockade was found only in IND patients. A higher frequency of CD4+ Treg CD28+ lymphocytes, as well as an association between CD4+ Treg lymphocytes and CD28+ expression on CD4+ Treg cells in the CARD group, but not in IND patients, and once again only after anti-CD80 antibody blockade, was observed. We proposed that Treg cells from IND patients could be activated via CD86-CTLA-4 interaction, leading to modulation of the immune response only in asymptomatic patients with Chagas disease, while CD80 may be involved in the proliferation control of T CD8+ lymphocytes, as also in the modulation of regulatory cell activation via CD28 receptor. For the first time, our data highlight the role of CD80 in modulation of Treg lymphocytes activation in patients with CARD, highlighting a key molecule in the development of Chagas cardiomyopathy.

Expression of CD28 in Hepatocellular Carcinoma and Its Prognostic Value

Background: CD28 expression is correlated with malignancy development in long-term survivors after liver transplantation. Immune cell activation is mediated by the interaction of CD28 with CD4 and CD8. Objectives: In this study, we attempted to investigate the expression level and prognostic value of CD28 in hepatocellular carcinoma (HCC). Methods: A total of 54 HCC patients with complete clinical information were examined. The expression level of CD28 in HCC tissues was detected by immunohistochemistry. The correlations of CD28 expression with clinical characteristics, CD4+/CD8+ T-cells, and prognosis in HCC were analyzed. The expression profile of CD28 and survival time of HCC patients were retrieved from the TCGA database, followed by survival analysis. Results: The positive expression rate of CD28 in HCC tissues was 70.73%. The CD28 expression was significantly higher in the positive expression group (area: 659174.9 ± 670060, IOD: 123348.3 ± 106348.6) than in the negative expression group (area: 8405.7 ± 9983.3, IOD: 1959.6 ± 2117.7) (P < 0.01). The CD4+ and CD8+ cell counts were 526.13 ± 258.17 cells/µL and 383.93 ± 223.39 cells/µL, respectively. The expression level of CD28 was significantly related to the degree of differentiation and the number of CD4+ and CD8+ T-cells (P < 0.05). The survival time of patients was longer in the positive CD28 expression group than in the negative expression group. Based on the CD28 expression profiles of 406 HCC patients retrieved from the TCGA database, patients with high CD28 expression showed a better prognosis than those with low expression (P < 0.05). Conclusions: CD28 may play a vital role in the occurrence, development, and prognosis of HCC by interacting with CD4+ and CD8+ T-cells. Thus, CD28 could be suggested as the immune checkpoint target for HCC treatment.

Control of Memory Phenotype T Lymphocyte Homeostasis: Role of Costimulation.

Foxp3+ T regulatory cells (Tregs), CD4+Foxp3- T cells, and CD8+ T cells are composed of naive phenotype (NP) and memory phenotype (MP) subsets. Ten to 20% of each MP T cell population are cycling (Ki-67+) in vivo. We investigated the contribution of costimulatory (CD28) and coinhibitory (CTLA-4, PD-1) receptors on MP T cell homeostatic proliferation in vivo in the mouse. Blockade of CD28-CD80/CD86 signaling completely abolished MP Tregs and profoundly inhibited MP CD4+Foxp3- T cell proliferation, but it did not affect MP CD8+ T cell proliferation. Marked enhancement of homeostatic proliferation of MP Tregs and MP CD4+Foxp3- T cells was seen after blocking CTLA4-CD80/CD86 interactions and PD-1-PD-L1/2 interactions, and greater enhancement was seen with blockade of both pathways. The CD28 pathway also played an important role in the expansion of Tregs and MP T cells after treatment of mice with agonistic Abs to members of the TNF receptor superfamily, which can act directly (anti-GITR, anti-OX40, anti-4-1BB) or indirectly (anti-CD40) on T cells. Induction of a cytokine storm by blocking the interaction of NK inhibitory receptors with MHC class I had no effect on Treg homeostasis, enhanced MP CD4+ proliferation, and expansion in a CD28-dependent manner, but it enhanced MP CD8+ T cell proliferation in a CD28-independent manner. Because MP T cells exert potent biologic effects primarily before the induction of adaptive immune responses, these findings have important implications for the use of biologic agents designed to suppress autoimmune disease or enhance T effector function in cancer that may have negative effects on MP T cells.

Abstract P5-16-04: Preliminary safety and efficacy results of KN046 (an anti-PD-L1/CTLA-4 bispecific antibody) in combination with KN026 (a HER2-targeted bispecific antibody) in patients with metastatic HER2-positive breast cancer: A phase II trial

Abstract Background: HER2-targeted therapies combined with chemotherapy have improved survival outcomes for patients with metastatic HER2-positive breast cancer. However, for patients progressed after several lines of anti-HER2 combinational therapies, the overall survival (OS) remained unfavorable. Prior studies showed that immunotherapy in combination with chemotherapy or targeted therapy could significantly prolong OS of metastatic breast cancer patients, especially in patients with triple-negative breast cancer. Reports of immunotherapy combined with HER2-targeted therapy are still limited. Here we reported the preliminary results from an ongoing phase II trial assessing the safety and efficacy for KN046 (a bispecific antibody blocks both PD-L1 interaction with PD-1/CD80 and CTLA-4 interaction with CD80/CD86) in combination with KN026 (a bispecific antibody that binds to two different HER2 epitopes shared by trastuzumab and pertuzumab) in HER2-positive metastatic breast cancer patients, who have progressed after prior anti-HER2 combinational therapies.Methods: Female patients with metastatic HER2-positive breast cancer who were previously treated with at least one line of HER2-targeted combinational therapy were enrolled from multiple academic hospitals in China to receive KN046 (iv. 5 mg/kg Q3W) plus KN026 (iv. 30 mg/kg Q3W) until progression, unacceptable toxicities or patient withdrawal. Efficacy was evaluated Q6W per RECIST 1.1. The primary endpoint was objective response rate (ORR). Results: As of the June 20th, 2021, 36 patients with the median age of 53 years (range: 33-67) were enrolled. 30 of 36 patients (83.3%) received ≥3 lines of HER2-targeted combinational therapies in the metastatic setting. 22 patients were evaluable for overall response and all 36 for safety. The ORR was 50.0% (11 of 22, 95% CI: 28.2-71.8), and one patient achieved complete response (CR). And the disease control rate (DCR) was 81.8% (18 of 22, 95% CI 59.7-94.8). The median progression-free survival (PFS) was 5.6 (95%CI 2.5-not reached) months. 34 of 36 (94.4%) patients had treatment-related adverse events (TRAEs) of any grade, while 4 of 36 (11.1%) patients had experienced ≥grade 3 TRAEs. The most common (≥10%) TEAEs were infusion related reaction (36.1%), rash (16.7%), alanine aminotransferase increased (13.9%), diarrhea (13.9%), pruritus (13.9%), aspartate aminotransferase increased (11.1%), and hypokalemia (11.1%). No treatment-related deaths were observed.Conclusions: The combination of KN046 and KN026, as a chemo free regimen, has shown favorable clinical efficacy with manageable side effects in heavily pre-treated patients with metastatic HER2-positive breast cancer. This trial is currently ongoing. ClinicalTrials.gov number, NCT04521179. Citation Format: Jieqiong Liu, Chuangui Song, Xiangcai Wang, Mingli Ni, Xujuan Wang, Lei Chen, Hongwei Yang, Rusen Zhao, Ting Xu, Lin Shen. Preliminary safety and efficacy results of KN046 (an anti-PD-L1/CTLA-4 bispecific antibody) in combination with KN026 (a HER2-targeted bispecific antibody) in patients with metastatic HER2-positive breast cancer: A phase II trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-16-04.

Anti-C1q autoantibodies from systemic lupus erythematosus patients enhance CD40-CD154-mediated inflammation in peripheral blood mononuclear cells in vitro.

ObjectivesSystemic lupus erythematosus (SLE) is a clinically heterogeneous autoimmune disease with complex pathogenic mechanisms. Complement C1q has been shown to play a major role in SLE, and autoantibodies against C1q (anti‐C1q) are strongly associated with SLE disease activity and severe lupus nephritis suggesting a pathogenic role for anti‐C1q. Whereas C1q alone has anti‐inflammatory effects on human monocytes and macrophages, C1q/anti‐C1q complexes favor a pro‐inflammatory phenotype. This study aimed to elucidate the inflammatory effects of anti‐C1q on peripheral blood mononuclear cells (PBMCs).MethodsIsolated monocytes, isolated T cells and bulk PBMCs of healthy donors with or without concomitant T cell activation were exposed to C1q or complexes of C1q and SLE patient‐derived anti‐C1q (C1q/anti‐C1q). Functional consequences of C1q/anti‐C1q on cells were assessed by determining cytokine secretion, monocyte surface marker expression, T cell activation and proliferation.ResultsExposure of isolated T cells to C1q or C1q/anti‐C1q did not affect their activation and proliferation. However, unspecific T cell activation in PBMCs in the presence of C1q/anti‐C1q resulted in increased TNF, IFN‐γ and IL‐10 secretion compared with C1q alone. Co‐culture and inhibition experiments showed that the inflammatory effect of C1q/anti‐C1q on PBMCs was due to a direct CD40–CD154 interaction between activated T cells and C1q/anti‐C1q‐primed monocytes. The CD40‐mediated inflammatory reaction of monocytes involves TRAF6 and JAK3‐STAT5 signalling.ConclusionIn conclusion, C1q/anti‐C1q have a pro‐inflammatory effect on monocytes that depends on T cell activation and CD40–CD154 signalling. This signalling pathway could serve as a therapeutic target for anti‐C1q‐mediated inflammation.