Cell Surface Carbohydrate Antigens Research Articles

Paradoxical Expression of R-10G-reactive Antigen in Human Testicular Embryonal Carcinoma.

Thus far, several monoclonal antibodies directed against cell-surface carbohydrate antigens have been generated. Among them, R-10G reportedly reacts selectively with human embryonic stem and induced pluripotent stem cells, but not with embryonal carcinoma (EC) cells. However, EC cells derived from patients' EC tumors may exhibit varying levels of R-10G-reactive antigen expression. Thus, we asked whether human EC tissues or germ cell tumor (GCT) tissues other than EC express R-10G-reactive antigen. To do so, we quantitatively analyzed R-10G-reactive antigen expression in 83 testicular GCT surgical specimens containing a total of 125 various GCT components. Accordingly, in all EC components examined, the EC cell plasma membrane was immunolabeled with R-10G, while most seminoma components were R-10G-negative. In non-seminomatous GCT (NSGCT) other than EC (non-EC NSGCT), R-10G-reactive antigen expression was variable, but signal distribution was focal, and the average intensity was weaker than that seen in EC. The percentages of R-10G-positive cells in these three groups varied with high statistical significance (p<0.001 for all combinations). These findings indicate that the R-10G-reactive antigen is preferentially expressed in human testicular EC tissues and, thus, could be used as a diagnostic marker for this malignancy.

An Efficacious Transgenic Strategy for Triple Knockout of Xeno-Reactive Antigen Genes GGTA1, CMAH, and B4GALNT2 from Jeju Native Pigs.

Pigs are promising donors of biological materials for xenotransplantation; however, cell surface carbohydrate antigens, including galactose-alpha-1,3-galactose (α-Gal), N-glycolylneuraminic acid (Neu5Gc), and Sd blood group antigens, play a significant role in porcine xenograft rejection. Inactivating swine endogenous genes, including GGTA1, CMAH, and B4GALNT2, decreases the binding ratio of human IgG/IgM in peripheral blood mononuclear cells and erythrocytes and impedes the effectiveness of α-Gal, Neu5Gc, and Sd, thereby successfully preventing hyperacute rejection. Therefore, in this study, an effective transgenic system was developed to target GGTA1, CMAH, and B4GALNT2 using CRISPR-CAS9 and develop triple-knockout pigs. The findings revealed that all three antigens (α-Gal, Neu5Gc, and Sd) were not expressed in the heart, lungs, or liver of the triple-knockout Jeju Native Pigs (JNPs), and poor expression of α-Gal and Neu5G was confirmed in the kidneys. Compared with the kidney, heart, and lung tissues from wild-type JNPs, those from GGTA1/CMAH/ B4GALNT2 knockout-recipient JNPs exhibited reduced human IgM and IgG binding and expression of each immunological rejection component. Hence, reducing the expression of swine xenogeneic antigens identifiable by human immunoglobulins can lessen the immunological rejection against xenotransplantation. The findings support the possibility of employing knockout JNP organs for xenogeneic transplantation to minimize or completely eradicate rejection using multiple gene-editing methods.

Elevação dos níveis de CA 19-9 em portadores de Síndrome de Mirizzi na ausência de doença maligna: um relato de caso

Objetivo: Descrever o caso raro de elevação dos níveis de CA 19-9 na presença de Síndrome de Mirizzi, uma afecção benigna do trato biliar, sem relação com a presença de doença maligna. Relato de caso: Mulher, 61 anos, admitida ao serviço de emergência com história de dor abdominal em epigástrio, com irradiação para hipocôndrio direito e dorso, associada a episódios de náuseas e vômitos, além de quadro de icterícia com colúria e acolia fecal. Durante investigação diagnóstica apresentava CA 19-9 de 8.962U/mL, foi realizada colangioressonância, a qual evidenciou imagem sugestiva de síndrome de Mirizzi. Paciente submetida colecistectomia videolaparoscópica associada a colangiopancreatografia retrógrada com passagem de dreno plástico intra-colédoco, apresentando intensa drenagem de conteúdo biliar para duodeno. No seguimento, paciente permaneceu sem intercorrências ou evidências de doença maligna, com redução dos níveis séricos de CA 19-9 para 28,9U/mL após 12 semanas da cirurgia. Considerações finais: A síndrome de Mirizzi, ainda que pouco frequente, é uma das possibilidades etiológicas para a elevação do marcador tumoral CA 19-9. É um diagnóstico benigno para situações que cursam com elevação do antígeno carboidrato de superfície celular, que tem seu valor de referência normalizado após tratamento cirúrgico do processo obstrutivo.

The Use of Single‐Domain Antibodies from Camelidae for the Inhibition of Clostridium difficile Toxins A and B

Clostridium difficile is an anaerobic, gram‐positive bacterium and a common gastrointestinal pathogen. Two virulence factors of C. difficile known to mediate disease are Toxin A (TcdA) and Toxin B (TcdB). These toxins are glucosyltransferase‐containing multi‐domain proteins that enter the host's epithelial cells by binding to cell–surface carbohydrate antigens. Once inside the cell, the toxins undergo a pH‐induced conformational change and release their glucosyltransferase domains (GTD), leading to disruption of cell cytoskeleton integrity.Existing treatments for C. difficile such as fecal transplants and antibiotics have not proven highly effective. Passive immunotherapy with inhibitory antibodies recognizing TcdA and TcdB is a promising alternative. Recombinant Camelidae antibodies (VHHs) that neutralize the toxins' function have been identified. TcdA's receptor‐binding domain has seven repetitive elements known to interact with cell‐surface carbohydrates. The VHH antibodies A20.1 and A26.8, which are known to neutralize TcdA, do not block the carbohydrate‐binding site on TcdA directly, suggesting a novel mode of TcdA inhibition.The Ashbury College MSOE Center for BioMolecular Modeling SMART Team used 3‐D modelling and printing technology to examine the structure‐function relationships of a TcdA fragment (TcdA‐A2) simultaneously bound to A20.1 and A26.8. The structure shows that the VHHs target distinct epitopes on the toxin and neutralize TcdA by a novel mechanism independent of the carbohydrate binding sites, providing a rationale for designing highly potent biparatopic TcdA‐neutralizing antibodies.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Comparison of the glycosphingolipids of human-induced pluripotent stem cells and human embryonic stem cells.

High expectations are held for human-induced pluripotent stem cells (hiPSC) since they are established from autologous tissues thus overcoming the risk of allogeneic immune rejection when used in regenerative medicine. However, little is known regarding the cell-surface carbohydrate antigen profile of hiPSC compared with human embryonic stem cells (hESC). Here, glycosphingolipids were isolated from an adipocyte-derived hiPSC line, and hiPSC and hESC glycosphingolipids were compared by concurrent characterization by binding assays with carbohydrate-recognizing ligands and mass spectrometry. A high similarity between the nonacid glycosphingolipids of hiPSC and hESC was found. The nonacid glycosphingolipids P1 pentaosylceramide, x2 pentaosylceramide and H type 1 heptaosylceramide, not previously described in human pluripotent stem cells (hPSC), were characterized in both hiPSC and hESC. The composition of acid glycosphingolipids differed, with increased levels of GM3 ganglioside, and reduced levels of GD1a/GD1b in hiPSC when compared with hESC. In addition, the hESC glycosphingolipids sulf-globopentaosylceramide and sialyl-globotetraosylceramide were lacking in hiPSC. Neural stem cells differentiating from hiPSC had a reduced expression of sialyl-lactotetra, whereas expression of the GD1a ganglioside was significantly increased. Thus, while sialyl-lactotetra is a marker of undifferentiated hPSC, GD1a is a novel marker of neural differentiation.

Glycosphingolipids of human embryonic stem cells

The application of human stem cell technology offers theoretically a great potential to treat various human diseases. However, to achieve this goal a large number of scientific issues remain to be solved. Cell surface carbohydrate antigens are involved in a number of biomedical phenomena that are important in clinical applications of stem cells, such as cell differentiation and immune reactivity. Due to their cell surface localization, carbohydrate epitopes are ideally suited for characterization of human pluripotent stem cells. Amongst the most commonly used markers to identify human pluripotent stem cells are the globo-series glycosphingolipids SSEA-3 and SSEA-4. However, our knowledge regarding human pluripotent stem cell glycosphingolipid expression was until recently mainly based on immunological assays of intact cells due to the very limited amounts of cell material available. In recent years the knowledge regarding glycosphingolipids in human embryonic stem cells has been extended by biochemical studies, which is the focus of this review. In addition, the distribution of the human pluripotent stem cell glycosphingolipids in human tissues, and glycosphingolipid changes during human stem cell differentiation, are discussed.

Glycan arrays containing synthetic Clostridium difficile lipoteichoic acid oligomers as tools toward a carbohydrate vaccine

Clostridium difficile is a leading cause of severe nosocomial infections. Cell-surface carbohydrate antigens are promising vaccine candidates. Here we report the first total synthesis of oligomers of the lipoteichoic acid antigen repeating unit. Synthetic glycan microarrays revealed anti-glycan antibodies in the blood of patients that help to define epitopes for vaccine development.

Abstract B46: Targeting tumor-propagating cells in medulloblastoma through inhibition of G2/M cell cycle regulators

Abstract Medulloblastoma is the most common malignant brain tumor in children. While the current treatment strategy of surgery plus radiation has a 60–80% cure rate, the survivors suffer severe side effects, including growth delays and cognitive deficits. Therefore, more effective, less toxic treatments are needed. One approach to achieving this is targeting the cells within a tumor that are capable of re-populating the tumor, known as tumor-propagating cells (TPCs). These cells are thought to be responsible for tumor resistance to conventional therapies. In the patched mutant mouse model of medulloblastoma, TPCs are marked by expression of the cell surface carbohydrate antigen CD15. Our previous studies have suggested that CD15+ cells display increased expression of genes associated with the G2/M phases of the cell cycle. Cell cycle analysis suggests that CD15+ cells move quickly through the G1 and S phases of the cell cycle, but accumulate in the G2/M phases. This accumulation in G2/M may represent a vulnerability of CD15+ TPCs, and inhibition of G2/M regulators, such as Aurora kinases, may represent one approach for targeting TPCs and overcoming therapeutic resistance. Treatment of tumor cells from patched mutant mice or human Hedgehog-associated medulloblastoma with Aurora kinase inhibitors in vitro leads to inhibition of proliferation, arrest in G2/M and apoptosis. Furthermore, in vivo treatment of tumor-bearing mice with Aurora kinase inhibitors significantly delays tumor progression and prolongs survival. Our findings suggest that targeting Aurora kinases in TPCs may represent a new approach for the treatment of human medulloblastoma.

Abstract 3443: Targeting G2/M cell cycle regulators in medulloblastoma tumor-propagating cells

Abstract Medulloblastoma is the most common malignant brain tumor in children. While the current treatment strategy of surgery, radiation and chemotherapy has a 60-80% cure rate, the survivors suffer severe side effects, including growth delays and cognitive deficits. Therefore, more effective, less toxic treatments are needed. One approach to achieving this is targeting the cells within a tumor that are capable of re-populating the tumor, known as tumor-propagating cells (TPCs). In the patched mutant mouse model of medulloblastoma, TPCs are marked by expression of the cell surface carbohydrate antigen CD15. Our previous studies suggest that CD15+ cells display increased expression of genes associated with G2/M phase of the cell cycle. Cell cycle analysis suggests that these CD15+ cells move quickly through the G1 and S phases of the cell cycle, but accumulate in G2/M phase. Therefore, inhibition of G2/M regulators, such as Aurora kinases, may represent one approach to targeting TPCs in these tumors. Treatment of tumor cells with the Aurora kinase inhibitor VX-680 (tozasertib) leads to inhibition of proliferation in vitro, with arrest in G2/M and apoptosis. Preliminary studies suggest that patched mutant tumors are also sensitive to Aurora kinase inhibition in vivo. Our findings suggest that targeting Aurora kinases may represent a novel approach for the treatment of hedgehog-associated human medulloblastoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3443. doi:10.1158/1538-7445.AM2011-3443

Human Tumor Antigens Tn and Sialyl Tn Arise from Mutations inCosmc

Neoplastic lesions typically express specific carbohydrate antigens on glycolipids, mucins, and other glycoproteins. Such antigens are often under epigenetic control and are subject to reversion and loss upon therapeutic selective pressure. We report here that two of the most common tumor-associated carbohydrate antigens, Tn and sialyl Tn (STn), result from somatic mutations in the gene Cosmc that encodes a molecular chaperone required for formation of the active T-synthase. Diverse neoplastic lesions, including colon cancer and melanoma-derived cells lines, expressed both Tn and STn antigen due to loss-of-function mutations in Cosmc. In addition, two human cervical cancer specimens that showed expression of the Tn/STn antigens were also found to have mutations in Cosmc and loss of heterozygosity for the cross-linked Cosmc locus. This is the first example of somatic mutations in multiple types of cancers that cause global alterations in cell surface carbohydrate antigen expression.

Detection of metastatic colon cancer cells in sentinel nodes by flow cytometry

In colon cancer the presence of metastases in the regional lymph nodes is an important prognostic factor. Currently, examination is based on histological and immunohistochemical evaluations of lymph node sections. However, these methods are time-consuming, labour intensive and micro-metastases might be missed. The sentinel node technique may be used to identify the direct tumour draining lymph node. In this study the possible use of flow cytometry for detection of sentinel node metastases in patients with colon cancer has been investigated.Peripheral blood mononuclear cells (PBMC) with the addition of DLD-1 colon cancer cells were stained intracellularly for cytokeratin 20 (CK20), and for the cell surface markers epithelial cell adhesion molecule (EpCAM) and carbohydrate antigen 19-9 (CA19-9). CK20 positive colon cancer cells were reliably detected with as few as 0.037% events. However, PBMCs from both colon cancer patients and from healthy individuals contained CK20 positive cells. Staining for EpCAM resulted in an almost complete recovery of tumour cells, and as few as 0.037% added cells were detected. Low intra-assay variability was determined for EpCAM (CV 8.8) and CA19-9 (CV 9.7) stainings. The results from staining for CK20 or for EpCAM and CA19-9 concorded, but the degree to which respective antigens were expressed varied. The use of flow cytometry for detection of metastatic colon cancer cells was verified in fourteen sentinel nodes specimens from patients with colon cancer.Herein we have explored the potential of flow cytometry to become a fast, sensitive and reliable method for detection of lymphatic metastases in patients with colon cancer using direct fluorophore-conjugated antibodies against multiple surface antigens. The method seems feasible and further testing is warranted.

Enhanced interferon-γ secretion and antitumor activity of T-lymphocytes activated by dendritic cells loaded with glycoengineered myeloma antigens

Immunotherapy is emerging as a promising cure for cancer. However, a severe problem in this area is the immune tolerance to tumor cells and tumor-associated antigens, as evidenced by the ability of cancer to escape immune surveillance. To overcome this problem this work examined the potential of improving the antigenicity of myeloma by metabolic engineering of its cell surface carbohydrate antigens (i.e., glycoengineering) and presentation of the modified tumor antigens by dendritic cells (DCs) to generate cytotoxic T-lymphocytes (CTLs). CD138+ myeloma cells were isolated from 11 multipe myeloma (MM) patients by the immunomagnetic bead method. The MM cells were treated with N-propionyl-D-mannosamine (ManNPr), a synthetic analog of N-acetyl-D-mannosamine (ManNAc), the natural biosynthetic precursor of N-acetyl sialic acid (NeuNAc), to express unnatural N-propionylated sialoglycans. The glycoengineered cells were then induced to apoptosis, and the apoptotic products were added to cultured functional DCs that could present the unnatural carbohydrate antigens to autologous T-lymphocytes. It was found that the resultant DCs could activate CD4+ and CD8+ T-lymphocytes, resulting in increased expression of T cell surface markers, including CD8CD28 and CD4CD29. Moreover, upon stimulation by glycoengineered MM cells, these DC-activated T-lymphocytes could release significantly higher levels of IFN-gamma (P < 0.05). Lactate dehydrogenase (LDH) assays further showed that the stimulated T-lymphocytes were cytotoxic to glycoengineered MM cells. This work demonstrated that glycoengineered myeloma cells were highly antigenic and the CTLs induced by the DCs loaded with the unnatural myeloma antigens were specifically cytotoxic to the glycoengineered myeloma. This may provide a new strategy for overcoming the problem of immune tolerance for the development of effective immunotherapies for MM.

Characteristics of two CD75-related cell-surface expressed antigens of human lymphocytes

The structure of cell surface carbohydrates expressed on human leukocytes is dependent on the cell's developmental stage, differentiation, and activation. Although modification of oligosaccharide side chains by sialylation is quite common, antigenic determinants on lymphocytes associated with the presence of sialoglycans are still incompletely defined. In the study presented here, monoclonal antibodies (mAbs) were used to characterize two novel but related cell surface carbohydrate antigens. One antigen, denominated as B8, is largely masked by sialyl residues on most lymphocytes, while it is detectable on the majority of B cells. Treatment with sialidase resulted in the exposure of B8 on the surface of blood cells including lymphocytes. Although the second carbohydrate antigen, C1, was sialidase-sensitive, its molecular properties and cellular distribution place it in close vicinity to B8. B8 + as well as C1 + lymphocytes were found predominantly in the mantle zone of secondary follicles of tonsillar tissue. These findings raised the possibility that B8 and C1 are closely related to a category of carbohydrate antigens previously classified as CDw76 (recently assigned to CD75s). MAbs directed against B8 or C1 precipitated 34, 37, 43, and 200 kDa glycoproteins from tonsillar lymphocytes, indicating that identical cell surface proteins are associated with both antigens. In contrast to B8, however, the expression of C1 was increased on lymphocytes upon activation. Together the results suggest that CD75-related epitopes are distinct molecular entities which may be exposed on glycoproteins and are differently expressed on lymphocytes.

Cell-surface α-glucan in Campylobacter jejuni 81-176

Campylobacter jejuni infection is a main source of severe gastroenteritis-related illnesses in humans and there is also evidence that it may be linked to neurological disorders. C. jejuni 81-176 is a virulent strain that has become the global model in the study of mechanisms and pathogenesis of C. jejuni infection. For this reason, we were engaged in studying the fine structures of cell-surface carbohydrate antigens of C. jejuni 81-176, namely, the capsule polysaccharide (CPS) and lipooligosaccharide (LOS). Serologically, C. jejuni 81-176 has been classified as belonging to serogroups HS23 and HS36, and indeed previous studies have shown that the LOS and CPS structures possess components similar to those expressed by serostrains HS23 and HS36. Here, we describe that in addition to the LOS and CPS, this strain also produced an independent cell-surface (1→4)-α-glucan capsule.

Sialyl Lewisa Expression as a Predictor of the Prognosis of Colon Carcinoma Patients in a Prospective Randomized Clinical Trial

The metastatic potential of tumors is dependent on the cell to cell adhesion by cell surface carbohydrate antigens. Thus, expression of sialyl Lewis(a), which is one of the important molecules of cell surface carbohydrates, may serve as a prognostic marker of aggressive and metastasizing tumor growth. However, the prognostic value of sialyl Lewis(a) expression in colon cancer is still controversial. In this study, we investigated the expression of sialyl Lewis(a) antigen in 233 colon cancer specimens from patients who were registered in a prospective adjuvant immunochemotherapy clinical trial. The clinical course and the prognosis of the patients were evaluated after all the immunohistochemical analyses had been performed. Sialyl Lewis(a) expression levels were correlated with both overall survival (P = 0.0006) and disease-free survival (P = 0.004) in all patients with the log-rank test. This result could be assumed to have been influenced by the difference in the metastatic preponderance in a high versus low sialyl Lewis(a) expression in the tumor cells. This prospective study in a randomized controlled trial suggests that sialyl Lewis(a) expression levels may serve as an indicator of the metastatic potential of colon cancer cells, which would strongly predict the prognosis.

Isolation and partial characterization of Gal alpha-containing polyglycosylceramides from porcine tissues.

Mammalian cell surface carbohydrate antigens are present both as glycoproteins and glycolipids. Of the glycolipids, polyglycosylceramides (PGC) have very long carbohydrate chains extending out from the cell surface. Hereto, Gal alpha-terminating xenoantigens in pig tissues have been identified in glycoproteins and short chain glycolipids but no studies of the complex PGC have been performed. In this communication, we describe the isolation and partial characterization of PGC from pig erythrocytes, small intestinal mucosa, kidney and liver. The mucosa, kidney and liver PGC fractions contained a complex pattern of Gal alpha antigens as shown by immunostaining using the Griffonia Simplicifolia isolectin B(4) while no reactivity was found with the erythrocyte PGC fractions. The mucosa PGC fractions stained strongly for blood group A antigens while the erythrocyte PGC fractions were negative. The presence of Gal alpha-terminating PGC compounds in porcine tissue adds further complexity to the distribution of this xenoantigen. Due to the long carbohydrate chains, PGC will be important targets for the Gal alpha xenoantibodies in pig to human xenotransplantation.

Use of surrogate antigens as vaccines against cancer.

Tumor cells may evade immune surveillance by possessing polysaccharides or carbohydrates on their surface. This evasive strategy is effective because glycans are poorly immunogenic and fail to elicit immunological memory responses due to an absence of T-cell processing. Induction of an immune response to cell surface carbohydrate antigens is considered as an important strategy to fight cancer. As carbohydrates per se are poor immunogens, alternative approaches are being evaluated to induce functional cross-reactive responses. We are focusing on the use of peptide mimotopes of tumor-associated carbohydrate antigens to challenge cancer, as we would manipulate the immune system to establish protective immunity based on carbohydrate cross-reactive humoral and cellular responses.

Keyhole limpet hemocyanin conjugate vaccines against cancer: the Memorial Sloan Kettering experience.

Passively administered and actively induced antibodies have been associated with the eradication of circulating tumor cells and micrometastases in mice and humans. We have identified a series of cell surface carbohydrate and peptide antigens on melanomas, sarcomas, and cancer of the breast, prostate. ovary, and lung tissues. We found that breaking tolerance toward these tumor antigens was best achieved using vaccines containing antigens chemically conjugated to keyhole limpet hemocyanin (KLH) plus a potent immunological adjuvant (QS-21). To date, by using this approach to vaccination. antibodies have been induced in patients against glycolipid antigens GM2, GD2, GD3, FucosylGM1, Globo H, and Lewis Y, and glycoprotein (mucin) antigens Tn, sialyl Tn. TF, and MUC1. More recently, in a comparative study we investigated the T cell response induced by MUCI-KLH conjugates. Although a MUC1-specific T cell response was not consistently detected in any patient, the role of KLH in orienting the cytokine environment was crucial. We were able to confirm that KLH in these conjugate vaccines induces a Th1 T cell response as demonstrated by the high anti-KLH INF-gamma secretion and the IgGI and IgG3 subclasses of this high titer IgG antibodies induced. Clinical trials using KLH conjugated glycolipid and glycoprotein vaccines, are currently ongoing. These range from phase I/II single antigens trials with glycosilated MUC1, polysialic acid, synthetic Fucosyl GMI and GD2, to phase II trials with a polyvalent vaccine containing six or seven antigens. Randomized phase II trials with polyvalent vaccines are planned for initiation in 2001-2002 in patients with ovarian, breast, and prostate cancer.

Tumor site-selective localization of an adoptively transferred T cell line expressing a macrophage lectin.

CTLL-2 cells were transfected with an expression vector that contained cDNA of a mouse macrophage galactose/N-acetylgalactosamine-specific calcium-type lectin (MMGL) and a stable transfectant (CTL-ML) was established. These cells and mock transfectant cells (CTL-CEP) were labeled with a long-term fluorescent cell tracer, DiI. The labeled cells were intravenously injected into mice that contained established lung metastases produced by OV2944-HM-1 ovarian tumor cells. Analyses with fluorescence microscopy of a series of frozen lung sections from the recipient mice revealed that CTL-ML preferentially accumulated in the lung metastatic nodules, whereas CTL-CEP did not. Time course studies showed that the preferential accumulation was evident 3 days after adoptive transfer. We also found that OV2944-HM-1 cells bound peanut agglutinin and Vicia villosa agglutinin B4, whose sugar specificity overlaps with the specificity of MMGL. These results suggested that MMGL molecules expressed on CTLL-2 cells contributed to their selective trafficking or retention in tumor foci possibly through recognition of tumor-associated cell surface carbohydrate antigens. These results also suggested that MMGL could be used for the selective targeting of effector cells in adoptive immunotherapy.

Carbohydrate antigens as targets for active specific immunotherapy.

Carbohydrate antigens such as GM2, GD2 and GD3 (gangliosides), Lewis(y) and globo-H (neutral glycolipids and glycoproteins), and Tn, TF and sTn (glycoproteins) are overexpressed in a variety of cancers. Antibodies against several of these carbohydrate antigens have been detected in sera from patients treated with cancer vaccines, and have been associated with a more favorable prognosis. Clinical responses have been reported after treatment with monoclonal antibodies against some of these antigens. Hence cell-surface carbohydrate antigens have been identified as suitable targets for immune attack by both active and passive immunotherapies. Different approaches have been adopted to induce immune responses against these carbohydrate antigens. These includes vaccination with whole or lysed tumor cells, purified or synthetic carbohydrates, immunogenic carbohydrate derivatives, or carbohydrates conjugated with immunogenic carriers and administered with immunological adjuvants. In the case of gangliosides, immunization with either whole tumor cells or cell lysates has only occasionally induced responses against carbohydrate antigens, and the antibodies were generally IgM antibodies of low titer. Compared with other methods of vaccination, conjugate vaccines have consistently induced the highest titer of IgM and IgG antibodies against gangliosides and other carbohydrate antigens. Preclinical and clinical studies with conjugate carbohydrate vaccines have induced IgM and IgG antibody responses capable of inducing complement-mediated cytotoxicity of tumor cells in vitro and associated with prolonged disease-free and overall survival in patients.