Total Number Of CD4 Research Articles

Ten-year clinical outcome, toxicity and compliance of dose-dense sequential adjuvant administration of cyclophosphamide & epirubicin followed by docetaxel in patients with early breast cancer: A hellenic cooperative oncology group observational study (HE 10/10) with concurrent investigation of significance of tumor infiltrating lymphocytes

BackgroundDose-dense sequential (dds) chemotherapy has changed the clinical outcome of patients with early breast cancer (BC). To investigate the impact of dose intensity (DI) in the adjuvant setting of BC, this observational trial (HE 10/10) was conducted assessing the long-term survival outcome, safety and toxicity of a currently widely used chemotherapeutic regimen. In addition, the prognostic significance of tumor infiltrating lymphocytes (TILs) and infiltrating CD8+ lymphocytes were also evaluated in the same cohort. Patients and methodsTotally, 1054 patients were prospectively enrolled in the current study with 1024 patients being eligible, while adequate tissue was available for 596 of them. TILs, CD8+ lymphocytes in intratumoral areas in contact with malignant cells (iCD8), CD8+ lymphocytes in tumor stroma (sCD8) as well as the total number of CD8+ lymphocytes within the tumor area (total CD8) were assessed by immunohistochemistry. ResultsWithin a median follow-up of 125.18 months, a total of 200 disease-free survival (DFS) events (19.5%) were reported. Importantly, the 10-year DFS and OS rates were 78.4% (95% CI 75.0–81.5) and 81.7% (95% CI 79.0–84.1), respectively. Interestingly, higher CD8+ T cells as well as TILs in the tumor microenvironment were associated with an improved long-term survival outcome. ConclusionsIn conclusion, this study confirms the significance of dds adjuvant chemotherapeutic regimen in terms of long-term survival outcome, safety and toxicity as well as the prognostic significance of TILs and infiltrating CD8+ lymphocytes in BC patients with early-stage disease.

Prmt5 deficiency inhibits CD4+ T-cell Klf2/S1pr1 expression and ameliorates EAE disease

BackgroundProtein arginine methyltransferase 5 (Prmt5) is the main type II methyltransferase, catalyzes protein arginine residue symmetric dimethylation, and modulates normal cellular physiology and disease progression. Prmt5 inhibition or deletion in CD4+ T cells has been reported to ameliorate experimental autoimmune encephalomyelitis (EAE), but the detailed molecular mechanisms have not yet been elucidated.MethodsEAE was induced by administration of myelin oligodendrocyte glycoprotein (MOG35–55) in T cells Prmt5 conditional knockout (CD4-cre-Prmt5fl/fl, Prmt5cko) and Prmt5fl/fl (WT) mice. Flow cytometry, single-cell RNA sequencing, ATAC sequencing and chromatin immunoprecipitation assay (ChIP) approaches were used to explore the detail mechanisms.ResultsWe find that Prmt5cko mice are resistant to EAE; infiltrating inflammatory CD4+ T cells in the central nervous system (CNS) are greatly reduced. However, in Prmt5cko mice, T cells in the spleen show much more proliferation and activation properties, the total number of CD4+ T cells in the spleen is not reduced, and the percentage of Rora+ CD4+ T cells is elevated. Also, CD4+ T cells express lower levels of S1pr1 and Klf2 than WT mice, which may influence pathogenic CD4+ T-cell egress from the spleen and migration to the CNS. Moreover, the single-cell ATAC sequence and ChIP assay reveal that the transcription factor Klf2 is enriched at the S1pr1 promoter and that Klf2 motif activity is reduced in Prmt5cko mice.ConclusionsOur study delineates the undiscovered role of Prmt5 in T-cell biology in which Prmt5 may inhibit Klf2-S1pr1 pathway to ameliorate EAE disease. Controlling T-cell Prmt5 expression may be helpful for the treatment of autoimmune diseases.

CD39 Expression in Peripheral T Cells is Associated with Clinicopathological Characteristics in Patients with Cervical Cancer.

CD39 is an inhibitory checkpoint exerting rate-limiting effects on the ATP-adenosine pathway. It can be targeted to block adenosine-mediated immunosuppression. To analyze the relationship between the CD39 expression and clinicopathological characteristics including FIGO stage, lymph node and distant metastasis, and to further explore its potential role in cervical cancer. Peripheral blood was collected from 59 healthy people and 43 patients with cervical cancer. The percentage and absolute counts of CD3-positive, CD4-positive and CD8-positive T lymphocytes, CD4/CD8 ratio and the percentage of the CD39+ T cells in T lymphocytes were assessed by flow cytometry, and their correlations with clinical parameters were analyzed. Absolute numbers of CD8+ T lymphocytes, CD4/CD8 ratios, and the percentage of the CD39+ T cells were linked with FIGO stage, lymph node metastasis, and distant metastasis. The total numbers of CD8+ T lymphocytes were significantly higher in the peripheral blood of patients with cervical cancer in the early and middle stages than in the advanced stage. In addition, patients with early and middle-stage cervical cancer had considerably lower percentage of CD4+ CD39 + and CD8 + CD39 + T lymphocytes than those with advanced cervical cancer. These results suggest that the absolute counts of CD8+ T lymphocytes may be associated with the patient's prognosis and that the CD39 molecule, expressed on the surface of CD8+ T cells, is also related to FIGO stage, lymph node metastasis, and distant metastasis. CD39 expression on CD8-positive T cells exhibits a negative correlation with the number of CD8-positive T lymphocytes.

(092) Leptin Increases T-cells in Testis to Modulate Leydig Stem Cell Function

Abstract Introduction Testis microenvironment which is comprised of cells like Sertoli and peritubular cells releases paracrine factors which could potentially modulate testicular functions. In our previous studies, we identified Leptin as a key paracrine factor in the testicular microenvironment, released by Sertoli and peritubular cells and goes to bind its receptor in Leydig cells. Once this association happens it further induces the expression of the desert hedgehog signaling pathway, which is known to play an important role in the Leydig Stem cell’s differentiation to Adult Lydig Cells, which are capable of producing testosterone. However, one of the limitations in our study was that the model we used were from human cells that were extracted from testes’ biopsies which lacked an intact immune microenvironment. In the present study we explored the influence of Leptin on an intact testicular immune microenvironment. Objective To explore the influence of Leptin on an intact testicular immune microenvironment. Methods We used 6-weeks old C57BL6 mice which were exposed to two different concentrations of Leptin, 10 and 100 mg/ml for seven days. After seven days of treatment, these animals were humanly sacrificed and we collected their blood and testes. Blood was subjected to the CBC differential profile performed using EDTA anti-coagulated blood samples with a Hemavet Mascot Multispecies Hematology System Counter 1500R (CDC Technologies, Inc., Oxford, CT). Samples were counted no longer than five minutes after blood was drawn. In addition to that, the testes were used and subjected to comprehensive immunophenotyping that allowed us to evaluate in detail the impact of Leptin treatment at different doses on different immune cell types which are found within the testes. Results Results showed that Leptin at low dose (10mg/ml) showed increased levels of serum Testosterone (13.20 + 0.37 ng/dl) but were not significant, LH and FSH (LH 0.016 + 0.02 ng/ml, FSH in 51.71 + 12.93 ng/ml) showed significant (p<0.05) increase. On the contrary, animals which received Leptin at 100mg/ml showed no significant changes in hormone levels. CBC profiling suggested that amongst all the factors that were compared, Lymphocytes and Platelets were significantly influenced specifically upon low doses of Leptin. Interestingly, comprehensive immunophenotyping highlighted that the animals that received Leptin at low doses had a significant increase in the total number of CD4+ (helper T cells) and CD8+ (Cytotoxic T lymphocytes) cells. This pattern was not observed in animals which received high doses of Leptin. Conclusions The observation made in this study highlights unexplored aspects of influence of paracrine factors released by Sertoli and peritubular myoid cells on modulating immune microenvironment within the testis to potentially influence testosterone production. In future studies we will be exploring how the changes in the different immune cell types are correlated directly with the increase in T cells and how this correlation can influence the Leydig Stem Cell differentiation into Leydig Adult Cells. Disclosure No

Maintenance of the naive T cell population during malnutrition is associated with residency in the bone marrow

Abstract In mammals, T cell migration is under circadian control, likely to anticipate daily rhythms in infection risk. Glucocorticoids control this process, and malnutrition is associated with increased glucocorticoid levels. Therefore, we evaluated whether malnutrition disrupts the circadian migratory patterns of T cells. Malnutrition did not impact circadian patterns of T cell residency of lymphoid tissues; indicating that fluctuations, rather than specific concentrations, of glucocorticoids are a key circadian signal. Additionally, the total number of CD4+ and CD8+ T cells in the lymph nodes and blood were lower in malnourished as compared to well-nourished mice. However, the percentage and total number of naïve T cells was maintained in the lymph nodes, blood, and spleen of malnourished mice, suggesting preferential preservation of naïve T cells. Interestingly, the percentage and total number of CD4+ and CD8+ T cells in the bone marrow was elevated significantly in mice on a malnourished diet. Additionally, malnourished CD4+ and CD8+ T cells in the bone marrow showed significantly high CCR7 expression and CCL21 expression was increased in malnourished bone marrow compared to control. CCR7 and its chemokine, CCL21, may be responsible for trafficking malnourished T cells to the bone marrow during malnutrition. Overall, these findings suggest that the bone marrow may contribute to naïve T cell preservation during malnutrition. NSF-MRI [DBI- 1920116] NSF -RUI [IOS-1951881]

79P Ten-year clinical outcome, toxicity and compliance of dose-dense sequential adjuvant administration of cyclophosphamide & epirubicin followed by docetaxel in patients with early breast cancer: An observational study with concurrent investigation of significance of TILs

Dose-dense sequential (dds) chemotherapy has tremendously changed the clinical outcome of patients with early breast cancer (BC). To investigate the impact of dose intensity (DI) in the adjuvant setting of BC, this observational trial (HE 10/10) was conducted assessing the long-term survival outcome, safety and toxicity of a now widely used chemotherapeutic regimen consisting of 4 cycles of cyclophosphamide and epirubicin q2 weeks, followed by 4 cycles of docetaxel q3 weeks. In addition, the prognostic significance of tumor infiltrating lymphocytes (TILs) and infiltrating CD8+ lymphocytes were also evaluated in the same cohort. Totally, 1,054 patients were prospectively enrolled in the current study with 1,024 patients being eligible, while adequate tissue was available for 659 of them. TILs, CD8+ lymphocytes in intratumoral areas in contact with malignant cells (iCD8), CD8+ lymphocytes in tumor stroma (sCD8) as well as the total number of CD8+ lymphocytes within the tumor area (total CD8) were assessed by immunohistochemistry. Within a median follow-up of 125.18 months, a total of 200 disease-free survival (DFS) events (19.5%) were reported. The median DFS and overall survival (OS) had not been reached yet at the time of data cut-off for the analysis, while the 10-year DFS and OS rates were 78.4% (95% CI 75.0-81.5) and 81.7% (95% CI 79.0-84.1), respectively. The studied regimen was well tolerated with 94.7% of the patients completing the full course of adjuvant chemotherapy (8 cycles), while the rest of them discontinued the treatment, mainly due to non-fatal reasons. Only a very small percentage of patients faced clinically significant myelotoxicity. Interestingly, higher CD8+ T cells in the tumor microenvironment were associated with an improved long-term survival outcome. In conclusion, this study confirms the significance of dds adjuvant chemotherapeutic regimen in terms of long-term survival outcome, safety and toxicity as well as the prognostic significance of infiltrating CD8+ lymphocytes in BC patients with early stage disease.

Thrombocytopenia and Low CD4/CD8 Ratio at Apheresis Along with Prior Bendamustine Use Increase Risk of CAR-T Cell Manufacturing Failure

[Introduction] Chimeric antigen receptor T (CAR-T) cell therapy targeting CD19 has shown good outcomes in patients with relapsed or refractory (r/r) B-cell malignancies, and the number of patients awaiting this therapy is increasing dramatically. Successful CAR-T cell therapy can be achieved only after a number of steps are optimized. Of these, it is essential to ensure that CAR-T cells are manufactured without failure. Although manufacturing failure rates range from 1 to 13%, its causes and risk factors remain unclear. Therefore, we sought to determine risk factors for CAR-T cell manufacturing failure in a real-world setting. [Methods] This retrospective study, conducted by the Japan Society of Transfusion Medicine and Cell Therapy, enrolled patients who underwent CAR-T cell production for tisagenlecleucel (tisa-cel) using T cells harvested at 23 Japanese institutions from October 2019 to March 2022. Clinical factors, including patient characteristics, laboratory tests at apheresis, and apheresis procedures, were compared between successful and unsuccessful case groups. Categorical and continuous variables were compared between groups using Fisher's exact test and two-tailed unpaired Student's t-test, respectively. In comparison between groups, CD4/CD8 ratio was log-transformed to normalize skewed distribution. We evaluated the effect of each factor on the manufacturing outcome using a logistic regression model. p values <0.05 were considered statistically significant. [Results] We analyzed 519 cases, including 438 diffuse large B-cell lymphoma (DLBCL) and 81 B-cell acute lymphoblastic leukemia (B-ALL) cases. Whereas no manufacturing failure was observed among B-ALL cases, there were 30 manufacturing failures (6.8%) among DLBCL cases. Then, we compared clinical factors between DLBCL cases that failed (n = 30) and that succeeded (n = 378), excluding those employed in clinical trials for out-of-spec products. The number of chemotherapy cycles performed prior to apheresis (median 13 vs. 10; p = 0.01) and the proportion of patients with previously treated with 3 or more cycles of bendamustine (43.3 vs. 10.9%; p < 0.01) were significantly higher in the failed group than the successful group. Regarding cell counts in peripheral blood at apheresis, platelet count (1.20 vs. 1.70 × 105/μL; p = 0.01) and CD4/CD8 ratio (0.30 vs. 0.56; p < 0.01) were significantly lower in the failed group than the successful group (Figure 1). For T-cell collection, Spectra Optia® was used in 403 cases (98.8%), and there were no significant differences in the failure rate in terms of the device type or collection program. There were no significant differences in the total number of CD3+ cells (3.1 vs. 2.9 ×109; p = 0.51) or proportion of CD3+ cells to total nucleated cells (55.6 vs. 46.4%; p = 0.14) shipped for tisa-cel production between the failed and successful groups. Multivariate logistic analysis revealed that history of 3 or more cycles of bendamustine therapy prior to apheresis (odds ratio [OR], 3.19; 95% confidence interval [CI], 1.04-9.82; p = 0.04), low platelet counts (OR, 0.52 per 105/μL; 95% CI, 0.28-0.96; p = 0.04), and low CD4/CD8ratio (less than one third) (OR, 3.06; 95% CI 1.23-7.59; p = 0.02) in peripheral blood at apheresis were risk factors for CAR-T manufacturing failure. [Conclusions] This study showed that manufacturing failure remains an obstacle to CAR-T cell therapy. Repeated use of bendamustine prior to apheresis, low platelet counts, and low CD4/CD8 ratio in peripheral blood at apheresis were associated with increased risk of manufacturing failure. Avoiding these risk factors before apheresis and risk-adopted therapeutic strategy after apheresis may help to optimize CAR-T cell therapy for patients with r/r B-cell malignancies. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Ex Vivo Culture with Albumin Greatly Increases the Immunosuppressive Subset of T Lymphocytes

Emerging studies suggest that the expression of co-inhibitory receptors such as PD1, TIM3, TIGIT, and LAG3 on the T cell surface is important in regulating T cell response. However, the low number of cells expressing such co-inhibitory receptors in peripheral blood severely limits their clinical potential in treating GVHD. In this study, we introduce a novel method to culture and obtain a high number of CD3+PD1+TIM3+ lymphocytes that also exert strong immunosuppression. We demonstrate that culturing CD3+ cells isolated from G-CSF mobilized peripheral blood stem cells (G-PBSCs) with human serum albumin (HSA) greatly increases the number of immunosuppressive CD3+ cells. Also, we confirm that the CD3+PD1+TIM3+ lymphocytes are the most potent subset of the CD3+ cells that induce immunosuppression and inhibit T cell proliferation. Methods. The donors were subcutaneously injected with G-CSF (10μg/kg) for five days. G-PBSCs were collected from the donors using a COBE spectra cell separator, and CD3+ cells were isolated by positive selection by magnetic-activated cell sorting (MACS) using CD3 Dynabeads™. Isolated CD3+ cells were cultured with 5% HSA for 4 days (1x105 cells/mL). PD1, TIM3, LAG3, and TIGIT expressions were analyzed using flow cytometry (FACS). CD3+, CD3+PD1+, and CD3+PD1+TIM3+ lymphocytes were sorted and cultured with irradiated allo-MNCs for three days (Mixed Lymphocyte Reaction; MLR). 5,6-carboxyfluorescein diacetate succinimidyl ester (CFSE) was used as an intracellular fluorescent dye in MLR (CFSE-MLR) to measure T cell proliferation. Results. We discovered that treating G-PBSC cells with 5% HSA resulted in a dramatic increase in the number of immunosuppressive lymphocytes after the HSA treatment. In untreated G-PBSCs, there were very low numbers of CD3+PD1+TIM3+, CD3+PD1+LAG3+, and CD3+PD1+TIGIT+ lymphocytes (0.9±0.3x103, 0.1±0.1x103, and 0.3±0.2x103, respectively). In G-PBSCs, the HSA treatment markedly increased the cell numbers (47.6±1.9x103, 7.8±3.0x103, and 0.7±0.3x103, respectively) while resulting in a mild increase in the total number of CD3+ cells (1.2-fold increase, 1x105 to 1.2±0.4x105). Our data also demonstrated significant percent changes in subpopulations of CD3+ lymphocytes. In untreated G-PBSCs, very low percentages of cells were CD3+PD1+TIM3+, CD3+PD1+LAG3+, and CD3+PD1+TIGIT+ (9.0±3.1%, 1.2±0.1% and 3.2±2.8% in G-PBSC, respectively). After the HSA treatment, the percentages of the immunosuppressive lymphocytes in G-PBSCs markedly increased to 39.7±9.1%, 6.5±1.3%, and 0.6±0.4%, respectively. In particular, CD3+PD1+TIM3+ lymphocytes demonstrated the greatest increase in the cell number and the percentage after the HSA treatment, increasing by ~52 fold. Next, we tested whether the HSA-treatment induced proliferation of immunosuppressive T cells translated into increased immunosuppression. To do this, we used CSFE-MLR, co-cultured the CD3+ G-PBSCs with allo-MNCs, and analyzed the number of unstimulated T cells. The HSA-treated CD3+ G-PBSCs significantly increased the levels of unstimulated T cells compared to the untreated G-PBSCs (% of unstimulated T cells in untreated cells vs. in HSA-treated cells; 0.5±0.1 vs. 15.4±11.7), indicating that the HSA treatment increased CD3+ cell-mediated immunosuppression. Lastly, we tested the immunosuppressive effects of CD3+PD1+ and CD3+PD1-lymphocytes in HSA-treated CD3+ G-PBSCs. Both CD3+PD1+ and CD3+PD1+TIM3+ lymphocytes demonstrated significantly enhanced levels of immunosuppression compared to CD3+PD1-lymphocytes and CD3+PD1+TIM3- lymphocytes, respectively (% of unstimulated T cells in CD3+PD1+ vs. in CD3+PD1-lymphocytes, 27.9±5.5 vs. 4.3±7.5, and % of unstimulated T cells in CD3+PD1+TIM3+ vs. in CD3+PD1+TIM3- lymphocytes, 46.1±5.5 vs. 17.4±7.4). Collectively, these data suggest that PD1 and TIM3 are key markers in the HSA-dependent increase in immunosuppression. Conclusion. The ex vivo culture of CD3+ G-PBSCs with HSA markedly increases both the number and the effect of immunosuppressive CD3+ lymphocytes. Our analysis also indicates that the increased immunosuppression is likely due to the proliferation of CD3+PD1+TIM3+ lymphocytes. Taken together, our data suggest that the ex vivo HSA treatment of CD3+ G-PBSCs shows promising therapeutic potential for treating patients with GVHD.

Methotrexate Inhibits T Cell Proliferation but Not Inflammatory Cytokine Expression to Modulate Immunity in People Living With HIV.

Inflammation associated with increased risk of comorbidities persists in people living with HIV (PWH) on combination antiretroviral therapy (ART). A recent placebo-controlled trial of low-dose methotrexate (MTX) in PWH found that numbers of total CD4 and CD8 T cells decreased in the low-dose MTX arm. In this report we analyzed T cell phenotypes and additional plasma inflammatory indices in samples from the trial. We found that cycling (Ki67+) T cells lacking Bcl-2 were reduced by MTX but plasma inflammatory cytokines were largely unaffected. In a series of in vitro experiments to further investigate the mechanisms of MTX activity, we found that MTX did not inhibit effector cytokine production but inhibited T cell proliferation downstream of mTOR activation, mitochondrial function, and cell cycle entry. This inhibitory effect was reversible with folinic acid, suggesting low-dose MTX exerts anti-inflammatory effects in vivo in PWH largely by blocking T cell proliferation via dihydrofolate reductase inhibition, yet daily administration of folic acid did not rescue this effect in trial participants. Our findings identify the main mechanism of action of this widely used anti-inflammatory medicine in PWH and may provide insight into how MTX works in the setting of other inflammatory conditions.

Synergistic Effect of Huangqin Decoction Combined Treatment With Radix Actinidiae chinensis on DSS and AOM-Induced Colorectal Cancer.

Objective: To demonstrate the effectiveness of Huangqin decoction (Huangqin Tang in Chinese, HQT) combined with Radix Actinidiae chinensis (Tengligen in Chinese, TLG) under the guidance of “dampness–heat theory” in preventing and treating colorectal cancer (CRC) with dampness–heat accumulation and to preliminarily reveal its mechanism. Methods: The mice model of CRC was established by intraperitoneal injection of AOM combined with consumption of 2.5% DSS solution, and celecoxib, HQT, TLG, and their combination (HQT + TLG) were administered at the same time. The physical signs and death of the mice were observed daily. At the end of the experiment, the colorectal tissue was dissected, and the tumor was observed and counted. HE staining and Masson’s staining were used to observe the histopathological changes of colon. Expression levels of TNF-α, IL-6, and IL-10 in colorectal tissue were detected by ELISA, and the expression of TNF-α was observed by immunofluorescence. TUNEL assay was used to observe the apoptosis of tumor tissues, and immunohistochemistry was used to observe the expression of Ki-67 and occludin. The mRNA expression levels of claudin-1, occludin, ZO-1, and IL-6 and IL-17 were detected by RT-PCR, and occludin, ZO-1, NF-κB, and STAT3 protein levels were detected by Western blot. The composition of intestinal flora was analyzed by 16S rRNA. Results: HQT + TLG could significantly reduce the mortality of model mice and improve the intestinal mucosal inflammatory cell infiltration and high-grade intraepithelial neoplasia in model mice. All administration groups show a great reduction in the levels of IL-6 and TNF-α in the colorectal tissues of model mice, and increase in the level of IL-10, the total number of CD3+ T cells, the proportion of CD3+CD4+ T cells, and the ratio of CD4/CD8. HQT and HQT + TLG could significantly change the composition of intestinal flora and increase the abundance of Firmicutes and Patescibacteria. Conclusion: HQT and TLG combination has a good effect on inhibiting AOM-DSS-induced CRC. This function may be related to improving the composition of the intestinal flora, regulating the proportion of T-cell subsets in colorectal lymphoid tissue to improve inflammatory response, and downregulating the expression of claudin-1, inhibiting the activation of IL-6/STAT3 signaling pathway to improving abnormal hyperplasia.

Interspatial Distribution of Tumor and Immune Cells in Correlation with PD-L1 in Molecular Subtypes of Gastric Cancers.

Simple SummaryThe majority of gastric cancers are negative for the Epstein–Barr virus (EBV) and mismatch repair-proficient, or microsatellite stable. Molecular subtyping currently does not influence clinical decision making, and accurate response prediction towards immunotherapy remains a major challenge. We therefore analyzed PD-L1 expression, tumor-infiltrating lymphocytes, and their spatial relationship to tumor cells in EBV-negative mismatch repair-proficient gastric cancers compared to EBV-positive and mismatch repair-deficient tumors to identify an immunogenic phenotype that is susceptible to immunotherapy in this large group. We demonstrated a close relationship between the total number of tumor-infiltrating lymphocytes, their proximity to tumor cells, and the expression of PD-L1 across all subtypes, including the EBV-negative and mismatch repair-proficient cancers. However, we also identified a subgroup of PD-L1-negative, EBV-negative, and mismatch repair-proficient cancers with high numbers of tumor-associated CD8+ lymphocytes. This is indicative of an immunoreactive phenotype in a subgroup of gastric cancers along or independent of PD-L1 status and molecular type.(1) Background: EBV-positive and mismatch repair-deficient (MMRd) gastric cancers (GCs) show higher levels of tumor-infiltrating lymphocytes (TILs) and PD-L1 expression and thus a more profound response to immunotherapy. However, the majority of GCs are EBV-negative (EBV−) and MMR proficient (MMRp). We analyzed PD-L1 expression and TILs in EBV-MMRpGCs in comparison to EBV-positive (EBV+) and MMRdGCs to identify an immunogenic phenotype susceptible to immunotherapy. (2) Methods: A next-generation tissue microarray of 409 primary resected GCs was analyzed by Epstein-Barr encoding region (EBER) in situ hybridization for MSH1, PMS2, MSH2, MSH6, PD-L1, and CD8 immunohistochemistry. PD-L1 positivity was defined as a combined positive score (CPS) of ≥1. CD8+ TILs and their proximity to cancer cells were digitally analyzed on the HALO™ image analysis platform. (3) Results: Eleven cases were EBV+, 49 cases MMRd, and 349 cases EBV-MMRpGCs. The highest rate of PD-L1 positivity was seen in EBV+GCs, followed by MMRdGCs and EBV-MMRpGCs (81.8%, 73.5%, and 27.8%, respectively). EBV+ and MMRdGCs also demonstrated increased numbers and proximity of CD8+ TILs to tumor cells compared to EBV-MMRpGCs (p < 0.001 each). PD-L1 status positively correlated with the total numbers of CD8+ TILs and their proximity to tumor cells in all subtypes, including EBV-MMRpGCs (p < 0.001 each). A total of 28.4% of EBV-MMRpGCs showed high CD8+ TILs independent of PD-L1. (4) Conclusions: PD-L1 and CD8 immunohistochemistry, supplemented by digital image analysis, may identify EBV-MMRpGCs with high immunoreactivity indices, indicating susceptibility to immunotherapy.

Abstract P1-04-07: Xiap expression is associated with infiltration of cd163+ tumor-associated macrophages in the tumor micro-environment of inflammatory breast cancer

Abstract BACKGROUND: Inflammatory breast cancer (IBC) is a rare, but aggressive type of locally advanced breast cancer for which a specific immune response seems to be an important driver (Van Laere et al., CCR 2013). The tumor immune micro-environment (TIME) of IBC is characterized by an influx of tumor-associated macrophages (TAMs) and patients with spatial colocalization of TAMs with tumor cells seem to have a worse prognosis (Van Berckelaer et al., SABCS 2019). In contrast with TAMs, the presence of CD8+ T cells was associated with a better prognosis in IBC. Cytotoxic T cells mediate killing of the tumor by inducing apoptosis after activation of effector caspases-3/-7, regulated by the X-Linked Inhibitor of Apoptosis protein (XIAP). Recently, we reported that XIAP in breast cancer is associated with shorter survival and resistance to chemotherapy (Devi et al, Cancers 2021). In IBC, XIAP is translationally upregulated during cellular stress and induces, via NFkB, an immunosuppressive signaling (Evan et al, Cancer Res 2018). Therefore, we investigated the interplay between tumor cell driven XIAP expression and the TIME. METHODOLOGY: IBC patient clinicopathological variables (n=75) along with Affymetrix data (n=30/75) were collected. Immunostainings for XIAP, CD8 and CD163 (Hematoxylin-DAB) were done according to validated protocols. All slides were digitized and evaluated in Visiopharm to quantify the number of DAB+ immune cells and the relative marker area (RMA: the DAB+ area/total area of interest). Spatial interactions were examined using an effector index (EI) that counts the number of immune cells in a circle with a radius of 30 mcm around a CD8+ T cell or a tumor cell. We evaluated correlations between XIAP protein and mRNA expression, immune cell signatures (using CIBERSORT) &amp; gene-expression pathways as a validation of our IHC findings. RESULTS: High XIAP expression was detected in 45.3% of the IBC samples (n= 34/75). Although, XIAP expression was not associated with any clinicopathological parameters like grade, molecular subtype, or disease stage. High XIAP expressing tumors had more sTIL infiltration (P= 0.008), PDL1 expression (P= 0.012) and infiltration with TAMs (RMA: 1.03% (0.03% – 5.97%) vs. 2.73% (0.01% – 11.3%), P= 0.003). Furthermore, in these XIAP high samples TAMs were also located closer to the tumor cells (EI: 0.95 cells (0.06 – 3.48) vs. 2.04 cells (0.28 – 5.20), P&amp;lt; 0.001) and the CD8+ T cells (EI: 2.85 cells (0.26 – 8.85) vs. 5.13 cells (0.87 – 10.16), P&amp;lt; 0.001), while there was no correlation between XIAP and the total number of CD8+ cells. Although gene expression data analysis did not reveal any correlation between protein and mRNA expression of XIAP, there was a significant correlation between XIAP activation signature and protein expression (P&amp;lt;0.001). Furthermore, we discovered a strong association between XIAP protein and cellular stress response- &amp; inflammation-related gene sets. Finally, in the CIBERSORT data, we observed the strongest correlation between XIAP expression and M2 macrophages &amp; activated dendritic cells. CONCLUSION: This is the first study showing high XIAP expressing IBC tumors have increased infiltration of immunosuppressive TAMs, which co-localized near tumor and cytotoxic T cells. We also demonstrated an association between XIAP protein expression and inflammation related &amp; cellular stress response gene signatures. This is relevant as XIAP function depends on translational upregulation during cellular stress which leads to immunosuppressive signaling and an aggressive breast cancer phenotype. XIAP antagonists are in clinical trials and these data suggest potential benefit in targeting XIAP to enhance immunotherapeutic efficacy in IBC therapy. FUNDING: DoDs-W81XWH-17-1-0297,W81XWH-20-1-0153, ACS Mission Boost Grants(GRD) Citation Format: Christophe Van Berckelaer, Steven Van Laere, Joseph Gerardts, Luc Dirix, Michael Morse, Mark Kockx, François Bertucci, Peter Van Dam, Gayathri R Devi. Xiap expression is associated with infiltration of cd163+ tumor-associated macrophages in the tumor micro-environment of inflammatory breast cancer [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 P1-04-07.

The Transmembrane Receptor TIRC7 Identifies a Distinct Subset of Immune Cells with Prognostic Implications in Cholangiocarcinoma.

Simple SummaryCholangiocarcinoma (CCA) is an epithelial malignancy with a dismal prognosis due to rapid tumoral spread and poor therapeutic options. Innovative therapies, such as immune-modulating drugs, are urgently needed. Here, we assessed the quantity and clinical implications of immune cells expressing the T cell immune response cDNA 7 receptor (TIRC7) in a cohort of 135 CCA patients. We found that TIRC7+ immune cells are present both in the tumor epithelia and in the stroma in the majority of patients with particularly high intraepithelial levels in intrahepatic CCA. Distinct histomorphological tumor subtypes were exclusively associated with a TIRC7+ phenotype. By correlation analysis, we uncovered that a high level of intraepithelial TIRC7+ immune cells was associated with a favorable prognosis in intrahepatic CCA. Our results reveal a distinct subset of immune cells marked by TIRC7 to be present and prognostically relevant in CCA.Cholangiocarcinoma (CCA) is a heterogeneous malignancy with a dismal prognosis. Therapeutic options are largely limited to surgery and conventional chemotherapy offers limited benefit. As immunotherapy has proven highly effective in various cancer types, we have undertaken a quantitative immunohistopathological assessment of immune cells expressing the immunoinhibitory T cell immune response cDNA 7 receptor (TIRC7), an emerging immunoinhibitory receptor, in a cohort of 135 CCA patients. TIRC7+ immune cells were present in both the tumor epithelia and stroma in the majority of CCA cases with the highest levels found in intrahepatic CCA. While intraepithelial density of TIRC7+ immune cells was decreased compared to matched non-neoplastic bile ducts, stromal quantity was higher in the tumor samples. Tumors exhibiting signet ring cell or adenosquamous morphology were exclusively associated with an intraepithelial TIRC7+ phenotype. Survival analysis showed intraepithelial TIRC7+ immune cell density to be a highly significant favorable prognosticator in intrahepatic but not proximal or distal CCA. Furthermore, intraepithelial TIRC7+ immune cell density correlated with the number of intraepithelial CD8+ immune cells and with the total number of CD4+ immune cells. Our results suggest the presence and prognostic relevance of TIRC7+ immune cells in CCA and warrant further functional studies on its pharmacological modulation.

T-Bet Deficiency Attenuates Bile Duct Injury in Experimental Biliary Atresia.

Biliary atresia (BA) is an obstructive neonatal cholangiopathy leading to liver cirrhosis and end stage liver disease. A Kasai portoenterostomy may restore biliary drainage, but most patients ultimately require liver transplantation for survival. At diagnosis, immune cells within the liver of patients with BA demonstrate a T-helper 1 (Th1) inflammatory profile similar to rhesus rotavirus (RRV)-infected mice livers developing BA. The transcription factor Tbx21 (T-bet) is essential for induction of a Th1 immune response in both the adaptive and innate immune system. Here we used animals with targeted deletion of the T-bet gene to determine its role in the progression of BA. Infection of newborn T-bet knockout (KO) pups with RRV resulted in a decreased Th1 inflammatory chemokine/cytokine profile when compared to infected wild-type mice. Analysis of the mononuclear cells profile from T-bet KO mice revealed both a significant decrease in the total number of CD3, CD4, and CD8 T cells and their effector molecules granzyme A, perforin, and FasL. Even though the percentage of T-bet KO mice displaying symptoms of an obstructive cholangiopathy and overall mortality rate was not different compared to wild-type mice, the extrahepatic bile ducts of T-bet KO mice remained patent.

Effect of Poly(I:C) and melanoma B16-F10 on the immunophenotype of murine spleen cells

Introduction. It is known that the agonist of TLR-3 Poly(I:C), used as an adjuvant in a number of models of antitumor vaccines, causes inhibition of melanoma B16 growth, but the immunological aspects involved in this process have not been fully studied.The aim of the study was to evaluate changes of the immunophenotype of the spleen cells of C57BL / 6 mice caused by the tumor load and / or Poly(I:C), which is necessary for better understanding of the processes occurring during Poly(I:C) inhibition of melanoma B16-F10.Materials and methods. The immunophenotype of splenocytes of C57Bl / 6 mice was studied by flow cytometry asfollowing: the group 1 was a control (intact animals), the group 2 was mice with subcutaneously transplanted melanoma B16-F10, the group 3 was mice without a tumor treated with Poly(I:C) and the group 4 – mice with subcutaneously transplanted melanoma B16-F10 treated with Poly(I:C).Results. Median values of parameters such as the CD4 / CD8 immunoregulatory index, the percentage of CD69+ CD4+ and CD8+ T cells, the number of B and NK cells for the group of mice with melanoma treated with Poly(I:C) were between the values in the control group and in the group of mice with B16-F10. when comparing the results, the number of B and NK cells, the percentage of CD69+ on CD4+ and CD8+ T cells, their median in the group of mice with melanoma treated with Poly(I:C) was closer to the control than to the values obtained in the B16-F10 group and in the group of healthy mice receiving Poly(I:C). At the same time, we found that the total number of CD3+ cells, the number of naive CD4+ and CD8+ T cells was higher in the group of mice with melanoma treated with Poly(I:C) compared to all other groups.Conclusion. The analysis revealed the changes of the immunophenotype of murine spleen cells (CD4 / CD8, the percentage of CD69+ CD4+ and CD8+ T cells, the number of B and NK cells), which were affected by the tumor load and / or the administration of Poly adjuvant (I:C). Changes in the immunophenotype of murine splenocytes were associated with the tumor load and its size. It was also found that the splenocyte immunophenotype was affected by the repeated administration of Poly(I:C) during the tumor growth.

Interleukin-10-Mediated Lymphopenia Caused by Acute Infection with Foot-and-Mouth Disease Virus in Mice.

Foot-and-mouth disease (FMD) is characterized by a pronounced lymphopenia that is associated with immune suppression. However, the mechanisms leading to lymphopenia remain unclear. In this study, the number of total CD4+, CD8+ T cells, B cells, and NK cells in the peripheral blood were dramatically reduced in C57BL/6 mice infected with foot-and-mouth disease virus (FMDV) serotype O, and it was noted that mice with severe clinical symptoms had expressively lower lymphocyte counts than mice with mild or without clinical symptoms, indicating that lymphopenia was associated with disease severity. A further analysis revealed that lymphocyte apoptosis and trafficking occurred after FMDV infection. In addition, coinhibitory molecules were upregulated in the expression of CD4+ and CD8+ T cells from FMDV-infected mice, including CTLA-4, LAG-3, 2B4, and TIGIT. Interestingly, the elevated IL-10 in the serum was correlated with the appearance of lymphopenia during FMDV infection but not IL-6, IL-2, IL-17, IL-18, IL-1β, TNF-α, IFN-α/β, TGF-β, and CXCL1. Knocking out IL-10 (IL-10-/-) mice or blocking IL-10/IL-10R signaling in vivo was able to prevent lymphopenia via downregulating apoptosis, trafficking, and the coinhibitory expression of lymphocytes in the peripheral blood, which contribute to enhance the survival of mice infected with FMDV. Our findings support that blocking IL-10/IL-10R signaling may represent a novel therapeutic approach for FMD.

The Blockade of Interleukin-2 During the Acute Phase of Trypanosoma cruzi Infection Reveals Its Dominant Regulatory Role.

Trypanosoma cruzi infection causes Chagas’ disease in humans. The infection activates the innate and adaptative immunity in an orchestrated immune response to control parasite growth, guaranteeing host survival. Despite an effective immune response to the parasite in the acute phase, the infection progresses to a chronic stage. The parasite infects different tissues such as peripheral neurons, the brain, skeletal muscle, and heart muscle, among many others. It is evident now that tissue-specific immune responses may develop along with anti-parasite immunity. Therefore, mechanisms to regulate immunity and to ensure tissue-specific tolerance are operating during the infection. Studying those immunoregulatory mechanisms is fundamental to improve host protection or control inflammatory reactions that may lead to pathology. The role of IL-2 during T. cruzi infection is not established. IL-2 production by T cells is strongly down-modulated early in the disease by unknown mechanisms and remains low during the chronic phase of the disease. IL-2 activates NK cells, CD4, and CD8 T cells and may be necessary to immunity development. Also, the expansion and maintenance of regulatory T cells require IL-2. Thus, IL-2 may be a key cytokine involved in promoting or down-regulating immune responses, probably in a dose-dependent manner. This study blocked IL-2 during the acute T. cruzi infection by using a neutralizing monoclonal antibody. The results show that parasitemia and mortality rate was lower in animals treated with anti-IL-2. The percentages and total numbers of CD4+CD25+Foxp3+ T cells diminished within three weeks of infection. The numbers of splenic activated/memory CD4 and CD8 splenic T cells increased during the acute infection. T cells producing IFN-γ, TNF-α and IL-10 also augmented in anti-IL-2-treated infected mice. The IL-2 blockade also increased the numbers of inflammatory cells in the heart and skeletal muscles and the amount of IL-17 produced by heart T cells. These results suggest that IL-2 might be involved in the immune regulatory response during the acute T. cruzi infection, dampening T cell activation through the expansion/maintenance of regulatory T cells and regulating IL-17 production. Therefore, the IL-2 pathway is an attractive target for therapeutic purposes in acute and chronic phases of Chagas’ disease.

Low Density of CD3+ Tumor-Infiltrating Lymphocytes Is Predictive of a Poor Prognosis in Diffuse Large B-Cell Lymphoma Independently of MYC and BCL2 Double Expression Status: A Potential Utility of Immunoscore Based on Whole-Slide Image Analysis

Background: Anti-tumor immunity plays a key role in tumor development and progression and the landscape of tumor immune microenvironment could affect the clinical outcome of patients. The concept of immunoscore based on immune cell infiltration has been actively applied to solid tumors including colon cancer and malignant melanoma and successfully predicted prognosis of patients. However, a potential utility of immunoscore in predicting prognosis of patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. For easy application of immunoscore to daily practice, we investigated the prognostic value of tumor-infiltrating CD3+ T-cell density which is routinely stained for diagnosing malignant lymphomas, and then explored the feasibility of immunoscore application in DLBCL.Method: One-hundred-four patients with DLBCL treated with R-CHOP therapy, whose tumors were prospectively immunoprofiled for routine clinical diagnosis, were enrolled in this study. Immunohistochemistry was performed on representative whole formalin-fixed paraffin-embedded tissue sections using CD3, CD20, MYC, BCL2, BCL6, CD10 and MUM1. Cell-of-origin was determined using the Hans' algorithm and MYC/BCL2 double expressor (DE) was defined as the co-expression of MYC (in ≥ 40% of tumor cells) and BCL2 (in ≥ 70% of tumor cells). Whole-slide scanning was performed, whole tumor regions were annotated, and images were analyzed with Aperio ImageScope v.12.4.3 software (Leica Biosystems, Nussloch, Germany). The CD3+ density was quantified in three different methods: the total numbers of CD3+ cells/area (mm 2), CD3+ cells/total cells and CD3+ cells/CD20+ cells. Correlation between the CD3 density and clinicopathologic parameters and prognostic impact of the CD3 density were analyzed. To validate the findings, publicly available mRNA and clinical datasets of two DLBCL cohorts were downloaded and analyzed (Schmitz et al. 2018 and Sha et al. 2019). To dichotomizing low versus high CD3 density cases, the optimal cut-off values for overall survival were determined by ROC curve analysis using MedCalc Software v 19.4 (MedCalc Software, Ostend, Belgium). Remaining all statistical analyses were performed using SPSS version 25.0 (SPSS).Result: All three methods assessing CD3+ cell density showed high concordance (CD3+ cells/area vs CD3+ cells/total cells, k=0.540 p=0.000; CD3+ cells/total cells vs CD3+ cells/CD20+ cells, k=0.394 p=0.000; CD3+ cells/CD20+ cells vs CD3+ cells/area, k=0.739 p=0.000). Patients with low CD3 density had elevated serum LDH (all, p<0.05) and tended to show poor clinical parameters including high Ann Arbor stage (III-IV), high international prognostic index (IPI, 3-5) and DE status. Patients with low CD3 density by all three methods had worse overall survival (OS) and progression free survival (PFS) (all, p<0.05). In univariate analysis, the following clinical variables were predictive of worse OS: Ann Arbor stage IV, Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2, elevated serum LDH, IPI ≥3, DE and low CD3 density by all three methods. In multivariate analysis, low CD3 density by all methods predicted poor OS independent of the DE status, ECOG PS, LDH or Ann Arbor stage (all, p<0.05). Taken together, these findings suggested that evaluating CD3 density by any methods worked well as prognostic indicators and further might work well as immunoscoring methods in DLBCL. Potential utility of CD3+ cell density as an immunoscore observed in our cohort was validated using publicly available dataset generated by Schmitz et al. and Sha et al. In both validation cohorts, patients with low CD3E mRNA expression had elevated serum LDH (p<0.05) and in Sha et al. cohort, low CD3E mRNA expression was correlated with high ECOG PS, high IPI and DE status (p<0.05). Moreover, in both of Schmitz et al. and Sha et al. cohorts, patients with low CD3E mRNA expression tended to have worse PFS (p=0.067 and 0.002, respectively) and OS (both, p<0.05). In multivariate analysis, low CD3E mRNA predicted poor OS, independent of the IPI and DE status, in both validation cohorts.Conclusion: Low CD3 density was a poor prognostic factor in DLBCL independent of other poor prognostic parameters such as IPI score and DE status. Therefore, evaluating CD3 density might be suitable for immunoscoring DLBCL cases to predict prognosis. DisclosuresKim: Boryung: Consultancy, Membership on an entity's Board of Directors or advisory committees; BeyondBIO: Consultancy, Membership on an entity's Board of Directors or advisory committees; Hanmi: Consultancy, Membership on an entity's Board of Directors or advisory committees; AstraZeneca/MedImmune: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bayer: Consultancy, Membership on an entity's Board of Directors or advisory committees; AstraZeneca-KHIDI: Research Funding; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees; Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; GI CELL: Consultancy, Membership on an entity's Board of Directors or advisory committees; Roche/Genentech: Consultancy, Membership on an entity's Board of Directors or advisory committees.

Ex Vivo IL-2 Treatment Increases the Immunosuppressive Subset of T Lymphocytes to Suppress Allo-Immune Response

T lymphocytes are critical players in graft-versus-host disease (GVHD); however, their specific roles and mechanisms in GVHD have not been clearly defined. Co-inhibitory receptors including PD1, TIM3, TIGIT, and LAG3 play a key role in regulating T cell responses and maintaining immune homeostasis. TIM3 expression on lymphocytes was identified to induce immune tolerance in a mouse GVHD model; in addition, PD1 +TIM3 + double-positive T cells displayed more potent immunosuppression compared to PD1 + T cells. However, despite the strong immunosuppression exerted by PD1 +TIM3 + double-positive T cells, their clinical potential is greatly limited by their low cell number in peripheral blood. In this study, we introduce a novel method to isolate CD3 + cells from G-CSF mobilized peripheral blood stem cells (G-PBSCs), and culture CD3 +PD1 +TIM3 + lymphocytes to treat GVHD.Methods. The donors were subcutaneously injected with G-CSF (10μg/kg) for five days. G-PBSCs were collected from the donors using a COBE spectra cell separator. Then, the highly purified CD3 + cells were isolated by positive selection with magnetic-activated cell sorting (MACS) from G-PBSCs using CD3 Dynabeads™. Isolated CD3 + cells were cultured with a low concentration of IL-2 (50U/mL), and PD1, TIM3, LAG3, and TIGIT expressions were assessed using flow cytometry (FACS). CD3 +PD1 +TIM3 +, CD3 +PD1 +TIM3 +LAG3 +TIGIT - and CD3 +PD1 +TIM3 +LAG3 +TIGIT +cells are sorted and cultured with irradiated allo-MNCs for 4 days (Mixed Lymphocyte Reaction; MLR). We used 5,6-carboxyfluorescein diacetate succinimidyl ester (CFSE) as an intracellular fluorescent dye in MLR (CFSE-MLR) to measure of T cells proliferation.Results. In normal, untreated G-PBSCs, very low percentages of cells are CD3 +PD1 +TIM3 +, CD3 +PD1 +LAG3 + and CD3 +PD1 +TIGIT + (0.6±0.4, 0.3±0.2 and 1.3±0.5% in G-PBSC, respectively). However, after treating G-PBSC cells with a low concentration of IL-2 (50 U/mL), we discovered the percentages of CD3 +PD1 +TIM3 +, CD3 +PD1 +LAG3 +, and CD3 +PD1 +TIGT + lymphocytes in G-PBSCs markedly increased by 19.6±5.9, 18.5±4.3, 17.7±6.5%, respectively. Of note, there was a very small change (~1.2 fold increase) in the total number of CD3 + lymphocytes, which indicates that the low dose IL-2 therapy alters subpopulations of T lymphocytes, rather than increasing the proliferation rate. Next, we tested the immunosuppressive capacity of the cultured CD3 +PD1 +TIM3 +cells. To do this, we used CSFE-MLR to measure T cell proliferation. CD3 +PD1 +TIM3 + lymphocytes were depleted in CD3 + G-PBSCs by flow cytometry-based cell sorting. Then we cultured the CD3 + G-PBSCs with allo-MNCs and discovered that the CD3 + G-PBSCs that lacked CD3 +PD1 +TIM3 + lymphocytes demonstrated a significantly increased level of T-cell proliferation compared to CD3 + G-PBSCs, and thereby confirming the immunosuppressive function of CD3 +PD1 +TIM3 + lymphocytes in inhibiting T cell proliferation (% of unstimulated T cells in CD3 + G-PBSCs vs. in CD3 +PD1 +TIM3 + depleted G-PBSC CD3 + cells; 33.5±7.5% vs. 6.3±4.2%).After confirming the immunosuppressive function of the IL-2 treated CD3 +PD1 +TIM3 + lymphocytes, we investigated expressions of other co-inhibitory surface markers such as LAG3 and TIGIT. Amongst the cultured CD3 +PD1 +TIM3 + lymphocytes, 96.2±3.3% of the CD3 +PD1 +TIM3 + lymphocytes were LAG3 +, 28.9±5.4% of the CD3 +PD1 +TIM3 + lymphocytes were TIGIT +, and 63.7±7.8% of the cells were TIGIT -. Interestingly, CD3 +PD1 +TIM3 +LAG3 +TIGIT - lymphocytes demonstrated significantly enhanced levels of immunosuppression compared to CD3 +PD1 +TIM3 +LAG3 +TIGIT + lymphocytes (% of unstimulated T cells in CD3 +PD1 +TIM3 +LAG3 +TIGIT - lymphocytes vs. in CD3 +PD1 +TIM3 +LAG3 +TIGIT + lymphocytes, 53.8±5.5% vs. 23.2±7.4%).Conclusion.We demonstrate that treating CD3 + G-PBSCs with low-dose IL-2 markedly increases the percentage of CD3 +PD1 +TIM3 + lymphocytes, which is known to exert strong immunosuppression. Also, we suggest that CD3 +PD1 +TIM3 +LAG3 +TIGIT - lymphocytes are the subpopulation within CD3 +PD1 +TIM3 + cells that demonstrate the most potent immunosuppression compared to other subpopulations of CD3 +PD1 +TIM3 + lymphocytes. Taken together, such findings suggest that the low-dose IL-2 therapy has therapeutic potential to treat patients with GVHD. DisclosuresNo relevant conflicts of interest to declare.

Relationship Between Immunity Level and Quality of Life among Housewives Living with HIV (Cross-sectional Study in Central Borneo, Indonesia)

Background: In Central Kalimantan Province, housewives constitute the second largest group of people with HIV (+) (19.4%) after the private group. Most of them (61.4%) reported on the poor quality of life, especially in the domain of psychology due to frustration and poverty. In its management, the intervention program has not fully integrated the life quality of people with HIV toward the accepted treatment model because of the lack of information about the case. Therefore, the particular study aims to find out the relationship between quality of life and the level of immunity of housewives with HIV (+), which expect to have benefited the development of a program for managing ODHA in Central Kalimantan Province. Method: Cross-sectional study approach used in the research where the population is a housewife with HIV (+) who lives in Central Kalimantan Province. The purposive sampling technique used to select the sample with criteria of the subjects have a CD4 &gt; 200 cell/µL and are excluded when experiencing psychiatric disorders and/or dying. There were 54 people as the sample. Data were analyzed bivariate using chi-square test and multivariate analysis with logistic regression. Result and conclusion :The results of statistical tests showed no significant relationship between quality of life and the level of immunity of participants in the physical domain (p = .2.071); psychological domain (p = 0.610); social domain (p = 0.595); environmental domain (p = 0.393); perception of health conditions (p = 0.317) and; perception of quality of life (p = 2.140).It needs further assessment toward the total number of CD4 before starting ART, treatment adherence, disease history and lifestyle of the participants. And, interventions can improve the quality of life and increase the immunity of participants