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      An Historical Overview: The Discovery of How NK Cells Can Kill Enemies, Recruit Defense Troops, and More

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          Abstract

          Natural killer (NK) cells were originally defined as effector lymphocytes of innate immunity characterized by the unique ability of killing tumor and virally infected cells without any prior priming and expansion of specific clones. The “missing-self” theory, proposed by Klas Karre, the seminal discovery of the first prototypic HLA class I-specific inhibitory receptors, and, later, of the Natural Cytotoxicity Receptors (NCRs) by Alessandro Moretta, provided the bases to understand the puzzling behavior of NK cells. Actually, those discoveries proved crucial also for many of the achievements that, along the years, have contributed to the modern view of these cells. Indeed, NK cells, besides killing susceptible targets, are now known to functionally interact with different immune cells, sense pathogens using TLR, adapt their responses to the local environment, and, even, mount a sort of immunological memory. In this review, we will specifically focus on the main activating NK receptors and on their crucial role in the ever-increasing number of functions assigned to NK cells and other innate lymphoid cells (ILCs).

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          Most cited references197

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          The blockade of immune checkpoints in cancer immunotherapy.

          Among the most promising approaches to activating therapeutic antitumour immunity is the blockade of immune checkpoints. Immune checkpoints refer to a plethora of inhibitory pathways hardwired into the immune system that are crucial for maintaining self-tolerance and modulating the duration and amplitude of physiological immune responses in peripheral tissues in order to minimize collateral tissue damage. It is now clear that tumours co-opt certain immune-checkpoint pathways as a major mechanism of immune resistance, particularly against T cells that are specific for tumour antigens. Because many of the immune checkpoints are initiated by ligand-receptor interactions, they can be readily blocked by antibodies or modulated by recombinant forms of ligands or receptors. Cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) antibodies were the first of this class of immunotherapeutics to achieve US Food and Drug Administration (FDA) approval. Preliminary clinical findings with blockers of additional immune-checkpoint proteins, such as programmed cell death protein 1 (PD1), indicate broad and diverse opportunities to enhance antitumour immunity with the potential to produce durable clinical responses.
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            Activation of NK cells and T cells by NKG2D, a receptor for stress-inducible MICA.

            Stress-inducible MICA, a distant homolog of major histocompatibility complex (MHC) class I, functions as an antigen for gammadelta T cells and is frequently expressed in epithelial tumors. A receptor for MICA was detected on most gammadelta T cells, CD8+ alphabeta T cells, and natural killer (NK) cells and was identified as NKG2D. Effector cells from all these subsets could be stimulated by ligation of NKG2D. Engagement of NKG2D activated cytolytic responses of gammadelta T cells and NK cells against transfectants and epithelial tumor cells expressing MICA. These results define an activating immunoreceptor-MHC ligand interaction that may promote antitumor NK and T cell responses.
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              Anti-NKG2A mAb Is a Checkpoint Inhibitor that Promotes Anti-tumor Immunity by Unleashing Both T and NK Cells

              Summary Checkpoint inhibitors have revolutionized cancer treatment. However, only a minority of patients respond to these immunotherapies. Here, we report that blocking the inhibitory NKG2A receptor enhances tumor immunity by promoting both natural killer (NK) and CD8+ T cell effector functions in mice and humans. Monalizumab, a humanized anti-NKG2A antibody, enhanced NK cell activity against various tumor cells and rescued CD8+ T cell function in combination with PD-x axis blockade. Monalizumab also stimulated NK cell activity against antibody-coated target cells. Interim results of a phase II trial of monalizumab plus cetuximab in previously treated squamous cell carcinoma of the head and neck showed a 31% objective response rate. Most common adverse events were fatigue (17%), pyrexia (13%), and headache (10%). NKG2A targeting with monalizumab is thus a novel checkpoint inhibitory mechanism promoting anti-tumor immunity by enhancing the activity of both T and NK cells, which may complement first-generation immunotherapies against cancer.
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                Author and article information

                Contributors
                Journal
                Front Immunol
                Front Immunol
                Front. Immunol.
                Frontiers in Immunology
                Frontiers Media S.A.
                1664-3224
                19 June 2019
                2019
                : 10
                : 1415
                Affiliations
                [1] 1U.O.C. Immunologia, IRCCS Ospedale Policlinico San Martino , Genoa, Italy
                [2] 2Department of Experimental Medicine, University of Genoa , Genoa, Italy
                [3] 3Centre of Excellence for Biomedical Research, University of Genoa , Genoa, Italy
                [4] 4Laboratory of Clinical and Experimental Immunology, Integrated Department of Services and Laboratories, IRCCS Istituto Giannina Gaslini , Genoa, Italy
                [5] 5Laboratory of Immunology and Biotherapy, Department of Human Pathology, University of Messina , Messina, Italy
                [6] 6Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino , Genoa, Italy
                [7] 7Dipartimento di Scienze della Salute (DISSAL), University of Genoa , Genoa, Italy
                [8] 8Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino , Genoa, Italy
                [9] 9Laboratory of Tumor Immunology, Department of Immunology, IRCCS Ospedale Bambino Gesù , Rome, Italy
                Author notes

                Edited by: Eric Vivier, INSERM U1104 Centre D'immunologie de Marseille-Luminy, France

                Reviewed by: Amir Horowitz, Icahn School of Medicine at Mount Sinai, United States; Cai Zhang, Shandong University, China

                *Correspondence: Simona Sivori simona.sivori@ 123456unige.it

                This article was submitted to NK and Innate Lymphoid Cell Biology, a section of the journal Frontiers in Immunology

                †These authors have contributed equally to this work

                Article
                10.3389/fimmu.2019.01415
                6611392
                31316503
                7c411b30-8666-44c9-abfc-9a2e5324038a
                Copyright © 2019 Vitale, Cantoni, Della Chiesa, Ferlazzo, Carlomagno, Pende, Falco, Pessino, Muccio, De Maria, Marcenaro, Moretta and Sivori.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 12 April 2019
                : 04 June 2019
                Page count
                Figures: 3, Tables: 0, Equations: 0, References: 244, Pages: 15, Words: 13622
                Funding
                Funded by: Associazione Italiana per la Ricerca sul Cancro 10.13039/501100005010
                Award ID: AIRC 5X1000, 2018 Project Code 21147
                Award ID: AIRC IG 2017 Project Code 20312
                Award ID: AIRC IG 2017, Project Code 19920
                Award ID: Fondazione AIRC IG 2015, Project Code 16764 (DP)
                Award ID: AIRC IG 2014 project no. 15428 (MV)
                Award ID: 5X1000 Min. Sal. 2013 (MV)
                Categories
                Immunology
                Review

                Immunology
                human natural killer cells,innate immunity,natural cytotoxicity receptors,toll-like receptors,activating nk receptors

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