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      Eradication of Metastatic Renal Cell Carcinoma after Adenovirus-Encoded TNF-Related Apoptosis-Inducing Ligand (TRAIL)/CpG Immunotherapy

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          Abstract

          Despite evidence that antitumor immunity can be protective against renal cell carcinoma (RCC), few patients respond objectively to immunotherapy and the disease is fatal once metastases develop. We asked to what extent combinatorial immunotherapy with Adenovirus-encoded murine TNF-related apoptosis-inducing ligand (Ad5mTRAIL) plus CpG oligonucleotide, given at the primary tumor site, would prove efficacious against metastatic murine RCC. To quantitate primary renal and metastatic tumor growth in mice, we developed a luciferase-expressing Renca cell line, and monitored tumor burdens via bioluminescent imaging. Orthotopic tumor challenge gave rise to aggressive primary tumors and lung metastases that were detectable by day 7. Intra-renal administration of Ad5mTRAIL+CpG on day 7 led to an influx of effector phenotype CD4 and CD8 T cells into the kidney by day 12 and regression of established primary renal tumors. Intra-renal immunotherapy also led to systemic immune responses characterized by splenomegaly, elevated serum IgG levels, increased CD4 and CD8 T cell infiltration into the lungs, and elimination of metastatic lung tumors. Tumor regression was primarily dependent upon CD8 T cells and resulted in prolonged survival of treated mice. Thus, local administration of Ad5mTRAIL+CpG at the primary tumor site can initiate CD8-dependent systemic immunity that is sufficient to cause regression of metastatic lung tumors. A similar approach may prove beneficial for patients with metastatic RCC.

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          Most cited references45

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          Clearance of apoptotic cells: implications in health and disease

          Recent advances in defining the molecular signaling pathways that regulate the phagocytosis of apoptotic cells have improved our understanding of this complex and evolutionarily conserved process. Studies in mice and humans suggest that the prompt removal of dying cells is crucial for immune tolerance and tissue homeostasis. Failed or defective clearance has emerged as an important contributing factor to a range of disease processes. This review addresses how specific molecular alterations of engulfment pathways are linked to pathogenic states. A better understanding of the apoptotic cell clearance process in healthy and diseased states could offer new therapeutic strategies.
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            Arginase, prostaglandins, and myeloid-derived suppressor cells in renal cell carcinoma.

            Tumor-induced tolerance is a well-established phenomenon in cancer patients that can severely impair the therapeutic efficacy of immunotherapy. One mechanism leading to T-cell tolerance is the generation of myeloid-derived suppressor cells (MDSC) by soluble factors produced by the tumor. MDSC express CD11b(+) as a common marker but may vary in their stage of maturation, depending on the tumor factors being produced. Arginase production by MDSC depletes arginine from the tumor microenvironment and impairs T-cell signal transduction and function. We studied whether an increase in MDSC could explain the molecular alterations and dysfunction found in T cells of patients with renal cell carcinoma (RCC). Arginase activity in the peripheral blood mononuclear cells of 117 RCC patients was increased between 6- to 8-fold compared with normal controls. The increased arginase activity was limited to the CD11b(+)CD14(-) myeloid cells and resulted in significantly decreased serum levels of arginine and increased ornithine in patients. Depletion of MDSC restored IFN-gamma production and T-cell proliferation. Preliminary data suggest that prostaglandin E(2) produced by the tumor induces arginase I expression in MDSC. Therefore, blocking MDSC activity may enhance the therapeutic efficacy of immunotherapy in RCC.
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              Development of TLR9 agonists for cancer therapy.

              In vertebrates, the TLRs are a family of specialized immune receptors that induce protective immune responses when they detect highly conserved pathogen-expressed molecules. Synthetic agonists for several TLRs, including TLR3, TLR4, TLR7, TLR8, and TLR9, have been or are being developed for the treatment of cancer. TLR9 detects the unmethylated CpG dinucleotides prevalent in bacterial and viral DNA but not in vertebrate genomes. As discussed in this Review, short synthetic oligodeoxynucleotides containing these immune stimulatory CpG motifs activate TLR9 in vitro and in vivo, inducing innate and adaptive immunity, and are currently being tested in multiple phase II and phase III human clinical trials as adjuvants to cancer vaccines and in combination with conventional chemotherapy and other therapies.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                1 February 2012
                : 7
                : 2
                : e31085
                Affiliations
                [1 ]Department of Urology, The University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America
                [2 ]Microbiology, Immunology, and Cancer Biology Program, University of Minnesota, Minneapolis, Minnesota, United States of America
                [3 ]Interdisciplinary Graduate Program in Immunology, The University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America
                [4 ]Department of Urology, University of Minnesota, Minneapolis, Minnesota, United States of America
                [5 ]Department of Physiology, The University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America,
                French National Centre for Scientific Research, France
                Author notes

                Conceived and designed the experiments: LAN TPK TRR TSG. Performed the experiments: LAN TPK HMR AJL TAK TRR BRJ CS CJW. Analyzed the data: LAN TRR CJW MDH TSG. Contributed reagents/materials/analysis tools: CJW MDH. Wrote the paper: LAN TPK TSG.

                Article
                PONE-D-10-05576
                10.1371/journal.pone.0031085
                3270031
                22312440
                db137a5e-e24d-4fcb-b556-8d62ff10718d
                Norian et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 29 November 2010
                : 2 January 2012
                Page count
                Pages: 13
                Categories
                Research Article
                Biology
                Immunology
                Immunologic Subspecialties
                Medicine
                Oncology
                Cancer Treatment
                Urology

                Uncategorized
                Uncategorized

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