Immune correlates of protection against intracellular bacterial pathogens are largely thought to be cell-mediated, although a reasonable amount of data supports a role for antibody-mediated protection. To define a role for antibody-mediated immunity against an intracellular pathogen, Rhodococcus equi, that causes granulomatous pneumonia in horse foals, we devised and tested an experimental system relying solely on antibody-mediated protection against this host-specific etiologic agent. Immunity was induced by vaccinating pregnant mares 6 and 3 weeks prior to predicted parturition with a conjugate vaccine targeting the highly conserved microbial surface polysaccharide, poly-N-acetyl glucosamine (PNAG). We ascertained antibody was transferred to foals via colostrum, the only means for foals to acquire maternal antibody. Horses lack transplacental antibody transfer. Next, a randomized, controlled, blinded challenge was conducted by inoculating at ~4 weeks of age ~106 cfu of R. equi via intrabronchial challenge. Eleven of 12 (91%) foals born to immune mares did not develop clinical R. equi pneumonia, whereas 6 of 7 (86%) foals born to unvaccinated controls developed pneumonia (P = 0.0017). In a confirmatory passive immunization study, infusion of PNAG-hyperimmune plasma protected 100% of 5 foals against R. equi pneumonia whereas all 4 recipients of normal horse plasma developed clinical disease (P = 0.0079). Antibodies to PNAG mediated killing of extracellular and intracellular R. equi and other intracellular pathogens. Killing of intracellular organisms depended on antibody recognition of surface expression of PNAG on infected cells, along with complement deposition and PMN-assisted lysis of infected macrophages. Peripheral blood mononuclear cells from immune and protected foals released higher levels of interferon-γ in response to PNAG compared to controls, indicating vaccination also induced an antibody-dependent cellular release of this critical immune cytokine. Overall, antibody-mediated opsonic killing and interferon-γ release in response to PNAG may protect against diseases caused by intracellular bacterial pathogens.
Genetic studies have implicated the early involvement of a gene on chromosome arm 9p in the development of cutaneous melanoma. We have performed loss-ofheterozygosity studies to confirm these original findings and identify the most frequently rearranged or deleted region of9p.Eight markers were analyzed, including (from 9pter to proximal 9q) D9S33, the (-interferon (IFNBI) locus, the a-interferon (IFNA) gene cluster, D9S126, D9S3, D9S19, the glycoprotein 4(3-galactosylbtansferase (GGTB2) gene, and the argininosuccinate synthetase pseudogene 3 (ASSP3). Two or more of these loci were found to be hemizygously reduced in 12 of 14 (86%) informative metastatic melanoma tumor and cell line DNAs, and homozygous deletions of the marker D9S126 were observed in 2 of 20 (10%) melanoma cell lines. These findings have resulted in the identification of a small critical region of 2-3 megabases on 9p21 in which a putative melanoma tumorsuppressor gene appears likely to reside. Several 9p candidate genes, including IFNBI, the IFNA gene duster, GGTB2, and the tyrosinase-related protein (TYRP) locus, have all been eliminated as potential targets because they are located outside of the homozygously deleted regions.Cytogenetic and molecular studies suggest that several critical genes are important in the progression of cutaneous melanoma (CM) (for review, see ref. 1). One focus is on the p arm of chromosome 9, where four independent reports support the existence of a tumor-suppressor locus which is mutated during the early stages of melanoma tumor development (2-5). Overall, rearrangements of this chromosome occur in nearly half of all melanomas, with the most frequently targeted region extending from 9pter to 9q13 (1). The a-interferon (IFNA) gene cluster and (3-interferon (IFNBI) locus are located within this region and are viewed as potential candidates for involvement in CM because they have growth-inhibitory properties and, as therapeutic agents, have caused the regression of metastatic melanoma (6-8). In addition, interferon-like molecules have been detected in the basal layer of the epidermis, suggesting that they may contribute to the control of normal epidermal growth or regeneration (9).The glycoprotein 4f3-galactosyltransferase (GGTB2) locus and the tyrosinase-related protein (TYRP) gene are also candidates for involvement in CM and reside within this region of 9p. The enzyme encoded by GGTB2 plays a role in glycosylation, and mutations in this protein could adversely affect cell adhesion and/or cell growth (10, 11). This gene has been mapped to 9p13-p21 (6). TYRP is the human homolog of the mouse brown locus (12, 13) and a member of the tyrosinase-related gene family (14). TYRP encodes a transmembrane melanosomal glycoprotein, gp75, which was originally identified in melanoma cells by using autoantibodies from an affected patient (15, 16). The gp75 antigen is expressed exclusively in melanocytic cells (17) and already has an established role in the development of melanoma (18). The TYRP locus was localized init...
This phase III multicenter trial showed (1) no advantage for high-dose paclitaxel and (2) excessive hematologic toxicity associated with both regimens. Therefore, neither of the paclitaxel regimens evaluated in this trial can be recommended.
The low titer and incidence of autologous antibody to melanoma has hampered its evaluation. Through acid dissociation and ultrafiltration of serum, we have been able to augment the autologous immune response in 9 of 10 patients studied. This result suggests that autologous antibody is present in most patients with melanoma, but is obscured by circulating antigen and the formation of immune complexes. Because native antibody and antibody derived from circulating immune complexes are produced by the host against physiologically relevant antigens, correlations can be made to clinical course. Serological studies of three patients with melanoma were performed with serum samples obtained over many months; these studies demonstrated correlations with tumor progression and clinical course.
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