Changes of CD4+ Lymphocyte Profile in Patients with Renal Cell Carcinoma and its

我们先前已经观察到肿瘤特异性CD 4 + T细胞的功能极化有很强的偏向性， 晚期肾细胞癌（RCC）患者外周血中的反应，宫颈癌， 癌症或黑素瘤。值得注意的是，活动性播散性疾病患者的典型特征是： 主要的Th 2或T调节型免疫肿瘤抗原衍生的Th表位，而这些患者 成功治疗且在分析时未显示疾病证据（NED），显示 主要是对这些相同表位的Th 1型免疫反应性。几乎所有患者都保留了Th 1型 对病毒（EBV，Flu）Th表位的免疫力，无论疾病阶段如何，支持肿瘤特异性 这些癌症患者的CD 4 + T细胞区室中的免疫偏离。在目前的提案中， 我们将确定肾细胞癌患者Th免疫偏离的机制， 其在体外纠正这些缺陷，然后将纠正疗法转化为I/II期临床试验 旨在治疗晚期肾细胞癌患者。具体而言，我们将： 目标1.验证肿瘤晚期患者肿瘤特异性Th 1型免疫偏离的假设 RCC涉及肿瘤诱导的DC功能亚群或DC表达的平衡的改变。 共刺激分子 目标2.验证肾癌患者肿瘤特异性Th 1型免疫功能障碍与肿瘤活动性相关的假设。 疾病涉及优先凋亡的Th 1型，而不是Th 2或T调节型CD 4 + T细胞。 目标3.检验基于aDC 1的疫苗可以纠正功能失调的抗原特异性1型的假设 体外免疫 目标4。检验基于aDC 1/肿瘤肽的RCC患者的疫苗接种对晚期肾癌患者的预后的影响的假设。 疾病将在I/II期临床试验中纠正功能障碍的抗RCC 1型CD 4 + T细胞应答。

We have previously observed a strong bias in the functional polarization of tumor-specific CD4+ T cell responses in the peripheral blood of patients with advanced stage renal cell carcinoma (RCC), cervical cancer or melanoma. Notably, patients with active disseminated disease were typically characterized by predominant Th2- or T regulatory-type immunity to tumor antigen-derived Th epitopes, while those patients successfully treated and exhibiting no evidence of disease (NED) at the time of analysis, displayed principally Th1-type immune reactivity to these same epitopes. Virtually all patients retained Th1-type immunity to viral (EBV, Flu) Th epitopes, regardless of disease stage, supporting the tumor-specific nature of immune deviation in the CD4+ T cell compartment of these cancer-bearing patients. In the current proposal, we will determine mechanism(s) underlying Th immune deviation in patients with RCC, resolve means by which to correct such deficiencies in vitro and then translate corrective therapies into a phase l/ll clinical trial designed to treat patients with advanced stage RCC. Specifically, we will: Aim 1. Test the hypothesis that tumor-specific Th1-type immune deviation in patients with advanced stage RCC involves tumor-induced alterations in the balance of DC functional subsets or DC-expressed costimulatory molecues. Aim 2. Test the hypothesis that tumor-specific Th1-type immune dysfunction in RCC patients with active disease involves the preferential apoptosis of Th1-type, but not Th2- or T regulatory-type CD4+ T cells. Aim 3. Test the hypothesis that aDC1-based vaccines can correct dysfunctional, antigen-specific Type-1 immunity in vitro. Aim 4. Test the hypothesis that aDC1/tumor peptide-based vaccination of RCC patients with advanced disease will correct dysfunctional anti-RCC Type-1 CD4+ T cell responses in a phase l/ll clinical trial.