Enhancement by Interleukin 4 of Interleukin 2- Or Antibody-Induced Proliferation of Lymphocytes from Interleukin 2-Treated Cancer Patients1
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ICANCER RESEARCH 50. 1160-1 164. Februar} 15. 1990) Enhancement by Interleukin 4 of Interleukin 2- or Antibody-induced Proliferation of Lymphocytes from Interleukin 2-treated Cancer Patients1 Jonathan Treisman, Carl M. Higuchi, John A. Thompson, Steven Gillis, Catherine G. Lindgren, Donald E. Kern, Stanley R. Ridell, Philip D. Greenberg, and Alexander I efer Department of Medicine, Division of Medical Oncolog); University of Washington School of Medicine, Seattle. Has/tinglan 9X195 fJ. T., C. M. H.,J. A. T., C, G. L., D. E. K., S. R. R., P. D. G., A. F.]; and Immunex Corporation, Seattle, H'ashington 98101 [S. G.J ABSTRACT IL-2-activated cells for therapy are usually generated by ob taining PBMC from cancer patients shortly after systemic IL- Systemic interleukin 2 (IL-2) and IL-2-activated lymphocytes have 2 therapy and culturing them with IL-2 in vitro. The cells thus induced tumor regression in some cancer patients. The IL-2-activated cells have usually been generated by obtaining peripheral blood mono- generated for infusion are phenotypically and functionally het nuclear cells (PB1V1C)from cancer patients shortly after systemic IL-2 erogeneous and contain cells with LAK activity (5, 7), as well therapy and culturing them with IL-2 in vitro. In an effort to augment as other cells which may mediate or contribute to antitumor the ex vivogeneration of such cells preactivated in vivo, we examined the responses (8). In an effort to enhance the generation of such proliferative responses of PBIVIC from IL-2-treated cancer patients to cells i/i vitro, several agents which induce a proliferative re several proliferative signals including IL-2, interleukin 4 (II -4). and sponse in normal human PBMC were studied for their possible mitogenic antibodies to CD3 and CD28. Although much is known about proliferative effects on PBMC from IL-2-treated patients. the response of normal PBMC to these signals, the possibility was IL-4 is a multipotent lymphokine which enhances prolifera considered that the response of lymphocytes preactivated by IL-2 in vivo tion of B-cells, T-cells, natural killer cells, and monocytes (9- might differ from that of normal PBMC. Accordingly, PBIVICobtained 17). In normal lymphocytes, IL-4 is comitogenic with antigen from ten normal, healthy controls and from 17 patients with advanced cancer 1 to 3 days after systemic IL-2 therapy were cultured for 4 days (15), lectins (16, 17), and antibodies to CD3 (17). IL-4 can with 11.-4(1000 units/ml) and/or IL-2 (10 units/ml or 1000 units/ml) or augment the generation of antigen-specific cytotoxic T-cells with combinations of 11.-I and ant ¡-('1)3±anti-CD28, and they were (18-20) and can induce non-major histocompatibility complex- then tested for proliferation by ('Hjthymidine incorporation. IL-4 failed restricted LAK activity in human PBMC preactivated with IL- to induce proliferation of normal PBMC and inhibited IL-2-induced 2 (21, 22). In contrast to the pleotropic effects of IL-4, mono proliferation, whereas IL-4 alone induced proliferation in PBMC from clonal antibodies directed against CD3 (anti-CD3) specifically five of 11 IL-2-treated patients and did not inhibit but augmented the activate and induce the proliferation of CD3+ T-cells (23) and proliferation induced by IL-2 (10 units/ml and 1000 units/ml) in PBMC can support the growth of major histocompatibility complex- from six of nine patients and five of 11 patients, respectively. Anti-CD3 restricted T-cells (24) as well as cells with LAK activity (25). induced proliferation in PBMC from eight of nine patients, and the The proliferative response to anti-CD3 can be enhanced using proliferation was consistently augmented by coculture with anti-CD28. Finally, IL-4 significantly augmented the proliferative responses of monoclonal antibodies directed against CD28, a M, 44,000 PBMC from IL-2-treated patients to anti-CD3, as well as to the combi homodimer found on approximately 80% of peripheral T-cells nation of anti-CD3 and anti-CD28. Thus, in PBMC from IL-2-treated (26). The proliferative response of normal lymphocytes to anti- cancer patients, IL-4 enhanced the in vitro proliferation induced by IL-2 CD3 is also known to be enhanced by IL-4. or by anti-CD3 ±anti-CD28. The results suggest that IL-4 and/or Although much is known about the proliferative response of mitogenic antibodies may be useful in augmenting the ex vivo generation normal lymphocytes to these agents, the response of lympho of lymphocytes for clinical adoptive ¡mmunotherapy. cytes from IL-2-treated patients, i.e., cells which have been preactivated in vivo by IL-2, and, potentially, by other inter INTRODUCTION mediary lymphokines and cytokines, may be different from that of normal lymphocytes. For example, IL-4 inhibits IL-2-in- The systemic administration of IL-2'1 and autologous lym duced LAK activity in normal human PBMC, but enhances IL- phocytes activated by culture with IL-2 has induced tumor 2-induced LAK activity in PBMC preactivated by IL-2 (21, 22). regression in some cancer patients (1-3). However, the re Accordingly, the proliferative effects of IL-4 and mitogenic sponses have been observed in only a minority of patients, and antibodies on PBMC from IL-2-treated cancer patients were the doses of IL-2 required have usually been toxic (4, 5). In examined. The data demonstrate that (a) in contrast to the animal models, the antitumor effects observed correlated with inhibition of IL-2-induced proliferation by IL-4 in normal the amount of IL-2 administered and with the number of PBMC, IL-4 alone induced substantial proliferation and aug activated cells infused (6). Thus, the development of techniques mented the proliferative response to IL-2 in PBMC from the to augment the generation of activated lymphocytes ex vivo majority of the patients tested; (¿>)anti-CD3induced prolifera may potentially enhance tumor responses in vivo. One approach tion of patient PBMC; (c) anti-CD28 enhanced the proliferative to this goal is the use of other proliferative signals in addition response to anti-CD3; and (d) IL-4 augmented the proliferative to or in lieu of IL-2. response to both mitogenic antibodies. The results suggest that Received 10/10/89: accepted 11/13/89. IL-4 ±mitogenic antibodies may have a role in the ex vivo The costs of publication of this article were defrayed in part by the payment generation of lymphocytes for adoptive immunotherapy trials. of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. ' This work was supported in part by Grant CA 09515 and Contract NO1- CM47668 awarded by the National Cancer Institute. Department of Health and MATERIALS AND METHODS Human Services. Some of the data in this manuscript were presented at the 80th Annual Meeting of the American Association for Cancer Research. May 1989. Study Population and Blood Sampling. Seventeen patients aged 30 to ' To whom requests for reprints should be addressed, at the Department of 71 yr with metastatic renal cell carcinoma (9 patients), melanoma (6 Medicine. Division of Oncology, RM-17, University of Washington, Seattle. WA patients), diffuse histiocytic lymphoma (one patient), and carcinoma of 98195. JThe abbreviations used are: IL-2, interleukin 2; IL-4, interleukin 4; LAK, the colon (one patient) participated in a Phase I/II trial of IL-2 and lymphokine-activated killer; PBMC, peripheral blood mononuclear cells; dThd, adoptive transfer of LAK cells (3, 4). Patients had no preceding treat thymidine; p55, M, 55,000 protein; TIL, tumor-infiltrating lymphocytes. ments within 4 wk of study and had Karnofsky scores >70% at initiation 1160 Downloaded from cancerres.aacrjournals.org on September 27, 2021. © 1990 American Association for Cancer Research. IL-4 ENHANCEMENT OF PROLIFERATION AFTER IL-2 THERAPY of IL-2 therapy. All patients received systemic recombinant human of IL-2, which is normally used for LAK cell generation in IL-2 (Hoffman-LaRoche Inc., Nutley, NJ), with treatment cycles con clinical trials (1-3), was also studied. The results are shown in sisting of IL-2 administered by continuous i.v. infusion for 5 consecutive Table 1. IL-4 alone failed to induce proliferation and inhibited days. Seven patients received 1 to 4 treatment cycles of IL-2 (3 x IO6 IL-2-driven proliferation in PBMC from healthy controls (n = units/m2/day) (4, 5), and 10 patients received a single cycle of IL-2 at a higher dose (6 x IO6units/m2/day) (3). Blood samples were collected 7), as previously reported (16, 22, 31). By contrast, IL-4 induced proliferation in PBMC from 5 of 11 IL-2-treated patients. 1 to 3 days after termination of a treatment cycle, which corresponded Furthermore, rather than inhibit proliferation induced by IL-2, to the time of initial leukapheresis for ex vivo cell culture for LAK generation. Blood was collected from healthy controls on the day of IL-4 augmented proliferation induced by IL-2 (10 units/ml or assay. 1000 units/ml) in PBMC from 6 of 9 and 5 of 11 IL-2-treated Preparation of Human Blood Mononuclear Cells and T-Cells. PBMC patients, respectively. were isolated from heparinized peripheral blood by Ficoll-Hypaque Dependence of the Proliferative Effects of IL-4 upon Preacti density gradient separation. For purification of T-cells, PBMC were vation of Lymphocytes by IL-2 in Vivo or in Vitro. To determine adherence depleted of macrophages followed by resetting with 2-amino- whether the ability of IL-4 to augment IL-2-induced prolifera ethyl-isothiouronium bromide-treated sheep RBC (27).