Skip to main content
Top
Published in: Current Infectious Disease Reports 6/2010

01-11-2010

Challenges and Prospects of Adoptive Immunotherapy in Prevention and Treatment of Opportunistic Mycoses in Hematologic Transplant Recipients

Authors: Lars Tramsen, Stanislaw Schmidt, Frauke Roeger, Ulrike Koehl, Thomas Lehrnbecher

Published in: Current Infectious Disease Reports | Issue 6/2010

Login to get access

Abstract

Invasive fungal infections remain a serious and life-threatening complication in patients undergoing hematopoietic stem cell transplantation. Since it became clear that lymphocytes, in particular lymphocytes from the T helper 1 (TH1) subset, play a critical secondary defense against fungal pathogens, the adoptive transfer of functionally active antifungal TH1 cells might be an attractive option to restore adaptive antifungal immune effector mechanisms. Major advances have been made in the generation and characterization of antifungal T cells, which are active against medical important fungi such as Aspergillus spp and Candida spp. However, given the paucity of large homogenous patient populations, major challenges remain in evaluating the clinical usefulness of adoptive antifungal immunotherapy, which should be performed in international collaborative trials.
Literature
1.
go back to reference • Neofytos D, Horn D, Anaissie E, et al.: Epidemiology and outcome of invasive fungal infection in adult hematopoietic stem cell transplant recipients: analysis of Multicenter Prospective Antifungal Therapy (PATH) Alliance registry. Clin Infect Dis 2009, 48:265–273. This article reports one of the few larger studies on epidemiology and outcome of invasive fungal infections in transplant recipients.CrossRefPubMed • Neofytos D, Horn D, Anaissie E, et al.: Epidemiology and outcome of invasive fungal infection in adult hematopoietic stem cell transplant recipients: analysis of Multicenter Prospective Antifungal Therapy (PATH) Alliance registry. Clin Infect Dis 2009, 48:265–273. This article reports one of the few larger studies on epidemiology and outcome of invasive fungal infections in transplant recipients.CrossRefPubMed
2.
go back to reference •• De Pauw B, Walsh TJ, Donnelly JP, et al.: Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 2008, 46:1813–1821. This article presents the revised definitions of invasive fungal infections used in all major clinical trials.CrossRefPubMed •• De Pauw B, Walsh TJ, Donnelly JP, et al.: Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 2008, 46:1813–1821. This article presents the revised definitions of invasive fungal infections used in all major clinical trials.CrossRefPubMed
3.
go back to reference Pagano L, Caira M, Nosari A, et al.: Fungal infections in recipients of hematopoietic stem cell transplants: results of the SEIFEM B-2004 study—Sorveglianza Epidemiologica Infezioni Fungine Nelle Emopatie Maligne. Clin Infect Dis 2007, 45:1161–1170.CrossRefPubMed Pagano L, Caira M, Nosari A, et al.: Fungal infections in recipients of hematopoietic stem cell transplants: results of the SEIFEM B-2004 study—Sorveglianza Epidemiologica Infezioni Fungine Nelle Emopatie Maligne. Clin Infect Dis 2007, 45:1161–1170.CrossRefPubMed
4.
go back to reference Caillot D, Thiebaut A, Herbrecht R, et al.: Liposomal amphotericin B in combination with caspofungin for invasive aspergillosis in patients with hematologic malignancies: a randomized pilot study (Combistrat trial). Cancer 2007, 110:2740–2746.CrossRefPubMed Caillot D, Thiebaut A, Herbrecht R, et al.: Liposomal amphotericin B in combination with caspofungin for invasive aspergillosis in patients with hematologic malignancies: a randomized pilot study (Combistrat trial). Cancer 2007, 110:2740–2746.CrossRefPubMed
5.
go back to reference • Cornely OA, Maertens J, Bresnik M, et al.: Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin Infect Dis 2007, 44:1289–1297. This randomized study evaluates the benefit of high-dose liposomal amphotericin B.CrossRefPubMed • Cornely OA, Maertens J, Bresnik M, et al.: Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin Infect Dis 2007, 44:1289–1297. This randomized study evaluates the benefit of high-dose liposomal amphotericin B.CrossRefPubMed
6.
go back to reference Roilides E, Lyman CA, Panagopoulou P, Chanock S: Immunomodulation of invasive fungal infections. Infect Dis Clin North Am 2003, 17:193–219.CrossRefPubMed Roilides E, Lyman CA, Panagopoulou P, Chanock S: Immunomodulation of invasive fungal infections. Infect Dis Clin North Am 2003, 17:193–219.CrossRefPubMed
7.
go back to reference Safdar A, Rodriguez GH, Lichtiger B, et al.: Recombinant interferon gamma1b immune enhancement in 20 patients with hematologic malignancies and systemic opportunistic infections treated with donor granulocyte transfusions. Cancer 2006, 106:2664–2671.CrossRefPubMed Safdar A, Rodriguez GH, Lichtiger B, et al.: Recombinant interferon gamma1b immune enhancement in 20 patients with hematologic malignancies and systemic opportunistic infections treated with donor granulocyte transfusions. Cancer 2006, 106:2664–2671.CrossRefPubMed
9.
go back to reference Wald A, Leisenring W, van Burik JA, Bowden RA: Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation. J Infect Dis 1997, 175:1459–1466.CrossRefPubMed Wald A, Leisenring W, van Burik JA, Bowden RA: Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation. J Infect Dis 1997, 175:1459–1466.CrossRefPubMed
10.
go back to reference Beck O, Koehl U, Tramsen L, et al.: Enumeration of functionally active anti-Aspergillus T-cells in human peripheral blood. J Immunol Methods 2008, 335:41–45.CrossRefPubMed Beck O, Koehl U, Tramsen L, et al.: Enumeration of functionally active anti-Aspergillus T-cells in human peripheral blood. J Immunol Methods 2008, 335:41–45.CrossRefPubMed
11.
go back to reference Cenci E, Mencacci A, Bacci A, et al.: T cell vaccination in mice with invasive pulmonary aspergillosis. J Immunol 2000, 165:381–388.PubMed Cenci E, Mencacci A, Bacci A, et al.: T cell vaccination in mice with invasive pulmonary aspergillosis. J Immunol 2000, 165:381–388.PubMed
12.
go back to reference Hebart H, Bollinger C, Fisch P, et al.: Analysis of T-cell responses to Aspergillus fumigatus antigens in healthy individuals and patients with hematologic malignancies. Blood 2002, 100:4521–4528.CrossRefPubMed Hebart H, Bollinger C, Fisch P, et al.: Analysis of T-cell responses to Aspergillus fumigatus antigens in healthy individuals and patients with hematologic malignancies. Blood 2002, 100:4521–4528.CrossRefPubMed
13.
go back to reference Einsele H, Roosnek E, Rufer N, et al.: Infusion of cytomegalovirus (CMV)-specific T cells for the treatment of CMV infection not responding to antiviral chemotherapy. Blood 2002, 99:3916–3922.CrossRefPubMed Einsele H, Roosnek E, Rufer N, et al.: Infusion of cytomegalovirus (CMV)-specific T cells for the treatment of CMV infection not responding to antiviral chemotherapy. Blood 2002, 99:3916–3922.CrossRefPubMed
14.
go back to reference Feuchtinger T, Matthes-Martin S, Richard C, et al.: Safe adoptive transfer of virus-specific T-cell immunity for the treatment of systemic adenovirus infection after allogeneic stem cell transplantation. Br J Haematol 2006, 134:64–76.CrossRefPubMed Feuchtinger T, Matthes-Martin S, Richard C, et al.: Safe adoptive transfer of virus-specific T-cell immunity for the treatment of systemic adenovirus infection after allogeneic stem cell transplantation. Br J Haematol 2006, 134:64–76.CrossRefPubMed
15.
go back to reference Wagner HJ, Cheng YC, Huls MH, et al.: Prompt versus preemptive intervention for EBV lymphoproliferative disease. Blood 2004, 103:3979–3981.CrossRefPubMed Wagner HJ, Cheng YC, Huls MH, et al.: Prompt versus preemptive intervention for EBV lymphoproliferative disease. Blood 2004, 103:3979–3981.CrossRefPubMed
16.
go back to reference Beck O, Topp MS, Koehl U, et al.: Generation of highly purified and functionally active human TH1 cells against Aspergillus fumigatus. Blood 2006, 107:2562–2569.CrossRefPubMed Beck O, Topp MS, Koehl U, et al.: Generation of highly purified and functionally active human TH1 cells against Aspergillus fumigatus. Blood 2006, 107:2562–2569.CrossRefPubMed
17.
go back to reference Tramsen L, Beck O, Schuster FR, et al.: Generation and characterization of anti-Candida T cells as potential immunotherapy in patients with Candida infection after allogeneic hematopoietic stem-cell transplant. J Infect Dis 2007, 196:485–492.CrossRefPubMed Tramsen L, Beck O, Schuster FR, et al.: Generation and characterization of anti-Candida T cells as potential immunotherapy in patients with Candida infection after allogeneic hematopoietic stem-cell transplant. J Infect Dis 2007, 196:485–492.CrossRefPubMed
18.
go back to reference Appay V, Zaunders JJ, Papagno L, et al.: Characterization of CD4(+) CTLs ex vivo. J Immunol 2002, 168:5954–5958.PubMed Appay V, Zaunders JJ, Papagno L, et al.: Characterization of CD4(+) CTLs ex vivo. J Immunol 2002, 168:5954–5958.PubMed
19.
go back to reference Ramadan G, Konings S, Kurup VP, Keever-Taylor CA: Generation of Aspergillus- and CMV- specific T-cell responses using autologous fast DC. Cytotherapy 2004, 6:223–234.CrossRefPubMed Ramadan G, Konings S, Kurup VP, Keever-Taylor CA: Generation of Aspergillus- and CMV- specific T-cell responses using autologous fast DC. Cytotherapy 2004, 6:223–234.CrossRefPubMed
20.
go back to reference •• Tramsen L, Koehl U, Tonn T, et al.: Clinical-scale generation of human anti-Aspergillus T cells for adoptive immunotherapy. Bone Marrow Transplant 2009, 43:13–19. This paper describes for the first time a method for the clinical-scale generation of antifungal T cells.CrossRefPubMed •• Tramsen L, Koehl U, Tonn T, et al.: Clinical-scale generation of human anti-Aspergillus T cells for adoptive immunotherapy. Bone Marrow Transplant 2009, 43:13–19. This paper describes for the first time a method for the clinical-scale generation of antifungal T cells.CrossRefPubMed
21.
go back to reference Latge JP: Aspergillus fumigatus and aspergillosis. Clin Microbiol Rev 1999, 12:310–350.PubMed Latge JP: Aspergillus fumigatus and aspergillosis. Clin Microbiol Rev 1999, 12:310–350.PubMed
22.
go back to reference •• Bozza S, Clavaud C, Giovannini G, et al.: Immune sensing of Aspergillus fumigatus proteins, glycolipids, and polysaccharides and the impact on Th immunity and vaccination. J Immunol 2009, 183:2407–2014. This study analyzes the cellular host response to various recombinant Aspergillus antigens.CrossRefPubMed •• Bozza S, Clavaud C, Giovannini G, et al.: Immune sensing of Aspergillus fumigatus proteins, glycolipids, and polysaccharides and the impact on Th immunity and vaccination. J Immunol 2009, 183:2407–2014. This study analyzes the cellular host response to various recombinant Aspergillus antigens.CrossRefPubMed
23.
go back to reference Hanley PJ, Cruz CR, Savoldo B, et al.: Functionally active virus-specific T cells that target CMV, adenovirus, and EBV can be expanded from naive T-cell populations in cord blood and will target a range of viral epitopes. Blood 2009, 114:1958–1967.CrossRefPubMed Hanley PJ, Cruz CR, Savoldo B, et al.: Functionally active virus-specific T cells that target CMV, adenovirus, and EBV can be expanded from naive T-cell populations in cord blood and will target a range of viral epitopes. Blood 2009, 114:1958–1967.CrossRefPubMed
24.
go back to reference Sun Y, Tawara I, Toubai T, Reddy P: Pathophysiology of acute graft-versus-host disease: recent advances. Transl Res 2007, 150:197–214.CrossRefPubMed Sun Y, Tawara I, Toubai T, Reddy P: Pathophysiology of acute graft-versus-host disease: recent advances. Transl Res 2007, 150:197–214.CrossRefPubMed
25.
go back to reference Rauser G, Einsele H, Sinzger C, et al.: Rapid generation of combined CMV-specific CD4+ and CD8+ T-cell lines for adoptive transfer into recipients of allogeneic stem cell transplants. Blood 2004, 103:3565–3572.CrossRefPubMed Rauser G, Einsele H, Sinzger C, et al.: Rapid generation of combined CMV-specific CD4+ and CD8+ T-cell lines for adoptive transfer into recipients of allogeneic stem cell transplants. Blood 2004, 103:3565–3572.CrossRefPubMed
26.
go back to reference Perruccio K, Tosti A, Burchielli E, et al.: Transferring functional immune responses to pathogens after haploidentical hematopoietic transplantation. Blood 2005, 106:4397–4406.CrossRefPubMed Perruccio K, Tosti A, Burchielli E, et al.: Transferring functional immune responses to pathogens after haploidentical hematopoietic transplantation. Blood 2005, 106:4397–4406.CrossRefPubMed
27.
go back to reference Leen AM, Christin A, Myers GD, et al.: Cytotoxic T lymphocyte therapy with donor T cells prevents and treats adenovirus and Epstein-Barr virus infections after haploidentical and matched unrelated stem cell transplantation. Blood 2009, 114:4283–4292.CrossRefPubMed Leen AM, Christin A, Myers GD, et al.: Cytotoxic T lymphocyte therapy with donor T cells prevents and treats adenovirus and Epstein-Barr virus infections after haploidentical and matched unrelated stem cell transplantation. Blood 2009, 114:4283–4292.CrossRefPubMed
28.
go back to reference Bollard CM, Aguilar L, Straathof KC, et al.: Cytotoxic T lymphocyte therapy for Epstein-Barr virus+ Hodgkin’s disease. J Exp Med 2004, 200:1623–1633.CrossRefPubMed Bollard CM, Aguilar L, Straathof KC, et al.: Cytotoxic T lymphocyte therapy for Epstein-Barr virus+ Hodgkin’s disease. J Exp Med 2004, 200:1623–1633.CrossRefPubMed
29.
go back to reference Tiberghien P, Ferrand C, Lioure B, et al.: Administration of herpes simplex-thymidine kinase-expressing donor T cells with a T-cell-depleted allogeneic marrow graft. Blood 2001, 97:63–72.CrossRefPubMed Tiberghien P, Ferrand C, Lioure B, et al.: Administration of herpes simplex-thymidine kinase-expressing donor T cells with a T-cell-depleted allogeneic marrow graft. Blood 2001, 97:63–72.CrossRefPubMed
30.
go back to reference Passweg JR, Koehl U, Uharek L, et al.: Natural-killer-cell-based treatment in haematopoietic stem-cell transplantation. Best Pract Res Clin Haematol 2006, 19:811–824.CrossRefPubMed Passweg JR, Koehl U, Uharek L, et al.: Natural-killer-cell-based treatment in haematopoietic stem-cell transplantation. Best Pract Res Clin Haematol 2006, 19:811–824.CrossRefPubMed
31.
go back to reference Gill S, Olson JA, Negrin RS: Natural killer cells in allogeneic transplantation: effect on engraftment, graft- versus-tumor, and graft-versus-host responses. Biol Blood Marrow Transplant 2009, 15:765–776.CrossRefPubMed Gill S, Olson JA, Negrin RS: Natural killer cells in allogeneic transplantation: effect on engraftment, graft- versus-tumor, and graft-versus-host responses. Biol Blood Marrow Transplant 2009, 15:765–776.CrossRefPubMed
32.
go back to reference Ruggeri L, Mancusi A, Capanni M, et al.: Donor natural killer cell allorecognition of missing self in haploidentical hematopoietic transplantation for acute myeloid leukemia: challenging its predictive value. Blood 2007, 110:433–440.CrossRefPubMed Ruggeri L, Mancusi A, Capanni M, et al.: Donor natural killer cell allorecognition of missing self in haploidentical hematopoietic transplantation for acute myeloid leukemia: challenging its predictive value. Blood 2007, 110:433–440.CrossRefPubMed
33.
go back to reference Newman KC, Riley EM: Whatever turns you on: accessory-cell-dependent activation of NK cells by pathogens. Nat Rev Immunol 2007, 7:279–291.CrossRefPubMed Newman KC, Riley EM: Whatever turns you on: accessory-cell-dependent activation of NK cells by pathogens. Nat Rev Immunol 2007, 7:279–291.CrossRefPubMed
34.
go back to reference Morrison BE, Park SJ, Mooney JM, Mehrad B: Chemokine-mediated recruitment of NK cells is a critical host defense mechanism in invasive aspergillosis. J Clin Invest 2003, 112:1862–1870.PubMed Morrison BE, Park SJ, Mooney JM, Mehrad B: Chemokine-mediated recruitment of NK cells is a critical host defense mechanism in invasive aspergillosis. J Clin Invest 2003, 112:1862–1870.PubMed
35.
go back to reference Park SJ, Hughes MA, Burdick M, et al.: Early NK cell-derived IFN-{gamma} is essential to host defense in neutropenic invasive aspergillosis. J Immunol 2009, 182:4306–4312.CrossRefPubMed Park SJ, Hughes MA, Burdick M, et al.: Early NK cell-derived IFN-{gamma} is essential to host defense in neutropenic invasive aspergillosis. J Immunol 2009, 182:4306–4312.CrossRefPubMed
Metadata
Title
Challenges and Prospects of Adoptive Immunotherapy in Prevention and Treatment of Opportunistic Mycoses in Hematologic Transplant Recipients
Authors
Lars Tramsen
Stanislaw Schmidt
Frauke Roeger
Ulrike Koehl
Thomas Lehrnbecher
Publication date
01-11-2010
Publisher
Current Science Inc.
Published in
Current Infectious Disease Reports / Issue 6/2010
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-010-0130-3

Other articles of this Issue 6/2010

Current Infectious Disease Reports 6/2010 Go to the issue