Cancer immunotherapy aims to use and manipulate the host’s immune system to fight against cancer. The objective of this strategy is to induce specific and persistent immune responses leading to tumor eradication. Heat shock proteins (HSP) purified from cancer tissues have been identified as unique mediators of specific anti-tumor immunity. In our laboratory, we have developed an original vaccine, termed CRCL (Chaperone-Rich Cell Lysate) that consists of multiple HSP complexes enriched from tumor lysates. CRCL immunization leads to an efficient protection against a wide variety of murine cancers by inducing a strong, long-lasting, and specific T and NK-cell dependent immune responses against the tumor from which it has been generated. Tumor-derived CRCL has been shown to be more efficient in triggering DC activation than individual purified HSP or tumor lysates. The immunostimulatory effects of CRCL arise from its superior ability to provide a wide variety of tumor antigens to the immune system and by providing potent adjuvant effects. However, CD4⁺CD25⁺ regulatory T lymphocytes (Treg) critically contribute to the mechanisms of cancer-induced suppression. Data from independent groups including ours suggests they may also restrain the function of antigen presenting cells. The current study was designed to elucidate the molecular signaling events triggered by the tumor-derived CRCL vaccine in antigen presenting cells and evaluate whether CRCL may overcome the inhibitory effects of Treg modulation of DC and macrophage activation. Our results indicate CRCL activates DC and macrophages by inducing proinflammatory cytokine chemokine secretion. CRCL induces iNOS expression and NO production in macrophages. CRCL activation of DC and macrophages results in transcription factor NF-κB activation in vitro and in vivo, and this includes the activation of additional signaling molecules upstream of NF-κB. Following CRCL treatment the phenotypic maturation of DC, the production of DC and macrophage pro-inflammatory cytokines, and the activation of the transcription factor NF-κB are not affected by Treg. Additionally, CRCL induced activation of DC is not diminished by the immunosuppressive cytokine TGF-β 1. Our results indicate tumor-derived CRCL-treated DC and macrophages are refractory to Treg inhibition. These results are important for advancing CRCL-based vaccines in Phase I clinical trials.

HER2/neu is an oncogenic tumor-associated antigen over-expressed in several human tumors including breast and ovarian cancer. The selective expression of HER2/neu and its role in epithelial carcinogenesis makes HER2/neu an ideal target for immunotherapy. Tumor-derived chaperone-rich cell lysate (CRCL), containing numerous heat shock proteins, has successfully been used to generate tumor-specific immunity against a wide range of murine tumors and is a great candidate for an effective vaccine against HER2/neu positive tumors. In the first part of this study, the potency of human ovarian cancer-derived CRCL to activate dendritic cells (DCs) and to generate tumor-specific T cells in vitro has been investigated. Chaperone-rich cell lysate was generated from primary ovarian cancer tissues and SKOV3-A2, a HER2/neu, Wilm's tumor gene 1 (WT1) and HLA-A2 positive human ovarian tumor cell line. T cells from healthy donors and from ovarian cancer patients secreted higher amounts of interferon-γ following in vitro re-stimulation with ovarian cancer-derived CRCL compared to HER2/neu or WT1 peptide-pulsed DCs. We were also able to generate cytotoxic T lymphocyte activity against cancer-specific antigens such as HER2/neu and WT1 from all healthy donors, but from only one of the four ovarian cancer patients with bulky disease. In the second part of the study, the potency of tumor-derived CRCL to elicit the humoral immune response against a murine HER2/neu positive tumor (TUBO) has been examined. Vaccination of mice bearing a palpable tumor efficiently delayed the development of the tumor. In the vaccinated mice, CRCL vaccination induced significant anti-HER2/neu antibodies. Using B cell deficient mice and antibody transfer experiments, we have shown that the induction of anti-HER2/neu antibodies is both necessary and sufficient for the anti-tumor effect. Further, we have demonstrated that serum from TUB0 CRCL-vaccinated mice stimulated the internalization of the HER2/neu molecules, resulting in the down-regulation of their surface expression. Moreover, antibody-dependent cellular cytotoxicity has been observed against TUBO cells when presented with sera from vaccinated mice. These results indicate that CRCL may be a potent adjuvant for women suffering from HER2/neu positive ovarian or breast cancer and that this personalized vaccine may be a promising approach for active immunotherapy.

Chronic myelogenous leukemia (CML) is a clonal hematopoetic stem cell disorder characterized by proliferation of cells expressing BCR-ABL fusion protein. In the BCR-ABL+ leukemia murine model, 12B1, we explored the therapeutic applicability of chaperone-rich cell lysate (CRCL) in the context of syngeneic hematopoietic cell transplantation (HCT) to treat pre-existing leukemia. Our results demonstrate that tumor growth is significantly delayed in mice receiving syngeneic HCT from 12B1 tumor CRCL immunized donors compared to animals receiving HCT from non-immunized donors. CRCL immunization post-immune HCT further hindered tumor growth when compared to immune HCT without post-transplant vaccination. The magnitude of the immune response was consistent with the anti-tumor effects observed in vivo. We also demonstrated that cured mice had developed long-term tumor specific immunity against 12B1 tumor cells. In addition, we documented that both T cells and NK cells contributed to the anti-tumor effect of CRCL vaccination as depletion of either subset hampered tumor growth delay. Thus, our results suggest that CRCL represents a promising vaccine capable of generating specific immune responses. This anti-tumor immunity can be effectively transferred to a host via HCT and further enhanced post-HCT with additional tumor CRCL immunizations.CD4+CD25+ regulatory T cells (Treg) play a central role in the prevention of autoimmunity and in the control of immune responses by down-regulating the function of effector CD4+ or CD8+ T cells. The role of Treg in Mycobacterium tuberculosis infection and persistence is inadequately documented. Therefore, the current study was designed to determine whether CD4+CD25+ FoxP3+ regulatory T cells may modulate immunity against human tuberculosis (TB). Ourresults indicate that the number of CD4+CD25+FoxP3+ Treg increases in the blood or at the site of infection in active TB patients. The frequency of CD4+CD25+FoxP3+ Treg in pleural fluid inversely correlates with local MTB-specific immunity(p<0.002). These CD4+CD25+FoxP3+ T lymphocytes isolated from the blood and pleural fluid are capable of suppressing MTB-specific IFN-γ and IL-10 production in TB patients. Therefore, CD4+CD25+FoxP3+ Treg expanded in TB patients suppress Mycobacterium tuberculosis immunity and may therefore contribute to the pathogenesis of human TB.