1 5912 144 TARGETED THERAPIES IN SYSTEMIC LUPUS ERYTHEMATOSUS. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IS A CHRONIC, MULTISYSTEM DISORDER CHARACTERISED BY LOSS OF TOLERANCE TO ENDOGENOUS NUCLEAR ANTIGENS AND AUTOANTIBODY FORMATION. RECENT INSIGHT INTO THE IMMUNOPATHOGENESIS OF LUPUS HAS PROVIDED THE FOUNDATION FOR A NOVEL CLASS OF AGENTS WHICH TARGET SPECIFIC, DYSREGULATED COMPONENTS OF THE IMMUNE SYSTEM. EFFORTS HAVE FOCUSED PREDOMINANTLY ON B-CELL DEPLETING THERAPIES, OF WHICH BELIMUMAB WAS THE FIRST TO DEMONSTRATE SUCCESS IN PHASE III STUDIES AND THUS RECEIVE MARKETING AUTHORISATION. OFF-LABEL PRESCRIBING OF RITUXIMAB IN REFRACTORY CASES IS COMMON AND SUPPORTED BY UNCONTROLLED STUDIES, WHICH SUGGEST A FAVOURABLE RISK:BENEFIT PROFILE. HOWEVER, TWO PLACEBO-CONTROLLED TRIALS FAILED TO SHOW BENEFIT, POSSIBLY BECAUSE OF INAPPROPRIATE PATIENT SELECTION AND OTHER ASPECTS OF TRIAL METHODOLOGY. INHIBITION OF DYSREGULATED CO-STIMULATORY SIGNALS AND CYTOKINES ARE OTHER THERAPEUTIC STRATEGIES CURRENTLY UNDER INVESTIGATION. SOME CANDIDATE DRUGS FAILED TO MEET PRIMARY ENDPOINTS IN EARLY-PHASE CLINICAL TRIALS, YET DEMONSTRATED CLINICAL BENEFIT WHEN ALTERNATIVE ASSESSMENT CRITERIA WERE APPLIED OR SPECIFIC PATIENT SUB-GROUPS ANALYSED. WELL-DESIGNED STUDIES OF GREATER SIZE AND DURATION ARE NEEDED TO CLARIFY THE THERAPEUTIC UTILITY OF THESE AGENTS. FUTURE IMMUNOMODULATORY STRATEGIES TARGETING INTERFERON-ALPHA, T CELLS, OXIDATIVE STRESS AND EPIGENETIC ABNORMALITIES MAY REDUCE MULTISYSTEM DISEASE ACTIVITY AND PROLONG SURVIVAL IN THIS COMPLEX AND HETEROGENEIC DISEASE. 2013 2 6857 39 [NOVEL CONVENTIONAL THERAPIES IN ONCO-HEMATHOLOGY]. CYTOGENETIC, MOLECULAR AND PHENOTYPING FEATURES OF MALIGNANT HEMATOLOGIC DISEASES SUCCEEDED IN IMPROVING THEIR MANAGEMENT BY A MORE ACCURATE STRATIFICATION OF PATIENTS ACCORDING TO SEVERAL GROUPS OF RISK AND BY PROVIDING A RATIONAL FOR TARGETED THERAPY. THREE MAJOR TYPES OF TREATMENT (EXCLUDING CELLULAR THERAPY) ARE CURRENTLY AVAILABLE IN ONCO-HEMATOLOGY: CONVENTIONAL CHEMOTHERAPY, SMALL MOLECULES FOR TARGETED THERAPY AND MONOCLONAL ANTIBODIES. CONVENTIONAL CHEMOTHERAPY WITH OPTIMIZATION OF DOSES AND MULTIDRUG-BASED REGIMENS ALLOWED TO SUBSTANTIALLY IMPROVE SURVIVAL OF PATIENTS AND KEEPS A PLACE OF CHOICE IN TREATMENT OF THESE DISEASES. TARGETED TREATMENTS CAME FROM THE CYTOGENETIC AND MOLECULAR CHARACTERIZATION OF HEMOPATHIES. THUS, THE KINASE BCR-ABL, AS A RESULT OF THE TRANSLOCATION T(9;22)(Q34;Q11), HAS BEEN SUCCESSFULLY TARGETED BY TYROSINE KINASE INHIBITORS (TKI) IN CHRONIC MYELOID LEUKEMIA AND PH+ ACUTE LYMPHOBLASTIC LEUKEMIA. MOLECULAR ABNORMALITIES LIKE INTERNAL-TANDEM DUPLICATION/POINT ACTIVATING MUTATIONS IN FLT3 IN SOME ACUTE MYELOBLASTIC LEUKEMIA OR EPIGENETIC DYSREGULATIONS IN SOME BLOOD MALIGNANCIES CAN ALSO BE TARGETED BY SMALL MOLECULES. HEMATOPOIETIC MALIGNANT CELLS ARE PHENOTYPICALLY CHARACTERIZED BY EXPRESSION OF CLUSTER OF DIFFERENTIATION (CD) ON THEIR SURFACE. THESE CD ARE DETECTED BY FLOW CYTOMETRY USING SPECIFIC ANTIBODIES. MONOCLONAL ANTIBODIES TARGETING DIFFERENT CD HAVE BEEN DEVELOPED FOR TREATMENT. RITUXIMAB, AN ANTI-CD20 ANTIBODY, WAS THE FIRST MONOCLONAL ANTIBODY SUCCESSFULLY DEVELOPED FOR TREATMENT OF MALIGNANT HEMATOLOGIC DISEASES. SINCE RITUXIMAB, MANY OTHER MONOCLONAL ANTIBODIES ARE BEING DEVELOPED. TRENDS IN MALIGNANT HEMATOLOGIC DISEASES PRESENTED HERE WILL INCLUDE TREATMENTS, WHICH HAVE AT LEAST ENTERED PHASE I/II CLINICAL TRIALS IN ADULT OR CHILDHOOD LEUKEMIA. THEY INCLUDE SOME NOVEL DRUGS OF CONVENTIONAL CHEMOTHERAPY LIKE SECOND-GENERATION NUCLEOSIDE ANALOGUES. WE WILL GIVE AN OVERVIEW OF THE SMALL MOLECULES TARGETING THE DIFFERENT CELLULAR PATHWAYS AND WE WILL HIGHLIGHT THOSE APPEARING AS THE MOST PROMISING LIKE NOVEL TKIS. THE LARGE FIELD OF MONOCLONAL ANTIBODIES WILL BE ALSO APPROACHED FOCUSING ON ANTIBODIES DEVELOPED IN LEUKEMIAS. 2011 3 4964 34 PATHOGENETIC AND CLINICAL ASPECTS OF ANTI-NEUTROPHIL CYTOPLASMIC AUTOANTIBODY-ASSOCIATED VASCULITIDES. ANTI-NEUTROPHIL CYTOPLASMIC AUTOANTIBODIES (ANCA) TARGETING PROTEINASE 3 (PR3) AND MYELOPEROXIDASE EXPRESSED BY INNATE IMMUNE CELLS (NEUTROPHILS AND MONOCYTES) ARE SALIENT DIAGNOSTIC AND PATHOGENIC FEATURES OF SMALL VESSEL VASCULITIS, COMPRISING GRANULOMATOSIS WITH POLYANGIITIS (GPA), MICROSCOPIC POLYANGIITIS, AND EOSINOPHILIC GPA. GENETIC STUDIES SUGGEST THAT ANCA-ASSOCIATED VASCULITIDES (AAV) CONSTITUTE SEPARATE DISEASES, WHICH SHARE COMMON IMMUNOLOGICAL AND PATHOLOGICAL FEATURES, BUT ARE OTHERWISE HETEROGENEOUS. THE SUCCESSFUL THERAPEUTIC USE OF ANTI-CD20 ANTIBODIES EMPHASIZES THE PROMINENT ROLE OF ANCA AND POSSIBLY OTHER AUTOANTIBODIES IN THE PATHOGENESIS OF AAV. HOWEVER, TO ELUCIDATE CAUSAL EFFECTS IN AAV, A BETTER UNDERSTANDING OF THE COMPLEX INTERPLAY LEADING TO THE EMERGENCE OF B LYMPHOCYTES THAT PRODUCE PATHOGENIC ANCA REMAINS A CHALLENGE. DIFFERENT SCENARIOS SEEM POSSIBLE; E.G., THE BREAK OF TOLERANCE INDUCED BY A SHIFT FROM NON-PATHOGENIC TOWARD PATHOGENIC AUTOANTIGEN EPITOPES IN INFLAMED TISSUE. THIS REVIEW GIVES A BRIEF OVERVIEW ON CURRENT KNOWLEDGE ABOUT GENETIC AND EPIGENETIC FACTORS, BARRIER DYSFUNCTION AND CHRONIC NON-RESOLVING INFLAMMATION, NECRO-INFLAMMATORY AUTO-AMPLIFICATION OF CELLULAR DEATH AND INFLAMMATION, ALTERED AUTOANTIGEN PRESENTATION, ALTERNATIVE COMPLEMENT PATHWAY ACTIVATION, ALTERATIONS WITHIN PERIPHERAL AND INFLAMED TISSUE-RESIDING T- AND B-CELL POPULATIONS, ECTOPIC LYMPHOID TISSUE NEOFORMATION, THE CHARACTERIZATION OF PR3-SPECIFIC T-CELLS, PROPERTIES OF ANCA, LINKS BETWEEN AUTOIMMUNE DISEASE AND INFECTION-TRIGGERED PATHOLOGY, AND ANIMAL MODELS IN AAV. 2018 4 1033 27 CITRULLINATION OF AUTOANTIGENS IMPLICATES NETOSIS IN THE INDUCTION OF AUTOIMMUNITY. TOLERANCE BLOCKS THE EXPRESSION OF AUTOANTIBODIES, WHEREAS AUTOIMMUNITY PROMOTES IT. HOW TOLERANCE BREAKS AND AUTOANTIBODY PRODUCTION BEGINS THUS ARE CRUCIAL QUESTIONS FOR UNDERSTANDING AND TREATMENT OF AUTOIMMUNE DISEASES. EVIDENCE IMPLICATES CELL DEATH AND AUTOANTIGEN MODIFICATIONS IN THE INITIATION OF AUTOIMMUNE REACTIONS. ONE FORM OF NEUTROPHIL CELL DEATH CALLED NETOSIS DESERVES ATTENTION BECAUSE IT REQUIRES THE POST-TRANSLATIONAL MODIFICATION OF HISTONES AND RESULTS IN THE EXTRACELLULAR RELEASE OF CHROMATIN. NETOSIS RECEIVED ITS NAME FROM NET, THE ACRONYM GIVEN TO NEUTROPHIL EXTRACELLULAR TRAP. THE EXTRACELLULAR CHROMATIN INCORPORATES HISTONES IN WHICH ARGININES HAVE BEEN CONVERTED TO CITRULLINES BY PEPTIDYLARGININE DEIMINASE IV (PAD4). THE DEIMINATED CHROMATIN MAY FUNCTION TO CAPTURE OR 'TRAP' BACTERIAL PATHOGENS, THUS GENERATING AN EXTRACELLULAR COMPLEX OF DEIMINATED HISTONES AND BACTERIAL CELL ADJUVANTS. THE COMPLEX OF BACTERIAL ANTIGENS AND DEIMINATED CHROMATIN MAY BE INTERNALISED BY HOST PHAGOCYTES DURING ACUTE INFLAMMATORY CONDITIONS, AS ARISE DURING BACTERIAL INFECTIONS OR CHRONIC AUTOINFLAMMATORY DISORDERS. THE UPTAKE AND PROCESSING OF DEIMINATED CHROMATIN TOGETHER WITH BACTERIAL ADJUVANTS BY PHAGOCYTES MAY INDUCE THE PRESENTATION OF MODIFIED HISTONE EPITOPES AND CO-STIMULATION, THUS YIELDING A POWERFUL STIMULUS TO BREAK TOLERANCE. AUTOANTIBODIES TO DEIMINATED HISTONES ARE PREVALENT IN FELTY'S SYNDROME PATIENTS AND ARE PRESENT IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND PATIENTS WITH RHEUMATOID ARTHRITIS (RA). THESE OBSERVATIONS CLEARLY IMPLICATE HISTONE DEIMINATION AS AN EPIGENETIC MARK THAT CAN ACT AS AN AUTOANTIBODY STIMULANT. 2014 5 6117 31 THE EPIGENETIC DRUG TRICHOSTATIN A AMELIORATES EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS VIA T CELL TOLERANCE INDUCTION AND IMPAIRED INFLUX OF T CELLS INTO THE SPINAL CORD. MULTIPLE SCLEROSIS IS A T CELL MEDIATED CHRONIC DEMYELINATING DISEASE OF THE CENTRAL NERVOUS SYSTEM. ALTHOUGH CURRENTLY AVAILABLE THERAPIES REDUCE RELAPSES, THEY DO NOT FACILITATE TOLERIZATION OF MYELIN ANTIGEN-SPECIFIC T LYMPHOCYTES TO ENSURE PROLONGED PROTECTION AGAINST MULTIPLE SCLEROSIS. HERE, WE SHOW THAT TREATMENT OF NOD MICE WITH THE HISTONE DEACETYLASE INHIBITOR, TRICHOSTATIN A AFFORDS ROBUST PROTECTION AGAINST MYELIN PEPTIDE INDUCED EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS, A MOUSE MODEL OF MULTIPLE SCLEROSIS. PROTECTION WAS ACCOMPANIED BY HISTONE HYPERACETYLATION, AND REDUCED INFLAMMATION AND AXONAL DAMAGE IN THE SPINAL CORD. DRUG TREATMENT DIMINISHED THE GENERATION OF CD4(+) MEMORY T CELLS AND INDUCED TOLERANCE IN CD4(+) T CELLS RECOGNIZING THE IMMUNIZING MYELIN PEPTIDE. DURING THE EARLY IMMUNIZATION PERIOD, CD4(+) T CELLS PRODUCING GM-CSF+IFN-GAMMA, GM-CSF+IL-17A, AS WELL AS THOSE EXPRESSING BOTH IL-17A+IFN-GAMMA (DOUBLE-PRODUCERS) WERE DETECTED IN THE SECONDARY LYMPHOID ORGANS FOLLOWED BY THE APPEARANCE OF CELLS PRODUCING IFN-GAMMA AND GM-CSF. ON THE OTHER HAND, IFN-GAMMA PRODUCING TH1 CELLS APPEAR FIRST IN THE SPINAL CORD FOLLOWED BY CELLS PRODUCING IL-17A AND GM-CSF. TREATMENT WITH TRICHOSTATIN A SUBSTANTIALLY REDUCED THE FREQUENCIES OF ALL T CELLS SECRETING VARIOUS LYMPHOKINES BOTH IN THE PERIPHERY AND IN THE SPINAL CORD. THESE DATA INDICATE THAT EPIGENETIC MODIFICATIONS INDUCED BY HISTONE HYPERACETYLATION FACILITATES T CELL TOLERANCE INDUCTION IN THE PERIPHERY LEADING TO REDUCED MIGRATION OF T CELLS TO THE SPINAL CORD AND MITIGATION OF NEURONAL DAMAGE AND IMPROVED CLINICAL OUTCOME. THESE RESULTS SUGGEST THAT EPIGENETIC MODULATION OF THE GENOME MAY SIMILARLY OFFER BENEFITS TO MULTIPLE SCLEROSIS PATIENTS VIA ABROGATING THE FUNCTION OF ENCEPHALITOGENIC T LYMPHOCYTES WITHOUT EXERTING SEVERE SIDE EFFECTS ASSOCIATED WITH CURRENTLY USED DISEASE-MODIFYING THERAPIES. 2017 6 3323 28 HISTONE DEACETYLASE 1 (HDAC1): A KEY PLAYER OF T CELL-MEDIATED ARTHRITIS. RHEUMATOID ARTHRITIS (RA) REPRESENTS A CHRONIC T CELL-MEDIATED INFLAMMATORY AUTOIMMUNE DISEASE. STUDIES HAVE SHOWN THAT EPIGENETIC MECHANISMS CONTRIBUTE TO THE PATHOGENESIS OF RA. HISTONE DEACETYLASES (HDACS) REPRESENT ONE IMPORTANT GROUP OF EPIGENETIC REGULATORS. HOWEVER, THE ROLE OF INDIVIDUAL HDAC MEMBERS FOR THE PATHOGENESIS OF ARTHRITIS IS STILL UNKNOWN. IN THIS STUDY WE DEMONSTRATE THAT MICE WITH A T CELL-SPECIFIC DELETION OF HDAC1 (HDAC1-CKO) ARE RESISTANT TO THE DEVELOPMENT OF COLLAGEN-INDUCED ARTHRITIS (CIA), WHEREAS THE ANTIBODY RESPONSE TO COLLAGEN TYPE II WAS UNDISTURBED, INDICATING AN UNALTERED T CELL-MEDIATED B CELL ACTIVATION. THE INFLAMMATORY CYTOKINES IL-17 AND IL-6 WERE SIGNIFICANTLY DECREASED IN SERA OF HDAC1-CKO MICE. IL-6 TREATED HDAC1-DEFICIENT CD4(+) T CELLS SHOWED AN IMPAIRED UPREGULATION OF CCR6. SELECTIVE INHIBITION OF CLASS I HDACS WITH THE HDAC INHIBITOR MS-275 UNDER TH17-SKEWING CONDITIONS INHIBITED THE UPREGULATION OF CHEMOKINE RECEPTOR 6 (CCR6) IN MOUSE AND HUMAN CD4(+) T CELLS. ACCORDINGLY, ANALYSIS OF HUMAN RNA-SEQUENCING (RNA-SEQ) DATA AND HISTOLOGICAL ANALYSIS OF SYNOVIAL TISSUE SAMPLES FROM HUMAN RA PATIENTS REVEALED THE EXISTENCE OF CD4(+)CCR6(+) CELLS WITH ENHANCED HDAC1 EXPRESSION. OUR DATA INDICATE A KEY ROLE FOR HDAC1 FOR THE PATHOGENESIS OF CIA AND SUGGEST THAT HDAC1 AND OTHER CLASS I HDACS MIGHT BE PROMISING TARGETS OF SELECTIVE HDAC INHIBITORS (HDACI) FOR THE TREATMENT OF RA. 2020 7 5897 21 T FOLLICULAR HELPER CELL-DEPENDENT CLEARANCE OF A PERSISTENT VIRUS INFECTION REQUIRES T CELL EXPRESSION OF THE HISTONE DEMETHYLASE UTX. EPIGENETIC CHANGES, INCLUDING HISTONE METHYLATION, CONTROL T CELL DIFFERENTIATION AND MEMORY FORMATION, THOUGH THE ENZYMES THAT MEDIATE THESE PROCESSES ARE NOT CLEAR. WE SHOW THAT UTX, A HISTONE H3 LYSINE 27 (H3K27) DEMETHYLASE, SUPPORTS T FOLLICULAR HELPER (TFH) CELL RESPONSES THAT ARE ESSENTIAL FOR B CELL ANTIBODY GENERATION AND THE RESOLUTION OF CHRONIC VIRAL INFECTIONS. MICE WITH A T CELL-SPECIFIC UTX DELETION HAD FEWER TFH CELLS, REDUCED GERMINAL CENTER RESPONSES, LACKED VIRUS-SPECIFIC IMMUNOGLOBULIN G (IGG), AND WERE UNABLE TO RESOLVE CHRONIC LYMPHOCYTIC CHORIOMENINGITIS VIRUS INFECTIONS. UTX-DEFICIENT T CELLS SHOWED DECREASED EXPRESSION OF INTERLEUKIN-6 RECEPTOR-ALPHA AND OTHER TFH CELL-RELATED GENES THAT WERE ASSOCIATED WITH INCREASED H3K27 METHYLATION. ADDITIONALLY, TURNER SYNDROME SUBJECTS, WHO ARE PREDISPOSED TO CHRONIC EAR INFECTIONS, HAD REDUCED UTX EXPRESSION IN IMMUNE CELLS AND DECREASED CIRCULATING CD4(+) CXCR5(+) T CELL FREQUENCY. THUS, WE IDENTIFY A CRITICAL LINK BETWEEN UTX IN T CELLS AND IMMUNITY TO INFECTION. 2015 8 3510 32 IDENTIFYING NOVEL B-CELL TARGETS FOR CHRONIC INFLAMMATORY AUTOIMMUNE DISEASE BY SCREENING OF CHEMICAL PROBES IN A PATIENT-DERIVED CELL ASSAY. B-CELL SECRETION OF AUTOANTIBODIES DRIVES AUTOIMMUNE DISEASES, INCLUDING SYSTEMIC LUPUS ERYTHEMATOSUS AND IDIOPATHIC INFLAMMATORY MYOSITIS. FEW THERAPIES ARE PRESENTLY AVAILABLE FOR TREATMENT OF THESE PATIENTS, OFTEN RESULTING IN UNSATISFACTORY EFFECTS AND HELPING ONLY SOME OF THE PATIENTS. WE DEVELOPED A SCREENING ASSAY FOR EVALUATION OF NOVEL TARGETS SUSPENDING B-CELL MATURATION INTO ANTIBODY SECRETING CELLS, WHICH COULD CONTRIBUTE TO FUTURE DRUG DEVELOPMENT. THE ASSAY WAS EMPLOYED FOR TESTING 43 HIGH QUALITY CHEMICAL PROBES AND COMPOUNDS INHIBITING UNDER-EXPLORED PROTEIN TARGETS, USING PRIMARY CELLS FROM PATIENTS WITH AUTOIMMUNE DISEASE. PROBES INHIBITING BROMODOMAIN FAMILY PROTEINS AND HISTONE METHYL TRANSFERASES DEMONSTRATED ABROGATION OF B-CELL FUNCTIONS TO A DEGREE COMPARABLE TO A POSITIVE CONTROL, THE JAK INHIBITOR TOFACITINIB. INHIBITION OF EACH TARGET RENDERED A SPECIFIC FUNCTIONAL CELL AND POTENTIAL DISEASE MODIFYING EFFECT, INDICATING SPECIFIC EPIGENETIC PROTEIN TARGETS AS POTENTIAL NEW INTERVENTION POINTS FOR FUTURE DRUG DISCOVERY AND DEVELOPMENT EFFORTS. 2021 9 5223 34 PRIMARY MURINE CD4+ T CELLS FAIL TO ACQUIRE THE ABILITY TO PRODUCE EFFECTOR CYTOKINES WHEN ACTIVE RAS IS PRESENT DURING TH1/TH2 DIFFERENTIATION. CONSTITUTIVE RAS SIGNALING HAS BEEN SHOWN TO AUGMENT IL-2 PRODUCTION, REVERSE ANERGY, AND FUNCTIONALLY REPLACE MANY ASPECTS OF CD28 CO-STIMULATION IN CD4+ T CELLS. THESE DATA RAISE THE POSSIBILITY THAT INTRODUCTION OF ACTIVE RAS INTO PRIMARY T CELLS MIGHT RESULT IN IMPROVED FUNCTIONALITY IN PATHOLOGIC SITUATIONS OF T CELL DYSFUNCTION, SUCH AS CANCER OR CHRONIC VIRAL INFECTION. TO TEST THE BIOLOGIC EFFECTS OF ACTIVE RAS IN PRIMARY T CELLS, CD4+ T CELLS FROM COXSACKIE-ADENOVIRUS RECEPTOR TRANSGENIC MICE WERE TRANSDUCED WITH AN ADENOVIRUS ENCODING ACTIVE RAS. AS EXPECTED, ACTIVE RAS AUGMENTED IL-2 PRODUCTION IN NAIVE CD4+ T CELLS. HOWEVER, WHEN CELLS WERE CULTURED FOR 4 DAYS UNDER CONDITIONS TO PROMOTE EFFECTOR CELL DIFFERENTIATION, ACTIVE RAS INHIBITED THE ABILITY OF CD4+ T CELLS TO ACQUIRE A TH1 OR TH2 EFFECTOR CYTOKINE PROFILE. THIS DIFFERENTIATION DEFECT WAS NOT DUE TO DEFICIENT STAT4 OR STAT6 ACTIVATION BY IL-12 OR IL-4, RESPECTIVELY, NOR WAS IT ASSOCIATED WITH DEFICIENT INDUCTION OF T-BET AND GATA-3 EXPRESSION. IMPAIRED EFFECTOR CYTOKINE PRODUCTION IN ACTIVE RAS-TRANSDUCED CELLS WAS ASSOCIATED WITH DEFICIENT DEMETHYLATION OF THE IL-4 GENE LOCUS. OUR RESULTS INDICATE THAT, DESPITE AUGMENTING ACUTE ACTIVATION OF NAIVE T CELLS, CONSTITUTIVE RAS SIGNALING INHIBITS THE ABILITY OF CD4+ T CELLS TO PROPERLY DIFFERENTIATE INTO TH1/TH2 EFFECTOR CYTOKINE-PRODUCING CELLS, IN PART BY INTERFERING WITH EPIGENETIC MODIFICATION OF EFFECTOR GENE LOCI. ALTERNATIVE STRATEGIES TO POTENTIATE RAS PATHWAY SIGNALING IN T CELLS IN A MORE REGULATED FASHION SHOULD BE CONSIDERED AS A THERAPEUTIC APPROACH TO IMPROVE IMMUNE RESPONSES IN VIVO. 2014 10 295 29 AGING INDUCES B CELL DEFECTS AND DECREASED ANTIBODY RESPONSES TO INFLUENZA INFECTION AND VACCINATION. BACKGROUND: AGING IS CHARACTERIZED BY A PROGRESSIVE DECLINE IN THE CAPACITY OF THE IMMUNE SYSTEM TO FIGHT INFLUENZA VIRUS INFECTION AND TO RESPOND TO VACCINATION. AMONG THE SEVERAL FACTORS INVOLVED, IN ADDITION TO INCREASED FRAILTY AND HIGH-RISK CONDITIONS, THE AGE-ASSOCIATED DECREASE IN CELLULAR AND HUMORAL IMMUNE RESPONSES PLAYS A RELEVANT ROLE. THIS IS IN LARGE PART DUE TO INFLAMMAGING, THE CHRONIC LOW-GRADE INFLAMMATORY STATUS OF THE ELDERLY, ASSOCIATED WITH INTRINSIC INFLAMMATION OF THE IMMUNE CELLS AND DECREASED IMMUNE FUNCTION. RESULTS: AGING IS USUALLY ASSOCIATED WITH REDUCED INFLUENZA VIRUS-SPECIFIC AND INFLUENZA VACCINE-SPECIFIC ANTIBODY RESPONSES BUT SOME ELDERLY INDIVIDUALS WITH HIGHER PRE-EXPOSURE ANTIBODY TITERS, DUE TO A PREVIOUS INFECTION OR VACCINATION, HAVE LESS PROBABILITY TO GET INFECTED. EXAMPLES OF THIS EXCEPTION ARE THE ELDERLY INDIVIDUALS INFECTED DURING THE 2009 PANDEMIC SEASON WHO MADE ANTIBODIES WITH BROADER EPITOPE RECOGNITION AND HIGHER AVIDITY THAN THOSE MADE BY YOUNGER INDIVIDUALS. SEVERAL STUDIES HAVE ALLOWED THE IDENTIFICATION OF B CELL INTRINSIC DEFECTS ACCOUNTING FOR SUB-OPTIMAL ANTIBODY RESPONSES OF ELDERLY INDIVIDUALS. THESE DEFECTS INCLUDE 1) REDUCED CLASS SWITCH RECOMBINATION, RESPONSIBLE FOR THE GENERATION OF A SECONDARY RESPONSE OF CLASS SWITCHED ANTIBODIES, 2) REDUCED DE NOVO SOMATIC HYPERMUTATION OF THE ANTIBODY VARIABLE REGION, 3) REDUCED BINDING AND NEUTRALIZATION CAPACITY, AS WELL AS BINDING SPECIFICITY, OF THE SECRETED ANTIBODIES, 4) INCREASED EPIGENETIC MODIFICATIONS THAT ARE ASSOCIATED WITH LOWER ANTIBODY RESPONSES, 5) INCREASED FREQUENCIES OF INFLAMMATORY B CELL SUBSETS, AND 6) SHORTER TELOMERES. CONCLUSIONS: ALTHOUGH INFLUENZA VACCINATION REPRESENTS THE MOST EFFECTIVE WAY TO PREVENT INFLUENZA INFECTION, VACCINES WITH GREATER IMMUNOGENICITY ARE NEEDED TO IMPROVE THE RESPONSE OF ELDERLY INDIVIDUALS. RECENT ADVANCES IN TECHNOLOGY HAVE MADE POSSIBLE A BROAD APPROACH TO BETTER UNDERSTAND THE AGE-ASSOCIATED CHANGES IN IMMUNE CELLS, NEEDED TO DESIGN TAILORED VACCINES AND EFFECTIVE THERAPEUTIC STRATEGIES THAT WILL BE ABLE TO IMPROVE THE IMMUNE RESPONSE OF VULNERABLE INDIVIDUALS. 2020 11 557 33 B-CELL ANTIGEN RECEPTOR SIGNALING IN CHRONIC LYMPHOCYTIC LEUKEMIA: THERAPEUTIC TARGETS AND TRANSLATIONAL OPPORTUNITIES. B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS CHARACTERIZED BY CLONALLY EXPANDED AND MOLECULARLY HETEROGENEOUS POPULATIONS OF B LYMPHOCYTES WITH IMPAIRED APOPTOTIC MECHANISMS. THIS OCCURS AS A RESULT OF MULTIPLE GENETIC AND EPIGENETIC ABNORMALITIES, INCLUDING CHROMOSOMAL ABERRATIONS AND ENHANCER REGION HYPOMETHYLATION, OFTEN IMPINGING ON INTRACELLULAR SIGNALING PATHWAYS THAT ARE ESSENTIAL TO NORMAL B-CELL ACTIVATION, PROLIFERATION, AND SURVIVAL. THE B-CELL ANTIGEN RECEPTOR (BCR) SIGNALING IS ONE SUCH PATHWAY USURPED BY MALIGNANT B CELLS, AS EXEMPLIFIED BY THE EARLY PHASE CLINICAL SUCCESS ACHIEVED BY SMALL-MOLECULE AGENTS TARGETING KEY PLAYERS INVOLVED IN THE PATHWAY. SUCH NEW TARGETED AGENTS, INCLUDING THOSE THAT INHIBIT THE FUNCTION OF SPLEEN TYROSINE KINASE (SYK), BRUTON'S TYROSINE KINASE (BTK), PHOSPHATIDYLINOSITOL 3-KINASES (PI3K), AND B-CELL LYMPHOMA 2 (BCL-2), ALONG WITH THE CURRENT STANDARD THERAPY COMPRISING CHEMO-IMMUNOTHERAPIES WITH OR WITHOUT B-CELL DEPLETING BIOLOGIC AGENT RITUXIMAB (ANTI-CD20 MONOCLONAL ANTIBODY), SHOULD EXPAND THE ARMAMENTARIUM FOR CLL THERAPY. WE REVIEW THE THERAPEUTIC AGENTS CURRENTLY IN CLINICAL DEVELOPMENT WHICH TARGET DIFFERENT EFFECTORS OF THE MALIGNANT BCR SIGNALING, AND DISCUSS THEIR OVERLAPPING AND DISCRIMINATING TRANSLATIONAL OPPORTUNITIES IN THE CONTEXT OF CLL TREATMENT. 2013 12 4030 24 LUPUS ERYTHEMATOSUS: A SHORT ACCOUNT. LUPUS ERYTHEMATOSUS IS A CHRONIC AUTOIMMUNE INFLAMMATORY DISEASE WITH DIVERSE CLINICAL MANIFESTATIONS INCLUDING ARTHRITIS, SKIN DISORDERS AND KIDNEY DISEASE. PATHOLOGICALLY IT IS CHARACTERISED BY COMPLEX INTERACTIONS BETWEEN MULTIPLE GENETIC, EPIGENETIC AND EXTRANEOUS FACTORS; AND SEROLOGICALLY BY THE PRESENCE OF A VARIETY OF ANTIBODIES WHICH ARE REACTIVE TO INTRACELLULAR MOLECULAR CONSTITUENTS. IMPAIRED CLEARANCE OF APOPTOTIC CELLS AND OF IMMUNE COMPLEXES, LOSS OF IMMUNE TOLERANCE TO SELF-ANTIGENS AND DYSREGULATION OF THE CYTOKINE NETWORK ACT SYNERGISTICALLY WITH EXTRANEOUS FACTORS SUCH AS ULTRAVIOLET RADIATION, VIRUSES AND CERTAIN DRUGS TO INDUCE AND SUSTAIN LUPUS ERYTHEMATOSUS. 2011 13 170 38 ABNORMALITIES OF THE TYPE I INTERFERON SIGNALING PATHWAY IN LUPUS AUTOIMMUNITY. TYPE I INTERFERONS (IFNS), MOSTLY IFNALPHA AND IFNBETA, AND THE TYPE I IFN SIGNATURE ARE IMPORTANT IN THE PATHOGENESIS OF SYSTEMIC LUPUS ERYTHEMATOSUS (SLE), AN AUTOIMMUNE CHRONIC CONDITION LINKED TO INFLAMMATION. BOTH IFNALPHA AND IFNBETA TRIGGER A SIGNALING CASCADE THAT, THROUGH THE ACTIVATION OF JAK1, TYK2, STAT1 AND STAT2, INITIATES GENE TRANSCRIPTION OF IFN STIMULATED GENES (ISGS). NOTEWORTHY, OTHER STAT FAMILY MEMBERS AND IFN RESPONSIVE FACTORS (IRFS) CAN ALSO CONTRIBUTE TO THE ACTIVATION OF THE IFN RESPONSE. ABERRANT TYPE I IFN SIGNALING, THEREFORE, CAN EXACERBATE SLE BY DEREGULATED HOMEOSTASIS LEADING TO UNNECESSARY PERSISTENCE OF THE BIOLOGICAL EFFECTS OF TYPE I IFNS. THE ETIOPATHOGENESIS OF SLE IS PARTIALLY KNOWN AND CONSIDERED MULTIFACTORIAL. FAMILY-BASED AND GENOME WIDE ASSOCIATION STUDIES (GWAS) HAVE IDENTIFIED GENETIC AND TRANSCRIPTIONAL ABNORMALITIES IN KEY MOLECULES DIRECTLY INVOLVED IN THE TYPE I IFN SIGNALING PATHWAY, NAMELY TYK2, STAT1 AND STAT4, AND IRF5. GAIN-OF-FUNCTION MUTATIONS THAT HEIGHTEN IFNALPHA/BETA PRODUCTION, WHICH IN TURN MAINTAINS TYPE I IFN SIGNALING, ARE FOUND IN OTHER PATHOLOGIES LIKE THE INTERFERONOPATHIES. HOWEVER, THE DISTINCTIVE CHARACTERISTICS HAVE YET TO BE DETERMINED. SIGNALING MOLECULES ACTIVATED IN RESPONSE TO TYPE I IFNS ARE UPREGULATED IN IMMUNE CELL SUBSETS AND AFFECTED TISSUES OF SLE PATIENTS. MOREOVER, TYPE I IFNS INDUCE CHROMATIN REMODELING LEADING TO A STATE PERMISSIVE TO TRANSCRIPTION, AND SLE PATIENTS HAVE INCREASED GLOBAL AND GENE-SPECIFIC EPIGENETIC MODIFICATIONS, SUCH AS HYPOMETHYLATION OF DNA AND HISTONE ACETYLATION. EPIGENOME WIDE ASSOCIATION STUDIES (EWAS) HIGHLIGHT IMPORTANT DIFFERENCES BETWEEN SLE PATIENTS AND HEALTHY CONTROLS IN INTERFERON STIMULATED GENES (ISGS). THE COMBINATION OF ENVIRONMENTAL AND GENETIC FACTORS MAY STIMULATE TYPE I IFN SIGNALING TRANSIENTLY AND PRODUCE LONG-LASTING DETRIMENTAL EFFECTS THROUGH EPIGENETIC ALTERATIONS. SUBSTANTIAL EVIDENCE FOR THE PATHOGENIC ROLE OF TYPE I IFNS IN SLE ADVOCATES THE CLINICAL USE OF NEUTRALIZING ANTI-TYPE I IFN RECEPTOR ANTIBODIES AS A THERAPEUTIC STRATEGY, WITH CLINICAL STUDIES ALREADY SHOWING PROMISING RESULTS. CURRENT AND FUTURE CLINICAL TRIALS WILL DETERMINE WHETHER DRUGS TARGETING MOLECULES OF THE TYPE I IFN SIGNALING PATHWAY, LIKE NON-SELECTIVE JAK INHIBITORS OR SPECIFIC TYK2 INHIBITORS, MAY BENEFIT PEOPLE LIVING WITH LUPUS. 2021 14 1323 31 DENDRITIC CELLS IN SYSTEMIC LUPUS ERYTHEMATOSUS: FROM PATHOGENESIS TO THERAPEUTIC APPLICATIONS. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IS A SEVERE CHRONIC SYSTEMIC AUTOIMMUNE DISEASE CAUSED BY COMPLICATED INTERACTIONS AMONG GENETIC, EPIGENETIC, AND IMMUNOLOGICAL FACTORS. DENDRITIC CELLS (DCS), AS THE MOST IMPORTANT ANTIGEN-PRESENTING CELLS, PLAY PIVOTAL ROLES IN BOTH TRIGGERING PATHOGENIC AUTOIMMUNE RESPONSES, AND ALSO MAINTAINING IMMUNE TOLERANCE. DISTINCT DC SUBSETS ARE ENDOWED WITH DIVERSIFIED PHENOTYPIC AND FUNCTIONAL CHARACTERISTICS, AND PLAY VARIABLE ROLES IN SHAPING IMMUNITY AND TOLERANCE DURING THE DEVELOPMENT OF SLE. ABNORMAL ACTIVATION OR DISABLED TOLERANCE OF DCS NOT ONLY TRIGGERS ABERRANT PRODUCTION OF INFLAMMATORY MEDIATORS AND TYPE I INTERFERONS LEADING TO PATHOGENIC INNATE IMMUNITY AND AUTOINFLAMMATION, BUT ALSO CAUSES AN IMBALANCE OF EFFECTOR VERSUS REGULATORY T CELL RESPONSES AND SUSTAINED PRODUCTION OF AUTO-ANTIBODIES FROM B CELLS, LEADING TO CONTINUOUSLY AMPLIFIED AUTOIMMUNE PATHOGENESIS IN SLE. OVER THE PAST DECADE, SIGNIFICANT PROGRESS HAS BEEN MADE IN REVEALING THE CHANGES OF DC ACCUMULATION OR FUNCTION IN SLE, AND HOW THE FUNCTIONAL DYSREGULATIONS OF DCS CONTRIBUTE TO THE PATHOLOGICAL INFLAMMATION OF SLE, LEADING TO BREAKTHROUGHS IN DC-BASED THERAPEUTICS IN THE TREATMENT OF SLE. IN THIS REVIEW, WE REVIEW THE RECENT ADVANCES IN THE ACTIVATION AND FUNCTION OF THE MAJOR DC SUBSETS IN THE PATHOGENESIS OF SLE AS WELL AS THE THERAPEUTIC POTENTIAL OF TARGETING DC SUBSET OR STATUS AGAINST SLE. 2022 15 3025 33 GENETICS AND PATHOPHYSIOLOGY OF GRANULOMATOSIS WITH POLYANGIITIS (GPA) AND ITS MAIN AUTOANTIGEN PROTEINASE 3. GRANULOMATOSIS WITH POLYANGIITIS (GPA) IS A SEVERE AUTOIMMUNE DISEASE AND ONE OF THE SMALL VESSEL ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA)-ASSOCIATED VASCULITIDES. ALTHOUGH ITS ETIOLOGY AND PATHOPHYSIOLOGY ARE STILL WIDELY UNKNOWN, IT IS ACCEPTED THAT INFECTIONS, ENVIRONMENTAL FACTORS, EPIGENETIC MODIFICATIONS, AND A GENETIC PREDISPOSITION PROVIDE THE BASIS FOR THIS SYSTEMIC DISORDER. GPA TYPICALLY EVOLVES INTO TWO PHASES: AN INITIAL PHASE CHARACTERIZED BY EAR, NOSE AND THROAT (ENT) MANIFESTATIONS, SUCH AS CHRONIC SINUSITIS AND OTITIS, ULCERATION OF THE ORAL CAVITY AND PHARYNX, AS WELL AS PULMONARY NODULES AND A SEVERE GENERALIZED PHASE, DEFINED BY THE OCCURRENCE OF RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS, PULMONARY HEMORRHAGE, AND ARTHRITIS. ANCAS, DIRECTED AGAINST THE NEUTROPHILIC ENZYMES PROTEINASE 3 AND MYELOPEROXIDASE, ARE PRESENT IN UP TO 90% OF THE AFFECTED PATIENTS IN THE SYSTEMIC PHASE. AS THE HUMORAL IMMUNITY IS PREDOMINANTLY DIRECTED AGAINST NEUTROPHILIC ANTIGENS, IT IS APPARENT THAT NEUTROPHILS PLAY A CRITICAL ROLE IN GPA BOTH AS TARGET AND EFFECTOR CELLS. ALTHOUGH GPA PATHOGENESIS IS NOT WELL KNOWN, SOME SUSCEPTIBILITY GENES AND LOCI HAVE BEEN IDENTIFIED BY CANDIDATE GENE APPROACHES, GENOME-WIDE ASSOCIATION STUDIES, AND META-ANALYSES, AS WELL AS FAMILIAL ASSOCIATION STUDIES. SUCH GENES ARE CTLA4, PTPN22, COL11A2, SERPINA1, AND THE MHC CLASS II GENE CLUSTER. THIS REVIEW HIGHLIGHTS THE CLINICAL, PATHOPHYSIOLOGICAL, AND GENETIC BACKGROUND OF GPA AND AIMS TO GIVE AN OVERVIEW OF RECENT EFFORTS TO IDENTIFY GPA SUSCEPTIBILITY GENES. WE POINT OUT THE GENETIC BASIS OF THE MAIN AUTOANTIGEN PR3 AND WHY IT IS SO DIFFICULT TO ESTABLISH A MURINE GPA MODEL. 2016 16 590 25 BET BROMODOMAIN PROTEIN INHIBITION REVERSES CHIMERIC ANTIGEN RECEPTOR EXTINCTION AND REINVIGORATES EXHAUSTED T CELLS IN CHRONIC LYMPHOCYTIC LEUKEMIA. CHIMERIC ANTIGEN RECEPTOR (CAR) T CELLS HAVE INDUCED REMARKABLE ANTITUMOR RESPONSES IN B CELL MALIGNANCIES. SOME PATIENTS DO NOT RESPOND BECAUSE OF T CELL DEFICIENCIES THAT HAMPER THE EXPANSION, PERSISTENCE, AND EFFECTOR FUNCTION OF THESE CELLS. WE USED LONGITUDINAL IMMUNE PROFILING TO IDENTIFY PHENOTYPIC AND PHARMACODYNAMIC CHANGES IN CD19-DIRECTED CAR T CELLS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL). CAR EXPRESSION MAINTENANCE WAS ALSO INVESTIGATED BECAUSE THIS CAN AFFECT RESPONSE DURABILITY. CAR T CELL FAILURE WAS ACCOMPANIED BY PREEXISTING T CELL-INTRINSIC DEFECTS OR DYSFUNCTION ACQUIRED AFTER INFUSION. IN A SMALL SUBSET OF PATIENTS, CAR SILENCING WAS OBSERVED COINCIDENT WITH LEUKEMIA RELAPSE. USING A SMALL MOLECULE INHIBITOR, WE DEMONSTRATED THAT THE BROMODOMAIN AND EXTRA-TERMINAL (BET) FAMILY OF CHROMATIN ADAPTERS PLAYS A ROLE IN DOWNREGULATING CAR EXPRESSION. BET PROTEIN BLOCKADE ALSO AMELIORATED CAR T CELL EXHAUSTION AS MANIFESTED BY INHIBITORY RECEPTOR REDUCTION, ENHANCED METABOLIC FITNESS, INCREASED PROLIFERATIVE CAPACITY, AND ENRICHED TRANSCRIPTOMIC SIGNATURES OF T CELL REINVIGORATION. BET INHIBITION DECREASED LEVELS OF THE TET2 METHYLCYTOSINE DIOXYGENASE, AND FORCED EXPRESSION OF THE TET2 CATALYTIC DOMAIN ELIMINATED THE POTENCY-ENHANCING EFFECTS OF BET PROTEIN TARGETING IN CAR T CELLS, PROVIDING A MECHANISM LINKING BET PROTEINS AND T CELL DYSFUNCTION. THUS, MODULATING BET EPIGENETIC READERS MAY IMPROVE THE EFFICACY OF CELL-BASED IMMUNOTHERAPIES. 2021 17 750 19 CARDIAC INVOLVEMENT IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES. AUTHORS HAVE REVIEWED LITERATURE ABOUT THE MANAGEMENT OF PATIENTS WITH CARDIOLOGIC DISEASE OCCURRING SECONDARY TO HEMATOLOGIC PATHOLOGY ITSELF OR ITS THERAPY, WITH A FOCUS ON INFILTRATION OF MYOCARDIUM IN ACUTE AND CHRONIC LEUKEMIA, LYMPHOMA, MULTIPLE MYELOMA, AND HYPEREOSINOPHILIC SYNDROME. MOREOVER, THEY EVALUATED CHEMOTHERAPY-ASSOCIATED TOXICITY, PARTICULARLY FOR NEW DRUGS SUCH AS MONOCLONAL ANTIBODY THERAPY, TYROSINE KINASE INHIBITORS, ARSENIC TRIOXIDE, BORTEZOMIB, AND EPIGENETIC THERAPY. IN FACT, CARDIAC TOXICITY MAY RANGE FROM ASYMPTOMATIC SUBCLINICAL ABNORMALITIES, SUCH AS ELECTROCARDIOGRAPHIC CHANGES AND LEFT VENTRICULAR EJECTION DECLINE, TO LIFE-THREATENING EVENTS AND LEAD TO CHEMOTHERAPY DOSE REDUCTION AND DELAY AND, IN SOME CASES, FOR PATIENTS WITH SEVERE SIDE EFFECTS, DISCONTINUATION OF TREATMENT. FINALLY, THEY DISCUSSED ON THE IDENTIFICATION OF EARLY MARKERS OF CARDIAC INJURY AND ON CARDIAC STEM CELL THERAPY AS A PROMISING APPROACH TO FACILITATE MYOCARDIAL REGENERATION. 2010 18 5477 29 RESTORING THE FUNCTIONAL IMMUNOGENICITY OF CHRONIC LYMPHOCYTIC LEUKEMIA USING EPIGENETIC MODIFIERS. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS A MALIGNANCY ARISING FROM IMMUNE CELLS (B-LYMPHOCYTES) ENDOWED WITH INTRINSIC ANTIGEN-PRESENTING CAPABILITIES. SUCH A FUNCTION HOWEVER IS LOST DURING MALIGNANT TRANSFORMATION AND CLL CELLS ARE WELL KNOWN FOR THEIR INABILITY TO PROCESS AND PRESENT ANTIGENS TO THE T-CELL ARM OF THE IMMUNE SYSTEM. INSTEAD, MALIGNANT CLL CELLS ELICIT A VAST ARRAY OF IMMUNE REGULATORY MECHANISMS CONDUCIVE TO T-CELL DYSFUNCTION AND IMMUNOSUPPRESSION. PREVIOUSLY, WE HAVE SHOWN THAT TREATMENT OF CLL CELLS WITH THE DEMETHYLATING AGENT 5-AZA-2'-DEOXYCYTIDINE UNLEASHED TARGET ANTIGEN EXPRESSION. HERE WE SHOW FOR THE FIRST TIME THAT COMBINING TWO EPIGENETIC MODIFIERS, 5-AZA-2'-DEOXYCYTIDINE AND THE HISTONE DEACETYLASE INHIBITOR LAQ824 EFFECTIVELY RESTORES THE IMMUNOGENICITY OF CLL CELL LINES AS WELL AS PRIMARY CELLS OBTAINED FROM CLL PATIENTS. INDEED, SUCH A COMBINATION INDUCES THE EXPRESSION OF NOVEL AND HIGHLY ANTIGENIC CANCER-TESTIS ANTIGENS (CTAS) AND COSTIMULATORY MOLECULES. THESE CHANGES FACILITATE THE FORMATION OF ROBUST SUPRAMOLECULAR ACTIVATION COMPLEXES (SMAC) BETWEEN CLL CELLS AND RESPONDER T-CELLS LEADING TO INTRACELLULAR SIGNALING, LYTIC GRANULE MOBILIZATION, AND POLARIZATION OF FUNCTIONAL AND RELEVANT T-CELL RESPONSES. THIS CASCADE OF T-CELL ACTIVATING EVENTS TRIGGERED BY CLL CELLS WITH RESTORED APC FUNCTION, POINTS TO COMBINED EPIGENETIC MODIFIER TREATMENT AS A POTENTIAL IMMUNOTHERAPEUTIC STRATEGY FOR CLL PATIENTS. 2011 19 2765 24 EXPRESSION, EPIGENETIC REGULATION, AND HUMORAL IMMUNOGENICITY OF CANCER-TESTIS ANTIGENS IN CHRONIC MYELOID LEUKEMIA. OBJECTIVE: CANCER-TESTIS (CT) ANTIGENS REPRESENT ATTRACTIVE TARGETS FOR TUMOR IMMUNOTHERAPY BASED ON THEIR TUMOR-RESTRICTED EXPRESSION AND IMMUNOGENICITY. HOWEVER, A BROAD PICTURE OF THE EXPRESSION OF CT ANTIGENS AND ASSOCIATED HUMORAL IMMUNE RESPONSES IN CHRONIC MYELOID LEUKEMIA (CML) IS STILL MISSING. METHODS: WE SCREENED CML CELL LINES AND BONE MARROW (BM) SAMPLES FROM HEALTHY DONORS BY RT-PCR FOR THE EXPRESSION OF 31 CT ANTIGENS BEFORE AND AFTER TREATMENT WITH EPIGENETIC AGENTS. EXPRESSION OF TUMOR-RESTRICTED ANTIGENS WAS FURTHER EXAMINED IN 60 CML PATIENTS AND HUMORAL IMMUNE RESPONSES AGAINST 15 CT ANTIGENS WERE SCREENED BY ELISA. RESULTS: IN UNTREATED CELL LINES WE DETECTED THE EXPRESSION OF 17 CT ANTIGENS THAT WERE ABSENT FROM NORMAL BM. EXPRESSION OF MOST ANTIGENS INCREASED FOLLOWING DEMETHYLATING TREATMENT WITH 5'-AZA-2'-DEOXYCYTIDINE. IN THESE SAMPLES, ONLY PRAME WAS REPEATEDLY DETECTED AND EXPRESSION CORRELATED WITH SEVERAL CLINICOPATHOLOGICAL PARAMETERS AND DECREASED OVERALL SURVIVAL. WE FURTHER SHOW THAT A LOWER FREQUENCY OF PRAME-POSITIVE SAMPLES DURING IMATINIB TREATMENT WAS NOT CAUSED BY GENE-SPECIFIC DOWNREGULATION. ANALYZING THE PATIENTS' ANTIBODY RESPONSES WE FOUND THAT THE VAST MAJORITY OF PATIENTS LACKED SPONTANEOUS IMMUNITY AGAINST CT ANTIGENS INCLUDING PRAME. CONCLUSIONS: CT ANTIGEN EXPRESSION CAN BE INCREASED BY THE APPLICATION OF EPIGENETIC AGENTS AND THE EXPRESSION OF PRAME CORRELATES WITH CLINICOPATHOLOGICAL PARAMETERS AND OVERALL SURVIVAL IN PATIENTS WITH CML, BUT DOES NOT LEAD TO HUMORAL IMMUNE RESPONSES. PRAME-SPECIFIC IMMUNOTHERAPY MIGHT REPRESENT A PROMISING APPROACH FOR THE ERADICATION OF RESIDUAL THERAPY-RESISTANT LEUKEMIC CELLS DUE TO ITS FREQUENT EXPRESSION AND STABILITY UNDER IMATINIB TREATMENT. 2010 20 261 37 ADVANCES IN TARGET THERAPY FOR LUNG CANCER. RECENT PROGRESS IN MOLECULAR BIOLOGY HAS SHOWN THAT CANCER CELLS ACQUIRE COMMON PHENOTYPES SUCH AS SELF-SUFFICIENCY OF GROWTH SIGNALS, RESISTANCE TO ANTI-PROLIFERATIVE AND APOPTOTIC SIGNALS THROUGH THE ACCUMULATION OF GENETIC AND EPIGENETIC CHANGES. RECENTLY DEVELOPED ANTICANCER DRUGS TARGET THESE MOLECULAR MECHANISMS AND GOOD RESULTS HAVE BEEN REPORTED FOR VARIOUS CANCER TYPES. IN LUNG CANCER, TYROSINE KINASE INHIBITORS SPECIFIC FOR THE EPIDERMAL GROWTH FACTOR RECEPTOR SUCH AS GEFITINIB AND ERLOTINIB HAVE CHANGED CLINICAL PRACTICE DRAMATICALLY. ABOUT HALF OF THE JAPANESE PATIENTS WITH LUNG CANCERS HARBOR AN ACTIVATING MUTATION OF THE EPIDERMAL GROWTH FACTOR RECEPTOR GENE AND THEY ARE VERY SENSITIVE TO EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE KINASE INHIBITORS. PROGRESSION-FREE SURVIVAL OF SUCH PATIENTS IS APPROXIMATELY 10 MONTHS WHEN TREATED WITH GEFITINIB, WHEREAS THE SURVIVAL FOR THOSE TREATED WITH PLATINUM DOUBLET THERAPY IS APPROXIMATELY 6 MONTHS. TARGET THERAPIES AGAINST ECHINODERM MICROTUBULE-ASSOCIATED PROTEIN-LIKE 4-ANAPLASTIC LYMPHOMA KINASE FUSION PROTEIN OR A MUTATED ERBB2 (V-ERB-B AVIAN ERYTHROBLASTIC LEUKEMIA VIRAL ONCOGENE HOMOLOGUE 2) PRESENT IN APPROXIMATELY 5% AND APPROXIMATELY 3% OF THE JAPANESE PATIENTS WITH ADENOCARCINOMAS, RESPECTIVELY, ARE CURRENTLY UNDER DEVELOPMENT. ADDITION OF AN ANTI-EPIDERMAL GROWTH FACTOR RECEPTOR ANTIBODY, CETUXIMAB, OR ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR ANTIBODY, BEVACIZUMAB, TO PLATINUM DOUBLET THERAPY SIGNIFICANTLY BUT MODESTLY PROLONGED THE SURVIVAL IN RECENT CLINICAL TRIALS. HOWEVER, CLINICAL DEVELOPMENT OF SMALL MOLECULE MULTI-KINASE INHIBITORS INCLUDING THOSE TARGETING VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTORS, SUCH AS VANDETANIB, SUNITINIB AND SORAFENIB, HAS NOT BEEN VERY SUCCESSFUL. THROUGH THESE COLLABORATIONS AMONG CLINICIANS, BASIC RESEARCHERS AND PHARMACEUTICAL COMPANIES, IT SHOULD BE POSSIBLE TO INDIVIDUALIZE LUNG CANCER TREATMENT TO TURN THIS FATAL DISEASE INTO A CHRONIC DISORDER AND, EVENTUALLY, TO CURE IT. 2010