Soh Ha Chan

Histopathology of nasopharyngeal carcinoma: correlations with epidemiology, survival rates and other biological characteristics.

A total of 363 cases of nasopharyngeal carcinoma (NPC) in Singapore were classified into squamous cell carcinoma (SCC; 73 cases), non‐keratinizing carcinoma (NKC; 178 cases) and undifferentiated carcinoma (UC; 172 cases). Possible biological differences between these histologic types and between tumors with and without lymphocytic infiltration were investigated by correlations with survival rates and with selected epidemiologic, immunovirologic, and immunogenetic data on the disease. The 5‐year survival rates following radiotherapy were 25.3% for all cases and 58.8% for tumors restricted to the nasopharynx. The 5‐year survival rate for SCC was poorer than for the combined NKC and UC groups (p < 0.05). The 3‐year survival rate was better for tumors with lymphocytic infiltration (p < 0.05), but there were no differences in the 5‐year survivals. The survival rates were better in females (p < 0.01) and in the younger age groups (p < 0.01). There were no significant correlations between histopathology of NPC and the distributions of cases by age, sex, HLA antigen profiles, or cell‐mediated immune status. Squamous cell carcinoma was associated with lower levels of antibodies to the Epstein‐Barr nuclear antigen (p < 0.05), but there were no differences with respect to antibodies against other EBV related antigens. These findings support the view that SCC, NKC, and UC of the nasopharynx, as defined in the WHO classification, are variants of a fairly homogeneous group of neoplasms in the Singapore population.

The Structural Basis for Serotype-Specific Neutralization of Dengue Virus by a Human Antibody

The mechanism of action of a serotype-specific natural human antibody against dengue virus has been identified. Defeating Dengue Dengue virus is a major mosquito-borne viral pathogen that is transmitted through the bite of an infected mosquito. Infection can be asymptomatic, cause a self-limiting fever, or result in potentially fatal hemorrhage. There are no approved vaccines or antiviral therapies for dengue, and current treatment is restricted to fluid replacement. Thus, there is an urgent need for new treatment options for this disease. Dengue virus consists of four related but distinct serotypes, and infection is thought to elicit lifelong immunity to the infecting serotype in patients who recover but only short-term immunity against the other serotypes. Immunity is mediated by serotype-specific antibodies, but little is known about their specificity or mode of action. Now, Teoh et al. characterize a neutralizing human monoclonal antibody induced by natural dengue infection. This antibody is specific for dengue virus serotype 1 and shows little or no binding or neutralizing activity for serotypes 2, 3, and 4. The authors demonstrate that the antibody binds across two adjacent viral envelope proteins and identify the amino acids that comprise the binding site. The antiviral activity of this antibody is linked principally to a blockade of virus binding to target host cells. Treatment with this antibody results in increased survival in a mouse model of dengue virus infection. This human antibody represents a new therapeutic candidate for treating dengue serotype 1 infection. These findings also provide a structural and molecular context for understanding the nature of durable, serotype-specific immunity to dengue infection and thus have implications for the design and evaluation of vaccines against dengue. Dengue virus (DENV) is a mosquito-borne flavivirus that affects 2.5 billion people worldwide. There are four dengue serotypes (DENV1 to DENV4), and infection with one elicits lifelong immunity to that serotype but offers only transient protection against the other serotypes. Identification of the protective determinants of the human antibody response to DENV is a vital requirement for the design and evaluation of future preventative therapies and treatments. Here, we describe the isolation of a neutralizing antibody from a DENV1-infected patient. The human antibody 14c10 (HM14c10) binds specifically to DENV1. HM14c10 neutralizes the virus principally by blocking virus attachment; at higher concentrations, a post-attachment step can also be inhibited. In vivo studies show that the HM14c10 antibody has antiviral activity at picomolar concentrations. A 7 Å resolution cryoelectron microscopy map of Fab fragments of HM14c10 in a complex with DENV1 shows targeting of a discontinuous epitope that spans the adjacent surface of envelope protein dimers. As found previously, a human antibody specific for the related West Nile virus binds to a similar quaternary structure, suggesting that this could be an immunodominant epitope. These findings provide a structural and molecular context for durable, serotype-specific immunity to DENV infection.

Activation of T lymphocytes by polysaccharide-protein complex from Lycium barbarum L

T lymphocytes play central roles in adaptive immunity. Lycium barbarum L. (L. barbarum), also known as wolfberry, is a Chinese herbal medicine with various biological activities, such as enhancing immunity, protecting liver damage, and reducing the side effects of chemotherapy and radiotherapy. Here, we report that polysaccharide-protein complex from L. barbarum (LBP) is able to activate T cells. LBP was isolated from L. barbarum and separated to five homogenous fractions, designated LBPF1, LBPF2, LBPF3, LBPF4, and LBPF5. We found that LBP, LBPF4, and LBPF5 significantly stimulated mouse splenocyte proliferation. The proliferation proved to be of T cells, but not B cells. Cell cycle profile analysis indicated that LBP, LBPF4, and LBPF5 markedly reduced sub-G1 cells. LBP, LBPF4, and LBPF5 could activate transcription factors NFAT and AP-1, prompt CD25 expression, and induce IL-2 and IFN-gamma gene transcription and protein secretion. LBP (i.p. or p.o.) significantly induced T cell proliferation. Our results suggest that activation of T lymphocytes by LBP may contribute to one of its immuno-enhancement functions.

Dengue seroepidemiology in Singapore.

The resurgence of dengue in Singapore since 1986 had been associated with an adult predominance and a very low incidence in children. No study had been carried out to investigate this finding. Here we report a serological study of 1068 children aged 0 to 15 years. There is a significant rise in seroconversion in children aged 6 years and older coinciding with the start of formal schooling. This suggests that there may be a change in the location where dengue is acquired.

Polysaccharide-protein complex from Lycium barbarum L. is a novel stimulus of dendritic cell immunogenicity.

Dendritic cell (DC) immunogenicity correlates with its maturation, which can be induced by toxic microbial products such as LPS. In this study, we report that a nontoxic polysaccharide-protein complex isolated from a Chinese medicinal herb, Lycium barbarum (LBP), induces phenotypic and functional maturation of DCs with strong immunogenicity. LBP up-regulated DC expression of CD40, CD80, CD86, and MHC class II molecules; down-regulated DC uptake of Ag; enhanced DC allostimulatory activity; and induced IL-12p40 and p70 production. All of its five fractions were active. LBP developed enhanced Th1 response, and LBP-treated DCs enhanced Th1 and Th2 responses in vitro and in vivo. Our study provides evidence and rationale on using LBP in various clinical conditions to enhance host immunity and suggests LBP as a potent adjuvant for the design of DC-based vaccines.

KINETICS OF INTERFERON-GAMMA SECRETION AND ITS REGULATORY FACTORS IN THE EARLY PHASE OF ACUTE GRAFT-VERSUS-HOST DISEASE

Increased serum levels of interferon‐γ (IFN‐γ) have been observed in acute graft‐versus‐host disease (GVHD). Recent in vitro studies have demonstrated that interleukin‐12 (IL‐12) and interleukin‐18 (IL‐18) synergistically up‐regulate IFN‐γ secretion. In this communication, we investigated the factors relevant to IFN‐γ secretion in acute GVHD. A murine model of acute GVHD was established by injecting donor spleen cells into severe combined immunodeficiency (SCID) mice. A series of specimens, including sera, livers and spleens derived from the GVHD mice, were investigated with histological examination, enzyme‐linked immunosorbent assay (ELISA), flow cytometry, and semiquantitative reverse transcription–polymerase chain reaction (RT–PCR). IFN‐γ secretion increased in serum 3 days after spleen cell transfer, peaked on day 7, and then gradually decreased close to the baseline level by day 35. A synchronized increase of activated T cells and mRNA expression of IL‐12, IL‐18 and their respective receptors was observed after spleen cell transfer. However, only the kinetic expression pattern of IL‐12 receptor (IL‐12R) β2 chains was closely correlated with that of IFN‐γ, while IL‐12 dropped to the baseline level earlier than IFN‐γ. Therefore, IFN‐γ expression in the early phase of acute GVHD is a mono‐peak and self‐restricted pattern. Its secretion is closely related with T‐cell activation, the presence of IL‐12, IL‐18 and their respective receptors. However, the limiting factors for IFN‐γ secretion seem to be IL‐12 and IL‐12R β2 chains.

Expression of Epstein-Barr virus lytic gene BRLF1 in nasopharyngeal carcinoma: potential use in diagnosis

Tumour cells of undifferentiated nasopharyngeal carcinoma (NPC) consistently harbour Epstein-Barr virus (EBV) genes. Expression of mRNA transcripts associated with EBV latency has been demonstrated in such cells. However, expression of EBV lytic genes has not been well elucidated, although various lines of evidence have suggested that there is EBV replication in NPC tumour cells. We have studied mRNA expression of representative EBV lytic genes by RT-PCR in nasopharynx biopsies obtained from NPC and control individuals. In both NPC and control biopsies, EBV lytic genes BZLF1, BALF2 and BCLF1 were detected readily. However, BRLF1 was detected in NPC biopsies only. The BRLF1 gene was then cloned and expressed in vitro, and the protein product, Rta, was used as an antigen to detect specific antibodies by immunoprecipitation in plasma samples obtained from NPC patients and healthy controls. IgG antibodies directed against Rta were detected in 44 of 53 NPC plasma samples (83.0%), but only in 1 of 53 control samples (1.9%). Furthermore, the antibody binding regions were found in the C-terminal two-thirds of Rta. This serological result confirms indirectly that BRLF1 is specifically expressed in NPC tumour cells. Rta might play an important role in NPC pathogenesis, considering its multiple functions in EBV replication and cell cycles. Moreover, the detection of IgG antibodies directed against Rta could be developed into a diagnostic parameter for NPC.

Activation of macrophages by polysaccharide–protein complex from Lycium barbarum L.

Macrophages play crucial roles in innate immunity. This paper reports that a polysaccharide–protein complex isolated from Lycium barbarum (LBP) is able to activate macrophages. LBP was isolated from Lycium barbarum fruit and separated to five homogenous fractions, designated LBPF1, LBPF2, LBPF3, LBPF4 and LBPF5. It was found that LBP (50 mg/kg, i.p.) markedly upregulated the expressions of CD40, CD80, CD86 and MHC class II molecules on peritoneal macrophages. In vitro studies showed that LBP and LBPF1‐5 activated transcription factors NF‐κB and AP‐1 by RAW264.7 macrophage cells, induced TNF‐α, IL‐1β, IL‐12p40 mRNA expression, and enhanced TNF‐α production in a dose‐dependent manner. Furthermore, LBP (50 mg/kg, i.p.) significantly enhanced macrophage endocytic and phagocytic capacities in vivo. These results indicate that LBP enhances innate immunity by activating macrophages. The mechanism may be through activation of transcription factors NF‐κB and AP‐1 to induce TNF‐α production and upregulation of MHC class II costimulatory molecules. Copyright

Blocking L‐selectin and α4‐integrin changes donor cell homing pattern and ameliorates murine acute graft versus host disease

L‐selectin, LFA‐1 and α4 integrins play important roles in the homing of naïve T cells into peripheral lymphoid tissues. L‐selectin‐ or LFA‐1‐deficient lymphocytes cannot effectively home to lymph nodes (LN), and antibody blockade of α4 integrins also hinders lymphocytes homing. The present study was initiated to explore whether it is feasible to ameliorate acute graft‐versus‐host disease (aGVHD) by modulating the homing process of donor cells in the recipient in a mouse model. Using a fluorescence labeling method, we found that two monoclonal antibodies directed at L‐selectin and α4 integrins, respectively, when used in combination, could delay half of the donor C57BL / 6J mouse spleen cells homing into the LN of recipient BALB / c mouse 15 h after injection. Spleen cells (1 × 107) derived from C57BL / 6J (H‐2b) mice were injected into each C.B‐17 SCID recipient mouse (H‐2d) with or without prior incubation with 10 μg each of the two antibodies. T cell repopulation in the blood was observed in both groups of mice at a comparable level 14 days after injection of the donor cells. Eight control mice started to show aGVHD signs 7 – 14 days after the injection, and all died by day 31. However, among the ten mice that received the antibody‐treated donor cells, two died before day 29, four survived between 36 and 78 days, and the remaining four survived more than 150 days, with two of them aGVHD free. It is apparent that the temporarily reduced lymphocyte homing into LN reduced the alloreactivity of the donor T cells, thus providing a simple way of modifying aGVHD. This novel approach may shed light on the prevention of aGVHD associated with clinical bone marrow transplantation.

Differential signal transduction, membrane trafficking, and immune effector functions mediated by FcγRI versus FcγRIIa

Receptors for the fragment crystallizable region of immunoglobulin-G (FcgammaRs) play an important role in linking the humoral and cellular arms of the immune response. In this study, we present a comprehensive functional comparison of 2 human Fc-receptors, FcgammaRI and FcgammaRIIa. Activation of FcgammaRI results in a novel signaling cascade that links phospholipase D1 to sphingosine kinase-1 in U937 cells and primary human monocytes. This induces the expression of proinflammatory mediators and is associated with trafficking of immune complexes into human leukocyte antigen-DM positive antigen-processing compartments coupled with improved MHC class II-mediated antigen presentation to T lymphocytes. In contrast, activation of FcgammaRIIa elicits signaling through phospholipase Cgamma1, resulting in increases in intracellular calcium, activation of nicotinamide adenine dinucleotide phosphate-oxidative burst, and differential membrane trafficking combined with impaired antigen presentation and proinflammatory cytokine expression. These data provide a mechanistic insight into the disparate activities associated with Fc receptors in immunity, namely, reinforcement of immune responses through stimulation of proinflammatory signaling and antigen presentation, versus the maintenance of immunologic homeostasis through the noninflammatory clearance of immune complexes.