RESUMEN

Our previous phase I/IIA study showed that autologous dendritic cells (DCs) pulsed with tumor-associated antigens are well tolerated in patients with hepatocellular carcinoma (HCC). In this randomized, multicenter, open-label, phase II trial, we investigated the efficacy and safety of this DC-based adjuvant immunotherapy with 156 patients, who treated for HCC with no evidence of residual tumor after standard treatment modalities. Patients were randomly assigned to immunotherapy (n = 77; injection of 3 × 107 DC cells, six times over 14 weeks) or control (n = 79; no treatment). The primary end point was recurrence-free survival (RFS), and the secondary endpoints were immune response and safety. The RFS between the immunotherapy and control groups was not significantly different (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.60-1.56; p = 0.90). However, post-hoc subgroup analyses revealed that DC immunotherapy significantly reduced the risk of tumor recurrence of non-radiofrequency ablation (non-RFA) group patients (n = 83, HR, 0.49; 95% CI, 0.26-0.94; p = 0.03), whereas unexpectedly increased the risk of recurrence in RFA group (n = 61, p = 0.01). Tumor-specific immune responses were significantly enhanced (both p < 0.01) in the immunotherapy group. Baseline serum interleukin (IL)-15 was statistically correlated with RFS prolongation (HR, 0.16; 95% CI, 0.03-1.58; p = 0.001) within the immunotherapy groups. Overall adverse events were more frequent in the immunotherapy group (p < 0.001) but were mainly mild to moderate in severity. In conclusion, adjuvant immunotherapy with DC vaccine reduces the risk of tumor recurrence in HCC patients who underwent standard treatment modalities other than RFA. Baseline IL-15 might be a candidate biomarker for DC-based HCC immunotherapy.

RESUMEN

BACKGROUND: To date, no adjuvant treatment has been shown to have a clear benefit in patients with hepatocellular carcinoma (HCC). In this prospective phase I/IIa study, we evaluated the safety and efficacy of adjuvant dendritic cell (DC) therapy in HCC patients who received primary treatment for HCC. METHODS: Twelve HCC patients who had no viable tumour after primary treatments were included. Dendritic cell vaccines pulsed with cytoplasmic transduction peptide-attached alpha-fetoprotein, glypican-3 and melanoma-associated antigen 1 recombinant fusion proteins were injected subcutaneously near to inguinal lymph nodes. Adverse effects, time to progression (TTP), and associated immune responses were evaluated after DC vaccination. RESULTS: Nine of 12 patients had no tumour recurrence up to 24 weeks after DC vaccination. Among a total of 144 adverse events, 129 events (89.6%) were regarded as adverse drug reactions, all of which were grade 1 or 2. The majority of patients showed enhanced anti-tumour immune responses after DC vaccination. Recurrence-free patients exhibited relatively stronger anti-tumour immune responses than patients who developed recurrence after DC vaccination, as evidenced by lymphocyte proliferation and IFN-γ ELISPOT assays. The median time of TTP was 36.6 months in the DC-vaccination group and 11.8 months in the control group (hazard ratio, 0.41; 95% confidence interval, 0.18-0.95; P=0.0031 by log-rank test). CONCLUSIONS: Adjuvant DC vaccine for HCC was safe and well tolerated in phase I/IIa study, and preliminary efficacy data are encouraging to warrant further clinical study in patients with HCC after primary treatments.

Asunto(s)

RESUMEN

Beta-glucan (ß-glucan) including zymosan has been known as a super food because of its multifunctional activities, such as the enhancement of immune responses. To study the functional mechanism of ß-glucan in immune stimulation, the effect of zymosan on dendritic cell (DC) was investigated by monitoring the production of TNF-α, a pro-inflammatory cytokine. DC was differentiated from Mutz-3, a human acute myeloid leukemia cell line, by cytokine treatment and characterized. DC-specific cell surface markers were increased during the differentiation. Especially, Dectin-1, a ß-glucan receptor, was upregulated during DC differentiation, and mediated zymosan-induced TNF-α production, which was inhibited by silencing of dectin-1. Zymosan exhibited synergistic effect with other immune stimuli such as lipopolysaccharide (LPS) and phorbol 12-myristate 13-acetate (PMA), a well-known PKC activator. Simultaneous treatment of zymosan and PMA enhanced the nuclear translocation of NF-κB subunits, p50 and p65, mediating the increase of TNF-α production. Bay 11-7082, an NF-κB inhibitor, blocked morphological changes and TNF-α production induced by zymosan and/or PMA treatment. Western blot analysis has showed zymosan-Dectin-1 pathway mediated destructive phosphorylation of inhibitor of NF-κB (IκB) kinase α subunit (IKKα) in IKK complexes, while PMA-PKC pathway regulated selective phosphorylation and degradation of IKKß. Simultaneous phosphorylation of separate IKK subunits by co-treatment of zymosan and PMA resulted in cooperative activation of NF-κB and TNF-α production.

Asunto(s)

RESUMEN

We report the successful application of multiwall carbon nanotubes (CNTs) as electrocatalysts for triiodide reduction in a dye-sensitized solar cell (DSSC). Defect-rich edge planes of bamboolike-structure multiwall CNTs facilitate the electron-transfer kinetics at the counter electrode-electrolyte interface, resulting in low charge-transfer resistance and an improved fill factor. In combination with a dye-sensitized TiO2 photoanode and an organic liquid electrolyte, a multiwall CNT counter-electrode DSSC shows 7.7% energy conversion efficiency under 1 sun illumination (100 mW/cm(2), air mass 1.5 G). The short-term stability test at moderate conditions confirms the robustness of CNT counter-electrode DSSCs.

RESUMEN

Nano rutile, anatase, and bicrystalline (anatase + brookite) titania powders with an average crystal size of below 10 nm are prepared from aqueous TiOCl(2) solution at low temperatures by adjusting pH values of the starting solution and adding different additives. Adding a small amount of octyl phenol poly(ethylene oxide) into aqueous TiOCl(2) solution leads to the change of particle morphologies of obtained nano titania from needlelike to nano spherical rutile crystals. Amorphous-anatase transformation of titania could proceed in liquid-solid reaction at low temperatures, even at room temperature. A formation mechanism of rutile, anatase, and brookite titania was proposed. It is found that H(+) or H(3)O(+) plays a catalytic role in the phase transformation from amorphous to anatase titania and that the presence of a small amount of SO(4)(2)(-) ion is unfavorable to the formation of both rutile and brookite. By carefully adjusting preparation conditions, nano pure anatase with higher surface area, good crystallinity, and a lower recombination rate of photoexcited electrons and holes was obtained. This nano pure anatase showed a very good photocatalytic activity for gas-phase photo-oxidation of benzene.

Asunto(s)