Marcelo de Souza Fernandes Pereira

Monoclonal antibodies to the serum parvovirus-like virus (SPLV) were prepared by the hybridoma technique. They provided an antibody reagent which was used to develop solid phase antibody-capture assays for anti-SPLV IgM and IgG and for SPLV antigen. These assays were more sensitive than those based on human convalescent antibody as a reagent, and were more economical in the use of SPLV antigen. Their use enabled the serological responses to SPLV to be studied more fully and their sensitivity revealed the extent of SPLV infection. SPLV antigen was detected in four patients by both counter-immuno electrophoresis (CIE) and radioimmunoassay (RIA) and in two others by RIA alone. Parvovirus particles were seen in all six by electron microscopy. The anti-SPLV IgM response was measured in patients infected by SPLV. It was strong 5-18 days after the onset of illness, then declined and was only detectable in trace amounts after 6 months. Anti-SPLV IgG was also formed early, and persisted for at least 6 months. In a survey of 310 blood donors anti-SPLV was detected in 134 (43%) by CIE, but in 190 (61%) by IgG antibody capture RIA.

Multiple myeloma (MM) is a plasma cell neoplasm that commonly expresses CD38. Daratumumab (DARA), a human monoclonal antibody targeting CD38, has significantly improved the outcome of patients with relapsed or refractory MM, but the response is transient in most cases. Putative mechanisms of suboptimal efficacy of DARA include downregulation of CD38 expression and overexpression of complement inhibitory proteins on MM target cells as well as DARA-induced depletion of CD38high natural killer (NK) cells resulting in crippled antibody-dependent cellular cytotoxicity (ADCC). Here, we tested whether maintaining NK cell function during DARA therapy could maximize DARA-mediated ADCC against MM cells and deepen the response. We used the CRISPR/Cas9 system to delete CD38 (CD38KO) in ex vivo expanded peripheral blood NK cells. These CD38KO NK cells were completely resistant to DARA-induced fratricide, showed superior persistence in immune-deficient mice pretreated with DARA, and enhanced ADCC activity against CD38-expressing MM cell lines and primary MM cells. In addition, transcriptomic and cellular metabolic analysis demonstrated that CD38KO NK cells have unique metabolic reprogramming with higher mitochondrial respiratory capacity. Finally, we evaluated the impact of exposure to all-trans retinoic acid (ATRA) on wild-type NK and CD38KO NK cell function and highlighted potential benefits and drawbacks of combining ATRA with DARA in patients with MM. Taken together, these findings provide proof of concept that adoptive immunotherapy using ex vivo expanded CD38KO NK cells has the potential to boost DARA activity in MM.

In relation to the study of infectious mononucleosis a survey of the prevalence of antibody to EB virus was made on the sera of persons of varying age from several different areas in England by the indirect immunofluorescence technique. About half those tested were found to have acquired antibody by the age of 4 years and there was a further significant increase in the proportion of those positive between the ages of 15 and 24 years. The finding of seroconversion in two patients who developed infectious mononucleosis provides further support for an association between EB virus and this condition.

The mechanism that leads to the remarkable T cell unresponsiveness to antigens in paracoccidioidomycosis is unknown. We investigated the involvement of cytokines, of Fas-Fas ligand (Fas-FasL)-induced apoptosis, and of cytotoxic T lymphocyte antigen 4 (CTLA-4) engagement, in the mediation of this phenomenon. T cell unresponsiveness was not associated with imbalanced cytokine production or with absence of CD28 expression. Only patient T cells expressed higher levels of CTLA-4, Annexin V(+), and FasL. The addition of anti-FasL decreased the levels of apoptosis, suggesting an activation-induced cell death triggered through the Fas-FasL pathway. Blockage of CTLA-4 and FasL resulted in increased production of interferon-gamma. Moreover, concomitant inhibition of FasL and of CTLA-4, but not of transforming growth factor-beta, resulted in significant T cell proliferation in patients, in response to phytohemagglutinin. Together, these data show that apoptosis mediated by Fas-FasL and engagement of CTLA-4 are involved in modulation of the immune response in patients infected with Paracoccidioides brasiliensis.