WO1995001992A1

WO1995001992A1 - Compositions for and methods of treating cancer and autoimmune diseases

Info

Publication number: WO1995001992A1
Application number: PCT/US1994/007669
Authority: WO
Inventors: Thomas M. Rodgers, Jr.; T. Ronald Theodore
Original assignee: Private Biologicals Corporation
Priority date: 1993-07-09
Filing date: 1994-07-08
Publication date: 1995-01-19
Also published as: AU7256994A; EP0662089A1; CA2147873A1

Abstract

The present invention provides methods and compositions for stimulating the immune system and thereby causing reduction, lysis and/or necrosis of tumors and slowing the progression of diseases including cancer, autoimmune diseases and diseases caused by viral infection. In particular is provided a cytokine containing composition and methods of obtaining the same from cells comprising culturing the cells on fresh medium, harvesting the culture supernatant in the absence of filtration of the supernatant, and maintaining the supernatant until administration, the supernatant thereby being a composition for administration. Additionally provided are methods of treating cancers, autoimmune diseases and viral infections comprising administering the supernatant compositions.

Description

COMPOSITIONS FOR AND METHODS OF TREATING CANCER AND AUTOIMMUNE DISEASES

BACKGROUND OF THE INVENTION

FIELD OF THE INVENTION

The present invention relates to methods and compositions for activating the immune system and thereby causing reduction, lysis and/or necrosis of tumors and slowing the progression of diseases including cancer, autoimmune diseases and diseases caused by viral infection. In particular is provided a lymphokine and cytokine composition and methods of making the same. Additionally provided are methods of treating cancers, autoimmune diseases and viral infections comprising administering the claimed compositions.

BACKGROUND ART

Cancer is a disease that affects a significant portion of the population in the United States as well as the rest of the world. It is estimated that one in four persons will develop cancer within his or her lifetime. Of those who develop cancer, more than half die from it. Cancer deaths have been steadily rising in the United States. The number of cancer deaths doubles approximately every thirty years. It is believed that this increase in deaths is due, at least in part, to the increase in the aging population, environmental carcinogens and the increase in lung cancer.

Furthermore, recent years have seen an increase in virus-mediated diseases as well as autoimmune disorders. For example, chronic active hepatitis, historically associated with hepatitis A, B, and C is caused by viral infection, alcoholism and toxin exposure. It involves progressive changes and necrosis of the liver. Current treatment, which is pharmaceutically oriented with steroid therapy, has shown minimal effect on slowing the disease process which ultimately leads to destruction of the liver. Additionally, Kaposi's sarcoma, a virally-caused tumor seen in elderly patients and frequently in the black population of Africa, is increasing in frequency due to association with immunocompromised patients, such as HIV-positive patients.

Autoimmune diseases encompass a large number of pathological and clinical entities which have historically been treated with both immunosuppresive and immunostimulating agents. Studies indicate that autoimmune diseases may be modulated through genetic and/or hemopoietic mechanisms, the entire spectrum of which is not adequately defined outside of the pathological conditions.

At the present time there are three basic approaches to the treatment of cancer. The modalities are sometimes used simultaneously or in sequence. These modalities are surgical resection, chemotherapy and radiation therapy.

Since the early 1970's, a new approach to treatment of cancer has been slowly evolving in the area of immunologic research. Early investigators began testing size- filtered fractions of cell supernatants and found that certain cytokines possessed ability to influence tumor activity as well as a capability to affect the hemopoietic system (see, e.g., McDaniel, M.C., etal., Clin. Immunol. Immunopathol, pp. 91- 104 (1976); Papermaster, B.W., et al, Clin. Immunol. Immunopathol, 5:48-59 (1976)). Methods used involved not only size-filtering but also lyophilization, chromatographic separation and extraction or reconstitution into various buffers. Research then focused on identifying individual components of these supernatants (see, e.g., Papermaster, B., etal, Advances In Immunopharmacology, pp. 507-511 (1981); Dunn, P. A, et al, J. Immunol. Methods 64:71-83 (1983); Papermaster, B. W., etal, Cancer 45:1248- 1253 (1980)). New techniques for identifying cytokines evolved, and the activity of many cytokines and lymphokines were studied. The actions and mechanisms are still not well understood in many aspects. Specific cytokines that have been tested for effect on tumors, hemopoietic activity and infectious disease have shown limited promise as anti-tumor agents, and they have had short-lived effects.

Thus there exists a great need for agents to treat various cancers and reduce tumors, as well as to treat virus-mediated diseases and autoimmune disorders. Though many attempts have been made to find such treatments, none have been entirely satisfactory. The present invention fills this great need, as it provides a nontoxic, highly effective treatment that rapidly and significantly reduces tumors in subjects, increases CD₄ cell counts and reduces virus-induced lesions and lesions associated with autoimmune disorders. The present invention is different from the prior methods of treating disease in that it uses a composition comprising a cytokine- containing supernatant from cells rather than a purified component isolated from cells. It is also different from prior methods in the rapidity of its effects and the multiplicity of effects, further including halting wasting, increasing appetite, and decreasing pain.

SUMMARY OF THE INVENTION

The present invention provides a method of preparing a cytokine containing composition from hemopoietic cells for administration to a subject comprising: a) culturing the cells on fresh medium; b) harvesting the cell culture supernatant in the absence of filtration of the supernatant; and c) maintaining the supernatant until administration, the maintained supernatant thereby being the cytokine containing composition for administration, and also a method wherein further the cells are activated by a virus, in particular, Epstein-Barr virus.

Also provided is a composition produced by the above methods.

The invention also provides a method of activating the immune system of a subject, comprising administering to the subject an amount of the claimed composition such that the immune system is activated. "Activating" can include activating, for example, a stimulator or a blocker of immunological activities. Further provided is a method of increasing CD₄ counts in a subject comprising administering to the subject an amount of the supernatant compositions such that CD₄ counts are increased.

Also provided is a method of reducing tumor size in a subject comprising administering to the subject a tumor-reducing amount of the supernatant compositions such that the tumor size is thereby reduced.

The present invention provides a method of treating autoimmune diseases in a subject, comprising administering to the subject an amount of the supernatant compositions such that progression of the autoimmune pathophysiology of the disease is slowed.

Also provided are methods of treating viral infections and of reducing pain and/or inflammation in a subject, comprising administering the supernatant compositions.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention may be understood more readily by reference to the following detailed description of specific embodiments and the Examples included therein.

The present invention provides a method of preparing a cytokine containing composition from hemopoietic cells for administration to a subject comprising: a) culturing the cells on fresh medium; b) harvesting the culture supernatant in the absence of filtration of the supernatant; and c) maintaining the supernatant until administration, the supernatant thereby being a cytokine containing composition for administration. This invention provides a composition produced by this method that comprises cytokines, lymphokines and other substances produced by the cells in naturally occurring formulations and ratios that are involved in complex physiologic mechanisms and cause the physiological effects of administration of the composition described herein. The immune system and/or cellular mechanisms are activated in more than one way under specific conditions, both normal and pathologic. "Activating", as used herein, can include activating, for example, a stimulator or a blocker of a mechanism or function.

As used herein, "cells" includes cell lines. Cells that can be useful for this invention include any hemopoietic cell lines which, when grown such that the supernatant is harvested and maintained as described herein, produce immune system activating effects, such as reduction, lysis and/or necrosis of tumors and slowing the progression of diseases including cancer, autoimmune diseases and diseases caused by viral infection, when the supernatant is administered to a subject. Useful cell lines can be determined by an initial test for the production by a cell line of a supernatant having active cytokines, the test comprising, for example, obtaining a supernatant from the test cells by the methods herein, and injecting about 0.1-1 ml of the supernatant subcutaneously into a laboratory animal, a wheal and flare reaction at or around the injection site indicating the presence of active cytokines in the supernatant, and thus indicating a useful cell line. Further testing can be done with the supernatant on, for example, laboratory animals, following the protocol described herein and screening for effects indicating an activated immune system such as, for example, an increase in CD₄ counts, or by treating animals having tumors, lesions or other manifestations of a particular cancer or other disease, and monitoring the reduction in tumor size, lesions or other manifestation, as exemplified and taught by the methods and examples herein. Since the composition is nontoxic, such tests can be routinely performed, given the teachings and examples herein. Furthermore, since immune system effects in subjects occur very quickly, cell lines can be rapidly screened.

In a presently preferred embodiment, the hemopoietic cells used in the culturing step are selected for prior exposure to a virus associated with cancer. By "associated with cancer" is meant a virus whose infection of a subject has been linked by those of skill in the art with the occurrence of cancer, such as, for example, influenza viruses, rotaviruses, adenoviruses, herpesviruses, immunodeficiency viruses and cocksackieviruses. An example of such a cell line is the cell line designated RPMI 1788 and deposited with the American Type Cell Culture under Accession Number CLL 156, which has been previously exposed to Epstein-Barr virus. This embodiment contemplates any hemopoietic cell line as described herein that has been previously exposed to any such virus associated with cancer which, when a supernatant is prepared as described herein and administered to a subject, causes the effects described herein, such as tumor reduction, etc. It is believed that the presence of antigens from such viral exposure can block or enhance certain pathways that allow for higher anti-tumor, anti¬ viral, immune system activating, etc. capability by the supernatant collected from these cells.

Preferred cell lines include those activated by prior exposure to Epstein- Barr virus, as can be detected, for example, by detecting the presence of Epstein-Barr virus nucleic antigen. For example, cell line RPMI 1788, deposited with the American Type Cell Culture Collection under Accession Number CLL 156, is Epstein-Barr virus nucleic antigen-positive, as is about 60% of the human population from whom additional cell lines can be derived. Tests for determining the presence of Epstein-Barr virus nucleic antigen are standard and known in the art given the teaching provided herein.

In an alternative embodiment, the culturing step further comprises activating production of cytokines by the cells. Agents which cause an increase in production of cytokines by the cells can be added during the culturing step to activate the cells by, for example, activating the immune system or activating a cellular mechanism, e.g., ionic flux alterations or alterations in cellular division mechanisms. Thus, for example, the cells can be immunologically stimulated cells. Examples of steps that can activate the cells include endotoxin stimulation and PAS (protein activation stimulation) techniques, as known to those of skill in the art. As discussed above, prior exposure to viruses associated with cancer can activate the cells.

Also preferred are cells that are IgM secreting. Many commercially available hemopoietic cell lines have already been examined for this characteristic, and other cell lines can be routinely tested for this characteristic by methods standard and known in the art given the teaching provided herein.

Subjects to be treated by the method of this invention can include not only humans, as exemplified by the examples, but also other animals, for example, dogs, cats, horses, cattle, pigs, sheep, and chickens. Such veterinary uses include treating, for example, cancers, viral infections, autoimmune diseases, etc. as further enumerated herein. Cell lines to be used for any given animal can be chosen accordingly, as tested for activity in that animal as described herein.

As used in the claims, "a" can mean one or more.

By "absence of filtration" is meant that the supernatant is either not filtered at all or is filtered with a filter having a large enough pore size such as not to exclude any immune modulating cellular products in the supernatant, in particular, cytokines and lymphokines. It is preferable that, if it is believed that any given collected supernatant is free from contaminants, no filtration be done. Such belief can come from direct observation of the supernatant or from testing performed on a reserved aliquot of the subsequently frozen collected supernatant. In furtherance of avoiding the need to filter the supernatant, steps should be taken, as exemplified in the examples and known in the art, to test reagents used to produce the composition for contaminants. If filtration is desired, filter size should be at least large enough not to exclude products of at least about 150,000 daltons, and preferably not to exclude products of about 250,000 daltons. Thus, if filtration is undertaken, a preferred filter size is, therefore, not less than about 0.25 microns.

Maintenance of the harvested supernatant until administration will depend on how soon after harvesting the composition is to be administered. If it is to be administered immediately, i.e., within about two to three hours, it can be maintained sterilely at any desirable temperature up to about 37°C. Excessive mechanical disturbance should be avoided during this time. If the supernatant is to be administered later than about two to three hours after it is harvested, or if it is to be transported such that it would be mechanically disturbed, it is preferred that the supernatant be maintained by freezing, preferably to a temperature below about -40 °C, and even more preferred that it be maintained by quick freezing, again preferably to a temperature below about -40°C. By "quick" is meant that the temperature of the supernatant is dropped to the ultimate freezing temperature within about 60 minutes, and preferably within about 30 minutes, as by placing the supernatant into an ultrafreezer set at the desired temperature, as exemplified in the examples. A most preferred temperature is below about -70°C.

In a preferred embodiment, the frozen supernatant is maintained less than about 3 months. Longer maintenance times can be possible, especially at colder temperatures, as long as the supernatant retains its effectiveness, as can be tested, according to the teachings herein, upon thawing the supernatant.

In the present method it is also preferred that the supernatant not be lyophilized during maintenance, since this can destroy the activities of some components of the composition. Since the invention provides that the effectiveness of the composition is derived, at least in part, from the naturally occurring ratios of the individual components of the composition that properly activate the subject's immune system and cellular mechanisms to treat disorders, it is preferred that the activity of none of the components be endangered by steps such as lyophilization, which are traditionally routinely performed to store and/or to concentrate a given biological composition.

Furthermore, a preferred method includes maintaining the supernatant in the absence of a buffer. "In the absence of a buffer" means that the composition is not placed in the presence of a buffered solution, i.e., one that tends to stabilize the hydrogen ion concentration in the solution by neutralizing any added alkali or acid. The medium used should be that appropriate to the specific cell type for normal growth. The medium can be supplemented with either standard amounts of serum or serum albumin, as exemplified in the examples. If albumin is used, it is preferable that early generations of cell culture growth, prior to the final growth from which the supernatant will be isolated, be in media containing serum, as cell growth on medium with albumin but no serum is much slower. Additionally, however, known techniques, such as PAS techniques and endotoxin stimulation, can be utilized to cause faster growth of cells and/or higher concentrations of specific cytokines.

Additionally, the supernatant harvested from each generation of cells can be tested for a minimum of activity, to ensure that the batch from each successive generation is still effective. Should effectiveness decline, fresh cells can be grown. As an example of such a test, the supernatant can be tested for the presence of several known cytokines, by standard techniques known to those of skill in the art. Effectiveness of a supernatant can also be monitored by monitoring in a subject after receiving the supernatant positive indicators of effectiveness such as, for example, (1) increased cytokine levels, (2) reduction, lysis or necrosis of a tumor and/or (3) decrease in overall distribution of lesions, produced by such batch of supernatant, a reduction in any such indicator indicating a decrease in effectiveness.

The present invention provides methods of using the supernatant to cause various described effects in the body. The effects can occur immediately, during continuation of therapy, or even after treatment is stopped, as delayed effects.

The present invention provides a method of activating the immune system of a subject, comprising administering to the subject an amount of the cell supernatant such that the immune system is activated. A preferred method utilizes a supernatant collected from cells that have been exposed to a virus associated with cancer, including Epstein-Barr virus among others. Indicators of immune system activation include an increase in CD₃, CD₄, CD_g and/or CD ₂₀ counts from the count prior to treatment, increase in cytokine activity, and increase in stem cell production. The invention thus also provides a method of increasing CD₄ counts (cluster determinate) in a subject comprising administering to the subject an amount of the cell supernatant composition such that CD₄ counts are increased. A preferred method utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, especially Epstein-Barr virus. CD₄ counts can be readily determined by hand counting or by automated counters by standard protocols known to those of skill in the art, and as exemplified in the examples. CD₄ counts of approximately 800 to 1000 are considered to be normal, while counts below normal represent various levels of immunosuppression, and below about 200 is considered severely immunosuppressed. This invention contemplates any increase in CD₄ counts.

The invention further provides a method of reducing tumor size in a subject comprising administering to the subject a tumor-reducing amount of the cell supernatant composition such that the tumor size is thereby reduced. A preferred method utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, including Epstein-Barr virus, among others. Tumor size can be monitored by standard tumor detection and measurement methods such as CAT scanning (computerized axial tomography), MRI (magnetic resonance imaging), and nuclear medicine scans, as known to those of skill in the art. Any tumor that is reduced by this method, as can be tested as taught herein, can be treated by this method, including, for example, tumors of ectodermal, mesodermal and endodermal origin, such as tumors associated with non-Hodgkins lymphoma, adenocarcinomas, metastatic mesothelioma, squamous cell carcinomas such as squamous cell carcinoma of the brain, embryonic carcinoma of the testicle, carcinoma of the breast, metastatic carcinoid tumors, ovarian carcinoma, malignant melanomas such as malignant melanoma metastatic to the bone and liver and malignant melanoma of the brain (cerebellum and cerebrum), cancer of the lung, cancer of the larynx, seminoma, mesothelioma, mycosis fungoides, multiple myeloma lymphosarcoma, Kaposi's sarcoma, and brain tumors such as primary cancer of the brain, metastatic carcinoma, astrocytoma and glioma, among many others, as exemplified by the examples. Also provided by the invention is a method of treating autoimmune diseases in a subject, comprising administering to the subject an amount of the cell supernatant composition such that progression of the autoimmune pathology of the disease is slowed. By "slowed" is meant to include any decrease in progression of the disease such as slowing, stopping or reversal of the disease. For example, the method can halt wasting, lower antibody titers, and increase energy, appetite and quality of sleep. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, especially Epstein-Barr virus. Progression and involvement of lesions caused by the virus or total anatomic involvement of the disease, which are herein used as indicators of the progression of the disease, can be determined by standard methods known in the art for each specific lesion type, depending upon the specific disease, for example, organ function or antibody titers. Any autoimmune disease that responds favorably to this method, as can be tested as taught herein, can be treated by this method, such as acquired immunodeficiency syndrome (AIDS), diabetes, interstitial nephritis, leukoplakia, aphthous stomatitis, lichen planis, multiple sclerosis, psoriasis, glomerulonephritis, myasthenia gravis, systemic lupus erythromatosis, uveitis and rheumatoid arthritis.

The present invention also provides a method of reducing a lesion caused by a virus in a subject, comprising administering to the subject an amount of the cell supernatant composition such that the lesion is reduced. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, in particular Epstein-Barr virus. Lesion progression and involvement can be monitored by standard methods known to those of skill in the art, such as, for example, blood tests, antibody titers and visual inspection, as well as other evaluation techniques known to those of ordinary skill in the art. Lesions caused by any virus that produces lesions that are reduced by this method are included in this invention, as can be tested by the methods herein, such as, for example, Kaposi's sarcoma, herpes simplex, herpes zoster, and genital herpes.

The invention further provides a method of reducing the intensity and duration of a viral infection in a subject, comprising administering to the subject an amount of the cell supernatant composition such that the intensity and duration of the viral infection are reduced. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, in particular Epstein-Barr virus. The method can be utilized for any viral infection, the intensity and duration of which is reduced by the administration of a composition of the present invention by the claimed method, as can be tested by the methods described herein. Such viral infections are exemplified by the examples and can include, for example, infection by influenza viruses, rotaviruses, adenoviruses, herpesviruses, immunodeficiency viruses, and coxsackieviruses.

Also provided herein is a method of treating hepatitis in a subject, comprising administering to the subject an amount of the cell supernatant composition such that the pathologic and pathophysiologic activity of hepatitis is reduced. Such pathologic and pathophysiologic activities that are reduced by this method include, for example, elevated liver functions, elevated bilirubin levels, enlarged liver size and enlarged spleen. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, including Epstein-Barr virus. By "hepatitis" is meant to include, for example, hepatitis A, hepatitis B, alcoholic hepatitis and hepatitis C (formerly non A non B).

Also provided is a method of reducing side effects of chemotherapy and radiation therapy in a subject, comprising administering to the subject an amount of the cell supernatant composition such that the side effects of chemotherapy and radiation therapy are reduced. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, including Epstein- Barr virus. Side effects which can be reduced include any which such treatment relieves, such as nausea, vomiting and hair loss.

Further provided by this invention is a method of reducing pain and/or inflammation in a subject, comprising administering to the subject an amount of the cell supernatant composition such that pain and/or inflammation are thereby reduced. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, in particular, Epstein-Barr virus, among others. Pain remission can include remission of pain from a decrease in tumor size or in space-occupying lesions, thus decreasing organ pressure and compression of anatomical structures (i.e., nerves, vessels and other organs), as well as remission in pain not associated with a decrease in tumor size or a decrease in lesions, such as pain in bones and other pain remission that occurs before a significant decrease in tumor size or lesions occurs. Such pain remission can occur by other physiologic mechanisms such as changes in production of endorphins and similar biochemicals as well as alterations in nervous system activity and changes in ionic conduction of cells.

A method of reducing effects of mental depression in a subject is also provided, comprising administering to the subject an amount of the cell supernatant composition such that the effects of mental depression are reduced. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, including Epstein Barr virus among others. Effects that are within this invention are those that can be reduced by this method, as can be tested by the methods taught herein and by standard protocols for measuring such effects. Examples of effects which can be reduced by this method include weight loss, insomnia, and dejected mood. Some results from this method include increase in appetite, increased quality of sleep and increase in euphoria.

Also provided is a method of treating a cancer in a subject, comprising administering to the subject an amount of the cell supernatant composition such that progression of the cancer is slowed. By "slowed" is meant to include any decrease in progression of the disease such as slowing, stopping or reversal of the disease. A preferred method of treatment utilizes supernatant collected from cells that have been exposed to a virus associated with cancer, including Epstein-Barr virus among others. Cancers included in this method are those which are reduced by this method, as can be tested given the teachings herein. Some examples of such cancers include cancers of the blood, i.e., cancers of the hemopoietic system, non-Hodgkins lymphoma, adenocarcinomas, metastatic mesothelioma, squamous cell carcinomas such as squamous cell carcinoma of the brain, embryonic carcinoma of the testicle, carcinoma of the breast, metastatic carcinoid tumors, ovarian carcinoma, malignant melanomas such as malignant melanoma metastatic to the bone and liver and malignant melanoma of the brain (cerebellum and cerebrum), brain tumors such as primary cancer of the brain, metastatic carcinoma, astrocytoma and glioma, cancer of the lung, cancer of the larynx, seminoma, mesothelioma, mycosis fungoides, multiple myeloma lymphosarcoma and Kaposi's sarcoma, among many others, as exemplified by the examples.

The present invention also provides a method of detecting infection in a subject comprising administering, preferably intravenously, the cell supernatant composition to the subject and monitoring development of a reaction such as fever, chills, diaphoresis and/or rigor by the subject, such development indicating detection of infection. It is preferred that supernatant from cells grown on medium containing serum be used for this method. Once a reaction such as fever, chills, diaphoresis and/or rigor is detected, the patient can be screened by standard methods known to those of skill in the art to determine the precise infection and to choose and institute standard antibiotic therapy for that particular infection, or alternatively, broad spectrum antibiotic therapy can be instituted. As shown in the examples, the development of reaction to administration of the composition is very fast (within about five minutes to about three hours). Thus a very rapid test for detecting infection is provided.

Furthermore, after treatment for the infection, the patient can be monitored for the absence of reaction to a second administration of the composition, the absence of reaction indicating successful control of the infection.

The compositions may be administered parenterally, e.g., intravenously, subcutaneously, and the like. The exact amount of a composition required will vary from subject to subject, depending on the species, age, weight and general condition of the subject, the severity of the disease that is being treated, the mode of administration used and the like. Thus it is not possible to state an exact amount. However, an appropriate amount may be determined by one of ordinary skill in the art using only routine testing given the teachings herein, including the examples. Generally dosage will preferably be in the range of about 0.1 cc to about 100 cc, with an average range of about 10 cc to 50 cc, administered once or twice a day. Generally, when an increase in dosage is desired (e.g., when response is not as high as desired), the increase is effected by adding additional doses per day rather than increasing the amount of a single dose. Additionally, once the subject is responding well to treatment, it may be desirable to decrease the number of doses, for example, to about two to three doses per week.

Depending on the intended mode of administration, the composition can be in pharmaceutical compositions in solid, semi-solid or, preferably, liquid forms. The compositions can include, if desired, an effective amount of the composition in combination with a pharmaceutically acceptable carrier and, in addition, may include any other medicinal agents, pharmaceutical agents, carriers, adjuvants, diluents, etc. that do not interfere with the activity of the composition, for example physiological saline. By "pharmaceutically acceptable" is meant a material that is not biologically or otherwise undesirable, i.e., without causing any undesirable biological effects or interacting in a deleterious manner with any of the other components of the pharmaceutical composition in which it is contained.

The present invention is more particularly described in the following examples which are intended as illustrative only since numerous modifications and variations therein will be apparent to those skilled in the art.

EXAMPLES

Cell culture and supernatant isolation ATCC CLL156 cell line RPMI 1788 was obtained from the American

Type Tissue Culture Collection. This cell line contains human hemopoietic cells derived from the peripheral blood leukocytes of a normal human male. The cells are a mixture of hemopoietic cells, likely including stem cells, CD4 cells, CD8 cells, CD20 cells, neutrophils and leukocytes. They are IgM secreting, and they are positive for the Epstein Barr virus nucleic antigen (ATCC catalog), indicating that they have been previously exposed to this virus. The cells were rapidly thawed to 37 °C in a constant temperature water bath. The cells were suspended at room temperature in 0.2 micron-filtered Iscov's Media containing HEPES (GIBCO BRL Life Technologies, Inc., Gaithersburg, Maryland) and supplemented with 2% glutamine and 2-5% normal human serum (GIBCO BRL Life Technologies, Inc.) or 10-25% human albumin (GIBCO BRL Life Technologies, Inc.). The normal human serum, type AB, was tested and shown to be free of mycoplasma, Hepatitis B antigen, antibody to Hepatitis B core antigen, antibody to Hepatitis C virus, antibody to HTV-1, and antibody against HTLV-1, in accordance with test criteria established and recommended by the Centers for Disease Control.

The cells were cultured in T75 flasks in an atmosphere of 5% CO₂ at 37 °C until the cell density exceeds 1 X 10⁶ cells/ml. The cells were then recovered by centrifugation at 800 X g for 5 minutes and resuspended in T150 flasks at a density of 0.2 X 10⁶ cells/ml in a total volume of 200 mis of media. Cells were cultured in 5% CO₂ at 37°C until their density again approached 1 X 10⁶ cells/ml. At this time the cells were resuspended as above to produce new T150 flask cultures. The other cells were used to initiate cultures in 500 ml roller bottles (Corning).

Cells placed in 500 ml roller bottles were then initially suspended at 0.2 X 10⁶ cells/ml in media as noted above. The flasks were flushed for 5 minutes with 10% CO₂ and sealed. Cells were subsequently cultured at 37°C until cell density exceeded 1 X 10⁶ cells/ml. At this time the culture supernatant was harvested by slowly drawing off the supernatant using a sterile pipette. The supernatant was then spun down to remove any cells or cell debris. The supernatant was then either not filtered or filtered through a 250,000 Da filter to remove contaminants such as bacteria but not any cytokines. The supernatant was sterilely transferred into sterile 50 ml conical tubes in volumes of 30 mis. It was immediately frozen and maintained at - 80°C. This composition is referred to as "LK 200." No buffer was added, and the pH was not altered (remained at normal human pH of about 7.4).

New roller bottle cultures were repeatedly produced using cells from the T150 flasks. The cells, once the supernatant was harvested, were not reutilized. Aliquots of cell culture lots were monitored for 14 days at 37 °C for evidence of bacterial or fungal contamination. In addition, they were monitored for mycoplasma contamination using host staining or a broth assay by standard methods. in case of question, GenProb analysis (Gen-Probe Corp., San Diego, California) was performed.

Administration of composition

Frozen aliquots of LK 200 were thawed quickly to 37°C without shaking the vials and used within about 2-3 hours. The dosage was administered intravenously or subcutaneously. In some cases, dosage was allowed to be based on tumor response (but was still within the range of about 0.1 cc to 100 cc); however, the standard course of protocol for the patients listed in Table I was as follows:

Day 1 through Day 7: One daily dose of 10-50 cc LK 200 intravenously in 100 cc normal saline, over 15 to 30 minutes. In some newer cases, an additional 4 cc (undiluted) was administered subcutaneously with each intravenous dose.

Day 8 forward: 10-50 cc LK 200 two to three times per week. In some newer cases, an additional 4 cc (undiluted) was administered subcutaneously. Thus far, treatment has been continued for approximately 8 weeks.

Increases in any given dosage, if tumor response was not satisfactory, were found to be better accomplished by increasing the number of doses per day, rather than the amount in a single dose. No adverse reactions were observed from additional doses.

Patient condition

Upon administration of the first dose of LK 200, all patients experienced the following immediate effects, i.e., within about 24-48 hours, in addition to the immediate tumor shrinkage detailed in Table I:

(1) remission of pain caused by pressure from tumor or space-occupying lesions which caused organ pressure and compression of anatomical structures (i.e., nerves, vessels and other organs), and pain in bones and other structures; (2) increase in appetite; (3) increase in energy; (4) halting of wasting; (5) increase in quality of sleep. Table I provides data from patients treated with LK 200, detailing the regression of specific tumors or lesions associated with the listed disease. Tumors and lesions were measured by CAT scan, MRI and visual inspection.

Table I

* Additional patient data:

Patient Al 12 (malignant melanoma metastatic to bone and liver)

Prior to treatment: Extensive disease of bone and liver Severe bone pain

Immediate effect of treatment: pain free

After one week of standard therapy: Liver functions, alkaline phosphatase and BUN rose dramatically; creatinine remained essentially normal; sternal bone lesion resolved 60% (estimated); Liver cleared approximately 50%

Resolution: Family decided to stop treatment. Patient expired from what was believed to be Tumor Necrosis Syndrome. Due to family's decision, dialysis was not tried.

Patient VI 01 (chronic active hepatitis):

Began treatment April 1993 Prior to treatment: Bilirubin 6.7 (April 1993) Liver functions: elevated

Patient icteric

On June 1,1993: Bilirubin 4.5

Liver functions: normal

Patient anicteric

Liver: 10% reduction in size

Spleen: 25-30% reduction in size

Patient VI 03 (psoriasis):

Initial response to treatment: Moderate decrease in discomfort; reddened and indurated patches decreased; palmer lesions disappeared; patient could stop cortisone treatment for several days and now uses 25% of the original dose.

Patient VI 05 (Kaposi's Sarcoma):

After one month of therapy, the largest lesion disappeared and the remaining four satellite lesions regressed 30%. One month after treatment was stopped, all lesions had disappeared. Patient R101 (Kaposi's Sarcoma):

Prior record: immunocompromised male due to HTV;

CD₄ counts less than 25; prior treatment included interferon 3 times per week for 1 year, with no regression of the multiple lesions.

After 8 weeks of standard therapy: larger lesions have reduced by 40-50%; several of the flat skin lesions have regressed 60%.

Some tumors disappeared entirely during treatment with LK 200; others, after shrinking about 40-60%, started to become necrotic and slowly disappear, probably from macrophage activity. Additionally, some residual capsule and collagen tissue formation occurred.

Several patients who were responding well to therapy with LK 200, showing reduction of tumors, were switched from preparations grown on human albumin to preparations grown on human serum. Several of these patients developed fever, chills, diaphoresis (sweats), and rigor (shaking chills), within 5 -ninutes to 3 hours of injections varying from 0.1 cc to 50 cc. These reacting patients were all found, by urine culture or chest X-ray, to have either urinary infections or tuberculosis infection, respectively. Either antibiotic therapy (individually determined according to sensitivity after initial broad spectrum reaction) or standard anti-tuberculosis antibiotic therapy was then instituted. All patients were again administered LK 200 prepared from cells grown on human serum after 48 hours of antibiotic therapy and none developed a reaction. Thus the administration of LK 200 prepared from serum comprises a method of detecting infections, particularly subclinical, i.e., previously undetected, infections of at least bacterial and mycoplasmic origin.

Throughout this application, various publications are referenced. The disclosures of these publications in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains. Although the present process has been described with reference to specific details of certain embodiments thereof, it is not intended that such details should be regarded as limitations upon the scope of the invention except as and to the extent that they are included in the accompanying claims.

Claims

What is claimed is:

1. A method of preparing a cytokine containing composition from hemopoietic cells for administration to a subject comprising: a) culturing the cells on fresh medium; b) harvesting the cell culture supernatant in the absence of filtration of the supernatant; and c) maintaining the supernatant until administration, the maintained supernatant being the cytokine containing composition for administration.

2. The method of Claim 1, wherein the culturing step further comprises activating production of cytokines by the cells.

3. The method c " Claim 1, wherein the cultured cells are immunologically stimulated cells.

4. The method of Claim 1, wherein the cultured cells are previously exposed to a virus associated with cancer.

5. The method of Claim 4, wherein the virus is an Epstein-Barr virus.

6. The method of Claim 1, wherein the supernatant is maintained by quick freezing to a temperature below about -40°C.

7. The method of Claim 6, wherein the frozen supernatant is maintained less than about 3 months.

8. The method of Claim 1, wherein the supernatant is not lyophilized during maintenance.

9. The method of Claim 1, wherein the supernatant is maintained in the absence of a buffer.

10. The method of Claim 1, wherein the medium comprises human serum albumin.

11. The method of Claim 1 , wherein the cells are IgM-secreting cells.

12. The method of Claim 1, wherein the cells are the cell line designated RPMI 1788 and deposited with the American Type Cell Culture under Accession Number CLL 156.

13. The composition produced by the method of Claim 1.

14. The composition produced by the method of Claim 5.

15. A method of activating the immune system of a subject, comprising administering to the subject an amount of the composition of Claim 13 such that the immune system is activated.

16. A method of increasing CD₄ counts in a subject comprising administering to the subject an amount of the composition of Claim 13 such that CD₄ counts are increased.

17. A method of reducing tumor size in a subject comprising administering to the subject a tumor-reducing amount of the composition of Claim 13 such that the tumor size is thereby reduced.

18. A method of treating an autoimmune disease in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that progression of the autoimmune pathophysiology of the disease is slowed.

19. A method of reducing a lesion caused by a virus in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that the lesion is reduced.

20. A method of reducing the intensity and duration of a viral infection in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that the intensity and duration of the viral infection are reduced.

21. A method of treating hepatitis in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that the pathologic and pathophysiologic activity of hepatitis is reduced.

22. A method of reducing a side effect of chemotherapy and radiation therapy in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that the side effect of chemotherapy and radiation therapy is reduced.

23. A method of reducing pain and/or inflammation in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that pain and/or inflammation are thereby reduced.

24. A method of reducing effects of mental depression in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that the effects of mental depression are reduced.

25. A method of treating a cancer in a subject, comprising administering to the subject an amount of the composition of Claim 13 such that progression of the cancer is slowed.

26. The method of Claim 25, wherein the cancer is a cancer of the blood.

27. The method of Claim 25, wherein the cancer is selected from the group consisting of adenocarcinoma, malignant melanoma, non-Hodgkins lymphoma, squamous cell carcinoma of the brain, Kaposi's sarcoma, seminoma, mesothelioma, embryonic carcinoma of the testicle, breast carcinoma, ovarian carcinoma, lung cancer, and larynx cancer.

28. A method of activating the immune system of a subject, comprising administering to the subject an amount of the composition of Claim 14 such that the immune system is activated.

29. A method of increasing CD₄ counts in a subject comprising administering to the subject an amount of the composition of Claim 14 such that CD₄ counts are increased.

30. A method of reducing tumor size in a subject comprising administering to the subject a tumor-reducing amount of the composition of Claim 14 such that the tumor size is thereby reduced.

31. A method of treating an autoimmune disease in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that progression of the autoimmune pathophysiology of the disease is slowed.

32. A method of reducing a lesion caused by a virus in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that the lesion is reduced.

33. A method of reducing the intensity and duration of a viral infection in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that the intensity and duration of the viral infection are reduced.

34. A method of treating hepatitis in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that the pathologic and pathophysiologic activity of hepatitis is reduced.

35. A method of reducing a side effect of chemotherapy and radiation therapy in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that the side effect of chemotherapy and radiation therapy is reduced.

36. A method of reducing pain and/or inflammation in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that pain and/or inflammation are thereby reduced.

37. A method of reducing effects of mental depression in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that the effects of mental depression are reduced.

38. A method of treating a cancer in a subject, comprising administering to the subject an amount of the composition of Claim 14 such that progression of the cancer is slowed.

39. The method of Claim 38, wherein the cancer is a cancer of the blood.

40. The method of Claim 38, wherein the cancer is selected from the group consisting of adenocarcinoma, malignant melanoma, non-Hodgkins lymphoma, squamous cell carcinoma of the brain, Kaposi's sarcoma, seminoma, mesothelioma, embryonic carcinoma of the testicle, breast carcinoma, ovarian carcinoma, lung cancer, and larynx cancer.

41. A method of detecting infection in a subject comprising administering the composition of Claim 13 to the subject and monitoring development of fever, chills, diaphoresis and/or rigor by the subject, such development indicating detection of infection.

42. A method of detecting infection in a subject comprising administering the composition of Claim 14 to the subject and monitoring development of fever, chills, diaphoresis and/or rigor by the subject, such development indicating detection of infection.