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  • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
  • C12N5/06—Animal cells or tissues; Human cells or tissues
  • C12N5/0602—Vertebrate cells
  • C12N5/0634—Cells from the blood or the immune system
  • C12N5/0639—Dendritic cells, e.g. Langherhans cells in the epidermis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K40/00—Cellular immunotherapy
  • A61K40/10—Cellular immunotherapy characterised by the cell type used
  • A61K40/19—Dendritic cells
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K40/00—Cellular immunotherapy
  • A61K40/20—Cellular immunotherapy characterised by the effect or the function of the cells
  • A61K40/24—Antigen-presenting cells [APC]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K40/00—Cellular immunotherapy
  • A61K40/30—Cellular immunotherapy characterised by the recombinant expression of specific molecules in the cells of the immune system
  • A61K40/34—Antigenic peptides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K40/00—Cellular immunotherapy
  • A61K40/40—Cellular immunotherapy characterised by antigens that are targeted or presented by cells of the immune system
  • A61K40/41—Vertebrate antigens
  • A61K40/42—Cancer antigens
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
  • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
  • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
  • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

• the invention relates to the use of synthetic immune response modifiers to induce the maturation of dendritic cells in vitro.
• the invention additionally relates to methods of maturing dendritic cells, to methods of enhancing the antigen presenting ability of dendritic cells, and of enhancing T-cell stimulation using synthetic immune response modifiers.
• the invention further relates to cellular adjuvants prepared with the dendritic cells that have been matured according to the method of the invention.
• Dendritic cells are known to play an important role in the immune system, both for their potent antigen presenting ability and their ability to initiate T-cell mediated immune responses. Indeed, dendritic cells (“DC”) activate T-cells more efficiently than any other known antigen presenting cell, and may be required for the initial activation of na ⁇ ve T- cells in vitro and in vivo. These cells are generally present in the body at locations that are routinely exposed to foreign antigens, such as the skin, lung, gut, blood, and lymphoid tissues. In general, DC are broadly classified as immature or mature. Immature DC endocytose and process antigen efficiently, but express low levels of costimulatory molecules.
• mature DC display increased levels of costimulatory molecules CD40, CD80 and CD86, as well as HLA-DR.
• mature DC express CD83 and secrete increased amounts of various cytokines and chemokines that aid T-cell activation.
• DC can influence the balance of the Thl/Th2 immune response.
• Several reports have indicated that DC preferentially activate Thl responses, with the major determining factor being IL-12 secretion from the activated DC. Macatonia et al., J. Immunol. 154:5071 (1995). Hilkens et al., Blood 90:1920 (1997).
• Other reports have shown that DC can induce the generation of either Thl or Th2 clones. Roth, et al., Scand. J. Immunol. 43:646 (1996).
• the evidence indicates that multiple factors influence the ability of DC to initiate a Thl or Th2 response, including the DC to
• T-cell ratio the DC tissue of origin, the amount of antigen used to prime the DC, the expression of costimulatory molecules and the antigen injection route.
• ex vivo DC generation consists of obtaining DC precursor cells and then differentiating the cells in vitro into DC before introduction back into the patient.
• the DC must be terminally differentiated, or they will de-differentiate into monocytes/macrophages and lose much of their immunopotentiating ability.
• Ex vivo DC maturation has been successfully accomplished with monocyte conditioned medium; recombinant cytokines such as TNF- ⁇ , IL-1 and IL-6; bacterial products such as LPS, bacterial DNA and cross-linking CD40; and transfection with genes that encode cytokines or costimulatory molecules. While these methods are capable of producing mature DC, there are disadvantages to using recombinant molecules and cellular supernatants for maturing DC.
• IRM immune response modifier
• the IRM compounds useful in the method of the invention are generally of the imidazoquinoline type; that is, they have a structure that contains the imidazoquinoline ring system or a similar ring system, such as imidazopyridine or imidazonaphthyridine.
• the invention provides a method of in vitro maturation of dendritic cells comprising treating said dendritic cells with an imidazoquinoline type immune response modifying compound, as well as a population of dendritic cells produced by this method.
• the invention further provides a method of enhancing the antigen presenting ability of dendritic cells comprising treating said dendritic cells with an imidazoquinoline type immune response modifying compound.
• the invention provides a method of preparing a cellular adjuvant for the treatment of a disease comprising the steps of maturing dendritic cells in vitro by treating the dendritic cells with an imidazoquinoline type immune response modifying compound and exposing the mature dendritic cells to an antigen associated with said disease.
• Fig. 1 is a graphical depiction of the ability of the IRM compound 4-amino-2- ethoxymethyl- ⁇ , ⁇ -dimethyl-lH-imidazo [4,5-c] quinolin-1-ethanol (R-848) to enhance cell surface expression of CD83 and CD86.
• Fig. 2 shows the ability of R-848 to enhance the cell surface expression of costimulatory molecules on MO-DC.
• Fig. 3 shows the maturation of DC as measured by cell surface expression of various markers after 6 hours of stimulation with 2 ⁇ g/ml R-848.
• Fig. 4 depicts the results of treating MO-DC with R-848 on T-cell proliferation and T-cell cytokine production as seen by a primary MLR.
• Fig. 5 shows the response of R-848 treated MO-DC to tetanus toxoid.
• imidazoquinoline type IRM compounds refers to compounds containing an imidazoquinoline ring system or a similar ring system that have the ability to modify the immune response.
• Preferred imidazoquinoline type IRM compounds contain one or more of the following ring systems: imidazoquinoline; imidazopyridine; 6,7 fused cycloalkylimidazopyridine; 1 ,2-bridged imidazoquinoline; imidazonaphthyridine; and imidazotetrahydronaphthyridine.
• Particularly preferred IRM compounds contain an imidazoquinoline-4-amine ring system.
• Compounds useful in the methods of the invention will also typically have the ability to induce production of one or more of the cytokines TNF-cc, IL-1, IL-6 and IL-12 when administered to a host or applied in vitro to dendritic cells or monocyte/macrophages.
• Immune response modifier compounds useful in the method of the invention include compounds defined by Formulas I-IX(b) below.
• Preferred lH-imidazo [4,5-c] quinolin-4-amines are defined by Formulas I-V:
• R ⁇ is selected from the group consisting of alkyl of one to ten carbon atoms, hydroxyalkyl of one to six carbon atoms, acyloxyalkyl wherein the acyloxy moiety is alkanoyloxy of two to four carbon atoms or benzoyloxy, and the alkyl moiety contains one to six carbon atoms, benzyl, (phenyl)ethyl and phenyl, said benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from the group consisting of alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms and halogen, with the proviso that if said benzene ring is substituted by two of said moieties, then said moieties together contain no more than six carbon atoms;
• R 2 is selected from the group consisting of hydrogen, alkyl of one to eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from the group consisting of alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms and halogen, with the proviso that when the benzene ring is substituted by two of said moieties, then the moieties together contain no more than six carbon atoms; and each Ri is independently selected from the group consisting of alkoxy of one to four carbon atoms, halogen, and alkyl of one to four carbon atoms, and n is an integer from 0 to 2, with the proviso that if n is 2, then said Ri groups together contain no more than six carbon atoms;
• R ⁇ 2 is selected from the group consisting of straight chain or branched chain alkenyl containing two to ten carbon atoms and substituted straight chain or branched chain alkenyl containing two to ten carbon atoms, wherein the substituent is selected from the group consisting of straight chain or branched chain alkyl containing one to four carbon atoms and cycloalkyl containing three to six carbon atoms; and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; and R 22 is selected from the group consisting of hydrogen, straight chain or branched chain alkyl containing one to eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from the group consisting of straight chain or branched
• R is selected from the group consisting of hydrogen, straight chain or branched chain alkyl of one to eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from the group consisting of straight chain or branched chain alkyl of one to four carbon atoms, straight chain or branched chain alkoxy of one to four carbon atoms, and halogen, with the proviso that when the benzene ring is substituted by two such moieties, then the moieties together contain no more than six carbon atoms; and each R 3 is independently selected from the group consisting of straight chain or branched chain alkoxy of one to four carbon atoms, halogen, and straight chain or branched chain alkyl of one to four carbon atoms, and n is an integer from zero to 2, with the proviso
• R ⁇ 4 is -CHR x R y wherein R y is hydrogen or a carbon-carbon bond, with the proviso that when R y is hydrogen R x is alkoxy of one to four carbon atoms, hydroxyalkoxy of one to four carbon atoms, 1-alkynyl of two to ten carbon atoms, tetrahydropyranyl, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, 2-, 3-, or 4-pyridyl, and with the further proviso that when R y is a carbon-carbon bond R y and R x together form a tetrahydrofuranyl group optionally substituted with one or more substituents independently selected from the group consisting of hydroxy and hydroxyalkyl of one to four carbon atoms;
• R 24 is selected from the group consisting of hydrogen, alkyl of one to four carbon atoms, phenyl, and substituted phenyl wherein the substituent is selected from the group consisting of alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen; and R 4 is selected from the group consisting of hydrogen, straight chain or branched chain alkoxy containing one to four carbon atoms, halogen, and straight chain or branched chain alkyl containing one to four carbon atoms, and n is an integer from 0 to 2, with the proviso that if n is 2 then said R 4 groups together contain no more than six carbon atoms;
• R 15 is selected from the group consisting of: hydrogen; straight chain or branched chain alkyl containing one to ten carbon atoms and substituted straight chain or branched chain alkyl containing one to ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; straight chain or branched chain alkenyl containing two to ten carbon atoms and substituted straight chain or branched chain alkenyl containing two to ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; hydroxyalkyl of one to six carbon atoms; alkoxy
• Rs and Ry are independently selected from the group consisting of hydrogen, alkyl of one to four carbon atoms, phenyl, and substituted phenyl wherein the substituent is selected from the group consisting of alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen;
• X is selected from the group consisting of alkoxy containing one to four carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, hydroxyalkyl of one to four carbon atoms, haloalkyl of one to four carbon atoms, alkylamido wherein the alkyl group contains one to four carbon atoms, amino, substituted amino wherein the substituent is alkyl or hydroxyalkyl of one to four carbon atoms, azido, chloro, hydroxy, 1-morpholino, 1- pyrrolidino, alkylthio of one to four
• R 5 is selected from the group consisting of hydrogen, straight chain or branched chain alkoxy containing one to four carbon atoms, halogen, and straight chain or branched chain alkyl containing one to four carbon atoms, and n is an integer from 0 to 2, with the proviso that if n is 2, then said R 5 groups together contain no more than six carbon atoms.
• Ri 6 is selected from the group consisting of hydrogen; cycloalkyl of three, four, or five carbon atoms; straight chain or branched chain alkyl containing one to ten carbon atoms and substituted straight chain or branched chain alkyl containing one to ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to six carbon atoms and cycloalkyl containing three to six carbon atoms substituted by straight chain or branched chain alkyl containing one to four carbon atoms; fluoro- or chloroalkyl containing from one to ten carbon atoms and one or more fluorine or chlorine atoms; straight chain or branched chain alkenyl containing two to ten carbon atoms and substituted straight chain or branched chain alkenyl containing two to ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to six carbon atoms and cycloal
• R y is hydrogen or a carbon-carbon bond, with the proviso that when R y is hydrogen R x is alkoxy of one to four carbon atoms, hydroxyalkoxy of one to four carbon atoms, 1- alkynyl of two to ten carbon atoms, tetrahydropyranyl, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, 2-, 3-, or 4-pyridyl, and with the further proviso that when R y is a carbon-carbon bond R y and R x together form a tetrahydrofuranyl group optionally substituted with one or more substituents independently selected from the group consisting of hydroxy and hydroxyalkyl of one to four carbon atoms,
• R 26 is selected from the group consisting of hydrogen, straight chain or branched chain alkyl containing one to eight carbon atoms, straight chain or branched chain hydroxyalkyl containing one to six carbon atoms, morpholinoalkyl wherein the alkyl moiety contains 1 to 4 carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by a moiety selected from the group consisting of methyl, methoxy, and halogen; and -C(Rs)(R ⁇ )(X) wherein Rs and Rj are independently selected from the group consisting of hydrogen, alkyl of one to four carbon atoms, phenyl, and substituted phenyl wherein the substituent is selected from the group consisting of alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen
• X is selected from the group consisting of alkoxy containing one to four carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, haloalkyl of one to four carbon atoms, alkylamido wherein the alkyl group contains one to four carbon atoms, amino, substituted amino wherein the substituent is alkyl or hydroxyalkyl of one to four carbon atoms, azido, alkylthio of one to four carbon atoms, halogen, hydroxy, morpholino, and morpholinoalkyl wherein the alkyl moiety contains one to four carbon atoms, and R ⁇ is selected from the group consisting of hydrogen, fluoro, chloro, straight chain or branched chain alkyl containing one to four carbon atoms, and straight chain or branched chain fluoro- or chloroalkyl containing one to four carbon atoms and at least one flu
• Preferred imidazopyridine-4-amine IRM compounds are defined by Formula VII below:
• R ⁇ is selected from the group consisting of hydrogen; -CH Rw wherein Rw is selected from the group consisting of straight chain, branched chain, or cyclic alkyl containing one to ten carbon atoms, straight chain or branched chain alkenyl containing two to ten carbon atoms, straight chain or branched chain hydroxyalkyl containing one to six carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to six carbon atoms, and phenylethyl; and -
• CH CRzRz wherein each Rz is independently straight chain, branched chain, or cyclic alkyl of one to six carbon atoms;
• R 27 is selected from the group consisting of hydrogen, straight chain or branched chain alkyl containing one to eight carbon atoms, straight chain or branched chain hydroxyalkyl containing one to six carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to six carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by a moiety selected from the group consisting of methyl, methoxy, and halogen; and morpholinoalkyl wherein the alkyl moiety contains one to four carbon atoms; and R 67 and R 7 are independently selected from the group consisting of hydrogen and alkyl of one to five carbon atoms, with the proviso that R ⁇ 7 and R 77 taken together contain no more than six carbon atoms, and with
• Preferred 1,2-bridged imidazoquinoline-4-amine IRM compounds are defined by Formula VIII below:
• Z is selected from the group consisting of: -(CH 2 ) P - wherein p is 1 to 4;
• RD is hydrogen or alkyl of one to four carbon atoms
• R E is selected from the group consisting of alkyl of one to four carbon atoms, hydroxy, -OR F wherein R F is alkyl of one to four carbon atoms, and -NR G R' G wherein R G and R' G are independently hydrogen or alkyl of one to four carbon atoms;
• a and b are integers and a+b is 0 to 3
• Y is O, S, or -NRj- wherein Rj is hydrogen or alkyl of one to four carbon atoms; and wherein q is 0 or 1 and R 8 is selected from the group consisting of alkyl of one to four carbon atoms, alkoxy of one to four carbon atoms, and halogen.
• IRM compounds are defined by Formulas IX(a) and IX(b) below:
• R ⁇ 9 is selected from the group consisting of:
• R 29 is selected from the group consisting of: -hydrogen; -Ci-io alkyl;
• each R is independently selected from the group consisting of hydrogen and C M O alkyl; and each R is independently selected from the group consisting of hydrogen,
• B is -NR-C(R) 2 -C(R) 2 -C(R) 2 -; -C(R) 2 -NR-C(R) 2 -C(R) 2 -; -C(R) 2 -C(R) 2 -NR-C(R) 2 - or -C(R) 2 -C(R) 2 -C(R) 2 -NR-;
• R ⁇ 9 is selected from the group consisting of: - hydrogen;
• o alkyl or C2-20 alkenyl that is unsubstituted or substituted by one or more substituents selected from the group consisting of: -aryl;
• -heteroaryl -heterocyclyl; -O-Ci.20 alkyl; -O-(C ⁇ - 20 alkyl)o-i-aryl; -O-(C ⁇ _ 2 oalkyl)o- ⁇ -heteroaryl;
• Y is -N- or -CR-;
• R 29 is selected from the group consisting of: -hydrogen; -C M O alkyl; -C 2 -io alkenyl;
• each R 39 is independently selected from the group consisting of hydrogen and C M O alkyl; and each R is independently selected from the group consisting of hydrogen, C M O alkyl, C O alkoxy, halogen and trifluoromethyl.
• the substituents Rn - R ⁇ above are generally designated "1 -substituents", as they are located at the 1 -position of the various ring systems.
• Preferred 1 -substituents include alkyl containing one to six carbon atoms and hydroxyalkyl containing one to six carbon atoms. More preferably the 1- substituent is 2-methylpropyl or 2-hydroxy-2-methylpropyl.
• the substituents R 21 - R 2 above are generally designated "2-substituents", due to their placement at the 2-position of the various ring systems.
• Preferred 2-substituents include hydrogen, alkyl of one to six carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to four carbon atoms and the alkyl moiety contains one to four carbon atoms, and hydroxyalkyl of one to four carbon atoms. More preferably the 2-substituent is hydrogen, methyl, butyl, hydroxymethyl, ethoxymethyl or methoxyethyl. In instances where n can be zero, one, or two, n is preferably zero or one.
• alkyl As used herein, the terms "alkyl”, “alkenyl”, and the prefix “-alk” are inclusive of both straight chain and branched chain groups and of cyclic groups, i.e. cycloalkyl and cycloalkenyl. These cyclic groups can be monocyclic or polycyclic and preferably have from 3 to 10 ring carbon atoms. Exemplary cyclic groups include cyclopropyl, cyclopentyl, cyclohexyl and adamantyl. Alkyl and alkenyl groups contain from 1 to 10 (or
• aryl as used herein includes carbocyclic aromatic rings or ring systems. Examples of aryl groups include phenyl, naphthyl, biphenyl, fluorenyl and indenyl.
• heteroaryl includes aromatic rings or ring systems that contain at least one ring hetero atom (e.g. O, S, N). Suitable heteroaryl groups include furyl, thienyl, pyridyl, quinolinyl, tetrazolyl, imidazolyl, and so on.
• Heterocyclyl includes non-aromatic rings or ring systems that contain at least one ring hetero atom (e.g. O, S, N).
• exemplary heterocyclic groups include pyrrolidinyl, tetrahydrofuranyl, morpholinyl, thiazolidinyl, imidazolidinyl and the like.
• the aryl, heteroaryl and heterocyclyl groups may be unsubstituted or substituted by one or more substituents selected from the group consisting of C ⁇ .
• each Rio is independently selected from the group consisting of hydrogen, C M O alkyl, NO2, C 1 -20 alkoxy, C1.20 alkylthio, trihalomethyl, C ⁇ - 2 o acyl, arylcarbonyl, heteroarylcarbonyl, (C M oalkyl)o- ⁇ -aryl, (C ⁇ - ⁇ oalkyl)o- ⁇ -heteroaryl, nitrile, C ⁇ - 20 alkoxycarbonyl, oxo, arylalkyl wherein the alkyl group has from 1 to 10 carbon atoms, and heteroarylalkyl wherein the alkyl group has from 1 to 10 carbon atoms.
• the invention is inclusive of the compounds described herein in any of their pharmaceutically acceptable forms, including salts, isomers such as diastereomers and enantiomers, solvates, polymorphs, and the like.
• IRM compounds those having the imidazoquinoline structure are prefe ⁇ ed.
• imidazoquinoline-4-amine compounds of formulas I and V are prefe ⁇ ed.
• the compounds 4-amino-2-ethoxymethyl- ⁇ , -dimethyl-lH-imidazo[4,5- c]quinolin-l-ethanol and 1 -(2-methylpropyl)- lH-imidazo[4,5-c]quinolin-4-amine are especially preferred.
• the IRM compounds useful in the methods of the invention can be prepared using methods that are known in the art, as seen for example in U.S. Patent Nos. 4,689,338, 5,389,640, 5,268,376, 4,929,624, 5,266,575, 5,352,784, 5,494,916, 5,482,936, 5,346,905, 5,395,937, 5,756,747, 4,988,815, 5,175,296, 5,741,908, 5,367,076, 5,693,811 and 5,525,612, and in copending U.S. Patent Application Serial No. 09/210,114 all of which are incorporated by reference herein.
• the IRM compounds described above have been found to induce the maturation of DC ex vivo.
• mature DC display properties such as cytokine secretion, the expression of particular cell surface markers, and an enhanced ability to stimulate T-cells.
• Dendritic cells that can be matured using the method of the invention can be obtained from any source, which sources can be readily determined by those of skill in the art.
• the immature DC can be obtained by isolating the DC from tissues such as blood, spleen, bone marrow, skin (e.g., Langerhans cells) and the like or by inducing the differentiation of monocytes or stem cells using methods known in the art.
• a preferred method of obtaining DC comprises the cytokine-induced differentiation of human peripheral blood mononuclear cells.
• a particularly preferred method comprises culturing CD14+ peripheral blood monocytes with GM-CSF and IL-4 using the method described by Romani, supra.
• the DC thus obtained will be in an immature state, generally possessing a high capability for antigen capture and processing, but relatively low T-cell stimulatory capacity.
• the DC To acquire optimal T-cell stimulating capacity, the DC must be in a stable, mature state.
• Mature DC can be identified by a number of properties, including their expression of the cell surface marker CD83 and by the behavior displayed during the mixed lymphocyte reaction. In this reaction mature DC will cause increased proliferation of na ⁇ ve allogeneic T-cells and/or increased production of dendritic cell cytokines.
• the mature DC will induce at least a two- fold increase in the proliferation of na ⁇ ve allogeneic T-cells and/or will display at least a three- fold increase in the production of dendritic cell cytokines, particularly IL-12 and TNF- ⁇ , as compared to DC that have been obtained from the same source but have not been contacted with any exogenous stimuli ("immature DC").
• immature DC may display some of the properties described above, they display them to a much lesser extent than DC which have been matured by exposure to exogenous stimuli such as an imidazoquinoline type IRM compound.
• the mature DC should be stable and not revert to their immature state, as the immature DC are much less potent stimulators of T-cell activity.
• the method of the invention comprises the maturation of DC by stimulating the DC with an imidazoquinoline type IRM in an amount and for a time sufficient to cause the DC to mature. It is understood that the DC are incubated in a tissue culture medium under conditions readily determinable to those of skill in the art.
• the specific amount of IRM used and the time of exposure will vary according to a number of factors that will be appreciated by those of skill in the art, including the origin of the DC to be matured, the potency and other characteristics of the IRM compound used, and so on. However, it is currently preferred that the IRM be used at a concentration of about 0.1 to about lO ⁇ g/ml, preferably about 0.5 to about 2.0 ⁇ g/ml.
• the IRM compound is solubilized before being added to the DC containing medium, preferably in water or a physiological buffer.
• the compound can be solubilized in a small amount of an organic solvent such as DMSO and then diluted or added directly to the DC containing medium.
• the DC are stimulated by the IRM compound for a sufficient amount of time to allow the DC to become fully mature. This can be determined by periodically withdrawing samples of the DC containing medium and assaying for one of the above described properties, such as secretion of dendritic cell cytokines.
• the DC can be said to be fully mature when the measured property has attained its maximal level and is no longer increasing with time.
• the time of exposure will vary according to factors understood by those of skill in the art (including but not limited to the origin of the DC, the concentration and potency of the IRM, and so on), in general approximately 16 to
• Dendritic cells that have been matured by exposure to one or more imidazoquinoline type IRMs express CD83 and display enhanced expression of CD80, CD86 and CD40.
• IRM matured DC secrete a number of cytokines, particularly pro-inflammatory cytokines such as TNF- ⁇ , IFN- ⁇ , IL-6, IL-1, IL-12 p40.
• Dendritic cells that have been matured by exposure to imidazoquinoline type IRMs have enhanced antigen presenting ability as compared to immature DC and can be used in a variety of ways to enhance the immune response of a subject.
• the mature DC can be injected directly into a patient.
• the DC are preferably monocyte derived DC wherein the monocytes have been obtained from the same patient.
• the DC can also be used in a number of immunotherapies.
• therapies include ex vivo cell transplantation therapies for treating disorders of the immune system, such as AIDS; the ex vivo expansion of T-cells, particularly antigen specific T- cells which can then be used to treat disorders characterized by deterioration of the immune system; the generation of monoclonal antibodies that recognize DC-specific markers; the preparation of antigen activated DC according to methods known in the art; and development of vaccines and vaccine adjuvants.
• Preferred uses of DC that have been matured by exposure to one or more imidazoquinoline type IRMs include those that make use of antigen activated DC and/or
• the antigen activated DC, or cellular adjuvants, of the invention are generally prepared by exposing DC matured according to the method of the invention to an antigen.
• the antigen may be protein, carbohydrate or nucleic acid in nature and may be derived from any suitable source, including neoplastic cells (e.g., tumor cells) and infectious agents (e.g., bacterium, virus, yeast, parasite). Alternatively, the antigen can be derived by recombinant means.
• the cellular adjuvant of the invention can be used in the treatment of diseases.
• cellular adjuvants prepared by exposing the mature DC to tumor derived antigens can be administered to a patient, thereby provoking an anti-tumor immune response in the patient.
• infectious diseases can be treated by administering to the patient cellular adjuvants prepared by exposing the DC to antigens derived from the infectious agent.
• Dendritic cells that have been matured by the method of the invention produce cytokines such as IL-12 and IFN- that favor the generation of Thl immune responses.
• cytokines such as IL-12 and IFN- that favor the generation of Thl immune responses.
• the ability to bias the immune response towards the Thl , as opposed to the Th2, response, can provide a means for treatment of Th2 mediated diseases.
• diseases include asthma; allergic rhinitis; systemic lupus erythematosis; eczema; atopic dermatitis Ommen's syndrome (hyperseosinophilia syndrome); certain parasitic infections such as cutaneous and systemic leishmaniais, toxoplasma infection and trypanosome infection; certain fungal infections, for example candidiasis and histoplasmosis; and certain intracellular bacterial infections such as leprosy and tuberculosis.
• parasitic infections such as cutaneous and systemic leishmaniais, toxoplasma infection and trypanosome infection
• fungal infections for example candidiasis and histoplasmosis
• certain intracellular bacterial infections such as leprosy and tuberculosis.
• cRPMI Complete RPMI
• FCS heat inactivated FCS
• 1 mM sodium pyruvate 1 mM sodium pyruvate
• 0.1 mM non-essential amino acids 1 mM L-glutamine and 50 ⁇ g/ml gentamicin sulphate (Life Technologies). Reagents.
• Peripheral blood derived CD14 + cells were differentiated into DC using recombinant human GM-CSF and recombinant human IL-4 at 800 U/ml and 25 ng/ml, respectively (R&D Corporation, Minneapolis, MN), as described by Romani and Bender, supra. Tetanus toxoid (Calbiochem, La Jolla, CA) was solubilized in cRPMI and used at 10 ⁇ g/ml.
• the compound R-848 (S-28463), 4-amino-2-ethoxymethyl- ⁇ , ⁇ -dimethyl-lH- imidazo[4,5-c]quinoline-l-ethanol, M.W. 314.4, was prepared by 3M Pharmaceuticals,
• ⁇ C1 salt was dissolved in pyrogen-free, sterile water and stored as a stock solution at 4°C for up to 4 months. Endotoxin levels were below the detectable level [1 pg/mg] in the Limulus amebocyte assay.
• a stock solution of bacterial LPS from Escherichia coli 055:B5 was dissolved at 1 mg/ml in pyrogen-free water and stored at 4°C until use.
• PBMC were isolated with Histopaque HybriMax -1077 density gradient (Sigma) from healthy volunteers after obtaining informed consent.
• CD14 + cells were purified by positive selection using CD14 + microbeads in conjunction with the MiniMACS system (Miltenyi Biotech, Auborn, CA) by following the manufacturer's instructions. Purity, as assessed by flow cytometry, was greater than 90%.
• the CD14 + cells were cultured at 2-5 x 10 6 cells per 3 ml cRPMI in 6- well plates (Costar, Cambridge, MA) with 800 U/ml GM-CSF and 25 ng/ml IL-4 as previously described by Romani and Bender, supra. Fresh medium containing GM-CSF and IL-4 was added every three days. MO-DC were routinely used between days 7 and 8 of culture. As a control, depleted lymphocytes were cultured in the same fashion.
• CD40 clone EA-5 (Biosource International, Camarillo, CA); PE-conjugated CD83, clone HB15a, PE- and FITC-conjugated ⁇ l/ ⁇ l isotype control, clone 679.1Mc7 (Immunotech, Marseille, France), PE-conjugated CD86, clone 2331(Pharmingen, San Diego, CA).
• Cells (5 x 10 5 ) were incubated for 15 minutes incubation at 4°C with purified IgD (Becton Dickinson) to block non-specific binding, and then the cells were stained for 30 minutes with the antibodies at 4°C in PBS containing 10% FCS and 0.1% sodium azide. After washing in PBS, the cells were analyzed using a FACScan flow cytometer and Cell Quest software (Becton Dickinson).
• T-cells were isolated using T-Cell Purification Columns according to manufacturer's specifications (R&D Systems, Minneapolis, MN).
• MO-DC stimulator cells were pulsed for various times with medium alone, R- 848, or LPS for 1, 6 or 24 hrs and then washed and treated with 50 ⁇ g/ml mitomycin C (Sigma) for 20 minutes at 37°C. Dendritic cells were subsequently washed, resuspended in cRPMI and added at various concentrations (1-32 x 10 3 per well) to purified responder T-cells (1 x 10 5 per well) in 96-well flat-bottomed microtiter plates (BD Labware) in a total volume of 200 ⁇ l.
• Autologous T Cell Activation Autologous T Cell Activation.
• Autologous T cells and R-848-treated MO-DC were prepared as described for allogeneic T cell stimulation.
• MO-DC were cultured with R-848 [2 ⁇ g/ml] and tetanus toxoid [10 ⁇ g/ml] for 24 hours.
• the MO-DC were washed and cultured at graded doses with PBMC-derived CD3 + T cells for 7 days. Cell proliferation and analysis were determined as described.
• Supernatants were also collected from the same cultures prior to pulsing with [ 3 H]TdR and analyzed for IFN- ⁇ and IL-5.
• Cytokine levels were measured by ELIS A.
• Human TNF- ⁇ , IL- 12 (p40/p70), IFN ⁇ , IL-4 and IL-2 kits were purchased from Genzyme (Cambridge, MA).
• Human IL-6 kits were obtained from Biosource International (Camarillo, CA).
• Human IL- 5 , IL-8, MIP- 1 ⁇ , MCP- 1 and RANTES were purchased from R&D Systems. All ELIS A were run according to manufacturer's specifications.
• IFN levels were measured by bioassay (40). IFN- ⁇ and IFN- ⁇ specific antibodies were used to determine which type I IFN was present in the MO-DC supernatants.
• Results for all ELISAs are presented in pg/ml, whereas IFN results are presented in U/ml.
• Statistical Analysis Data were analyzed using a paired Student's t-test. and the results were considered statistically significant if p ⁇ 0.05.
• FIG. 1C represents the quantitative CD83 and CD86 cell surface expression in mean fluorescence intensity (MFI) of R-848 treated MO-DC.
• R-848 induces an increase of both CD83 and CD86 expression in a dose dependent manner, with CD86 expression increasing between 0.1-0.4 ⁇ g/ml R-848.
• CD83 expression is significantly increased between 0.4-2 ⁇ g/ml R- 848. Maximal increases in both CD83 and CD86 expression are generated with 2 ⁇ g/ml
• R-848 which corresponds to an average increase of approximately 3- to 4-fold for both CD80 and CD86. Comparatively, maximal CD83 and CD86 cell surface expression induced with R-848 was equivalent to that induced by LPS. Both the relative cell number and MFI data correlate indicating an increased number of cells expressing these antigens in response to R-848.
• DC maturation results in the production of various cytokines and chemokines.
• numerous cytokines produced by mature DC such as TNF- ⁇ and IL-12 can induce or enhance DC maturation. Therefore, we tested if R-848 induces MO-DC cytokine and chemokine secretion characteristic of DC maturation.
• MO-DC were cultured with various concentrations of R-848 for 24 hours as in Figures 1 and 2. The supernatants were analyzed for secreted cytokines and chemokines by ELISA or by bioassay. The results in Table I indicate that MO-DC treated with R-848 produce significantly more TNF- ⁇ , IL-6, IL-12, IL-8, MlP-l ⁇ and IFN- ⁇ as compared to the vehicle control.
• LPS significantly enhanced TNF- ⁇ , IL-6, IL-12, MlP-l ⁇ and IFN- ⁇ as compared to the vehicle control group.
• the maximal cytokine and chemokine levels induced by LPS are comparable to the maximal levels induced by R-848.
• MO-DC The length of time MO-DC need to be in contact with R-848 for maturation to occur was determined by pulsing the cells with R-848 for various periods of time. Culture supernatants were analyzed for cytokine secretion after various treatment times with R-848 or LPS. TNF- ⁇ and IL-12 secretion were used as markers of DC maturation on the basis of the results in Table I and on previous studies. First, MO-DC were cultured with 2 ⁇ g/ml R-848 or 1 ⁇ g/ml LPS for 1 , 6 or 24 hours, and the supernatants were then analyzed for cytokine secretion immediately post culture (Table II, Groups I, II and V).
• IL-12 IL-12. Maximal TNF- ⁇ secretion is achieved between one and six hours stimulation, and maximal IL-12 secretion requires between six and twenty four hours stimulation with either R-848 or LPS.
• MO-DC pulsed for 6 hours with R-848 and stained immediately for maturation markers show a significant increase in
• CD83 but not CD80, CD86, CD40 or HLA-DR (Fig. 3A and 3B).
• CD40, CD86 and HLA-DR expression are elevated in the R-848 treated group following 6 hours in culture, the differences are not statistically significant as compared to the medium control.
• LPS treated MO-DC showed enhanced CD83 expression, but no change in CD40, CD80, CD86 and HLA-DR expression.
• MO-DC were pulsed for 1 or 6 hours with 2 ⁇ g/ml R-848 or 1 ⁇ g/ml LPS, washed free of stimulus, and then re-cultured for an additional 23 hours (1 hour pulse) or 18 hours (6 hour pulse) before cell surface DC maturation marker determination.
• MO-DC pulsed for one hour with 2 ⁇ g/ml R-848 or 1 ⁇ g/ml LPS did not show enhanced expression of CD83, CD80, CD86, CD40 or HLA-DR after 24 hours in culture.
• MO-DC pulsed for 6 hours with R-848 show a significant increase in CD83 and CD40 expression, but not CD80, CD86 or HLA-DR after 24 hours in culture (Fig. 3C and 3D).
• CD86 and HLA-DR markers are elevated above, but not statistically different, than the medium control group. Comparable results were obtained with similarly cultured LPS- stimulated MO-DC. Allogeneic T cell Proliferation and T cell Cytokine Secretion are Increased by R-
• MO-DC were treated with 0.1-8 ⁇ g/ml R-848 or 1 ⁇ g/ml LPS. After 24 hours, the MO-DC were washed free of stimulating agent and cultured with allogeneic CD3-enriched peripheral blood T cells for
• MLR supernatants were analyzed for T cell cytokines following 96 hours of culture.
• R-848-treated MO-DC enhance IL-2, IL-5 and IFN- ⁇ secretion from allogeneic T cells as compared to the vehicle control group (Figure 4B-4D).
• Figure 4A Concordant with the MLR proliferation results in Figure 4A, a significant 2- to 3-fold enhancement of IL-2, IL-5 and
• IFN- ⁇ production was induced by cultures containing MO-DC treated with 2 and 8 ⁇ g/ml R-848 as compared to the untreated MO-DC cultures.
• T cell cytokines induced by R-848- stimulated MO-DC were equivalent to cytokine levels induced by LPS-stimulated MO- DC.
• IL-2, IL-5 and IFN- ⁇ production require MO-DC cultured with T cells, because cultures containing only MO-DC or only T cells did not produce detectable levels of IL-2,
• MO-DC When MO-DC were treated for less than 6 hours with R-848, allogeneic T cell proliferation was not significantly increased as compared to the untreated MO-DC controls.
• MO-DC (syngeneic) anamnestic response to tetanus toxoid.
• MO-DC were treated with 2 ⁇ g/ml R- 848 and 10 ⁇ g/ml tetanus toxoid for 24 hours.
• the MO-DC were washed free of compound and antigen and then cultured with syngeneic CD3-enriched peripheral blood T cells for 7 days at which time proliferation was assessed by [ 3 H]thymidine incorporation.
• the results in Figure 5 A and 5B indicate that tetanus toxoid-treated MO-DC and untreated
• MO-DC induced the same amount of syngeneic T cell proliferation.
• R-848- treated MO-DC increased T cell proliferation by 2-to 3-fold as compared to the MO-DC that were not treated with R-848.
• Cytokine secretion was also analyzed from the autologous MO-DC/T cell system. IFN- ⁇ secretion was only detected in the supernatants that contained MO-DC treated with both R-848 and tetanus toxoid ( Figures 5C and 5D).
• MO-DC treated with both R-848 and tetanus toxoid produced 4- to 11-fold more IFN- ⁇ than MO-DC cultured only with the tetanus toxoid antigen.
• IL-5 was not detected in any of the same culture supernatants containing IFN- ⁇ .
• the data in Figure 5 indicate that memory T cell IFN- ⁇ secretion, but not proliferation, is enhanced by R-848-treated MO- DC.
• the immune response modifier R-848 enhances cell surface expression of CD83 and CD86 on monocyte-derived dendritic cells (MO-DC).
• MO-DC were generated in vitro from CD14 + PBMC as described in Materials and Methods. MO-DC (2 x 10 5 ) were stimulated with 0.1-8 ⁇ g/ml R-848 [0.32-26 ⁇ M] or 1 ⁇ g/ml LPS for 24 hours. A, The cells were subsequently stained for CD83 and CD86 cell surface expression, and the MO-DC gated population was analyzed by flow cytometry. B, The results are expressed as the relative cell number that stain positively within the gated population.
• the solid lines indicate R-848 or LPS treatment, and the dotted lines indicate medium (vehicle) control.
• the results in A and B are representative of six independent experiments from six different donors.
• C The results are expressed as the mean fluorescence intensity (MFI) + SEM of six independent experiments from six different donors. *p ⁇ 0.05
• R-848 enhances cell surface expression of co-stimulatory molecules on MO-DC.
• MO-DC (2 x 10 5 ) were stimulated with 2 ⁇ g/ml R-848 for 24 hours. The cells were subsequently stained for cell surface expression of CD80, CD86, CD40, HLA-DR,
• CD83 and CD la The results are expressed as the relative cell number that stain positively within the MO-DC gated population and are representative of three independent experiments from three different donors.
• the solid lines indicate R-848 treatment, and the dotted lines indicate medium (vehicle) control.
• B, C The results are expressed as the MFI + SEM of at least three independent experiments from three different donors. *p ⁇ 0.05
• FIG. 3 Maturation of monocyte-derived dendritic cells requires between 1 and 6 hours stimulation with R-848. MO-DC (2 x 10 5 ) were stimulated with 2 ⁇ g/ml R-848 for 6 hours.
• A, B The cells were subsequently stained for cell surface expression of CD80, CD86, CD40, HLA-DR, CD83 and CD la.
• C, D The cells were extensively washed, re- cultured for an additional 18 hours, and then subsequently stained for cell surface expression of CD80, CD86, CD40, HLA-DR, CD83 and CD la. The results are expressed as MFI + SEM of three independent experiments from three different donors. *p ⁇ 0.05 Figure 4.
• T cell proliferation and T cell cytokine production are increased by R- 848-treated MO-DC in a primary MLR.
• MO-DC (2 x 10 5 ) were stimulated with 0.1-8 ⁇ g/ml R-848 or 1 ⁇ g/ml LPS for 24 hours. The cells were extensively washed and cultured at graded doses with 1 x 10 5 CD3 enriched allogeneic T cells in triplicate. A, Proliferation was assessed by [ 3 H]thymidine incorporation after 96 hours. The results are expressed as mean CPM + SEM of three independent experiments from three different donors. Statistically significant differences (p ⁇ 0.05) were determined between R-848 [2 and 8 ⁇ g/ml] and LPS treated groups as compared to vehicle [0 ⁇ g/ml] treated group at 4-
• MO-DC (2 x 10 5 ) were stimulated with 2 ⁇ g/ml R-848 and 10 ⁇ g/ml tetanus toxoid for 24 hours. The cells were extensively washed and cultured at graded doses with 1 x 10 5 CD3 enriched syngeneic T cells in triplicate for seven days.
• A, B Proliferation was assessed by [ 3 H]thymidine incorporation after seven days.
• C, D IFN- ⁇ protein was assessed from the culture supernatants as described in Materials and Methods. The results are expressed as mean pg/ml + SEM of three independent experiments from three different donors. The values indicated above some of the data points represent p-values ⁇ 0.05.
• MO-DC (2 x 10 ) were cultured for 24 hours in cRPMI containing giaded doses of R-848 or LPS at 37°C with 5% C0 2 Culture supernatants were collected and stored at -70°C until analysis by ELISA or by bioassay Data are given as mean ⁇ SEM of five independent experiments from five different donors All values are in pg/ml, except IFN- ⁇ which is in U/ml *, p ⁇ 005, as compared to cytokine levels in vehicle control
• TNF- a and IL-12 production from MO-DC requires between 1 and 6 hours
• MO-DC (2 x 10 5 ) were cultured for 24 hours in cRPMI containing graded doses of
• Treatment time (hr) is the length of time MO-DC were in culture with R-848 or
• PBS vehicle

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