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Anti-PD-1 immune-related adverse events are associated with high therapeutic antibody fixation on T cells

Authors :
Marianne Gazzano
Christophe Parizot
Dimitri Psimaras
Aurore Vozy
Marine Baron
Baptiste Abbar
Vincent Fallet
Elena Litvinova
Anthony Canellas
Cristina Birzu
Valérie Pourcher
Mehdi Touat
Nicolas Weiss
Sophie Demeret
Damien Roos-Weil
Jean-Philippe Spano
Celeste Lebbe
Joe-Elie Salem
Jacques Cadranel
Baptiste Hervier
Guy Gorochov
Amélie Guihot
Source :
Frontiers in Immunology. 13
Publication Year :
2022
Publisher :
Frontiers Media SA, 2022.

Abstract

Immune checkpoint inhibitors (ICI) widely improved the treatment of solid and hematologic malignancies. Yet, a remarkable proportion of patients receiving ICI develop immune related adverse events (irAEs) which are difficult to define as treatment-related. This underlines the need to develop a biomarker to guide irAE diagnosis. We developed a novel flow cytometry assay combining measurement of anti-PD-1 (programmed cell death protein-1) occupancy and evaluation of remaining PD-1 receptor availability with anti-IgG4 PE and anti-PD-1 BV421. We prospectively collected blood and biological fluids samples from patients treated by IgG4 anti-PD-1 therapy (nivolumab or pembrolizumab), with (n=18) or without (n=12) current irAE. We analyzed PD-1+ and IgG4+ staining pattern and MFI values of these parameters on CD4 and CD8 T cells, and IgG4+/PD-1+ MFI ratios are calculated. A higher mean fluorescence intensity IgG4+/PD-1+ ratio was measured on peripheral CD4+ T cells of irAE cases, when compared to controls (p=0.003). ICI-related toxicity is therefore associated with increased therapeutic antibody occupancy of PD-1 receptors on CD4+ T cells. Furthermore, in one case of ICI-related pneumonitis, binding of therapeutic antibody was stronger on lung CD4+ T cell than in blood. In another case of ICI-related encephalitis, the PD-1 receptor occupancy was total on CSF CD4 T cells, but only partial on peripherical CD4 T cells. Our results suggest that flow cytometry monitoring of ICI occupancy can be used in patients treated with monoclonal ICI to guide irAE diagnosis.

Subjects

Subjects :
Immunology
Immunology and Allergy

Details

Language :
English
ISSN :
16643224
Volume :
13
Database :
OpenAIRE
Journal :
Frontiers in Immunology
Accession number :
edsair.doi.dedup.....febbb5fa25270130e6f41d171f1e5500
Full Text :
https://doi.org/10.3389/fimmu.2022.1082084