Consequences of 4-1BB-4-1BB Ligand Interaction for NK Cell Anti-Tumor Immunity: Opposite Effects of Seemingly Analogue Molecules in Mice and Men.

Abstract 279

In mouse models, stimulation of the TNF receptor family member 4-1BB/CD137 on cytotoxic lymphocytes by agonistic antibodies potently stimulated anti-tumor immunity, which has led to the development of humanized agonistic 4-1BB mAb that are presently being evaluated in clinical phase I/II studies (www.clinicaltrials.gov, keyword: CD137). However, seemingly analogue immunoregulatory molecules may mediate different effects in mice and men, and in humans yet nothing is known regarding the role of 4-1BB in NK cell reactivity. NK cells play an important role in tumor immunosurveillance, and largely contribute to the success of therapeutic strategies like (haploidentical) stem cell transplantation (SCT) or application of monoclonal antibodies like Rituximab by mediating graft versus leukemia activity and performing antibody-dependent cellular cytotoxicity (ADCC). Here we analyzed the expression of 4-1BB in human NK cells and compared the effect of 4-1BB signaling on effector functions of NK cells in mice and men. While being absent in resting state, both human and mouse NK cells acquire expression of 4-1BB at similar levels with comparable kinetics upon activation. Next we cultured human and mouse NK cells with target cells transfected with human and mouse 4-1BB ligand (4-1BBL) and analyzed the effect of 4-1BB on NK cell effector functions. 4-1BB – 4-1BBL interaction enhanced effector functions of mouse NK cells, while degranulation, cytotoxicity and cytokine production of human NK cells were substantially impaired (all p<0.01, Student's T-test). In line, employing primary leukemia cells from patients with AML (n= 65) and CLL (n=49), which were found to express 4-1BBL in 35% and 100%, respectively, we found that blocking 4-1BB-4-1BBL interaction markedly enhanced granule mobilization, cytotoxicity and interferon-g production of allogenic and autologous human NK cells in response to leukemia cells. In CLL, this inhibitory effect of 4-1BB-4-1BBL interaction on NK cell reactivity was observed both with regard to direct and Rituximab-induced cytotoxicity and cytokine production. Together, our data implicate that one should exercise caution in applying anti-4-1BB therapeutically, underline the necessity of detailed analyses regarding the function of seemingly analogue immunoregulatory molecules in mice compared to men and demonstrate that blocking 4-1BBL-4-1BB interaction may serve to enhance NK cell reactivity in therapeutic settings like allogenic SCT and antibody-treatment of malignancies in humans.