title: Autoregulatory circuits in myeloma. Tumor cell cytotoxicity mediated by soluble CD16.
abstract: BACKGROUND
  Multiple myeloma remains an incurable malignancy due to marked resistance of the tumor to standard doses of chemotherapy. Treatment approaches, using chemotherapeutic dose escalation and hematopoietic stem cell support have resulted in significant augmentation of tumor mass reduction such that complete remissions are effected in approximately 50% of patients. These remissions are however, often not durable. In the setting of minimal residual disease, therefore, adjunctive immunotherapy may be useful.
  
  
  METHODS
  Peripheral blood mononuclear cells were studied from 28 untreated patients with multiple myeloma (MM). Mononuclear cell CD16 (FcR gamma III) expression was determined by flow cytometry. The effect of lymphocyte-derived soluble CD16, isolated by affinity chromatography, on MM cell growth and differentiation was assessed. MM cell proliferation, viability, immunoglobulin production and gene expression was studied.
  
  
  RESULTS
  Data are presented indicating that cells expressing CD16 are increased in untreated patients with IgG-secreting myeloma. The predominant phenotype of these cells is CD8+ or CD56+. These CD16+ cells can produce a soluble form of the Fc receptor (sFcR, sCD16) that can bind to surface Ig on cultured human IgG-secreting myeloma cells and effect suppression of tumor cell growth and Ig secretion. This effector function is accompanied by concomitant suppression of c-myc as well as IgH and IgL gene transcription. Finally, prolonged exposure to sCD16 causes myeloma tumor cell cytolysis.
  
  
  CONCLUSIONS
  sCD16 and possibly other soluble FcR are candidate molecules for adjunctive immunotherapy of myeloma, once complete responses have been effected by intensive cytotoxic therapy, now possible in up to 50% of newly diagnosed patients.
authors.affiliation: Department of Pathology, Arkansas Cancer Research Center, University of Arkansas for Medical Sciences, Little Rock 72205.
authors.forename: R G
authors.initials: RG
authors.lastname: Hoover
authors.forename: C
authors.initials: C
authors.lastname: Lary
authors.forename: R
authors.initials: R
authors.lastname: Page
authors.forename: P
authors.initials: P
authors.lastname: Travis
authors.forename: R
authors.initials: R
authors.lastname: Owens
authors.forename: J
authors.initials: J
authors.lastname: Flick
authors.forename: J
authors.initials: J
authors.lastname: Kornbluth
authors.forename: B
authors.initials: B
authors.lastname: Barlogie
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D019002:CD56 Antigen; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002455:Cell Division; D003602:Cytotoxicity, Immunologic; D005260:Female; D005434:Flow Cytometry; D005786:Gene Expression Regulation; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000096:biosynthesis; D007147:Immunoglobulin Light Chains / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000209:etiology / Q000276:immunology*; D016271:Proto-Oncogene Proteins c-myc / Q000096:biosynthesis; D011961:Receptors, Fc; D017452:Receptors, IgG / Q000032:analysis*; D016176:T-Lymphocyte Subsets / Q000276:immunology*
chemical_list: D015703:Antigens, CD; D000945:Antigens, Differentiation, T-Lymphocyte; D019002:CD56 Antigen; D007143:Immunoglobulin Heavy Chains; D007147:Immunoglobulin Light Chains; D016271:Proto-Oncogene Proteins c-myc; D011961:Receptors, Fc; D017452:Receptors, IgG