title: Dendritic cell based antitumor vaccination: impact of functional indoleamine 2,3-dioxygenase expression.
abstract: BACKGROUND
  Recent reports have demonstrated that the enzyme indoleamine 2,3-dioxygenase (IDO) is upregulated in human dendritic cells (DCs) upon in vitro maturation. IDO is supposed to convey immunosuppressive effects by degrading the essential amino acid tryptophan, thereby downregulating T-cell functions. Hence, we evaluated IDO expression in DC preparations used for therapeutic DC vaccination and its in vivo effects.
  
  
  RESULTS
  IDO expression was detected by real-time-PCR in a series of human clinical grade DCs (n = 28) prior to vaccination of advanced melanoma patients (n = 11). These analyses revealed an intra- and interpersonal variation in IDO mRNA levels. IDO was strongly upregulated in human DCs on RNA and on protein level upon in vitro maturation by Interleukin-1beta (IL-1beta), tumour necrosis factor-alpha (TNF-alpha), Interleukin-6 (IL-6) and Prostaglandin E2 (PGE2) over a time course of 24 h. The enzymatic activity of induced IDO was demonstrated by measuring tryptophan degradation. Moreover, in biopsies obtained 24 h after application of the DC vaccine a prominent infiltrate of IDO-positive cells was observed by immunohistochemistry. The inflammatory infiltrate of these sites stained positive for the transcription factor Forkhead box P3 (FoxP3), suggesting an IDO-mediated induction of regulatory T-cells. All analysed melanoma patients (n = 11) receiving DC based immunotherapy exhibited rapid disease progression with a short overall survival due to advanced tumour stage.
  
  
  CONCLUSIONS
  The presented observations suggest a potential clinical relevance of IDO expression in DC-based therapeutic vaccines via the attraction or induction of FoxP3(+) T-cells.
authors.affiliation: Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Wobser
authors.forename: Heike
authors.initials: H
authors.lastname: Voigt
authors.forename: Roland
authors.initials: R
authors.lastname: Houben
authors.forename: Andreas O
authors.initials: AO
authors.lastname: Eggert
authors.forename: Matthias
authors.initials: M
authors.lastname: Freiwald
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kaemmerer
authors.forename: Eckhart
authors.initials: E
authors.lastname: Kaempgen
authors.forename: David
authors.initials: D
authors.lastname: Schrama
authors.forename: Juergen C
authors.initials: JC
authors.lastname: Becker
mesh_terms: D000328:Adult; D000818:Animals; D015153:Blotting, Western; D019496:Cancer Vaccines / Q000276:immunology / Q000378:metabolism* / Q000627:therapeutic use; D003713:Dendritic Cells / Q000201:enzymology* / Q000276:immunology; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007167:Immunotherapy; D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase / Q000378:metabolism*; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology / Q000378:metabolism; D008297:Male; D008545:Melanoma / Q000276:immunology / Q000628:therapy*; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014364:Tryptophan / Q000378:metabolism
chemical_list: D019496:Cancer Vaccines; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase; D012333:RNA, Messenger; D014364:Tryptophan