Name: monitoring pd-1-blocking antibodies bound to t cells derived from a drop of peripheral blood
Uploaded: 2020-02-05T13:00:00
Description: Watch this Scientific Journal Video about Monitoring PD-1-Blocking Antibodies Bound to T Cells Derived from a Drop of Peripheral Blood at JoVE.com

This work was supported by grants to S.K. from the Japan Society for the Promotion of Science KAKENHI (JP17K16045) and the Japan Agency for Medical Research and Development (JP18cm0106335 and 19cm0106310).

Sampling was performed during routine clinical procedures. All human samples were obtained after informed consent was provided by the subjects, in accordance with the Declaration of Helsinki and with the approval of the ethical review board of the Graduate School of Medicine, Osaka University, Japan (15383 and 752).
1. Whole Blood Sample Preparation and Staining
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	<li>Collect whole blood samples into blood collection tubes containing ethylene diamine tetra-acetic acid (EDTA). 
	NOTE...

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In this article, we report a method using a flow cytometer to detect PD-1&#8211;blocking antibodies bound to T cells derived from a drop of peripheral blood, which we originally developed for nivolumab detection10. Although this technique is very simple and easy to perform, two important points should be noted in order to obtain accurate results. One is that to detect PD-1 molecules, an appropriate antibody that competes with nivolumab and pembrolizumab should be used. This issue was evaluated in ...

PD-1&#8211;blocking antibodies have become the standard choice for treatment of various types of cancer, including non-small cell lung cancer (NSCLC)1,2,3,4. They show a remarkable therapeutic effect in a subset of cancer patients who have not responded to conventional cytotoxic chemotherapies. However, immune checkpoint inhibitors (ICIs), which include PD-1&#8211;blocking antibodies, can cause a unique and distinct spectrum of adverse events, termed immune-related adverse events (irAEs)5. Although irAEs can affect almost all tissues, they are most commonly observed in the gastrointestinal tract, endocrine glands, skin, and liver, and they can cause pruritus, rash, nausea, diarrhea, and thyroid disorders6,7. In general, most irAEs appear within 1 to 2 months after the initiation of ICIs. However, in some cases, they can occur later than 1 year after the beginning of treatment or even after treatment cessation6,7. They also cause various symptoms that may be difficult to discriminate from other pathologies. Thus, it can be challenging to promptly diagnose irAEs and treat them appropriately. irAEs can affect all tissues, and their onset is strongly influenced by circulating immune cells, especially T cells bound to PD-1&#8211;blocking antibodies. Therefore, a straightforward and minimally invasive method to monitor antibody-targeted T cells is important in clinical settings.
Here, we developed a simple method to assess the binding of PD-1&#8211;blocking antibodies to T cells using a drop of peripheral whole blood from cancer patients who received nivolumab or pembrolizumab. Using this approach, we were able to monitor each of the following: 1) the duration of antibody binding to T cells, 2) the occupancy of T cell PD-1 molecules by therapeutic antibodies, and 3) the activation status and immunological features of T cells. This method is a modification of a previously reported technique8. The amount of blood required is almost the same as that needed for a glucose test, and the approach does not require mononuclear cell enrichment or co-culturing with PD-1&#8211;blocking antibodies. We confirmed that this method can also be performed using frozen samples, including peripheral blood mononuclear cells (PBMCs) and cells from pleural effusion, pericardial effusion, bronchoalveolar lavage fluid, and cerebrospinal fluid, suggesting that this strategy may be useful in the context of a multicenter study. This method may facilitate the early diagnosis of irAEs, and also help to determine the appropriate immunosuppressive treatments to control their symptoms and to identify the optimal times to initiate subsequent therapies after PD-1 inhibitors.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>10X RBC Lysis Buffer (Multi-species)</td>
			<td>Thermo Fisher Scientific</td>
			<td>00-4300-54</td>
			<td>50 mL</td>
		</tr>
		<tr>
			<td>APC/Cyanine7 anti-human CD4 Antibody</td>
			<td>BioLegend</td>
			<td>300518</td>
			<td>Clone RPA-T4</td>
		</tr>
		<tr>
			<td>BD FACS Canto II Flow Cytometer</td>
			<td>BD</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Brilliant Violet 510 anti-human CD8a Antibody</td>
			<td>BioLegend</td>
			<td>301048</td>
			<td>Clone RPA-T8</td>
		</tr>
		<tr>
			<td>Dulbecco&#39;s Phosphate Buffered Saline</td>
			<td>nacalai tesque</td>
			<td>14249-95</td>
			<td>500 mL</td>
		</tr>
		<tr>
			<td>Falcon Round-Bottom Polystyrene Tubes</td>
			<td>STEMCELL Technologies</td>
			<td>352058</td>
			<td>5 mL</td>
		</tr>
		<tr>
			<td>FcR Blocking Reagent, human</td>
			<td>Miltenyi Biotec</td>
			<td>130-059-901</td>
			<td>2 mL</td>
		</tr>
		<tr>
			<td>FLOWJO</td>
			<td>BD</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Gibco Fetal Bovine Serum</td>
			<td>Thermo Fisher Scientific</td>
			<td>12676029</td>
			<td>500 mL</td>
		</tr>
		<tr>
			<td>Mouse IgG1 monoclonal - Isotype control</td>
			<td>abcam</td>
			<td>ab81200</td>
			<td></td>
		</tr>
		<tr>
			<td>Mouse monoclonal Anti-Human IgG4 Fc</td>
			<td>abcam</td>
			<td>ab99825</td>
			<td>Clone HP6025</td>
		</tr>
		<tr>
			<td>Pacific Blue Mouse Anti-Human CD3</td>
			<td>BD</td>
			<td>558117</td>
			<td>Clone UCHT1</td>
		</tr>
		<tr>
			<td>PE-Cy7 Mouse anti-Human CD279 (PD-1)</td>
			<td>BD</td>
			<td>561272</td>
			<td>Clone EH12.1</td>
		</tr>
		<tr>
			<td>PE-Cy7 Mouse IgG1 &#954; Isotype Control</td>
			<td>BD</td>
			<td>557646</td>
			<td></td>
		</tr>
	</tbody>
</table>

monitoring pd-1-blocking antibodies bound to t cells derived from a drop of peripheral blood

Immune checkpoint inhibitors, including PD-1&#8211;blocking antibodies, have significantly improved treatment outcomes in various types of cancer. The pharmacological efficacy of these immunotherapies is long lasting, extending even beyond the discontinuation of their injections, due to persistent blood concentrations. Here we developed a simple flow cytometry assay to evaluate the T cell binding status of the PD-1&#8211;blocking antibodies nivolumab and pembrolizumab. Like a glucose test, this assay requires just a single drop of peripheral blood. Visualizing antibody binding on T cells is more reliable than measuring antibody blood concentrations. In addition, if necessary, we can potentially analyze many distinctive immune-related markers on T cells bound to PD-1&#8211;blocking antibodies. Thus, this is a simple and minimally invasive strategy to analyze the pharmacological effect of PD-1&#8211;blocking antibodies in cancer patients.

The gating strategy and flow cytometry analysis (Figure 1) can detect PD-1&#8211;blocking antibody binding to T cells obtained from a drop of NSCLC patient peripheral blood. Before PD-1&#8211;blocking antibody is administered, no human IgG4-positive CD8 or CD4 T cells are present, and PD-1 expression can be confirmed by a PD-1&#8211;detecting antibody (EH12.1) (Figure 2A). After nivolumab or pembrolizumab administration, IgG4 (nivolumab, pembrol...

Watch this Scientific Journal Video about Monitoring PD-1-Blocking Antibodies Bound to T Cells Derived from a Drop of Peripheral Blood at JoVE.com

Monitoring PD-1-Blocking Antibodies Bound to T Cells Derived from a Drop of Peripheral Blood

We developed a simple flow cytometry assay for evaluating the binding of PD-1&#8211;blocking antibodies to T cells, requiring only a drop of peripheral blood from cancer patients.

Immune checkpoint inhibitors, including PD-1&#8211;blocking antibodies, have significantly improved treatment outcomes in various types of cancer. The ...

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