Introduction
A number of previous studies have reported that various types of cancer are caused by Infectious pathogens such as human papilloma virus (HPV),
Helicobacter pylori, and hepatitis viruses [
1],[
2]. HPV has been proven as a major causative pathogen of cervical cancer, anal cancer and nasopharyngeal cancer. Cervical cancer is the third most commonly diagnosed cancer and second leading cause of cancer-related death worldwide in women [
3],[
4] and the incidence of nasopharyngeal cancer have been markedly increased during last decade in both men and women [
5]–[
8]. Therefore, the control of HPV infection is critical for the prevention or treatment of not only in precancerous states, but also in HPV-induced cancers. Among over 100 subtypes of HPV, HPV 16 and 18 are most important subtypes and about 70% of cervical cancers are associated with these two types of HPV [
9].
Although currently available two prophylactic HPV vaccines have been shown to effectively prevent HPV-associated anogenital disease in young women and men [
8],[
9], only 32% of teenagers who qualify for immunization have received all three recommended doses of the vaccine in the USA [
10]. These vaccines did not show a therapeutic effect on pre-existing cervical infection or cervical lesions [
11],[
12]. Moreover, conventional primary treatments for early stage cervical cancer showed a recurrence rate of about 15% [
13],[
14]. In the case of late stage or recurrent disease, treatment results are relatively poor. Thus, more effective ways which can control or treat HPV infection and HPV-related cancer should be needed.
Spontaneous regression of HPV-infected precancerous lesions has been reported in patients who had strong HPV-specific Th1-biased T-cell responses [
15]–[
18]. In particularly, a strong CD8+ cytotoxic T lymphocyte (CTL) response could play an important role not only for control of HPV infection, but also for treatment of HPV-induced cervical cancer. The peptides from the HPV protein could successfully sensitize and expand HPV-specific CTLs and these peptides can be used for immune monitoring as well as for vaccine or immune therapy against HPV-induced disease [
19],[
20]. However, one of the major drawback limiting the use of peptide-based immune monitoring or immunotherapy is that identification of at least one immune dominant epitopes from HPV molecules for each HLA class I alleles are needed for wide clinical application because CD8+ CTLs from patients or donors who have different HLA class I genetic background recognized different epitopes of HPV molecules. For overcome this drawback of peptide-based immune monitoring or immunotherapy, the identification of single peptides that can bind to multiple HLA types have been investigated and theses could lead to effective coverage of the human population by a peptide-based immune monitoring or immunotherapy. However, very few studies have addressed PBMC recognition of single peptides in a genetically heterogeneous group previously exposed to an infectious agent or cancer [
21]–[
24].
In this study, we report that novel single peptides that can bind to 4 different HLA class I which are A*02:01, A*24:02, A*11:01 and A*33:03, most frequent allele in human race. Theses single peptides were successfully elicit HPV 18-speciifc Th 1 responses of PBMCs.
Methods
Donors and peripheral blood mononuclear cells
Peripheral blood mononuclear cells (PBMCs) were collected from four HLA class I (HLA-A*02:01, A*24:02, A*11:01, A*33:03) healthy donors. Human leukocyte antigen (HLA) class I genotypes were determined by the HLA laboratory at the Seoul Medical Science Institute (Seoul, South Korea) via sequence-specific polymerase chain reaction using genomic DNA. PBMCs were isolated via density gradient centrifugation using Ficoll-Hypaque 1.077 (Pharmacia Biotech, Wilkstrom, Sweden). The mononuclear cells were cryopreserved at −160°C in human AB + serum containing 10% dimethylsulfoxide (DMSO; Sigma, St Louis, MO, USA). This research was approved by the institutional review board of Yonsei University Health System, and all participants provided written informed consent.
Synthesis of HPV16 E7 peptides
A total of twenty-four, 15-amino acid peptides spanning the HPV18 E7 protein that overlapped by 11 residues, were synthesized commercially (purity of >95%; A & Pep, Yeongi-gun, South Korea; Table
1). After selection of the immune dominant candidate 15-amino acid peptides which were restricted to each HLA class I from the peptide library by screening and confirmation tests, truncated peptides spanning the candidate 15-amino acid peptides were synthesized (Table
2). The peptides were diluted to working solution concentrations (1 μg/μL) in diethylpyrocarbonate-treated water (Invitrogen, Carlsbad, CA, USA) containing 1% DMSO and stored at −80°C before testing.
Table 1
15-amino acid overlapping peptides spanning the HPV type 18 E7 protein
1 | 1-15 | MHGPKATLQDIVLHL |
2 | 5-19 | KATLQDIVLHLEPQN |
3 | 9-23 | QDIVLHLEPQNEIPV |
4 | 13-27 | LHLEPQNEIPVDLLC |
5 | 17-31 | PQNEIPVDLLCHEQL |
6 | 21-35 | IPVDLLCHEQLSDSE |
7 | 25-39 | LLCHEQLSDSEEEND |
8 | 29-43 | EQLSDSEEENDEIDG |
9 | 33-47 | DSEEENDEIDGVNHQ |
10 | 37-51 | ENDEIDGVNHQHLPA |
11 | 41-55 | IDGVNHQHLPARRAE |
12 | 45-59 | NHQHLPARRAEPQRH |
13 | 49-63 | LPARRAEPQRHTMLC |
14 | 53-67 | RAEPQRHTMLCMCCK |
15 | 57-71 | QRHTMLCMCCKCEAR |
16 | 61-75 | MLCMCCKCEARIKLV |
17 | 65-79 | CCKCEARIKLVVESS |
18 | 69-83 | EARIKLVVESSADDL |
19 | 73-87 | KLVVESSADDLRAFQ |
20 | 77-91 | ESSADDLRAFQQLFL |
21 | 81-95 | DDLRAFQQLFLNTLS |
22 | 85-99 | AFQQLFLNTLSFVCP |
23 | 89-103 | LFLNTLSFVCPWCAS |
24 | 93-107 | TLSFVCPWCASQQ |
Table 2
HPV type 18 E7
81–95
and E
89–103
truncated peptides
21-1 | 82-95 | DLRAFQQLFLNTLS | 23-1 | 90-103 | FLNTLSFVCPWCAS |
21-2 | 83-95 | LRAFQQLFLNTLS | 23-2 | 91-103 | LNTLSFVCPWCAS |
21-3 | 84-95 | RAFQQLFLNTLS | 23-3 | 92-103 | NTLSFVCPWCAS |
21-4 | 85-95 | AFQQLFLNTLS | 23-4 | 93-103 | TLSFVCPWCAS |
21-5 | 86-95 | FQQLFLNTLS | 23-5 | 94-103 | LSFVCPWCAS |
21-6 | 87-95 | QQLFLNTLS | 23-6 | 95-103 | SFVCPWCAS |
21-7 | 88-98 | QLFLNTLS | 23-7 | 96-103 | FVCPWCAS |
21-8 | 81-94 | DDLRAFQQLFLNTL | 23-8 | 89-102 | LFLNTLSFVCPWCA |
21-9 | 81-93 | DDLRAFQQLFLNT | 23-9 | 89-101 | LFLNTLSFVCPWC |
21-10 | 81-92 | DDLRAFQQLFLN | 23-10 | 89-100 | LFLNTLSFVCPW |
21-11 | 81-90 | DDLRAFQQLFL | 23-11 | 89-99 | LFLNTLSFVCP |
21-12 | 81-89 | DDLRAFQQLF | 23-12 | 89-98 | LFLNTLSFVC |
21-13 | 81-88 | DDLRAFQQL | 23-13 | 89-97 | LFLNTLSFV |
21-14 | 81-87 | DDLRAFQQ | 23-14 | 89-96 | LFLNTLSFV |
Generation of autologous dendritic cells and peptide-specific CTLs
Autologous dendritic cells (DCs) were generated as previously described, with minor modifications [
25],[
26]. PBMCs were incubated for 2 h at 37°C using complete RPMI medium containing 10% fetal bovine serum (FBS). Adherent monocytes were resuspended at a concentration of 5 × 10
6 cells/mL in complete RPMI medium with granulocyte-macrophage colony-stimulating factor (1500 IU/mL; PeproTech, Rocky Hill, NJ, USA) and interleukin (IL)-4 (1200 IU/mL; PeproTech). On days 2, 4, and 6 of culture, fresh cytokines were added. On day 5 of culture, 10 ng/mL of tumor necrosis factor-α (R&D Systems, Minneapolis, MN, USA) was added for DC maturation. After maturation, autologous DCs were pulsed with peptides for at least 6 h. PBMCs were plated at a concentration of 2 × 10
6 cells per well in a 24-well culture plate (Nunc, Rochester, NY, USA) with 2 mL of complete RPMI medium. PBMCs were sensitized with synthetic HPV18 E7 peptides (10 μg/mL/well), and 1000 IU/mL/well of recombinant human IL-2 (rhIL-2; PeproTech) was added. Additionally, rhIL-2 (1000 IU/mL/well) was added to the culture every other day. For 1-week expansion, peptide-pulsed autologous DCs (4–10 × 10
6/well) were added to the PBMCs on day 7, incubated for 6 h, and analyzed with flow cytometry. DC-treated PBMCs were cultured for another 7 days, and cytotoxicity assays were performed.
Intracellular flow cytometric analysis
Phycoerythrin (PE)-conjugated anti–interferon-gamma (anti-IFN-γ), APC-Cy7-conjugated anti-CD44, FITC-conjugated anti-CD3, PerCp-Cy5.5-conjugated anti-CD4, and APC-conjugated anti-CD8 were purchased from BD Biosciences (San Jose, CA, USA). For each sample, 1 × 10
5 events were gated on a LSR II flow cytometer (BD Biosciences, Franklin Lakes, NJ, USA). For data analysis (Flowjo software; Tree Star, Ashland, OR, USA), positive cells were expressed as a percentage of the respective reference population. The assessment of responses was previously described in more detail [
24]. Briefly, peptide-sensitized PBMCs (1 × 10
6 cells/mL) stimulated with phytohemagglutinin (PHA, Sigma) and PBMCs pulsed with autologous DCs that were not loaded with any peptide were used as positive and negative controls, respectively. One hour after stimulation, 10 μg of Brefeldin A (Sigma) was added to each well. After 5 additional hours of incubation, PBMCs were washed once with phosphate-buffered saline (PBS) and then incubated in PBS containing 1 mM ethylene-diamine-tetraacetic acid for 10 min. After 2 additional washes with PBS containing 5% FBS, the cells were incubated with fluorescently-labeled monoclonal anti-CD3, anti-CD8, anti-CD4, anti-CD44, and anti–INF-γ antibodies for 15 min on ice in the dark prior to analysis.
IFN-γ enzyme-linked immunosorbent spot assay (ELISpot)
IFN-γ production was determined in PBMCs stimulated with HPV18 E7 peptides. Cryopreserved PBMCs were thawed into complete RPMI (RPMI supplemented with L-Glutamine, penicillin, streptomycin, and 10% heat inactivated fetal calf serum; Invitrogen). Then, 5 × 105 cells/well were plated in triplicate for each treatment in the ELISpot plates (Millipore, Billerica, MA, USA). Plates were previously coated with anti-IFN-γ antibody (Clone AN-18, Ebioscience, San Diego, CA, USA) at 4°C, overnight. PBMCs were incubated with HPV18 E7 peptides for 48 h at 37°C and 5% CO2. Phytohemagglutinin (PHA) was added at 2.5 μg/mL as a positive control and PBMCs sensitized with no peptide were used as a negative control. Biotinylated IFN-γ detection antibody (100 μL; 1 μg/mL in PBS) was added to each well (clone R4-6A2, Ebioscience, San Diego, CA, USA) and incubated at RT for 1.5 hours. After washing the plate 5 times with PBS, 100 μl of streptavidin-alkaline phosphatase (Invitrogen) diluted 1:1000 in PBS was added. The plate was incubated at RT for 1 h in the dark and developed with color solution by mixing 10 mL of Tris-MgCl2 buffer with 100 μL of NBT solution (Bio-Rad, Berkeley, CA, USA) and 100 μL of BCIP solution (Bio-Rad). The plate was dried before reading. The spots were quantified with an ELISpot plate reader and software version 3.5 (AID ELISpot Reader System, Strassberg, Germany). Data were obtained by calculating the means of triplicate wells. ELISpot data were expressed as the total IFN-γ spot-forming units (SFU)/106 PBMCs.
Cell culture
The human HPV 18+, cervical cancer cell lines (HTB-34 for HLA-A*02:01, SNU-1160-A*2402) were purchased from by the Korean Cell Line Bank (Seoul, Korea), and it has been tested and authenticated. Cancer cell line was expanded and frozen in aliquots within 4 weeks of purchase. Cancer cells were thawed and cultured at 37°C and 5% CO2 in Dulbecco’s modified Eagle medium (Gibco, Grand Island, NY, USA) containing 10% FBS and 1% antibiotics for no more than 8 passages.
Immortalized Epstein-Barr virus-B lymphoblastoid cell lines (EBV-BLC) which were restricted each HLA class I (kindly gifted from Dr. David Stroncek, in NIH) were cultured at 37°C and 5% CO2 in RPMI-1640 with 10% FBS. Cells were routinely tested for the absence of mycoplasma.
In vitro cytotoxicity assay
Cytotoxicity assays were performed using the 51Cr release assay. Briefly, cervical cancer cells labeled for 45 min with 51Cr (100 mCi/106 cells; Perkin Elmer, Waltham, MA, USA), washed in PBS, and dispensed in triplicate into 96-well U-bottom plates (Nunc, Rochester, NY, USA) at 4 × 103 cells/well. Peptide-sensitized PBMCs were added at an effector: target ratio of either 10:1, 30:1, 50:1, or 100:1. The cells were pelleted and incubated for 6 h, and the supernatant was analyzed using a WIZARD2 Automatic Gamma Counter (Perkin Elmer). Spontaneous and total release for each target were used to calculate the percentage of specific release according to the following formula: % specific release = (experimental counts per minute – spontaneous counts per minute)/(total counts per minute – spontaneous counts per minute) × 100.
Statistical analysis
Data presented as mean ± standard error are the representative of at least 3 different experiments. To compare between control group and each tested group, a student t- test (two-tailed) was used. P-values less than 0.05 was considered statistically significant.
Discussion
A strong Th1-biased T-cell response is important for control or elimination of not only infection of HPV 16 and 18 in precancerous disease, but also HPV-induced cervical cancer. E6 and E7 protein of HPV have been suggested as good targets for immune monitoring or immunotherapy against HPV-associated disease because E6 and E7 are constitutively expressed in both HPV-infected cells and cervical cancer cells and are not express in normal cervical epithelia. Therefore, the identification of CTL specific epitopes from E6 and E7 proteins of HPV 16 and 18 is essential for the development of peptide-based immune monitoring of HPV-specific CTL response and immunotherapy in patients. However, a major drawback of the development of clinically effective peptide-base immune monitoring or immunotherapy is the fact that different epitopes are recognized by T cells from individuals displaying distinct major HLA molecules. Moreover, although HPV 18 is second most common subtype after HPV 16 which is associated with cervical cancer, only few CTL-specific epitopes of HPV18 have been identified.
Until very recently, the studies searching for immune dominant peptides were performed testing of substantial numbers of overlapping peptides or peptide libraries. The identification of major HLA-binding motifs allowed the prediction of potential T cell epitopes (21,22), and supertypes or single peptide which can sensitize multiple HLA molecules simultaneously were found (23). However, very few studies have addressed CTL recognition of single peptide in a genetically heterogeneous group previously exposed to HPV infection or cervical cancer.
In this study, we found that two overlapping 15-amino acid peptides from HPV 18 E7 protein, E781-95DDLRAFQQLFLNTLS (#21) and E789-103LFLNTLSFVCPWCAS (#23), which could sensitize PBMCs of four major HLA class I A molecules including HLA-A*02:01, A*24:02, A*1101, and A*33:03, simultaneously. These four major HLA class I alleles are the most frequent HLA class I allele in human race. These 15-amino acid peptides were also successfully recognized by CD8+ CTLs of four different HLA class I alleles.
In the screening test, E7
81–95 (#21) and E7
89–103 (#23) were selected because these peptides induced most strong IFN-γ responses from PBMCs of four different HLA class I than other peptides (Figure
1A-D). However, IFN-γ could be released from many kinds of immune cells, including CD8
+ and CD4
+ T cells and NK cells. Thus, to determine if IFN-γ was produced from CD8
+ T lymphocytes, CD3
+CD8
+IFN-γ
+ T cells were counted using flow cytometry, and HPV-18 E7
81–95 (#21) and E7
89–103 (#23) induced greater numbers of CD3
+CD8
+IFN-γ
+ T cells than other peptides and negative control (PBMCs sensitized with no peptide) in all four different HLA types (Figure
2A-D). HPV18 E7
81–95 (#21)- and E7
89–103 (#23)-sensitized CTLs lysed more EBV-BLCs loaded with E7
81–95 (#21) and E7
89–103 (#23), respectively, than negative control (EBV-BLCs with no peptide) in all four HLA types (Figure
3A-D). It suggested that these epitopes successfully bound to HLA-A*02:01, 24:02, 11:01 and 33:03 molecules on the surface of EBV-BLCs and also were successfully recognized by CD8
+ CTLs within the PBMCs that were in vitro sensitized with same peptides. HPV18 E7
81–95 (#21)- and E7
89–103 (#23)-sensitized HLA-A*02:01 and 24:02 PBMCs also lysed more HLA-matched cervical cancer cell lines (HTB-34 and SNU-1160, respectively) than negative control (PBMCs sensitized with no peptide) (Figure
5A, B). These results confirmed that both HPV-18 E7
81–95 (#21) and E7
89–103 (#23) epitopes were naturally processed in both HTB-34 cell lines and SNU-1160 cell lines and were to be useful HLA-A*02:01 and HLA-A*24:02 immunogenic epitopes within the HPV18 E7 protein. We only used HTB-34 and SNU-1160 for cytotoxicity assay against cervical cancer cell in this study because these two cervical cancer cell lines were only available HPV 18+ E7 expressed cell lines in ATCC and Korean Cell Line Bank.
Virally infected human cells or human cancer cells can be recognized by CD8
+ CTLs through immunogenic epitopes of 8 to 12 amino acids that are presented on the cell surface with HLA class I molecules. Thus, we used truncated peptides to determine the critical residues that induce CD8
+ CTL responses within the 15-amino acid peptides and to determine the position of MHC anchor residues. Residue 81,82 of the N-terminus of E7
81–95 (#21) were important to elicit Th1 response of PBMCS in all four HLA class I (Figure
5A-D). Residue 92, 94, 95 would mark the C-terminal edge of the CD8
+ CTL-stimulating epitope in HLA-A*02:01 and 24:02 (Figure
5A, B). In HLA-A*11:01 and 33:03, residue 94, 95 would mark the C-terminal edge of the CD8
+ CTL-stimulating epitope within E7
81–95 (#21) (5C, 5D). In HLA-A*02:01, A*11:01 and A*33:03, residue 100 and 103 comprise the C-terminal end of the CD8
+ CTL-stimulating epitope in peptide #23 (5A, 5C, 5D). However, in case of HLA-A*24:02, residue 100, 101 and 103 comprise the C-terminal end of the CD8
+ CTL-stimulating epitope within E7
89–103 (#23) (5B). These results were comparable to the results of cytotoxicity assays using PBMCs sensitized with truncated peptides within E7
81–95 (#21) and E7
89–103 (#23), and HLA-matched EBV-BLCs loaded with same truncated peptides in Figure
6.
In conclusion, we identified E781-95DDLRAFQQLFLNTLS (#21) and E789-103LFLNTLSFVCPWCAS (#23), which could sensitize PBMCs of four HLA class I A molecules including HLA-A*02:01, A*24:02, A*11:01, and A*33:03, simultaneously, and demonstrated that PBMCs sensitized with these peptides showed cytotoxicity against cervical cancer cells. These epitopes could be useful for immune monitoring or immunotherapy against for HPV18-related diseases including cervical cancer, anal cancer, and oropharyngeal cancer.
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Competing interests
The authors declare that they have no competing interests.
Authors’ contributions
KSH, CHY, LKR, and LJB designed the research. KSH, CHY, and LJB performed the research and analyzed the data. KSH, CHY, LKR, and LJB wrote the paper. All authors read and approved the final manuscript. All authors read and approved the final manuscript.