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US20130302302A1 - Dendritic cells having enhanced yo t-cell activating and/or proliferating activity and methods of preparation or use thereof - Google Patents

Dendritic cells having enhanced yo t-cell activating and/or proliferating activity and methods of preparation or use thereof Download PDF

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US20130302302A1
US20130302302A1 US13/942,631 US201313942631A US2013302302A1 US 20130302302 A1 US20130302302 A1 US 20130302302A1 US 201313942631 A US201313942631 A US 201313942631A US 2013302302 A1 US2013302302 A1 US 2013302302A1
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dendritic cells
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Mie Nieda
Manami Isogai
Kazuhiro Kakimi
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Medinet Co Ltd
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    • A61K35/14Blood; Artificial blood
    • A61K35/15Cells of the myeloid line, e.g. granulocytes, basophils, eosinophils, neutrophils, leucocytes, monocytes, macrophages or mast cells; Myeloid precursor cells; Antigen-presenting cells, e.g. dendritic cells
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    • C12N5/0602Vertebrate cells
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    • C12N5/0639Dendritic cells, e.g. Langherhans cells in the epidermis
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    • A61K40/00Cellular immunotherapy
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    • A61K35/12Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
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Definitions

  • Dendritic cells work as antigen-presenting cells to present antigens, through phagocytosis and fragmentation, as antigenic epitopes on Major Histocompatibility Complex (MHC) molecules at their cell surface. When dendritic cells come in contact with T-cells in a lymph node, the T-cells recognize these antigenic epitopes.
  • MHC Major Histocompatibility Complex
  • T-cells In T-cells, ⁇ T-cells expressing ⁇ T-cell receptors and ⁇ T-cells expressing ⁇ T-cell receptors are present.
  • the ⁇ T-cells primarily assume the responsibility for acquired immunity, while the ⁇ T-cells work as effector cells for immune responses to particular bacterial infections such as tuberculosis, as well as tumors, and mainly assume the responsibility for natural immunity.
  • ⁇ T-cells also have cytotoxic activity against cancer cells, drawing attention to the development of immunotherapy utilizing the powerful antitumor activity possessed by ⁇ T-cells.
  • ⁇ T-cells are also activated and/or proliferated by nonpeptide antigens; they are known to be activated and/or proliferated by alkaloids such as alkylamines, as well as pyrophosphate monoesters and bisphosphonates.
  • the present application relates to dendritic cells pulsed with bisphosphonate-based bone metabolism improving drugs (hereinafter referred to as bisphosphonates).
  • the present application also relates to pharmaceutical compositions comprising said dendritic cells, therapeutic methods and ⁇ T-cell culture methods utilizing said dendritic cells.
  • the present application provides dendritic cells capable of efficiently activating and/or proliferating ⁇ T-cells in vivo and/or in vitro, pharmaceutical compositions comprising said dendritic cells, therapeutic methods of the pharmaceutical compositions and ⁇ T-cell culture methods utilizing said dendritic cells.
  • ⁇ T-cells can be activated and/or proliferated by using dendritic cells, which are normally used for CTL induction, pulsed with bisphosphonates, instead of directly stimulating ⁇ T-cells with bisphosphonates. Furthermore, the inventors found that, unlike the case of inducing antigen-specific ⁇ T-cells using a disease antigen peptide, ⁇ T-cells, unexpectedly, can be suitably activated and/or proliferated by utilizing immature dendritic cells.
  • the present application enables easy proliferation of ⁇ T-cells without imposing a burden on a patient, leading to practical applications of immune cell therapies that utilize ⁇ T-cells.
  • the present application may achieve one or more of these objectives as described below.
  • FIG. 1 shows the results of Example 3. Controls (dendritic cells not pulsed with a bisphosphonate), dendritic cells pulsed with Aredia, Onclast, and Zometa were respectively cocultivated with the reacted cells. The number of cells measured seven days later using a hemocytometer; the proportion of ⁇ T-cells measured using a flow cytometer; and the number of ⁇ T-cells calculated from the two figures are shown.
  • FIG. 2 shows the results of Example 5.
  • the ordinate indicates the number of spots and the abscissa indicates the intensity of the spots.
  • the IFN- ⁇ produced by ⁇ T-cells alone; ⁇ T-cells and Aredia; and the dendritic cells alone are shown.
  • the dendritic cells produced by the present methods will be explained in detail first.
  • the dendritic cells of the present application refer to dendritic cells having been pulsed with a bisphosphonate.
  • immature dendritic cells As the dendritic cells of the application, immature dendritic cells, mature dendritic cells, or the mixture of the two may be used. It is preferable, however, to use immature dendritic cells, since they are capable of more suitably activating and/or proliferating ⁇ T-cells.
  • any bisphosphonate may be used as long as it functions as a bone-resorption inhibitor and is generally used as a drug to treat osteoporosis.
  • Examples include pamidronic acid, a salt thereof and/or their hydrates (for example, pamidronate disodium pentahydrate (Aredia by Novartis Pharma)), alendronic acid, a salt thereof and/or their hydrates (for example, alendronate sodium trihydrate (Onclast by Banyu Pharmaceutical)), zoledronic acid, a salt thereof and/or their hydrates (for example, zoledronate sodium hydrate (Zometa by Novartis Pharma)), risedronic acid, a salt thereof and/or their hydrates (for example, risedronate sodium hydrate), ibandronic acid, a salt thereof and/or their hydrates (for example, ibandronate sodium), incadronic acid, a salt thereof and/or their hydrates (for example, incadronate disodium), etidronic acid
  • a sample is obtained first in order to obtain precursors of dendritic cells.
  • Peripheral blood, bone marrow, umbilical cord blood or the like can be used as a sample. Considering the ease of collection and the minimal burden imposed on the patient, utilizing peripheral blood is preferable.
  • ⁇ blood It is preferable to collect an amount of blood that does not burden the donor.
  • whole blood can be collected utilizing a vacuum blood tube or the like. Heparin or citric acid may be added so that the collected blood does not coagulate.
  • peripheral blood monocytes can be directly obtained by a method to collect the mononuclear component using a component collection system.
  • Mononuclear cells are then separated from the blood collected.
  • Any method for separating nucleated cells from red blood cells may be used.
  • the Ficoll separation method i.e., a Ficoll-Paque density gradient, or elution is commonly used.
  • PBS phosphate buffered saline
  • the dendritic cell precursors are separated from the mononuclear cells collected.
  • CD14 is a known marker expressed in the dendritic cell precursors
  • a method to isolate and collect monocytes (CD14-positive cells) utilizing the Magnetic Cell Sorting (Miltenyi Biotec; hereinafter referred to as MACS) is preferred since it is simple, and yields a high cell collection rate.
  • Another method may also be used, wherein the mononuclear cells collected are cultivated for at least one hour in a culture flask under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO2, more preferably 5% CO2, and the cells deposited are used as the dendritic cell precursors.
  • AIM-V medium (Invitrogen) is used as a culture medium.
  • any commercially available medium used in cell cultivation such as RPMI-1640 Medium (Invitrogen), Dulbecco's Modified Eagle Medium (Invitrogen; hereinafter referred to as DMEM), TIL (Immuno-Biological Laboratories Co., Ltd.), epidermal keratinocyte medium (Kojin Bio, Ltd.; hereinafter referred to as KBM), and Iscove's Medium (Invitrogen; hereinafter referred to as IMEM), may be used.
  • DMEM Dulbecco's Modified Eagle Medium
  • TIL Immuno-Biological Laboratories Co., Ltd.
  • KBM epidermal keratinocyte medium
  • IMEM Iscove's Medium
  • 5-20% bovine serum, fetal bovine serum (hereinafter referred to as FBS), human plasma or the like may be added as needed.
  • immature dendritic cells they are obtained by adding a differentiation-inducing factor to the culture medium and cultivating the dendritic cell precursors.
  • cytokine may be used as a differentiation-inducing factor; for example, granulocyte-macrophage colony-stimulating factor (hereinafter referred to as GM-CSF), interleukin-4 (hereinafter referred to as IL-4), stem cell factor (hereinafter referred to as SCF), IL-13, tumor necrosis factor a (hereinafter referred to as TNF- ⁇ ) and the like can efficiently induce the differentiation of immature dendritic cells. It is also preferable to add IL-1, IL-2, IL-3 and the like as needed. More preferably, the use of a combination of GM-CSF and IL-4 enables efficient induction.
  • GM-CSF granulocyte-macrophage colony-stimulating factor
  • IL-4 interleukin-4
  • SCF stem cell factor
  • IL-13 tumor necrosis factor a
  • TNF- ⁇ tumor necrosis factor a
  • the cultivation is carried out under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO 2 , more preferably 5% CO 2 ; the cultivation duration is preferably 5-7 days.
  • an additional differentiation-inducing factor is added on the 5th-7th day after starting the culture for further cultivation.
  • cytokine may be used as a differentiation-inducing factor; it is preferable to use, for example, GM-CSF, IL-4, SCF, IL-1 ⁇ , IL-6, IL-13, INF- ⁇ , prostaglandin E 2 (hereinafter referred to as PGE 2 ) and the like to efficiently induce the differentiation of mature dendritic cells.
  • IL-1, IL-2, IL-3 and the like are preferably added as needed. More preferably, employing a combination of GM-CSF, IL-4, IL-6, IL-1 ⁇ , PGE 2 and TNF- ⁇ enables efficient induction.
  • the cultivation is carried out under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO 2 , more preferably 5% CO 2 ; the duration is preferably 24-48 hours.
  • a method for obtaining immature or mature dendritic cells by collecting hematopoietic stem cells (CD34-positive cells) as dendritic cell precursors and adding GM-CSF and TNF- ⁇ , as well as flt-3 Ligand (FL), c-kit Ligand (SCF) or trombopoetin (TPO), singly or in combination, or a method of directly collecting dendritic cell fractions from blood or separated peripheral blood monocytes by using a density-gradient medium such as Percoll, may also be used.
  • hematopoietic stem cells CD34-positive cells
  • TNF- ⁇ GM-CSF and TNF- ⁇
  • FL flt-3 Ligand
  • SCF c-kit Ligand
  • TPO trombopoetin
  • a bisphosphonate is added and cultured to prepare stimulating cells (dendritic cells pulsed with a bisphosphonate).
  • the concentration of the bisphosphonate added is preferably 0.1-30 ⁇ M, more preferably 1-10 ⁇ M.
  • the duration of pulsing the cells with the bisphosphonate is preferably 1 36 hours, more preferably 12 hours.
  • the dendritic cells obtained in this manner have the ability to activate and/or proliferate ⁇ T-cells, they can be used as a pharmaceutical composition capable of activating and/or proliferating ⁇ T-cells either in vitro or in vivo.
  • a composition capable of activating and/or proliferating ⁇ T-cells When used in vitro, they can be used as a composition capable of activating and/or proliferating ⁇ T-cells.
  • they can be used as a dendritic cell vaccine capable of activating and/or proliferating ⁇ T-cells after rinsing and removing free bisphosphonate.
  • a cytokine for example, IL-2
  • a protein for example, albumin
  • composition comprising the Dendritic Cells
  • the dendritic cells obtained in the first embodiment are collected by centrifugation or the like.
  • the collected cells are washed. Any washing solution may be used as long as it is isosmotic and suitable for use as a pharmaceutical composition. Considering the subsequent administration to a patient, the use of physiological saline, PBS or the like is preferable.
  • the dendritic cells collected When suspended in physiological saline, the dendritic cells collected become usable as a pharmaceutical preparation for administration.
  • a cytokine may be added as needed.
  • the number of cells administered can be properly selected in accordance with the condition of the patient; normally, however, the number of cells is preferably 10 6 -10 12 /person, more preferably at least 10 7 /person.
  • the preparation can be administered by intravenous, intradermal or hypodermic injection, injected into an affiliated lymph node, directly injected into a lesion, or drip-fed for general administration. It is also possible to inject the preparation into an artery in the vicinity of a lesion.
  • ⁇ T-cells in the patient's body can be activated. Since ⁇ T-cells have nonspecific cytotoxic activity, they can be used in various treatments, for example, treating cancers and infectious diseases.
  • One benefit of using dendritic cells in the form of a vaccine is a circumvention of the problem caused by directly administering a bisphosphonate. A bisphosphosphonate's reaction to ⁇ T-cells in the body is weakened and dissipated as the number of administrations increases, making the bisphosphonate incapable of repeatedly proliferating ⁇ T-cells. By pulsing dendritic cells with a bisphosphonate for use as a vaccine prevents this from occurring.
  • the dendritic cells obtained in the first embodiment and the responding cells are disseminated in a culture container.
  • the responding cells here refers to a cell subset containing ⁇ T-cells; mononuclear cells derived from peripheral blood and the like are preferable.
  • the container used a plate, laboratory dish, flask, bag or the like normally employed in cultivation in the art may be used.
  • concentration of the individual cell subsets disseminated may be freely set in accordance with the situation.
  • AIM-V medium is used to culture the dendritic cells and the responding cells.
  • any commercially available culture medium used in cell cultivation such as RPMI-1640 medium, DMEM, TIL, KBM, and IMEM, may be used.
  • 5-20% bovine serum, FBS, human plasma, cytokine or the like may be added as needed.
  • the cultivation is carried out under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO 2 , more preferably 5% CO 2 ; the cultivation duration is preferably 5-8 days, more preferably 7 days.
  • the numbers of dendritic and responding cells disseminated can be set depending on the container used and the purpose of the application.
  • the mixing proportions of the dendritic and responding cells can be properly set in accordance with the situation; considering the purpose, which is to increase the proportion of ⁇ T-cells in the reacted cells, the number of dendritic cells is preferably set smaller than the responding cells.
  • the present application enables the collection of a cell population containing activated ⁇ T-cells of high purity, in mass quantity and in a simple manner, without having to follow the complicated selection and purification processes which were required by prior art techniques to obtain ⁇ T-cells. Moreover, the cell population obtained in this manner can be used as it is in immune cell therapies. When the activated ⁇ T-cells are used in such immune cell therapies, high levels of therapeutic effect against tumors and infectious diseases are expected.
  • One benefit of activating and/or proliferating ⁇ T-cells in vitro is a circumvention of the problem associated with directly administering a bisphosphonate, whose reaction to ⁇ T-cells in the body weakens and dissipates when the number of administrations increases so that it is incapable of repeatedly proliferating ⁇ T-cells.
  • Activating and/or proliferating ⁇ T-cells in vitro for administration can prevent this from occurring.
  • composition Comprising the ⁇ T-Cells Obtained by the Present Method
  • the ⁇ T-cells obtained by the method described in the third embodiment are collected by centrifugation and the like.
  • the cells collected are washed. Any washing solution may be used as long as it is isosmotic and suitable for use as a pharmaceutical preparation; considering the subsequent administration to a patient, the use of physiological saline, PBS or the like is preferable.
  • the ⁇ T-cells collected become usable as a preparation for administration.
  • a cytokine may be added as needed.
  • the number of cells administered can be properly selected in accordance with the condition of the patient; normally, however, the number of cells is preferably 10 8 -10 12 /person, more preferably at least 10 9 /person.
  • the preparation can be administered by intravenous, intradermal or hypodermic injection, injected into an affiliated lymph node, directly injected into a lesion, or drip-fed for general administration.
  • the preparation can also be injected into an artery in the vicinity of a lesion.
  • peripheral blood collected from a healthy donor mononuclear cells were collected using a density gradient medium for separating blood cells.
  • the cells collected were washed several times to remove platelets and the like, and CD14-positive cells were isolated using MACS.
  • the dendritic cell precursors obtained were differentiated into dendritic cells.
  • AIM-V medium with 10% FBS added thereto was used as a culture medium.
  • 500 U/mL of GM-CSF (IMMUNEX) and 500 mL of IL-4 (Osteogenetics GmbH) were added.
  • Immature dendritic cells were obtained in 5-7 days after starting the culture.
  • 100U/mL of IL-6 R& D Systems
  • 10 ng/mL of IL-1 ⁇ CHEMICON
  • 10 ng/mL of TNF- ⁇ PHARMINGEN
  • SIGMA PGE 2
  • the antigens on the surface of the dendritic cells prepared were detected using a flow cytometer (Epics XL-MCL, Beckman Coulter). To the cells to be measured, suspended in PBS, target antibodies were added and stained for 1 5 minutes at 4° C. in a shaded condition. The antibodies used are PE-labeled anti-CD14, anti-CD83 and anti-HLA-DR antibodies (Beckman Coulter). As negative controls, the isotypes of the respective antibodies were used. The stained cells were washed with PBS and measured by using the Epics XL-MCL.
  • These stimulating cells were respectively cultivated in mixed cultures of 2 ⁇ 10 6 reacted cells using a 24-well plate (SUMILON) to a total volume of 1 mL (the ratio of reacted cells to stimulating cells was 4 to 1).
  • the cells remaining after isolating the CD14-positive cells in Example 1 (CD14-negative cell population, mainly T-cell population), which had been suspended in AIM-V medium containing 10% FBS and 10% dimethyl sulfoxide (DMSO), frozen and stored, were used as the reacted cells after thawing and rinsing.
  • the cultivation was carried out under the conditions of about 37° C. and 5% CO 2 for 7 days.
  • PC5-labeled anti-CD3 and FITC-labeled anti-pan ⁇ / ⁇ antibodies were used for the antibodies. These antibodies were added to the cells that were cultured and washed with PBS for dying at 4° C. for 15 minutes in a shaded condition. The isotype of anti-pan ⁇ / ⁇ antibody was utilized as a negative control.
  • peripheral blood mononuclear cells were collected using a density gradient medium for blood cell separation. The cells collected were washed several times to remove platelets and the like.
  • peripheral blood monocytes obtained were suspended in AIM-V medium (10% FCS), and Aredia was added so that the concentration in the peripheral blood monocyte suspension was 10 ⁇ M.
  • AIM-V (10% FCS) medium and IL-2 were added in accordance with the cell proliferation.
  • the phenotype of the cells cultured was confirmed to be a cell subset containing at least 95% of ⁇ T-cells.
  • An anti-interferon(IFN)- ⁇ antibody for coating (clone: 1-D1K, MABTECH ELISpot for Human Interferon- ⁇ kit) was diluted with PBS to 15 ⁇ g/ml, and added 100 ⁇ l/well.
  • the plate was left standing at 4° C. overnight.
  • the plate was washed with 200 ⁇ l/well of PBS four times.
  • AIM-V medium containing 10% FBS was added 200 ⁇ l/well, and blocking was performed at room temperature for at least 30 minutes.
  • the blocking medium was removed and the plate was washed with 200 ⁇ l/well of PBS four times.
  • the ⁇ T-cells obtained in Example 4 were collected by centrifugation and washed twice with AIM-V.
  • Example 1 Aredia To 30,000 of the ⁇ T-cells collected, and 15,000 of the immature or mature dendritic cells obtained in Example 1 Aredia, prepared to have a final concentration of 10 ⁇ M, was added, and precultivated in a 15 ml tube (Falcon) under the conditions of 37° C. and 5% CO 2 for two hours. At the same time, precultivation of ⁇ T-cells by themselves, precultivation of ⁇ T-cells with only Aredia added thereto, and precultivation of the respective dendritic cells by themselves were also conducted. Each culture volume was adjusted to 300 ⁇ l.
  • the plate was washed with PBS after blocking, and each group of cells which completed precultivation under the respective conditions was disseminated in three wells, 100 ⁇ l/well.
  • the culture solution containing the cells was removed and the plate was washed five times with 200 ⁇ l/well of PBS.
  • Biotin-labeled anti-IFN- ⁇ antibody for detection (clone: 7-B6-1, MABTECH ELISpot for Human Interferon- ⁇ kit) was diluted to 1 ⁇ g/ml with PBS containing 0.5% FBS and added 100 ⁇ l/well.
  • the plate was left standing for two hours at room temperature.
  • the PBS containing Biotin-labeled anti-IFN- ⁇ antibody was removed, and the plate was washed five times with 200 ⁇ l/well of PBS.
  • Alkaliphosphatase-bonded streptoabizine (MABTECH ELISpot for Human Interferon- ⁇ kit) was diluted with PBS containing 0.5% FBS to 1:1000, and added 100 ⁇ l/well.
  • the plate was left standing for one hour at room temperature.
  • the plate was washed five times with 200 ⁇ l/well of PBS.
  • BCIP/NBTplus substrate stock solution (Wako) was added 100 ⁇ l/well; the plate was left standing in the dark until spots were recognizable.
  • the number of spots was measured using an ELISpot reader (AID Autoimmune Diagnostika GmbH), and the data was analyzed using the AID software version 3.1 (AID).
  • the results showed that the number of spots and the spot intensity increased only when the dendritic cells and Aredia were added simultaneously to the ⁇ T-cells.
  • the results also showed that the immature dendritic cells pulsed with the bisphosphonate stimulated the generation of IFN- ⁇ more than the mature dendritic cells did.
  • the dendritic cells pulsed with bisphosphonates as described in the present application are capable of selectively activating and/or proliferating the ⁇ T-cells contained in peripheral blood. Accordingly, they can be used as a composition capable of activating and/or proliferating ⁇ T-cells in vitro. Moreover, by administering them to a patient as an administrable composition, ⁇ T-cells can be activated in vivo, from which effective treatment of cancers and viral infections can be expected.

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Abstract

A therapeutic method, which includes administering dendritic cells pulsed in vitro with a bisphosphonate-based bone metabolism improving drug, is provided. The dendritic cells may be capable of efficiently activating and/or proliferating γδ T-cells in vivo and/or in vitro. This can permit for easy proliferation of γδ T-cells without burdening a patient, leading to practical applications of immune cell therapies that utilize γδ T-cells.

Description

    CROSS REFERENCE TO RELATED APPLICATIONS
  • This patent application is a divisional of U.S. patent application Ser. No. 11/631,660, which is a U.S. national stage of International Patent Application PCT/JP2005/012971, filed on Jul. 7, 2005, which claims the benefit and priority of Japanese Patent Application 2004-229991, filed on Jul. 8, 2004; the entire contents of these applications are hereby incorporated by reference in their entirety, for any and all purposes.
  • BACKGROUND
  • Dendritic cells work as antigen-presenting cells to present antigens, through phagocytosis and fragmentation, as antigenic epitopes on Major Histocompatibility Complex (MHC) molecules at their cell surface. When dendritic cells come in contact with T-cells in a lymph node, the T-cells recognize these antigenic epitopes.
  • In T-cells, αβ T-cells expressing αβ T-cell receptors and γδ T-cells expressing γδ T-cell receptors are present. The αβ T-cells primarily assume the responsibility for acquired immunity, while the γδ T-cells work as effector cells for immune responses to particular bacterial infections such as tuberculosis, as well as tumors, and mainly assume the responsibility for natural immunity.
  • It has recently been found that γδ T-cells also have cytotoxic activity against cancer cells, drawing attention to the development of immunotherapy utilizing the powerful antitumor activity possessed by γδ T-cells. The vast majority of T-cells generally present in blood, however, are αβ T-cells; γδ T-cells account for a mere 1-5%. Accordingly, as a method to proliferate γδ T-cells, the γδ T-cells that are separated using magnets and the like are cultured in vitro and returned to the body.
  • It is known that γδ T-cells are also activated and/or proliferated by nonpeptide antigens; they are known to be activated and/or proliferated by alkaloids such as alkylamines, as well as pyrophosphate monoesters and bisphosphonates.
  • Above all, methods to cultivate γδ T-cells in vitro utilizing bisphosphonates have been considered in various studies, but failed to produce sufficient numbers of γδ T-cells. An attempt to obtain a sufficient number of γδ T-cells suitable for a treatment meant an increase in the amount of blood collected from a patient, which also increased the burden placed on the patient. Accordingly, there exists a need to establish a technique to easily obtain a sufficient number of γδ T-cells not only in vitro, but also in vivo.
  • SUMMARY
  • The present application relates to dendritic cells pulsed with bisphosphonate-based bone metabolism improving drugs (hereinafter referred to as bisphosphonates). The present application also relates to pharmaceutical compositions comprising said dendritic cells, therapeutic methods and γδ T-cell culture methods utilizing said dendritic cells.
  • The present application provides dendritic cells capable of efficiently activating and/or proliferating γδ T-cells in vivo and/or in vitro, pharmaceutical compositions comprising said dendritic cells, therapeutic methods of the pharmaceutical compositions and γδ T-cell culture methods utilizing said dendritic cells.
  • As a result of research in solving the aforementioned problems, the inventors found that γδ T-cells can be activated and/or proliferated by using dendritic cells, which are normally used for CTL induction, pulsed with bisphosphonates, instead of directly stimulating γδ T-cells with bisphosphonates. Furthermore, the inventors found that, unlike the case of inducing antigen-specific αβ T-cells using a disease antigen peptide, γδ T-cells, unexpectedly, can be suitably activated and/or proliferated by utilizing immature dendritic cells.
  • The present application enables easy proliferation of γδ T-cells without imposing a burden on a patient, leading to practical applications of immune cell therapies that utilize γδ T-cells.
  • The present application may achieve one or more of these objectives as described below.
      • (1) Dendritic cells having been pulsed with a bisphosphonate;
      • (2) The dendritic cells of said (1), wherein said dendritic cells are immature dendritic cells;
      • (3) The dendritic cells of said (1) or (2), wherein said bisphosphonate is any one of pamidronic acid, alendronic acid, zoledronic acid, risedronic acid, ibandronic acid, incadronic acid, etidronic acid, their salts and/or their hydrates;
      • (4) A pharmaceutical composition comprising dendritic cells pulsed with a bisphosphonate;
      • (5) The pharmaceutical composition of said (4), wherein said dendritic cells are immature dendritic cells;
      • (6) The pharmaceutical composition of said (4) or (5), wherein said bisphosphonate is any one of pamidronic acid, alendronic acid, zoledronic acid, risedronic acid, ibandronic acid, incadronic acid, etidronic acid, their salts and/or their hydrates;
      • (7) A therapeutic method wherein dendritic cells pulsed with a bisphosphonate are administered;
      • (8) The therapeutic method of said (7), wherein said dendritic cells are immature dendritic cells;
      • (9) The therapeutic method of said (7) or (8), wherein said bisphosphonate is any one of pamidronic acid, alendronic acid, zoledronic acid, risedronic acid, ibandronic acid, incadronic acid, etidronic acid, their salts and/or their hydrates;
      • (10) The therapeutic method of any of said (7) (9), wherein the therapy is for treating cancers and/or infectious diseases;
      • (11) The therapeutic method of any of said (7) (11) [sic], wherein said dendritic cells are autologous;
      • (12) A γδ T-cell culture method wherein dendritic cells pulsed with a bisphosphonate are added;
      • (13) The γδ T-cell culture method of said (12), wherein said dendritic cells are immature dendritic cells; and
      • (14) The γδ T-cell culture method of said (12) or (13), wherein said bisphosphonate is any one of pamidronic acid, alendronic acid, zoledronic acid, risedronic acid, ibandronic acid, incadronic acid, etidronic acid, their salts and/or their hydrates.
    BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 shows the results of Example 3. Controls (dendritic cells not pulsed with a bisphosphonate), dendritic cells pulsed with Aredia, Onclast, and Zometa were respectively cocultivated with the reacted cells. The number of cells measured seven days later using a hemocytometer; the proportion of γδ T-cells measured using a flow cytometer; and the number of γδ T-cells calculated from the two figures are shown.
  • FIG. 2 shows the results of Example 5. The ordinate indicates the number of spots and the abscissa indicates the intensity of the spots. As negative controls, the IFN-γ produced by γδ T-cells alone; γδ T-cells and Aredia; and the dendritic cells alone are shown.
  • DETAILED DESCRIPTION First Embodiment Preparation of the Dendritic Cells
  • The dendritic cells produced by the present methods will be explained in detail first.
  • The dendritic cells of the present application refer to dendritic cells having been pulsed with a bisphosphonate.
  • As the dendritic cells of the application, immature dendritic cells, mature dendritic cells, or the mixture of the two may be used. It is preferable, however, to use immature dendritic cells, since they are capable of more suitably activating and/or proliferating γδ T-cells.
  • Moreover, any bisphosphonate may be used as long as it functions as a bone-resorption inhibitor and is generally used as a drug to treat osteoporosis. Examples include pamidronic acid, a salt thereof and/or their hydrates (for example, pamidronate disodium pentahydrate (Aredia by Novartis Pharma)), alendronic acid, a salt thereof and/or their hydrates (for example, alendronate sodium trihydrate (Onclast by Banyu Pharmaceutical)), zoledronic acid, a salt thereof and/or their hydrates (for example, zoledronate sodium hydrate (Zometa by Novartis Pharma)), risedronic acid, a salt thereof and/or their hydrates (for example, risedronate sodium hydrate), ibandronic acid, a salt thereof and/or their hydrates (for example, ibandronate sodium), incadronic acid, a salt thereof and/or their hydrates (for example, incadronate disodium), etidronic acid, a salt thereof and/or their hydrates (for example, etidronate disodium). Above all, pamidronic acid, alendronic acid, zoledronic acid, their salts and/or their hydrates are particularly preferable.
  • Next, the method of preparing the dendritic cells of the present application will be explained in detail.
  • A sample is obtained first in order to obtain precursors of dendritic cells. Peripheral blood, bone marrow, umbilical cord blood or the like can be used as a sample. Considering the ease of collection and the minimal burden imposed on the patient, utilizing peripheral blood is preferable.
  • It is preferable to collect an amount of blood that does not burden the donor. As a method of collection, whole blood can be collected utilizing a vacuum blood tube or the like. Heparin or citric acid may be added so that the collected blood does not coagulate. In the case wherein a large number of cells is required, peripheral blood monocytes can be directly obtained by a method to collect the mononuclear component using a component collection system.
  • Mononuclear cells, or the precursors of dendritic cells, are then separated from the blood collected. Any method for separating nucleated cells from red blood cells may be used. For example, the Ficoll separation method, i.e., a Ficoll-Paque density gradient, or elution is commonly used.
  • In order to remove platelets and the like, it is preferable to clean the collected cells several times using a culture medium, physiological saline, phosphate buffered saline (hereinafter referred to as PBS) or the like.
  • Next, the dendritic cell precursors are separated from the mononuclear cells collected.
  • Since CD14 is a known marker expressed in the dendritic cell precursors, a method to isolate and collect monocytes (CD14-positive cells) utilizing the Magnetic Cell Sorting (Miltenyi Biotec; hereinafter referred to as MACS) is preferred since it is simple, and yields a high cell collection rate.
  • Another method may also be used, wherein the mononuclear cells collected are cultivated for at least one hour in a culture flask under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO2, more preferably 5% CO2, and the cells deposited are used as the dendritic cell precursors.
  • This is followed by differentiating the dendritic cell precursors into immature or mature dendritic cells. AIM-V medium (Invitrogen) is used as a culture medium.
  • In addition to AIM-V medium, any commercially available medium used in cell cultivation, such as RPMI-1640 Medium (Invitrogen), Dulbecco's Modified Eagle Medium (Invitrogen; hereinafter referred to as DMEM), TIL (Immuno-Biological Laboratories Co., Ltd.), epidermal keratinocyte medium (Kojin Bio, Ltd.; hereinafter referred to as KBM), and Iscove's Medium (Invitrogen; hereinafter referred to as IMEM), may be used. Moreover, 5-20% bovine serum, fetal bovine serum (hereinafter referred to as FBS), human plasma or the like may be added as needed.
  • In the case of immature dendritic cells, they are obtained by adding a differentiation-inducing factor to the culture medium and cultivating the dendritic cell precursors.
  • Any cytokine may be used as a differentiation-inducing factor; for example, granulocyte-macrophage colony-stimulating factor (hereinafter referred to as GM-CSF), interleukin-4 (hereinafter referred to as IL-4), stem cell factor (hereinafter referred to as SCF), IL-13, tumor necrosis factor a (hereinafter referred to as TNF-α) and the like can efficiently induce the differentiation of immature dendritic cells. It is also preferable to add IL-1, IL-2, IL-3 and the like as needed. More preferably, the use of a combination of GM-CSF and IL-4 enables efficient induction.
  • The cultivation is carried out under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO2, more preferably 5% CO2; the cultivation duration is preferably 5-7 days.
  • In the case of obtaining mature dendritic cells, an additional differentiation-inducing factor is added on the 5th-7th day after starting the culture for further cultivation.
  • Any cytokine may be used as a differentiation-inducing factor; it is preferable to use, for example, GM-CSF, IL-4, SCF, IL-1β, IL-6, IL-13, INF-α, prostaglandin E2 (hereinafter referred to as PGE2) and the like to efficiently induce the differentiation of mature dendritic cells. IL-1, IL-2, IL-3 and the like are preferably added as needed. More preferably, employing a combination of GM-CSF, IL-4, IL-6, IL-1β, PGE2 and TNF-α enables efficient induction.
  • The cultivation is carried out under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO2, more preferably 5% CO2; the duration is preferably 24-48 hours.
  • Moreover, a method for obtaining immature or mature dendritic cells by collecting hematopoietic stem cells (CD34-positive cells) as dendritic cell precursors and adding GM-CSF and TNF-α, as well as flt-3 Ligand (FL), c-kit Ligand (SCF) or trombopoetin (TPO), singly or in combination, or a method of directly collecting dendritic cell fractions from blood or separated peripheral blood monocytes by using a density-gradient medium such as Percoll, may also be used.
  • To the immature or mature dendritic cells obtained, a bisphosphonate is added and cultured to prepare stimulating cells (dendritic cells pulsed with a bisphosphonate). The concentration of the bisphosphonate added is preferably 0.1-30 μM, more preferably 1-10 μM.
  • The duration of pulsing the cells with the bisphosphonate is preferably 1 36 hours, more preferably 12 hours.
  • Since the dendritic cells obtained in this manner have the ability to activate and/or proliferate γδ T-cells, they can be used as a pharmaceutical composition capable of activating and/or proliferating γδ T-cells either in vitro or in vivo. When used in vitro, they can be used as a composition capable of activating and/or proliferating γδ T-cells. When used in vivo, they can be used as a dendritic cell vaccine capable of activating and/or proliferating γδ T-cells after rinsing and removing free bisphosphonate. In either case, in vitro or in vivo, a cytokine (for example, IL-2), a protein (for example, albumin) or the like may be added as needed.
  • Second Embodiment Pharmaceutical Composition Comprising the Dendritic Cells
  • The therapeutic method utilizing the dendritic cells of the application will be explained below.
  • The dendritic cells obtained in the first embodiment are collected by centrifugation or the like.
  • The collected cells are washed. Any washing solution may be used as long as it is isosmotic and suitable for use as a pharmaceutical composition. Considering the subsequent administration to a patient, the use of physiological saline, PBS or the like is preferable.
  • When suspended in physiological saline, the dendritic cells collected become usable as a pharmaceutical preparation for administration. In addition, a cytokine may be added as needed.
  • The number of cells administered can be properly selected in accordance with the condition of the patient; normally, however, the number of cells is preferably 106-1012/person, more preferably at least 107/person.
  • The preparation can be administered by intravenous, intradermal or hypodermic injection, injected into an affiliated lymph node, directly injected into a lesion, or drip-fed for general administration. It is also possible to inject the preparation into an artery in the vicinity of a lesion.
  • By administering the dendritic cells of the present application in this manner, the γδ T-cells in the patient's body can be activated. Since γδ T-cells have nonspecific cytotoxic activity, they can be used in various treatments, for example, treating cancers and infectious diseases. One benefit of using dendritic cells in the form of a vaccine is a circumvention of the problem caused by directly administering a bisphosphonate. A bisphosphosphonate's reaction to γδ T-cells in the body is weakened and dissipated as the number of administrations increases, making the bisphosphonate incapable of repeatedly proliferating γδ T-cells. By pulsing dendritic cells with a bisphosphonate for use as a vaccine prevents this from occurring.
  • Third Embodiment The γδ T-Cell Culture Method Using the Dendritic Cells
  • The γδ T-cell culture method of the application will be explained in detail below.
  • The dendritic cells obtained in the first embodiment and the responding cells are disseminated in a culture container.
  • The responding cells here refers to a cell subset containing γδ T-cells; mononuclear cells derived from peripheral blood and the like are preferable.
  • There is no particular limitation for the container used; a plate, laboratory dish, flask, bag or the like normally employed in cultivation in the art may be used. The concentration of the individual cell subsets disseminated may be freely set in accordance with the situation.
  • AIM-V medium is used to culture the dendritic cells and the responding cells. In addition to AIM-V medium, any commercially available culture medium used in cell cultivation, such as RPMI-1640 medium, DMEM, TIL, KBM, and IMEM, may be used. Moreover, 5-20% bovine serum, FBS, human plasma, cytokine or the like may be added as needed.
  • The cultivation is carried out under the conditions of 34-38° C., more preferably 37° C., and 2-10% CO2, more preferably 5% CO2; the cultivation duration is preferably 5-8 days, more preferably 7 days.
  • The numbers of dendritic and responding cells disseminated can be set depending on the container used and the purpose of the application. The mixing proportions of the dendritic and responding cells can be properly set in accordance with the situation; considering the purpose, which is to increase the proportion of γδ T-cells in the reacted cells, the number of dendritic cells is preferably set smaller than the responding cells.
  • The present application enables the collection of a cell population containing activated γδ T-cells of high purity, in mass quantity and in a simple manner, without having to follow the complicated selection and purification processes which were required by prior art techniques to obtain γδ T-cells. Moreover, the cell population obtained in this manner can be used as it is in immune cell therapies. When the activated γδ T-cells are used in such immune cell therapies, high levels of therapeutic effect against tumors and infectious diseases are expected.
  • One benefit of activating and/or proliferating γδ T-cells in vitro is a circumvention of the problem associated with directly administering a bisphosphonate, whose reaction to γδ T-cells in the body weakens and dissipates when the number of administrations increases so that it is incapable of repeatedly proliferating γδ T-cells. Activating and/or proliferating γδ T-cells in vitro for administration can prevent this from occurring.
  • Fourth Embodiment Pharmaceutical Composition Comprising the γδ T-Cells Obtained by the Present Method
  • The method of administering the γδ T-cells obtained above to a patient will be explained next.
  • The γδ T-cells obtained by the method described in the third embodiment are collected by centrifugation and the like.
  • The cells collected are washed. Any washing solution may be used as long as it is isosmotic and suitable for use as a pharmaceutical preparation; considering the subsequent administration to a patient, the use of physiological saline, PBS or the like is preferable.
  • When suspended in physiological saline, the γδ T-cells collected become usable as a preparation for administration. In addition, a cytokine may be added as needed.
  • The number of cells administered can be properly selected in accordance with the condition of the patient; normally, however, the number of cells is preferably 108-1012/person, more preferably at least 109/person.
  • It can be administered by intravenous, intradermal or hypodermic injection, injected into an affiliated lymph node, directly injected into a lesion, or drip-fed for general administration. The preparation can also be injected into an artery in the vicinity of a lesion.
  • EXAMPLES
  • The present invention will be illustrated in more detail with reference to examples; the present invention, however, is obviously not limited to these examples.
  • Example 1 Collection and Preparation of Dendritic Cells
  • From the 30 ml of peripheral blood collected from a healthy donor mononuclear cells were collected using a density gradient medium for separating blood cells. The cells collected were washed several times to remove platelets and the like, and CD14-positive cells were isolated using MACS.
  • The dendritic cell precursors obtained were differentiated into dendritic cells. AIM-V medium with 10% FBS added thereto was used as a culture medium. To the medium 500 U/mL of GM-CSF (IMMUNEX) and 500 mL of IL-4 (Osteogenetics GmbH) were added. Immature dendritic cells were obtained in 5-7 days after starting the culture. Moreover, on the 5 th-7th day after starting the culture, 100U/mL of IL-6 (R& D Systems), 10 ng/mL of IL-1β (CHEMICON), 10 ng/mL of TNF-α (PHARMINGEN), and 1 μg/ml of PGE2 (SIGMA) were added for further cultivation. Mature dendritic cells were collected 24-48 hours later.
  • Example 2 Confirmation of the Condition of the Dendritic Cells
  • The antigens on the surface of the dendritic cells prepared were detected using a flow cytometer (Epics XL-MCL, Beckman Coulter). To the cells to be measured, suspended in PBS, target antibodies were added and stained for 15 minutes at 4° C. in a shaded condition. The antibodies used are PE-labeled anti-CD14, anti-CD83 and anti-HLA-DR antibodies (Beckman Coulter). As negative controls, the isotypes of the respective antibodies were used. The stained cells were washed with PBS and measured by using the Epics XL-MCL.
  • The results showed that the cells cultured with GM-CSF and IL-4 were CD14 and CD83 negative, HLA-DR positive, and confirmed to be an immature dendritic cell population. The cells cultivated with GM-CSF, IL-4, IL-6, IL-1β, TNFα, and PGE2 were positive except for CD14, and confirmed to be a mature dendritic cell population.
  • Example 3 Proliferation of γδ T-cell With Dendritic Cells
  • To the suspensions containing the immature or mature dendritic cells derived from peripheral blood prepared in Example 1, bisphosphonates, Aredia, Onclast and Zometa, were added to achieve the concentrations of 10 μM, 10 μM and 1 μM, respectively, and cultured for about 12 hours to prepare stimulating cells (dendritic cells pulsed with bisphosphonates). As a negative control, dendritic cells cultured without adding a bisphosphonate were used.
  • These stimulating cells, 5×105 each, were respectively cultivated in mixed cultures of 2×106 reacted cells using a 24-well plate (SUMILON) to a total volume of 1 mL (the ratio of reacted cells to stimulating cells was 4 to 1). The cells remaining after isolating the CD14-positive cells in Example 1 (CD14-negative cell population, mainly T-cell population), which had been suspended in AIM-V medium containing 10% FBS and 10% dimethyl sulfoxide (DMSO), frozen and stored, were used as the reacted cells after thawing and rinsing. The cultivation was carried out under the conditions of about 37° C. and 5% CO2 for 7 days.
  • An even better cell proliferation was observed in this mixed culture solution when 50 U/mL of IL-2 was added. When the rate of cell proliferation was high, 100 U/mL of IL-2 and 1 mL of AIM-V medium containing 10% FBS were added on the 4th-6th day.
  • Seven days later the number of cells was measured using a hemocytometer, and the proportion of γδ T-cells using a flow cytometer. For the antibodies, PC5-labeled anti-CD3 and FITC-labeled anti-pan γ/δ antibodies (Beckman Coulter) were used. These antibodies were added to the cells that were cultured and washed with PBS for dying at 4° C. for 15 minutes in a shaded condition. The isotype of anti-pan γ/δ antibody was utilized as a negative control.
  • As shown in FIG. 1, it was found that, compared to the controls (dendritic cells not pulsed with bisphosphonate), all of the mature dendritic cells and immature dendritic cells pulsed with Aredia, Onclast, and Zometa increased the proportion of γδT-cells in the cocultivated cell subsets.
  • Moreover, it was found that the immature cells pulsed with bisphosphonates increased the proportion of γδ T-cells more than the mature dendritic cells pulsed with bisphosphonates did.
  • Example 4 Collection and Preparation of γδ T-Cells
  • From a healthy donor 30 ml of peripheral blood was collected, and peripheral blood mononuclear cells were collected using a density gradient medium for blood cell separation. The cells collected were washed several times to remove platelets and the like.
  • The peripheral blood monocytes obtained were suspended in AIM-V medium (10% FCS), and Aredia was added so that the concentration in the peripheral blood monocyte suspension was 10 μM.
  • This was cultivated for 14 days. During this period, AIM-V (10% FCS) medium and IL-2, at a final concentration of 1,000 U/ml, were added in accordance with the cell proliferation.
  • Using a flow cytometer, the phenotype of the cells cultured was confirmed to be a cell subset containing at least 95% of γδ T-cells.
  • Example 5 Confirmation of the Activation of γδ T-Cells
  • In each well of a MultiScreen plate (Millipore), 70% ethanol was added and removed within two minutes.
  • Each well of the plate was washed with 200 μl of PBS five times.
  • An anti-interferon(IFN)-γ antibody for coating (clone: 1-D1K, MABTECH ELISpot for Human Interferon-γ kit) was diluted with PBS to 15 μg/ml, and added 100 μl/well.
  • The plate was left standing at 4° C. overnight.
  • The plate was washed with 200 μl/well of PBS four times.
  • AIM-V medium containing 10% FBS was added 200 μl/well, and blocking was performed at room temperature for at least 30 minutes.
  • The blocking medium was removed and the plate was washed with 200 μl/well of PBS four times.
  • The γδ T-cells obtained in Example 4 were collected by centrifugation and washed twice with AIM-V.
  • To 30,000 of the γδ T-cells collected, and 15,000 of the immature or mature dendritic cells obtained in Example 1 Aredia, prepared to have a final concentration of 10 μM, was added, and precultivated in a 15 ml tube (Falcon) under the conditions of 37° C. and 5% CO2 for two hours. At the same time, precultivation of γδ T-cells by themselves, precultivation of γδ T-cells with only Aredia added thereto, and precultivation of the respective dendritic cells by themselves were also conducted. Each culture volume was adjusted to 300 μl.
  • The plate was washed with PBS after blocking, and each group of cells which completed precultivation under the respective conditions was disseminated in three wells, 100 μl/well.
  • They were cultured overnight under the conditions of 37° C. and 5% CO2.
  • The culture solution containing the cells was removed and the plate was washed five times with 200 μl/well of PBS.
  • Biotin-labeled anti-IFN-γ antibody for detection (clone: 7-B6-1, MABTECH ELISpot for Human Interferon-γ kit) was diluted to 1 μg/ml with PBS containing 0.5% FBS and added 100 μl/well.
  • The plate was left standing for two hours at room temperature.
  • The PBS containing Biotin-labeled anti-IFN-γ antibody was removed, and the plate was washed five times with 200 μl/well of PBS.
  • Alkaliphosphatase-bonded streptoabizine (MABTECH ELISpot for Human Interferon-γ kit) was diluted with PBS containing 0.5% FBS to 1:1000, and added 100 μl/well.
  • The plate was left standing for one hour at room temperature.
  • The plate was washed five times with 200 μl/well of PBS.
  • BCIP/NBTplus substrate stock solution (Wako) was added 100 μl/well; the plate was left standing in the dark until spots were recognizable.
  • When spots were visually recognized, the plate was washed thoroughly with distilled water.
  • After confirming that the membrane on the plate was dry, the number of spots was measured using an ELISpot reader (AID Autoimmune Diagnostika GmbH), and the data was analyzed using the AID software version 3.1 (AID).
  • The results showed that the number of spots and the spot intensity increased only when the dendritic cells and Aredia were added simultaneously to the γδ T-cells. The results also showed that the immature dendritic cells pulsed with the bisphosphonate stimulated the generation of IFN-γ more than the mature dendritic cells did.
  • Potential for Industrial Application
  • As described above, the dendritic cells pulsed with bisphosphonates as described in the present application are capable of selectively activating and/or proliferating the γδ T-cells contained in peripheral blood. Accordingly, they can be used as a composition capable of activating and/or proliferating γδ T-cells in vitro. Moreover, by administering them to a patient as an administrable composition, γδ T-cells can be activated in vivo, from which effective treatment of cancers and viral infections can be expected.

Claims (14)

1. A therapeutic method wherein cultured, isolated dendritic cells which have been pulsed with a bisphosphonate-based bone metabolism improving drug in vitro, are administered to a patient in an amount effective for treating a cancer and/or an infectious disease.
2. The therapeutic method of claim 1, wherein said cultured, isolated dendritie cells have enhanced functional activity for activating and/or proliferating γδ T-cells in culture in relation to cultured, isolated dendritic cells which have not been exposed to a bisphosphonate-based bone metabolism improving drug.
3. The therapeutic method of claim 1, wherein said cultured, isolated dendritic cells are immature dendritic cells.
4. The therapeutic method of claim 1, wherein said cultured, isolated dendritic cells are a mixture of immature and mature dendrite cells.
5. The therapeutic method of claim 1, wherein said bisphosphonate-based bone metabolism improving drug is selected from the group consisting pamidronic acid, alendronic acid, zoledronic acid, risedronic acid, ibandronic acid, incadronic acid, etidronic acid, their salts their hydrates and combinations thereof.
6. The therapeutic method of claim 1, wherein said cultured, isolated dendritic cells are produced by a process comprising:
a) differentiating precursor cells in vitro, wherein the precursor cells are selected from the group consisting (i) isolated CD14 positive cells; (ii) isolated peripheral blood mononuclear cells; (iii) isolated CD34 positive hematopoietic stem cells; and (iv) a mixture thereof, to provide isolated, cultured dendritic cells; and
b) pulsing the cultured isolated dendritic cells with said bisphosphonate-based bone metabolism improving drug.
7. The therapeutic method of claim 6 wherein said precursor cells are derived from said patient.
8. The therapeutic method of claim 2 wherein said cultured, isolated dendritic cells comprise immature dendritic cells.
9. The method of claim 8, wherein the bisphosphonate-based bone metabolism improving drug is pamidronic acid, a salt thereof, a hydrate thereof, or a mixture thereof.
10. The method of claim 8, wherein the bisphosphonate-based bone metabolism improving drug is alendronic acid, a salt thereof, a hydrate thereof, or a mixture thereof.
11. The method of claim 8, wherein the bisphosphonate-based bone metabolism improving drug is zoledronic acid, a salt thereof, a hydrate thereof, or a mixture thereof.
12. The therapeutic method of claim 2 wherein said cultured, isolated dendritic cells are administered to the patient in an amount effective for treating a cancer.
13. The therapeutic method of claim 2 wherein said cultured, isolated dendritic cells are administered to the patient in an amount effective for treating an infectious disease.
14. The therapeutic method of claim 2 wherein said infectious disease is a bacterial infection.
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