Effects of peptide therapy on ex vivo T-cell responses

Abstract Background: Peptide therapy targets T cells directly with short peptides containing multiple T-cell receptor epitopes. Murine studies suggest T-cell anergy as the mechanism of action; however, changes in T-cell cytokine profiles may be more relevant in human beings. Objective: We sought to study the effects of peptide therapy on ex vivo antigen-specific T-cell responses. Methods: Antigen-specific T-cell lines were generated from subjects enrolled in a double-blind, placebo controlled, two-dose study of the ALLERVAX CAT therapeutic, containing Fel d 1 peptides (ImmuLogic Pharmaceutical Corp., Waltham, Mass.) ( n  = 7, 8, and 7, respectively, for groups receiving placebo, 75 μg, or 750 μg). Each subject had three lines propagated before and after receiving peptide therapy; antigens used were cat hair extract, Fel d 1 peptides, and tetanus toxoid (negative control). Proliferative responses and cytokine generation from each line were assessed after two restimulations with antigen and autologous antigen-presenting cells. Results: The Fel d 1 peptide lines showed a dose-dependent decrease of IL-4 production ( p  = 0.02 and 0.025, respectively, for the 750 μg group vs both the 75 μg and placebo groups). IL-4 production from the cat hair allergen extract lines and interferon-γ production from both the Fel d 1 peptide lines and cat hair allergen extract lines showed no statistically significant changes. The control tetanus toxoid lines showed no changes in cytokine production; there were no significant changes in proliferation with any of the antigens in any of the treatment groups. In the clinical arm of the trial, only the 750 μg dose of peptides produced a significant response. Conclusions: Peptide therapy induces a significant, dose-dependent decrease in peptide-stimulated IL-4 production, consistent with either a shift in T-cell phenotype or peptide-specific T-cell tolerance. (J Allergy Clin Immunol 1998;101:506-13.)