摘要：

Tumor-specific immune responses can be induced in patients with indolent B cell lymphomas (iNHL) by active immunization against the individual B cell receptor (BCR) expressed by the malignant B cell clone, the so-called "idiotype" (Id). In subsequent trials of intradermal vaccination with recombinant lymphoma-derived Fab fragment in iNHL, we have studied the specificity of MHC class I-restricted anti-Id T cell responses by epitope mapping experiments with synthetic Id-derived peptides predicted to be presented by the respective patient's HLA complex. While such peptides exist in hypervariable and conserved Id regions, these assays have shown consistently that in vivo-induced T cell responses occur preferentially against individual Id epitopes located in complementaritydetermining regions (CDR), whereas framework (FR) and constant region-derived epitopes are ignored (Bertinetti et al., Cancer Res. 2006; Navarrete et al., ASH 2008). These results contrast with in vitro studies showing that FRderived peptides are excellent targets for cytotoxic T cells in iNHL patients (Trojan et al., Nat Med 2000). To gain further insight into the relative predominance and immunological role of MHC class I-restricted Id epitopes, we conducted a comprehensive reverse immunology study in follicular lymphoma (FL). Clonal and functional IgH chain transcript sequences were identified from tumor biopsies of 39 FL patients by APCR (Bertinetti et al., EJH 2006). The HLA-A and B haplotype of the patients was determined by conventional serological testing and high-resolution PCR genotyping. Potentially MHC-presentable peptides from all Id sequences and their corresponding germ-line (GL) VH genes were identified for the HLA haplotypes of all 39 patients by reverse immunology (bimas.cit.nih.gov). Identified peptides were ranked for each haplotype according to their predicted score, and the sum of the scores for the 20 highest ranking peptides was calculated. The sum score for any given Id was compared to the mean of the sum scores of the other 38 Ids on the respective patient's HLA haplotypes. Separate analyses were performed for CDR peptides (containing at least 2 AA in any CDR) versus non-CDR-peptides (allocated through imgt.cines.fr), Id versus GL sequences, and Id versus contaminating sporadic Ig sequences that represent bona fide normal B cells in the biopsies. 72% of all peptides with BIMAS scores of 50 and 10, respectively, were located in FR, expecially in FR3. The ranked sum Id scores were lower for the patients' own tumor Id than for the mean of the allogeneic Ids (Table; Wilcoxon's matched pair test). This difference was mostly attributable to CDR-derived epitopes throughout all CDRs despite overall lower immunogenicity compared to FR. There was no evidence for differential immunogenicity between a hypermutated FL Id and the corresponding GL (p=0.58). Finally, a preliminary survey of IgH sequences from non-clonal B cells indicated similar immunogenicity compared to FL Id (p=0.31). These bioinformatic findings indicate T cell-mediated immunosurveillance against the BCR of malignant and perhaps nonmalignant B cells. T cell activity appears to be directed predominantly against individual CDR peptides despite their lesser predicted HLA binding capacity compared to FR peptides. Existing CDR epitopes are not generated during the hypermutation process of BCRs, raising the possibility that randomly generated, more immunogenic hypervariable peptides are not permitted by the immune system. In conjunction with the T cell activity observed in in vivo and in vitro studies cited above, these findings are consistent with strong peripheral tolerance to shared Id structures. On the other hand, T cell control of individual Id peptides may play a role in immunosurveillance of malignant B cells and may be exploited for active immunotherapy of lymphoma. In contrast, generic or pan-B-cell epitopes are predicted to be less effective in inducing anti-lymphoma T cell responses.

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