Neutralizing Anti-IL-17A Antibody Demonstrates Preclinical Activity Enhanced by Vinblastine in Langerhans Cell Histiocytosis

Selma Olsson Åkefeldt; Mohamad Bachar Ismail; Alexandre Belot; Giulia Salvatore; Nathalie Bissay; Désirée Gavhed; Maurizio Aricò; Jan-Inge Henter; Hélène Valentin; Christine Delprat

doi:10.3389/fonc.2021.780191

Neutralizing Anti-IL-17A Antibody Demonstrates Preclinical Activity Enhanced by Vinblastine in Langerhans Cell Histiocytosis

Front Oncol. 2022 Jan 21:11:780191. doi: 10.3389/fonc.2021.780191. eCollection 2021.

Authors

Selma Olsson Åkefeldt^{1

2

3}, Mohamad Bachar Ismail^{3

4

5}, Alexandre Belot^{3

6

7}, Giulia Salvatore^{3

8}, Nathalie Bissay^{3

9}, Désirée Gavhed^{1

2}, Maurizio Aricò¹⁰, Jan-Inge Henter^{1

2}, Hélène Valentin¹¹, Christine Delprat^{3

11}

Affiliations

¹ Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
² Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
³ UnivLyon, Université Claude Bernard Lyon 1, Villeurbanne, France.
⁴ Laboratoire Microbiologie Santé et Environnement, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.
⁵ Faculty of Science, Lebanese University, Tripoli, Lebanon.
⁶ Centre International de Recherche en Infectiologie (CIRI), Univ Lyon, Inserm, U1111, Université Claude Bernard, Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France.
⁷ Pediatric Nephrology, Rheumatology, Dermatology Unit, HFME, Hospices Civils de Lyon, Bron, France.
⁸ Radiotherapy Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Firenze, Italy.
⁹ Unité de recherche "Lymphoma Immuno-Biology", Faculté de Médecine Lyon-Sud, Oullins, France.
¹⁰ Pediatrics, Azienda Sanitaria Locale, Pescara, Italy.
¹¹ Centre de Recherche en Cancérologie de Lyon (CRCL) - INSERM U1052 - CNRS UMR5286 - Centre Léon Bérard, Lyon, France.

Abstract

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasm characterised by the accumulation into granulomas of apoptosis-resistant pathological dendritic cells (LCH-DCs). LCH outcome ranges from self-resolving to fatal. Having previously shown that, (i) monocyte-derived DCs (Mo-DCs) from LCH patients differentiate into abnormal and pro-inflammatory IL-17A-producing DCs, and (ii) recombinant IL-17A induces survival and chemoresistance of healthy Mo-DCs, we investigated the link between IL-17A and resistance to apoptosis of LCH-DCs. In LCH granulomas, we uncovered the strong expression of BCL2A1 (alias BFL1), an anti-apoptotic BCL2 family member. In vitro, intracellular IL-17A expression was correlated with BCL2A1 expression and survival of Mo-DCs from LCH patients. Based on the chemotherapeutic drugs routinely used as first or second line LCH therapy, we treated these cells with vinblastine, or cytarabine and cladribine. Our preclinical results indicate that high doses of these drugs decreased the expression of Mcl-1, the main anti-apoptotic BCL2 family member for myeloid cells, and killed Mo-DCs from LCH patients ex vivo, without affecting BCL2A1 expression. Conversely, neutralizing anti-IL-17A antibodies decreased BCL2A1 expression, the downregulation of which lowered the survival rate of Mo-DCs from LCH patients. Interestingly, the in vitro combination of low-dose vinblastine with neutralizing anti-IL-17A antibodies killed Mo-DCs from LCH patients. In conclusion, we show that BCL2A1 expression induced by IL-17A links the inflammatory environment to the unusual pro-survival gene activation in LCH-DCs. Finally, these preclinical data support that targeting both Mcl-1 and BCL2A1 with low-dose vinblastine and anti-IL-17A biotherapy may represent a synergistic combination for managing recurrent or severe forms of LCH.

Keywords: biotherapy and chemotherapy; cytokine; dendritic cells; interleukin-17A (IL-17A); langerhans cell histiocytosis (LCH); survival; vinblastine.