Immunotherapy for Infectious Diseases

Transcription

1 Immunotherapy for Infectious Diseases

2 SERIES EDITOR: Vassil St. Georgiev National Institute of Allergy and Infectious Diseases National Institutes of Health Immunotherapy for Infectious Diseases, edited by Jeffrey M. Jacobson, MD, 2002 Retroviral Immunology: Immune Response and Restoration, edited by Giuseppe Pantaleo, MD and Bruce D. Walker, MD, 2001 Antimalarial Chemotherapy: Mechanisms of Action, Resistance, and New Directions in Drug Discovery, edited by Philip J. Rosenthal, MD, 2001 Drug Interactions in Infectious Diseases, edited by Stephen C. Piscitelli, PharmD and Keith A. Rodvold, PharmD, 2001 Management of Antimicrobials in Infectious Diseases: Impact of Antibiotic Resistance, edited by Arch G. Mainous III, PhD and Claire Pomeroy, MD, 2001 Infectious Disease in the Aging: A Clinical Handbook, edited by Thomas T. Yoshikawa, MD and Dean C. Norman, MD, 2001 Infectious Causes of Cancer: Targets for Intervention, edited by James J. Goedert, MD, 2000

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4 2002 Humana Press Inc. Softcover reprint of the hardcover 15t edition Riverview Drive, Suite 208 Totowa, New Jersey hum ana press. com All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. The content and opinions expressed in this book are the sole work of the authors and editors, who have warranted due diligence in the creation and issuance of their work. The publisher, editors, and authors are not responsible for errors or omissions or for any consequences arising from the information or opinions presented in this book and make no warranty, express or implied, with respect to its contents. Due diligence has been taken by the publishers, editors, and authors of this book to assure the accuracy of the information published and to describe generally accepted practices. The contributors herein have carefully checked to ensure that the drug selections and dosages set forth in this text are accurate and in accord with the standards accepted at the time of publication. Notwithstanding, as new research, changes in government regulations, and knowledge from clinical experience relating to drug therapy and drug reactions constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a new or infrequently used drug. It is the responsibility of the treating physician to determine dosages and treatment strategies for individual patients. Further it is the responsibility of the health care provider to ascertain the Food and Drug Administration status of each drug or device used in their clinical practice. The publisher, editors, and authors are not responsible for errors or omissions or for any consequences from the application of the information presented in this book and make no warranty, express or implied, with respect to the contents in this publication. This publication is printed on acid-free ANSI Z (American Standards Institute) Permanence of Paper for Printed Library Materials. Production Editor: Diana Mezzina Cover design: Patricia Cleary For additional copies, pricing for bulk purchases, and/ or information about other Humana titles, contact Humana at the above address or at any of the following numbers: Tel.: ; Fax: ; humana@humanapr.com; or visit our Website: Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Humana Press Inc., provided that the base fee of US $10.00 per copy, plus US $00.25 per page, is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA For those organizations that have been granted a photocopy license from the CCc, a separate system of payment has been arranged and is acceptable to Humana Press Inc. The fee code for users of the Transactional Reporting Service is: [ /02 $ $00.25]. Library of Congress Cataloging in Publication Data Immunotherapy for infectious diseases / edited by Jeffrey M. Jacobson. p. ; cm. -- (Infectious disease) Includes bibliographical references and index. ISBN ISBN (ebook) DOI / Immunotherapy. 2. AIDS (Disease)--Immunotherapy. I. Jacobson, Jeffrey M. II. Infectious disease (Totowa, N.J.) [DNLM: 1. Communicable Diseases--therapy. 2. Immunotherapy--methods. 3. HIV Infections--immunology. 4. HIV Infections--therapy. 5. Immunity. 6. Viral Vaccines. WC ] RM '046--dc

5 Preface The HIV epidemic has brought renewed attention to the immune system and an enhanced understanding of its mechanisms for defending against infection. Despite the development of potent chemotherapeutic agents against HIV, chronic HIV infection cannot be cured over the long term with this approach. Chronic exposure to these medications is limited by debilitating toxicities and the development of drug resistance. Hence, there is a need to understand how the immune system can be manipulated to effect better control of viral replication and disease progression. This effort is proceeding in tandem with progress toward development of an effective vaccine. Other infections, particularly those for which the development of safe, effective chemotherapy has proved difficult, have been targeted with specific immunotherapeutic approaches, from monoclonal antibodies to vaccines to interferons and cytokines. Immunotherapy for Infectious Diseases is intended to review the state-of-the-art developments of this rapidly emerging and evolving field. Much of the work in this area is only beginning to be appreciated by clinicians and medical scientists. We hope Immunotherapy for Infectious Diseases will not only serve as a useful guide to current knowledge of the field, but will also stimulate readers to contribute to its further development. As such, the book should be of interest to basic scientists and clinicians active in the fields of immunology and infectious diseases, particularly HIV infection. Immunotherapy for Infectious Diseases is divided into four sections. The first section provides an overview of the basic principles of immune defense, as seen in the context of developing strategies of immunotherapy. Humoral and cellular immunity are reviewed. Because many infectious agents enter and exit through mucosal surfaces, there has been growing appreciation of the role of mucosal immunity in protection against infection and immunopathogenesis. Therefore, a chapter on mucosal immunity is included. The second section discusses the principles of immunotherapy on a molecular level. There are discussions of monoclonal antibodies, types of vaccines, methods of antigen presentation, cytokines, and cytokine antagonists. The third section reviews the current state of anti-hiv immunotherapy. The current knowledge of HIV immunopathogenesis is reviewed, as is the degree of immune reconstitution that occurs as a result of anti-hiv chemotherapy. Chapters dealing with HIV-specific passive and active immunization strategies, gene therapy, and host celltargeted approaches for treating HIV infection and restoring immune function are presented. The fourth section reviews immunotherapy for additional infections and virus-associated malignancies. v

6 vi Preface I am grateful to all of our experts who contributed chapters to the book. They represent some of the finest minds working in this area, and did superb jobs in reviewing the latest information in their areas of expertise. I am deeply appreciative of Dr. Vassil St. Georgiev, the series editor, for inviting me to edit this book, and Thomas Lanigan, Sr., Elyse O'Grady, Craig Adams and Diana Mezzina, at Humana Press for their support in compiling it. Thanks also to the secretaries and copy editors who diligently worked to put together the elements of the book. Finally, I wish to thank the readers, who I hope will use the knowledge gained from this book to advance our ability to treat infectious diseases. Jeffrey M. Jacobson, MD

7 Contents I Preface... v List of Contributors... ix BASIC PRINCIPLES OF IMMUNITY 1 Humoral Immunity Peter L. Nara Some Basic Cellular Immunology Principles Applied to the Pathogenesis of Infectious Diseases R. Pat Bucy and Paul Goepfert Immune Defense at Mucosal Surfaces Prosper N. Boyaka and Jerry R. McGhee II MOLECULAR BASIS FOR IMMUNOTHERAPY 4 Production of Immunoglobulins and Monoclonal Antibodies Targeting Infectious Diseases Renate Kunert and Hermann Katinger Dendritic Cells: Their Role in the Immune Response to Infectious Organisms and Their Potential Use in Therapeutic Vaccination Smriti K. Kundu-Raychaudhuri and Edgar G. Engleman Cytokines, Cytokine Antagonists, and Growth Factors for Treating Infections Barbara G. Matthews Principles of Vaccine Development Constantin A. Bona III IMMUNOTHERAPY FOR HIV INFECTION 8 Immunopathogenesis of HIV Infection Lawrence M. Fox Immune Reconstitution with Antiretroviral Chemotherapy Elizabeth Connick Active Immunization as Therapy for HIV Infection Spyros A. Kalams vii

8 viii Contents 11 Passive Immunotherapy for HIV Infection Jeffrey M. Jacobson Host Cell-Directed Approaches for Treating HIV and Restoring Immune Function J. Michael Kilby and R. Pat Bucy Gene Therapy for HIV -1 Infection Ralph Dornburg and Roger J. Pomerantz IV IMMUNOTHERAPY FOR INFECTIOUS DISEASES OTHER THAN HIV 14 Immunotherapy for Viral Infections Other than HIV Michelle Onorato and Richard B. Pollard Immunotherapy for Virus-Associated Malignancies Uluhan Sili, Helen Heslop, and Cliona M. Rooney Immunotherapy of Bacterial Infections and Sepsis Sam T. Donta Immunotherapy for Tuberculosis and Other Mycobacterial Infections Robert S. Wallis and John L. Johnson Immunotherapy for Fungal Infections Arturo Casadevall Index

9 Contributors CONSTANTIN A. BONA, MD, PhD Department of Microbiology, Mount Sinai School of Medicine, New York, NY PROSPER N. BOYAKA, PhD Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL R. PAT Bucy, MD, PhD Department of Pathology, University of Alabama at Birmingham, Birmingham, AL ARTURO CASADEVALL, MD, PhD Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY ELIZABETH CONNICK, MD Division of Infectious Diseases, University of Colorado Health Sciences Center, Denver, CO SAM T. DONTA, MD Department of Medicine, Divisions of Infectious Diseases and Biomolecular Medicine, Boston University School of Medicine, Boston, MA RALPH DORNBURG, PhD Division of Infectious Diseases, Jefferson Medical College, Philadelphia, PA EDGAR G. ENGLEMAN, MD Stanford Blood Center, Palo Alto, CA LAWRENCE M. Fox, MD, PhD HIV Research Branch, Division of AIDS NIAID, NIH, Bethesda, MD PAUL GOEPFERT, MD Department of Pathology, University of Alabama at Birmingham, Birmingham, AL HELEN HESLOP, MD Departments of Medicine, Pediatrics, and Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX JEFFREY M. JACOBSON, MD AIDS Center, Mount Sinai School of Medicine, New York, NY JOHN L. JOHNSON, MD Case Western Reserve University School of Medicine, Division of Infectious Diseases, Cleveland, OH SPYROS A. KALAMS, MD Partners AIDS Research Center, Massachusetts General Hospital, Charlestown, MA HERMANN KATINGER, PhD Institute of Applied Microbiology, University for Agricultural Sciences, Vienna, Austria J. MICHAEL KILBY, MD Department of Pathology, University of Alabama at Birmingham, Birmingham, AL SMRITI K. KUNDU-RAYCHAUDHURI, MD Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA RENATE KUNERT, PhD Institute of Applied Microbiology, University for Agricultural Sciences, Vienna, Austria ix

10 x Con tribu tors BARBARA G. MATIHEWS, MD, MPH FDA/CBER/OTRR, Rockville, MD JERRY R. McGHEE, PhD Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL PETER L. NARA, DVM, MSc, PHD Biological Mimetics Inc., Frederick, MD MICHELLE ONORATO, MD. Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX RICHARD B. POLLARD, MD Division of Infectious Diseases, University of California, Davis Medical Center, Sacramento, CA ROGERJ. POMERANTZ, MD Division of Infectious Diseases, Center for Human Virology, Jefferson Medical College, Philadelphia, PA CLIONA M. ROONEY, PhD Departments of Molecular Virology and Microbiology, Pediatrics, and Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX ULUHAN SILl, MD Departments of Molecular Virology and Microbiology, Pediatrics, and Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX ROBERT S. WALLIS, MD UMDNJ New Jersey Medical School, Division of Infectious Diseases, Newark, NJ