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tel-00827710, version 1 - 29 May 2013 molecules that are known to induce type I IFN production, including TLR and RLR ligands, are currently being tested for their effectiveness and feasibility as candidate adjuvants. (b) TLR3 and RLR ligands Doubled stranded RNA (dsRNA) is a potent activator of innate immune cell activity following engagement with endosomal TLR3, as well as cytosolic ribonucleic acid helicases RIG-I and Mda5 (Alexopoulou et al., 2001; Kato et al., 2006). Poly I:C is a synthetic dsRNA analog that is known to be detected by TLR3 and Mda5. In this case, the size of this ligand is critical, as long dsRNA is required for optimal activation of Mda5. Several derivatives of poly I:C have been developed to limit toxicity and modify the downstream biological effects (Nicodemus and Berek, 2010). Poly ICLC corresponds to poly I:C complexed with poly-L- lysine and carboxymethylcellulose, allowing for a prolonged effect in vivo. This complexe is actively used in clinical trials under the brand name Hiltonol ® . Ampligen ® (polyI: polyC12U) is another modified dsRNA obtained by the addition of uridine in the sequence leading to occasional base pair mismatches and a more rapid metabolism in vivo, which serves to limit its toxicity. Ampligen appears to act only through TLR3. TLR3 expression, and therefore stimulation, is not uniform and is likely different in specific tissue microenvironments. TLR3 is expressed in some subsets of cDCs, macrophages, and NK cells as well as non-immune cells such as fibroblasts and epithelial cells. Additionally, RLRs are expressed in different cell types, although the RLR expression profile has not yet been detailed thoroughly. The signaling pathways triggering type I IFN production upon TLR3 or RLR engagement are different and will be described later in this introduction. TLR3 stimulation has been demonstrated to act on DCs by stimulating IL-12 and type I IFN secretion, as well as upregulating antigen presentation (Schulz et al., 2005). Mda5 appears to be more involved in the response of non-hematopoietic cells by stimulating their production of type I IFN (Longhi et al., 2009). The activation of both TLR3 and Mda5 pathways by poly I:C serves to strongly enhance the Th1 and CD8 + T cell response, better than either one of the two pathways alone. Thus far, the combination of TLR3 action directly on DCs and bystander Mda5 action mainly on non-hematopoietic cells appears to be the best way to boost the CD8 + T cell response. (c) TLR7 and TLR8 ligands TLR7 and TLR8 are also endosomal PRRs, responsible for detecting single stranded RNAs (Diebold et al., 2004). These PAMPs are not particularly stable because they are quickly degraded by RNases in the environment. Thus, they do not make for good adjuvants unless they are modified or formulated with another component that confers an increased stability. 62

tel-00827710, version 1 - 29 May 2013 Some synthetic compounds such as imidazoquinolines and adenosine and guanosine analogs, first developed as type I IFN inducers are known to act as ligands for TLR7 and TLR8 (Hemmi et al., 2002). Although they bind similar ligands, TLR7/8 are differentially expressed in vivo: TLR7 is found in B cells, neutrophils and pDCs in both human and mice, and also in macrophages and CD8α − DC in mice; TLR8 is expressed in DCs in human but does not seem functional in mice (Iwasaki and Medzhitov, 2010). Use of TLR7 and TLR8 ligands has been demonstrated to activate DCs and pDCs by upregulating costimulatory molecules and inducing the production of type I IFN and IL-12. (d) TLR9 ligands TLR9 is also found in the endosome and is capable of recognizing DNA, preferentially modified by the CpG dinucleotide (Blasius and Beutler, 2010). Synthetic 18-25 oligodeoxynucleotides with CpG motifs have been developed commercially as an adjuvant and have been tested as either a soluble molecule or formulated as nanoparticles. TLR9 has a much more restricted expression profile than the other PRRs previously discussed: it is only expressed in pDCs and in B cells in humans and mice, and also seen in cDCs in mice only (Campbell et al., 2009). CpG has been shown to both enhance humoral immunity and favor Th1 response. CpG primarily activates pDCs. Their stimulation usually results in the release of large amounts of type I IFN, as pDCs are understood to be “professional” producers of these cytokines. 3) Signaling pathways implicated in type I IFN production Several signaling pathways are responsible for the production of type I IFN depending on the receptor that has been engaged. While ligation of TLR3 and TLR4 ligands triggers a TRIF- dependent pathway, other molecules such as TLR9 ligands induce a Myd88-dependent pathway. In most cells, activation of either of these pathways leads to the phosphorylation of the transcription factor IRF3 that will interact with other molecules to form the enhanceosome. The enhanceosome then promotes the expression of IFNβ and IFNα4 is then induced. Secreted type I IFN can participate in an autocrine amplification loop through IFNAR signaling. Type I IFN bind their receptor inducing the phosphorylation of IRF7, which stimulates further type I IFN production (Figure 10). Interestingly, the mechanism of type I IFN production in pDCs is slightly different. They constitutively express IRF7, thus any inflammatory stimuli directly triggers IRF7 phosphorylation and rapid regulation of type I IFN production without the requirement for an amplification loop (Honda et al., 2006). Page 63 of 256

tel-00827710, version 1 - 29 May 2013<br />

Some synth<strong>et</strong>ic compounds such as imidazoquinolines and a<strong>de</strong>nosine and guanosine analogs,<br />

first <strong>de</strong>veloped as type I IFN inducers are known to act as ligands for TLR7 and TLR8<br />

(Hemmi <strong>et</strong> al., 2002). Although they bind similar ligands, TLR7/8 are differentially expressed<br />

in vivo: TLR7 is found in B cells, neutrophils and pDCs in both human and mice, and also in<br />

macrophages and CD8α − DC in mice; TLR8 is expressed in DCs in human but does not seem<br />

functional in mice (Iwasaki and Medzhitov, 2010). Use of TLR7 and TLR8 ligands has been<br />

<strong>de</strong>monstrated to activate DCs and pDCs by upregulating costimulatory molecules and<br />

inducing the production of type I IFN and IL-12.<br />

(d) TLR9 ligands<br />

TLR9 is also found in the endosome and is capable of recognizing DNA, preferentially<br />

modified by the CpG dinucleoti<strong>de</strong> (Blasius and Beutler, 2010). Synth<strong>et</strong>ic 18-25<br />

oligo<strong>de</strong>oxynucleoti<strong>de</strong>s with CpG motifs have been <strong>de</strong>veloped commercially as an adjuvant<br />

and have been tested as either a soluble molecule or formulated as nanoparticles. TLR9 has a<br />

much more restricted expression profile than the other PRRs previously discussed: it is only<br />

expressed in pDCs and in B cells in humans and mice, and also seen in cDCs in mice only<br />

(Campbell <strong>et</strong> al., 2009). CpG has been shown to both enhance humoral immunity and favor<br />

Th1 response. CpG primarily activates pDCs. Their stimulation usually results in the release<br />

of large amounts of type I IFN, as pDCs are un<strong>de</strong>rstood to be “professional” producers of<br />

these cytokines.<br />

3) Signaling pathways implicated in type I IFN production<br />

Several signaling pathways are responsible for the production of type I IFN <strong>de</strong>pending on the<br />

receptor that has been engaged. While ligation of TLR3 and TLR4 ligands triggers a TRIF-<br />

<strong>de</strong>pen<strong>de</strong>nt pathway, other molecules such as TLR9 ligands induce a Myd88-<strong>de</strong>pen<strong>de</strong>nt<br />

pathway. In most cells, activation of either of these pathways leads to the phosphorylation of<br />

the transcription factor IRF3 that will interact with other molecules to form the<br />

enhanceosome. The enhanceosome then promotes the expression of IFNβ and IFNα4 is then<br />

induced. Secr<strong>et</strong>ed type I IFN can participate in an autocrine amplification loop through<br />

IFNAR signaling. Type I IFN bind their receptor inducing the phosphorylation of IRF7,<br />

which stimulates further type I IFN production (Figure 10). Interestingly, the mechanism of<br />

type I IFN production in pDCs is slightly different. They constitutively express IRF7, thus<br />

any inflammatory stimuli directly triggers IRF7 phosphorylation and rapid regulation of type<br />

I IFN production without the requirement for an amplification loop (Honda <strong>et</strong> al., 2006).<br />

Page 63 of 256

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