Treatment of inflammatory bowel disease
A method of treating inflammatory bowel disease (IBD) comprises collecting regulatory T cells in an activated or non-activated state from a patient's sentinel lymph nodes draining bowel segments with or without IBD, optionally activating the cells by contacting them with a cytokine and an antigen extract obtained from an inflamed bowel segment, expanding the T cells in vitro, and re-infusing the expanded T cell to the patient. Also disclosed are methods for obtaining sentinel nodes, for expanding T cells, for re-establishing the T H 1/T H 2 balance in the patient suffering from Crohn's disease, and corresponding uses of the expanded T cells, the cytokine and of antigen extract, as well as of correspondingly activated and expanded T cells.
1. A method of treating inflammatory bowel disease (IBD) in a human patient, comprising:
injecting a lymphatic staining agent into lesional areas of an intestine of a human patient suffering from IBD, identifying lymphatic tissue stained by the agent as sentinel lymph node draining bowel, isolating regulatory T cells from the sentinel lymph nodes, expanding the collected T cells in vitro in culture medium, contacting the collected T cells with one or more cytokines in combination with an antigen extract obtained from an inflamed bowel segment before, concurrently or after expansion, and re-infusing the expanded T cells to the patient.
2. The method of claim 1 , wherein the inflammatory bowel disease is Crohn's disease.
3. The method of claim 1 , wherein the inflammatory bowel disease is ulcerative colitis.
4. The method of claim 1 , wherein the one or more cytokine is selected from the group consisting of IL-2, IL-7, IL-10, TGF-β1, and TSLP.
5. The method of claim 1 , further comprising activation of the collected T cells by anti-CD3, anti-CD28 or rapamycin or a combination thereof.
6. The method of claim 1 , further comprising conditioning the culture medium at periodic intervals.
7. The method of claim 1 , further comprising activation of the collected T cells by an anti CD28 antibody in combination with an anti IL-12 antibody.
8. The method of claim 1 , wherein the regulatory T cells are activated by contacting them with an antigen extract obtained from the inflammatory site in combination with one or more of a cytokine selected from the group consisting of IL-2, IL-12 and IFN-α.
9. The method of claim 8 , wherein additional activation is effected by contacting the regulatory T cells with CD3 or CD28 or both.
10. The method of claim 1 , further comprising (a) additionally activating the regulatory T cells with antigen extract from an inflammatory site in combination with a cytokine IL-2; (b) expanding the cells; and (c) optionally contacting the cells during expansion with antibody against IFN-γ or TNF-α or both to suppress TH1 skewing and TH2expansion, whereby the TH1/TH2 balance in a patient is rebalanced.
11. The method of claim 10 , further comprising conditioning of the culture medium in intervals.
12. The method of claim 11 , further comprising stimulating expansion by contacting the cells with a CD3 antibody.
13. The method of claim 1 , wherein the lymphatic staining agent is patent blue.