BARF1 AS A NEW THERAPEUTIC TARGET FOR EBV-ASSOCIATED MALIGNANCIES.

While Epstein-Barr virus-specific cytotoxic T lymphocytes (EBV-CTLs) have been used successfully for the prophylaxis and treatment of the highly immunogenic post-transplant lymphoproliferative disorders, the clinical experience for other EBV-associated malignancies, such as Hodgkin's lymphoma and undifferentiated nasopharyngeal carcinoma (NPC), is limited and the results obtained so far indicate that EBV-CTLs are less effective in these settings. Decreased CTL efficacy most likely reflects immune evasion strategies by tumor cells, including down-regulation of immunodominant EBV proteins and the weak immunogenicity of the viral proteins expressed. One of the possible approaches to overcome these limitations is the identification of additional immunogenic viral proteins expressed by tumor cells that may serve as tumor-associated antigens to be targeted by improved CTL induction and expansion protocols. We have recently demonstrated that NPC patients show strong spontaneous CD4+ and CD8+ T cell responses specific for the EBV-encoded oncogenic protein BARF1. We also showed that BARF1 provides immunogenic HLA-A*0201-restricted epitopes, suggesting that exploitation of the immunogenic features of this viral antigen may help improve the current immunotherapeutic strategies for EBV-associated malignancies. On these grounds, we characterized more extensively the immunogenic properties of BARF1 with the final goal to develop improved protocols of adoptive immunotherapy based on the use of EBV-CTLs enriched in BARF1-specific effectors. In particular, we identified and validated additional BARF1 CTL epitopes presented in the context of common HLA class I alleles. These results strictly correlate to those deriving from a high-resolution HLA genotyping of a large series of NPC, giving a precise estimate of the immunogenicity of BARF1 in relation to the HLA class I profile of Italian NPC patients. To fully exploit the immunologic properties of BARF1, we are also developing and characterizing BARF1-specific monoclonal antibodies that may be of both diagnostic and therapeutic usefulness in these clinical settings. In future perspective, the proposed research may provide a strong rationale for the clinical application of improved adoptive immunotherapy protocols for the treatment of EBV-associated malignancies, particularly the less immunogenic forms, such as NPC and, possibly, Hodgkin’s lymphoma.