This thesis focuses on using liposomes in two different treatment strategies; vaccination (or immunotherapy) and delivery of a small molecule, and in two different disease models; cancer and... Show moreThis thesis focuses on using liposomes in two different treatment strategies; vaccination (or immunotherapy) and delivery of a small molecule, and in two different disease models; cancer and atherosclerosis. For each of these treatment strategies, the liposomal formulation was tailored to obtain the desired therapeutic effect. Chapter 2 reviews some of the most important physicochemical properties (size, shape, and rigidity) that determine the immunological effects of liposomes and other nanoparticles. In chapter 3 we present a detailed study on the effect of the rigidity of anionic liposomes, as measured by atomic force microscopy, on antigen-specific regulatory T-cell (Treg) responses. In chapter 4, we show that our optimized anionic liposomes can induce potent antigen-specific Treg responses, and can be used to delay atherosclerosis progression in a mouse model. Chapter 5 also focuses on liposomal treatment of atherosclerosis, but here targeted liposomes were prepared to successfully deliver a small molecule to foam cells in atherosclerotic plaques. In Chapter 6, we used cationic liposomes in combination with an adjuvant for cancer immunotherapy in mice. Finally, we summarize the overall findings in chapter 7 and discuss perspectives of using liposomes for vaccination and targeted drug delivery. Show less
Pregnancy can be seen as an immunologic paradox. Even though the fetus expresses paternally inherited alloantigens it is protected from rejection by a proper regulation of the maternal immune... Show morePregnancy can be seen as an immunologic paradox. Even though the fetus expresses paternally inherited alloantigens it is protected from rejection by a proper regulation of the maternal immune system. With the studies described in this thesis, we want to get more insight in the immunologic mechanisms that play a role in pregnancy. The results of this research can help to identify underlying etiologies in patients with unexplained pregnancy complications, such as recurrent miscarriage. Identifying these causes is important for providing answers and taking away anxiety in these couples, and eventually for the development of effective therapies. Furthermore, elucidating the mechanism leading to survival or rejection of the fetal allograft is not only essential for our understanding of processes leading to normal and abnormal pregnancies, but may also result in important concepts in the field of transplantation and autoimmunity. Show less
During pregnancy a unique situation arises in which the mother's immune system accepts the fetus, which carries both maternal and paternal genes, and does not reject it as can occur in solid organ... Show moreDuring pregnancy a unique situation arises in which the mother's immune system accepts the fetus, which carries both maternal and paternal genes, and does not reject it as can occur in solid organ transplantation. The aim of this dissertation was to unravel the immunological mechanisms that ensure tolerance during a healthy pregnancy and uncover how alterations could contribute to the development of pregnancy complications, such as pre-eclampsia and preterm birth.We applied the new technique mass cytometry and the associated computational analyzes to map all immune cells of the mother during a healthy pregnancy. Furthermore, we demonstrated the presence of three types of functional regulatory CD4+ T cells, identified a phenotype of CD8+ T cells that can offer both tolerance and immunity against infections, and demonstrated potential cross-reactivity of T cells against fetal allo-antigens. The results described in this thesis have contributed to a better understanding of healthy pregnancies and form a basis on which further research can be built. Show less
Caspar Coolhaes was a controversial, tolerant, Spiritualist, Reformed preacher in Leiden in the late sixteenth-century. He has been called "the forerunner of Arminius and the Remonstrants."... Show moreCaspar Coolhaes was a controversial, tolerant, Spiritualist, Reformed preacher in Leiden in the late sixteenth-century. He has been called "the forerunner of Arminius and the Remonstrants." Coolhaes criticised the stricter Calvinist clergy of his day and, in, fact, found all confessions wanting. This dissertation presents an updated biographical sketch, which expands and collates what is known of Coolhaes' life. Then, it defines his ecclesiology from a detailed study of his own works, asking the question: "If Coolhaes could have designed a church for the new Dutch Republic, what would it have looked like?" Specifically, areas which concerned Coolhaes the most are laid out: his views of the relationship between secular and ecclesiastical government, his requirements for good preachers, and his concepts of diversity and Christian freedom in both the visible and invisible church. Show less
This study concerns three central aspects of multiculturalism, which are closely related to fundamental debates on citizenship and are described as the principal dimensions of multicultural... Show moreThis study concerns three central aspects of multiculturalism, which are closely related to fundamental debates on citizenship and are described as the principal dimensions of multicultural citizenship. The first of these dimensions relates to national belonging: the recognition that citizens of various ethnic and cultural backgrounds belong to the national group. The second dimension bears upon social equality, on grounds such as ethnic origin, religion, gender and sexual orientation. The third dimension is the most defining aspect of multiculturalism: the recognition of cultural distinctiveness of the various groups in society, which is considered necessary (by proponents of multiculturalism) to achieve citizen equality. This study explores views in Dutch society on these potentially divisive issues. Essentially, this study provides insight into the question to which extent society attributes the quality ‘Dutch’ to Dutch citizens from various ethnic and cultural backgrounds. Show less
Dendritic cells (DCs) are antigen-presenting cells (APCs) which play a key role in the regulation of immune responses. DCs are often referred to as __professional__ APCs, since their primary... Show moreDendritic cells (DCs) are antigen-presenting cells (APCs) which play a key role in the regulation of immune responses. DCs are often referred to as __professional__ APCs, since their primary function is to present antigens from pathogens or malignant cells. Consequently, there is a great deal of interest in how DCs might be exploited as a form of immunotherapy e.g. to induce immunity to cancers. However, DCs are also thought to play an important role in directing regulatory immune responses to innocuous antigens, which are targeted in autoimmune disease or during transplantation. Soluble factors secreted by DCs are crucial mediators in determining this balance between the immunogenic and regulatory arms of the immune system. One such group of factors is cytokines and one family which is gaining increasing attention is the IL-12 family. It is composed of four members; two are immunogenic and their expression has been very well characterised in DCs. The other two are regulatory, but relatively little is known about their regulation and expression in DC populations. In this thesis we aim to give a comprehensive overview of the expression and regulation of IL-12 family members in human DCs, with a particularly emphasis on IL-12, IL-27 and IL-35. Show less
The risk of (skin) cancer is highly increased in organ-transplant recipients who are kept on immunesuppressive drugs to prevent graft rejection. This thesis dealt with the epidemiologic aspects and... Show moreThe risk of (skin) cancer is highly increased in organ-transplant recipients who are kept on immunesuppressive drugs to prevent graft rejection. This thesis dealt with the epidemiologic aspects and risk factors for cancer focused on cutaneous squamous cell carcinoma and basal cell carcinoma. Show less
Multiple Sclerosis is a degenerative disease of the central nervous system (CNS), involving autoimmunity against myelin, resulting in demyelination and paralysis. Antigen-specific immunotherapy may... Show moreMultiple Sclerosis is a degenerative disease of the central nervous system (CNS), involving autoimmunity against myelin, resulting in demyelination and paralysis. Antigen-specific immunotherapy may reduce this pathological autoimmunity, without disturbing normal immune function. This could be achieved by targeting of myelin antigens towards C-type lectin receptors (CLR) that recognize carbohydrate structures and are expressed on immune cells, because targeting of CLR under steady state conditions can suppress immunity in an antigen-specific way. In vitro studies showed that mannosylation of peptides results in internalization via the mannose receptor. In this study we observed, that immunization with mannosylated peptide does not induce disease in EAE, a model for Multiple Sclerosis. Instead, antigen-specific tolerance was induced; CNS inflammation was absent and DTH responses were impaired. Using transfer of TCR transgenic T cells in vivo we visualized that immunization with mannosylated peptide enhanced antigen presentation and induced vigorous expansion of T cells. However, T cells showed reduced blast formation and did not transfer EAE, despite normal production of inflammatory cytokines and chemokines. Lymphocytes accumulated in the lymph node of tolerized mice, which was counteracted by injection of Pertussis Toxin. Established EAE or ongoing DTH responses were ameliorated after mannosylated peptide treatment. In conclusion, mannosylated myelin peptide induced tolerance to EAE due to incomplete differentiation of encephalitogenic T cells and can be used to treat ongoing autoimmunity. Therefore, mannosylated antigens may represent a novel therapeutic approach for antigen-specific modulation of autoreactive T cells in vivo. Show less
The studies described in this thesis focus on the feasibility of using carcinoembryonic antigen (CEA) as a target for immunotherapy of colorectal cancer and on the balance between anti-tumor... Show moreThe studies described in this thesis focus on the feasibility of using carcinoembryonic antigen (CEA) as a target for immunotherapy of colorectal cancer and on the balance between anti-tumor immunity and autoimmune pathology. The potential of CEA as a target antigen for immunotherapy of cancer is conceivably restricted by the fact that CEA is expressed in several abundant and vital tissues, including intestine and stomach, and is even routinely found in the serum of healthy individuals. We demonstrate that the CEA-specific CD4+ T-cell repertoire in CEA-tg mice is severely limited compared to wild-type mice and that this CD4+ T-cell tolerance for CEA was induced by the thymus. In addition we showed that CEA was expressed in medullary thymic epithelial cells (mTEC) in both mice and human beings. The latter suggests that the CEA-specific T-cell repertoire may also be tolerized in people. In further studies we have focussed on possibilities to overcome tolerance of CEA by reconstituting the T-cell repertoire of CEA-tg mice by adoptive transfer of the T-cell repertoire of CEA-immunized wild-type mice into tumor-bearing CEA-tg mice. Adoptive transfer in combination with immune modulation can result in efficient eradication of CEA-positive tumors. However, in order to prevent hazardous CEA-specific autoimmune reactions, the choice of the right immune modulation protocol is critical. Show less
