Lipid A and Immunotherapy

Abstract
Endotoxin isolated from Re mutants of Salmonella typhimurium or Salmonella minnesota and consisting only of 3-deoxy-d-mannooctulosonic acid (KDO) and lipid A synergistically enhances the ability of mycobacterial cell wall skeleton (CWS) to regress transplantable, line-10 tumor (hepatocellular carcinoma) in syngeneic guinea pigs. Tumor regression is rapid, and systemic tumor immunity concomitantly develops when as little as 50 βg of each of these two components is combined and injected intralesionally. Selective removal of KDO from endotoxin yields diphosphoryl lipid A, which retains its toxic properties. Subsequent selective removal of the phosphate moiety at the reducing end of the diphosphoryl lipid A molecule yields nontoxic, monophosphoryl lipid A (determined by lethality for chick embryos). Like the parent endotoxin or toxic diphosphoryl lipid A, monophosphoryl lipid A retains the ability to synergistically enhance the antitumor activity of mycobacterial CWS adjuvant. Both di- and monophosphoryllipid A contain mixtures of a series of structural analogs. They can be separated chromatographically into single components that differ in number, type, and position of ester-linked fatty acids. Comparison of chromatographic fractions reveals that components of toxic and nontoxic lipid A can be paired according to structure. Each component of the pair has the same molecular structure, with the exception of an additional phosphate group in the toxic component. The toxicity of “lipid A's” liberated from endotoxin by acid hydrolysis appears to be determined by the proportion of di- and monophosphoryl lipid A in the hydrolysis mixture. Structural analogs of monophosphoryl lipid A, which differ in degree of O-acylation and type and distribution of fatty acids, have comparable antitumor activity. Nontoxic monophosphoryl lipid A may be useful for immunotherapy of certain human tumors.