Committee. The study was performed in accordance to the principles of the Helsinki declaration and all individuals gave written informed consent to participate.Figure 4. Chemotherapy upregulates DR5 expression on coloc CICs. Colon CICs were treated with medium, 5-FU (25 mg/ml) or DXR (0.25 mM) for 48 hrs, washed extensively and stained with anti-DR5 mAb. Flow cytometry histograms show DR5. Mean fluorescence intensity (MFI) for DR5 staining is indicated in the upper right corner of each panel. Dotted lines represent isotype control mAb, while grey filled histogram represent anti-DR5 mAb. doi:10.1371/journal.pone.0065145.gPurification and Culture of CICsCancer tissues were extensively washed in saline buffer containing antibiotics and incubated overnight in DMEM/F12 (Life Technologies) containing penicillin (500 IU/ml), streptomycin (500 mg/ml) and amphotericin B (1.25 mg/ml) (Life TechnolChemotherapy Potentiates cd T Cell CytotoxicityFigure 5. Modulation of the cytotoxic activity of Vc9Vd2 T cells by blocking the TCR or NKG2D interactions. The Vc9Vd2 T cell line COLD2-1 was cultured with two chemotherapy-treated colon CICs (CIC#3 and CIC#5) at an E:T ratio of 20:1, in the presence of blocking antibodies to the cd TCR, CD3, NKG2D, or in the presence of mevastatin. Specific cytotoxicity levels achieved by the Vc9Vd2 T cell line COLD2-1 were 65611 for CIC#3 and 7169 for CIC#5. Data are mean 6 SD of two experiments carried out in triplicate. Percent inhibition with anti-NKG2D mAb was significantly different than values in all other groups (*p,0.001). doi:10.1371/journal.pone.0065145.gogies). Enzymatic digestion was performed using collagenase (Life Technologies, 1.5 mg/ml) and Title Loaded From File hyaluronidase (Sigma, 20 mg/ml) in DMEM containing antibiotics/antimycotics for 1 hour. Recovered cells were then cultured in serum-free medium (DMEM/F12) supplemented with 6 mg/ml Glucose, 1 mg/ml NaHCO3, 5 mM HEPES, 2 mM L-Glutamine, 4 mg/ml Heparin, 4 mg/ml BSA, 10 ng/ml bFGF, 20 ng/ml EGF, 100 mg/ml apotrasferrin, 25 mg/ml insulin, 9,6 mg/ml putrescin, 30 nM sodium selenite anhydrous and 20 nM progesterone (Sigma) to a final concentration of 36105 cells/ml. These culture conditions select for Title Loaded From File immature tumor cells that slowly proliferate, giving rise, within 2? months, to tumor cell aggregates, called “spheres”. Sphereforming cells can be propagated by enzymatic dissociation of spheres (3 mM EDTA, 50 nM DTT in PBS), followed by replating of single cells and residual small cell aggregates in fresh serum-free medium [28,46,47]. Tumorigenicity was evaluated by subcutaneous implantation of either disaggregated colon cancer sphere cells or sphere-derived differentiated cells [27]. Differentiated colon cancer cells linesDLD-1, SW620 and SW403 (American Type Culture Collection) were obtained from Dr. Ruggero De Maria (“Regina Elena” National Cancer Institute, Rome, Italy) and were maintained in DMEM containing antibiotics and 10 FCS. All cell cultures were carried out at 37uC in a 5 CO2 humidified incubator.Anti-tumor Agents, Antibodies and ReagentsThe chemotherapeutic agents 5-fluorourcil (5-FU) and doxorubicin (DXR) were obtained from Sigma, through the pharmacy of the University Hospital. Drugs were diluted in DMSO and diluted to the required concentrations in PBS prior to use. The following unconjugated, FITC-, PE-, PE-Cy5- or APCconjugated monoclonal antibodies (mAbs) were used: anti-TCR Vd2 (B6, BD Biosciences, San Jose, CA), anti-NKG2D (1D11, ?eBioscience, San.Committee. The study was performed in accordance to the principles of the Helsinki declaration and all individuals gave written informed consent to participate.Figure 4. Chemotherapy upregulates DR5 expression on coloc CICs. Colon CICs were treated with medium, 5-FU (25 mg/ml) or DXR (0.25 mM) for 48 hrs, washed extensively and stained with anti-DR5 mAb. Flow cytometry histograms show DR5. Mean fluorescence intensity (MFI) for DR5 staining is indicated in the upper right corner of each panel. Dotted lines represent isotype control mAb, while grey filled histogram represent anti-DR5 mAb. doi:10.1371/journal.pone.0065145.gPurification and Culture of CICsCancer tissues were extensively washed in saline buffer containing antibiotics and incubated overnight in DMEM/F12 (Life Technologies) containing penicillin (500 IU/ml), streptomycin (500 mg/ml) and amphotericin B (1.25 mg/ml) (Life TechnolChemotherapy Potentiates cd T Cell CytotoxicityFigure 5. Modulation of the cytotoxic activity of Vc9Vd2 T cells by blocking the TCR or NKG2D interactions. The Vc9Vd2 T cell line COLD2-1 was cultured with two chemotherapy-treated colon CICs (CIC#3 and CIC#5) at an E:T ratio of 20:1, in the presence of blocking antibodies to the cd TCR, CD3, NKG2D, or in the presence of mevastatin. Specific cytotoxicity levels achieved by the Vc9Vd2 T cell line COLD2-1 were 65611 for CIC#3 and 7169 for CIC#5. Data are mean 6 SD of two experiments carried out in triplicate. Percent inhibition with anti-NKG2D mAb was significantly different than values in all other groups (*p,0.001). doi:10.1371/journal.pone.0065145.gogies). Enzymatic digestion was performed using collagenase (Life Technologies, 1.5 mg/ml) and hyaluronidase (Sigma, 20 mg/ml) in DMEM containing antibiotics/antimycotics for 1 hour. Recovered cells were then cultured in serum-free medium (DMEM/F12) supplemented with 6 mg/ml Glucose, 1 mg/ml NaHCO3, 5 mM HEPES, 2 mM L-Glutamine, 4 mg/ml Heparin, 4 mg/ml BSA, 10 ng/ml bFGF, 20 ng/ml EGF, 100 mg/ml apotrasferrin, 25 mg/ml insulin, 9,6 mg/ml putrescin, 30 nM sodium selenite anhydrous and 20 nM progesterone (Sigma) to a final concentration of 36105 cells/ml. These culture conditions select for immature tumor cells that slowly proliferate, giving rise, within 2? months, to tumor cell aggregates, called “spheres”. Sphereforming cells can be propagated by enzymatic dissociation of spheres (3 mM EDTA, 50 nM DTT in PBS), followed by replating of single cells and residual small cell aggregates in fresh serum-free medium [28,46,47]. Tumorigenicity was evaluated by subcutaneous implantation of either disaggregated colon cancer sphere cells or sphere-derived differentiated cells [27]. Differentiated colon cancer cells linesDLD-1, SW620 and SW403 (American Type Culture Collection) were obtained from Dr. Ruggero De Maria (“Regina Elena” National Cancer Institute, Rome, Italy) and were maintained in DMEM containing antibiotics and 10 FCS. All cell cultures were carried out at 37uC in a 5 CO2 humidified incubator.Anti-tumor Agents, Antibodies and ReagentsThe chemotherapeutic agents 5-fluorourcil (5-FU) and doxorubicin (DXR) were obtained from Sigma, through the pharmacy of the University Hospital. Drugs were diluted in DMSO and diluted to the required concentrations in PBS prior to use. The following unconjugated, FITC-, PE-, PE-Cy5- or APCconjugated monoclonal antibodies (mAbs) were used: anti-TCR Vd2 (B6, BD Biosciences, San Jose, CA), anti-NKG2D (1D11, ?eBioscience, San.