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Contenido archivado el 2024-06-16

Safe and effective immunotherapy of leukaemia with suicide gene-modified human T lymphocytes retaining anti-minor histocompatibility antigen reactivity

Final Activity Report Summary - SGT FOR GVL (Safe and effective immunotherapy of leukaemia with suicide gene-modified human T lymphocytes retaining anti-minor histocompatibility antigen reactivity)

The most important scientific achievement made in this project is the demonstration that retroviral (RV) gene transfer into human T lymphocytes, after stimulation with cell-sized beads covered with anti-CD3 and anti CD28 antibodies (CD3/CD28-beads) and culture with interleukin (IL-) 7 and IL-15, fully preserves their anti-leukaemic potential for minor histocompatibility antigens (mHag). This finding is not only novel but also of crucial importance for the optimisation of suicide gene therapy for the management of graft-versus-host disease (GvHD after allogeneic hemopoietic cell transplantation (allo-HCT). At the start of the project, it was unknown whether RV gene transfer with existing protocols retained the reactivity of human T lymphocytes against alloantigens (alloreactivity). In allo-HCT, alloreactive donor T cells critically participate to an anti-leukaemic effect, also known as the graft versus leukaemia (GvL) effect. Suicide gene transfer into donor T cells aims at taking advantage of the GvL effect, while controlling a generalised immune attack against the patient, the so called graft-versus-host disease (GvHD). The problem is that due to decreased alloreactivity, the GvL effect mediated by TK+ cells is suboptimal. To preserve the alloreactivity of TK+ cells, I firstly designed novel protocols for RV gene transfer. The two major changes over existing protocols were: i) using polyclonal stimulation with CD3/CD28-beads, instead of soluble anti-CD3 antibodies (OKT3), ii) culturing cells with homeostatic cytokines, such as IL-7 and IL-15, instead of IL-2.

mHag are HLA-restricted immunogenic peptides derived from intracellular polymorphic proteins. mHag differences between patient and donor dictate both the GvL effect and GvHD after HLA-matched allo-HCT. Prof. E. Goulmy, the head of my hosting laboratory, is a world-recognised authority in the field of mHag. To demonstrate that the newly designed protocols offer a solution to the problem of decreased alloreactivity of TK+ lymphocytes, I used the HLA-A2-restricted mHag HA-1 and H-Y as model alloantigens.

Below a brief summary of the results achieved within the specific objectives of the project is provided:

1) Ex vivo generation of TK+ lymphocytes with novel and existing protocols. Starting from peripheral blood mononuclear cells (PBMC) of HLA-A2+ HA-1- or H-Y-, I generated TK+ cells with protocols that included polyclonal stimulation with CD3/CD28-beads and culture with low-dose IL-2, IL-7 or IL-15, alone or in combination. Regardless of the cytokine used for culture, TK+ cells generated after stimulation with CD3/CD28-beads were mainly central memory (CM). TK+ cells generated with aCD3 and high dose-IL-2 were enriched for effector memory (EM) cells.

2) In vitro evaluation of anti-mHag reactivity of TK+ lymphocytes. Upon exploring different protocols, TK+ lymphocytes were pulsed with autologous dendritic cells loaded with the HLA-A2-restricted mHag HA-1 and H-Y peptides. HA-1- or H-Y-specific TK+ high-affinity cytotoxic T cell lines (CTL) were generated only in the case RV gene transfer was previously performed with CD3/CD28-beads and a combination of IL-7 and IL-15. In vitro expansion of high-affinity HA-1- and H-Y-specific CTL was associated with IL-7 receptor expression.

3) In vivo demonstration of GvL and GvHD activity of TK+ lymphocytes. After expansion, HA-1- or H-Y-specific TK+ high-affinity CTL were infused into cohorts of immunodeficient mice previously grafted with HLA-A2+, HA-1+, H-Y+ human leukaemia. When compared to control animals infused with saline or virus-specific CTL, HA-1- or H-Y-specific TK+ high-affinity CTL were able to significantly delay leukaemic outgrowth. In collaboration with my home laboratory, I verified that TK+ cells generated with CD3/CD28-beads cause significant GvHD in an in vivo model based on the grafting of fully mismatched human skin onto immunodeficient mice and that this can be controlled upon GCV administration.