Boardman D A, Philippeos C, Fruhwirth G O, Ibrahim M A A, Hannen R F, Cooper D, Marelli-Berg F M, Watt F M, Lechler R I, Maher J, Smyth L A, Lombardi G
MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK.
NIHR Biomedical Research Centre, Guy's & St Thomas' NHS Foundation Trust & King's College London, Guy's Hospital, London, UK.
Am J Transplant. 2017 Apr;17(4):931-943. doi: 10.1111/ajt.14185. Epub 2017 Feb 1.
Regulatory T cell (Treg) therapy using recipient-derived Tregs expanded ex vivo is currently being investigated clinically by us and others as a means of reducing allograft rejection following organ transplantation. Data from animal models has demonstrated that adoptive transfer of allospecific Tregs offers greater protection from graft rejection compared to polyclonal Tregs. Chimeric antigen receptors (CAR) are clinically translatable synthetic fusion proteins that can redirect the specificity of T cells toward designated antigens. We used CAR technology to redirect human polyclonal Tregs toward donor-MHC class I molecules, which are ubiquitously expressed in allografts. Two novel HLA-A2-specific CARs were engineered: one comprising a CD28-CD3ζ signaling domain (CAR) and one lacking an intracellular signaling domain (ΔCAR). CAR Tregs were specifically activated and significantly more suppressive than polyclonal or ΔCAR Tregs in the presence of HLA-A2, without eliciting cytotoxic activity. Furthermore, CAR and ΔCAR Tregs preferentially transmigrated across HLA-A2-expressing endothelial cell monolayers. In a human skin xenograft transplant model, adoptive transfer of CAR Tregs alleviated the alloimmune-mediated skin injury caused by transferring allogeneic peripheral blood mononuclear cells more effectively than polyclonal Tregs. Our results demonstrated that the use of CAR technology is a clinically applicable refinement of Treg therapy for organ transplantation.
我们和其他研究团队目前正在临床上研究使用体外扩增的受体来源调节性T细胞(Treg)进行治疗,以此作为减少器官移植后同种异体移植排斥反应的一种手段。动物模型数据表明,与多克隆Treg相比,同种异体特异性Treg的过继转移能提供更强的抗移植排斥保护。嵌合抗原受体(CAR)是可将T细胞特异性重定向至指定抗原的具有临床可转化性的合成融合蛋白。我们利用CAR技术将人多克隆Treg重定向至供体MHC I类分子,该分子在同种异体移植物中普遍表达。构建了两种新型的HLA - A2特异性CAR:一种包含CD28 - CD3ζ信号结构域(CAR),另一种缺乏细胞内信号结构域(ΔCAR)。在存在HLA - A2的情况下,CAR Treg被特异性激活,并且比多克隆或ΔCAR Treg具有更强的抑制作用,且不会引发细胞毒性活性。此外,CAR和ΔCAR Treg优先穿过表达HLA - A2的内皮细胞单层。在人皮肤异种移植模型中,与多克隆Treg相比,CAR Treg的过继转移能更有效地减轻因转移同种异体外周血单个核细胞引起的同种免疫介导的皮肤损伤。我们的结果表明,使用CAR技术是一种临床上适用于器官移植的Treg治疗优化方法。