Patterns of reactivity of Epstein-Barr virus-specific T cells in A-type donor cultures after reactivation with autologous A- or B-type transformants

An Epstein-Barr virus deletion mutant associated with fatal lymphoproliferative disease unresponsive to therapy with virus-specific CTLs

There is a growing interest in using antigen-specific T cells for the treatment of human malignancy. For example, adoptive transfer of Epstein-Barr virus (EBV)-specific cytotoxic T lymphocytes (CTLs) has been effective prophylaxis and treatment of EBV-associated lymphoproliferative disease in immunocompromised patients. For all immunotherapies, however, there has been a hypothetical concern that mutations in tumor-specific antigens may lead to tumor escape. We now demonstrate that such events may indeed occur, with lethal outcome. A patient who developed lymphoma after marrow transplantation received donor-derived, EBV-specific CTLs but died with progressive disease. The tumor cells proved substantially less sensitive to cytolysis than the EBV-transformed B-cell line used for CTL generation. The major cytolytic activity of the donor CTL was directed against 2 HLA-A11-restricted epitopes in the viral EBNA-3B antigen. Sequence analysis of this gene in the tumor virus revealed a 245-base pair deletion, which removed these 2 CTL epitopes. Hence, the viral antigen in the tumor had mutated in a way that allowed escape from CTLs. Analysis of EBV polymorphisms demonstrated that before CTL infusion, more than one virus was present, including a virus with wild-type EBNA-3B. After CTL infusion, only the virus with the EBNA-3B deletion could be detected, suggesting that the infused CTLs had selected a resistant strain in vivo. Such an occurrence, even when polyclonal CTL lines are used against genetically stable virus antigens, suggests that escape mutants may be a serious problem when CTL therapy is directed against more unstable tumor cell-derived targets.

Presentation of endogenous viral peptide epitopes by anti-CD40 stimulated human B cells following recombinant vaccinia infection

Cytotoxic T lymphocytes (CTLs) recognising viral antigens are an important host defence mechanism in restricting the proliferation of virus-infected cells. Previously, lymphoblastoid cell lines (LCLs) infected with vaccinia recombinants encoding viral proteins have been used to identify specific CTL epitopes. However, to localise the EBV CTL epitopes encoded by Epstein-Barr virus (EBV) transformants, LCLs are an inappropriate host for vaccinia recombinants. In the present study, an alternative host cell for vaccinia infection is described. Initial studies demonstrated that anti-CD40 stimulated human B cells replicated vaccinia virus and expressed EBV nuclear antigen(s) (EBNA) following infection with recombinant vaccinia encoding the appropriate region of the EBV genome. Recombinant vaccinia-infected anti-CD40 stimulated B cell lines were then used to localise target epitopes for a panel of EBV-specific CTL clones. Most importantly, in vitro stimulation of unfractionated mononuclear cells with recombinant vaccinia-infected anti-CD40 B cells activated a memory CTL response. Based on the vaccinia results, screening of peptides from EBNA6 defined the epitope for the EBNA6-specific CTL clones to the sequence KEHVIQNAFRK. This work clearly demonstrates that anti-CD40 stimulated B cell lines not only provide an efficient tool for localising CTL epitopes but also presents an alternative mechanism of reactivating a memory T cell response to any gene product expressed by recombinant vaccinia.

Oligopeptide induction of a secondary cytotoxic T-cell response to Epstein-Barr virus in vitro

Three Epstein-Barr virus (EBV) nuclear antigen (EBNA)-encoded oligopeptide epitopes have been mapped, each capable of acting as a recognition determinant for class I-restricted lysis by CD8+ cytotoxic T lymphocytes (CTL). This report shows that each peptide, when presented on an appropriate autologous antigen-presenting cell (APC), also stimulates EBV-specific memory T cells present in peripheral blood mononuclear cell (PBMC) populations to develop in vitro into peptide-specific CTL. These CTL specifically lysed autologous EBV-infected lymphoblastoid cell lines (LCL) and peptide-sensitized uninfected targets. Identical viral oligopeptides could therefore function as recognition determinants for both the induction and commission of class I-restricted specific cytotoxicity. A model system is described in which autologous phytohaemagglutinin (PHA) blasts present exogenous peptide during the stimulation phase. The magnitude of the peptide-specific CTL response was dependent on the concentration of peptide added to the APC and specific lysis was inhibited by anti-class I monoclonal antibody (MoAb) but not anti-class II MoAb. Cultures depleted of CD8+ T cells by cell separation with immunomagnetic beads prior to stimulation invariably failed to generate a peptide-specific CTL response. However, the effect of CD4 depletion on CTL activity was equivocal and indicated that a need for CD4+ T cells as accessory helper cells may depend on the efficiency of the APC to elaborate their own help. This model has advantages in the analysis of events involved in the development of CTL activity in vitro.