1
|
Bader CS, Pavlova A, Lowsky R, Muffly LS, Shiraz P, Arai S, Johnston LJ, Rezvani AR, Weng WK, Miklos DB, Frank MJ, Tamaresis JS, Agrawal V, Bharadwaj S, Sidana S, Shizuru JA, Fernhoff NB, Putnam A, Killian S, Xie BJ, Negrin RS, Meyer EH. Single-center randomized trial of T-reg graft alone vs T-reg graft plus tacrolimus for the prevention of acute GVHD. Blood Adv 2024; 8:1105-1115. [PMID: 38091578 PMCID: PMC10907400 DOI: 10.1182/bloodadvances.2023011625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/27/2023] [Indexed: 02/29/2024] Open
Abstract
ABSTRACT Allogeneic hematopoietic cell transplantation (HCT) is a curative therapy for hematological malignancies for which graft-versus-host disease (GVHD) remains a major complication. The use of donor T-regulatory cells (Tregs) to prevent GVHD appears promising, including in our previous evaluation of an engineered graft product (T-reg graft) consisting of the timed, sequential infusion of CD34+ hematopoietic stem cells and high-purity Tregs followed by conventional T cells. However, whether immunosuppressive prophylaxis can be removed from this protocol remains unclear. We report the results of the first stage of an open-label single-center phase 2 study (NCT01660607) investigating T-reg graft in myeloablative HCT of HLA-matched and 9/10-matched recipients. Twenty-four patients were randomized to receive T-reg graft alone (n = 12) or T-reg graft plus single-agent GVHD prophylaxis (n = 12) to determine whether T-reg graft alone was noninferior in preventing acute GVHD. All patients developed full-donor myeloid chimerism. Patients with T-reg graft alone vs with prophylaxis had incidences of grade 3 to 4 acute GVHD of 58% vs 8% (P = .005) and grade 3 to 4 of 17% vs 0% (P = .149), respectively. The incidence of moderate-to-severe chronic GVHD was 28% in the T-reg graft alone arm vs 0% with prophylaxis (P = .056). Among patients with T-reg graft and prophylaxis, CD4+ T-cell-to-Treg ratios were reduced after transplantation, gene expression profiles showed reduced CD4+ proliferation, and the achievement of full-donor T-cell chimerism was delayed. This study indicates that T-reg graft with single-agent tacrolimus is preferred over T-reg graft alone for the prevention of acute GVHD. This trial was registered at www.clinicaltrials.gov as #NCT01660607.
Collapse
Affiliation(s)
- Cameron S. Bader
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Anna Pavlova
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Robert Lowsky
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
- Cellular Immune Tolerance Program, Stanford Department of Medicine, Stanford University, Stanford, CA
| | - Lori S. Muffly
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Parveen Shiraz
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Sally Arai
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
- Cellular Immune Tolerance Program, Stanford Department of Medicine, Stanford University, Stanford, CA
| | - Laura J. Johnston
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Andrew R. Rezvani
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Wen-Kai Weng
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
- Cellular Immune Tolerance Program, Stanford Department of Medicine, Stanford University, Stanford, CA
| | - David B. Miklos
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Matthew J. Frank
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | | | - Vaibhav Agrawal
- Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA
| | - Sushma Bharadwaj
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Surbhi Sidana
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Judith A. Shizuru
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
| | | | | | | | | | - Robert S. Negrin
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
- Cellular Immune Tolerance Program, Stanford Department of Medicine, Stanford University, Stanford, CA
| | - Everett H. Meyer
- Stanford Blood and Marrow Transplantation and Cellular Therapy Division, Stanford School of Medicine, Stanford University, Stanford, CA
- Cellular Immune Tolerance Program, Stanford Department of Medicine, Stanford University, Stanford, CA
| |
Collapse
|
2
|
Martinez HA, Koliesnik I, Kaber G, Reid JK, Nagy N, Barlow G, Falk BA, Medina CO, Hargil A, Zihsler S, Vlodavsky I, Li JP, Pérez-Cruz M, Tang SW, Meyer EH, Wrenshall LE, Lord JD, Garcia KC, Palmer TD, Steinman L, Nepom GT, Wight TN, Bollyky PL, Kuipers HF. Regulatory T cells use heparanase to access IL-2 bound to extracellular matrix in inflamed tissue. Nat Commun 2024; 15:1564. [PMID: 38378682 PMCID: PMC10879116 DOI: 10.1038/s41467-024-45012-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 01/08/2024] [Indexed: 02/22/2024] Open
Abstract
Although FOXP3+ regulatory T cells (Treg) depend on IL-2 produced by other cells for their survival and function, the levels of IL-2 in inflamed tissue are low, making it unclear how Treg access this critical resource. Here, we show that Treg use heparanase (HPSE) to access IL-2 sequestered by heparan sulfate (HS) within the extracellular matrix (ECM) of inflamed central nervous system tissue. HPSE expression distinguishes human and murine Treg from conventional T cells and is regulated by the availability of IL-2. HPSE-/- Treg have impaired stability and function in vivo, including in the experimental autoimmune encephalomyelitis (EAE) mouse model of multiple sclerosis. Conversely, endowing monoclonal antibody-directed chimeric antigen receptor (mAbCAR) Treg with HPSE enhances their ability to access HS-sequestered IL-2 and their ability to suppress neuroinflammation in vivo. Together, these data identify a role for HPSE and the ECM in immune tolerance, providing new avenues for improving Treg-based therapy of autoimmunity.
Collapse
Affiliation(s)
- Hunter A Martinez
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Ievgen Koliesnik
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Gernot Kaber
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Jacqueline K Reid
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nadine Nagy
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Graham Barlow
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Ben A Falk
- Matrix Biology Program, Benaroya Research Institute, Seattle, WA, USA
| | - Carlos O Medina
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Aviv Hargil
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Svenja Zihsler
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Jin-Ping Li
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Magdiel Pérez-Cruz
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Sai-Wen Tang
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Everett H Meyer
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Lucile E Wrenshall
- Department of Neuroscience, Cell Biology, and Physiology, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - James D Lord
- Translational Research Program, Benaroya Research Institute, Seattle, WA, USA
| | - K Christopher Garcia
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Theo D Palmer
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Lawrence Steinman
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Gerald T Nepom
- Immune Tolerance Network, Benaroya Research Institute, Seattle, WA, USA
| | - Thomas N Wight
- Matrix Biology Program, Benaroya Research Institute, Seattle, WA, USA
| | - Paul L Bollyky
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Hedwich F Kuipers
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Department of Cell Biology and Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| |
Collapse
|
3
|
Martinez HA, Koliesnik I, Kaber G, Reid JK, Nagy N, Barlow G, Falk BA, Medina CO, Hargil A, Vlodavsky I, Li JP, Pérez-Cruz M, Tang SW, Meyer EH, Wrenshall LE, Lord JD, Garcia KC, Palmer TD, Steinman L, Nepom GT, Wight TN, Bollyky PL, Kuipers HF. FOXP3 + regulatory T cells use heparanase to access IL-2 bound to ECM in inflamed tissues. bioRxiv 2023:2023.02.26.529772. [PMID: 36909599 PMCID: PMC10002643 DOI: 10.1101/2023.02.26.529772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
FOXP3+ regulatory T cells (Treg) depend on exogenous IL-2 for their survival and function, but circulating levels of IL-2 are low, making it unclear how Treg access this critical resource in vivo. Here, we show that Treg use heparanase (HPSE) to access IL-2 sequestered by heparan sulfate (HS) within the extracellular matrix (ECM) of inflamed central nervous system tissue. HPSE expression distinguishes human and murine Treg from conventional T cells and is regulated by the availability of IL-2. HPSE-/- Treg have impaired stability and function in vivo, including the experimental autoimmune encephalomyelitis (EAE) mouse model of multiple sclerosis. Conversely, endowing Treg with HPSE enhances their ability to access HS-sequestered IL-2 and their tolerogenic function in vivo. Together, these data identify novel roles for HPSE and the ECM in immune tolerance, providing new avenues for improving Treg-based therapy of autoimmunity.
Collapse
Affiliation(s)
- Hunter A Martinez
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Ievgen Koliesnik
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Gernot Kaber
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Jacqueline K Reid
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary; Calgary, Canada
| | - Nadine Nagy
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Graham Barlow
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Ben A Falk
- Matrix Biology Program, Benaroya Research Institute; Seattle, USA
| | - Carlos O Medina
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Aviv Hargil
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Israel Vlodavsky
- Tumor Integrated Cancer Center, Technion-Israel Institute of Technology; Haifa, Israel
| | - Jin-Ping Li
- Department of Medical Biochemistry and Microbiology, Uppsala University; Uppsala, Finland
| | - Magdiel Pérez-Cruz
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Sai-Wen Tang
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Everett H Meyer
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Lucile E Wrenshall
- Department of Surgery, Boonshoft School of Medicine, Wright State University; Dayton, USA
| | - James D Lord
- Translational Research Program, Benaroya Research Institute; Seattle, USA
| | - K Christopher Garcia
- Department of Molecular & Cellular Physiology, Stanford University; Stanford, USA
| | - Theo D Palmer
- Department of Neurosurgery, Stanford University School of Medicine; Stanford, USA
| | - Lawrence Steinman
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine; Stanford, USA
| | - Gerald T Nepom
- Immune Tolerance Network, Benaroya Research Institute; Seattle, USA
| | - Thomas N Wight
- Matrix Biology Program, Benaroya Research Institute; Seattle, USA
| | - Paul L Bollyky
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
| | - Hedwich F Kuipers
- Department of Medicine, Stanford University School of Medicine; Stanford, USA
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary; Calgary, Canada
| |
Collapse
|
4
|
Jackson C, Shiraz P, Iglesias M, Egeler E, Sahaf B, Arai S, Bharadwaj S, Johnston L, Lowsky R, Meyer EH, Negrin RS, Rezvani AR, Weng WK, Shizuru JA, Marcondes MQ, Tagliaferri MA, Sidana S, Frank MJ, Smith M, Feldman S, Miklos DB, Mackall C, Syal S, Patil S, Reynolds WD, Muffly L. Early Results of a Phase I Study of CAR-T Cells + NKTR-255 (PEG-IL-15) in Adults with R/R ALL. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00343-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
5
|
Wu X, Chen PI, Pathak S, Whitener RL, Nguyen V, Iliopolou BP, Mangayan KR, Jensen KP, Kim SK, Meyer EH. CD39 Delineates Chimeric Antigen Receptor T Regulatory Cell Populations with Different Cytotoxic and Immunoregulatory Potential Against Monocytes and Pancreatic Islet Beta Cells. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00308-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
6
|
Srour SA, Salhotra A, Lowsky R, Hoeg RT, Saad A, Pavlova A, Waller EK, Chao MM, McClellan JS, Fernhoff NB, Meyer EH, Abedi M. Orca-Q Demonstrates Favorable GvHD-and-Relapse-Free Survival with Haploidentical Donors without Post-Transplant Cyclophosphamide. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00102-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
7
|
Liang EC, Craig J, Torelli S, Cunanan K, Iglesias M, Arai S, Frank MJ, Johnston L, Lowsky R, Meyer EH, Miklos DB, Negrin R, Rezvani A, Shiraz P, Shizuru J, Sidana S, Weng WK, Bharadwaj S, Muffly L. Allogeneic Hematopoietic Cell Transplantation for Adult Acute Lymphoblastic Leukemia in the Modern Era. Transplant Cell Ther 2022; 28:490-495. [PMID: 35584783 PMCID: PMC10153066 DOI: 10.1016/j.jtct.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/19/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) remains an important treatment for adults with acute lymphoblastic leukemia (ALL). We hypothesized that advances in ALL and transplantation have resulted in improved HCT outcomes in recent years. In this study, we evaluated the characteristics and outcomes of adult ALL patients undergoing allogeneic HCT over the last decade. Patients with ALL aged 18 years and older who underwent allogeneic HCT at Stanford University between 2008 and 2019 were included in this study. Patients were divided into 2 eras based on year of HCT: 2008 to 2013 (earlier era) and 2014 to 2019 (later era). A total of 285 patients were included: 119 patients underwent HCT in the earlier era and 166 in the later era. Patients who underwent transplantation in the later era were more likely to be Hispanic (38% versus 21%) and to have an HCT-comorbidity index ≥3 (31% versus 18%). Donor source for HCT also differed with an increase in the use of HLA-mismatched donor sources (38% versus 24%), notably umbilical cord blood in the later era (16% versus 0%). Patients in the later era were less likely to undergo transplantation with active disease (4% versus 16%); pre-HCT rates of measurable residual disease were similar across the eras (38% versus 40%). In unadjusted analyses, overall survival (OS) improved across eras, with 2-year estimates for the later and earlier eras of 73% (95% confidence interval [CI], 66%-80%) versus 55% (95% CI, 46%-64%), respectively. Multivariable analysis confirmed the association between later era and OS (hazard ratio = 0.52, 95% CI, 0.34-0.78). Finally, among patients relapsing after HCT (25% in later era and 33% in earlier era), the use of novel immunotherapies increased in the later era (44% versus 3%), as did the median OS after post-HCT relapse (16 months versus 8 months, P< .001). OS after HCT for adult ALL has improved in recent years. This is due, in part, to a significant improvement in the ability to effectively salvage adults with ALL relapsing after HCT.
Collapse
Affiliation(s)
- Emily C Liang
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Juliana Craig
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Stefan Torelli
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Kristen Cunanan
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Maria Iglesias
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Sally Arai
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Matthew J Frank
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Laura Johnston
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Robert Lowsky
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Everett H Meyer
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - David B Miklos
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Robert Negrin
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Andrew Rezvani
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Parveen Shiraz
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Judith Shizuru
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Surbhi Sidana
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Wen-Kai Weng
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Sushma Bharadwaj
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Lori Muffly
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California.
| |
Collapse
|
8
|
Sidana S, Bankova AK, Hosoya H, Kumar S, Tamaresis J, Le A, Muffly L, Johnston L, Arai S, Lowsky R, Meyer EH, Rezvani AR, Weng WK, Frank MJ, Shiraz P, Girgenti D, Goncalves KA, Schmelmer V, Davis J, Lu Y, Shizuru JA, Miklos DB. Mgta-145 + Plerixafor Provides GCSF-Free Rapid and Reliable Hematopoietic Stem Cell Mobilization for Autologous Stem Cell Transplant in Patients with Multiple Myeloma: A Phase 2 Study. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00246-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
9
|
Gandhi A, Moroz A, Muffly L, Shiraz P, Schachter L, Fernhoff N, McClellan JS, Negrin RS, Gotlib JR, Meyer EH. Outcomes for Myelofibrosis Patients Following Myeloablative Allogeneic Stem Cell Transplantation Using the Orca-T Graft from HLA-Matched Related and Unrelated Donors. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00573-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
10
|
Moroz A, Hoeg R, Gandhi A, Muffly L, Shiraz P, Oliai C, Mehta RS, Srour SA, McGuirk JP, Waller EK, Arai S, Johnston L, Lowsky R, Rezvani AR, Weng WK, Miklos DB, Frank MJ, Tamaresis J, Agrawal V, Fernhoff N, Bauer G, Putnam A, McClellan JS, Shaw BE, Abedi M, Negrin RS, Meyer EH. Orca-T Demonstrates Encouraging Overall Survival, Gvhd Reduction, and Tolerability in Patients with Hematologic Malignancies. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00572-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
11
|
Liang EC, Muffly LS, Shiraz P, Shizuru JA, Johnston L, Arai S, Frank MJ, Weng WK, Lowsky R, Rezvani A, Meyer EH, Negrin R, Miklos DB, Sidana S. Use of Backup Stem Cells for Stem Cell Boost and Second Transplant in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation. Transplant Cell Ther 2021; 27:405.e1-405.e6. [PMID: 33775587 PMCID: PMC8113075 DOI: 10.1016/j.jtct.2021.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/10/2021] [Accepted: 02/21/2021] [Indexed: 10/22/2022]
Abstract
Autologous hematopoietic stem cell transplantation (ASCT) is a standard treatment for multiple myeloma (MM). Consensus guidelines recommend collecting sufficient stem cells in case there is a need for stem cell boost for delayed/poor engraftment or for future second ASCT. However, collecting and storing backup stem cells in all patients requires significant resources and cost, and the rates of backup stem cell utilization are not well studied. We sought to examine the utilization of backup stem cells (BSCs) in patients with MM undergoing ASCT. Patients with MM aged ≥18 years old who underwent first ASCT at our institution from January 2010 through December 2015 and collected sufficient stem cells for at least 2 transplants were included in this single-center retrospective study. This timeframe was selected to allow for adequate follow-up. A total of 393 patients were included. The median age was 58 years (range, 25-73). After a median follow-up of 6 years, the median progression-free survival (PFS) of the cohort was 3 years. Sixty-one percent (n = 240) of patients progressed or relapsed. Chemotherapy-based mobilization was used in almost all patients (98%). The median total CD34+ cells collected was 18.2 × 106/kg (range, 3.4-112.4). A median of 5.7 × 106 CD34+ cells/kg (range, 1.8-41.9) was infused during the first ASCT, and a median of 10.1 × 106 CD34+ cells/kg (range, 1.5-104.5) was cryopreserved for future use. Of the patients, 6.9% (n = 27) used backup stem cells, with 2.3% (n = 10) using them for stem cell boost, 4.6% (n = 18) for a second salvage ASCT, including 1 patient for both stem cell boost and second ASCT. Rates of backup stem cell use among patients aged <60, 60-69, and ≥70 years were 7.8%, 5.7%, and 5.9%, respectively. There was a trend toward higher rates of backup stem cell use for second ASCT in patients who were younger, had suboptimal disease control at time of first ASCT, and longer PFS. The median dose of stem cell boost given was 5.6 × 106 CD34+ cells/kg (range, 1.9-20). The median time from stem cell boost to neutrophil, hemoglobin, and platelet engraftment was 4 (range, 2-11), 15 (range, 4-34), and 12 (range, 0-34) days, respectively. Lower CD34+ dose and older age at time of ASCT predicted need for stem cell boost. With new salvage therapies for relapsed MM, the rates of second ASCT are very low. The low rates of use suggest that institutional policies regarding universal BSC collection and long-term storage should be reassessed and individualized. However, need for stem cell boost in 2.3% of patients may present a challenge to that.
Collapse
Affiliation(s)
- Emily C Liang
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Lori S Muffly
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Parveen Shiraz
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Judith A Shizuru
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Laura Johnston
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Sally Arai
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Matthew J Frank
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Wen-Kai Weng
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Robert Lowsky
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Andrew Rezvani
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Everett H Meyer
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Robert Negrin
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - David B Miklos
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Surbhi Sidana
- Department of Medicine, Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, California..
| |
Collapse
|
12
|
Johnsrud A, Ladha A, Muffly L, Shiraz P, Goldstein G, Osgood V, Shizuru JA, Johnston L, Arai S, Weng WK, Lowsky R, Rezvani AR, Meyer EH, Frank MJ, Negrin RS, Miklos DB, Sidana S. Stem Cell Mobilization in Multiple Myeloma: Comparing Safety and Efficacy of Cyclophosphamide +/- Plerixafor versus Granulocyte Colony-Stimulating Factor +/- Plerixafor in the Lenalidomide Era. Transplant Cell Ther 2021; 27:590.e1-590.e8. [PMID: 33915323 DOI: 10.1016/j.jtct.2021.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/05/2021] [Accepted: 04/18/2021] [Indexed: 11/17/2022]
Abstract
Growth factor and chemotherapy-based stem cell mobilization strategies are commonly used to treat patients with multiple myeloma. We retrospectively compared 398 patients mobilized between 2017 and 2020 using either cyclophosphamide (4 g/m2) plus granulocyte colony-stimulating factor (G-CSF) or G-CSF alone, with on demand plerixafor (PXF) in both groups. Although total CD34+ yield was higher after chemomobilization compared with G-CSF +/- PXF (median, 13.6 × 106/kg versus 4.4 × 106/kg; P < .01), achievement of ≥2 × 106 CD34+ cells (95% versus 93.7%; P = .61) and rates of mobilization failure (5% versus 6.3%; P = .61) were similar. Fewer patients required PXF with chemomobilization (12.3% versus 49.5%; P < .01), and apheresis sessions were fewer (median, 1 [range, 1 to 4] versus 2 [range, 1 to 5]). The rate of complications, including neutropenic fever, emergency department visits, and hospitalizations, was higher after chemomobilization (30% versus 7.4%; P < .01). Previous use of ≤6 cycles of lenalidomide did not impair cell yield in either group. The median cost of mobilization was 17.4% lower in the G-CSF +/- PXF group (P = .01). Between group differences in time to engraftment were not clinically significant. Given similar rates of successful mobilization, similar engraftment time, and less toxicity and lower costs compared with chemomobilization, G-CSF with on-demand PXF may be preferable in myeloma patients with adequate disease control and limited lenalidomide exposure.
Collapse
Affiliation(s)
- Andrew Johnsrud
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Abdullah Ladha
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California; Division of Hematology, University of Southern California, Los Angeles, California
| | - Lori Muffly
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Parveen Shiraz
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Gary Goldstein
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Victoria Osgood
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Judith A Shizuru
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Laura Johnston
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Sally Arai
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Wen-Kai Weng
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Robert Lowsky
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Andrew R Rezvani
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Everett H Meyer
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Matthew J Frank
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Robert S Negrin
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - David B Miklos
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California
| | - Surbhi Sidana
- Stanford Cancer Institute, Stanford, California; Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University, Stanford, California.
| |
Collapse
|
13
|
Keating SM, Mizrahi RA, Adams MS, Asensio MA, Benzie E, Carter KP, Chiang Y, Edgar RC, Gautam BK, Gras A, Leong J, Leong R, Lim YW, Manickam VA, Medina-Cucurella AV, Niedecken AR, Saini J, Simons JF, Spindler MJ, Stadtmiller K, Tinsley B, Wagner EK, Wayham N, Tracy L, Lundberg CV, Büscher D, Terencio JV, Roalfe L, Pearce E, Richardson H, Goldblatt D, Ramjag AT, Carrington CVF, Simmons G, Muench MO, Chamow SM, Monroe B, Olson C, Oguin TH, Lynch H, Jeanfreau R, Mosher RA, Walch MJ, Bartley CR, Ross CA, Meyer EH, Adler AS, Johnson DS. Generation of recombinant hyperimmune globulins from diverse B-cell repertoires. Nat Biotechnol 2021; 39:989-999. [PMID: 33859400 PMCID: PMC8355030 DOI: 10.1038/s41587-021-00894-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 12/14/2022]
Abstract
Plasma-derived polyclonal antibody therapeutics, such as intravenous immunoglobulin, have multiple drawbacks, including low potency, impurities, insufficient supply, and batch-to-batch variation. Here we describe a microfluidics and molecular genomics strategy for capturing diverse mammalian antibody repertoires to create recombinant multivalent hyperimmune globulins. Our method generates thousands-diverse mixtures of recombinant antibodies, enriched for specificity and activity against therapeutic targets. Each hyperimmune globulin product comprised thousands to tens of thousands of antibodies derived from convalescent or vaccinated human donors, or immunized mice. Using this approach, we generated hyperimmune globulins with potent neutralizing activity against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) in under three months, Fc-engineered hyperimmune globulins specific for Zika virus that lacked antibody-dependent enhancement of disease, and hyperimmune globulins specific for lung pathogens present in patients with primary immune deficiency. To address the limitations of rabbit-derived anti-thymocyte globulin (ATG), we generated a recombinant human version and demonstrated its efficacy in mice against graft-versus-host disease.
Collapse
Affiliation(s)
| | | | - Matthew S Adams
- GigaGen Inc., South San Francisco, CA, USA.,Department of Molecular, Cell, and Developmental Biology, University of California, Santa Cruz, Santa Cruz, CA, USA
| | | | | | | | - Yao Chiang
- GigaGen Inc., South San Francisco, CA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lucy Roalfe
- Immunobiology Section, Great Ormond Street Institute of Child Health, University College London, London, England
| | - Emma Pearce
- Immunobiology Section, Great Ormond Street Institute of Child Health, University College London, London, England
| | - Hayley Richardson
- Immunobiology Section, Great Ormond Street Institute of Child Health, University College London, London, England
| | - David Goldblatt
- Immunobiology Section, Great Ormond Street Institute of Child Health, University College London, London, England
| | - Anushka T Ramjag
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago
| | - Christine V F Carrington
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago
| | | | | | | | | | | | - Thomas H Oguin
- Regional Biocontainment Laboratory, Duke University Medical Center, Durham, NC, USA
| | - Heather Lynch
- Regional Biocontainment Laboratory, Duke University Medical Center, Durham, NC, USA
| | | | - Rachel A Mosher
- Waisman Biomanufacturing, University of Wisconsin, Madison, WI, USA
| | - Matthew J Walch
- Waisman Biomanufacturing, University of Wisconsin, Madison, WI, USA
| | | | - Carl A Ross
- Waisman Biomanufacturing, University of Wisconsin, Madison, WI, USA
| | - Everett H Meyer
- Stanford Diabetes Research Center, Stanford University Medical Center, Stanford, CA, USA.,Stanford Cancer Institute, Stanford University Medical Center, Stanford, CA, USA
| | | | | |
Collapse
|
14
|
Frank MJ, Khodadoust MS, Czerwinski DK, Haabeth OAW, Chu MP, Miklos DB, Advani RH, Alizadeh AA, Gupta NK, Maeda LS, Reddy SA, Laport GG, Meyer EH, Negrin RS, Rezvani AR, Weng WK, Sheehan K, Faham M, Okada A, Moore AH, Phillips DL, Wapnir IL, Brody JD, Levy R. Autologous tumor cell vaccine induces antitumor T cell immune responses in patients with mantle cell lymphoma: A phase I/II trial. J Exp Med 2021; 217:151871. [PMID: 32558897 PMCID: PMC7478738 DOI: 10.1084/jem.20191712] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/13/2020] [Accepted: 05/06/2020] [Indexed: 11/04/2022] Open
Abstract
Here, we report on the results of a phase I/II trial (NCT00490529) for patients with mantle cell lymphoma who, having achieved remission after immunochemotherapy, were vaccinated with irradiated, CpG-activated tumor cells. Subsequently, vaccine-primed lymphocytes were collected and reinfused after a standard autologous stem cell transplantation (ASCT). The primary endpoint was detection of minimal residual disease (MRD) within 1 yr after ASCT at the previously validated threshold of ≥1 malignant cell per 10,000 leukocyte equivalents. Of 45 evaluable patients, 40 (89%) were found to be MRD negative, and the MRD-positive patients experienced early subsequent relapse. The vaccination induced antitumor CD8 T cell immune responses in 40% of patients, and these were associated with favorable clinical outcomes. Patients with high tumor PD-L1 expression after in vitro exposure to CpG had inferior outcomes. Vaccination with CpG-stimulated autologous tumor cells followed by the adoptive transfer of vaccine-primed lymphocytes after ASCT is feasible and safe.
Collapse
Affiliation(s)
| | | | | | | | - Michael P Chu
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - David B Miklos
- Division of Blood and Marrow Transplantation, Stanford University Healthcare, Stanford, CA
| | | | | | - Neel K Gupta
- Division of Oncology, Stanford University, Stanford, CA
| | | | - Sunil A Reddy
- Division of Oncology, Stanford University, Stanford, CA
| | - Ginna G Laport
- Division of Blood and Marrow Transplantation, Stanford University Healthcare, Stanford, CA
| | - Everett H Meyer
- Division of Blood and Marrow Transplantation, Stanford University Healthcare, Stanford, CA
| | - Robert S Negrin
- Division of Blood and Marrow Transplantation, Stanford University Healthcare, Stanford, CA
| | - Andrew R Rezvani
- Division of Blood and Marrow Transplantation, Stanford University Healthcare, Stanford, CA
| | - Wen-Kai Weng
- Division of Blood and Marrow Transplantation, Stanford University Healthcare, Stanford, CA
| | - Kevin Sheehan
- Division of Oncology, Stanford University, Stanford, CA
| | | | - Ami Okada
- Division of Oncology, Stanford University, Stanford, CA
| | | | | | - Irene L Wapnir
- Department of Surgery, Stanford University Healthcare, Stanford, CA
| | | | - Ronald Levy
- Division of Oncology, Stanford University, Stanford, CA
| |
Collapse
|
15
|
Meyer EH, Hoeg R, Moroz A, Xie BJ, Wu HH, Pawar R, Heydari K, Miklos DB, Shiraz P, Muffly L, Arai S, Johnston L, Lowsky R, Rezvani AR, Shizuru JA, Weng WK, Fernhoff N, Bauer G, Ghandi A, McClellan JS, Shaw BE, Oliai C, McGuirk JP, Abedi M, Negrin RS. Orca-T, a Precision Treg-Engineered Donor Product, in Myeloablative HLA-Matched Transplantation Prevents Acute Gvhd with Less Immunosuppression in an Early Multicenter Experience. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
16
|
Liang EC, Muffly L, Shiraz P, Shizuru JA, Johnston L, Arai S, Weng WK, Lowsky R, Rezvani AR, Meyer EH, Frank MJ, Negrin RS, Miklos DB, Sidana S. Utilization of Backup Stem Cells for Stem Cell Boost and Second Transplant in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00507-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
17
|
Muffly L, Sundaram V, Arai S, Frank MJ, Johnston L, Lowsky R, Meyer EH, Negrin RS, Rezvani AR, Sidana S, Shiraz P, Shizuru JA, Weng WK, Miklos DB. Concordance of Next Generation Sequencing-Based Measurable Residual Disease between Peripheral Blood and Bone Marrow in Adults with Acute Lymphoblastic Leukemia Receiving Cellular Therapies. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Johnsrud A, Craig J, Baird J, Spiegel J, Muffly L, Zehnder JL, Negrin RS, Johnston L, Arai S, Shizuru JA, Lowsky R, Meyer EH, Weng WK, Shiraz P, Rezvani AR, Latchford TM, Mackall CL, Miklos DB, Frank MJ, Sidana S. Bleeding and Thrombosis Are Associated with Endothelial Dysfunction in CAR-T Cell Therapy and Are Increased in Patients Experiencing Neurologic Toxicity. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00257-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Narayan R, Niroula A, Wang T, Kuxhausen M, Meyer EH, Chen YB, Marsh SGE, Gadalla SM, Paczesny S, Spellman SR, Lee SJ. HLA Class I Genotypes with Predicted Strong Binding Affinity to Mutated NPM1 Are Associated with Lower Relapse Risk in Matched Related or Unrelated Transplant for NPM1 Mutated Acute Myeloid Leukemia. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
20
|
Abstract
Pancreatic islet transplantation is a promising method for the treatment of type 1 and type 3 diabetes whereby replacement of islets may be curative. However, long-term treatment with immunosuppressive drugs (ISDs) remains essential for islet graft survival. Current ISD regimens carry significant side-effects for transplant recipients, and are also toxic to the transplanted islets. Pre-clinical efforts to induce immune tolerance to islet allografts identify ways in which the recipient immune system may be reeducated to induce a sustained transplant tolerance and even overcome autoimmune islet destruction. The goal of these efforts is to induce tolerance to transplanted islets with minimal to no long-term immunosuppression. Two most promising cell-based therapeutic strategies for inducing immune tolerance include T regulatory cells (Tregs) and donor and recipient hematopoietic mixed chimerism. Here, we review preclinical studies which utilize Tregs for tolerance induction in islet transplantation. We also review myeloablative and non-myeloablative hematopoietic stem cell transplantation (HSCT) strategies in preclinical and clinical studies to induce sustained mixed chimerism and allograft tolerance, in particular in islet transplantation. Since Tregs play a critical role in the establishment of mixed chimerism, it follows that the combination of Treg and HSCT may be synergistic. Since the success of the Edmonton protocol, the feasibility of clinical islet transplantation has been established and nascent clinical trials testing immune tolerance strategies using Tregs and/or hematopoietic mixed chimerism are underway or being formulated.
Collapse
Affiliation(s)
- Shiva Pathak
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, CA, United States
- Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, United States
| | - Everett H. Meyer
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, CA, United States
- Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, United States
| |
Collapse
|
21
|
Marshall PL, Nagy N, Kaber G, Barlow GL, Ramesh A, Xie BJ, Linde MH, Haddock NL, Lester CA, Tran QL, de Vries CR, Hargil A, Malkovskiy AV, Gurevich I, Martinez HA, Kuipers HF, Yadava K, Zhang X, Evanko SP, Gebe JA, Wang X, Vernon RB, de la Motte C, Wight TN, Engleman EG, Krams SM, Meyer EH, Bollyky PL. Hyaluronan synthesis inhibition impairs antigen presentation and delays transplantation rejection. Matrix Biol 2020; 96:69-86. [PMID: 33290836 DOI: 10.1016/j.matbio.2020.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 12/13/2022]
Abstract
A coat of pericellular hyaluronan surrounds mature dendritic cells (DC) and contributes to cell-cell interactions. We asked whether 4-methylumbelliferone (4MU), an oral inhibitor of HA synthesis, could inhibit antigen presentation. We find that 4MU treatment reduces pericellular hyaluronan, destabilizes interactions between DC and T-cells, and prevents T-cell proliferation in vitro and in vivo. These effects were observed only when 4MU was added prior to initial antigen presentation but not later, consistent with 4MU-mediated inhibition of de novo antigenic responses. Building on these findings, we find that 4MU delays rejection of allogeneic pancreatic islet transplant and allogeneic cardiac transplants in mice and suppresses allogeneic T-cell activation in human mixed lymphocyte reactions. We conclude that 4MU, an approved drug, may have benefit as an adjunctive agent to delay transplantation rejection.
Collapse
Affiliation(s)
- Payton L Marshall
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Nadine Nagy
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Gernot Kaber
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Graham L Barlow
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Amrit Ramesh
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Bryan J Xie
- Division of Blood and Marrow Transplantation, Dept. of Medicine, Stanford University School of Medicine, CCSR, 1291 Welch Road, Stanford, CA 94305, United States
| | - Miles H Linde
- Division of Hematology, Dept. of Medicine, Cancer Institute, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, SIM1, 265 Campus Drive, Stanford, CA 94305, United States
| | - Naomi L Haddock
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Colin A Lester
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Quynh-Lam Tran
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Christiaan R de Vries
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Aviv Hargil
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Andrey V Malkovskiy
- Biomaterials and Advanced Drug Delivery (BioADD) Laboratory Stanford School of Medicine, Stanford, CA 94304, United States
| | - Irina Gurevich
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Hunter A Martinez
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Hedwich F Kuipers
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Koshika Yadava
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States
| | - Xiangyue Zhang
- Department of Pathology, Stanford School of Medicine, 3373 Hillview Ave, Palo Alto CA 94304, United States
| | - Stephen P Evanko
- Benaroya Research Institute, 1201 Ninth Avenue, Seattle, WA 98101, United States
| | - John A Gebe
- Benaroya Research Institute, 1201 Ninth Avenue, Seattle, WA 98101, United States
| | - Xi Wang
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford University School of Medicine, 1201 Welch Rd, MSLS P313, Stanford, CA 94305, United States
| | - Robert B Vernon
- Benaroya Research Institute, 1201 Ninth Avenue, Seattle, WA 98101, United States
| | - Carol de la Motte
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, 9500 Euclid Avenue Cleveland, OH 4419, United States
| | - Thomas N Wight
- Benaroya Research Institute, 1201 Ninth Avenue, Seattle, WA 98101, United States
| | - Edgar G Engleman
- Division of Hematology, Dept. of Medicine, Cancer Institute, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, SIM1, 265 Campus Drive, Stanford, CA 94305, United States
| | - Sheri M Krams
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford University School of Medicine, 1201 Welch Rd, MSLS P313, Stanford, CA 94305, United States
| | - Everett H Meyer
- Division of Blood and Marrow Transplantation, Dept. of Medicine, Stanford University School of Medicine, CCSR, 1291 Welch Road, Stanford, CA 94305, United States
| | - Paul L Bollyky
- Division of Infectious Diseases and Geographic Medicine, Dept. of Medicine, Stanford University School of Medicine, Beckman Center, 279 Campus Drive, Stanford, CA 94305, United States.
| |
Collapse
|
22
|
Spindler MJ, Nelson AL, Wagner EK, Oppermans N, Bridgeman JS, Heather JM, Adler AS, Asensio MA, Edgar RC, Lim YW, Meyer EH, Hawkins RE, Cobbold M, Johnson DS. Massively parallel interrogation and mining of natively paired human TCRαβ repertoires. Nat Biotechnol 2020; 38:609-619. [PMID: 32393905 PMCID: PMC7224336 DOI: 10.1038/s41587-020-0438-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 12/12/2022]
Abstract
T cells engineered to express antigen-specific T cell receptors (TCRs) are potent therapies for viral infections and cancer. However, efficient identification of clinical candidate TCRs is complicated by the size and complexity of T cell repertoires and the challenges of working with primary T cells. Here, we present a high-throughput method to identify TCRs with high functional avidity from diverse human T cell repertoires. The approach uses massively parallel microfluidics to generate libraries of natively paired, full-length TCRαβ clones, from millions of primary T cells, which are then expressed in Jurkat cells. The TCRαβ-Jurkat libraries enable repeated screening and panning for antigen-reactive TCRs using peptide:MHC binding and cellular activation. We captured >2.9 million natively paired TCRαβ clonotypes from six healthy human donors and identified rare (<0.001% frequency) viral antigen–reactive TCRs. We also mined a tumor-infiltrating lymphocyte (TIL) sample from a melanoma patient and identified several tumor-specific TCRs, which, after expression in primary T cells, led to tumor cell killing.
Collapse
Affiliation(s)
| | | | | | - Natasha Oppermans
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | | | - James M Heather
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | - Everett H Meyer
- Stanford Diabetes Research Center, Stanford University Medical Center, Stanford, CA, USA.,Stanford Cancer Institute, Stanford University Medical Center, Stanford, CA, USA
| | - Robert E Hawkins
- Division of Cancer Sciences, University of Manchester, Manchester, UK.,Immetacyte Ltd, Manchester, UK
| | - Mark Cobbold
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, MA, USA.,AstraZeneca, Cambridge, MA, USA
| | | |
Collapse
|
23
|
Frank MJ, Olsson N, Huang A, Tang SW, Negrin RS, Elias JE, Meyer EH. A novel antibody-cell conjugation method to enhance and characterize cytokine-induced killer cells. Cytotherapy 2020; 22:135-143. [DOI: 10.1016/j.jcyt.2020.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/24/2019] [Accepted: 01/08/2020] [Indexed: 12/20/2022]
|
24
|
Muffly L, Arai S, Johnston L, Lowsky R, Meyer EH, Miklos DB, Negrin RS, Rezvani A, Shiraz P, Shizuru JA, Sidana S, Weng WK, Cunanan K. Allogeneic Hematopoietic Cell Transplantation for Adult Acute Lymphoblastic Leukemia: Significant Increase in Survival in the Post-Targeted Immunotherapy Era. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
25
|
Shah O, Tamaresis JS, Kenyon LJ, Xu L, Zheng P, Gupta P, Rangarajan K, Lee S, Spellman S, Nikiforow S, Zehnder J, Meyer EH. Analysis of the Whole CDR3 T Cell Receptor Repertoire after Hematopoietic Stem Cell Transplantation in 2 Clinical Cohorts. Biol Blood Marrow Transplant 2020; 26:1050-1070. [PMID: 32081787 DOI: 10.1016/j.bbmt.2020.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/12/2020] [Accepted: 01/27/2020] [Indexed: 01/19/2023]
Abstract
A major cause of morbidity and mortality for patients who undergo hematologic stem cell transplantation (HSCT) is acute graft-versus-host disease (aGVHD), a mostly T cell-mediated disease. Examination of the T cell receptor (TCR) repertoire of HSCT recipients and the use of next-generation nucleotide sequencing have raised the question of whether features of TCR repertoire reconstitution might reproducibly associate with aGVHD. We hypothesized that the peripheral blood TCR repertoire of patients with steroid-nonresponsive aGVHD would be less diverse. We also hypothesized that patients with GVHD who shared HLA might also share common clones at the time of GVHD diagnosis, thereby potentially providing potential clinical indicators for treatment stratification. We further hypothesized that HSCT recipients with the same HLA mismatch might share a more similar TCR repertoire based on a potentially shared focus of alloreactive responses. We studied 2 separate patient cohorts and 2 separate platforms for measuring TCR repertoire. The first cohort of patients was from a multicenter Phase III randomized double-blinded clinical trial of patients who developed aGVHD (NCT01002742). The second cohort comprised samples from biobanks from 2 transplantation centers and the Center for International Blood and Marrow Transplant Research of patients who underwent mismatched HSCT. There were no statistically significant differences in the TCR diversity of steroid responders and nonresponders among patients with aGVHD on the day of diagnosis. Most clones in the repertoire were unique to each patient, but a small number of clones were found to be both exclusive to and shared among aGVHD nonresponders. We were also able to show a strong correlation between the presence of Vβ20 and Vβ29 and steroid responsiveness. Using the Bhattacharya coefficient, those patients who shared the same HLA mismatch were shown to be no more similar to one another than to those who had a completely different mismatch. Using 2 separate clinical cohorts and 2 separate platforms for analyzing the TCR repertoire, we have shown that the sampled human TCR repertoire is largely unique to each patient but contains glimmers of common clones of subsets of clones based on responsiveness to steroids in aGVHD on the day of diagnosis. These studies are informative for future strategies to assess for reproducible TCR responses in human alloreactivity and possible markers of GVHD responsiveness to therapy.
Collapse
Affiliation(s)
- Omid Shah
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California
| | - John S Tamaresis
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California
| | - Laura Jean Kenyon
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California
| | - Liwen Xu
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Pingping Zheng
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California
| | - Puja Gupta
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California
| | - Krish Rangarajan
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California
| | - Stephanie Lee
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Stephen Spellman
- National Marrow Donor Program/C Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | | | - James Zehnder
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Everett H Meyer
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California.
| |
Collapse
|
26
|
Meyer EH, Laport G, Xie BJ, MacDonald K, Heydari K, Sahaf B, Tang SW, Baker J, Armstrong R, Tate K, Tadisco C, Arai S, Johnston L, Lowsky R, Muffly L, Rezvani AR, Shizuru J, Weng WK, Sheehan K, Miklos D, Negrin RS. Transplantation of donor grafts with defined ratio of conventional and regulatory T cells in HLA-matched recipients. JCI Insight 2019; 4:127244. [PMID: 31092732 DOI: 10.1172/jci.insight.127244] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/02/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUNDIn preclinical murine and early clinical studies of hematopoietic cell transplantation, engineering of donor grafts with defined ratios of CD4+CD25+FoxP3+ Tregs to conventional T cells (Tcons) results in the prevention of graft-versus-host disease and improved immune reconstitution. The use of highly purified primary graft Tregs for direct cell infusion has potential advantages over impure immunomagnetic selection or culture expansion, but has not been tested clinically. We performed a phase I study of the timed addition of CD34-selected hematopoietic stem cells and Tregs, followed by Tcons for the treatment of patients with high-risk hematological malignancies.METHODSWe present interim evaluation of a single-center open phase I/II study of administration of human leukocyte-matched Tregs and CD34-selected hematopoietic cells, followed by infusion of an equal ratio of Tcons in adult patients undergoing myeloablative hematopoietic stem cell transplantation (HCT) for high-risk or active hematological malignancies. Tregs were purified by immunomagnetic selection and high-speed cell sorting.RESULTSHere we report results for the first 12 patients who received Tregs of between 91% and 96% purity. Greater than grade II GVHD was noted in 2 patients in the first cohort of 5 patients, who received cryopreserved Tregs, but neither acute nor chronic GVHD was noted in the second cohort of 7 patients, who received fresh Tregs and single-agent GVHD prophylaxis. Patients in the second cohort appeared to have normal immune reconstitution compared with patients who underwent transplantation and did not develop GVHD.CONCLUSIONOur study shows that the use of highly purified fresh Tregs is clinically feasible and supports continued investigation of the strategy.TRIAL REGISTRATIONClinicalTrials.gov NCT01660607.FUNDINGNIH NHBLI R01 HL114591 and K08HL119590.
Collapse
Affiliation(s)
- Everett H Meyer
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA.,Cell Therapy Facility, Stanford Health Care, Stanford, California, USA
| | - Ginna Laport
- Tempest Therapeutics, San Francisco, California, USA
| | - Bryan J Xie
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Kate MacDonald
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Kartoosh Heydari
- Cell Therapy Facility, Stanford Health Care, Stanford, California, USA
| | - Bita Sahaf
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Sai-Wen Tang
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Jeanette Baker
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Randall Armstrong
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Keri Tate
- Laboratory for Cell and Gene Medicine, Stanford University, Palo Alto, California, USA
| | - Cynthia Tadisco
- Laboratory for Cell and Gene Medicine, Stanford University, Palo Alto, California, USA
| | - Sally Arai
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Laura Johnston
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Robert Lowsky
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Lori Muffly
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Andrew R Rezvani
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Judith Shizuru
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Wen-Kai Weng
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Kevin Sheehan
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - David Miklos
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| | - Robert S Negrin
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California, USA
| |
Collapse
|
27
|
Narayan R, Benjamin JE, Shah O, Tian L, Tate K, Armstrong R, Xie BJ, Lowsky R, Laport G, Negrin RS, Meyer EH. Donor-Derived Cytokine-Induced Killer Cell Infusion as Consolidation after Nonmyeloablative Allogeneic Transplantation for Myeloid Neoplasms. Biol Blood Marrow Transplant 2019; 25:1293-1303. [PMID: 30951840 DOI: 10.1016/j.bbmt.2019.03.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/15/2019] [Accepted: 03/28/2019] [Indexed: 12/27/2022]
Abstract
Non-myeloablative conditioning, such as with total lymphoid irradiation and antithymocyte globulin (TLI-ATG), has allowed allogeneic hematopoietic cell transplantation (allo-HCT) with curative potential for older patients and those with comorbid medical conditions with myeloid neoplasms. However, early achievement of full donor chimerism (FDC) and relapse remain challenging. Cytokine-induced killer (CIK) cells have been shown to have antitumor cytotoxicity. Infusion of donor-derived CIK cells has been studied for hematologic malignancies relapsed after allo-HCT but has not been evaluated as post-transplant consolidation. In this phase II study, we prospectively studied whether a one-time infusion of 1 × 108/kg CD3+ donor-derived CIK cells administered between day +21 and day +35 after TLI-ATG conditioning could improve achievement of FDC by day +90 and 2-year clinical outcomes in patients with myeloid neoplasms. CIK cells, containing predominantly CD3+CD8+NKG2D+ cells along with significantly expanded CD3+CD56+ cells, were infused in 31 of 44 patients. Study outcomes were compared to outcomes of a retrospective historical cohort of 100 patients. We found that this one-time CIK infusion did not increase the rate of FDC by day +90. On an intention-to-treat analysis, 2-year non-relapse mortality (6.8%; 95% confidence interval [CI], 0-14.5%), event-free survival (27.3%; 95% CI, 16.8-44.2%), and overall survival (50.6%; 95% CI, 37.5-68.2%) were similar to the values seen in the historical cohort. The cumulative incidence of grade II-IV acute graft-versus-host disease at 1-year was 25.1% (95% CI, 12-38.2%). On univariate analysis, the presence of monosomal or complex karyotype was adversely associated with relapse-free survival and overall survival. Given the favorable safety profile of CIK cell infusion, strategies such as repeat dosing or genetic modification merit exploration. This trial was registered at ClinicalTrials.gov (NCT01392989).
Collapse
Affiliation(s)
- Rupa Narayan
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Jonathan E Benjamin
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Omid Shah
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Lu Tian
- Department of Health Research and Policy, Stanford University, Stanford, California
| | - Keri Tate
- Stanford Laboratory for Cell and Gene Medicine, Stanford, California
| | - Randall Armstrong
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Bryan J Xie
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Robert Lowsky
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Ginna Laport
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Robert S Negrin
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
| | - Everett H Meyer
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California.
| |
Collapse
|
28
|
Gandhi A, Rezvani A, Lowsky R, Johnston L, Shizuru JA, Miklos DB, Arai S, Muffly L, Meyer EH, Negrin RS, Weng WK. Dose-Intense BCNU/Melphalan Regimen Followed By Autologous Hematopoietic Cell Transplantation (AHCT) Results in Prolonged PFS in Myeloma Patients. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
29
|
Xie BJ, Erkers T, Kenyon L, Rieck M, Basina M, Jensen K, Strober S, Negrin RS, Maecker HT, Meyer EH. A Proinflammatory Invariant Natural Killer T Cell Phenotypic State Associates with Human Graft-Versus-Host Disease Onset. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
30
|
Pierini A, Iliopoulou BP, Peiris H, Pérez-Cruz M, Baker J, Hsu K, Gu X, Zheng PP, Erkers T, Tang SW, Strober W, Alvarez M, Ring A, Velardi A, Negrin RS, Kim SK, Meyer EH. T cells expressing chimeric antigen receptor promote immune tolerance. JCI Insight 2017; 2:92865. [PMID: 29046484 DOI: 10.1172/jci.insight.92865] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 09/14/2017] [Indexed: 12/22/2022] Open
Abstract
Cellular therapies based on permanent genetic modification of conventional T cells have emerged as a promising strategy for cancer. However, it remains unknown if modification of T cell subsets, such as Tregs, could be useful in other settings, such as allograft transplantation. Here, we use a modular system based on a chimeric antigen receptor (CAR) that binds covalently modified mAbs to control Treg activation in vivo. Transient expression of this mAb-directed CAR (mAbCAR) in Tregs permitted Treg targeting to specific tissue sites and mitigated allograft responses, such as graft-versus-host disease. mAbCAR Tregs targeted to MHC class I proteins on allografts prolonged islet allograft survival and also prolonged the survival of secondary skin grafts specifically matched to the original islet allograft. Thus, transient genetic modification to produce mAbCAR T cells led to durable immune modulation, suggesting therapeutic targeting strategies for controlling alloreactivity in settings such as organ or tissue transplantation.
Collapse
Affiliation(s)
- Antonio Pierini
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA.,Department of Medicine, Hematopoietic Stem Cell Transplantation Program, University of Perugia, Perugia, Italy
| | - Bettina P Iliopoulou
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Heshan Peiris
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, California, USA
| | - Magdiel Pérez-Cruz
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Jeanette Baker
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Katie Hsu
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Xueying Gu
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, California, USA
| | - Ping-Ping Zheng
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Tom Erkers
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Sai-Wen Tang
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - William Strober
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Maite Alvarez
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Aaron Ring
- Department of Molecular and Cellular Physiology, Stanford University, Stanford, California, USA
| | - Andrea Velardi
- Department of Medicine, Hematopoietic Stem Cell Transplantation Program, University of Perugia, Perugia, Italy
| | - Robert S Negrin
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| | - Seung K Kim
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, California, USA
| | - Everett H Meyer
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
31
|
de Almeida PE, Meyer EH, Kooreman NG, Diecke S, Dey D, Sanchez-Freire V, Hu S, Ebert A, Odegaard J, Mordwinkin NM, Brouwer TP, Lo D, Montoro DT, Longaker MT, Negrin RS, Wu JC. Transplanted terminally differentiated induced pluripotent stem cells are accepted by immune mechanisms similar to self-tolerance. Nat Commun 2014; 5:3903. [PMID: 24875164 PMCID: PMC4075468 DOI: 10.1038/ncomms4903] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 04/15/2014] [Indexed: 12/18/2022] Open
Abstract
The exact nature of the immune response elicited by autologous induced pluripotent stem cell (iPSC) progeny is still not well understood. Here we show in murine models that autologous iPSC-derived endothelial cells (iECs) elicit an immune response that resembles the one against a comparable somatic cell, the aortic endothelial cell (AEC). These cells exhibit long-term survival in vivo and prompt a tolerogenic contexture of intra-graft characterized by elevated IL-10 expression. In contrast, undifferentiated iPSCs elicit a very different immune response with high lymphocytic infiltration and elevated IFN-γ, granzyme-B, and perforin intra-graft. Furthermore, the clonal structure of infiltrating T cells from iEC grafts is statistically indistinguishable from that of AECs, but is different from that of undifferentiated iPSC grafts. Taken together, our results indicate that the differentiation of iPSCs results in a loss of immunogenicity and leads to the induction of tolerance, despite expected antigen expression differences between iPSC-derived versus original somatic cells.
Collapse
Affiliation(s)
- Patricia E de Almeida
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA [4]
| | - Everett H Meyer
- 1] Department of Medicine, Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2]
| | - Nigel G Kooreman
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA [4]
| | - Sebastian Diecke
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Devaveena Dey
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Veronica Sanchez-Freire
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Shijun Hu
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Antje Ebert
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Justin Odegaard
- Department of Pathology, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Nicholas M Mordwinkin
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Thomas P Brouwer
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - David Lo
- 1] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Daniel T Montoro
- 1] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Michael T Longaker
- 1] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Robert S Negrin
- Department of Medicine, Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| | - Joseph C Wu
- 1] Departments of Medicine and Radiology, Stanford University School of Medicine, Stanford, California 94305-5323, USA [2] Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California 94305-5323, USA [3] Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305-5323, USA
| |
Collapse
|
32
|
Sanchez Rodriguez R, Pauli ML, Neuhaus IM, Yu SS, Arron ST, Harris HW, Yang SHY, Anthony BA, Sverdrup FM, Krow-Lucal E, MacKenzie TC, Johnson DS, Meyer EH, Löhr A, Hsu A, Koo J, Liao W, Gupta R, Debbaneh MG, Butler D, Huynh M, Levin EC, Leon A, Hoffman WY, McGrath MH, Alvarado MD, Ludwig CH, Truong HA, Maurano MM, Gratz IK, Abbas AK, Rosenblum MD. Memory regulatory T cells reside in human skin. J Clin Invest 2014; 124:1027-36. [PMID: 24509084 DOI: 10.1172/jci72932] [Citation(s) in RCA: 253] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/21/2013] [Indexed: 01/07/2023] Open
Abstract
Regulatory T cells (Tregs), which are characterized by expression of the transcription factor Foxp3, are a dynamic and heterogeneous population of cells that control immune responses and prevent autoimmunity. We recently identified a subset of Tregs in murine skin with properties typical of memory cells and defined this population as memory Tregs (mTregs). Due to the importance of these cells in regulating tissue inflammation in mice, we analyzed this cell population in humans and found that almost all Tregs in normal skin had an activated memory phenotype. Compared with mTregs in peripheral blood, cutaneous mTregs had unique cell surface marker expression and cytokine production. In normal human skin, mTregs preferentially localized to hair follicles and were more abundant in skin with high hair density. Sequence comparison of TCRs from conventional memory T helper cells and mTregs isolated from skin revealed little homology between the two cell populations, suggesting that they recognize different antigens. Under steady-state conditions, mTregs were nonmigratory and relatively unresponsive; however, in inflamed skin from psoriasis patients, mTregs expanded, were highly proliferative, and produced low levels of IL-17. Taken together, these results identify a subset of Tregs that stably resides in human skin and suggest that these cells are qualitatively defective in inflammatory skin disease.
Collapse
|
33
|
Meyer EH, Liliental JA, Florek M, Lohr A, Hsu A, Johnson D, Lavori P, Zehnder JL, Miklos DB, Strober S, Negrin R. The Expansion of Gastrointestinal-Associated αβ T Cell Clones in Peripheral Blood Associates with Severe Steroid Refractory GVHD. Biol Blood Marrow Transplant 2013. [DOI: 10.1016/j.bbmt.2012.11.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
34
|
Lee HH, Meyer EH, Goya S, Pichavant M, Kim HY, Bu X, Umetsu SE, Jones JC, Savage PB, Iwakura Y, Casasnovas JM, Kaplan G, Freeman GJ, DeKruyff RH, Umetsu DT. Apoptotic cells activate NKT cells through T cell Ig-like mucin-like-1 resulting in airway hyperreactivity. J Immunol 2010; 185:5225-35. [PMID: 20889552 DOI: 10.4049/jimmunol.1001116] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
T cell Ig-like mucin-like-1 (TIM-1) is an important asthma susceptibility gene, but the immunological mechanisms by which TIM-1 functions remain uncertain. TIM-1 is also a receptor for phosphatidylserine (PtdSer), an important marker of cells undergoing programmed cell death, or apoptosis. We now demonstrate that NKT cells constitutively express TIM-1 and become activated by apoptotic cells expressing PtdSer. TIM-1 recognition of PtdSer induced NKT cell activation, proliferation, and cytokine production. Moreover, the induction of apoptosis in airway epithelial cells activated pulmonary NKT cells and unexpectedly resulted in airway hyperreactivity, a cardinal feature of asthma, in an NKT cell-dependent and TIM-1-dependent fashion. These results suggest that TIM-1 serves as a pattern recognition receptor on NKT cells that senses PtdSer on apoptotic cells as a damage-associated molecular pattern. Furthermore, these results provide evidence for a novel innate pathway that results in airway hyperreactivity and may help to explain how TIM-1 and NKT cells regulate asthma.
Collapse
Affiliation(s)
- Hyun-Hee Lee
- Division of Immunology and Allergy, Department of Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Koh YI, Kim HY, Meyer EH, Pichavant M, Akbari O, Yasumi T, Savage PB, DeKruyff RH, Umetsu DT. Activation of nonclassical CD1d-restricted NK T cells induces airway hyperreactivity in beta 2-microglobulin-deficient mice. J Immunol 2008; 181:4560-4569. [PMID: 18802058 DOI: 10.4049/jimmunol.181.7.4560] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Allergic asthma is characterized by Th2-driven eosinophilic airway inflammation and by a central feature called airway hyperreactivity (AHR), development of which requires the presence of classical type I invariant NK T (iNKT) cells. Allergen-induced AHR, however, develops in beta(2)-microglobulin (beta(2)m)(-/-) mice, which lack classical iNKT cells, suggesting that in some situations iNKT cells may be dispensable for the development of AHR. In contrast, our studies now suggest that a CD1d-restricted, NK1.1(+) noninvariant TCR NKT cell population is present in beta(2)m(-/-) mice and is responsible for the development of AHR but not for Th2 responses. Furthermore, treatment of beta(2)m(-/-) mice with anti-CD1d mAb or anti-NK1.1 mAb unexpectedly abolished allergen-induced AHR. The CD1-restricted NKT cells in these mice, which failed to respond to alpha-galactosylceramide and which therefore were not classical type I iNKT cells, appear to represent an NKT cell subset restricted by a beta(2)m-independent form of CD1d. These results indicate that, although classical type I iNKT cells are normally required for the development of AHR, under different circumstances other NKT cell subsets, including nonclassical NKT cells, may substitute for classical iNKT cells and induce AHR.
Collapse
Affiliation(s)
- Youngil I Koh
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115.,Department of Internal Medicine, Division of Allergy and Asthma, Chonnam National University Medical School and Research Institute of Medical Sciences, Gwangju, South Korea
| | - Hye Young Kim
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115
| | - Everett H Meyer
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115
| | - Muriel Pichavant
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115
| | - Omid Akbari
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115
| | - Takahiro Yasumi
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115
| | - Paul B Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602
| | - Rosemarie H DeKruyff
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115
| | - Dale T Umetsu
- Division of Immunology and Allergy, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115
| |
Collapse
|
36
|
Akbari O, Stock P, Meyer EH, Freeman GJ, Sharpe AH, Umetsu DT, DeKruyff RH. ICOS/ICOSL interaction is required for CD4+ invariant NKT cell function and homeostatic survival. J Immunol 2008; 180:5448-56. [PMID: 18390727 DOI: 10.4049/jimmunol.180.8.5448] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The development of airway hyperreactivity (AHR), a cardinal feature of asthma, requires the presence of invariant NKT (iNKT) cells. In a mouse model of asthma, we demonstrated that the induction of AHR required ICOS costimulation of iNKT cells. ICOS was highly expressed on both naive and activated iNKT cells, and expression of ICOS was greater on the CD4(+) iNKT than on CD4(-) iNKT cells. Furthermore, the number of CD4(+) iNKT cells was significantly lower in spleens and livers of ICOS(-/-) and ICOSL(-/-) mice, and the remaining iNKT cells in ICOS(-/-) mice were dysfunctional and failed to reconstitute AHR when adoptively transferred into iNKT cell-deficient Jalpha18(-/-) mice. In addition, direct activation of iNKT cells with alpha-GalCer, which induced AHR in wild-type mice, failed to induce AHR in ICOS(-/-) mice. The failure of ICOS(-/-) iNKT cells to induce AHR was due in part to an inability of the ICOS(-/-) iNKT cells to produce IL-4 and IL-13 on activation. Moreover, survival of wild-type iNKT cells transferred into ICOSL(-/-) mice was greatly reduced due to the induction of apoptosis. These results indicate that ICOS costimulation plays a major role in induction of AHR by iNKT cells and is required for CD4(+) iNKT cell function, homeostasis, and survival in the periphery.
Collapse
Affiliation(s)
- Omid Akbari
- Division of Immunology, Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
Asthma is an immunological disease with multiple inflammatory and clinical phenotypes, characterized by symptoms of wheezing, shortness of breath, and coughing due to airway hyperreactivity (AHR) and reversible airway obstruction. In allergic asthma, the most common form of asthma, airway inflammation is mediated by adaptive immune recognition of protein allergens by Th2 cells, resulting in airway eosinophilia. However, in other forms of asthma, inflammation is associated with immune responses to respiratory infections and airway neutrophilia. A central feature common to all forms of asthma is AHR, the heightened responsiveness of the airways to nonspecific stimuli. AHR has been shown recently in animal models of asthma to require the presence of CD1d-restricted, invariant T cell receptor-positive, natural killer T (iNKT) cells. Although allergen-specific Th2 cells and iNKT cells have many phenotypic similarities (e.g., expression of CD4 and production of Th2 cytokines), they have complementary activities, such as production of Th2 cytokines under different conditions, differential sensitivity to corticosteroids, and responsiveness to different classes of antigen (proteins versus glycolipids). We hypothesize that Th2 cells and iNKT cells interact synergistically to induce asthma but that different forms of asthma result from distinct roles of CD4(+) iNKT cells versus Th2 cells.
Collapse
Affiliation(s)
- Everett H Meyer
- Immunology Program, Stanford University, Stanford, California 94305, USA.
| | | | | |
Collapse
|
38
|
Pichavant M, Goya S, Meyer EH, Johnston RA, Kim HY, Matangkasombut P, Zhu M, Iwakura Y, Savage PB, DeKruyff RH, Shore SA, Umetsu DT. Ozone exposure in a mouse model induces airway hyperreactivity that requires the presence of natural killer T cells and IL-17. ACTA ACUST UNITED AC 2008; 205:385-93. [PMID: 18250191 PMCID: PMC2271004 DOI: 10.1084/jem.20071507] [Citation(s) in RCA: 251] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Exposure to ozone, which is a major component of air pollution, induces a form of asthma that occurs in the absence of adaptive immunity. Although ozone-induced asthma is characterized by airway neutrophilia, and not eosinophilia, it is nevertheless associated with airway hyperreactivity (AHR), which is a cardinal feature of asthma. Because AHR induced by allergens requires the presence of natural killer T (NKT) cells, we asked whether ozone-induced AHR had similar requirements. We found that repeated exposure of wild-type (WT) mice to ozone induced severe AHR associated with an increase in airway NKT cells, neutrophils, and macrophages. Surprisingly, NKT cell-deficient (CD1d(-/-) and Jalpha18(-/-)) mice failed to develop ozone-induced AHR. Further, treatment of WT mice with an anti-CD1d mAb blocked NKT cell activation and prevented ozone-induced AHR. Moreover, ozone-induced, but not allergen-induced, AHR was associated with NKT cells producing interleukin (IL)-17, and failed to occur in IL-17(-/-) mice nor in WT mice treated with anti-IL-17 mAb. Thus, ozone exposure induces AHR that requires the presence of NKT cells and IL-17 production. Because NKT cells are required for the development of two very disparate forms of AHR (ozone- and allergen-induced), our results strongly suggest that NKT cells mediate a unifying pathogenic mechanism for several distinct forms of asthma, and represent a unique target for effective asthma therapy.
Collapse
Affiliation(s)
- Muriel Pichavant
- Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Meyer EH, Wurbel MA, Staton TL, Pichavant M, Kan MJ, Savage PB, DeKruyff RH, Butcher EC, Campbell JJ, Umetsu DT. iNKT cells require CCR4 to localize to the airways and to induce airway hyperreactivity. J Immunol 2007; 179:4661-71. [PMID: 17878364 PMCID: PMC2564604 DOI: 10.4049/jimmunol.179.7.4661] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
iNKT cells are required for the induction of airway hyperreactivity (AHR), a cardinal feature of asthma, but how iNKT cells traffic to the lungs to induce AHR has not been previously studied. Using several models of asthma, we demonstrated that iNKT cells required the chemokine receptor CCR4 for pulmonary localization and for the induction of AHR. In both allergen-induced and glycolipid-induced models of AHR, wild-type but not CCR4-/- mice developed AHR. Furthermore, adoptive transfer of wild-type but not CCR4-/- iNKT cells reconstituted AHR in iNKT cell-deficient mice. Moreover, we specifically tracked CCR4-/- vs wild-type iNKT cells in CCR4-/-:wild-type mixed BM chimeric mice in the resting state, and when AHR was induced by protein allergen or glycolipid. Using this unique model, we showed that both iNKT cells and conventional T cells required CCR4 for competitive localization into the bronchoalveolar lavage/airways compartment. These results establish for the first time that the pulmonary localization of iNKT cells critical for the induction of AHR requires CCR4 expression by iNKT cells.
Collapse
Affiliation(s)
- Everett H. Meyer
- Division of Immunology, Karp Laboratories, Children’s Hospital, Harvard Medical School, Boston, MA 02115
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
| | - Marc-André Wurbel
- Department of Pathology, Harvard Medical School, Boston, MA 02115
- Department of Dermatology, Harvard Medical School, Boston, MA 02115
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA 02115
| | - Tracy L. Staton
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
| | - Muriel Pichavant
- Division of Immunology, Karp Laboratories, Children’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Matthew J. Kan
- Division of Immunology, Karp Laboratories, Children’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Paul B. Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602
| | - Rosemarie H. DeKruyff
- Division of Immunology, Karp Laboratories, Children’s Hospital, Harvard Medical School, Boston, MA 02115
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
| | - Eugene C. Butcher
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305
| | - James J. Campbell
- Department of Pathology, Harvard Medical School, Boston, MA 02115
- Department of Dermatology, Harvard Medical School, Boston, MA 02115
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA 02115
| | - Dale T. Umetsu
- Division of Immunology, Karp Laboratories, Children’s Hospital, Harvard Medical School, Boston, MA 02115
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
- Address correspondence and reprint requests to Dr. Dale T. Umetsu, Division of Immunology, Karp Laboratories, Children’s Hospital, Harvard Medical School, Room 10127, One Blackfan Circle, Boston, MA 02115. E-mail address:
| |
Collapse
|
40
|
Abstract
Recent studies indicate that invariant TCR+ CD1d-restricted natural killer T (iNKT) cells play an important role in regulating the development of asthma and allergy. iNKT cells can function to skew adaptive immunity toward Th2 responses, or can act directly as effector cells at mucosal surfaces in diseases such as ulcerative colitis and bronchial asthma. In mouse models of asthma, NKT cell-deficient strains fail to develop allergen-induced airway hyperreactivity (AHR), a cardinal feature of asthma, and NKT cells are found in the lungs of patients with chronic asthma, suggesting a critical role for NKT cells in the development of AHR. However, much work remains in characterizing iNKT cells and their function in asthma, and in understanding the relationship between the iNKT cells and conventional CD4+ T cells.
Collapse
Affiliation(s)
- E H Meyer
- Division of Immunology, Children's Hospital Boston, Harvard Medical School, One Blackfan Circle, Boston, MA 02115, USA
| | | | | |
Collapse
|
41
|
Affiliation(s)
- Dale T Umetsu
- Division of Immunology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA
| | | | | |
Collapse
|
42
|
Akbari O, Meyer EH, Freeman GJ, Sharpe AH, DeKruyff RH, Umetsu DT. ICOS/ICOSL interaction is required for CD4+ NKT cells function and for the induction of airway hyperreactivity (39.4). The Journal of Immunology 2007. [DOI: 10.4049/jimmunol.178.supp.39.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Asthma is a major public health problem that has increased markedly in prevalence in the past two decades. In several mouse models, natural killer T cells (NKT) have recently been found to be required for the development of airway hyperreactivity (AHR), a cardinal feature of asthma. Moreover, in patients with persistent severe asthma, a significant number of NKT cells are present in the lungs. While T cell receptor signaling is required to activate NKT cells, the costimulatory requirements for NKT cell activation and function are not clear. In this study we found that ICOS was highly expressed on both naïve and activated NKT cells and that expression of ICOS was much higher on the CD4+ NKT than CD4− NKT cells. The function of NKT cells from ICOS−/− mice was impaired, as adoptive transfer of these cells into NKT cell deficient Ja18−/− mice failed to restore AHR, whereas transfer of wildtype NKT cells fully restored AHR in the Ja18−/− recipients. The failure of ICOS−/− NKT to induce AHR may be due to a great extent to the absence of cytokine production by ICOS−/− NKT cells. Additionally, ICOS−/− mice challenged with α-GalCer did not develop AHR, but adoptive transfer of WT NKT cells into ICOS−/− mice restored AHR. Finally, ICOS may be required for CD4+ NKT cell survival in the periphery, as the number of CD4+ NKT cells was significantly lower in spleen and liver of ICOS−/− mice. These results indicate that costimulation by ICOS is required for the function and homeostasis of CD4+ NKT cells, which play a major role in development of AHR.
Collapse
Affiliation(s)
- Omid Akbari
- 1Division of Immunology, Children’s Hospital, Harvard Medical School, 1 Blackfan Cir. Karp Research Building, 10th Floor, Boston, MA, 02115,
| | - Everett H Meyer
- 1Division of Immunology, Children’s Hospital, Harvard Medical School, 1 Blackfan Cir. Karp Research Building, 10th Floor, Boston, MA, 02115,
| | - Gordon J Freeman
- 2Adult Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA, 02115,
| | - Arlene H Sharpe
- 3Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115
| | - Rosemarie H DeKruyff
- 1Division of Immunology, Children’s Hospital, Harvard Medical School, 1 Blackfan Cir. Karp Research Building, 10th Floor, Boston, MA, 02115,
| | - Dale T Umetsu
- 1Division of Immunology, Children’s Hospital, Harvard Medical School, 1 Blackfan Cir. Karp Research Building, 10th Floor, Boston, MA, 02115,
| |
Collapse
|
43
|
Meyer EH, Goya S, Akbari O, Berry GJ, Savage PB, Kronenberg M, Nakayama T, DeKruyff RH, Umetsu DT. Glycolipid activation of invariant T cell receptor+ NK T cells is sufficient to induce airway hyperreactivity independent of conventional CD4+ T cells. Proc Natl Acad Sci U S A 2006; 103:2782-7. [PMID: 16478801 PMCID: PMC1413796 DOI: 10.1073/pnas.0510282103] [Citation(s) in RCA: 169] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2005] [Indexed: 01/22/2023] Open
Abstract
Asthma is an inflammatory lung disease, in which conventional CD4+ T cells producing IL-4/IL-13 appear to play an obligatory pathogenic role. Here we show, in a mouse model of asthma, that activation of pulmonary IL-4/IL-13 producing invariant TCR+ CD1d-restricted natural killer T (NKT) cells is sufficient for the development of airway hyperreactivity (AHR), a cardinal feature of asthma, in the absence of conventional CD4+ T cells and adaptive immunity. Respiratory administration of glycolipid antigens that specifically activate NKT cells (alpha-GalactosylCeramide and a Sphingomonas bacterial glycolipid) rapidly induced AHR and inflammation typically associated with protein allergen administration. Naïve MHC class II-deficient mice, which lack conventional CD4+ T but have NKT cells, showed exaggerated baseline AHR and, when challenged with alpha-GalactosylCeramide, demonstrated even greater AHR. These studies demonstrate an expanded role for NKT cells, in which NKT cells not only produce cytokines that influence adaptive immunity but also function as critical effector cells that can induce AHR. These results suggest that NKT cells responding to glycolipid antigens, as well as conventional CD4+ T cells responding to peptide antigens, may be synergistic in the induction of AHR, although in some cases, each may independently induce AHR.
Collapse
Affiliation(s)
- Everett H. Meyer
- *Division of Immunology, Children’s Hospital, Harvard Medical School, One Blackfan Circle, Boston, MA 02115
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
| | - Sho Goya
- *Division of Immunology, Children’s Hospital, Harvard Medical School, One Blackfan Circle, Boston, MA 02115
| | - Omid Akbari
- *Division of Immunology, Children’s Hospital, Harvard Medical School, One Blackfan Circle, Boston, MA 02115
| | - Gerald J. Berry
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305
| | - Paul B. Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602
| | - Mitchell Kronenberg
- Division of Developmental Immunology, La Jolla Institute for Allergy and Immunology, San Diego, CA 92121; and
| | | | - Rosemarie H. DeKruyff
- *Division of Immunology, Children’s Hospital, Harvard Medical School, One Blackfan Circle, Boston, MA 02115
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
| | - Dale T. Umetsu
- *Division of Immunology, Children’s Hospital, Harvard Medical School, One Blackfan Circle, Boston, MA 02115
- Immunology Program and School of Medicine, Stanford University, Stanford, CA 94305
| |
Collapse
|
44
|
Watt WB, Wheat CW, Meyer EH, Martin JF. Adaptation at specific loci. VII. Natural selection, dispersal and the diversity of molecular-functional variation patterns among butterfly species complexes (Colias: Lepidoptera, Pieridae). Mol Ecol 2003; 12:1265-75. [PMID: 12694289 DOI: 10.1046/j.1365-294x.2003.01804.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Natural genetic variants at the phosphoglucose isomerase, PGI, gene differ in spatial patterning of their polymorphism among species complexes of Colias butterflies in North America. In both lowland and alpine complexes, molecular-functional properties of the polymorphic genotypes can be used to predict genotype-specific adult flight performances and resulting large genotypic differences in adult fitness components. In the lowland species complex, there is striking uniformity of PGI polymorph frequencies at a number of sites across the American West; this fits with earlier findings of strong, similar differences in fitness components over this range. In an alpine complex, Colias meadii shows similar uniformity of PGI frequencies within habitat types, either montane steppe or alpine tundra, over several hundred kilometres in the absence of dispersal. At the same time, large shifts (10-20%) in frequency of the most common alleles occur between steppe and tundra populations, whether these are isolated or, as in some cases, are in contact and exchange many dispersing adults each generation. Data on male mating success of common C. meadii PGI genotypes in steppe and tundra show heterozygote advantage in both habitat types, with shifts in relative homozygote disadvantage between habitats which are consistent with observed frequency differences. Nonadaptive explanations for this situation are rejected, and alternative, thermal-ecology-based adaptive hypotheses are proposed for later experimental test. These findings show that strong local selection may dominate dispersal as an evolutionary agent, whether or not dispersal is present, and that selection may often be the major force promoting 'cohesion' of species over long distances. This case offers new opportunities for integrating studies of molecular structure and function with ecological aspects of natural selection in the wild, both within and among species.
Collapse
Affiliation(s)
- W B Watt
- Rocky Mountain Biological Laboratory, Crested Butte, Colorado, USA.
| | | | | | | |
Collapse
|
45
|
Akbari O, Freeman GJ, Meyer EH, Greenfield EA, Chang TT, Sharpe AH, Berry G, DeKruyff RH, Umetsu DT. Antigen-specific regulatory T cells develop via the ICOS-ICOS-ligand pathway and inhibit allergen-induced airway hyperreactivity. Nat Med 2002; 8:1024-32. [PMID: 12145647 DOI: 10.1038/nm745] [Citation(s) in RCA: 625] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Asthma is caused by T-helper cell 2 (Th2)-driven immune responses, but the immunological mechanisms that protect against asthma development are poorly understood. T-cell tolerance, induced by respiratory exposure to allergen, can inhibit the development of airway hyperreactivity (AHR), a cardinal feature of asthma, and we show here that regulatory T (T(R)) cells can mediate this protective effect. Mature pulmonary dendritic cells in the bronchial lymph nodes of mice exposed to respiratory allergen induced the development of T(R) cells, in a process that required T-cell costimulation via the inducible costimulator (ICOS-ICOS-ligand pathway. The T(R) cells produced IL-10, and had potent inhibitory activity; when adoptively transferred into sensitized mice, T(R) cells blocked the development of AHR. Both the development and the inhibitory function of regulatory cells were dependent on the presence of IL-10 and on ICOS-ICOS-ligand interactions. These studies demonstrate that T(R) cells and the ICOS-ICOS-ligand signaling pathway are critically involved in respiratory tolerance and in downregulating pulmonary inflammation in asthma.
Collapse
Affiliation(s)
- Omid Akbari
- Division of Immunology and Allergy, Department of Pediatrics, School of Medicine, Stanford University, Stanford, California, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Oh JW, Seroogy CM, Meyer EH, Akbari O, Berry G, Fathman CG, Dekruyff RH, Umetsu DT. CD4 T-helper cells engineered to produce IL-10 prevent allergen-induced airway hyperreactivity and inflammation. J Allergy Clin Immunol 2002; 110:460-8. [PMID: 12209095 DOI: 10.1067/mai.2002.127512] [Citation(s) in RCA: 152] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND T(H)2 cells play a critical role in the pathogenesis of asthma, but the precise immunologic mechanisms that inhibit T(H)2 cell function in vivo are not well understood. OBJECTIVE The purpose of our studies was to determine whether T cells producing IL-10 regulate the development of asthma. METHODS We used gene therapy to generate ovalbumin-specific CD4 T-helper cells to express IL-10, and we examined their capacity to regulate allergen-induced airway hyperreactivity. RESULTS We demonstrated that the CD4 T-helper cells engineered to express IL-10 abolished airway hyperreactivity and airway eosinophilia in BALB/c mice sensitized and challenged with ovalbumin and in SCID mice reconstituted with ovalbumin-specific T(H)2 effector cells. The inhibitory effect of the IL-10-secreting T-helper cells was accompanied by the presence of increased quantities of IL-10 in the bronchoalveolar lavage fluid, was antigen-specific, and was reversed by neutralization of IL-10. Moreover, neutralization of IL-10 by administration of anti-IL-10 mAb in mice sensitized and challenged with ovalbumin seriously exacerbated airway hyperreactivity and airway inflammation. CONCLUSION Our results demonstrate that T cells secreting IL-10 in the respiratory mucosa can indeed regulate T(H)2-induced airway hyperreactivity and inflammation, and they strongly suggest that IL-10 plays an important inhibitory role in allergic asthma.
Collapse
Affiliation(s)
- Jae-Won Oh
- Division of Immunology and Allergy, Department of Pediatrics, Stanford University, CA 94305, USA
| | | | | | | | | | | | | | | |
Collapse
|
47
|
du Plessis JL, Meyer EH, van Gas L. An attempt to establish an inbred line of mice genetically resistant to Cowdria ruminantium. Onderstepoort J Vet Res 1990; 57:283-5. [PMID: 2293139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
An attempt to establish an inbred line of mice resistant to Cowdria ruminantium failed. First generation couples were constituted from those mice out of 100 males and 100 females that had survived infection with the Kümm stock of C. ruminantium and that were serologically negative to the indirect fluorescent antibody test. An attempt to establish 10 separate inbred lines by constituting next generation brother and sister matings from predominantly seronegative survivor mice from the preceding generation, was unsuccessful because too few mice survived the challenge. The percentage seronegative survivors increased to 94% over the first 6 generations, but then declined sharply during the next.
Collapse
|
48
|
Meyer EH. Nursing in a parent cooperative child care center. Pediatr Nurs 1980; 6:21-5. [PMID: 6898018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
49
|
Meyer EH. Genetic aspects of the hormonal regulation of some testis enzymes during pubertal development of the rat. J S Afr Vet Assoc 1978; 49:243-5. [PMID: 745205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Using a rat model, it was shown that the synthesis of certain testis enzymes during pubertal development is under hormonal control, which acts as regulatory mechanism for gene expression during eukaryotic differentiation. Esterase activity and its electrophoretic banding pattern can be specifically induced by human chorionic gonadotrophin (HCG). Alcohol dehydrogenase and 3beta-hydroxysteroid dehydrogenase are independently induced by HCG, and are apparently coded for by 2 different genetic cistrons.
Collapse
|
50
|
Meyer EH, Forsgren K, Von Deimling O, Engel W. Induction of nonspecific carboxyl esterase in the immature rat testis by human chorionic gonadotrophin. Endocrinology 1974; 95:1737-9. [PMID: 4434913 DOI: 10.1210/endo-95-6-1737] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|