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1.
Mol Ther ; 21(11): 2113-21, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23783429

ABSTRACT

Adoptive transfer of virus-specific T cells can prevent and treat serious infections with Epstein-Barr virus (EBV), cytomegalovirus (CMV), and adenovirus (Adv) after allogeneic hematopoietic stem cell transplant. It has, however, proved difficult to make this approach widely available since infectious virus and viral vectors are required for T cell activation, followed by an intensive and prolonged culture period extending over several months. We now show that T cells targeting a range of viral antigens derived from EBV, CMV, and Adv can be reproducibly generated in a single culture over a 2-3-week period, using methods that exclude all viral components and employ a much-simplified culture technology. When administered to recipients of haploidentical (n = 5), matched unrelated (n = 3), mismatched unrelated (n = 1) or matched related (n = 1) transplants with active CMV (n = 3), Adv (n = 1), EBV (n = 2), EBV+Adv (n = 2) or CMV+Adv (n = 2) infections, the cells produced complete virological responses in 80%, including all patients with dual infections. In each case, a decrease in viral load correlated with an increase in the frequency of T cells directed against the infecting virus(es); both immediate and delayed toxicities were absent. This approach should increase both the feasibility and applicability of T cell therapy. The trial was registered at www.clinicaltrials.gov as NCT01070797.


Subject(s)
Adenoviridae Infections/therapy , Adoptive Transfer , DNA Viruses/immunology , Hematopoietic Stem Cell Transplantation , Herpesviridae Infections/therapy , T-Lymphocytes, Cytotoxic/immunology , Adenoviridae/immunology , Adolescent , Antigens, Viral/immunology , Child , Child, Preschool , Cytomegalovirus/immunology , Cytomegalovirus Infections/therapy , Epstein-Barr Virus Infections/therapy , Female , Herpesvirus 4, Human/immunology , Humans , Male , Transplantation, Homologous/adverse effects
2.
Blood ; 121(1): 207-18, 2013 Jan 03.
Article in English | MEDLINE | ID: mdl-23152545

ABSTRACT

Human herpesvirus (HHV) 6 causes substantial morbidity and mortality in the immunocompromised host and has no approved therapy. Adoptive transfer of virus specific T cells has proven safe and apparently effective as prophylaxis and treatment of other virus infections in immunocompromised patients; however, extension to subjects with HHV6 has been hindered by the paucity of information on targets of cellular immunity. We now characterize the cellular immune response from 20 donors against 5 major HHV6B antigens predicted to be immunogenic and define a hierarchy of immunodominance of antigens based on the frequency of responding donors and the magnitude of the T-cell response. We identified specific epitopes within these antigens and expanded the HHV6 reactive T cells using a GMP-compliant protocol. The expanded population comprised both CD4(+) and CD8(+) T cells that were able to produce multiple effector cytokines and kill both peptide-loaded and HHV6B wild-type virus-infected target cells. Thus, we conclude that adoptive T-cell immunotherapy for HHV6 is a practical objective and that the peptide and epitope tools we describe will allow such cells to be prepared, administered, and monitored in human subjects.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Hematopoietic Stem Cell Transplantation/adverse effects , Herpesvirus 6, Human/immunology , Immunotherapy, Adoptive , Roseolovirus Infections/therapy , Transplantation, Homologous/adverse effects , Virus Activation , Antigens, Viral/immunology , Cells, Cultured/immunology , Coculture Techniques , Cytomegalovirus/immunology , Cytotoxicity, Immunologic , Forkhead Transcription Factors/analysis , Herpesvirus 6, Human/isolation & purification , Herpesvirus 6, Human/physiology , Humans , Immunocompromised Host , Immunodominant Epitopes/immunology , Lymphocyte Activation , Monocytes/immunology , Roseolovirus Infections/prevention & control , T-Cell Antigen Receptor Specificity , Virus Activation/immunology
3.
Mol Ther ; 20(8): 1622-32, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22801446

ABSTRACT

Severe and fatal viral infections remain common after hematopoietic stem cell transplantation. Adoptive transfer of cytotoxic T lymphocytes (CTLs) specific for Epstein-Barr virus (EBV), cytomegalovirus (CMV), and adenoviral antigens can treat infections that are impervious to conventional therapies, but broader implementation and extension to additional viruses is limited by competition between virus-derived antigens and time-consuming and laborious manufacturing procedures. We now describe a system that rapidly generates a single preparation of polyclonal (CD4(+) and CD8(+)) CTLs that is consistently specific for 15 immunodominant and subdominant antigens derived from 7 viruses (EBV, CMV, Adenovirus (Adv), BK, human herpes virus (HHV)-6, respiratory syncytial virus (RSV), and Influenza) that commonly cause post-transplant morbidity and mortality. CTLs can be rapidly produced (10 days) by a single stimulation of donor peripheral blood mononuclear cells (PBMCs) with a peptide mixture spanning the target antigens in the presence of the potent prosurvival cytokines interleukin-4 (IL4) and IL7. This approach reduces the impact of antigenic competition with a consequent increase in the antigenic repertoire and frequency of virus-specific T cells. Our approach can be readily introduced into clinical practice and should be a cost-effective alternative to common antiviral prophylactic agents for allogeneic hematopoietic stem cell transplant (HSCT) recipients.


Subject(s)
T-Lymphocytes, Cytotoxic/immunology , Virus Diseases/therapy , Antigens, Viral/immunology , Cells, Cultured , Cytomegalovirus/immunology , Flow Cytometry , Herpesvirus 4, Human/immunology , Humans , Immunotherapy, Adoptive , Virus Diseases/immunology
4.
HPB (Oxford) ; 13(9): 643-50, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21843265

ABSTRACT

OBJECTIVE: Conventional chemotherapy and radiotherapy produce marginal survival benefits in pancreatic cancer, underscoring the need for novel therapies. The aim of this study is to develop an adoptive T cell transfer approach to target tumours expressing prostate stem cell antigen (PSCA), a tumour-associated antigen that is frequently expressed by pancreatic cancer cells. METHODS: Expression of PSCA on cell lines and primary tumour samples was confirmed by immunohistochemistry. Healthy donor- and patient-derived T cells were isolated, activated in vitro using CD3/CD28, and transduced with a retroviral vector encoding a chimeric antigen receptor (CAR) targeting PSCA. The ability of these cells to kill tumour cells was analysed by chromium-51 (Cr(51)) release. RESULTS: Prostate stem cell antigen was expressed on >70% of the primary tumour samples screened. Activated, CAR-modified T cells could be readily generated in clinically relevant numbers and were specifically able to kill PSCA-expressing pancreatic cancer cell lines with no non-specific killing of PSCA-negative target cells, thus indicating the potential efficacy and safety of this approach. CONCLUSIONS: Prostate stem cell antigen is frequently expressed on pancreatic cancer cells and can be targeted for immune-mediated destruction using CAR-modified, adoptively transferred T cells. The safety and efficacy of this approach indicate that it deserves further study and may represent a promising novel treatment for patients with pancreatic cancer.


Subject(s)
Antigens, Neoplasm/metabolism , Carcinoma, Pancreatic Ductal/therapy , Genetic Therapy , Immunotherapy, Adoptive , Neoplasm Proteins/metabolism , Pancreatic Neoplasms/therapy , Receptors, Antigen, T-Cell/genetics , Single-Chain Antibodies/genetics , T-Lymphocytes/transplantation , Carcinoma, Pancreatic Ductal/genetics , Carcinoma, Pancreatic Ductal/immunology , Carcinoma, Pancreatic Ductal/pathology , Cell Line, Tumor , Cytotoxicity, Immunologic , Feasibility Studies , GPI-Linked Proteins/metabolism , HEK293 Cells , Humans , Immunohistochemistry , Lymphocyte Activation , Muromonab-CD3/pharmacology , Pancreatic Neoplasms/genetics , Pancreatic Neoplasms/immunology , Pancreatic Neoplasms/pathology , Receptors, Antigen, T-Cell/biosynthesis , Single-Chain Antibodies/biosynthesis , T-Lymphocytes/drug effects , T-Lymphocytes/immunology , Time Factors , Transduction, Genetic , Up-Regulation
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