Abstract
Human cytomegalovirus (HCMV) reactivations are associated with lower overall survival after transplantations. Adoptive transfer of HCMV-reactive expanded or selected T cells can be applied as a compassionate use, but requires that the human leukocyte antigen-matched donor provides memory cells against HCMV. To overcome this, we developed engineered T cells expressing chimeric antigen receptors (CARs) targeted against the HCMV glycoprotein B (gB) expressed upon viral reactivation. Single-chain variable fragments (scFvs) derived from a human high-affinity gB-specific neutralizing monoclonal antibody (SM5-1) were fused to CARs with 4-1BB (BBL) or CD28 (28S) costimulatory domains and subcloned into retroviral vectors. CD4+ and CD8+ T cells obtained from HCMV-seronegative adult blood or cord blood (CB) transduced with the vectors efficiently expressed the gB-CARs. The specificity and potency of gB-CAR-T cells were demonstrated and compared in vitro using the following: 293T cells expressing gB, and with mesenchymal stem cells infected with a HCMV TB40 strain expressing Gaussia luciferase (HCMV/GLuc). BBL-gB-CAR-T cells generated with adult or CB demonstrated significantly higher in vitro activation and cytotoxicity performance than 28-gB-CAR-T cells. Nod.Rag.Gamma (NRG) mice transplanted with human CB CD34+ cells with long-term human immune reconstitution were used to model HCMV/GLuc infection in vivo by optical imaging analyses. One week after administration, response to BBL-gB-CAR-T cell therapy was observed for 5/8 mice, defined by significant reduction of the bioluminescent signal in relation to untreated controls. Response to therapy was sporadically associated with CAR detection in spleen. Thus, exploring scFv derived from the high-affinity gB-antibody SM5-1 and the 4-1BB signaling domain for CAR design enabled an in vitro high on-target effect and cytotoxicity and encouraging results in vivo. Therefore, gB-CAR-T cells can be a future clinical option for treatment of HCMV reactivations, particularly when memory T cells from the donors are not available.
Highlights
HUMAN CYTOMEGALOVIRUS (HCMV) is a ubiquitous human pathogen that latently infects a large proportion of the adult population, and, in most immunocompetent individuals, it persists by low-level reactivations and reinfections without causing clinical symptoms
Others have shown that glycoprotein B (gB)-chimeric antigen receptors (CARs)-T cells containing an scFv derived from a non-neutralizing antibody, incorporating the CD28 costimulatory domain, and generated through RNA transfection became activated in the presence of gB, but failed to exhibit effector functions against HCMV-infected cells.[36]
This lack of functionality has been interpreted as the consequence of HCMV-mediated T cell suppression mechanisms that abrogated gB-CAR-T cell function and cytotoxicity.[37,38]
Summary
HUMAN CYTOMEGALOVIRUS (HCMV) is a ubiquitous human pathogen that latently infects a large proportion of the adult population, and, in most immunocompetent individuals, it persists by low-level reactivations and reinfections without causing clinical symptoms.
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