U.S. patent application number 15/956537 was filed with the patent office on 2018-10-25 for engineering antiviral t cell immunity through stem cells and chimeric antigen receptors.
The applicant listed for this patent is The Regents of the University of California. Invention is credited to Irvin Chen, Masakazu Kamata, Scott G. Kitchen, Otto O. Yang, Jerome A. Zack.
Application Number | 20180305435 15/956537 |
Document ID | / |
Family ID | 52432455 |
Filed Date | 2018-10-25 |
United States Patent
Application |
20180305435 |
Kind Code |
A1 |
Kitchen; Scott G. ; et
al. |
October 25, 2018 |
Engineering Antiviral T Cell Immunity through Stem Cells and
Chimeric Antigen Receptors
Abstract
The HIV-specific cytotoxic T lymphocyte (CTL) response is a
critical component in controlling HIV replication and is an
important part of the ultimate failure to eradicate the virus.
Disclosed herein are methods for genetically enhancing the
HIV-specific CTL response to allow long-term viral suppression or
viral clearance. Human hematopoietic stem cells (HSCs) were
genetically modified such that they differentiate into mature CTLs
that will kill HIV infected cells. As disclosed herein, the
functional effector cells are not human leukocyte antigen
(HLA)-restricted. As disclosed herein, stem cells are transduced
with non-HLA restricted chimeric antigen receptors (CARs) that
allow the recognition of HIV or HIV-infected cells when expressed
by a CTL. These CARs are hybrid molecules that contain an
extracellular HIV recognition domain and an intracellular TCR-zeta
signaling domain. The CTL response may be enhanced through the
targeting of T cell inhibitory receptors. The methods and
compositions disclosed herein may be used to engineer antiviral
immunity and HIV-specific CTL responses in vivo. Also disclosed
herein are methods and compositions for the treatment of chronic
viral infections such as HIV.
Inventors: |
Kitchen; Scott G.; (Los
Angeles, CA) ; Zack; Jerome A.; (Tarzana, CA)
; Yang; Otto O.; (Los Angeles, CA) ; Chen;
Irvin; (Palos Verdes Estates, CA) ; Kamata;
Masakazu; (Los Angeles, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
The Regents of the University of California |
Oakland |
CA |
US |
|
|
Family ID: |
52432455 |
Appl. No.: |
15/956537 |
Filed: |
April 18, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14908476 |
Jan 28, 2016 |
9951118 |
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PCT/US2014/049360 |
Aug 1, 2014 |
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15956537 |
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61861684 |
Aug 2, 2013 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
C07K 14/70514 20130101;
A61K 35/28 20130101; C12N 2510/00 20130101; C07K 14/7051 20130101;
A61K 35/17 20130101; C12N 5/0647 20130101; C07K 2319/70 20130101;
C07K 2319/03 20130101; C07K 2317/622 20130101; C12N 5/0636
20130101; C07K 16/1045 20130101; C07K 2317/76 20130101; A61P 31/12
20180101 |
International
Class: |
C07K 14/73 20060101
C07K014/73; C12N 5/0789 20060101 C12N005/0789; C07K 16/10 20060101
C07K016/10; C07K 14/725 20060101 C07K014/725; A61K 35/28 20060101
A61K035/28; C12N 5/0783 20060101 C12N005/0783; A61K 35/17 20060101
A61K035/17 |
Goverment Interests
ACKNOWLEDGEMENT OF GOVERNMENT SUPPORT
[0002] This invention was made with Government support under
AI1028697, AI070010, and AI078806, awarded by the National
Institutes of Health. The Government has certain rights in the
invention.
Claims
1. A recombinant progenitor cell which comprises a stem cell
transduced with a vector containing a nucleic acid molecule which
encodes a chimeric antigen receptor (CAR) specific for a virus or
an epitope thereof, wherein the recombinant progenitor cell is
capable of differentiating into a functional effector cell.
2. The recombinant progenitor cell of claim 1, wherein the nucleic
acid molecule is contained within a CAR construct.
3. The recombinant progenitor cell of claim 1, wherein the stem
cell is a hematopoietic stem cell or a hematopoietic progenitor
cell.
4. The recombinant progenitor cell of claim 3, wherein the stem
cell is a memory T stem cell.
5. The recombinant progenitor cell according to claim 1, wherein
the vector is a lentiviral vector.
6. The recombinant progenitor cell according to claim 1, wherein
the chimeric antigen receptor comprises a CD4 extracellular and
transmembrane domains and a CD3 zeta signaling domain
(CD4.zeta.).
7. The recombinant progenitor cell of claim 6, wherein the CD4
extracellular domain binds gp120 expressed on the surface of cells
infected with HIV.
8. The recombinant progenitor cell according to claim 1, wherein
the virus is a lentivirus.
9. The recombinant progenitor cell of claim 8, wherein the
lentivirus is a human immunodeficiency virus.
10. The recombinant progenitor cell according to claim 1, wherein
the functional effector cell is a T-cell.
11. The recombinant progenitor cell of claim 10, wherein the T-cell
expresses CD4.zeta. CAR on its cell surface.
12. The recombinant progenitor cell according to claim 1, wherein
the vector further comprises one or more genetic sequences which
protect the recombinant progenitor cell from infection by the
virus.
13. The recombinant progenitor cell of claim 12, wherein the
genetic sequences are selected from the group consisting of:
sh1005, sh516, and a nucleic acid molecule encoding C46, and the
virus is a human immunodeficiency virus.
14. A method of producing a functional effector cell which
comprises differentiating or developing the recombinant progenitor
cell of claim 1 and then maturing it into the functional effector
cell.
15. The method of claim 14, wherein the recombinant progenitor cell
is administered to or engrafted in a subject.
16. (canceled)
17. An engineered functional effector cell made by the method
according to claim 14.
18. The engineered functional effector cell of claim 17, which
expresses CD4.zeta. CAR on its cell surface.
19. A method of inhibiting, reducing, or treating a viral infection
in a subject which comprises administering the recombinant
progenitor cell according to claim 1 or a functional effector cell
matured therefrom to the subject.
20. The recombinant progenitor cell according to claim 1, wherein
the recombinant progenitor cell lacks HLA-restricted T cell
receptors.
21. A nucleic acid molecule which comprises a sequence encoding CD4
fused to the signaling domain of the CD3 complex .zeta.-chain.
22. (canceled)
23. The nucleic acid molecule of claim 21, wherein the molecule is
CD4.zeta. CAR, Double CAR C46, Triple CD4.zeta. CAR, CD4D1D2D3CAR,
CD4D1D2CAR, or CD4D1CAR.
24. The nucleic acid molecule of claim 21, wherein the molecule
contains a nucleotide sequence encoding a single chain antibody
having an amino acid sequence selected from the group consisting of
SEQ ID NO:2; SEQ ID NO:3; SEQ ID NO:4; SEQ ID NO:5; SEQ ID NO:6;
SEQ ID NO:7; SEQ ID NO:8; SEQ ID NO:9; SEQ ID NO:10; SEQ ID NO:11;
SEQ ID NO:12; SEQ ID NO:13; SEQ ID NO:14; and SEQ ID NO:15.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Application No.
61/861,684, filed 2 Aug. 2013, which is herein incorporated by
reference in its entirety.
REFERENCE TO A SEQUENCE LISTING SUBMITTED VIA EFS-WEB
[0003] The content of the ASCII text file of the sequence listing
named "20140731_034044_128WO1 seq ST25" which is 16.7 KB in size
was created on 31 Jul. 2014 and electronically submitted via
EFS-Web herewith the application is incorporated herein by
reference in its entirety.
BACKGROUND OF THE INVENTION
1. Field of the Invention
[0004] The present invention generally relates to recombinant human
progenitor cells, and engineered functional effector cells
including engineered human thymocytes, and engineered human T
cells, and methods of treating subjects therewith.
2. Description of the Related Art
[0005] CD8+ cytotoxic T-lymphocytes (CTLs) partially control human
immunodeficiency virus (HIV) in almost all infected persons, but
eventually fail due to viral mutation, downregulation of Human
Leukocyte Antigen (HLA), lack of CD4+ T-cell help, and CTL clonal
exhaustion. While HIV infections can be controlled in many
individuals with antiretroviral drugs, these are expensive and
associated with significant toxicities. Due to viral reservoirs, if
therapy is terminated, virus replication and disease progression
resume, requiring patients to remain on these medications
permanently. To date there has only been a single reported case of
cured chronic HIV infection in an adult, via bone marrow transplant
from a donor lacking the normal gene for C--C chemokine receptor
type 5 (CCR5), which is a cell receptor required for most strains
of HIV to infect cells. However, the mortality rate of this
procedure is about 40%, and matched bone marrow with this genetic
profile is almost nonexistent for most ethnic groups, rendering
this approach impractical for broader clinical applicability.
Several recent studies have attempted to remove CCR5 from
hematopoietic stem cells and/or deliver anti-HIV genes to protect
cells from HIV infection in humans, but these studies face
limitations due to unknowns regarding levels of transduced cell
engraftment required to generate an HIV-resistant immune
system.
SUMMARY OF THE INVENTION
[0006] In some embodiments, the present invention is directed to a
recombinant progenitor cell which comprises a stem cell transduced
with a vector containing a nucleic acid molecule which encodes a
chimeric antigen receptor (CAR) specific for a virus or an epitope
thereof, wherein the recombinant progenitor cell is capable of
differentiating into a functional effector cell. In some
embodiments, the nucleic acid molecule is contained within a CAR
construct according to the present invention. In some embodiments,
the stem cell is a hematopoietic stem cell or a hematopoietic
progenitor cell. In some embodiments, the stem cell is a memory T
stem cell (such as central memory T cell, an effector memory T
cell, or a stem cell memory T cell). In some embodiments, the
vector is a lentiviral vector. In some embodiments, the chimeric
antigen receptor comprises, consists essentially of, or consists of
CD4 extracellular and transmembrane domains and a CD3 zeta
signaling domain (CD4). In some embodiments, the CD4 extracellular
domain binds gp120 expressed on the surface of cells infected with
HIV. In some embodiments, the virus is an immunodeficiency virus
such as HIV or SIV. In some embodiments, the virus is a lentivirus.
In some embodiments, the lentivirus is a human immunodeficiency
virus. In some embodiments, the functional effector cell is a
T-cell. In some embodiments, the T-cell expresses CD4.zeta. CAR on
its cell surface. In some embodiments, the vector further comprises
one or more genetic sequences which protect the recombinant
progenitor cell from infection by the virus and/or inhibit
infection by the virus. In some embodiments, the genetic sequences
are selected from the group consisting of: sh1005, sh516, and a
nucleic acid molecule encoding C46.
[0007] In some embodiments, the present invention is directed to a
method of producing a functional effector cell which comprises
differentiating or developing the recombinant progenitor cell of
the present invention and then maturing it into the functional
effector cell. In some embodiments, the nucleic acid molecule is
contained within a CAR construct according to the present
invention. In some embodiments, the recombinant progenitor
comprises a stem cell transduced with a vector containing a nucleic
acid molecule which encodes a chimeric antigen receptor (CAR)
specific for a virus or an epitope thereof. In some embodiments,
the stem cell is a hematopoietic stem cell or a hematopoietic
progenitor cell. In some embodiments, the stem cell is a memory T
stem cell (such as central memory T cell, an effector memory T
cell, or a stem cell memory T cell). In some embodiments, the
vector is a lentiviral vector. In some embodiments, the chimeric
antigen receptor comprises, consists essentially of, or consists of
CD4 extracellular and transmembrane domains and a CD3 zeta
signaling domain (CD4.zeta.). In some embodiments, the CD4
extracellular domain binds gp120 expressed on the surface of cells
infected with HIV. In some embodiments, the virus is an
immunodeficiency virus such as HIV or SIV. In some embodiments, the
virus is a lentivirus. In some embodiments, the lentivirus is a
human immunodeficiency virus. In some embodiments, the functional
effector cell is a T-cell. In some embodiments, the T-cell
expresses CD4.zeta. CAR on its cell surface. In some embodiments,
the vector further comprises one or more genetic sequences which
protect the recombinant progenitor cell from infection by the virus
and/or inhibit infection by the virus. In some embodiments, the
genetic sequences are selected from the group consisting of:
sh1005, sh516, and a nucleic acid molecule encoding C46. In some
embodiments, the recombinant progenitor cell is administered to or
engrafted in a subject. In some embodiments, the subject is
mammalian. In some embodiments, the subject is a model animal such
as a mouse or a non-human primate. In some embodiments, the subject
is a human subject. In some embodiments, the recombinant progenitor
cell is subjected to the thymus tissue of the subject. In some
embodiments, the present invention is directed to an engineered
functional effector cell made by the method according to the
present invention. In some embodiments, the engineered functional
effector cell expresses CD4.zeta. CAR on its cell surface.
[0008] In some embodiments, the present invention is directed to a
method of inhibiting, reducing, or treating a viral infection in a
subject which comprises administering the recombinant progenitor
cell according to the present invention and/or the engineered
functional effector cell according to the present invention to the
subject. In some embodiments, the subject is mammalian. In some
embodiments, the subject is a model animal such as a mouse or a
non-human primate. In some embodiments, the subject is a human
subject.
[0009] In some embodiments, the recombinant progenitor cells and
engineered functional effector cells according to the present
invention lack HLA-restricted T cell receptors.
[0010] In some embodiments, the present invention is directed to a
CAR construct, i.e., a nucleic acid molecule which comprises a
sequence encoding CD4, preferably human CD4, fused to the signaling
domain of the CD3 complex .zeta.-chain. In some embodiments, the
nucleic acid molecule is selected from the group consisting of CAR
constructs, Double CAR constructs, Triple CAR constructs, truncated
CAR constructs, truncated Double CAR constructs, truncated Triple
CAR constructs, and second generation CAR constructs. In some
embodiments, the nucleic acid molecule is CD4.zeta. CAR, Double CAR
C46, Triple CD4.zeta. CAR, CD4D1D2D3CAR, CD4D1D2CAR, or CD4D1CAR.
In some embodiments, the nucleic acid molecule contains a
nucleotide sequence encoding a single chain antibody having an
amino acid sequence selected from the group consisting of SEQ ID
NO:2; SEQ ID NO:3; SEQ ID NO:4; SEQ ID NO:5; SEQ ID NO:6; SEQ ID
NO:7; SEQ ID NO:8; SEQ ID NO:9; SEQ ID NO:10; SEQ ID NO:11; SEQ ID
NO:12; SEQ ID NO:13; SEQ ID NO:14; and SEQ ID NO:15.
[0011] Both the foregoing general description and the following
detailed description are exemplary and explanatory only and are
intended to provide further explanation of the invention as
claimed. The accompanying drawings are included to provide a
further understanding of the invention and are incorporated in and
constitute part of this specification, illustrate several
embodiments of the invention, and together with the description
serve to explain the principles of the invention.
DESCRIPTION OF THE DRAWINGS
[0012] This invention is further understood by reference to the
drawings wherein:
[0013] FIG. 1 are graphs showing that CD4.zeta. CAR allows
differentiation of T cells from stem cells.
[0014] FIG. 2 is a graph showing suppression of HIV replication by
HIV-TCR containing T cells.
[0015] FIG. 3 is a schematic representation of the CD4.zeta.
chimeric antigen receptor.
[0016] FIG. 4A is a graph showing the ability of CD4.zeta. CAR
transduced T cells to kill HIV infected T1 cells.
[0017] FIG. 4B is a graph showing the ability of by HLA-I matched
or mismatched CTL clones, and CD4.zeta. CAR transduced CD8+ T cells
to suppress viral replication.
[0018] FIG. 5 is a graph showing HLA-I independence of CD4.zeta.
transduced CD8+ T cell antiviral activity.
[0019] FIG. 6 are graphs showing HIV-1 specific cytokine production
from CD4+ T cells via CD4 .zeta..
[0020] FIG. 7 is a graph showing the susceptibility of the cells
transduced with the CD4.zeta. CAR construct and the Triple
CD4.zeta. construct to HIV infection.
[0021] FIG. 8 is a schematic representation of the protective
CD4.zeta. CAR construct.
[0022] FIG. 9A is a graph showing the development of T cells from
HSCs genetically modified with a CD4.zeta. CAR in humanized
mice
[0023] FIG. 9B is a graph showing the percent of HIV infected
unmodified T cells and those expressing CD4.zeta. CAR.
[0024] FIG. 10 schematically represents the dual CD46-CD4.zeta. CAR
lentiviral vectors (Double CAR constructs).
[0025] FIG. 11A shows CD8 cells purified from healthy donors and
transduced with either GFP control vector, or CD4.zeta. CAR or the
Triple CD4.zeta. CAR construct.
[0026] FIG. 11B shows CCRS expression is down regulated by
protective CD4.zeta. CAR compared to GFP or CD4.zeta. CAR
control.
[0027] FIG. 11C shows the fold increase of HIV infection rate
comparing HIV-1 exposed CD8 cells transduced with CD4.zeta. CAR or
the Triple CD4.zeta. CAR construct to GFP control vector.
[0028] FIG. 11D shows cytokine production of GFP or Triple
CD4.zeta. CAR transduced CD8 cells after stimulation with infected
T2 cells.
[0029] FIG. 12A is a graph summarizing the % EM&CM ratio among
CD45+ and CD45+GFP+ CD4.zeta. CAR cells from infected CD4.zeta. CAR
mice.
[0030] FIG. 12B is summarizes the CD38 mean fluorescence intensity
(MFI) comparing CD45+ and CD45+GFP+ CD4.zeta. CAR cells from
infected CD4.zeta. CAR mice.
[0031] FIG. 13A is a graph showing a significant decrease in TREC
levels in CD4.zeta. CAR expressing cells.
[0032] FIG. 13B is a graph showing CD3 expression on CD4.zeta. CAR
expressing cells which was analyzed separately by high or low GFP
expression.
[0033] FIG. 14A and FIG. 14B are graphs showing the percentage of
cells expressing the HIV p24Gag antigen.
[0034] FIG. 15A shows the percentage of GFP+CD4+ CD4.zeta. CAR
expressing cells in peripheral blood before and 5 weeks after
infection.
[0035] FIG. 15B shows the blood HIV DNA burden and CD4/CD8 ratio
comparing control and CD4.zeta. CAR mice that are infected with
HIV-1.
[0036] FIG. 15C shows the correlation of CD4.zeta. CAR expression
cell expansion with viral burden in the peripheral blood.
[0037] FIG. 16 schematically shows CAR vector modification and
strategy to develop CAR constructs according to the present
invention.
[0038] FIG. 17 schematically shows the various truncation mutants
that have been made. As shown, from top to bottom, the CD4.zeta.
constructs are: CD4.zeta. CAR, CD4D1D2D3 CAR, CD4D1D2CAR, and
CD4D1CAR.
[0039] FIG. 18 are graphs showing that Triple CD4D1D2CAR is even
more resistant to HIV infection than Triple CD4.zeta. CAR. Jurkat
cells were transduced and then infected with NL4-3 for 3 days.
DETAILED DESCRIPTION OF THE INVENTION
[0040] The present invention provides a method for programming stem
cells to provide a self-renewing population of both CD8+ and CD4+
HIV-targeted T-cells that are resistant to direct HIV infection,
and which bypass the mechanisms by which HIV usually evades the
immune response. The present invention involves the genetic
modification of hematopoietic stem cells (HSCs), hematopoietic
progenitor cells (HPCs), or hematopoietic stem and progenitor cells
(HSPCs) using chimeric antigen receptors (CARs) to form
antigen-specific T cells against HIV.
[0041] Modification of human HSCs with a T-cell receptor (TCR)
comprising an alpha and beta chain (which bind HIV peptide in the
context of an HLA molecule) allows the differentiation of
HIV-specific T cells in vivo in humanized mice. See Kitchen et al.
(2012) PLoS Pathog. 8(4): e1002649; see also U.S. application Ser.
No. 13/045,073, filed 10 Mar. 2011, both of which are herein
incorporated by reference in their entirety. The engineered T
cells, however, are human leukocyte antigen (HLA) restricted.
[0042] The present invention utilizes CARs specific for HIV in
place of T cell receptors (TCRs). CARs have an antigen binding
domain specific for HIV and an internal TCR signaling domain. When
they bind the target antigen, which occurs directly without HLA,
they trigger the cell like a TCR. Unlike natural T cell receptors,
CARs do not need to recognize HLA molecules to detect antigen.
Thus, the engineered T cells according to the present invention are
not HLA restricted. Consequently, the CAR constructs and engineered
cells according to the present invention need not be matched to a
subject's genetic HLA profile for effectively treating the subject.
Thus, treatments according to the present invention may be used in
HIV infected persons of any HLA types.
[0043] The CAR used as an example herein comprises human CD4
external domain fused to the CD3-zeta signaling region on the
T-cell receptor (which mediates T cell activation). Prior to the
present invention, it was thought that artificially having the
CD4-zeta expressed on the surface of a developing T cell would
cause aberrant signaling which would cause the cell to fail the
development process because CD4 and the zeta chain component are
involved in the proper development of T cells from stem cells. As
shown in FIG. 1, HSPCs transduced with a CAR construct comprising
human CD4 fused to the CD3 zeta-signaling region on the T-cell
receptor allows the differentiation of HIV-specific T cells in vivo
and exhibit normal function in humanized mice. Specifically, human
CD34+ HSCs were transduced with a lentiviral vector containing the
CD4.zeta. CAR and eGFP reporter and these cells were implanted into
humanized mice (NSG strain). Twelve weeks following implantation,
peripheral blood was analyzed for expression of human CD45 and the
eGFP reporter gene (left column) in mice that either received no
vector (control) (top panel) and mice that received cells that were
transduced (middle and bottom panels). In mice receiving vector
transduced cells, vector expressing cells (middle panels) and cells
not expressing vector (bottom panels) were analyzed for the human T
cell marker CD3, human differentiation marker CD45 RO (middle
column). Human T cells expressing CD3 were further analyzed for
expression of CD4 and CD8 (right column). These results indicate
that cells expressing the CD4.zeta. CAR are capable of undergoing
differentiation from stem cells into mature T cells. Surprisingly,
CAR expression did not substantially alter the differentiation or
lineage commitment of developing T-cells.
[0044] Thus, in some embodiments, the present invention is directed
to methods of genetically engineering and enhancing the human
cellular immune response against HIV, preferably Human
Immunodeficiency Virus Type 1 (HIV-1), using CARs specific to HIV.
These CARs are engineered T-cell receptors (TCRs) which comprise or
consist of an HIV, preferably an HIV-1, envelope recognition
domain, a transmembrane domain, and an intracellular signaling
domain that direct T-cells to kill HIV-infected cells. As such, the
CARs according to the present invention are freed from a drawback
of natural TCRs for gene therapy--HLA restriction.
[0045] Treatments according to the present invention include
one-time dosing, or an infrequent procedure involving stem cell
mobilization, purification, culture, lentiviral transduction, and
infusion. Treatments may be by administration of a gene delivery
vector, e.g., lentivirus, containing a gene encoding a CAR
according to the present invention and/or administration of stem
cells genetically modified to express one or more CARs according to
the present invention. In some embodiments, the gene delivery
vector is designed to deliver the gene into stem cells. In some
embodiments, the stem cells are HSCs, HPCs, or both. In some
embodiments, treatments according to the present invention do not
suffer from low-levels of transduced cell engraftment that limits
other stem cell therapeutic approaches due to the fact that, even
at low stem cell engraftment frequencies, CAR-containing T-cells
are expected to proliferate in the periphery in response to HIV,
preferably HIV-1, antigens. This harnesses the natural
proliferative capacity of stem cells and mature T cell progeny to
generate key antiviral effector cells.
[0046] The methods of the present invention may be used to treat
any infected subject, preferably mammalian subjects, more
preferably human subjects, including those with HIV stably
suppressed by highly active antiretroviral therapy (HAART), and/or
clear latent viral reservoirs. In some embodiments, the subjects to
be treated are those who are failing standard antiretroviral
therapy due to drug resistance, unable to tolerate the
complications or side effects of antiretroviral drugs, and/or
unwilling or unable logistically to take life-long antiretroviral
therapy.
[0047] According to the present invention, delivery of CARs to stem
cells will provide a non-exhaustible source of CD4+ and CD8+ T and
NK cells specific for HIV, preferably HIV-1, to recognize and kill
cells infected with HIV in vivo, as opposed to natural cellular
immunity that faces clonal exhaustion. Furthermore, T-cells made by
the method of the present invention are superior to T-cells
obtained using other methods in the art, because the CARs are
HLA-independent, and are therefore broadly applicable to any
person, and not subject to a key immune evasion strategy of HLA
downregulation by HIV infected cells.
[0048] The genetic modification of HSCs with a CAR in subjects will
result in the production of mature effector cells that can lower
viral loads in the infected subjects and promote the eradication of
the virus. Although there are a variety of models known in the art
that can be employed to test and screen various embodiments of the
present invention, the non-human primate model (NHP) of simian
immunodeficiency virus (SIV) and chimeric simian-human
immunodeficiency virus (SHIV) infection, which has been an
important surrogate system in the understanding of HIV
pathogenesis, disease progression, and in the development of
antiretroviral therapeutic and vaccine strategies, may be employed
as described herein.
[0049] SHIV chimeras are created by inserting HIV-1 genes, for
instance env, rev, tat, and vpu, into a background of SIVmac. Such
"env-SHIVs" readily infect macaques, and offer all the advantages
of the SIVmac/macaque model. An example of a SHIV chimera is the
CCR5-tropic subtype C SHIV-1157ipd3N4 (referred to as SHIV-C).
Infected macaques develop CD4.sup.+ T-cell loss usually in a few
weeks and develop AIDS at intervals ranging from a few weeks to two
years. Histological changes in lymphoid and other tissues closely
resemble those seen in human AIDS. Thus, the SHIV/macaque model is
a superb model to study novel HIV/AIDS treatment strategies.
[0050] The present invention offers several advantages over current
therapeutic modalities. First, as it involves long-lived stem
cells, treatments should require only a single administration. The
risk of undesirable T-cell reactivity would be minimized, as stem
cell-derived T-cells will pass through thymic selection. As both
CD4 and CD8 cells arise from CAR-transduced stem cells, there will
be both anti-HIV CD4-(helper) and CD8-(CTL) T-cell function.
Finally, as new HIV/SHIV-specific cells are constantly renewed from
stem cells, HIV production from activation of HIV/SHIV reservoir
cells can be contained and prevented from systemic spread.
Preliminary Studies
[0051] A surrogate humanized bone marrow, fetal liver and thymus
(BLT) mouse model was used to demonstrate that human CD34+ HSCs can
be genetically modified with a lentiviral vector containing a
molecularly cloned TCR specific to HIV (HIV-TCR construct), and
subsequently develop into mature, fully functional CTL using
methods known in the art. Humanized mice containing the HIV-TCR
construct (SL-9) or control TCR were infected with the HIV reporter
virus and were assessed for human CD45+ cells expressing HIV by
flow cytometry for the HSA-HA marker gene encoded by the virus
genome. As shown in FIG. 2, The HIV-TCR construct significantly
suppresses HIV expressing cells in vivo.
[0052] To determine whether stem cells transduced with a vector
containing a CAR specific to HIV (CAR construct), can develop into
functional effector cells, CD4.zeta. CAR was used. FIG. 3
schematically shows CD4.zeta. CAR, which is a fusion molecule of
human CD4 with the signaling domain of the CD3 complex
.zeta.-chain. This harnesses CD4 as a recognition receptor for HIV
gp120 envelope on the surface of infected cells; engagement of CD4
triggers T-cell recognition of infected cells through .zeta.-chain
signaling.
[0053] HIV infected T1 cells were tested for susceptibility to
killing by T cells transduced with the CD4.zeta. CAR construct.
HIV-infected T1 cells were tested for killing by HLA-I matched or
mismatched CTL clones (i.e., having the HIV-TCR construct) or
CD4.zeta. transduced CD8+ T cells (i.e., having the CAR construct).
As shown in FIG. 4A and FIG. 4B, CD8+ T-cells transduced with
CD4.zeta. CAR are capable of killing HIV-infected cells (FIG. 4A,
CD8-CAR) and suppressing viral replication (FIG. 4B, CD8-CAR).
Surprisingly, the CD4.zeta. CAR construct resulted in dramatically
superior suppressive activity compared to the HIV-TCR construct,
even when the CTL clone is matched.
[0054] T1 cells or derivative T2 cells were infected with HIV-1
IIIB and co-cultured with CD8+ T cells transduced with the
CD4.zeta. CAR construct or a primary HIV-I specific HLA-I
restricted CD8+ T cell clone recognizing an epitope in reverse
transcriptase (pol). Unlike the HIV-specific TCR cells of FIG. 2,
the data in FIG. 5 shows that the killing and suppressive activity
of the cells having the CD4.zeta. CAR construct is independent of
HLA-I molecules. Thus, the methods and engineered cells according
to the present invention are not HLA-restricted.
[0055] CD4+ T cells were transduced with lentiviral vectors
encoding either EGFP (EGFP, control) or EGFP-2A-CD4.zeta. (CD4
.zeta.). The cells were then incubated with HIV-1 infected T1
cells. Intracellular IL-2 and IFN-.gamma. were analyzed by flow
cytometry. The data in FIG. 6 shows that CARs can also function in
CD4+ T-cells to act as HIV-1-specific helper cells.
[0056] Unfortunately, it was found that CD8+ T-cells that express
CD4 through transduction with CD4.zeta. CAR become susceptible to
HIV infection. Specifically, as shown in FIG. 7, purified primary
CD8+ T-cells were transduced with either CD4.zeta. CAR (CD4.zeta.)
or EGFP control vector (EGFP) and infected with R5-tropic
HIV-1.sub.JR-CSF (JRCSF). The results demonstrate that CD8+ cells
which were transduced with CD4.zeta. CAR are susceptible to HIV
infection whereas CD8+ T-cells transduced with control vector were
not significantly infected by HIV (EGFP).
[0057] Thus, to determine whether CD4.zeta. CAR could be combined
with other anti-HIV reagents to confer protection from HIV
infection, two shRNAs, one that downregulates CCR5 and one that
downregulates HIV expression by targeting the LTR region, were
introduced into the gene delivery vector containing CD4.zeta. CAR.
The first shRNA, sh1005, inhibits R5-tropic HIV at the point of
entry through downregulation of the CCR5 co-receptor. The second
shRNA, sh516, directed to HIV itself, which unlike sh1005, has been
found to be protective against both R5- and X4-tropic HIV.
[0058] Co-expression of sh1005 and sh516 in a single vector
efficiently down-regulates CCR5 expression and inhibits both X4-
and R5-tropic HIV replication in PBMCs in vitro. No effects on cell
viability, no up-regulation of interferon-inducible OAS1 expression
in PBMCs, and no effects on colony forming cell (CFC) assay after
transduction of FL-CD34+ cells were seen. Hematopoiesis in
transplanted BLT mice was normal in marked cell populations. Most
importantly, marked cells are protected from both R5 and X4 tropic
HIV. Thus, in some embodiments, this base vector may be used to
test expression and functionality of other CARs. For example,
protection from R5 and X4 tropic HIV infection may be assessed by
supernatant and intracellular gag p24 assays.
[0059] The sh1005/sh516 expression cassette was introduced into the
EGFP-2A-CD4.zeta. vector. FIG. 8 schematically shows the CD4.zeta.
CAR construct. This CAR construct having the sh1005, sh516, and
CD4.zeta. (Triple CAR construct) allowed production of mature CD4+
and CD8+ T-cells but with a reduced percent engraftment (5-6% vs.
11%; not shown) compared to the original EGFP-2A-CD4.zeta. vector.
The Triple CAR construct maintains ability to downregulate CCR5 and
downregulate an HIV vector bearing mCherry as a reporter gene
similar to sh1005/sh516 (data not shown). As shown in FIG. 7, using
the Triple CAR construct, CD4.zeta. CAR successfully diminished
HIV-1 susceptibility (Triple CD4.zeta.).
[0060] Therefore, in some embodiments, inhibitory RNAs known in the
art may be similarly employed. Such inhibitory RNAs include those
as disclosed in U.S. Pat. No. 7,737,124; U.S. Pat. No. 7,732,207;
U.S. Pat. No. 7,195,916; and U.S. Pat. No. 7,919,309, which are
herein incorporated by reference in their entirety. In some
embodiments, other sequences such as the sequence encoding C46, a
transmembrane fusion inhibitor, can be added or used in place of
the shRNAs. It should be noted that other antiviral sequences may
be used in place of or in addition to the shRNAs and C46 as
described herein, and that selection of such antiviral sequences is
within the skill of those in the art and may be based on the
subject to be treated. Assays known in the art may be used to
assess the activity of vectors and constructs according to the
present invention. For example, the CFC assay can be used to
determine the hematopoietic potential of CAR construct treated
CD34+ HSPC compared to control vector and mock transduced cells in
vitro by measuring total colony forming units (CFU) and various
hematopoietic lineage types (erythroid, myeloid, and
erythroid/myeloid) of CFU generated per condition. Briefly,
transduced CD34+ cells are re-suspended in MethoCult H4034 and 500
cells plated per replicate. 12-14 days later, CFUs are scored under
a microscope. Individual colonies can also be assessed for vector
copy number by PCR; one may aim to maintain a copy number less than
3. Generally, no greater than 0.5-fold variation in total CFU and
sub-type colonies compared to that of control vector or mock
transduced conditions is desired.
[0061] To determine whether HSC transduced with a CAR would proceed
successfully through thymopoiesis, HSCs modified with a lentiviral
vector containing the CD4.zeta. CAR were transplanted into the
humanized mouse model. Humanized mice were made with either
CD4.zeta. CAR or left unmodified (control). As shown in FIG. 9A,
peripheral blood of mature T-cells expressing the lentiviral vector
marker gene (EGFP) and CD4.zeta. CAR were found to efficiently
develop and expand following infection with HIV. In addition, as
shown in FIG. 9B, HIV infection of T cells expressing CD4.zeta. CAR
was suppressed as compared to the control.
CAR+C46 Construct
[0062] C46 is a peptide known to exhibit antiviral activity in
non-human primates (NHPs). Thus, a lentiviral-based vector was
developed to express a HIV-specific CAR along with the C46 fusion
inhibitory antiviral peptide to determine whether the CAR construct
prevents or inhibits infection of CAR-expressing effector cells in
NHPs. A vector expressing both C46 and CD4.zeta. CAR as well as an
eGFP reporter was generated to examine the antiviral effects during
SHIV infection in the M. nemestrina model. Specifically, FIG. 10
schematically represents the CD46-CD4.zeta. CAR construct
exemplified herein. The CAR construct has an FG-12-derived
backbone. The inserts are central polypurine tract (cPPT);
EF1.alpha. promoter (EF1.alpha.); C46; Ubiquitin C promoter (UbiC);
EGFP-2A-CD4.zeta. CAR; and wPRE. EGFP fused with CD4.zeta. CAR with
2A peptide sequence serves as a transduction marker.
[0063] The ability of the lentiviral-based vector to transduce
target cells and express the CAR and C46 molecules following
modification of simian peripheral blood mononucleated cells (PBMCs)
and HSCs may be screened using methods known in the art. The
inhibition of SHIV infection and CAR-mediated polyfunctional
responses in vector modified simian peripheral blood cells may be
assayed the methods known in the art. Vectors expressing C46 and
eGFP (without the CAR) or the CD4.zeta. CAR and eGFP (without C46)
may be used as controls.
[0064] For example, to test the ability of newly synthesized
lentiviral vectors, e.g., both single and double vectors containing
C46 and/or the CAR, to effectively transduce and express in target
cells, the respective vectors can be used to transduce simian
PBMCs, in a limiting dilution fashion, following their stimulation
with PHA and Interleukin-2 (IL-2). Vector expression may be
determined by flow cytometry for eGFP and simian host cells and
examined for expression of simian CD3, CD4, CD8. Vector expressing
cells can be assessed for CAR CD4 expression by gating. In
addition, C46 and CAR expression can be examined by Western blot
using antibody probes for the respective proteins of transduced
cell lysates. Transduction efficiencies and viral infectivity
titers can be determined by limiting dilution analysis of vector
expressing cells.
[0065] To determine the ability of these vectors to transduce and
express in HSC and resultant progeny following their
differentiation, simian HSC are transduced with C46 and/or CAR
containing vectors at a multiplicity of infection (MOI) of 5-25
similar to that described by Trobridge, G., et al. (Blood 111,
5537-5543 (2008)). Cells will then be placed in methylcellulose and
hematopoietic colony-forming activity is monitored. Resultant
colonies are assessed for development into erythroid or
myeloid/granulocyte lineages and vector expression is examined on
individual colonies by flow cytometry for eGFP and CD4. Percentages
of cells in each lineage are determined and any alteration in
hematopoietic development is noted between untransduced, C46 and
CAR-only transduced, and C46 and CAR dual vector (Double CAR C46
construct) transduced cells.
[0066] To confirm the protective antiviral effects of the C46
containing vector, groups of simian PBMCs are kept untransduced or
transduced with either the C46 or CAR-only control vectors, or the
Double CAR C46 construct following stimulation with PHA and IL-2.
Three days following transduction, cells will then be exposed to
infectious SHIV at a MOI of 1. Following virus exposure, cell
culture supernatant is assessed for SHIV gag p27 production to
monitor viral replication. A decreased or blocked SHIV replication
in cultures containing cells that express the C46 molecule is
expected.
[0067] The ability of the newly expressed CAR molecule to stimulate
polyfunctional T cell responses in vitro in response to exposure to
SHIV infected cells can be assayed using methods known in the art.
Stimulated simian PBMCs are untransduced or transduced as described
above with C46 or CAR-only control vectors, or the Double CAR C46
construct). Three days following transduction, cells are mixed with
irradiated, syngeneic, previously SHIV-infected PBMCs. Following
exposure, cells are assessed for expression of CD4, CD8 and
interferon-gamma (IFN-.gamma.), IL-2, tumor necrosis factor alpha,
CD107a, and MIP-1.beta. by flow cytometry. In addition, cytolytic
activity is assessed in CAR-containing and control PBMC utilizing
SHIV infected cells as target cells in a standard chromium-51
release assay. CAR ligation of HIV gp120 expressed on infected
cells should induce T cell activation and confirm function of the
receptor.
Triple Car Construct--In Vivo Studies
[0068] Human HSCs were transduced with the Triple CAR construct
(sh1005/sh516/CD4.zeta. CAR, referred to herein as Triple CAR,
Triple CD4.zeta., or Triple CD4.zeta. CAR) and were transplanted
into immunodeficient non-obese diabetic (NOD), severe combined
immunodeficient (SCID), common gamma chain knockout (.gamma.c-/-)
(NSG) mice containing human fetal liver and thymus tissue and
assayed using methods known in the art. Specifically, CD34+ cells
were purified from liver and transduced with lentiviruses
containing the protective CD4.zeta. CAR and then transplanted into
NSG mice with fetal liver stromal element and fetal thymus in
matrigel. 3 weeks after transplantation, the transplant mice were
sublethally irradiated (3Gy), previously frozen CD34+ cells are
thawed and transduced and injected into the mice where the cells
engraft in the bone marrow. 6-12 weeks later, peripheral blood was
collected and analyzed for human cell reconstitution and the mice
were infected with HIV-1.
[0069] Following development of the transplanted tissue and
genetically modified cells, vector-expressing cells in different
organs were assessed. Cells were isolated and analyzed for their
expression of human leucocytes GFP, CD4 and CCR5. Splenocytes from
the CD4.zeta. CAR hu-BLT mice were analyzed by flow cytometry and
gated on human CD45+ and CD4+GFP+ CD4.zeta. CAR expressing cells.
These cells were accessed for surface marker such as T cells
(CD5+), B cells (CD3-CD19+), macrophages/monocytes (CD14+) and NK
cells (CD56+TCRab-CD337).
[0070] It was found that the CD4.zeta. CAR was expressed on a
significant number of cells in the blood, spleen, thymus, and bone
marrow of animals receiving vector modified HSCs, thereby
indicating that these cells undergo hematopoiesis in the
transplanted animals. Additionally, knockdown of CCR5 expression
was observed in vector expressing cells in these animals, thereby
indicating that the shRNA specific to CCR5 is functioning.
Expression of the CD4.zeta. CAR construct on T cells, natural
killer (NK) cells, B cells, and myeloid cells was observed in
transplanted animals, thereby indicating that the genetically
modified HSCs are capable of multilineage hematopoiesis in
vivo.
[0071] The transduction and expression of the CD4.zeta. CAR
containing vector in sorted CD8+ T cells isolated from fresh
peripheral blood mononuclear cells (PBMCs) was examined. Cells
transduced with the Triple CAR construct were compared to cells
transduced with a vector containing only the CD4.zeta. CAR or a
vector containing only eGFP. As shown in FIG. 11A and FIG. 11B,
transduction and expression of the vector(s) resulted in
extracellular CD4 expression and CCR5 knockdown in cells expressing
the Triple CAR Construct.
[0072] As shown in FIG. 11C, the presence of the antiviral shRNAs
protected the cells from infection. In addition, as shown in FIG.
11D, co-incubation of these cells with HIV-infected cells resulted
in the induction of IL-2 and interferon-gamma (IFN-y) compared to
untransduced cells, thereby indicating that the CD4.zeta. CAR is
functionally capable of inducing antiviral responses when expressed
on CD8+ T cells. Thus, the Triple CAR construct protects transduced
cells from HIV infection as well as expresses the CD4.zeta.
CAR.
[0073] In order to assess the functionality of the new CD4.zeta.
CAR expressing cells, humanized mice transplanted with CD4.zeta.
CAR cells were then infected with HIV for 5 weeks. After this
infection time, virologic parameters and immune responses were
assessed. Splenocytes from HIV-1 infected CD4.zeta. CAR mice were
accessed for naive (CD45RA+CD62L+), effector memory (EM)
(CD45RA-CD62L-), central memory (CM) (CD45RA-CD62L+) and effector
memory RA (EMRA) (CD45RA+CD62L-) development. Splenocytes from
HIV-1 infected CD4.zeta. CAR mice were accessed for expression of
activation marker CD38+. As shown in FIG. 12A, HIV infection
resulted in the appearance of CD4.zeta. CAR expressing cells that
possessed an effector phenotype (CD4+eGFP+CD27-CD45RA+/-) that is
not represented in the non-CAR expressing cells. This was similar
to the types of responses that were observed in studies examining
HIV specific T cell responses utilizing a molecularly cloned TCR
against HIV. In addition, as shown in FIG. 12B, these CD4.zeta. CAR
expressing cells have greater levels of the CD38 activation
molecule, thereby indicating the functional recruitment of these
cells in antigen-specific T cell responses to HIV. Cells were then
assessed for virus-specific activation of antiviral responses
during HIV infection. Cells were removed from infected animals and
were then cultured with a virally infected cell line or with
uninfected cells. Shortly following exposure, CD4.zeta. CAR
expressing cells produced INF-.gamma. and TNF-.alpha. in response
to HIV infected cells and did not respond to uninfected cells.
These results show that CD4.zeta. CAR modified cells develop into
effector phenotype and are activated after HIV infection and that
cells carrying the CD4.zeta. CAR were primed in vivo to elicit HIV
specific T cell responses following antigen encounter.
[0074] Splenocytes from the CD4.zeta. mice were accessed and gated
on CD4+GFP+ CD4.zeta. CAR expressing cells. Expression of CD3, CD5,
CD7 and T cell receptor .alpha..beta. were assessed and analyzed by
flow cytometry. Thymocytes from the CD4.zeta. CAR mice and control
GFP mice were assessed for their expression of CD5 and CD3 by flow
cytometry. Thymocytes from the CD4.zeta. CAR and control mice were
sorted based on CD5+ and GFP expression. DNA was purified from the
sorted cells and TCR rearrangement excision circle (TREC) were
measured by real time PCR. CD3 expression on CD4.zeta. CAR
expressing cells was analyzed separately by high or low GFP
expression. Interestingly, while the majority of cells that express
the CD4.zeta. CAR vector that develop in vivo are T cells, as
determined by expression of CD5, CD7, or CD2, there is a
significant population of cells that lack cell surface CD3.epsilon.
expression. Further phenotypic analysis of this population
indicates that these cells have lower levels of endogenous
TCR.alpha..beta. receptor expression, which is necessary for cell
surface expression of CD3. These cells from animals transplanted
with human HSC modified with the CD4.zeta. CAR containing vector or
a vector containing a deletion of the CD4.zeta. CAR solely
expressing the eGFP marker protein were examined. A decrease in
cell surface CD3.epsilon. expression in cells expressing the
CD4.zeta. CAR/eGFP compared to cells expressing the eGFP control
vector in the thymus of transplanted animals was observed. When
these thymocytes were sorted and examined for the levels of T cell
receptor excision circles (TRECs), as shown in FIG. 13A there was a
significant decrease in TREC levels in CD4.zeta. CAR vector
expressing cells compared to control vector expressing cells,
thereby resulting in an approximately 50% decrease in TREC levels.
This indicates that endogenous T cell receptor rearrangement is
shut down as a result or CD4.zeta. CAR expression. FIG. 13B shows a
reduction of CD3 expression on those cells expressing the greatest
levels of the vector, thereby suggesting that higher levels of the
CD4.zeta. CAR on the surface of these developing cells more
effectively turns off endogenous TCR rearrangement. In summary,
these data indicate that genetic modification of human HSCs with a
CD4.zeta. CAR can result in multilineage hematopoiesis and the
production of HIV specific T cells; a significant population of
which that have their endogenous T cell receptor down regulated and
solely express the CD4.zeta. CAR molecule.
[0075] Mice were then examined for infection of CD4.zeta. CAR
expressing cells by intracellular staining for HIV p24Gag antigen.
Specifically, splenocytes from HIV-1 infected, CAR-transduced BLT
mice were analyzed for intracellular gag expression among human
CD45+ cells or CD45+GFP+ CD4.zeta. CAR cells. As shown in FIG. 14,
significantly reduced levels of p24Gag expression were observed in
cells expressing the Triple CAR Construct than in cells not
expressing the construct. This indicates that these cells are
protected from infection through the expression of the antiviral
genes in the construct, allowing them to persist and respond
against HIV in vivo.
[0076] HIV viral load was assessed in PBMCs and suppression of
virus in mice receiving the Triple CAR Construct was observed. The
percentage of GFP+CD4+ CD4.zeta. CAR expressing cells in peripheral
blood before and 5 weeks after infection are accessed by flow
cytometry. As shown in FIG. 15A, when mice reconstituted with
different levels of CD4.zeta. CAR expressing cells were analyzed,
mice that had a greater expansion of cells expressing the CD4.zeta.
CAR vector (high expansion) had almost full suppression of HIV,
whereas animals whose cells had lower levels of expansion did not
have significant suppression of the virus. As shown in FIG. 15B, in
addition to lower viral loads, a better preservation of CD4+ T cell
ratios was observed in animals that had greater levels of cellular
expansion of PBMC expressing the CD4.zeta. CAR vector. FIG. 15C
shows that the levels of cellular expansion correlated with
suppression of the virus. In summary, CD4.zeta. CAR cells
successfully suppress HIV replication in vivo. Thus, in some
embodiments, the present invention is directed to genetically
modifying HSCs, HPCs, or HSPCs with a gene delivery vector
containing a sequence encoding a CD4.zeta. CAR alone or in
combination with one or more antiviral sequences such as a shRNA
(e.g., sh1005 and/or sh516) to provide multilineage reconstitution
of HIV-specific cells that are protected from HIV infection and/or
lower viral loads in vivo following exposure to HIV.
Procedures
[0077] Human fetal tissue was purchased from Advanced Biosciences
Resources or from StemExpress and was obtained without identifying
information and did not require IRB approval for its use. Animal
research described in this manuscript was performed under the
written approval of the UCLA Animal Research Committee (ARC) in
accordance to all federal, state, and local guidelines.
Specifically, these studies were carried out under strict
accordance to the guidelines in The Guide for the Care and Use of
Laboratory Animals of the National Institutes of Health and the
accreditation and guidelines of the Association for the Assessment
and Accreditation of Laboratory Animal Care (AALAC) International
under UCLA ARC Protocol Number 2010-038-02B. All surgeries were
performed under ketamine/xylazine and isofluorane anesthesia and
all efforts were made to minimize animal pain and discomfort.
1. Antibodies and Flow Cytometry
[0078] The following antibodies were used in flow cytometry: CD45,
CD2, CD7, CD5, CD3, CD4, CD8, CD45RA, CD62L, CD38, CD19, CD14,
CD337, CD56, TCR.alpha..beta. (ebiosciences) and anti-HIV-1 core
antigen clone KC57 (Beckman Coulter). Cell surface markers are
conjugated to either FITC, PE, PerCP-Cy5.5, PE-Cy5, PE-Cy7, EVD,
APC, APC-eflou780, alexa700, eflour405, Pacific orange or pacific
blue in appropriate combination. The cells were acquired using
LSRFortessa flow cytometer (BD biosciences) and FACSDiva software.
Data were analyzed using FlowJo software.
2. Lentiviral Vector Production
[0079] The Lentivirus GFP control vector, the CD4.zeta. CAR
Construct, and the Triple CD4.zeta. CAR Construct were produced in
293FT cells using the Invitrogen ViraPower Lentiviral Expression
system with pCMV..DELTA.R8.2..DELTA.vpr packaging plasmid and the
pCMV-VSV-G envelope protein plasmid as previously described (D. M.
Brainard et al., J. Virol. 83, 7305-7321 (2009)).
4. Quantitation of TCR Rearrangement Excision Circles
[0080] Thymocytes from CD4 .zeta.CAR or GFP vector modified mice
were sorted on a FACSaria based on their expression of GFP and CDS.
DNA was extracted from sorted cells using phenol/chloroform. Real
time PCR was used to qualified TREC expression level normalized to
.beta.-globin. Oligos, probes and condition are described
previously (Douek et al., Lancet 355, 1875-1881 (2000)).
Novel Car Production
[0081] As used herein, "CAR constructs" refers to nucleic acid
molecules which comprise CD4, preferably human CD4, fused to the
signaling domain of the CD3 complex .zeta.-chain. CAR constructs
include truncated CAR constructs, Double CAR constructs, and Triple
CAR constructs. As used herein, "truncated CAR constructs" refers
to nucleic acid molecules which comprise a truncated CD4 (e.g.,
comprising only D1, D1+D2, or D1+D2+D3 of CD4, preferably human
CD4), fused to the signaling domain of the CD3 complex
.zeta.-chain. Truncated CAR constructs include truncated Double CAR
constructs, and truncated Triple CAR constructs. As used herein,
"Double CAR constructs" refers to nucleic acid molecules which
comprise CD4, preferably human CD4, fused to the signaling domain
of the CD3 complex .zeta.-chain and one antiviral sequence. As used
herein, "Triple CAR constructs" refers to nucleic acid molecules
which comprise CD4, preferably human CD4, fused to the signaling
domain of the CD3 complex .zeta.-chain and two antiviral sequences.
As used herein, "truncated Double CAR constructs" refers to nucleic
acid molecules which comprise a truncated CD4 (e.g., comprising
only D1, D1+D2, or D1+D2+D3 of CD4, preferably human CD4), fused to
the signaling domain of the CD3 complex .zeta.-chain and one
antiviral sequence. As used herein, "truncated Triple CAR
constructs" refers to nucleic acid molecules which comprise a
truncated CD4 (e.g., comprising only D1, D1+D2, or D1+D2+D3 of CD4,
preferably human CD4), fused to the signaling domain of the CD3
complex .zeta.-chain and two antiviral sequences. The CAR
constructs may further include one or more of the following
sequences: a viral promoter for binding regulator proteins (e.g.,
5' long terminal repeat (LTR)), one or more antiviral sequences
(e.g. sh1005, sh516, C46), a sequence that helps regulate
transcription (e.g., 7SK), a gene promoter (e.g., Ubiquitin C
promoter (UbC)), a reporter gene (e.g., enhanced green fluorescent
protein (EGFP)), and other transcription and expression sequences
such as H1, 2A, poly purine tract (cPPT), elongation factor 1 alpha
(EF1 .alpha.), woodchuck hepatitis post-transcriptional regulatory
element (wPRE), and .DELTA.LTR. Examples of CAR constructs
according to the present invention include CD4.zeta. CAR, Double
CAR C46, Triple CD4.zeta. CAR, CD4D1D2D3CAR, CD4D1D2CAR, CD4D1CAR,
and second generation CAR constructs.
[0082] CAR constructs according to the present invention may be
produced by genetic swapping of the gp120-binding domain and/or
signaling domain in the prototype CD4.zeta. CAR construct. See FIG.
8. One may produce additional CARs with improved functionality. For
example, second generation CAR constructs are produced by swapping
the CD4 domain with Env-binding single-chain broadly neutralizing
antibodies; this single-chain antibody approach was shown to
function in parallel with the CD4.zeta. CAR in early studies and is
the standard CAR approach used for targeting cancer. The genes for
several broadly neutralizing antibodies including b12, X5, 2G12,
4E10, and VRC01 may be used. Single chain versions can be produced
through standard methodology, introducing a flexible linker between
the heavy and light chains. Binding of single chain antibodies to
HIV is compared to the parental antibodies by standard methods. In
addition, truncation and mutation of the CD4 component of CAR
according to the present invention may be produced to eliminate
binding with other natural ligands of CD4 receptor, such as IL-16
and MHCII, to reduce potential nonspecific activation of the
CD4.zeta. CAR. Each of these novel receptors can be produced in two
versions: one with the CD3.zeta. chain signaling domain, and
another with a fusion of the CD3.zeta. chain and the CD28 signaling
domain. This "second generation CAR" strategy may improve the
survival and proliferation of CAR-transduced T-cells by providing a
co-stimulatory "second signal" in addition to the primary T-cell
receptor signal.
[0083] Vectors containing second generation single-chain antibody
CARs, in versions with either the CD28 or 4-1BB signaling domains
in tandem with the CD3 .zeta. chain were modified to allow
convenient replacement of the single-chain domains with new
single-chain genes. In brief, a portion including the Xba I-Sma I
restriction sites (starting just upstream of the single-chain
antibody and ending within the hinge region) was modified in a
secondary vector (pUC19) by point mutagenesis (QuikChange,
Invitrogen) to create an Apa I site in the hinge region through
silent mutations. After confirmation of the correct sequence, the
Xba I-Sma I restriction fragment was swapped into the vectors (also
including a first generation version with only the CD3 .zeta.
chain).
[0084] FIG. 16 schematically shows the CAR vector modification and
strategy to develop CAR constructs according to the present
invention. A map of a CAR construct is shown. Within the Xba I-Sma
I fragment, a silent mutation was introduced in the Hinge region to
introduce an Apa I site (GGCCCT.fwdarw.GGGCCC (SEQ ID NO:1)), and
this fragment was re-introduced into the vector. One plasmid was
generated for each version with different signaling domains
(CD28-.zeta., 4-1BB-.zeta., and .zeta.). New CARs were generated by
synthesizing the single chain antibody and partial hinge sequence
including the Xba I and Apa I sites, and using those enzymes to cut
and ligate the new constructs into the vector.
[0085] Using the three vectors described above (signaling domains:
.zeta., CD28-.zeta., and 4-1BB-.zeta.) novel single chain
antibodies designed from sequences of 7 well-defined broadly
neutralizing antibodies (Table 1) were inserted. Thus, in some
embodiments, second generation CAR constructs according to the
present invention comprises a sequence which encodes one of the
single chain antibody sequences set forth in Table 1 as
follows:
TABLE-US-00001 TABLE 1 Antibody Specificity Sequence VRC01 CD4BS VL
EIVLTQSPGTLSLSPGETAIISCRTSQYGSLAWYQQRPGQAPRLVIYSGSTRAAGIP
DRFSGSRWGPDYNLTISNLESGDFGVYYCQQYEFFGQGTKVQVDIKR (SEQ ID NO: 2) VH
VH MLLLVTSLLLCELPHPAFLLIPQVQLVQSGGQMKKPGESMRISCRASGYEFIDCTLN
WIRLAPGKRPEWMGWLKPRGGAVNYARPLQGRVTMTRDVYSDTAFLELRSLTVDDTA
VYFCTRGKNCDYNWDFEHWGRGTPVIVSS (SEQ ID NO: 3) X5 CD4i VL
ELVLTQSPGTLSLSAGERATLSCRASQSVSSGSLAWYQQKPGQAPRLLIYGASTRAT
GIPDRFSGSGSGTDFTLTIGRLEPEDLAVYYCQQYGTSPYTFGQGTKLEI (SEQ ID NO: 4)
VH MLLLVTSLLLCELPHPAFLLIPLEQSGAEVKKPGSSVQVSCKASGGTFSMYGFNWVR
QAPGHGLEWMGGIIPIFGTSNYAQKFRGRVTFTADQATSTAYMELTNLRSDDTAVYY
CARDFGPDWEDGDSYDGSGRGFFDFWGQGTLVTVSS (SEQ ID NO: 5) PGT126 N-Glycan
VL QSALTQPPSASGSPGQSISISCTGTSNRFVSWYQQHPGKAPKLVIYGVNKRPSGVPD
RFSGSKSGNTASLTVSGLQTDDEAVYYCSSLVGNWDVIFGGGTKLTVL (SEQ ID NO: 6) VH
MLLLVTSLLLCELPHPAFLLIPQPQLQESGPGLVEASETLSLTCTVSGDSTAACDYF
WGWVRQPPGKGLEWIGGLSHCAGYYNTGWTYHNPSLKSRLTISLDTPKNQVFLKLNS
VTAADTAIYYCARFDGEVLVYHDWPKPAWVDLWGRGTLVTVTVSS (SEQ ID NO: 7) PGT128
N-Glycan VL
QSALTQPPSASGSPGQSITISCTGTSNNFVSWYQQHAGKAPKLVIYDVNKRPSGVPD
RFSGSKSGNTASLTVSGLQTDDEAVYYCGSLVGNWDVIFGGGTKLTVL (SEQ ID NO: 8) VH
MLLLVTSLLLCELPHPAFLLIPQPQLQESGPTLVEASETLSLTCAVSGDSTAACNSF
WGWVRQPPGKGLEWVGSLSHCASYWNRGWTYHNPSLKSRLTLALDTPKNLVFLKLNS
VTAADTATYYCARFGGEVLRYTDWPKPAWVDLWGRGTLVTVSS (SEQ ID NO: 9) PG9 V2
VL QSALTQPASVSGSPGQSITISCNGTSNDVGGYESVSWYQQHPGKAPKVVIYDVSKRP
SGVSNRFSGSKSGNTASLTISGLQAEDEGDYYCKSLTSTRRRVFGTGTKLTVL (SEQ ID NO:
10) VH MLLLVTSLLLCELPHPAFLLIPQRLVESGGGVVQPGSSLRLSCAASGFDFSRQGMHW
VRQAPGQGLEWVAFIKYDGSEKYHADSVWGRLSISRDNSKDTLYLQMNSLRVEDTAT
YFCVREAGGPDYRNGYNYYDFYDGYYNYHYMDVWGKGTTVTVSS (SEQ ID NO: 11) 10E8
MPER VL SYELTQETGVSVALGRTVTITCRGDSLRSHYASWYQKKPGQAPILLFYGKNNRPSGV
PDRFSGSASGNRASLTISGAQAEDDAEYYCSSRDKSGSRLSVFGGGTKLTVL (SEQ ID NO:
12) VH MLLLVTSLLLCELPHPAFLLIPEVQLVESGGGLVKPGGSLRLSCSASGFDFDNAWMT
WVRQPPGKGLEWVGRITGPGEGWSVDYAAPVEGRFTISRLNSINFLYLEMNNLRMED
SGLYFCARTGKYYDFWSGYPPGEEYFQDWGRGTLVTVSS (SEQ ID NO: 13) 3BNC117
CD4BS VL DIQMTQSPSSLSASVGDTVTITCQANGYLNWYQQRRGKAPKLLIYDGSKLERGVPSR
FSGRRWGQEYNLTINNLQPEDIATYFCQVYEFVVPGTRLDLKRTVAAP (SEQ ID NO: 14) VH
MLLLVTSLLLCELPHPAFLLIPQVQLLQSGAAVTKPGASVRVSCEASGYNIRDYFIH
WWRQAPGQGLQWVGWINPKTGQPNNPRQFQGRVSLTRHASWDFDTFSFYMDLKALRS
DDTAVYFCARQRSDYWDFDVWGSGTQVTVSSASTKGP (SEQ ID NO: 15)
[0086] The Xba I-Apa I inserts were custom synthesized (GeneArt) as
concatenated heavy chain variable region with linker
(GGGGSGGGGSGGGGS (SEQ ID NO:16)) with light chain variable region,
and then swapped into the three vectors. These 21 CAR constructs
may be used to generate gene delivery vectors to be used in
accordance with the present invention, for example, to transduce
cells, e.g., stem cells, CD8+ T lymphocytes, etc., for functional
testing.
[0087] Truncation of CD4.zeta. CAR is generated by mutagenesis PCR
of the original CAR construct sequentially deleting CD4 D4 domain,
D3-D4 domains, D2-D4 domains. Mutagenesis on the CD4 D1 domain may
also be generated using mutagenesis PCR. FIG. 17 depicts the
various truncation mutants that have been made. FIG. 18
demonstrates how a truncation mutant containing the D1 and D2
domains of CD4, described in FIG. 17, can reduce the ability of
this CAR to allow HIV infection in the context of other protective
genes, which include a CCR5-specific shRNA and HIV-LTR specific
shRNA. These CAR constructs may be used to generate gene delivery
vector to reduce binding of the CD4 component to MHCII. These CAR
constructs may be used to generate gene delivery vectors to be used
in accordance with the present invention as stated above.
ADDITIONAL EXAMPLES
Selection of Stem Cell Type
[0088] CD34+ hematopoietic stem cells have been shown to fully
reconstitute the hematopoietic lineage. Human HSPC can fully
reconstitute human B-cell, T-cell, NK and myeloid lineages in an
advanced humanized mouse model (bone marrow, fetal liver, fetal
thymus-BLT mouse). The introduction of HIV-specific CARs into HSPC
allows differentiation of these cells in vivo into both CD4 and CD8
mature T-cell types expressing the receptor. As disclosed herein,
the surrogate humanized bone marrow, fetal liver and thymus (BLT)
mouse model was to in initial experiments to demonstrate that human
CD34+ HSPCs can be genetically modified with a lentiviral vector
containing a molecularly cloned TCR specific to HIV, and
subsequently develop into mature, fully functional CTL. Importantly
these mature effector cells do not require any particular HLA
molecule to attack target cells.
[0089] Memory T-cells have heterogeneous phenotypes, including
central memory T (T.sub.CM) cells and effector memory T (T.sub.EM)
cells. A new population of stem cell memory T (T.sub.SCM) cells
have been identified and exhibit stem-cell-like qualities of
self-renewal and multipotent differentiation to memory and effector
T-cell subsets. Human T.sub.SCM cells are a memory T-cell subset,
but with a distinct phenotype and gene expression profile from
T.sub.CM and T.sub.EM. They can be clonally expanded after
antigenic stimulation, with enhanced abilities to proliferate and
reconstitute and, importantly, can be serially transplanted in
immunodeficient mice. These cells are multi-potent in generating
T.sub.CM and T.sub.EM cells subsets in vitro. Thus, these cells
exhibit a stem-cell-like behavior, consistent with properties of
mouse T.sub.SCM cells that show enhanced self-renewal and
multi-potency in serial transplantation experiments. Because of the
long-term self-renewal properties and multi-potent differentiation
properties, the T.sub.SCM are ideal for genetic engineering of
T-cell effector activities. Using the methodology of Gattinoni, et
al., the in vitro propagation of T.sub.SCM cells
(CD8+/CD45RA+/CD45RO-/CCR7+/CD62L+/CD95+/CD58+). 67% of T.sub.SCM
differentiated to other subtypes including T.sub.EM
(CD8+/CD45RA-/CD45RO+/CCR7-/CD62L-) and T.sub.CM
(CD8+/CD45RA-/CD45RO+/CCR7+/CD62L+) subsets was achieved (data not
shown).
[0090] T.sub.SCM represent a population of T-cells that do not
require thymic development and transgene expression is limited to
T-cell lineages only. The derivation of T.sub.SCM cells can be
verified using methods known in the art. For example, CD45RA+naive
T-cells are positively isolated from human peripheral blood and
stimulated with anti-CD3/CD28 antibodies in the presence of
GSK-3.beta. inhibitor, TWS119, to inhibit T-cell differentiation
and IL-2 for 14 days. T.sub.SCM cells may be induced in about 5% of
either CD4+ or CD8+ T-cells. T.sub.SCM population can be expanded
from naive precursors in the presence of low doses of IL-7 and
IL-15 (5 ng/ml each) following anti-CD3/CD28 antibodies
stimulation. If desired, one can compare both protocols for
expansion of gene modified T.sub.SCM cells. CD45RA and CD62L naive
T-cells are FACS-sorted and stimulated with anti-CD3/CD28
antibodies in the presence (condition A) or absence (condition B)
of IL-2 and TWS119 for 2 days. Cells are then transduced with DC
CARs and cultured in the presence of either: IL-2 and TWS119
(condition A); or IL-7 and IL-15 (condition B) for 12 days. The
function of transduced T.sub.SCM can be characterized after
differentiation to T.sub.EM cells, e.g., with anti-CD3/CD28
antibodies for 6 days and CTL, cytokine production, and
proliferative activity against HIV using methods known in the
art.
[0091] The ability of T.sub.SCM propagated in vitro to kill HIV
infected cells was tested using a standard CTL chromium release
assay (Yang O. Methods in Molecular Biology. 2009; 485:407-15). The
results summarized in Table 1 show that T2 cells infected with HIV
were killed by T.sub.SCM transduced with CD4.zeta. CAR (Triple CAR)
at a significantly greater level than T.sub.SCM cells not
transduced or transduced with EGFP control vector.
TABLE-US-00002 TABLE 2 CD4.zeta. Specific HIV-1 Infected Cell
Killing Uninfected HIV-1 Infected Untransduced 3.48 .+-. 0.22% 2.80
.+-. 0.01% EGFP 1.04 .+-. 0.09% 1.78 .+-. 0.20% Triple CAR 4.30
.+-. 0.03% 28.20 .+-. 2.56% T2 cells infected with or without HIV-1
NL4-3 (M20A) labeled with Na.sub.2 (.sup.51CrO.sub.4) and incubated
for 3.5 hours with Tscm transduced with or without Triple CAR at a
10:1 ratio. Cytolytic activity determined by analysis of chromium
release.
CD4.zeta. CAR transduced CD4+ and CD8+ T.sub.SCM cells also respond
to HIV-1 infected cells by producing IL-2 and IFN-.gamma. (data not
shown).
[0092] If CAR expression on non-T-cells is undesired, the CAR
constructs may be modified for T-cell specific expression, e.g.,
contain a CD3 .delta. promoter in place of the ubiquitin C promoter
(see FIG. 8).
Engraftment and Differentiation of HSPCs and TSCM Transduced with
Cars in Humanized BLT Mice
[0093] The in vivo repopulation of T-cells derived from HSPC and
T.sub.SCM cells may be assayed using methods known in the art. For
example, for T.sub.SCM derivation, T-cells are isolated from the
spleen, thymic organoid, and/or peripheral blood of BLT mice and
T.sub.SCM cells are cultured as previously described. After
stimulation with anti-CD3/cd28 antibodies for two days, the cells
are transduced with the CAR-containing vector marked with EGFP or,
separately, with a control vector containing only EGFP and then
cultured for a further 12 days. CD34+ HSPCs from fetal liver is
also transduced with the CAR-containing vector or, separately, is
transduced with a control vector containing only EGFP. One million
of CAR vector-transduced cells or control vector containing cells
from HSPCs and T.sub.SCM cells are separately infused intravenously
into irradiated BLT mice. 6-8 weeks post-transplantation for mice
receiving HSPC or T.sub.SCM cells, one may begin analyzing
peripheral blood for EGFP expression and cellular lineage marker
expression on CD3+CD4+ and CD3+CD8+ T-cells, CD19+ B-cells,
CD3-CD56+ NK cells, CD14+ monocytes, CD11c+ dendritic cells every
two weeks for 18 weeks (24 weeks post-transplant) to determine the
maintenance of transduced cells.
[0094] CAR vector expression can also be assessed using flow
cytometry or sorting EGFP+ cells and then performing a Western Blot
for the CAR protein of interest. Antiviral shRNA gene expression
can be assessed in developing cells and in vector expressing cells
by quantitative reverse transcriptase PCR (qRT-PCR) specific for
the shRNA sequences. In addition, one may quantitate absolute cell
counts in peripheral blood samples from the treated subjects for
each cell subset using assay methods known in the art. One may also
assess the effects on the endogenous TCR repertoire to monitor for
skewing of T-cell development by spectratyping EGFP+ sorted
T-cells. Any alterations in hematopoietic development in
vector-modified cells versus unmodified cells may be noted and
further evaluated.
Anti-HIV Activity and Generation of Functional Immune Responses
[0095] Antiviral efficacy and immune function can be assessed in
BLT mice containing CAR vector-modified and unmodified cells
derived from HSPCs, and T.sub.SCM cells. For example, mice
containing either vector modified cells or control EGFP vector
modified cells are assessed following infection with HIV (200 ng
p24) or in uninfected animals. Cellular phenotype, particularly
CD3+CD4+ and CD3+CD8+ cell ratios, and HIV gag p24 expression is
assessed every two weeks following infection by flow cytometry.
Differentiation of vector-modified cells into T.sub.EM phenotype is
monitored using methods known in the art. Plasma viral RNA is
monitored by qRT-PCR for HIV sequences. HIV infection in CD4+
T-cells and in CAR vector expressing cells are assessed following
sorting the EGFP+ population and qPCR for HIV sequences. Viral
mutation and potential immune escape are monitored in plasma viral
RNA by direct sequencing. At sequential times, groups of mice are
assessed for these parameters in the spleen, bone marrow, human
thymus, lymph nodes, and gut for cellular phenotype and virologic
factors.
Effect of CARs on Viral Reservoir
[0096] A latent reservoir has been established in BLT mice (Marsden
M, Kovochich M, Suree N, et al. Journal of Virology.
2012;86(1):339-47). Preliminary data suggest that peripheral blood
T-cells transduced with genes encoding the anti-gag TCR can kill
latently infected cells induced to produce virus by addition of PKC
activators (not shown). Consequently, CAR-expressing cells may be
able to similarly eliminate activated reservoir cells. One may
assess the ability of T-cells from BLT mice expressing CARs to kill
reservoir cells ex vivo, using activated latently infected U1 cells
as targets. One may obtain splenocytes from infected animals
receiving CAR-transduced HSPC and control animals, and determine
levels of activation-inducible (i.e., latent) infection by
subjecting splenocytes to co-stimulation followed by analysis of
intracellular gag p24 expression. Quantitation of relative latent
infection levels can also be achieved using HIV-1 RNA-specific
rqRT-PCR performed on splenocytes co-stimulated ex vivo.
Clonal Tracking of Repopulating Cells in BLT Mice
[0097] Tracking of repopulating cells by monitoring vector
integration sites (VIS) is a powerful method to monitor the
behavior of individual repopulating HSPC clones, for example, to
enumerate the number, frequency, longevity, lineage representation
of clones, and evidence for aberrant clonal growth. One may use
high-throughput methods known in the art. For example, the lineage
potential of individual HSPC clones can be determined by
fractionation of T-cell (CD3+), B-cell (CD19+), and monocytes
(CD14+) from spleen, bone marrow where a sufficient number of cells
can be obtained for FACS sorting, followed by a PQCT assay for VIS
tracking. One may utilize at least 5 animals transplanted for 20-25
weeks following transplant with CAR vector and controls. One may
determine the relative number, frequency, and lineage distribution
of clones using the PQCT assay. Due to antigen-driven immune cell
proliferation, single or pauci-clonal outgrowth of normal
transgenic T-cells may occur. This type of expansion can be
distinguished from potential malignant transformation by a detailed
investigation including blast analysis, karyotype and marker
analysis, genomic position of VIS for oncogene activation, and by
gene profile analysis. Vector and HIV integration sites can be
distinguished by signature mutations within the LTR. Similar
analyses can be performed in T.sub.SCM transplants to monitor
differentiation of T.sub.SCM clones to progeny T.sub.EM and
T.sub.CM.
Bioinformatics Analysis
[0098] Virus integration site (VIS) sequence data can be analyzed
by aligning onto the human reference genome (hg19) with
Burrows-Wheeler Aligner or BLAT (genome.ucsc.edu) by comparing all
sequence reads with Blast software. Homopolymer error correction
(454 reads), sequence filtering, sorting, and enumeration may
performed by custom-made scripts, e.g., those as described
previously (Kim S, et al. Journal of Virology. 2010;
84(22):11771-80). Evidence for insertional mutagenesis through VIS
integration sites can be analyzed by applying the method of
Bayesian Change-Point model to the z-scores (Presson A, et al. BMC
Bioinformatics. 2011; 12(1):367).
In Vivo Activity in the NHP Model
[0099] The engraftment of CAR-transduced HSCs can be assayed in a
NHP model using methods known in the art.
[0100] For example, the ability of autologous, HSCs transduced with
a CAR construct according to the present invention to 1) engraft in
pigtailed macaques, and 2) produce a measurable decrement in plasma
viral load following SHIV challenge may be examined using methods
known in the art.
[0101] To generate cells expressing the optimized CAR- or control
vector in every hematopoietic lineage, one may collect, transduce,
and reinfuse autologous HSCs from mobilized bone marrow. Briefly,
bone marrow hematopoietic cells may be mobilized by administration
of granulocyte colony stimulating factor (GCSF) and stem cell
factor (SCF). Bone marrow aspirates will then be collected,
enriched for CD34.sup.+ HSCs, and transduced with CAR or control
lentiviral vectors. During manipulation of HSCs ex vivo, each
animal will receive a myeloablative conditioning regimen consisting
of 1020 cGy total body irradiation. Following conditioning,
transduced HSCs are reinfused into the animal.
[0102] Engraftment and animal recovery are monitored after
transplant, focusing on an expected reconstitution of neutrophil
and platelet counts 20-30 days after transplant, and CD4/CD8 T-cell
reconstitution over the first 3 months. Any adverse events will
closely be monitored in the animals, including any clinical
symptoms indicating any alterations in cytokine levels or clonal
cell expansion. These are not anticipated, based on the safety from
greater than 500 patient years in the use of the lentiviral vectors
in peripheral T cells. Using established markers for each
hematopoietic subset, including CD3, CD4, CD8, CD14, CD11c, CD56,
and CD19, engraftment of CAR- or vector control-containing cells in
each hematopoietic lineage can be demonstrated.
[0103] Lymphocyte recovery is expected to be observed approximately
3 months after transplant. Following demonstration of engraftment
and CAR marking in hematopoietic subsets, both CAR-expressing
animals and vector control animals are challenged with 10,000
TCID50 of SHIV-C. The viral loads in CAR-expressing and control
animals are compared and positive selection for gene-marked cells
in each condition is monitored.
[0104] PBMCs from CAR-containing and control animals are assessed
for polyfunctional responses to infected cells as described above.
PBMCs are stimulated with irradiated SHIV infected or uninfected
cells and assessed for the expression of CD4, CD8 and
interferon-gamma (IFN-.gamma.), IL-2, tumor necrosis factor alpha,
CD107a, and MIP-1.beta. by flow cytometry.
[0105] The dominant viral quasispecies in the peripheral blood for
mutations in the CD4 binding domain of the gp120 envelope protein
is monitored. The significant development of escape mutations is
not expected, since the SHIV requires CD4 binding for cell entry.
Viral escape is monitored by direct RT-PCR based sequencing of the
dominant quasispecies in the plasma.
[0106] Following transduction of enriched HSCs as described above,
the efficiency of CAR- or control gene marking in bulk leukocytes
and hematopoietic subsets is assayed by flow cytometry and
PCR-based methods in the art. A greater than 5% gene marking in
bulk leukocytes is expected based on past results with lentiviral
transduction of macaque CD34.sup.+ HSCs. Between 1 and 3 months
post-transplant, a more detailed determination regarding gene
marking in reconstituted hematopoietic subsets, including T-cells,
B-cells, monocyte/macrophages, granulocytes, and NK cells, may be
made. Based on past results, it is expected that CAR expression
will be qualitatively comparable in each subset examined.
[0107] Approximately 3 months after transplant, animals are
challenged with SHIV-C by intravenous injection. Past findings in
unprotected animals demonstrate peak viremia of 1-2.times.10.sup.7
viral RNA copies per mL plasma at 2 weeks after challenge; a viral
set point of 10.sup.5 copies/mL is usually reached within 8-10
weeks of challenge. CAR constructs according to the present
invention, when expressed successfully, should provide a
significant decrease in peak viral load and/or viral set point
following SHIV challenge. In addition, enrichment for CAR-protected
T-cells after challenge should be observed, since unprotected will
be lost to infection.
Therapeutics
[0108] One may genetically engineer and enhance the human cellular
immune response against HIV using virus-specific CARs according to
the present invention. In some embodiments, these CARs are
engineered T-cell receptors (TCRs) comprising or consisting of an
HIV envelope recognition domain, a transmembrane domain, and an
intracellular signaling domain that direct T-cells to kill
HIV-infected cells. In some embodiments, the CARs are expressed
within a lentiviral vector together with two shRNAs, sh1005 and
sh516 and/or other gene reagents, which protect transduced cells
from HIV infection.
Desired Dose, Route, and Regimen
[0109] In some embodiments, dosing entails a one-time procedure
involving stem cell mobilization, purification, culture, lentiviral
transduction, and infusion. Transduction would be into either or
both HSPC or T.sub.SCM. This therapy would work well at low-level
transduced cell engraftment that limits other stem cell therapeutic
approaches due to the fact that CAR-containing T-cells are expected
to proliferate in the periphery in response to HIV antigens, like
normal T-cells that start at a frequency of 1 per million. This
harnesses the natural proliferative capacity of stem cells and
mature T-cell progeny to generate key antiviral effector cells.
Transplant could be further combined with engineering of HSPC with
a lentiviral vector expressing only shRNAs to repopulate with a
chimeric hematopoietic system consisting of an HIV-resistant immune
system and CAR effector T-cells.
[0110] The present invention may be used to design a multi-pronged
approach for clinical use of anti-HIV transgenes through
combinations of the following therapeutic vectors and cell delivery
vehicles in order to optimize anti-HIV efficacy: CAR/shRNAs in
HSPC; CAR/shRNAs in T.sub.SCM; and shRNAs in HSPC. Information
regarding each stem cell type is provided below.
Preliminary Preclinical Safety Profile Studies
[0111] Stem cell therapy involves the introduction of therapeutic
genes potentially over the life of an individual. As such,
cytotoxicity or genotoxicity should be evaluated. New signaling
activity of CARs or off-target effects of shRNA may skew normal
hematopoiesis and/or immune function. The following assays can be
used for evaluation of safety/toxicity.
In Vitro Toxicity to Cells and Interferon Responses
[0112] Interferon responses can be induced by viruses and
double-stranded RNA, and can cause adverse effects due to cell
death and inflammation. One may measure evidence of cell death
using, e.g., the Promega CytoTox-Glo assay (intracellular protease
release) and induction of interferon response gene OAS1 using,
e.g., the SBI Interferon Response Detection Kit (quantitative
RT-PCR analysis of IFN-inducible genes).
Genotoxicity--Potential for Insertional Mutagenesis
[0113] Lentiviral vectors have demonstrated a strong safety profile
in clinical trials with more than 265 patient-years of data with no
treatment related serious adverse events reported
(virxsys.com/pages/technology-platforms/lentiviral-vector-platform.php).
Nevertheless, the impact of vector integration on gene expression
and cell functions may be assayed using methods known in the heart.
Additionally, one may monitor the repopulating clones using methods
known in the art, e.g., VIS as described above. Generally,
polyclonal, multi-lineage, multi-tissue repopulation without
aberrant clonal dominance is desirable.
Adverse Effects on Gene Expression
[0114] Off-target effects and signaling defects may result from
shRNA and CAR transgene expression. To minimize shRNA off-target
effects, one may specifically screened for potent shRNAs using
transcriptionally weaker promoters (H1 and 7SK). No adverse effects
have been observed of the dual sh1005/sh516 transduced T-cells in
vitro or in HSPC during in vivo multi-lineage hematopoietic
differentiation in BLT mice.
[0115] Gene profile analysis may be conducted if desired, e.g., if
aberrant phenotypes are observed in mice. Genes which are over-or
under-expressed can be correlated through bioinformatics analysis
with the genomic integration sites, cell surface markers assayed by
flow cytometry, by canonical pathway analysis (Ingenuity) and
homologies between sh1005 and sh516 and sequences within genes that
are under-expressed analyzed by the BLAST program
(//blast.ncbi.nlm.nih.gov/). One may use a vector without the EGFP
reporter gene to utilize a vector suitable for clinical studies.
One may follow vector-transduced cells through the identification
of the specific CAR by flow cytometry or cellular labeling; for
instance, flow cytometry for a specific immunoglobulin
extracellular domain if characterizing a CAR that contains this in
the HIV recognition domain.
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[0204] To the extent necessary to understand or complete the
disclosure of the present invention, all publications, patents, and
patent applications mentioned herein are expressly incorporated by
reference therein to the same extent as though each were
individually so incorporated. It should be noted that the inclusion
of references to journal articles throughout the specification
shall not be construed as any admission that the methods and
compositions of the present invention are anticipated and/or
obvious.
[0205] Having thus described exemplary embodiments of the present
invention, it should be noted by those skilled in the art that the
within disclosures are exemplary only and that various other
alternatives, adaptations, and modifications may be made within the
scope of the present invention. Accordingly, the present invention
is not limited to the specific embodiments as illustrated herein,
but is only limited by the following claims.
Sequence CWU 1
1
16112DNAArtificial SequenceBased on human sequence 1ggccctgggc cc
122104PRTHomo sapiens 2Glu Ile Val Leu Thr Gln Ser Pro Gly Thr Leu
Ser Leu Ser Pro Gly 1 5 10 15 Glu Thr Ala Ile Ile Ser Cys Arg Thr
Ser Gln Tyr Gly Ser Leu Ala 20 25 30 Trp Tyr Gln Gln Arg Pro Gly
Gln Ala Pro Arg Leu Val Ile Tyr Ser 35 40 45 Gly Ser Thr Arg Ala
Ala Gly Ile Pro Asp Arg Phe Ser Gly Ser Arg 50 55 60 Trp Gly Pro
Asp Tyr Asn Leu Thr Ile Ser Asn Leu Glu Ser Gly Asp 65 70 75 80 Phe
Gly Val Tyr Tyr Cys Gln Gln Tyr Glu Phe Phe Gly Gln Gly Thr 85 90
95 Lys Val Gln Val Asp Ile Lys Arg 100 3143PRTHomo sapiens 3Met Leu
Leu Leu Val Thr Ser Leu Leu Leu Cys Glu Leu Pro His Pro 1 5 10 15
Ala Phe Leu Leu Ile Pro Gln Val Gln Leu Val Gln Ser Gly Gly Gln 20
25 30 Met Lys Lys Pro Gly Glu Ser Met Arg Ile Ser Cys Arg Ala Ser
Gly 35 40 45 Tyr Glu Phe Ile Asp Cys Thr Leu Asn Trp Ile Arg Leu
Ala Pro Gly 50 55 60 Lys Arg Pro Glu Trp Met Gly Trp Leu Lys Pro
Arg Gly Gly Ala Val 65 70 75 80 Asn Tyr Ala Arg Pro Leu Gln Gly Arg
Val Thr Met Thr Arg Asp Val 85 90 95 Tyr Ser Asp Thr Ala Phe Leu
Glu Leu Arg Ser Leu Thr Val Asp Asp 100 105 110 Thr Ala Val Tyr Phe
Cys Thr Arg Gly Lys Asn Cys Asp Tyr Asn Trp 115 120 125 Asp Phe Glu
His Trp Gly Arg Gly Thr Pro Val Ile Val Ser Ser 130 135 140
4107PRTHomo sapiens 4Glu Leu Val Leu Thr Gln Ser Pro Gly Thr Leu
Ser Leu Ser Ala Gly 1 5 10 15 Glu Arg Ala Thr Leu Ser Cys Arg Ala
Ser Gln Ser Val Ser Ser Gly 20 25 30 Ser Leu Ala Trp Tyr Gln Gln
Lys Pro Gly Gln Ala Pro Arg Leu Leu 35 40 45 Ile Tyr Gly Ala Ser
Thr Arg Ala Thr Gly Ile Pro Asp Arg Phe Ser 50 55 60 Gly Ser Gly
Ser Gly Thr Asp Phe Thr Leu Thr Ile Gly Arg Leu Glu 65 70 75 80 Pro
Glu Asp Leu Ala Val Tyr Tyr Cys Gln Gln Tyr Gly Thr Ser Pro 85 90
95 Tyr Thr Phe Gly Gln Gly Thr Lys Leu Glu Ile 100 105 5150PRTHomo
sapiens 5Met Leu Leu Leu Val Thr Ser Leu Leu Leu Cys Glu Leu Pro
His Pro 1 5 10 15 Ala Phe Leu Leu Ile Pro Leu Glu Gln Ser Gly Ala
Glu Val Lys Lys 20 25 30 Pro Gly Ser Ser Val Gln Val Ser Cys Lys
Ala Ser Gly Gly Thr Phe 35 40 45 Ser Met Tyr Gly Phe Asn Trp Val
Arg Gln Ala Pro Gly His Gly Leu 50 55 60 Glu Trp Met Gly Gly Ile
Ile Pro Ile Phe Gly Thr Ser Asn Tyr Ala 65 70 75 80 Gln Lys Phe Arg
Gly Arg Val Thr Phe Thr Ala Asp Gln Ala Thr Ser 85 90 95 Thr Ala
Tyr Met Glu Leu Thr Asn Leu Arg Ser Asp Asp Thr Ala Val 100 105 110
Tyr Tyr Cys Ala Arg Asp Phe Gly Pro Asp Trp Glu Asp Gly Asp Ser 115
120 125 Tyr Asp Gly Ser Gly Arg Gly Phe Phe Asp Phe Trp Gly Gln Gly
Thr 130 135 140 Leu Val Thr Val Ser Ser 145 150 6105PRTHomo sapiens
6Gln Ser Ala Leu Thr Gln Pro Pro Ser Ala Ser Gly Ser Pro Gly Gln 1
5 10 15 Ser Ile Ser Ile Ser Cys Thr Gly Thr Ser Asn Arg Phe Val Ser
Trp 20 25 30 Tyr Gln Gln His Pro Gly Lys Ala Pro Lys Leu Val Ile
Tyr Gly Val 35 40 45 Asn Lys Arg Pro Ser Gly Val Pro Asp Arg Phe
Ser Gly Ser Lys Ser 50 55 60 Gly Asn Thr Ala Ser Leu Thr Val Ser
Gly Leu Gln Thr Asp Asp Glu 65 70 75 80 Ala Val Tyr Tyr Cys Ser Ser
Leu Val Gly Asn Trp Asp Val Ile Phe 85 90 95 Gly Gly Gly Thr Lys
Leu Thr Val Leu 100 105 7159PRTHomo sapiens 7Met Leu Leu Leu Val
Thr Ser Leu Leu Leu Cys Glu Leu Pro His Pro 1 5 10 15 Ala Phe Leu
Leu Ile Pro Gln Pro Gln Leu Gln Glu Ser Gly Pro Gly 20 25 30 Leu
Val Glu Ala Ser Glu Thr Leu Ser Leu Thr Cys Thr Val Ser Gly 35 40
45 Asp Ser Thr Ala Ala Cys Asp Tyr Phe Trp Gly Trp Val Arg Gln Pro
50 55 60 Pro Gly Lys Gly Leu Glu Trp Ile Gly Gly Leu Ser His Cys
Ala Gly 65 70 75 80 Tyr Tyr Asn Thr Gly Trp Thr Tyr His Asn Pro Ser
Leu Lys Ser Arg 85 90 95 Leu Thr Ile Ser Leu Asp Thr Pro Lys Asn
Gln Val Phe Leu Lys Leu 100 105 110 Asn Ser Val Thr Ala Ala Asp Thr
Ala Ile Tyr Tyr Cys Ala Arg Phe 115 120 125 Asp Gly Glu Val Leu Val
Tyr His Asp Trp Pro Lys Pro Ala Trp Val 130 135 140 Asp Leu Trp Gly
Arg Gly Thr Leu Val Thr Val Thr Val Ser Ser 145 150 155 8105PRTHomo
sapiens 8Gln Ser Ala Leu Thr Gln Pro Pro Ser Ala Ser Gly Ser Pro
Gly Gln 1 5 10 15 Ser Ile Thr Ile Ser Cys Thr Gly Thr Ser Asn Asn
Phe Val Ser Trp 20 25 30 Tyr Gln Gln His Ala Gly Lys Ala Pro Lys
Leu Val Ile Tyr Asp Val 35 40 45 Asn Lys Arg Pro Ser Gly Val Pro
Asp Arg Phe Ser Gly Ser Lys Ser 50 55 60 Gly Asn Thr Ala Ser Leu
Thr Val Ser Gly Leu Gln Thr Asp Asp Glu 65 70 75 80 Ala Val Tyr Tyr
Cys Gly Ser Leu Val Gly Asn Trp Asp Val Ile Phe 85 90 95 Gly Gly
Gly Thr Lys Leu Thr Val Leu 100 105 9157PRTHomo sapiens 9Met Leu
Leu Leu Val Thr Ser Leu Leu Leu Cys Glu Leu Pro His Pro 1 5 10 15
Ala Phe Leu Leu Ile Pro Gln Pro Gln Leu Gln Glu Ser Gly Pro Thr 20
25 30 Leu Val Glu Ala Ser Glu Thr Leu Ser Leu Thr Cys Ala Val Ser
Gly 35 40 45 Asp Ser Thr Ala Ala Cys Asn Ser Phe Trp Gly Trp Val
Arg Gln Pro 50 55 60 Pro Gly Lys Gly Leu Glu Trp Val Gly Ser Leu
Ser His Cys Ala Ser 65 70 75 80 Tyr Trp Asn Arg Gly Trp Thr Tyr His
Asn Pro Ser Leu Lys Ser Arg 85 90 95 Leu Thr Leu Ala Leu Asp Thr
Pro Lys Asn Leu Val Phe Leu Lys Leu 100 105 110 Asn Ser Val Thr Ala
Ala Asp Thr Ala Thr Tyr Tyr Cys Ala Arg Phe 115 120 125 Gly Gly Glu
Val Leu Arg Tyr Thr Asp Trp Pro Lys Pro Ala Trp Val 130 135 140 Asp
Leu Trp Gly Arg Gly Thr Leu Val Thr Val Ser Ser 145 150 155
10110PRTHomo sapiens 10Gln Ser Ala Leu Thr Gln Pro Ala Ser Val Ser
Gly Ser Pro Gly Gln 1 5 10 15 Ser Ile Thr Ile Ser Cys Asn Gly Thr
Ser Asn Asp Val Gly Gly Tyr 20 25 30 Glu Ser Val Ser Trp Tyr Gln
Gln His Pro Gly Lys Ala Pro Lys Val 35 40 45 Val Ile Tyr Asp Val
Ser Lys Arg Pro Ser Gly Val Ser Asn Arg Phe 50 55 60 Ser Gly Ser
Lys Ser Gly Asn Thr Ala Ser Leu Thr Ile Ser Gly Leu 65 70 75 80 Gln
Ala Glu Asp Glu Gly Asp Tyr Tyr Cys Lys Ser Leu Thr Ser Thr 85 90
95 Arg Arg Arg Val Phe Gly Thr Gly Thr Lys Leu Thr Val Leu 100 105
110 11158PRTHomo sapiens 11Met Leu Leu Leu Val Thr Ser Leu Leu Leu
Cys Glu Leu Pro His Pro 1 5 10 15 Ala Phe Leu Leu Ile Pro Gln Arg
Leu Val Glu Ser Gly Gly Gly Val 20 25 30 Val Gln Pro Gly Ser Ser
Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe 35 40 45 Asp Phe Ser Arg
Gln Gly Met His Trp Val Arg Gln Ala Pro Gly Gln 50 55 60 Gly Leu
Glu Trp Val Ala Phe Ile Lys Tyr Asp Gly Ser Glu Lys Tyr 65 70 75 80
His Ala Asp Ser Val Trp Gly Arg Leu Ser Ile Ser Arg Asp Asn Ser 85
90 95 Lys Asp Thr Leu Tyr Leu Gln Met Asn Ser Leu Arg Val Glu Asp
Thr 100 105 110 Ala Thr Tyr Phe Cys Val Arg Glu Ala Gly Gly Pro Asp
Tyr Arg Asn 115 120 125 Gly Tyr Asn Tyr Tyr Asp Phe Tyr Asp Gly Tyr
Tyr Asn Tyr His Tyr 130 135 140 Met Asp Val Trp Gly Lys Gly Thr Thr
Val Thr Val Ser Ser 145 150 155 12109PRTHomo sapiens 12Ser Tyr Glu
Leu Thr Gln Glu Thr Gly Val Ser Val Ala Leu Gly Arg 1 5 10 15 Thr
Val Thr Ile Thr Cys Arg Gly Asp Ser Leu Arg Ser His Tyr Ala 20 25
30 Ser Trp Tyr Gln Lys Lys Pro Gly Gln Ala Pro Ile Leu Leu Phe Tyr
35 40 45 Gly Lys Asn Asn Arg Pro Ser Gly Val Pro Asp Arg Phe Ser
Gly Ser 50 55 60 Ala Ser Gly Asn Arg Ala Ser Leu Thr Ile Ser Gly
Ala Gln Ala Glu 65 70 75 80 Asp Asp Ala Glu Tyr Tyr Cys Ser Ser Arg
Asp Lys Ser Gly Ser Arg 85 90 95 Leu Ser Val Phe Gly Gly Gly Thr
Lys Leu Thr Val Leu 100 105 13153PRTHomo sapiens 13Met Leu Leu Leu
Val Thr Ser Leu Leu Leu Cys Glu Leu Pro His Pro 1 5 10 15 Ala Phe
Leu Leu Ile Pro Glu Val Gln Leu Val Glu Ser Gly Gly Gly 20 25 30
Leu Val Lys Pro Gly Gly Ser Leu Arg Leu Ser Cys Ser Ala Ser Gly 35
40 45 Phe Asp Phe Asp Asn Ala Trp Met Thr Trp Val Arg Gln Pro Pro
Gly 50 55 60 Lys Gly Leu Glu Trp Val Gly Arg Ile Thr Gly Pro Gly
Glu Gly Trp 65 70 75 80 Ser Val Asp Tyr Ala Ala Pro Val Glu Gly Arg
Phe Thr Ile Ser Arg 85 90 95 Leu Asn Ser Ile Asn Phe Leu Tyr Leu
Glu Met Asn Asn Leu Arg Met 100 105 110 Glu Asp Ser Gly Leu Tyr Phe
Cys Ala Arg Thr Gly Lys Tyr Tyr Asp 115 120 125 Phe Trp Ser Gly Tyr
Pro Pro Gly Glu Glu Tyr Phe Gln Asp Trp Gly 130 135 140 Arg Gly Thr
Leu Val Thr Val Ser Ser 145 150 14105PRTHomo sapiens 14Asp Ile Gln
Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val Gly 1 5 10 15 Asp
Thr Val Thr Ile Thr Cys Gln Ala Asn Gly Tyr Leu Asn Trp Tyr 20 25
30 Gln Gln Arg Arg Gly Lys Ala Pro Lys Leu Leu Ile Tyr Asp Gly Ser
35 40 45 Lys Leu Glu Arg Gly Val Pro Ser Arg Phe Ser Gly Arg Arg
Trp Gly 50 55 60 Gln Glu Tyr Asn Leu Thr Ile Asn Asn Leu Gln Pro
Glu Asp Ile Ala 65 70 75 80 Thr Tyr Phe Cys Gln Val Tyr Glu Phe Val
Val Pro Gly Thr Arg Leu 85 90 95 Asp Leu Lys Arg Thr Val Ala Ala
Pro 100 105 15151PRTHomo sapiens 15Met Leu Leu Leu Val Thr Ser Leu
Leu Leu Cys Glu Leu Pro His Pro 1 5 10 15 Ala Phe Leu Leu Ile Pro
Gln Val Gln Leu Leu Gln Ser Gly Ala Ala 20 25 30 Val Thr Lys Pro
Gly Ala Ser Val Arg Val Ser Cys Glu Ala Ser Gly 35 40 45 Tyr Asn
Ile Arg Asp Tyr Phe Ile His Trp Trp Arg Gln Ala Pro Gly 50 55 60
Gln Gly Leu Gln Trp Val Gly Trp Ile Asn Pro Lys Thr Gly Gln Pro 65
70 75 80 Asn Asn Pro Arg Gln Phe Gln Gly Arg Val Ser Leu Thr Arg
His Ala 85 90 95 Ser Trp Asp Phe Asp Thr Phe Ser Phe Tyr Met Asp
Leu Lys Ala Leu 100 105 110 Arg Ser Asp Asp Thr Ala Val Tyr Phe Cys
Ala Arg Gln Arg Ser Asp 115 120 125 Tyr Trp Asp Phe Asp Val Trp Gly
Ser Gly Thr Gln Val Thr Val Ser 130 135 140 Ser Ala Ser Thr Lys Gly
Pro 145 150 1615DNAArtificial SequencePrimer based on human
sequence 16ggggsggggs ggggs 15
* * * * *