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T-cell gene therapy for perforin deficiency corrects cytotoxicity defects and prevents hemophagocytic lymphohistiocytosis manifestations - 06/09/18

Doi : 10.1016/j.jaci.2017.11.050 
Sujal Ghosh, MD a, b, Marlene Carmo, PhD a, Miguel Calero-Garcia, PhD a, Ida Ricciardelli, PhD a, Juan Carlos Bustamante Ogando, MD a, Michael P. Blundell, PhD a, Axel Schambach, MD, PhD c, Philip G. Ashton-Rickardt, PhD d, Claire Booth, MBBS, PhD a, Stephan Ehl, MD, PhD e, Kai Lehmberg, MD, PhD f, Adrian J. Thrasher, MBBS, PhD a, H. Bobby Gaspar, MBBS, PhD a,
a Infection, Immunity, Inflammation, Molecular and Cellular Immunology Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom 
b Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Center of Child and Adolescent Health, Heinrich-Heine-University, Dusseldorf, Germany 
c Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany 
d Section of Immunobiology, Division of Inflammation and Immunology, Department of Medicine, Faculty of Medicine, Imperial College, London, United Kingdom 
e Center for Chronic Immunodeficiency, University Medical Center, University of Freiburg, Freiburg, Germany 
f Department of Paediatric Haematology and Oncology, Division of Paediatric Stem Cell Transplantation and Immunology, University Medical Centre Hamburg-Eppendorf, Hamburg-Eppendorf, Germany 

Corresponding author: H. Bobby Gaspar, MBBS, PhD, Infection, Immunity, Inflammation, Molecular and Cellular Immunology Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London WC1N 1EH, United Kingdom.Infection, Immunity, Inflammation, Molecular and Cellular Immunology SectionUCL Great Ormond Street Institute of Child Health30 Guilford StLondonWC1N 1EHUnited Kingdom

Abstract

Background

Mutations in the perforin 1 (PRF1) gene account for up to 58% of familial hemophagocytic lymphohistiocytosis syndromes. The resulting defects in effector cell cytotoxicity lead to hypercytokinemia and hyperactivation with inflammation in various organs.

Objective

We sought to determine whether autologous gene-corrected T cells can restore cytotoxic function, reduce disease activity, and prevent hemophagocytic lymphohistiocytosis (HLH) symptoms in in vivo models.

Methods

We developed a gammaretroviral vector to transduce murine CD8 T cells in the Prf−/− mouse model. To verify functional correction of Prf−/− CD8 T cells in vivo, we used a lymphocytic choriomeningitis virus (LCMV) epitope–transfected murine lung carcinoma cell tumor model. Furthermore, we challenged gene-corrected and uncorrected mice with LCMV. One patient sample was transduced with a PRF1-encoding lentiviral vector to study restoration of cytotoxicity in human cells.

Results

We demonstrated efficient engraftment and functional reconstitution of cytotoxicity after intravenous administration of gene-corrected Prf−/− CD8 T cells into Prf−/− mice. In the tumor model infusion of Prf−/− gene–corrected CD8 T cells eliminated the tumor as efficiently as transplantation of wild-type CD8 T cells. Similarly, mice reconstituted with gene-corrected Prf−/− CD8 T cells displayed complete protection from the HLH phenotype after infection with LCMV. Patients' cells showed correction of cytotoxicity in human CD8 T cells after transduction.

Conclusion

These data demonstrate the potential application of T-cell gene therapy in reconstituting cytotoxic function and protection against HLH in the setting of perforin deficiency.

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Key words : Gene therapy, hemophagocytic lymphohistiocytosis, perforin deficiency, T cells

Abbreviations used : FHL, GFP, HLH, HSCT, IRES, LCMV, NK, PRF1, PS, TCM, TEM, WT


Plan


 Supported by grants from the German Research Foundation–Deutsche Forschungsgemeinschaft (grant no. GH 154/1-1 to S.G. and SFB1160, TP1 to S.E.), the Histiocytosis Research Trust and UCL Therapeutics Innovation Fund (to M.C.), the Wellcome Trust (to A.J.T.), the DAAD and the German Federal Ministry of Research and Education (to A.S.), the European Commission's 7th Framework Program Contract 261387 (CELL-PID), and grant MR/L012855/1 from the Medical Research Council. The authors would like to acknowledge the support of Great Ormond Street Hospital Children's Charity (to H.B.G.). This study was also supported by the National Institute of Health Research Biomedical Research Centre at Great Ormond Street Hospital and University College London.
 Disclosure of potential conflict of interest: S. Ghosh received a grant from the DFG (German Research Foundation) for this work. M. Carmo's institution received grants from the Medical Research Council (MRC) and the Histiocytosis Research Trust for this work and is employed by GlaxoSmithKline. M. Calero-Garcia is employed by GlaxoSmithKline. A. Schambach's institution received a grant from SCIDNET and CELLPID for this work and is employed by Hannover Medical School. S. Ehl's institution received a grant from BMBF and DFG for this work and from UCB for other works, and he personally received consultancy fees from UCB. A. J. Thrasher received board membership and consultancy fees from Orchard Therapeutics, Torus, and Rocket Pharmaceuticals and holds stock options from Orchard Therapeutics and Torus. H. B. Gaspar received board membership, consultancy fees, and stock options from Orchard Therapeutics. The rest of the authors declare that they have no relevant conflicts of interest.


© 2018  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
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