A Phase I Clinical Trial with Ex Vivo Expanded Recipient Regulatory T cells in Living Donor Kidney Transplants
There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion...
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Published in | Scientific reports Vol. 8; no. 1; pp. 7428 - 12 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
Nature Publishing Group UK
09.05.2018
Nature Publishing Group Nature Portfolio |
Subjects | |
Online Access | Get full text |
ISSN | 2045-2322 2045-2322 |
DOI | 10.1038/s41598-018-25574-7 |
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Abstract | There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of
ex vivo
expanded recipient polyclonal Tregs into living donor kidney transplant recipients. Despite variability in recipient’s renal disease, our expansion protocol produced Tregs which met all release criteria, expressing >98% CD4
+
CD25
+
with <1% CD8
+
and CD19
+
contamination. Our product displayed >80% FOXP3 expression with stable demethylation in the FOXP3 promoter. Functionally, expanded Tregs potently suppressed allogeneic responses and induced the generation of new Tregs in the recipient’s allo-responders
in vitro
. Within recipients, expanded Tregs amplified circulating Treg levels in a sustained manner. Clinically, all doses of Treg therapy tested were safe with no adverse infusion related side effects, infections or rejection events up to two years post-transplant. This study provides the necessary safety data to advance Treg cell therapy to phase II efficacy trials. |
---|---|
AbstractList | There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients. Despite variability in recipient’s renal disease, our expansion protocol produced Tregs which met all release criteria, expressing >98% CD4+CD25+ with <1% CD8+ and CD19+ contamination. Our product displayed >80% FOXP3 expression with stable demethylation in the FOXP3 promoter. Functionally, expanded Tregs potently suppressed allogeneic responses and induced the generation of new Tregs in the recipient’s allo-responders in vitro. Within recipients, expanded Tregs amplified circulating Treg levels in a sustained manner. Clinically, all doses of Treg therapy tested were safe with no adverse infusion related side effects, infections or rejection events up to two years post-transplant. This study provides the necessary safety data to advance Treg cell therapy to phase II efficacy trials. There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients. Despite variability in recipient's renal disease, our expansion protocol produced Tregs which met all release criteria, expressing >98% CD4+CD25+ with <1% CD8+ and CD19+ contamination. Our product displayed >80% FOXP3 expression with stable demethylation in the FOXP3 promoter. Functionally, expanded Tregs potently suppressed allogeneic responses and induced the generation of new Tregs in the recipient's allo-responders in vitro. Within recipients, expanded Tregs amplified circulating Treg levels in a sustained manner. Clinically, all doses of Treg therapy tested were safe with no adverse infusion related side effects, infections or rejection events up to two years post-transplant. This study provides the necessary safety data to advance Treg cell therapy to phase II efficacy trials.There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients. Despite variability in recipient's renal disease, our expansion protocol produced Tregs which met all release criteria, expressing >98% CD4+CD25+ with <1% CD8+ and CD19+ contamination. Our product displayed >80% FOXP3 expression with stable demethylation in the FOXP3 promoter. Functionally, expanded Tregs potently suppressed allogeneic responses and induced the generation of new Tregs in the recipient's allo-responders in vitro. Within recipients, expanded Tregs amplified circulating Treg levels in a sustained manner. Clinically, all doses of Treg therapy tested were safe with no adverse infusion related side effects, infections or rejection events up to two years post-transplant. This study provides the necessary safety data to advance Treg cell therapy to phase II efficacy trials. There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients. Despite variability in recipient’s renal disease, our expansion protocol produced Tregs which met all release criteria, expressing >98% CD4 + CD25 + with <1% CD8 + and CD19 + contamination. Our product displayed >80% FOXP3 expression with stable demethylation in the FOXP3 promoter. Functionally, expanded Tregs potently suppressed allogeneic responses and induced the generation of new Tregs in the recipient’s allo-responders in vitro . Within recipients, expanded Tregs amplified circulating Treg levels in a sustained manner. Clinically, all doses of Treg therapy tested were safe with no adverse infusion related side effects, infections or rejection events up to two years post-transplant. This study provides the necessary safety data to advance Treg cell therapy to phase II efficacy trials. Abstract There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients. Despite variability in recipient’s renal disease, our expansion protocol produced Tregs which met all release criteria, expressing >98% CD4+CD25+ with <1% CD8+ and CD19+ contamination. Our product displayed >80% FOXP3 expression with stable demethylation in the FOXP3 promoter. Functionally, expanded Tregs potently suppressed allogeneic responses and induced the generation of new Tregs in the recipient’s allo-responders in vitro. Within recipients, expanded Tregs amplified circulating Treg levels in a sustained manner. Clinically, all doses of Treg therapy tested were safe with no adverse infusion related side effects, infections or rejection events up to two years post-transplant. This study provides the necessary safety data to advance Treg cell therapy to phase II efficacy trials. There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients. Despite variability in recipient's renal disease, our expansion protocol produced Tregs which met all release criteria, expressing >98% CD4 CD25 with <1% CD8 and CD19 contamination. Our product displayed >80% FOXP3 expression with stable demethylation in the FOXP3 promoter. Functionally, expanded Tregs potently suppressed allogeneic responses and induced the generation of new Tregs in the recipient's allo-responders in vitro. Within recipients, expanded Tregs amplified circulating Treg levels in a sustained manner. Clinically, all doses of Treg therapy tested were safe with no adverse infusion related side effects, infections or rejection events up to two years post-transplant. This study provides the necessary safety data to advance Treg cell therapy to phase II efficacy trials. |
ArticleNumber | 7428 |
Author | He, Jie Stratton, Cheryl Ansari, Mohammed Javeed LeFever, Ann Konieczna, Iwona Huang, Xuemei H.-Voss, Jessica Gallon, Lorenzo Skaro, Anton Mathew, James M. Leventhal, Joseph R. |
Author_xml | – sequence: 1 givenname: James M. orcidid: 0000-0002-5667-750X surname: Mathew fullname: Mathew, James M. email: james-mathew@northwestern.edu organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Department of Microbiology and Immunology, Feinberg School of Medicine, Northwestern University – sequence: 2 givenname: Jessica surname: H.-Voss fullname: H.-Voss, Jessica organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University – sequence: 3 givenname: Ann surname: LeFever fullname: LeFever, Ann organization: Mathews Center for Cellular Therapy, Northwestern Memorial Hospital – sequence: 4 givenname: Iwona surname: Konieczna fullname: Konieczna, Iwona organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University – sequence: 5 givenname: Cheryl surname: Stratton fullname: Stratton, Cheryl organization: Mathews Center for Cellular Therapy, Northwestern Memorial Hospital – sequence: 6 givenname: Jie surname: He fullname: He, Jie organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University – sequence: 7 givenname: Xuemei surname: Huang fullname: Huang, Xuemei organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University – sequence: 8 givenname: Lorenzo surname: Gallon fullname: Gallon, Lorenzo organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Department of Medicine, Division of Nephrology, Feinberg School of Medicine, Northwestern University – sequence: 9 givenname: Anton surname: Skaro fullname: Skaro, Anton organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University – sequence: 10 givenname: Mohammed Javeed surname: Ansari fullname: Ansari, Mohammed Javeed organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Department of Medicine, Division of Nephrology, Feinberg School of Medicine, Northwestern University – sequence: 11 givenname: Joseph R. surname: Leventhal fullname: Leventhal, Joseph R. email: jleventh@nm.org organization: Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, TRACT Therapeutics |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29743501$$D View this record in MEDLINE/PubMed |
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10.1126/scitranslmed.aad4134 – volume: 17 start-page: 349 year: 2012 ident: 25574_CR43 publication-title: Curr Opin Organ Transplant doi: 10.1097/MOT.0b013e328355a992 – volume: 29 start-page: 396 year: 2015 ident: 25574_CR29 publication-title: Leukemia doi: 10.1038/leu.2014.180 – volume: 11 start-page: e0148474 year: 2016 ident: 25574_CR30 publication-title: PLoS ONE [Electronic Resource] doi: 10.1371/journal.pone.0148474 – volume: 331 start-page: 365 year: 1994 ident: 25574_CR4 publication-title: N Engl J Med doi: 10.1056/NEJM199408113310606 – volume: 63 start-page: 977 year: 1997 ident: 25574_CR13 publication-title: Transplantation doi: 10.1097/00007890-199704150-00013 – volume: 100 start-page: 39 year: 2016 ident: 25574_CR53 publication-title: Transplantation doi: 10.1097/TP.0000000000000869 – volume: 99 start-page: 1774 year: 2015 ident: 25574_CR27 publication-title: Transplantation doi: 10.1097/TP.0000000000000717 |
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Snippet | There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have... Abstract There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical... |
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Title | A Phase I Clinical Trial with Ex Vivo Expanded Recipient Regulatory T cells in Living Donor Kidney Transplants |
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