1. Transfer of gene-corrected T cells corrects humoral and cytotoxic defects in patients with X-linked lymphoproliferative disease
- Author
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Neelam, Panchal, Ben, Houghton, Begona, Diez, Sujal, Ghosh, Ida, Ricciardelli, Adrian J, Thrasher, H Bobby, Gaspar, and Claire, Booth
- Subjects
XLP, X-linked lymphoproliferative disease ,MOI, Multiplicity of infection ,PD-1, Programmed cell death protein 1 ,CTL, Cytotoxic T lymphocyte ,HVS, Herpesvirus saimiri ,Article ,HSCT, Hematopoietic stem cell transplantation ,Mice ,follicular helper T cells ,NK, Natural killer ,NP-CGG, 4-hydroxy-3-nitrophenylacetly conjugated chicken gammaglobulin ,SAP, SLAM-associated protein ,Animals ,Humans ,Signaling Lymphocytic Activation Molecule Associated Protein ,LCL, Lymphoblastoid cell line ,T-cell gene therapy ,TFH, T follicular helper ,Gene Transfer Techniques ,T-cell cytotoxicity ,Genetic Therapy ,PE, Phycoerythrin ,Lymphoproliferative Disorders ,HLH, Hemophagocytic lymphohistiocytosis ,BV, Brilliant Violet ,Heterografts ,X-linked lymphoproliferative disease ,T-Lymphocytes, Cytotoxic - Abstract
Background X-linked lymphoproliferative disease 1 arises from mutations in the SH2D1A gene encoding SLAM-associated protein (SAP), an adaptor protein expressed in T, natural killer (NK), and NKT cells. Defects lead to abnormalities of T-cell and NK cell cytotoxicity and T cell–dependent humoral function. Clinical manifestations include hemophagocytic lymphohistiocytosis, lymphoma, and dysgammaglobulinemia. Curative treatment is limited to hematopoietic stem cell transplantation, with outcomes reliant on a good donor match. Objectives Because most symptoms arise from defective T-cell function, we investigated whether transfer of SAP gene–corrected T cells could reconstitute known effector cell defects. Methods CD3+ lymphocytes from Sap-deficient mice were transduced with a gammaretroviral vector encoding human SAP cDNA before transfer into sublethally irradiated Sap-deficient recipients. After immunization with the T-dependent antigen 4-hydroxy-3-nitrophenylacetly chicken gammaglobulin (NP-CGG), recovery of humoral function was evaluated through germinal center formation and antigen-specific responses. To efficiently transduce CD3+ cells from patients, we generated an equivalent lentiviral SAP vector. Functional recovery was demonstrated by using in vitro cytotoxicity and T follicular helper cell function assays alongside tumor clearance in an in vivo lymphoblastoid cell line lymphoma xenograft model. Results In Sap-deficient mice 20% to 40% engraftment of gene-modified T cells led to significant recovery of germinal center formation and NP-specific antibody responses. Gene-corrected T cells from patients demonstrated improved cytotoxicity and T follicular helper cell function in vitro. Adoptive transfer of gene-corrected cytotoxic T lymphocytes from patients reduced tumor burden to a level comparable with that seen in healthy donor cytotoxic T lymphocytes in an in vivo lymphoma model. Conclusions These data demonstrate that autologous T-cell gene therapy corrects SAP-dependent defects and might offer an alternative therapeutic option for patients with X-linked lymphoproliferative disease 1.
- Published
- 2017