Background: In vitro generation and expansion of leukemia-reactive T cells may improve the efficacy and specificity of cellular immunotherapy against hematologic malignancies in the context of allogeneic stem cell transplantation. Since the expression of minor histocompatibility antigen HA-1(H) is limited to hematopoietic cells, ex vivo generated HA-1(H)-specific CD8+ cytotoxic T lymphocytes (CTLs) can be used for adoptive immunotherapy.
Study design and methods: Numerous studies have shown that primary CTL induction from naïve precursors requires professional antigen-presenting cells. Here, the feasibility of ex vivo induction of HA-1(H)-specific CD8+ CTLs is demonstrated from unfractionated peripheral blood mononuclear cells (PBMNCs) from healthy blood donors when CD4+ T-cell help is provided during primary stimulation. As a stimulus for the induction of T-cell help, tetanus toxoid (TT) was used.
Results: After the second restimulation cycle, approximately 1 percent of CD8+ T cells stained positively with the HLA-A*0201/HA-1(H) pentamer. Positive T cells were further expanded more than 1000-fold by antigen-independent stimulation with anti-CD3/CD28 monoclonal antibodies. HA-1(H)-induced T cells showed the classical phenotype for CD8+ memory effector cells: the phenotype changed from a mixed CD45RA/RO phenotype to an activated phenotype characterized by high expression of CD45RO and no expression of CCR7. The generated T cells revealed a very potent CTL response, even at low E:T ratios.
Conclusion: This study demonstrates that TT provides a very potent and cost-effective tool for the in vitro induction of antigen-specific CTLs from precursor PBMNCs that can easily be adapted to GMP conditions for translational purposes.