Adenosine Selectively Depletes Alloreactive T Cells to Prevent GVHD While Conserving Immunity to Viruses and Leukemia

Mol Ther. 2016 Sep;24(9):1655-64. doi: 10.1038/mt.2016.147. Epub 2016 Jul 6.

Abstract

Selective depletion (SD) of alloreactive T cells from allogeneic hematopoeitic stem cell transplants to prevent graft-versus-host disease (GVHD) without compromising immune reconstitution and antitumor responses remains a challenge. Here, we demonstrate a novel SD strategy whereby alloreacting T cells are efficiently deleted ex vivo with adenosine. SD was achieved in human leukocyte antigen (HLA) mismatched cocultures by multiple exposures to 2 mmol/l adenosine over 7 days. Adenosine depleted greater than to 90% of alloproliferating T cells in mismatched, haploidentical, and matched sibling pairs while conserving response to third-party antigens. Alloreactive CD4 and CD8 T cells were targeted for depletion while NK and B cells were preserved. Our novel approach also preserved nonalloreactive naive, central, and effector memory T-cell subsets, Tregs, and notably preserved T-cell responses against DNA viruses that contribute to transplant related mortality after allogeneic hematopoeitic stem cell transplants. Additionally, T cells recognizing leukemia-associated antigens were efficiently generated in vitro from the cell product post-SD. This study is the first to demonstrate that adenosine depletion of alloactivated T cells maintains a complete immune cell profile and recall viral responses. Expansion of tumor antigen-specific subsets postdepletion opens the possibility of generating T-cell products capable of graft-versus-tumor responses without causing GVHD.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adenosine / pharmacology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Neoplasm
  • Cell Survival / drug effects
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control*
  • Haplotypes
  • Humans
  • Immunity*
  • Leukemia / complications
  • Leukemia / immunology*
  • Leukemia / therapy
  • Lymphocyte Depletion*
  • Lymphocyte Subsets / drug effects
  • Lymphocyte Subsets / immunology
  • Lymphocyte Subsets / metabolism
  • Middle Aged
  • T-Cell Antigen Receptor Specificity / immunology
  • T-Lymphocytes / drug effects*
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism
  • Tissue Donors
  • Viruses / immunology*
  • Young Adult

Substances

  • Antigens, Neoplasm
  • Adenosine