Chimeric antigen receptor (CAR) technology can be used to engineer the antigen specificity of regulatory T cells (Tregs) and improve their potency as an adoptive cell therapy in multiple disease models. As synthetic receptors, CARs carry the risk of immunogenicity, particularly when derived from nonhuman antibodies. Using an HLA-A*02:01–specific CAR (A2-CAR) encoding a single-chain variable fragment (Fv) derived from a mouse antibody, we developed a panel of 20 humanized A2-CARs (hA2-CARs). Systematic testing demonstrated variations in expression, and ability to bind HLA-A*02:01 and stimulate human Treg suppression in vitro. In addition, we developed a new method to comprehensively map the alloantigen specificity of CARs, revealing that humanization reduced HLA-A cross-reactivity. In vivo bioluminescence imaging showed rapid trafficking and persistence of hA2-CAR Tregs in A2-expressing allografts, with eventual migration to draining lymph nodes. Adoptive transfer of hA2-CAR Tregs suppressed HLA-A2+ cell–mediated xenogeneic graft-versus-host disease and diminished rejection of human HLA-A2+ skin allografts. These data provide a platform for systematic development and specificity testing of humanized alloantigen-specific CARs that can be used to engineer specificity and homing of therapeutic Tregs.
Nicholas A.J. Dawson, Caroline Lamarche, Romy E. Hoeppli, Peter Bergqvist, Vivian C.W. Fung, Emma McIver, Qing Huang, Jana Gillies, Madeleine Speck, Paul C. Orban, Jonathan W. Bush, Majid Mojibian, Megan K. Levings
Title and authors | Publication | Year |
---|---|---|
Immunometabolism of Liver Xenotransplantation and Prospective Solutions
Deng S, Zhang Y, Shen S, Li C, Qin C |
Advanced Science | 2025 |
Cellular Strategies for Separating GvHD from GvL in Haploidentical Transplantation
Di Ianni M, Liberatore C, Santoro N, Ranalli P, Guardalupi F, Corradi G, Villanova I, Di Francesco B, Lattanzio S, Passeri C, Lanuti P, Accorsi P |
Cells | 2024 |
Immune modulation in transplant medicine: a comprehensive review of cell therapy applications and future directions
Knoedler L, Dean J, Diatta F, Thompson N, Knoedler S, Rhys R, Sherwani K, Ettl T, Mayer S, Falkner F, Kilian K, Panayi AC, Iske J, Safi AF, Tullius SG, Haykal S, Pomahac B, Kauke-Navarro M |
Frontiers in immunology | 2024 |
Short Report: CAR Tregs mediate linked suppression and infectious tolerance in islet transplantation
Wardell CM, Fung VC, Chen E, Haque M, Gillies J, Spanier JA, Mojibian M, Fife BT, Levings MK |
2024 | |
Biomaterial-enhanced treg cell immunotherapy: A promising approach for transplant medicine and autoimmune disease treatment
Mashayekhi K, Khazaie K, Faubion WA Jr, Kim GB |
Bioactive Materials | 2024 |
The method for assessing the specificity of developing CAR therapies
Prikhodko IV, Guria GT |
Biophysical Reports | 2024 |
Kidney transplants from elderly donors: what we have learned 20 years after the Crystal City consensus criteria meeting.
Mella A, Calvetti R, Barreca A, Congiu G, Biancone L |
Journal of nephrology | 2024 |
Unlocking Transplant Tolerance with Biomaterials
Pham JA, Coronel MM |
Advanced Healthcare Materials | 2024 |
Insulin B peptide-MHC class II-specific chimeric antigen receptor-Tregs prevent autoimmune diabetes
Justin Spanier, Vivian Fung, Christine Wardell, Mohannad Alkhatib, Yixin Chen, Linnea Swanson, Alexander Dwyer, Matthew Weno, Nubia Silva, Jason Mitchell, Paul Orban, Majid Mojibian, C. Verchere, Brian Fife, Megan Levings |
Journal of Clinical Investigation | 2023 |
Barriers to Treg therapy in Europe: From production to regulation
Hennessy C, Deptula M, Hester J, Issa F |
Frontiers in Medicine | 2023 |
Insulin B peptide-MHC class II-specific chimeric antigen receptor-Tregs prevent autoimmune diabetes
Spanier JA, Fung V, Wardell CM, Alkhatib MH, Chen Y, Swanson LA, Dwyer AJ, Weno ME, Silva N, Mitchell JS, Orban PC, Mojibian M, Verchere CB, Fife BT, Levings MK |
2023 | |
Human A2-CAR T cells reject HLA-A2+ human islets transplanted into mice without inducing graft versus host disease
Ellis CE, Mojibian M, Ida S, Fung VC, Skovsø S, McIver E, O\u2019Dwyer S, Webber TD, Braam MJ, Saber N, Kieffer TJ, Levings MK |
2023 | |
Tonic-signaling chimeric antigen receptors drive human regulatory T cell exhaustion
Lamarche C, Ward-Hartstonge K, Mi T, Lin DT, Huang Q, Brown A, Edwards K, Novakovsky GE, Qi CN, Kobor MS, Zebley CC, Weber EW, Mackall CL, Levings MK |
Proceedings of the National Academy of Sciences | 2023 |
Treg-based immunotherapy for antigen-specific immune suppression and stable tolerance induction: a perspective
Sakaguchi S, Kawakami R, Mikami N |
2023 | |
Regulatory T cells in autoimmune kidney diseases and transplantation.
Mikami N, Sakaguchi S |
Nature reviews. Nephrology | 2023 |
Human A2-CAR T Cells Reject HLA-A2+ Human Islets Transplanted into Mice Without Inducing Graft Versus Host Disease
Ellis CE, Mojibian M, Ida S, Fung VC, Skovsø S, McIver E, O\u2019Dwyer S, Webber TD, Braam MJ, Saber N, Sasaki S, Lynn FC, Kieffer TJ, Levings MK |
Transplantation | 2023 |
Identifying the Target Traumatic Brain Injury Population for Hyperbaric Oxygen Therapy
Schimmel S, El Sayed B, Lockard G, Gordon J, Young I, D\u2019Egidio F, Lee JY, Rodriguez T, Borlongan CV |
International journal of molecular sciences | 2023 |
Unlocking the potential of Tregs: innovations in CAR technology
Requejo Cier CJ, Valentini N, Lamarche C |
Frontiers in Molecular Biosciences | 2023 |
Intragraft regulatory T cells in the modern era: what can high-dimensional methods tell us about pathways to allograft acceptance?
Bei KF, Moshkelgosha S, Liu BJ, Juvet S |
Frontiers in immunology | 2023 |
Promises and Pitfalls of Next-Generation Treg Adoptive Immunotherapy
Christofi P, Pantazi C, Psatha N, Sakellari I, Yannaki E, Papadopoulou A |
Cancers | 2023 |
Modulatory immune responses in fungal infection associated with organ transplant - advancements, management, and challenges
Elalouf A, Elalouf H, Rosenfeld A |
Frontiers in immunology | 2023 |
Immunotherapy targeting B cells and long-lived plasma cells effectively eliminates pre-existing donor-specific allo-antibodies
Zhang Z, Markmann C, Yu M, Agarwal D, Rostami S, Wang W, Liu C, Zhao H, Ochoa T, Parvathaneni K, Xu X, Li E, Gonzalez V, Khadka R, Hoffmann J, Knox JJ, Scholler J, Marcellus B, Allman D, Fraietta JA, Samelson-Jones B, Milone MC, Monos D, Garfall AL, Naji A, Bhoj VG |
Cell reports. Medicine | 2023 |
Tregs in transplantation tolerance: role and therapeutic potential
Cassano A, Chong AS, Alegre ML |
2023 | |
Modeling the Potential of Treg-Based Therapies for Transplant Rejection: Effect of Dose, Timing, and Accumulation Site
Maya M Lapp, Guang Lin, Alexander Komin, Leah Andrews, Mei Knudson, Lauren Mossman, Giorgio Raimondi, Julia C Arciero |
Transplant international : official journal of the European Society for Organ Transplantation | 2022 |
Multipurposing CARs: Same engine, different vehicles
A Hossian, C Hackett, R Brentjens, S Rafiq |
Molecular Therapy | 2022 |
Chimeric Antigen Receptor (CAR) Regulatory T-Cells in Solid Organ Transplantation
Gille I, Claas FH, Haasnoot GW, Heemskerk MH, Heidt S |
Frontiers in immunology | 2022 |
Trafficking and persistence of alloantigen-specific chimeric antigen receptor regulatory T cells in Cynomolgus macaque
Ellis GI, Coker KE, Winn DW, Deng MZ, Shukla D, Bhoj V, Milone MC, Wang W, Liu C, Naji A, Duran-Struuck R, Riley JL |
Cell reports. Medicine | 2022 |
Study Design: Human Leukocyte Antigen Class I Molecule A∗02-Chimeric Antigen Receptor Regulatory T Cells in Renal Transplantation
Schreeb K, Culme-Seymour E, Ridha E, Dumont C, Atkinson G, Hsu B, Reinke P |
Kidney International Reports | 2022 |
A three-dimensional (3D), serum-free, Collagen Type I system for chondrogenesis of canine bone marrow-derived multipotent stromal cells (cMSCs)
MacIver MA, Dobson LK, Gregory CA, Muneoka K, Saunders WB |
PloS one | 2022 |
Current Strategies to Modulate Regulatory T Cell Activity in Allergic Inflammation.
Bellinghausen I, Khatri R, Saloga J |
Frontiers in immunology | 2022 |
Preclinical assessment of antigen-specific chimeric antigen receptor regulatory T cells for use in solid organ transplantation.
Proics E, David M, Mojibian M, Speck M, Lounnas-Mourey N, Govehovitch A, Baghdadi W, Desnouveaux J, Bastian H, Freschi L, Privat G, Pouzet C, Grossi M, Heimendinger P, Abel T, Fenard D, Levings MK, Meyer F, Dumont C |
Gene Therapy | 2022 |
Anti-HLA-A2-CAR Tregs prolong vascularized mouse heterotopic heart allograft survival
Wagner JC, Ronin E, Ho P, Peng Y, Tang Q |
American Journal of Transplantation | 2022 |
Chimeric Antigen Receptor Regulatory T Cell in Transplantation: The Future of Cell Therapy?
Lamarche C, Maltzman JS |
Kidney International Reports | 2022 |
Novel and Promising Strategies for Therapy of Post-Transplant Chronic GVHD
Kostareva I, Kirgizov K, Machneva E, Ustyuzhanina N, Nifantiev N, Skvortsova Y, Shubina I, Reshetnikova V, Valiev T, Varfolomeeva S, Kiselevskiy M |
Pharmaceuticals | 2022 |
IL-2 availability regulates the tissue specific phenotype of murine intra-hepatic Tregs
Kurt AS, Strobl K, Ruiz P, Osborn G, Chester T, Dawson L, Warwas KM, Grey EH, Mastoridis S, Kodela E, Safinia N, Sanchez-Fueyo A, Martinez-Llordella M |
Frontiers in immunology | 2022 |
Therapeutic Opportunities for Immunoreceptor-Engineered T Cell Therapy for Modulation of Alloimmunity.
Muralidharan K, Agarwal D, Naji A, Bhoj VG |
Journal of immunology (Baltimore, Md. : 1950) | 2022 |
Do Treg Speed Up with CARs? Chimeric Antigen Receptor Treg Engineered to Induce Transplant Tolerance
Kaljanac M, Abken H |
Transplantation | 2022 |
Modelling Graft-Versus-Host Disease in Mice Using Human Peripheral Blood Mononuclear Cells
Haque M, Boardman DA, Lam AJ, MacDonald KN, Sanderink L, Huang Q, Fung VC, Ivison S, Mojibian M, Levings MK |
Bio-protocol | 2022 |
Flagellin-specific human CAR Tregs for immune regulation in IBD
Boardman DA, Wong MQ, Rees WD, Wu D, Himmel ME, Orban PC, Vent-Schmidt J, Zachos NC, Steiner TS, Levings MK |
Journal of Autoimmunity | 2022 |
The potential for Treg-enhancing therapies in transplantation
Steiner R, Pilat N |
Clinical & Experimental Immunology | 2022 |
Regulatory T Cell Therapy of Graft-versus-Host Disease: Advances and Challenges
M Hefazi, S Bolivar-Wagers, BR Blazar |
International journal of molecular sciences | 2021 |
Harnessing Mechanisms of Immune Tolerance to Improve Outcomes in Solid Organ Transplantation: A Review
PF Slepicka, M Yazdanifar, A Bertaina |
Frontiers in immunology | 2021 |
The Therapeutic Potential of Regulatory T Cells: Challenges and Opportunities
F Bayati, M Mohammadi, M Valadi, S Jamshidi, AM Foma, E Sharif-Paghaleh |
Frontiers in immunology | 2021 |
Spatiotemporal in vivo tracking of polyclonal human regulatory T cells (Tregs) reveals a role for innate immune cells in Treg transplant recruitment
J Jacob, S Nadkarni, A Volpe, Q Peng, SL Tung, RF Hannen, YR Mohseni, C Scotta, FM Marelli-Berg, RI Lechler, LA Smyth, GO Fruhwirth, G Lombardi |
Molecular Therapy — Methods & Clinical Development | 2021 |
Non-human Primate Regulatory T Cells and Their Assessment as Cellular Therapeutics in Preclinical Transplantation Models
AW Thomson, K Sasaki, MB Ezzelarab |
Frontiers in Cell and Developmental Biology | 2021 |
Advances in Liver Transplantation: where are we in the pursuit of transplantation tolerance?
N Safinia, T Vaikunthanathan, RI Lechler, A SanchezFueyo, G Lombardi |
European Journal of Immunology | 2021 |
Regulatory Cell Therapy in Organ Transplantation: Achievements and Open Questions
M Fortunato, K Morali, L Passeri, S Gregori |
Frontiers in immunology | 2021 |
Genetic engineering of T cells for immunotherapy
GI Ellis, NC Sheppard, JL Riley |
Nature Reviews Genetics | 2021 |
Emerging Therapeutic Strategies to Restore Regulatory T Cell Control of Islet Autoimmunity in Type 1 Diabetes
V Volfson-Sedletsky, A Jones, J Hernandez-Escalante, H Dooms |
Frontiers in immunology | 2021 |
Precision Engineering of an Anti-HLA-A2 Chimeric Antigen Receptor in Regulatory T Cells for Transplant Immune Tolerance
YD Muller, LM Ferreira, E Ronin, P Ho, V Nguyen, G Faleo, Y Zhou, K Lee, KK Leung, N Skartsis, AM Kaul, A Mulder, FH Claas, JA Wells, JA Bluestone, Q Tang |
Frontiers in immunology | 2021 |
Transient mTOR inhibition rescues 4-1BB CAR-Tregs from tonic signal-induced dysfunction
B Lamarthée, A Marchal, S Charbonnier, T Blein, J Leon, E Martin, L Rabaux, K Vogt, M Titeux, M Delville, H Vinçon, E Six, N Pallet, D Michonneau, D Anglicheau, C Legendre, JL Taupin, I Nemazanyy, B Sawitzki, S Latour, M Cavazzana, I André, J Zuber |
Nature Communications | 2021 |
Recent advances and discoveries in the mechanisms and functions of CAR T cells
RC Larson, MV Maus |
Nature Reviews Cancer | 2021 |
Ex Vivo Expanded Donor Alloreactive Regulatory T Cells Lose Immunoregulatory, Proliferation, and Antiapoptotic Markers After Infusion Into ATG-lymphodepleted, Nonhuman Primate Heart Allograft Recipients
MB Ezzelarab, H Zhang, K Sasaki, L Lu, AF Zahorchak, DJ van der Windt, H Dai, A Perez-Gutierrez, JK Bhama, AW Thomson |
Transplantation | 2021 |
Immune System Investigation Using Parasitic Helminths
B Douglas, O Oyesola, MM Cooper, A Posey, ET Wojno, PR Giacomin, DB Herbert |
Annual Review of Immunology | 2021 |
Cellular therapies in organ transplantation
MJ Hoogduijn, F Issa, F Casiraghi, ME Reinders |
Transplant International | 2021 |
Immune and Genome Engineering as the Future of Transplantable Tissue
J Elisseeff, S Badylak, J Boeke |
New England Journal of Medicine | 2021 |
CAR-Tregs as a Strategy for Inducing Graft Tolerance
JC Wagner, Q Tang |
Current Transplantation Reports | 2020 |
Humanization of Immunodeficient Animals for the Modeling of Transplantation, Graft Versus Host Disease, and Regenerative Medicine
G Adigbli, S Ménoret, AR Cross, J Hester, F Issa, I Anegon |
Transplantation | 2020 |
How to Combine the Two Landmark Treatment Methods—Allogeneic Hematopoietic Stem Cell Transplantation and Chimeric Antigen Receptor T Cell Therapy Together to Cure High-Risk B Cell Acute Lymphoblastic Leukemia?
M Zhang, H Huang |
Frontiers in immunology | 2020 |
The Future of Regulatory T Cell Therapy: Promises and Challenges of Implementing CAR Technology
YR Mohseni, SL Tung, C Dudreuilh, RI Lechler, GO Fruhwirth, G Lombardi |
Frontiers in immunology | 2020 |
Identification, selection, and expansion of non-gene modified alloantigen-reactive Tregs for clinical therapeutic use
A Alzhrani, M Bottomley, K Wood, J Hester, F Issa |
Cellular Immunology | 2020 |
From Cancer to Immune-Mediated Diseases and Tolerance Induction: Lessons Learned From Immune Oncology and Classical Anti-cancer Treatment
S Klöß, S Dehmel, A Braun, MJ Parnham, U Köhl, S Schiffmann |
Frontiers in immunology | 2020 |
Detection and Monitoring of Regulatory Immune Cells Following Their Adoptive Transfer in Organ Transplantation
LM Tran, AW Thomson |
Frontiers in immunology | 2020 |
Manipulating the TCR signaling network for cellular immunotherapy: Challenges & opportunities
CA Matson, NJ Singh |
Molecular Immunology | 2020 |
The Chimeric Antigen Receptor Detection Toolkit
Y Hu, J Huang |
Frontiers in immunology | 2020 |
Genetic Engineering of T Cells for Immune Tolerance
DW Scott |
Molecular Therapy — Methods & Clinical Development | 2020 |
Applicability, safety, and biological activity of regulatory T cell therapy in liver transplantation
A SánchezFueyo, G Whitehouse, N Grageda, ME Cramp, TY Lim, M Romano, S Thirkell, K Lowe, L Fry, J Heward, A Kerr, J Ali, C Fisher, G Lewis, A Hope, E Kodela, M Lyne, F Farzaneh, S Kordasti, I RebolloMesa, JJ Lozano, N Safinia, N Heaton, R Lechler, M MartínezLlordella, G Lombardi |
American Journal of Transplantation | 2020 |
Treg cell-based therapies: challenges and perspectives
C Raffin, LT Vo, JA Bluestone |
Nature Reviews Immunology | 2019 |
Next-generation regulatory T cell therapy
LM Ferreira, YD Muller, JA Bluestone, Q Tang |
Nature Reviews Drug Discovery | 2019 |