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Stem cell–derived CAR T cells traffic to HIV reservoirs in macaques
Isaac M. Barber-Axthelm, … , Hans-Peter Kiem, Christopher W. Peterson
Isaac M. Barber-Axthelm, … , Hans-Peter Kiem, Christopher W. Peterson
Published January 11, 2021
Citation Information: JCI Insight. 2021;6(1):e141502. https://doi.org/10.1172/jci.insight.141502.
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Research Article AIDS/HIV Stem cells

Stem cell–derived CAR T cells traffic to HIV reservoirs in macaques

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) with CCR5– donor cells is the only treatment known to cure HIV-1 in patients with underlying malignancy. This is likely due to a donor cell–mediated graft-versus-host effect targeting HIV reservoirs. Allo-HSCT would not be an acceptable therapy for most people living with HIV due to the transplant-related side effects. Chimeric antigen receptor (CAR) immunotherapies specifically traffic to malignant lymphoid tissues (lymphomas) and, in some settings, are able to replace allo-HSCT. Here, we quantified the engraftment of HSC-derived, virus-directed CAR T cells within HIV reservoirs in a macaque model of HIV infection, using potentially novel IHC assays. HSC-derived CAR cells trafficked to and displayed multilineage engraftment within tissue-associated viral reservoirs, persisting for nearly 2 years in lymphoid germinal centers, the brain, and the gastrointestinal tract. Our findings demonstrate that HSC-derived CAR+ cells reside long-term and proliferate in numerous tissues relevant for HIV infection and cancer.

Authors

Isaac M. Barber-Axthelm, Valerie Barber-Axthelm, Kai Yin Sze, Anjie Zhen, Gajendra W. Suryawanshi, Irvin S.Y. Chen, Jerome A. Zack, Scott G. Kitchen, Hans-Peter Kiem, Christopher W. Peterson

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Figure 1

Study schematic for CAR 1, CAR 2, Control 1, and Control 2 animals.

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Study schematic for CAR 1, CAR 2, Control 1, and Control 2 animals.
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A total of 4 pigtail macaques were transplanted with autologous HSPCs modified to express CD4CAR (n = 2) or a control CD4CARΔζ (n = 2), which lacks intracellular signaling function but retains the extracellular domain for immunolabeling. Following 28 weeks of posttransplant recovery, animals were infected with SHIV-1157ipd3N4 via the i.v. route. Approximately 6 months later, antiretroviral therapy (ART) was initiated, then withdrawn 28 weeks later, in order to compare the persistence of CD4CAR and control-modified cells in low- and high-antigen conditions, respectively. Following ART withdrawal, animals were monitored for approximately 15 weeks prior to necropsy.

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