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CD7-deleted hematopoietic stem cells can restore immunity after CAR T cell therapy
Miriam Y. Kim, Matthew L. Cooper, Miriam T. Jacobs, Julie K. Ritchey, Julia Hollaway, Todd A. Fehniger, John F. DiPersio
Miriam Y. Kim, Matthew L. Cooper, Miriam T. Jacobs, Julie K. Ritchey, Julia Hollaway, Todd A. Fehniger, John F. DiPersio
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Research Article Immunology Oncology

CD7-deleted hematopoietic stem cells can restore immunity after CAR T cell therapy

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Abstract

Targeting T cell malignancies with universal CD7-targeting chimeric antigen receptor T cells (UCART7) can lead to profound immune deficiency due to loss of normal T and NK cells. While a small population of endogenous CD7– T cells exists, these cells are unlikely to be able to repopulate the entire immune repertoire after UCART7 treatment, as they are limited in number and proliferative capacity. To rescue T and NK cells after UCART7, we created hematopoietic stem cells genetically deleted for CD7 (CD7-KO HSCs). CD7-KO HSCs were able to engraft immunodeficient mice and differentiate into T and NK cells lacking CD7 expression. CD7-KO T and NK cells could perform effector functions as robustly as control T and NK cells. Furthermore, CD7-KO T cells were phenotypically and functionally distinct from endogenous CD7– T cells, indicating that CD7-KO T cells can supplement immune functions lacking in CD7– T cells. Mice engrafted with CD7-KO HSCs maintained T and NK cell numbers after UCART7 treatment, while these were significantly decreased in control mice. These studies support the development of CD7-KO HSCs to augment host immunity in patients with T cell malignancies after UCART7 treatment.

Authors

Miriam Y. Kim, Matthew L. Cooper, Miriam T. Jacobs, Julie K. Ritchey, Julia Hollaway, Todd A. Fehniger, John F. DiPersio

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Figure 1

CD7– T cells have limited proliferative capabilities and are potentially still susceptible to UCART7 after activation.

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CD7– T cells have limited proliferative capabilities and are potentially...
(A–C) CD7 expression on healthy T and NK cells was measured by flow cytometry (n = 16 donors). (A) CD7 expression on T cells and NK cells. (B) CD7 expression on CD4+ and CD8+ T cell subsets (paired 2-tailed Student’s t test). (C) CD7– T cells exhibit a predominantly effector memory phenotype. Memory phenotype was defined by CD45RO and CCR7 expression, as depicted in the left panel. Asterisks denote statistical comparisons of the frequency of each group within CD7+ versus CD7– cells by 2-way ANOVA with multiple comparisons. (D–F) T cells were divided into CD7+ and CD7– fractions and activated with anti-CD3/CD28 beads, followed by serial cell counts and flow cytometry to evaluate CD7 expression (n = 8 donors). (D) CD7 expression significantly increases after T cell activation with anti-CD3/CD28 beads in both bulk T cells (left) and CD7– cells (right) (paired 2-tailed Student’s t test). (E) Representative flow cytometry plots showing increased CD7 expression in total and CD7– T cells after activation. (F) Maximum fold-expansion of CD7+, total, and CD7– T cells (1-way ANOVA with Tukey’s multiple-comparison test). Representative growth curve is shown on the right. (G and H) Activated T cells were incubated with UCART7 for 48 hours, after which cell counts and percentage of CD7 of remaining CD3+ T cells were quantified by flow cytometry (n = 4 donors). All numbers are averages of 3 technical replicates. (G) Percentage of CD7 expression on CD3+ T cells at baseline and after incubation with UCART7. (H) Percent reduction of CD3+ T cells in each group after UCART7 treatment, calculated as the number of CD3+ cells in UCART7-treated groups divided by the number of CD3+ cells in untreated groups (1-way ANOVA with Tukey’s multiple-comparison test). **P < 0.01, ***P < 0.001, ****P < 0.0001.

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