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In vivo killing of primary HIV-infected cells by peripheral-injected early memory–enriched anti-HIV duoCAR T cells
Kim Anthony-Gonda, Alex Ray, Hang Su, Yuge Wang, Ying Xiong, Danica Lee, Ariele Block, Vanessa Chilunda, Jessica Weiselberg, Lily Zemelko, Yen Y. Wang, Sarah Kleinsorge-Block, Jane S. Reese, Marcos de Lima, Christina Ochsenbauer, John C. Kappes, Dimiter S. Dimitrov, Rimas Orentas, Steven G. Deeks, Rachel L. Rutishauser, Joan W. Berman, Harris Goldstein, Boro Dropulić
Kim Anthony-Gonda, Alex Ray, Hang Su, Yuge Wang, Ying Xiong, Danica Lee, Ariele Block, Vanessa Chilunda, Jessica Weiselberg, Lily Zemelko, Yen Y. Wang, Sarah Kleinsorge-Block, Jane S. Reese, Marcos de Lima, Christina Ochsenbauer, John C. Kappes, Dimiter S. Dimitrov, Rimas Orentas, Steven G. Deeks, Rachel L. Rutishauser, Joan W. Berman, Harris Goldstein, Boro Dropulić
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Research Article AIDS/HIV Therapeutics

In vivo killing of primary HIV-infected cells by peripheral-injected early memory–enriched anti-HIV duoCAR T cells

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Abstract

HIV-specific chimeric antigen receptor–T cell (CAR T cell) therapies are candidates to functionally cure HIV infection in people with HIV (PWH) by eliminating reactivated HIV-infected cells derived from latently infected cells within the HIV reservoir. Paramount to translating such therapeutic candidates successfully into the clinic will require anti-HIV CAR T cells to localize to lymphoid tissues in the body and eliminate reactivated HIV-infected cells such as CD4+ T cells and monocytes/macrophages. Here we show that i.v. injected anti-HIV duoCAR T cells, generated using a clinical-grade anti-HIV duoCAR lentiviral vector, localized to the site of active HIV infection in the spleen of humanized mice and eliminated HIV-infected PBMCs. CyTOF analysis of preinfusion duoCAR T cells revealed an early memory phenotype composed predominantly of CCR7+ stem cell–like/central memory T cells (TSCM/TCM) with expression of some effector-like molecules. In addition, we show that anti-HIV duoCAR T cells effectively sense and kill HIV-infected CD4+ T cells and monocytes/macrophages. Furthermore, we demonstrate efficient genetic modification of T cells from PWH on suppressive ART into anti-HIV duoCAR T cells that subsequently kill autologous PBMCs superinfected with HIV. These studies support the safety and efficacy of anti-HIV duoCAR T cell therapy in our presently open phase I/IIa clinical trial (NCT04648046).

Authors

Kim Anthony-Gonda, Alex Ray, Hang Su, Yuge Wang, Ying Xiong, Danica Lee, Ariele Block, Vanessa Chilunda, Jessica Weiselberg, Lily Zemelko, Yen Y. Wang, Sarah Kleinsorge-Block, Jane S. Reese, Marcos de Lima, Christina Ochsenbauer, John C. Kappes, Dimiter S. Dimitrov, Rimas Orentas, Steven G. Deeks, Rachel L. Rutishauser, Joan W. Berman, Harris Goldstein, Boro Dropulić

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Figure 1

Optimization of anti-HIV duoCAR T cells for clinical translation.

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Optimization of anti-HIV duoCAR T cells for clinical translation.
(A) Il...
(A) Illustration of the anti-HIV duoCAR T cell (Created with BioRender.com). (B) Schematic of the anti-HIV duoCAR LV constructs evaluated in preclinical studies. MSCV+W is the original anti-HIV duoCAR D13 vector, which contains the MSCV promoter and WPRE. The MSCV+W duoCAR vector was modified for clinical use by excising WPRE (MSCV-ΔW) followed by replacement of the MSCV promoter with the MND promoter (MND-ΔW). A vector identification (ID) tag is engineered upstream of the 3′SIN/LTR for qPCR detection of vector-marked cells. LV titers are indicated to the right of each duoCAR vector in transducing units per mL (TU/mL). (C–E) In vitro killing efficacy of MSCV+W, MSCV-ΔW, and MND-ΔW duoCAR T cells against autologous PBMCs infected with an HIV-LucR IMC expressing the 396-R1_F6_20 (Clade A), CH077 (Clade B), or Du151.2 (Clade C) HIV-1 Env glycoprotein. Magnitude of HIV-1 infection 7 days after challenge quantified via Renilla luciferase (LucR) activity (y axis; RLU, relative light units). Data are shown as mean ± SEM of 2 donors tested in triplicate. Statistical analysis performed by 1-way ANOVA followed by Tukey’s multiple-comparison post hoc test. (F) Long-term killing efficacy of duoCAR T cells after repeated challenge with Env+ GFP+ target cells. DuoCAR T cells were challenged with fresh Env+ GFP+ target cells (E:T ratio = 0.3:1) on Day 0* and subsequently on Day 7* (2nd challenge) and Day 13* (3rd challenge). Asterisks in y axis labels indicate date of challenge. Magnitude of duoCAR-mediated killing expressed as percent remaining Env+GFP+ target cells in the cocultures (y axis). Data are shown as mean ± SEM (n = 3 donors). Statistical analysis performed by 2-way ANOVA followed by Dunnett’s multiple-comparison post hoc test. ****P < 0.0001, ***P < 0.001, **P < 0.01, and *P < 0.05.

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