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Tregs integrate native and CAR-mediated costimulatory signals for control of allograft rejection
Isaac Rosado-Sánchez, … , Giorgio Raimondi, Megan K. Levings
Isaac Rosado-Sánchez, … , Giorgio Raimondi, Megan K. Levings
Published September 5, 2023
Citation Information: JCI Insight. 2023;8(19):e167215. https://doi.org/10.1172/jci.insight.167215.
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Research Article Immunology Transplantation

Tregs integrate native and CAR-mediated costimulatory signals for control of allograft rejection

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Abstract

Tregs expressing chimeric antigen receptors (CAR-Tregs) are a promising tool to promote transplant tolerance. The relationship between CAR structure and Treg function was studied in xenogeneic, immunodeficient mice, revealing advantages of CD28-encoding CARs. However, these models could underrepresent interactions between CAR-Tregs, antigen-presenting cells (APCs), and donor-specific Abs. We generated Tregs expressing HLA-A2–specific CARs with different costimulatory domains and compared their function in vitro and in vivo using an immunocompetent model of transplantation. In vitro, the CD28-encoding CAR had superior antigen-specific suppression, proliferation, and cytokine production. In contrast, in vivo, Tregs expressing CARs encoding CD28, ICOS, programmed cell death 1, and GITR, but not 4-1BB or OX40, all extended skin allograft survival. To reconcile in vitro and in vivo data, we analyzed effects of a CAR encoding CD3ζ but no costimulatory domain. These data revealed that exogenous costimulation from APCs can compensate for the lack of a CAR-encoded CD28 domain. Thus, Tregs expressing a CAR with or without CD28 are functionally equivalent in vivo, mediating similar extension of skin allograft survival and controlling the generation of anti–HLA-A2 alloantibodies. This study reveals a dimension of CAR-Treg biology and has important implications for the design of CARs for clinical use in Tregs.

Authors

Isaac Rosado-Sánchez, Manjurul Haque, Kevin Salim, Madeleine Speck, Vivian C.W. Fung, Dominic A. Boardman, Majid Mojibian, Giorgio Raimondi, Megan K. Levings

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Figure 1

Design and expression of costimulatory domain CAR variants.

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Design and expression of costimulatory domain CAR variants.
(A) Schemati...
(A) Schematic diagram summarizing the TM and signaling domains incorporated into the second-generation CAR variants. (B) Representative flow cytometry plots of at least 3 independent experiments showing CAR (c-Myc) and mKO2 reporter expression and binding to an HLA-A2 tetramer, with percentages shown in corners. (C) MFI of CAR expression for different CAR variants in Tregs after expansion gated on live c-Myc+CD4+Foxp3gfp+ cells; n = 6–13 replicates from at least 8 independent experiments. (D) Foxp3gfp expression in Tregs after expansion, gated on live CD4+ cells; n = 6–16 replicates from at least 11 independent experiments. (E) Representative data of at least 5 independent experiments showing intracellular Foxp3 and Helios expression in CAR-Tregs and control conventional T cells (Tconv) after expansion, gated on total live CD4+ cells. Data reported as mean ± SEM. Statistical significance was determined using 1-way ANOVA with a Holm-Šidak posttest. **P < 0.01, ***P < 0.001, ****P < 0.0001. Co-stim, costimulatory; UT, untransduced.

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