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GNTI-122: an autologous antigen-specific engineered Treg cell therapy for type 1 diabetes
Gene I. Uenishi, … , Thomas J. Wickham, Karen T. Mueller
Gene I. Uenishi, … , Thomas J. Wickham, Karen T. Mueller
Published March 22, 2024
Citation Information: JCI Insight. 2024;9(6):e171844. https://doi.org/10.1172/jci.insight.171844.
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Research Article Therapeutics

GNTI-122: an autologous antigen-specific engineered Treg cell therapy for type 1 diabetes

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Abstract

Tregs have the potential to establish long-term immune tolerance in patients recently diagnosed with type 1 diabetes (T1D) by preserving β cell function. Adoptive transfer of autologous thymic Tregs, although safe, exhibited limited efficacy in previous T1D clinical trials, likely reflecting a lack of tissue specificity, limited IL-2 signaling support, and in vivo plasticity of Tregs. Here, we report a cell engineering strategy using bulk CD4+ T cells to generate a Treg cell therapy (GNTI-122) that stably expresses FOXP3, targets the pancreas and draining lymph nodes, and incorporates a chemically inducible signaling complex (CISC). GNTI-122 cells maintained an expression profile consistent with Treg phenotype and function. Activation of CISC using rapamycin mediated concentration-dependent STAT5 phosphorylation and, in concert with T cell receptor engagement, promoted cell proliferation. In response to the cognate antigen, GNTI-122 exhibited direct and bystander suppression of polyclonal, islet-specific effector T cells from patients with T1D. In an adoptive transfer mouse model of T1D, a mouse engineered-Treg analog of GNTI-122 trafficked to the pancreas, decreased the severity of insulitis, and prevented progression to diabetes. Taken together, these findings demonstrate in vitro and in vivo activity and support further development of GNTI-122 as a potential treatment for T1D.

Authors

Gene I. Uenishi, Marko Repic, Jennifer Y. Yam, Ashley Landuyt, Priya Saikumar-Lakshmi, Tingxi Guo, Payam Zarin, Martina Sassone-Corsi, Adam Chicoine, Hunter Kellogg, Martina Hunt, Travis Drow, Ritika Tewari, Peter J. Cook, Soo Jung Yang, Karen Cerosaletti, Darius Schweinoch, Benjamin Guiastrennec, Eddie James, Chandra Patel, Tiffany F. Chen, Jane H. Buckner, David J. Rawlings, Thomas J. Wickham, Karen T. Mueller

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Figure 2

Stable FOXP3 expression imparts Treg phenotype and function.

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Stable FOXP3 expression imparts Treg phenotype and function.
(A) Cells p...
(A) Cells produced from 3 healthy donors (HDs) and 3 donors with type 1 diabetes (T1D) (total of 6 individual donors) were analyzed for flow cytometry immediately after thawing and after resting for 3 days. The percentages of each population (±SEM) are shown for GNTI-122 cells compared to mock-engineered (Mock) cells and are based on live CD4+ cells. The geometric MFI (gMFI) relative expression (mean ± SEM) for each marker is shown for the GNTI-122 cells compared to Mock cells. The MFI values for the Mock cells are based on CD4+, whereas the MFI values for the GNTI-122 cells are based on CD4+TCRVβ13.6+FOXP3+ (2-way ANOVA with Tukey’s multiple-comparison test). (B) Cells from 3 different HD and T1D donors were either stimulated with PMA/ionomycin/monensin for 5 hours and then stained (for intracellular IFN-γ and IL-2) or stimulated with anti-CD3/anti-CD28 activation beads for 24 hours and then stained (for surface LAP and GARP). Each cytokine was gated on either CD4+ for Mock cells or TCRVb13.6+FOXP3+ for GNTI-122 cells. Data presented as mean relative levels ± SD from duplicate measurements (2-way ANOVA with Šidák’s multiple-comparison test). (C) Representative bead-based suppression results from GNTI-122 cells generated from an individual HD and an individual donor with T1D (n = 3, mean ± SEM). *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001. Teff, T effectors; PMA, phorbol 12-myristate 13-acetate; LAP, latency-associated protein; GARP, glycoprotein A repetitions predominant.

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