यह पत्र एक साधारण मानव परिधीय रक्त कोशिकाओं mononuclear में alloantigen विशेष anergy प्रेरित तकनीक का वर्णन करता है. तकनीक चिकित्सकीय लागू किया जा सकता है गैर alloreactive दाता कोशिकाओं उत्पन्न. इन कोशिकाओं के आसव प्रतिरक्षा पुनर्गठन में सुधार और allogeneic hematopoietic स्टेम सेल प्रत्यारोपण के बाद विषाक्तता को कम कर सकता है.
Allogeneic hematopoietic stem cell transplantation (AHSCT) offers the best chance of cure for many patients with congenital and acquired hematologic diseases. Unfortunately, transplantation of alloreactive donor T cells which recognize and damage healthy patient tissues can result in Graft-versus-Host Disease (GvHD)1. One challenge to successful AHSCT is the prevention of GvHD without associated impairment of the beneficial effects of donor T cells, particularly immune reconstitution and prevention of relapse. GvHD can be prevented by non-specific depletion of donor T cells from stem cell grafts or by administration of pharmacological immunosuppression. Unfortunately these approaches increase infection and disease relapse2-4. An alternative strategy is to selectively deplete alloreactive donor T cells after allostimulation by recipient antigen presenting cells (APC) before transplant. Early clinical trials of these allodepletion strategies improved immune reconstitution after HLA-mismatched HSCT without excess GvHD5, 6. However, some allodepletion techniques require specialized recipient APC production6, 7and some approaches may have off-target effects including depletion of donor pathogen-specific T cells8and CD4 T regulatory cells9.One alternative approach is the inactivation of alloreactive donor T cells via induction of alloantigen-specific hyporesponsiveness. This is achieved by stimulating donor cells with recipient APC while providing blockade of CD28-mediated co-stimulation signals10.This “alloanergization” approach reduces alloreactivity by 1-2 logs while preserving pathogen- and tumor-associated antigen T cell responses in vitro11. The strategy has been successfully employed in 2 completed and 1 ongoing clinical pilot studies in which alloanergized donor T cells were infused during or after HLA-mismatched HSCT resulting in rapid immune reconstitution, few infections and less severe acute and chronic GvHD than historical control recipients of unmanipulated HLA-mismatched transplantation12. Here we describe our current protocol for the generation of peripheral blood mononuclear cells (PBMC) which have been alloanergized to HLA-mismatched unrelated stimulator PBMC. Alloanergization is achieved by allostimulation in the presence of monoclonal antibodies to the ligands B7.1 and B7.1 to block CD28-mediated costimulation. This technique does not require the production of specialized stimulator APC and is simple to perform, requiring only a single and relatively brief ex vivo incubation step. As such, the approach can be easily standardized for clinical use to generate donor T cells with reduced alloreactivity but retaining pathogen-specific immunity for adoptive transfer in the setting of AHSCT to improve immune reconstitution without excessive GvHD.
The authors have nothing to disclose.
Name of Reagent/Equipment | Company | Catalogue number | Comments (optional) |
Ficoll-Hypaque PLUS | GE Life Sciences | 17-1440-02 | |
RPMI 1640 | Invitrogen | 11875-093 | |
Hepes 1M | Invitrogen | 15630-080 | |
L-Glutamine 200mM | Invitrogen | 25030-081 | |
Gentamicin | Invitrogen | 15750-060 | |
Human AB serum (heat inactivated) | Gemini Bio-Products | 100-512 | Use validated batches |
Complete Culture Media (500ml) | 440ml RPMI 1640, 50ml AB serum, 5ml Hepes, 5 ml Glutamine, 167uL Gentamicin | ||
Irradiator | GammaCell 1000 | ||
T-25 Cell Culture Flasks with gas permeable caps | Corning, Inc. | 3056 | |
Humanized Monoclonal anti-B7.1 and anti B7.2 antibodies | See protocol text | ||
U bottomed 96 well culture plates | BD Labware | 353077 | |
Monoclonal CD3 antibody | Beckman Coulter | IM0178 | Reconstitute with 200ml distilled water |
Monoclonal CD28 antibody | Beckman Coulter | IM1376 | Reconstitute with 200ml distilled water |
CMV grade 2 antigen | Microbix | EL-01-02 | |
Tritiated Thymidine | NEN | NET027 | |
Scintillation Fluid | PerkinElmer, Inc. | 1205-440 | |
Harvester | Tomtec | ||
Printed Filtermat A | PerkinElmer, Inc. | 1450-421 | |
Filter Bag | PerkinElmer, Inc. | 1450-432 | |
1450 MicroBeta TriLux Scintillation Counter | Wallac |