Dual-locus, dual-HDR editing permits efficient generation of antigen-specific regulatory T cells with robust suppressive activity

MS Hunt, SJ Yang, E Mortensen, A Boukhris… - Molecular Therapy, 2023 - cell.com
MS Hunt, SJ Yang, E Mortensen, A Boukhris, J Buckner, PJ Cook, DJ Rawlings
Molecular Therapy, 2023cell.com
Adoptive regulatory T (Treg) cell therapy is predicted to modulate immune tolerance in
autoimmune diseases, including type 1 diabetes (T1D). However, the requirement for
antigen (ag) specificity to optimally orchestrate tissue-specific, Treg cell-mediated tolerance
limits effective clinical application. To address this challenge, we present a single-step,
combinatorial gene editing strategy utilizing dual-locus, dual-homology-directed repair
(HDR) to generate and specifically expand ag-specific engineered Treg (EngTreg) cells …
Adoptive regulatory T (Treg) cell therapy is predicted to modulate immune tolerance in autoimmune diseases, including type 1 diabetes (T1D). However, the requirement for antigen (ag) specificity to optimally orchestrate tissue-specific, Treg cell-mediated tolerance limits effective clinical application. To address this challenge, we present a single-step, combinatorial gene editing strategy utilizing dual-locus, dual-homology-directed repair (HDR) to generate and specifically expand ag-specific engineered Treg (EngTreg) cells derived from donor CD4+ T cells. Concurrent delivery of CRISPR nucleases and recombinant (r)AAV homology donor templates targeting FOXP3 and TRAC was used to achieve three parallel goals: enforced, stable expression of FOXP3; replacement of the endogenous T cell receptor (TCR) with an islet-specific TCR; and selective enrichment of dual-edited cells. Each HDR donor template contained an alternative component of a heterodimeric chemically inducible signaling complex (CISC), designed to activate interleukin-2 (IL-2) signaling in response to rapamycin, promoting expansion of only dual-edited EngTreg cells. Using this approach, we generated purified, islet-specific EngTreg cells that mediated robust direct and bystander suppression of effector T (Teff) cells recognizing the same or a different islet antigen peptide, respectively. This platform is broadly adaptable for use with alternative TCRs or other targeting moieties for application in tissue-specific autoimmune or inflammatory diseases.
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