The Journal of Clinical Investigation (Sep 2023)

Tregs with an MHC class II peptide–specific chimeric antigen receptor prevent autoimmune diabetes in mice

  • Justin A. Spanier,
  • Vivian Fung,
  • Christine M. Wardell,
  • Mohannad H. Alkhatib,
  • Yixin Chen,
  • Linnea A. Swanson,
  • Alexander J. Dwyer,
  • Matthew E. Weno,
  • Nubia Silva,
  • Jason S. Mitchell,
  • Paul C. Orban,
  • Majid Mojibian,
  • C. Bruce Verchere,
  • Brian T. Fife,
  • Megan K. Levings

Journal volume & issue
Vol. 133, no. 18

Abstract

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Adoptive immunotherapy with Tregs is a promising approach for preventing or treating type 1 diabetes. Islet antigen–specific Tregs have more potent therapeutic effects than polyclonal cells, but their low frequency is a barrier for clinical application. To generate Tregs that recognize islet antigens, we engineered a chimeric antigen receptor (CAR) derived from a monoclonal antibody with specificity for the insulin B chain 10–23 peptide presented in the context of the IAg7 MHC class II allele present in NOD mice. Peptide specificity of the resulting InsB-g7 CAR was confirmed by tetramer staining and T cell proliferation in response to recombinant or islet-derived peptide. The InsB-g7 CAR redirected NOD Treg specificity such that insulin B 10–23–peptide stimulation enhanced suppressive function, measured via reduction of proliferation and IL-2 production by BDC2.5 T cells and CD80 and CD86 expression on dendritic cells. Cotransfer of InsB-g7 CAR Tregs prevented adoptive transfer diabetes by BDC2.5 T cells in immunodeficient NOD mice. In WT NOD mice, InsB-g7 CAR Tregs prevented spontaneous diabetes. These results show that engineering Treg specificity for islet antigens using a T cell receptor–like CAR is a promising therapeutic approach for the prevention of autoimmune diabetes.

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