H3K27M, a driver mutation with T- and B-cell neoepitope characteristics, defines an aggressive subtype of diffuse glioma with poor survival. We functionally dissect the immune response of one patient who was treated with an H3K27M peptide vaccine and subsequently entered complete remission. The vaccine robustly expanded class II HLA-restricted peripheral H3K27M-specific T cells. Using functional assays, we characterized 34 clonally unique H3K27M-reactive T cell receptors and identified critical, conserved motifs in their CDR3 regions. Using detailed HLA mapping, we further demonstrate that diverse HLA-DQ, and -DR alleles present immunogenic H3K27M epitopes. Furthermore, we identified and profiled H3K27M-reactive B cell receptors from activated B cells in the cerebrospinal fluid. Our results uncover the breadth of the adaptive immune response against a shared clonal neoantigen across multiple HLA allelotypes and support the use of class II-restricted peptide vaccines to stimulate tumor-specific T and B cells harboring receptors with therapeutic potential.
Antigen processing and presentation are crucial for T-cell receptor engagement and potent adaptive immune responses. While establishing an antigen presentation system to identify TCR-epitope pairs from large libraries of genetically templated, ectopically expressed antigens, we observed a longitudinal suppression of antigen processing in B cells, which we call antigen processing attenuation (APA). Beyond its potential role in regulating B cell-enforced peripheral tolerance, APA represents a bottleneck to sustained antigen presentation in screening and vaccination approaches. To overcome APA we screened several pathways which might enhance processing. Notably, we identified several sequences derived from transmembrane domains (TM) of endoplasmic reticulum-resident proteins which promote sustained minigene-encoded antigen presentation. In particular, the first TM domain of SYT6, a protein associated with synaptic vesicles, greatly enhances processing and ameliorates APA. These findings suggest a new entry point into antigen processing pathways, enabling the discovery of novel immune epitopes and improving T-cell based immunization strategies.
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