Current protocols used to select CMV-specific T cells for adoptive immunotherapy focus on virus-specific memory T cells from seropositive donors. However, this strategy is not feasible in patients undergoing allogeneic haematopoietic stem-cell transplantation (HSCT) from CMV-seronegative donors. Here, we redirected T cells of CMV-seronegative donors with a human genetically engineered TCR recognizing an HLA-A*0201-binding peptide epitope of CMVpp65. To facilitate clinical translation of this approach, we used a non-viral expression system based on in vitro transcribed RNA and electroporation. Although memory and naïve-derived T-cell subsets were both efficiently transfected by TCR-RNA, memory-derived T cells showed much stronger levels of HLA-A*0201-restricted cytolytic activity to CMV-infected fibroblasts and maintained acquired function for 5-10 days. In addition to redirection of CD8 + cytotoxic T cells, TCR-RNA transfection was capable of redirecting CD4 + T cells into potent Ag-specific Th cells that efficiently triggered maturation of DCs. Our data suggest that memory rather than naïve-derived T cells are the preferred subset for transient TCR expression by RNA electroporation, providing more efficient and sustained virus-specific CD4 + and CD8 + T-cell function. CMV TCR-RNA may represent a suitable therapeutic 'off-the-shelf' reagent to be used in severe CMV infections of HSCT patients when endogenous CMV-specific T-cell immunity is insufficient.Keywords: Cytomegalovirus r memory T cells r naive T cells r RNA r T-cell receptor Supporting Information available online
IntroductionReactivation of latent human CMV infection is a frequent complication in patients undergoing allogeneic haematopoietic stemCorrespondence: Dr. Simone Thomas e-mail: thomass@uni-mainz.de cell transplantation (HSCT). Although effective antiviral drugs are available for the prophylaxis and treatment of CMV infection, progression to CMV disease still occurs and remains a major cause of morbidity and mortality in these patients. Risk factors for CMV reactivation include donor seronegativity in about 50% of transplantations, as well as the use of T-cell depleted allografts, transplants from unrelated or HLA-mismatched donors, and graftversus-host disease (GvHD) [1].C 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim www.eji-journal.eu Eur. J. Immunol. 2012. 42: 3442-3453 Clinical immunology
3443CMV control essentially requires the re-establishment of protective antiviral T-cell immunity in the host [2]. Thus, the adoptive transfer of virus-specific T lymphocytes into HSCT patients offers a reasonable alternative to antiviral drugs. Since treatment of reactivated CMV infection with unselected donor lymphocytes has been associated with GvHD [3], current efforts focus on the selection of CMV-specific CD4 + and CD8 + T cells for subsequent therapeutic use (reviewed in [4]). Specifically, direct sorting of virus-specific memory T cells from donor PBMCs using MHCpeptide multimers appears attractive [5]. However, this approach is presently res...