In vivo generation of human CD19-CAR T cells results in B-cell depletion and signs of cytokine release syndrome

EMBO Mol Med. 2018 Nov;10(11):e9158. doi: 10.15252/emmm.201809158.

Abstract

Chimeric antigen receptor (CAR) T cells brought substantial benefit to patients with B-cell malignancies. Notwithstanding, CAR T-cell manufacturing requires complex procedures impeding the broad supply chain. Here, we provide evidence that human CD19-CAR T cells can be generated directly in vivo using the lentiviral vector CD8-LV specifically targeting human CD8+ cells. Administration into mice xenografted with Raji lymphoma cells and human peripheral blood mononuclear cells led to CAR expression solely in CD8+ T cells and efficacious elimination of CD19+ B cells. Further, upon injection of CD8-LV into mice transplanted with human CD34+ cells, induction of CAR T cells and CD19+ B-cell depletion was observed in 7 out of 10 treated animals. Notably, three mice showed elevated levels of human cytokines in plasma. Tissue-invading CAR T cells and complete elimination of the B-lymphocyte-rich zones in spleen were indicative of a cytokine release syndrome. Our data demonstrate the feasibility of in vivo reprogramming of human CD8+ CAR T cells active against CD19+ cells, yet with similar adverse effects currently notorious in the clinical practice.

Keywords: T‐cell targeting; cytokine release syndrome; gene delivery; humanized mouse.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigens, CD19 / metabolism*
  • B-Lymphocytes / immunology*
  • Cytokines / metabolism*
  • Graft vs Host Disease / immunology
  • HEK293 Cells
  • Humans
  • Leukocytes, Mononuclear / transplantation
  • Lymphocyte Depletion*
  • Mice
  • Receptors, Chimeric Antigen / immunology*
  • Syndrome
  • T-Lymphocytes / immunology*

Substances

  • Antigens, CD19
  • Cytokines
  • Receptors, Chimeric Antigen