Viral infections cause morbidity and mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. We and others have successfully generated and infused T-cells specific for Epstein Barr virus (EBV), cytomegalovirus (CMV) and Adenovirus (Adv) using monocytes and EBV-transformed lymphoblastoid cell (EBV-LCL) gene-modified with an adenovirus vector as antigen presenting cells (APCs). As few as 2x10 5 /kg trivirus-specific cytotoxic T lymphocytes (CTL) proliferated by several logs after infusion and appeared to prevent and treat even severe viral disease resistant to other available therapies. The broader implementation of this encouraging approach is limited by high production costs, complexity of manufacture and the prolonged time (4-6 weeks for EBV-LCL generation, and 4-8 weeks for CTL manufacture -total 10-14 weeks) for preparation. To overcome these limitations we have developed a new, GMP-compliant CTL production protocol. First, in place of adenovectors to stimulate T-cells we use dendritic cells (DCs) nucleofected with DNA plasmids encoding LMP2, EBNA1 and BZLF1 (EBV), Hexon and Penton (Adv), and pp65 and IE1 (CMV) as antigen-presenting cells. These APCs reactivate T cells specific for all the stimulating antigens. Second, culture of activated T-cells in the presence of IL-4 (1,000U/ml) and IL-7 (10ng/ml) increases and sustains the repertoire and frequency of specific T cells in our lines. Third, we have used a new, gas permeable culture device (G-Rex) that promotes the expansion and survival of large cell numbers after a single stimulation, thus removing the requirement for EBV-LCLs and reducing technician intervention. By implementing these changes we can now produce multispecific CTL targeting EBV, CMV, and Adv at a cost per 10 6 cells that is reduced by >90%, and in just 10 days rather than 10 weeks using an approach that may be extended to additional protective viral antigens. Our FDAapproved approach should be of value for prophylactic and treatment applications for high risk allogeneic HSCT recipients.
Video LinkThe video component of this article can be found at https://www.jove.com/video/2736/ Protocol 1. DC nucleofection 1. Harvest monocyte-derived DCs, which have been enriched using plastic adherence, cultured for 5 days using Cell Genix Media supplemented with IL4(1000U/ml), GMCSF (800IU/ml) and further matured for 24hrs using the DC maturation cytokines IL4(1000U/ml), GMCSF (800IU/ml), IL6100ng/ml, TNF-α 10ng/ml, IL1-β 10ng/ml and PGE2 (1μg/ml) 1 , by gentle resuspension with a 3ml transfer pipette. 2. Count viable DCs using trypan blue, transfer into 3x 15ml tubes with no fewer than 0.5x10 6 and no more than 2x10 6 cells/tube.3. Centrifuge DCs for 10mins @ 200g. During this time pre-warm Cell Genix media supplemented with the DC maturation cytokines (DC maturation media) -2ml/well in three wells of a 12-well tissue culture treated plate in a 37°C/5% CO 2 incubator. 4. Once cells have finished spinning, aspirate the supernatant and add the relevant DNA plasmids to each o...