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2018 ; 8
(1
): 7428
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A Phase I Clinical Trial with Ex Vivo Expanded Recipient Regulatory T cells in
Living Donor Kidney Transplants
#MMPMID29743501
Mathew JM
; H-Voss J
; LeFever A
; Konieczna I
; Stratton C
; He J
; Huang X
; Gallon L
; Skaro A
; Ansari MJ
; Leventhal JR
Sci Rep
2018[May]; 8
(1
): 7428
PMID29743501
show ga
There is considerable interest in therapeutic transfer of regulatory T cells
(Tregs) for controlling aberrant immune responses. Initial clinical trials have
shown the safety of Tregs in hematopoietic stem cell transplant recipients and
subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may
induce transplant tolerance thus avoiding long-term use of toxic
immunosuppressive agents that cause increased morbidity/mortality. Towards
testing our hypothesis, we conducted a phase I dose escalation safety trial
infusing billions of ex vivo expanded recipient polyclonal Tregs into living
donor kidney transplant recipients. Despite variability in recipient's renal
disease, our expansion protocol produced Tregs which met all release criteria,
expressing >98% CD4(+)CD25(+) with <1% CD8(+) and CD19(+) contamination. Our
product displayed >80% FOXP3 expression with stable demethylation in the FOXP3
promoter. Functionally, expanded Tregs potently suppressed allogeneic responses
and induced the generation of new Tregs in the recipient's allo-responders in
vitro. Within recipients, expanded Tregs amplified circulating Treg levels in a
sustained manner. Clinically, all doses of Treg therapy tested were safe with no
adverse infusion related side effects, infections or rejection events up to two
years post-transplant. This study provides the necessary safety data to advance
Treg cell therapy to phase II efficacy trials.