title: Isolation and expansion of cytomegalovirus-specific cytotoxic T lymphocytes to clinical scale from a single blood draw using dendritic cells and HLA-tetramers.
abstract: Cytomegalovirus (CMV) reactivation in immunocompromised recipients of allogeneic stem cell transplantation is a cause of morbidity and mortality from viral pneumonitis. Antiviral drugs given to reactivating patients have reduced the mortality from CMV but have toxic side effects and do not always prevent late CMV disease. Cellular immunotherapy to prevent CMV disease is less toxic and could provide prolonged protection. However, a practical approach to generating sufficient quantities of CMV-specific cytotoxic T cells (CTLs) is required. This study describes a system for generating sufficient CMV-specific CTLs for adoptive immunotherapy of HLA-A*0201 bone marrow transplant recipients from 200 mL donor blood. Donor monocytes are used to generate dendritic cells (DCs) in medium with autologous plasma, interleukin 4, granulocyte-macrophage colony-stimulating factor, and CD40 ligand. The DCs are pulsed with the immunodominant HLA-A*0201-restricted CMV peptide pp65(495-503), and incubated with donor T cells. These cultures are restimulated twice with peptide-pulsed lymphoblastoid cell lines (LCLs) or CD40-ligated B cells and purified with phycoerythrin (PE)-labeled pp65(495-503)/HLA-A*0201 tetramers by flow sorting, or with anti-PE paramagnetic beads. The pure tetramer-positive population is then rapidly expanded to obtain sufficient cells for clinical immunotherapy. The expanded CTLs are more than 80% pure, of memory phenotype, with a Tc1 cytokine profile. They efficiently kill CMV-infected fibroblasts and express the integrin VLA-4, suggesting that the CTLs could cross endothelial barriers. This technique is reproducible and could be used for generating CMV-specific CTLs to prevent CMV disease after allogeneic blood and marrow transplantation. (Blood. 2001;98:505-512)
authors.affiliation: Division of Transplantation Medicine, South Carolina Cancer Center, Palmetto Health Alliance and University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: S
authors.initials: S
authors.lastname: Szmania
authors.forename: A
authors.initials: A
authors.lastname: Galloway
authors.forename: M
authors.initials: M
authors.lastname: Bruorton
authors.forename: P
authors.initials: P
authors.lastname: Musk
authors.forename: G
authors.initials: G
authors.lastname: Aubert
authors.forename: A
authors.initials: A
authors.lastname: Arthur
authors.forename: H
authors.initials: H
authors.lastname: Pyle
authors.forename: N
authors.initials: N
authors.lastname: Hensel
authors.forename: N
authors.initials: N
authors.lastname: Ta
authors.forename: L
authors.initials: L
authors.lastname: Lamb
authors.forename: T
authors.initials: T
authors.lastname: Dodi
authors.forename: A
authors.initials: A
authors.lastname: Madrigal
authors.forename: J
authors.initials: J
authors.lastname: Barrett
authors.forename: J
authors.initials: J
authors.lastname: Henslee-Downey
authors.forename: F
authors.initials: F
authors.lastname: van Rhee
mesh_terms: D000938:Antigen-Presenting Cells / Q000166:cytology / Q000276:immunology / Q000821:virology; D000956:Antigens, Viral / Q000276:immunology / Q000302:isolation & purification; D018929:Cell Culture Techniques / Q000379:methods; D002469:Cell Separation; D003587:Cytomegalovirus / Q000737:chemistry / Q000276:immunology*; D003713:Dendritic Cells / Q000166:cytology / Q000276:immunology / Q000821:virology*; D005347:Fibroblasts / Q000821:virology; D006801:Humans; D016130:Immunophenotyping; D016219:Immunotherapy, Adoptive; D007959:Lymphocyte Culture Test, Mixed; D010750:Phosphoproteins / Q000276:immunology; D013602:T-Lymphocytes, Cytotoxic / Q000166:cytology / Q000276:immunology / Q000821:virology*; D014763:Viral Matrix Proteins / Q000276:immunology
chemical_list: D000956:Antigens, Viral; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa