Integration of ?-deficient CARs into the CD3-zeta gene conveys potent cytotoxicity in T and NK cells

Authors:
Kath J, Franke C, Drosdek V, Du W, Glaser V, Fuster-Garcia C, Stein M, Zittel T, Schulenberg S, Porter CE, Andersch L, Künkele A, Alcaniz J, Hoffmann J, Abken H, Abou-El-Enein M, Pruß A, Suzuki M, Cathomen T, Stripecke R, Volk HD, Reinke P, Schmueck-Henneresse M, Wagner DL
In:
Source: Blood
Publication Date: (2024)
Issue: 143(25): :2599-2611
Research Area:
Cancer Research/Cell Biology
Immunotherapy / Hematology
Gene Expression
Basic Research
Molecular Biology
Drug Discovery
Cells used in publication:
Natural killer Cells (NK), human
Species: human
Tissue Origin: blood
NK-92
Species: human
Tissue Origin: blood
Platform:
4D-Nucleofector® X-Unit
Experiment

Genetic engineering

Targeted virus-free CAR-integration was performed as recently described. In short, human T or NK-cells were transfected with precomplexed CRISPR Cas9 ribonucleoproteins (RNP) and double-stranded DNA (dsDNA) (DNA/sgRNA Sequences: Suppl. Table 1). The dsDNA served as template for HDR and consisted of the (CAR/truncCAR) transgene flanked by 400bp homology arms. Cells were  resuspended in 20µl P3 Electroporation Buffer (Lonza, Cologne, Germany) and electroporated with 1µg HDR-template and 1.38µl RNP consisting of synthetic modified single guide RNA (sgRNA, 100 µM, Integrated DNA Technologies (IDT), Coralville, IA), 15-50kDa poly(L-glutamic acid) (100µg/µl, Sigma-Aldrich, St. Louis, MO) and recombinant SpCas9 protein (61µM, IDT) in a 0.96:1:0.8 volume ratio using the 4D-Nucleofector (Lonza). T-cells activated for 48h on CD3/CD28-coated tissue culture plates were electroporated at a density of 5x10^4 cells/µl buffer using program  EH-115. Primary human NK-cells were expanded in NK medium using NK activation/expansion beads (Miltenyi) for 6-7 days and electroporated using program DA-100. The NK-92 line was electroporated at 2.5x10^4 cells/µl with the program CA-137. 10min post-electroporation, T-cells were transferred into medium supplemented with 0.5µM HDR-Enhancer v2 (IDT).

Abstract

Chimeric antigen receptor (CAR)-redirected immune cells hold significant therapeutic potential for oncology, autoimmune diseases, transplant medicine, and infections. All  approved CAR-T therapies rely on personalized manufacturing using undirected viral gene transfer, which results in non-physiological regulation of CAR-signaling and  limits their accessibility due to logistical challenges, high costs and biosafety requirements. Random gene transfer modalities pose a risk of malignant transformation by insertional mutagenesis. Here, we propose a novel approach utilizing CRISPR-Cas gene editing to redirect T-cells and natural killer (NK) cells with  CARs. By transferring shorter, truncated CAR-transgenes lacking a main activation  domain into the human CD3? (CD247) gene, functional CAR fusion-genes are  generated that exploit the endogenous CD3? gene as the CAR’s activation domain. Repurposing this T/NK-cell lineage gene facilitated physiological regulation of CAR- expression and redirection of various immune cell types, including conventional T cells, TCR?/d T-cells, regulatory T-cells, and NK-cells. In T-cells, CD3? in-frame  fusion eliminated TCR surface expression, reducing the risk of graft-versus-host disease in allogeneic off-the-shelf settings. CD3?-CD19-CAR-T-cells exhibited comparable leukemia control to T cell receptor alpha constant (TRAC)-replaced and  lentivirus-transduced CAR-T-cells in vivo. Tuning of CD3?-CAR-expression levels significantly improved the in vivo efficacy. Notably, CD3? gene editing enabled redirection of NK-cells without impairing their canonical functions. Thus, CD3? gene editing is a promising platform for the development of allogeneic off-the-shelf cell therapies using redirected killer lymphocytes.