HLA matching or CRISPR editing of HLA class I/II enables engraftment and effective function of allogeneic human regulatory T cell therapy in a humanized mouse transplantation model

Authors:
Oliver McCallion, Weijie Du, Viktor Glaser, Kate Milward, Sarah Short, Merve Bilici, Amy Cross, Helen Stark, Clemens Franke, Jonas Kath, Mikhail Valkov, Mingxing Yang, Leila Amini, Annette Künkele, Julia K. Polansky, Michael Schmueck-Henneresse, Hans-Dieter Volk, Petra Reinke, Dimitrios L. Wagner, Joanna Hester & Fadi Issa 
In:
Source: Nat Commun.
Publication Date: (2025)
Issue: 16: 9090
Research Area:
Cancer Research/Cell Biology
Immunotherapy / Hematology
Gene Expression
Basic Research
Molecular Biology
Regenerative medicine
Drug Discovery
Cells used in publication:
T cell, human stim.
Species: human
Tissue Origin: blood
Culture Media:
Platform:
4D-Nucleofector® X-Unit
Experiment

Cell isolation and cell culture

For experiments intended for gene editing, pre-enrichment of CD4+ cells from PBMCs was performed using CD4 microbeads (Miltenyi Biotech) according to the manufacturer´s protocol. Due to their higher stability61, CCR7+ Tregs (CD4+CD25+CD127lowCCR7+) were sorted using a Tyto sorter (Miltenyi Biotech) after staining with aCD4 VioBlue (Miltenyi, REAL103), aCD25 APC (Miltenyi, REAL128), aCD127 PE-vio770 (Miltenyi, REAL102), aCD45RA FITC (Miltenyi, REAL164) and CCR7 PE (BioLegend, G043H7). Sorted Tregs were cultured in a 96 U well plate with 100,000 cells in 200 µl Treg medium per well. Treg medium consists of X-Vivo 15 (Lonza) medium supplemented with 10% heatinactivated FCS, 500IU/mL of recombinant human interleukin-2 (IL-2) (Miltenyi, Bergisch Gladbach, Germany) and 100 nMRapamycin (Pfizer).

Gene editing to modulate HLA surface expression on primary human Treg
Gene editing in Treg was performed as previously described40,41. After 7 days of culture MACS® GMP ExpAct™ Treg Kit beads were depleted using a MACSiMAG™ Separator (Miltenyi). Cells were removed from the magnet, counted, and then washed twice in sterile PBS by centrifugation at 100 × g for 10min at room temperature (RT). In parallel, Cas9 RNP was prepared. For the electroporation of 106 primary Tregs, 0.5 µL of poly(L-Glutamic acid) (PGA) (molecular weight 15,000- 50,000, Sigma-Aldrich, 100 µg/µL), 0.48 µL of synthetic modified sgRNA (Suppl. Data 3; 100 µM in TE buffer; IDT), and 0.4 µL recombinant SpCas9 protein (Alt-R S.p. Cas9 Nuclease V3; IDT; 61 µM) were mixed by thorough pipetting. Themixture was incubated for 15min at RT and placed on ice. For HLA-E KI conditions, 0.5 µL of HDRT (stock concentration: 1 µg/µL) was added prior to electroporation. 10^6 harvested Tregs were resuspended in 20 µL ice-cold P3 electroporation buffer (Lonza) just before electroporation to keep the exposure time to the electroporation buffers to a minimum. 20 µL of resuspended cells were transferred to the RNP/HDRT suspension, mixed thoroughly, and transferred into a 16-well electroporation strip (Lonza) without any air bubbles. The cellswere electroporated using the EH-115 program on the 4D-Nucleofector (Lonza). Immediately after electroporation, 90 µL of pre-warmed Tregmediumwas added per well. After 10 min, the cells were carefully resuspended and transferred to two 96- well round-bottom plates (50 µL/well) containing 150 µL pre-warmed Treg medium per well. The gene editing of HLA-E KI into B2M plus KO of CIITA Tregs (H/C Tregs) was performed in two subsequent editing steps. Seven days afterHLA-E KI into B2Ma second electroporationwas performed using adenine base editor ABE8.20-m30 mRNA produced in
house by in vitro transcription as described previously55. Tregs were harvested, beads were magnetically removed, and cells were washed twice in PBS. 5 × 10^6 cells were resuspended in 100 µl P3 electroporation buffer (Lonza) and mixed with 2 µg of ABE8.20-m mRNA and 0.48 µL of synthetic modified sgRNA (100 µM in TE buffer; IDT). The suspension was electroporated in 100 µl Nucleocuvette Vessels (Lonza) using a Lonza 4D nucleofector device (program EH-115). 900 µL of pre-warmed Treg medium was added per cuvette. After 10 min, the cells were carefully resuspended and transferred to a 24 well cell culture plate.

Abstract

Regulatory T cells (Tregs) hold promise for treating autoimmune disease and transplant rejection, yet generation of autologous products for adoptive transfer can suffer donor variability and slow turnaround, limiting their use in urgent indications. We therefore examine whether allogeneic, pre-manufactured (‘off-the-shelf’) Tregs could overcome these barriers. In a human skin-xenograft model, HLA-mismatched Tregs are swiftly eliminated by recipient CD8+ T cells and fail to protect grafts. Stringent matching of HLA class I and II restores efficacy but is clinically impractical. Using non-viral CRISPR editing we disrupt B2M and CIITA while inserting an HLA-E-B2M fusion, generating hypo-immunogenic Tregs that evade both T and NK cell attack. Engineered cells retain FOXP3 stability and potent in vitro suppression, and after a single low-dose infusion, prolong human skin graft survival in a humanized mouse model comparably to autologous Tregs. Histology and spatial transcriptomics reveal minimal cytotoxic infiltration and enrichment of immunoregulatory and tissue-repair programmes. Multiplex HLA engineering thus enables ready-to-use allogeneic Tregs that withstand host immune attack for adoptive transfer.