Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical application

Abstract Background Adoptive transfer of regulatory T cells (Tregs) has provided promising results in treating autoimmune disorders, transplant rejection and graft versus-host disease in early clinical trials. However, major challenges remain for developing a standardized and robust good manufacturi...

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Main Authors: Giorgia Fanelli, Philippa Marks, Apoorva Aiyengar, Marco Romano, Sakina Gooljar, Sandeep Kumar, Michael Burch, Giovanna Lombardi
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Journal of Translational Medicine
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Online Access:https://doi.org/10.1186/s12967-025-06561-9
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author Giorgia Fanelli
Philippa Marks
Apoorva Aiyengar
Marco Romano
Sakina Gooljar
Sandeep Kumar
Michael Burch
Giovanna Lombardi
author_facet Giorgia Fanelli
Philippa Marks
Apoorva Aiyengar
Marco Romano
Sakina Gooljar
Sandeep Kumar
Michael Burch
Giovanna Lombardi
author_sort Giorgia Fanelli
collection DOAJ
description Abstract Background Adoptive transfer of regulatory T cells (Tregs) has provided promising results in treating autoimmune disorders, transplant rejection and graft versus-host disease in early clinical trials. However, major challenges remain for developing a standardized and robust good manufacturing practice (GMP)-compliant cell product which is severely hampered by low frequency of Tregs in circulation and laborious ex vivo expansion. Methods Paediatric thymuses routinely obtained during heart surgery have been shown by us and others to be a valuable source of large numbers of pure Tregs (Thy-Tregs). Here we show results from our process development approach including systematic laboratory-scale testing of activation reagents, restimulation timing, and cryopreservation to translate our expansion protocol of Thy-Tregs into a clinical grade cell product. Results Thy-Tregs obtained through CD8+ cell depletion and subsequent CD25+ enrichment were expanded with αCD3/αCD28 beads in the presence of Rapamycin and IL-2 for 10–23 days using G-Rex bioreactors. We successfully embedded bead removal and final formulation of a cryopreserved cell product ready to be used at bedside transfusion. Conclusion This process has proved the capability of efficiently producing high number of functional Thy-Tregs, which will be administered as cell therapy in children undergoing heart transplantation (ATT-Heart, ISRCTN15374803), and enhancing the potential of using expanded Thy-Tregs for broad-ranging therapeutic applications.
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spelling doaj-art-5e2d36abe1514171bfcfc3c28e62a6592025-08-20T02:05:14ZengBMCJournal of Translational Medicine1479-58762025-06-0123111210.1186/s12967-025-06561-9Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical applicationGiorgia Fanelli0Philippa Marks1Apoorva Aiyengar2Marco Romano3Sakina Gooljar4Sandeep Kumar5Michael Burch6Giovanna Lombardi7Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King’s CollegeAdvanced Therapy Manufacturing (GMP) Unit Guy’s, St Thomas’ NHS Foundation Trust and King’s College London Clinical Research FacilityDepartment of Cardiology, Great Ormond Street Hospital NHS Foundation TrustPeter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King’s CollegeAdvanced Therapy Manufacturing (GMP) Unit Guy’s, St Thomas’ NHS Foundation Trust and King’s College London Clinical Research FacilityAdvanced Therapy Manufacturing (GMP) Unit Guy’s, St Thomas’ NHS Foundation Trust and King’s College London Clinical Research FacilityDepartment of Cardiology, Great Ormond Street Hospital NHS Foundation TrustPeter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King’s CollegeAbstract Background Adoptive transfer of regulatory T cells (Tregs) has provided promising results in treating autoimmune disorders, transplant rejection and graft versus-host disease in early clinical trials. However, major challenges remain for developing a standardized and robust good manufacturing practice (GMP)-compliant cell product which is severely hampered by low frequency of Tregs in circulation and laborious ex vivo expansion. Methods Paediatric thymuses routinely obtained during heart surgery have been shown by us and others to be a valuable source of large numbers of pure Tregs (Thy-Tregs). Here we show results from our process development approach including systematic laboratory-scale testing of activation reagents, restimulation timing, and cryopreservation to translate our expansion protocol of Thy-Tregs into a clinical grade cell product. Results Thy-Tregs obtained through CD8+ cell depletion and subsequent CD25+ enrichment were expanded with αCD3/αCD28 beads in the presence of Rapamycin and IL-2 for 10–23 days using G-Rex bioreactors. We successfully embedded bead removal and final formulation of a cryopreserved cell product ready to be used at bedside transfusion. Conclusion This process has proved the capability of efficiently producing high number of functional Thy-Tregs, which will be administered as cell therapy in children undergoing heart transplantation (ATT-Heart, ISRCTN15374803), and enhancing the potential of using expanded Thy-Tregs for broad-ranging therapeutic applications.https://doi.org/10.1186/s12967-025-06561-9Thy-TregsImmuno-therapyGMPClinical trial
spellingShingle Giorgia Fanelli
Philippa Marks
Apoorva Aiyengar
Marco Romano
Sakina Gooljar
Sandeep Kumar
Michael Burch
Giovanna Lombardi
Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical application
Journal of Translational Medicine
Thy-Tregs
Immuno-therapy
GMP
Clinical trial
title Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical application
title_full Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical application
title_fullStr Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical application
title_full_unstemmed Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical application
title_short Clinical grade expansion protocol for the manufacture of thymus-derived Treg cells for clinical application
title_sort clinical grade expansion protocol for the manufacture of thymus derived treg cells for clinical application
topic Thy-Tregs
Immuno-therapy
GMP
Clinical trial
url https://doi.org/10.1186/s12967-025-06561-9
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