Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host disease

Abstract: Allogeneic hematopoietic stem cell transplantation is an established treatment for hematological malignancies and some genetic diseases. Acute graft-versus-host disease (GVHD) is the most common and debilitating side effect with poor survival rates of 5% to 30% for severe cases. In this ma...

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Main Authors: Madelyn Espinosa-Cotton, Sayed Shahabuddin Hoseini, Ileana C. Miranda, John Herrick, Nai-Kong V. Cheung
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952924005561
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author Madelyn Espinosa-Cotton
Sayed Shahabuddin Hoseini
Ileana C. Miranda
John Herrick
Nai-Kong V. Cheung
author_facet Madelyn Espinosa-Cotton
Sayed Shahabuddin Hoseini
Ileana C. Miranda
John Herrick
Nai-Kong V. Cheung
author_sort Madelyn Espinosa-Cotton
collection DOAJ
description Abstract: Allogeneic hematopoietic stem cell transplantation is an established treatment for hematological malignancies and some genetic diseases. Acute graft-versus-host disease (GVHD) is the most common and debilitating side effect with poor survival rates of 5% to 30% for severe cases. In this manuscript, we describe a tetravalent T-cell–engaging bispecific antibody (BsAb) based on the immunoglobulin G-[L]-single-chain variable fragment (IgG-[L]-scFv) platform, with all 4 binding domains specific for CD3. In vitro, picomolar concentrations of the CD3×CD3 BsAb induced potent lysis of activated CD4 and CD8 T cells. In immunodeficient mice, in which human T cells induced xenogeneic GVHD, administration of 0.1 μg BsAb per dose depleted the majority of T cells from the peripheral blood, and 10 μg per dose completely reversed established GVHD and achieved a 100% survival rate. In mice bearing NALM6-luc xenografts, treatment with CD3×CD19 BsAb and activated human T cells induced complete remission of the leukemia, and all treated mice developed GVHD by 50 days after treatment. CD3×CD3 BsAb (3-30 μg doses) reversed clinical signs of GVHD, allowing long term follow-up beyond 250 days. T cells were undetectable by polymerase chain reaction in 4 of 5 mice in the 30 μg CD3×CD3 BsAb group 180 days after leukemia injection, and complete necropsies on day 259 revealed no evidence of human T cells or leukemia cells. Curing GVHD allows for long-term follow-up of tumor response heretofore impossible in humanized mouse models. Further studies are warranted to determine whether the CD3×CD3 BsAb has potential for treating clinical GVHD and other autoimmune diseases in humans.
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spelling doaj-art-637f2765b3af49128bd4fa45dc75c7cb2025-08-20T02:51:00ZengElsevierBlood Advances2473-95292025-01-019111612610.1182/bloodadvances.2022009187Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host diseaseMadelyn Espinosa-Cotton0Sayed Shahabuddin Hoseini1Ileana C. Miranda2John Herrick3Nai-Kong V. Cheung4Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NYDepartment of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NYLaboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, New York, NYDepartment of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NYDepartment of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY; Correspondence: Nai-Kong V. Cheung, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 170, New York, NY 10065;Abstract: Allogeneic hematopoietic stem cell transplantation is an established treatment for hematological malignancies and some genetic diseases. Acute graft-versus-host disease (GVHD) is the most common and debilitating side effect with poor survival rates of 5% to 30% for severe cases. In this manuscript, we describe a tetravalent T-cell–engaging bispecific antibody (BsAb) based on the immunoglobulin G-[L]-single-chain variable fragment (IgG-[L]-scFv) platform, with all 4 binding domains specific for CD3. In vitro, picomolar concentrations of the CD3×CD3 BsAb induced potent lysis of activated CD4 and CD8 T cells. In immunodeficient mice, in which human T cells induced xenogeneic GVHD, administration of 0.1 μg BsAb per dose depleted the majority of T cells from the peripheral blood, and 10 μg per dose completely reversed established GVHD and achieved a 100% survival rate. In mice bearing NALM6-luc xenografts, treatment with CD3×CD19 BsAb and activated human T cells induced complete remission of the leukemia, and all treated mice developed GVHD by 50 days after treatment. CD3×CD3 BsAb (3-30 μg doses) reversed clinical signs of GVHD, allowing long term follow-up beyond 250 days. T cells were undetectable by polymerase chain reaction in 4 of 5 mice in the 30 μg CD3×CD3 BsAb group 180 days after leukemia injection, and complete necropsies on day 259 revealed no evidence of human T cells or leukemia cells. Curing GVHD allows for long-term follow-up of tumor response heretofore impossible in humanized mouse models. Further studies are warranted to determine whether the CD3×CD3 BsAb has potential for treating clinical GVHD and other autoimmune diseases in humans.http://www.sciencedirect.com/science/article/pii/S2473952924005561
spellingShingle Madelyn Espinosa-Cotton
Sayed Shahabuddin Hoseini
Ileana C. Miranda
John Herrick
Nai-Kong V. Cheung
Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host disease
Blood Advances
title Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host disease
title_full Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host disease
title_fullStr Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host disease
title_full_unstemmed Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host disease
title_short Targeting T cells with tetravalent bispecific antibodies for the treatment of graft-versus-host disease
title_sort targeting t cells with tetravalent bispecific antibodies for the treatment of graft versus host disease
url http://www.sciencedirect.com/science/article/pii/S2473952924005561
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