CAR T cells targeting Aspergillus fumigatus are effective at treating invasive pulmonary aspergillosis in preclinical models

• Published in: Science translational medicine 2022-09, Vol.14 (664), p.eabh1209
• Main Authors: Seif, Michelle, Kakoschke, Tamara Katharina, Ebel, Frank, Bellet, Marina Maria, Trinks, Nora, Renga, Giorgia, Pariano, Marilena, Romani, Luigina, Tappe, Beeke, Espie, David, Donnadieu, Emmanuel, Hünniger, Kerstin, Häder, Antje, Sauer, Markus, Damotte, Diane, Alifano, Marco, White, P Lewis, Backx, Matthijs, Nerreter, Thomas, Machwirth, Markus, Kurzai, Oliver, Prommersberger, Sabrina, Einsele, Hermann, Hudecek, Michael, Löffler, Jürgen
• Format: Article
• Language: English
• Subjects: Adoptive immunotherapy; Adoptive transfer; Animals; Antifungal activity; Antifungal Agents; Antigens; Aspergillosis; Aspergillus fumigatus; CD4 antigen; CD8 antigen; Cell therapy; Cell walls; Chimeric antigen receptors; Clinical isolates; Cytokines; Granzyme B; Granzymes; Hyphae; Immunocompromised hosts; Immunodeficiency; Immunotherapy; Infectious diseases; Invasive Pulmonary Aspergillosis - therapy; Life Sciences; Lymphocytes; Lymphocytes T; Macrophages; Mice; Patients; Perforin; Receptors, Chimeric Antigen; T-Lymphocytes
• ISSN: 1946-6234; 1946-6242; 1946-3242
• DOI: 10.1126/scitranslmed.abh1209

is a ubiquitous mold that can cause severe infections in immunocompromised patients, typically manifesting as invasive pulmonary aspergillosis (IPA). Adaptive and innate immune cells that respond to are present in the endogenous repertoire of patients with IPA but are infrequent and cannot be consistently isolated and expanded for adoptive immunotherapy. Therefore, we gene-engineered -specific chimeric antigen receptor (Af-CAR) T cells and demonstrate their ability to confer antifungal reactivity in preclinical models in vitro and in vivo. We generated a CAR targeting domain AB90-E8 that recognizes a conserved protein antigen in the cell wall of hyphae. T cells expressing the Af-CAR recognized strains and clinical isolates and exerted a direct antifungal effect against hyphae. In particular, CD8 Af-CAR T cells released perforin and granzyme B and damaged hyphae. CD8 and CD4 Af-CAR T cells produced cytokines that activated macrophages to potentiate the antifungal effect. In an in vivo model of IPA in immunodeficient mice, CD8 Af-CAR T cells localized to the site of infection, engaged innate immune cells, and reduced fungal burden in the lung. Adoptive transfer of CD8 Af-CAR T cells conferred greater antifungal efficacy compared to CD4 Af-CAR T cells and an improvement in overall survival. Together, our study illustrates the potential of gene-engineered T cells to treat aggressive infectious diseases that are difficult to control with conventional antimicrobial therapy and support the clinical development of Af-CAR T cell therapy to treat IPA.