1. Adoptive T Cell Therapy: Harnessing the Other Arm
of the Adaptive Immune System to Fight Cancer
and Other Disease
Provides the specificity for
T Cell Antigen presenting
cell interactions
CD28
B7 proteins, CD80
and CD86
Signal 1
Signal 2
• Signal 2 amplifies
intracellular signals
initiated by signal
1
• Both signals
needed for T cell
activation,
redundancy likely
contributes to
mechanisms of
tolerance to self
antigens where
only signal 1 may
occur Upregulated by
pathogens
5. Integrins Contribute to the Strength of T Cell Antigen
Presentation Cell Interactions
weak initial
interaction between
integrin and ICAM
MHC/antigen-receptor
interaction sends signal
to activate integrin
strengthened
interaction between
integrin and ICAM
leukocyte adhesion
deficiency
beta subunit -LFA1 integrin
repeated bacterial
infections
inside-out signaling
6. Many Things have to Come Together to Activate a T
Cell, which BTW is Probably a Good Thing
11. Ribonucleotide Reductase: Properties
• Class I enzymes widely distributed
• Tetramer, R1 and R2 subunits
• 2 active sites at subunit interface
O
OH + 2Fe2+ + O2 + H+ + e
Fe3+
O2-
Fe3+
+ H2O
C
+
H
H
ENZ
C
H
H
ENZ
generation of tyrosine radical
on/off switch
substrate choice
• Multiple allosteric sites to regulate
enzyme activity and specificiy
12. Ribonucleotide Reductase: Insights into Reaction
Mechanism
OC
H
H
ENZ OHC
H
H
ENZ
C N OH
H
O
H2N
hydroxyurea
active enzyme inactive enzyme
tyrosine radical is distant from the enzyme’s
active site
14. O
OHOH
BP-P-O-CH2
H H
3′ H exchanges
with solvent
Ribonucleotide Reductase: Insights into Reaction
Mechanism
O
HOH
BP-P-O-CH2
H H
ribonucleotide
reductase
15. freeenergy(G)
reaction progress
S
P
-ΔG (P-S)
activation energy
(uncatalyzed reaction)
activation energy
(catalyzed reaction)
energy state
of substrates
energy state
of products
T*
transition
state
S P
reaction spontaneous
as written
Enzyme Energetics
[ES]
18. E
S
S
E
S H
S H
NDP
dNDP
225/462
RR
E
S H
S H
E
S
S
754/759
RR
E
S H
S H
E
S
S
thioredoxin
NADPH
NADP+
thioredoxin
reductase
reducing equivalents
derived from nutrients
Regeneration of Free Thiol Groups in the
Ribonucleotide Reductase Reaction Cycle
19. Use of Tumor Infiltrating Lymphocytes to Treat
Melanoma
• Melanoma is particularly responsive to immune-based therapies
• IL-2 alone can show significant responses in melanoma
• Melanoma tumor associated antigens – MART1 and gp100???
• Exomic sequencing in 3,000 tumor/normal pairs reveals a mutation rate
in melanoma of ~ 100 non-synonymous mutations/Mb compared to 0.1
in certain pediatric tumors
25. The Manufacturing Process for CAR-T Therapy
Can be performed in 10 days from blood
draw to reinfusion
26. James N. Kochenderfer et al. JCO 2015;33:540-549
CAR expression
central
memory T
cells
cytotoxicity
Anti-CD19 Chimeric Antigen Receptor (CAR) Design
and Function
27. Response to CAR-T Against CD19 in Patients with
Refractory Diffuse B Cell Lymphoma
mediastinal tumor
liver metastasis
splenic mass
Anti-CD19 chimeric antigen receptor (CAR) design and function. (A) Schematic of anti-CD19 CAR. Single-chain (sc) Fv region that recognizes CD19 was derived from FMC63 monoclonal antibody. CAR contained CD28 costimulatory domain and T-cell receptor (TCR) –ζ T-cell activation domain. (B) Anti-CD19 CAR T cells were produced by activating peripheral-blood mononuclear cells (PBMCs) with anti-CD3 antibody OKT3 on day 0 and transducing T cells on day 2. Cells were ready for infusion on day 10. (C) CAR expression on T-cell surface of infused cells of patient No. 1 was detected with anti-Fab antibodies. Isotype control staining of same T cells is also shown. Plots are gated on live CD3+ lymphocytes. (D) Plots show isotype control staining and CD45RA versus CCR7 staining of CD3+ CAR positive–infused cells of patient No. 1. (E) Anti-CD19 CAR-transduced T cells of patient No. 1 were cultured for 4 hours with either CD19-K562 cells expressing CD19 or nerve growth factor receptor (NGFR) –K562 cells not expressing CD19. CAR T cells upregulated CD107a, indicating degranulation, in CD19-specific manner. Plots gated on live CD3+ lymphocytes. Anti-CD19 CAR T cells of patient No. 1 were cultured for 6 hours with CD19-K562 or NGFR-K562 cells, and intracellular cytokine staining for (F) interferon gamma (IFNγ), (G) tumor necrosis factor (TNF), and (H) interleukin-2 (IL-2) was performed. CAR T cells produced cytokines in CD19-specific manner. Plots gated on CD3+ lymphocytes. For (E) to (H), experiments were performed on T cells at time of infusion into patient No. 1. LTR, long terminal repeat.