Genetically engineered human islets protected from CD8-mediated autoimmune destruction in vivo

Mol Ther. 2013 Aug;21(8):1592-601. doi: 10.1038/mt.2013.105. Epub 2013 May 21.

Abstract

Islet transplantation is a promising therapy for type 1 diabetes, but graft function and survival are compromised by recurrent islet autoimmunity. Immunoprotection of islets will be required to improve clinical outcome. We engineered human β cells to express herpesvirus-encoded immune-evasion proteins, "immunevasins." The capacity of immunevasins to protect β cells from autoreactive T-cell killing was evaluated in vitro and in vivo in humanized mice. Lentiviral vectors were used for efficient genetic modification of primary human β cells without impairing their function. Using a novel β-cell-specific reporter gene assay, we show that autoreactive cytotoxic CD8(+) T-cell clones isolated from patients with recent onset diabetes selectively destroyed human β cells, and that coexpression of the human cytomegalovirus-encoded US2 protein and serine proteinase inhibitor 9 offers highly efficient protection in vitro. Moreover, coimplantation of these genetically modified pseudoislets with β-cell-specific cytotoxic T cells into immunodeficient mice achieves preserved human insulin production and C-peptide secretion. Collectively, our data provide proof of concept that human β cells can be efficiently genetically modified to provide protection from killing mediated by autoreactive T cells and retain their function in vitro and in vivo.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autoimmunity*
  • C-Peptide / metabolism
  • CD8-Positive T-Lymphocytes / immunology*
  • Cytotoxicity, Immunologic
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / metabolism
  • Gene Expression
  • Gene Order
  • Genetic Vectors / genetics
  • HLA-A2 Antigen / immunology
  • Humans
  • Insulin / genetics
  • Insulin / immunology
  • Insulin-Secreting Cells / metabolism
  • Islets of Langerhans / immunology*
  • Islets of Langerhans / metabolism*
  • Islets of Langerhans Transplantation*
  • Lentivirus / genetics
  • Male
  • Mice
  • Organ Specificity / genetics
  • Promoter Regions, Genetic
  • Protein Precursors / immunology
  • Serpins / genetics
  • Serpins / immunology
  • T-Lymphocytes, Cytotoxic
  • Transduction, Genetic
  • Viral Envelope Proteins / genetics
  • Viral Envelope Proteins / immunology

Substances

  • C-Peptide
  • HLA-A2 Antigen
  • Insulin
  • Protein Precursors
  • Serpins
  • US2 protein, Varicellovirus
  • Viral Envelope Proteins
  • preproinsulin