While T cell-based immunotherapies using cells expressing antigen-specific receptors (CARs or TCRs) have produced promising clinical responses, current approaches are limited to autologous T cells due to the risk of graft-versus-host disease (GvHD) from allogeneic T cells through endogenous TCR expression and rejection through MHC incompatibility. Human pluripotent stem cells (PSCs) have the potential to address these challenges as they are an infinitely self-renewing source of hematopoietic cells, and are amenable to gene editing approaches to address alloreactivity; however, the two main barriers to using allogeneic T cells represent two critical components required for inducing positive selection in developing T cells. Mature, na�ve T cell differentiation is dependent on signaling through TCR-MHC interactions to induce positive selection, and removal of either would effectively block this process. This dissertation explores gene editing and T cell differentiation strategies that can circumvent the basic requirements for inducing positive selection to generate antigen-specific, Class I MHC- null, cytotoxic T cells using the in vitro “Artificial Thymic Organoid” system developed in our lab.
Chapter 2 focuses on preventing alloreactive TCRs development by ablating the recombination activating genes (RAG1 and RAG2), generating RAG1-/-RAG2-/- double knockout (DKO) PSCs, responsible for endogenous TCR recombination. To support positive selection, edited PSCs were transduced to express a fully rearranged, Class I MHC-restricted 1G4 TCR (DKO+TCR), and it was determined that positive selection hinged on endogenous expression of the 1G4 TCR’s cognate MHC.
Chapter 3 centers around artificially inducing positive selection in the absence of both endogenous TCRs and MHCs. To prevent T cell rejection, DKO+TCR PSCs were edited to knockout beta-2-microglobulin (B2M), a critical subunit of Class I MHC heterodimers, to generate RAG1-/-RAG2-/-B2M-/- triple knockout PSCs with the 1G4 TCR (TKO+TCR). In order to induce positive selection of antigen-specific, Class I MHC-null, mature, na�ve T cells from TKO+TCR PSCs, the stromal component of the ATO system was engineered to provide the 1G4 TCR’s cognate MHC. Functional and transcriptional validation of TKO+TCR engineered T cells revealed a similar phenotype and cytokine release profile to unedited T cells, complete restriction of endogenous TCRs, and improved antigen-specific cytotoxicity in vivo.