CA3040035C - Nucleotide sequence expressing an exosome-anchoring protein for use as vaccine - Google Patents

Abstract

The present invention concerns a nucleotide sequence expressing a fusion protein, said fusion protein comprising or consisting of an exosome- anchoring protein fused at its C-terminus with an antigen, or a DNA expression vector comprising said nucleotide sequence, for use as vaccine.

Description

Nucleotide sequence expressing an exosome-anchoring protein for use as vaccine The present invention concerns a nucleotide sequence expressing s an exosome-anchoring protein for use as vaccine. Particularly, the present invention concerns a nucleotide sequence expressing a fusion protein, said fusion protein comprising or consisting of an exosome-anchoring protein fused at its C-terminus with an antigen, or a DNA expression vector comprising said nucleotide sequence, for use as vaccine. 10 It is known that immune response protects from both external and internal health threats. In many cases, when the natural immunity cannot contain the development of the pathology, the immune response elicited by inoculation of immunogens can block the pathogenic process, as occurs, for instance, through the induction of neutralizing antibodies 1s against several infective pathogens.

Differently, the identification, production, and marketing of CTLbased vaccines is much more restricted although there is a wide consensus about its potential usefulness against the development of chronic infections and tumor diseases. 2 o Eliciting a strong and broad CTL immune response is expected to be of therapeutic relevance for the treatment of several pathologies. For instance, several lines of evidence suggest that cell-mediated immune responses are important in controlling HPV infection and, by consequence, the virus-associated neoplasia. In fact, either general immunosuppression, 2 s or poor anti-HPV CTL response associate with viral persistence and disease progression.

The most commonly used experimental techniques for the induction of antigen-specific CTL immunity are based on the use of viral vectors, peptides and inactivated pathogens. To date, however, no CTL 3 o immunogenic drug is available on the market.

DNA vaccination for the production of immunogenic proteins recognized successes. For instance, a DNA vaccine against Japanese encephalitis has been released in 2010 for human use (1). In addition, WO 2018/069947 PCT /IT2017 /000223 2 a veterinary DNA vaccine to protect horses from West Nile virus has been approved (2, 3). Also, a preliminary study in DNA vaccination against multiple sclerosis was reported as being effective (4). Altogether, these evidences support the idea that, in principle, DNA vaccination can s have a perspective of applicability in humans. Among the advantages of DNA vaccination, ease of development and production, stability for storage, cost-effectiveness, and persistence of the immunogen should be mentioned. Theoretical disadvantages would be represented by the possible production of anti-DNA antibodies, and interference on the 10 genetically-controlled mechanisms of cell growth. However, the major limitation is represented by the not adequate potency of the evoked immune response. For this reason, many vaccination protocols including the use of DNA for priming the immune response are followed by the inoculation of the immunogen under alternative formulations to boost the 15 immunity.

Exosomes are vesicles of 50-100 nanometers released constitutively by all cell types. They are generated by the inward invagination of endosome membranes. These intraluminal vesicles form the multivesicular bodies (MVBs) which can traffic to the plasma 2 o membrane, to which they fuse thereby releasing their vesicular contents in the extra-cellular milieu. Nanovesicles showing both physical and biochemical features resembling exosomes but generated through direct extrusion of plasma membrane have been described in muscle cells (5, 6).

While exosomes were previously thought to be exclusively devoted to 2s secretion of waste cell material, it is now accepted that exosomes are part of the intercellular communication network. They incorporate messenger RNAs, microRNAs, DNA, and proteins which can be functional in target cells.

Their immunogenicity is basically a consequence of the amounts 3 o and quality of antigens they incorporate. Exosomes were investigated in terms of anti-tumor immunostimulatory agents, and in some cases they reach the approval for clinical trials (7-9). Exosomes spontaneously uploading tumor antigens, mainly trans-membrane proteins like gp100, WO 2018/069947 PCT /IT2017 /000223 3 TRP-1, Her2/neu, and CEA, have been found inducing activation of specific anti-tumor T cell immunity (10, 11 ). Clinical trials demonstrated both feasibility and good tolerance of exosomes as cell-free vaccines in tumor patients. However, their therapeutic efficacy appeared quite limited, s posing the need of new methods to increase their immunogenicity. This issue has been faced by engineering foreign antigens to increase their display on the exosome membrane. In this regard, two strategies have been described so far. The first one exploits the binding of C1 C2 domains of lactadherin to exosome lipids resulting in the association of the 1 o heterologous antigen with the external side of exosome membranes. The other one relies on coating exosomes with Staphylococcus aureus enterotoxin A tailed with a highly hydrophobic trans-membrane domain.

The budding of HIV requires the interaction with a number of cell factors also involved in exosome biogenesis, i.e., Alix, Tsg101, and 1 s several other components of the endosomal sorting complex required for transport (ESCRT). Also the envelope membranes of HIV and exosomes share many components, including lipid rafts, i.e., cell membrane microdomains enriched in cholesterol, phospholipids with saturated side chains, and sphingolipids. The convergence of exosome and HIV 20 biogenesis implies the possibility that viral products incorporate in exosomes. It is the case of HIV-1 Nef which associates through anchoring its N-terminal myristoylation to lipid raft microdomains at the limiting membrane of MVB. Nef is a 27 kilodalton (kDa) protein lacking enzymatic activities, however acting as a scaffold/adaptor element in triggering 2 s activation of signal transducing molecules, in most cases upon association with lipid raft microdomains.

A v 153 L E177G Nef mutant incorporating at quite high levels in HIV- 1 particles, HIV-1-based virus-like particles (VLPs) (12), and exosomes (13) has been previously identified. The efficiency of exosome 3 o incorporation still increases when this mutant was engineered with an Nterminal palmitoylation through G3c mutation, expectedly consequence of an improved association with lipid rafts. This Nef mutant (referred to as Nef"1°1 ) is defective for basically all Nef functions, and its efficiency of 4 incorporation in nanovesicles does not change significantly when fused at its C-terminus with foreign proteins. Manipulating Nef11ut allows the incorporation of high amounts of antigens of choice into exosomes which thus remain protected from external neutralization/degradation factors. It s has been recently reported that Nernut_engineered exosomes produced in vitro induce .an effective antigen-specific CTL response (14). Particularly, quite promising results using in vitro produced exosomes carrying HPV-E7 protein as immunogen (14) have been already obtained.

However, in view of a potential clinic application of these findings, 10 this strategy would face with possible technical difficulties including standardization of industrial manufacturing, high cost-effectiveness, and storage of the immunogen. In addition, in vitro produced exosomes are expected to have a limited half-life upon injection, being also prone to clearance from the reticulum-endothelial system of the host through the 1s recognition of the "non-self' molecules associated to the exosome membrane. On this subject, it has been documented that the half-life of either ex vivo isolated or in vitro produced exosomes lasts around 2 minutes after injection, showing a prompt accumulation in liver and spleen, and. only small amounts of exosomes remain detectable after 4 20 hours.

In the light of above it is therefore apparent the need to provide for new immunotherapies able to overcome the disadvantages of the known therapies.

On this technical background, the present invention provides a new 25 vaccine strategy based on the production of endogenous engineered exosomes which is able to overcome the disadvantages of known therapeutic strategies inducing CTL immune response for the treatment of infective and tumor diseases.

According to the present invention, it has been found that the 3 o administration of DNA vectors expressing NefTiu1-based fusion proteins into the host animal by intramuscular (i.m.) inoculation elicits a potent CTL immune response strongly inhibiting the growth of already implanted tumor cells. Several lines of evidence indicate that the production of endogenous CA 03040035 201.9-04-l.0 engineered exosomes was on the basis of the observed anti-tumor effect.

Particularly, the results according to the present invention show: i) the ability of muscle cells to produce engineered exosomes after DNA transfection; ii) the reproducible induction of antigen-specific CTL immunity s after inoculation of a vector expressing Nef11u1/E7 showing a strong antitumor effect in . a therapeutic setting, and iii) the immunogenicity of exosomes isolated from plasma of DNA-inoculated mice reinfused in recipient mice.

In addition, whether and how efficiently the ectopic expression of 1 o Nernut leads to the release of engineered exosomes have been investigated. Data obtained with C2C12 cells supported the idea that Neriut accumulates into exosome-like nanovesicles released by murine muscle cells at levels similar to those detectable in human cells. The investigations did not include terminally differentiated muscle cells, i.e., the 15 cell type most likely targeted by i.m. inoculation in mice. It has been assumed th.at in these cells the mechanisms underlying the vesicle intracellular trafficking do not change, at least qualitatively.

On this subject, the detection of engineered exosomes in plasma from mice inoculated i.m. with Neflut-based DNA vectors supported the 2 o idea that Neflut can accumulate in exosomes released by differentiated muscle cells also. Theoretically, it cannot be excluded that at least part of injected DNA could target other cell types by means, for instance, of the diffusion of DNA in draining lymph nodes where it can be captured and internalized by dendritic cells(DCs). However, it is plausible that the DNA 2 s uptake by DCs was not relevant part of the mechanism of the here described CD8+ T cell activation events considering that the sub-cute inoculation of Nef1u1/E7 expressing DNA, which is expected to preferentially target DCs, gave rise to a significantly fainter E7-specific CD8+ T cell immune response (not shown). 3 o The extents of cos+ T cell activation detected in DNA inoculated mice appeared much stronger that those which has been observed in mice injected with in vitro produced engineered exosomes (14). Even though direct comparative experiments cannot be run in view of the impossibility 6 to compare the amounts· of the two different immunogens, the DNA inoculation elicited an E7-specific CD8+ T cell activation strong enough to be clearly detected without the in vitro stimulation/expansion of splenocytes. needed when mice were inoculated with exosomes produced s in vitro by human cells (14). The apparently superior outcomes obtained with DNA injection was likely the consequence of the fact that cells expressing the inoculated DNA can establish a continuous source of immunogenic exosomes ready to be internalized by both local and distal APCs. 1 o According to the present invention, several experimental evidences have been provided concerning the mechanism underlying the CTL immune response observed after DNA injection. In particular, the detection of fluorescent exosomes in plasma of mice inoculated with a vector expressing GFP fused with Nef1ut proved that engineered exosomes were 15 indeed produced upon DNA vector injection. In addition, Nef1ut activities other than its accumulation in exosomes seemed unimportant for the CD8+ T cell activation since it was detected in mice injected with vector expressing Nef1ut but not with wild-type Nef. Consistently, it has been observed that the CTL response did not rely on the release of free 2 o antigens from DNA-targeted cells, as indicated by the lack of E7-specific CD8+ T cell response in mice injected with E7-expressing vectors where the E7 extra-cellular shedding was witnessed by the anti-E7 antibody response. In addition, it has been proved that exosomes isolated from plasma of mice injected with vector expressing Nef1ut/E7, but not E7 2s alone, were immunogenic when injected in naive, recipient mice.

Taken together, these experimental evidences were consistent with the idea that the production of immunogenic endogenous engineered exosomes was on the basis of the coa+ T cell activation. Notably, this immune response appeared both fast and strong enough to efficiently 30 counteract the growth of syngeneic tumor cells implanted before the immunizations.

On the basis of the here presented experimental evidences, the most likely mechanism underlying the coa+ T cell activation induced by WO 2018/069947 PCT/IT2017 /000223 7 inoculation of DNA vectors expressing Nef"1u1-based vectors can be summarized as reported on fig. 1. Muscle cells expressing the injected DNA vector release engineered exosomes which are internalized by APCs. As previously demonstrated, the internalization of Nef"1u1-based s exosomes leads to cross-presentation of the associated antigens and, by consequence, priming of antigen-specific CD8+ T cells. The boosting of the immune response ensured by the second DNA injection would be strengthened by the continuous production of exosomes from cells targeted by the inoculated DNA Accordingly to what previously observed 10 in mice inoculated with in vitro produced exosomes (14), neither anti-E7 nor anti~Nef antibodies were detected in plasma from inoculated mice, strongly suggesting that exosome-uploaded antigens basically elicit a TH- 1 biased immune response.

Finally, in view of a possible application of this findings to human 15 breast cancer, the following aspects were also investigated: i) whether the immunogenic stimulus induced by the engineered exosomes can break immune tolerance, and ii) their effectiveness when applied in human system. In particular, to test whether the immune activation induced by in vivo engineered exosomes can be strong enough to break tolerance, the 2 o widely investigated model of HER2/neu transgenic mice has been considered (15). Here, the rHER2/neu transgene is expressed in thymus, leading to a tolerance severely impairing the CDS+ T branch, as proven by the fact that CD8+ T lymphocytes escaping the tolerance are very poorly represented (16). Through IFN-y Elispot assay, we reproducibly assessed 2 s that two injections of DNA vector expressing Neflutrused with the extracellular domain of HER2 (HER2-ECD) were sufficient to break the coa+ T tolerance towards HER2/neu.. These results were relevant since a significant HER2/neu-specific CTL response was never found in these transgenic mice upon injection of HER2/neu-expressing DNA vectors (17- 3 O 19).

Interestingly, it was found that this immune activation correlated with a delay in tumor development. This is the first time that a CTL-related but antibody-independent inhibition of tumor development has been 8 observed in HER2/neu transgenic mice. On the other hand, the fact that the immunologic pressure generated by the HER2-ECD-specific CTL immune response was not sufficient to cure the tumor disease was not surprising for at least two reasons. First, in HER2/neu transgenic mice all s mammary epithelial cells simultaneously express the oncogene, resulting in a synchronous development of multiple neoplastic lesions. Hence, the anti-tumor immunity can be overwhelmed by the multiplicity of transformation events. In addition, the intrinsic genetic instability of tumor cells can lead to escaping from the immune pressure through the so-called 10 immune-editing mechanism summarized by the three "Es", i.e., elimination, equilibrium, and escape (20). In this way, the anti-tumor immune response selects for alterations in cancer cells able to evade the immune control. Of course, the effectiveness of such a mechanism is expected to increase with the number of concurrent tumor lesions. 15 To open the possibility to exploit the tool of the present invention in clinic, its effectiveness in human system was also demonstrated. To this end, experiments were set up using conditions reproducing the mechanism underlying the induction of antigen-specific CDB+ T lymphocyte immune response previously described in mice (21 ). The 2 o outcome from a confocal microscope analysis was consistent with the idea that the product of DNA vector transfected in human primary muscle cells can be internalized by DCs through formation of engineered exosomes.

Furthermore, data from cross-priming assays indicate that the production by transfected muscle cells of exosomes engineered for the incorporation 2 s of Nef1u1 or derivatives thereof is sufficient to generate a well-detectable antigen-specific CTL activity. The fact that the antigen-specific crosspriming was severely impaired when inhibitors of exosome biosynthesis were used was consistent with the idea that the delivery of engineered exosomes to DCs was a key step for the generation of the antigen-specific 3 o CTL activation. Overall, the results obtained with ex vivo cells indicate the absence of obvious restrictions in the use of the Nef1u1-based CTL vaccine platform in humans.

On the basis of the above, the CTL vaccine platform according to WO 2018/069947 PCT/IT2017 /000223 9 the present invention represents a novel therapy against solid tumors.

Breaking tolerance towards tumor-associated self-antigens as well as improving the response against tumor-associated antigens represent the next frontier in terms of anti-tumor immunotherapy (22). CTL vaccine s platform based on engineering endogenous exosomes according to the present invention has the potential to meet both end-points, hence representing a truly novel concept in terms of CTL immunization.

The here proposed strategy to induce CTL immunity based on engineered endogenous exosomes exploits the ease of production, 10 storage, and delivery typical of DNA vaccines combined with the potent immunogenicity of antigens uploaded in exosomes upon fusion with Nef1°t as well as its intrinsic great flexibility in terms of the choice of the immunogen.

According to the present invention, it has been provided a DNA 15 vector called "Nef"ut shuttle" conceived to easily insert and express the sequences of the antigen of choice.

From the structural point of view; the DNA vector according to the present invention may undergo improvements both in terms of transcriptional efficiency, for example by replacing the CMV-IE promoter 2 o with other promoters even more powerful, and/or inserting stabilizing sequences of the transcript (eg., Woodchuck Hepatitis Virus posttranscriptional Regulatory Elements, WPRE), and reducing to the minimum size the "exosome-anchoring protein" thus favoring the incorporation of the antigen fused to it. 25 Since according to the present invention, exosomes/nanovesicles can be engineered "in vivo" to incorporate large amounts of any antigen, the present biotechnology platform can be of therapeutic benefit against any disease susceptible to the attack of specific CTL.

The use for therapeutic· purposes of vaccination based on DNA 3 o vectors expressing fusion products with the "exosome-anchoring protein" Nef1°t according to the present invention is applicable to all pathologies that may benefit from an effective CTL immune response.

Clearly, the number and origin of the antigens which can be engineered can be expanded in relation to the therapeutic strategies to deal with.

It is therefore specific object of the present invention a nucleotide sequence expressing a fusion protein, said fusion protein comprising or consisting of the exosome-anchoring protein of sequence SEQ ID NO:1 s fused at its C-terminus with an antigen, or a DNA expression vector comprising said nucleotide sequence, for use in vaccine prevention and therapy, wherein SEQ ID NO:1 is the following sequence: MGCKWSKSSV VGWPAVRERM RRAEPAADGV GAASRDLEKH GAITSSNTAA TNADCAWLEA QEEEEVGFPV TPQVPLRPMT YKAAVDLSHF LKEKGGLEGL IHSQRRQDIL DLWIYHTQGY FPDWQNYPTG PGIRYPL TFG WCYKLVPVEP EKLEEANKGE NTSLLHPVSL HGMDDPGREV LEWRFDSRLA FHHVARELHP EYFKNC.

The nucleotide sequence or DNA expression vector according to 1s the present invention can be administered preferably intramuscularly; other routes of administration can be aerosol administration (i.e. administration to the upper airway), intradermal, mucosal, sub-cute administration.

The antigen can be chosen from the group consisting of Human 20 Papilloma virus antigen such as E6 and E7, HIV antigen such as Gag and Tat, Ebola virus antigen such as VP24, VP40, NP, and GP, West Nile virus antigen such as NS3, HBV antigen such as Core, HCV antigen such as Core, NS3, E1 and E2, Crimean-Congo virus antigen such as GP and NP, Influenza A virus antigen such as NP and M1, human melanoma antigen 25 such as MAGE-A3 and MART-1, human tumor-associated antigens such as Her2/Neu, Hox B7.

As mentioned above, the nucleotide sequence expressing the exosome-anchoring protein of sequence SEQ ID NO: 1 can be the following nucleotide sequence SEQ ID NO:2 (Nef"u1 nucleotide sequence): 3 o atg ggt tgc aag tgg tea aaa agt agt gtg gtt gga tgg cct get gta agg gaa aga atg aga cga get gag cca gca gca gat ggg gtg gga gca gca tct cga gac eta gaa aaa cat gga gca ate aca agt age aat aca gca get ace aat get gat tgt gee tgg eta gaa gca caa gag gag gag gag gtg ggt ttt cca gtc aca cct cag WO 2018/069947 PCT/IT2017 /000223 11 gta cct tta aga cca atg act tac aag gca get gta gat ctt age cac ttt tta aaa gaa aag 999 gga ctg gaa gg9 eta att cac tee caa c9a a9a caa gat ate ctt gat ctg tgg ate tac cac aca caa ggc tac ttc cct gat tgg cag aac tac aca cca gga cca 999 gtt aga tat cca ctg ace ttt gga tgg tgc tac aag eta gta cca gtt s gag cca gag aag tta gaa gaa gee aac aaa gga gag aac ace age ttg tta cac cct gtg age ctg cat gga atg gat gac ccg gcg aga gaa gtg tta gag tgg agg ttt gae age cgc eta gea ttt cat cac gtg gee cga gag ctg cat ccg gag tac ttc aag aac tgc tga The nucleotide sequence or DNA expression vector according to 10 the present invention can be used for the prevention and treatment of diseases chosen from the group consisting of chronic infective diseases such as HBV, HGV and HIV, tuberculosis and malaria, acute infective diseases such as influenza, West Nile, Crimean-Congo hemorrhagic fever and Ebola diseases, tumors such as breast, pulmonary, prostate or 15 bladder tumor.

The present invention concerns also a pharmaceutical composition comprising or consisting of a nucleotide sequence expressing a fusion protein, said fusion protein comprising or consisting of the exosomeanchoring protein of sequence SEQ ID NO:1 fused at its C-terminus with 2 o an antigen or a DNA expression vector comprising said nucleotide sequence, in association with one or more pharmaceutically acceptable excipients and/or adjuvants, such as an adjuvant of CDS+ T cells response (for instance lscomatrix™ adjuvant), wherein SEQ ID NO:1 is the following sequence: 2s MGCKWSKSSV VGWPAVRERM RRAEPAADGV GAASRDLEKH GAITSSNTAA TNADCAWLEA YKAAVDLSHF LKEKGGLEGL QEEEEVGFPV IHSQRRQDIL TPQVPLRPMT DLWIYHTQGY FPDWQNYPTG PGIRYPL TFG WCYKLVPVEP EKLEEANKGE NTSLLHPVSL HGMDDPGREV LEWRFDSRLA FHHVARELHP EYFKNC.

As mentioned above, the antigen can be chosen from the group consisting of Human Papilloma virus antigen such as E6 and E7, HIV antigen such as Gag and Tat, Ebola virus antigen such as VP24, VP40, 12 NP and GP, West Nile virus antigen such as NS3, HBV antigen such as Core, HCV antigen such as Core, NS3, E1 and E2; Crimean-Congo virus antigen such as NP and GP; Influenza A virus antigen such as NP and M1; human melanoma antigen such as MAGE-A3 and MART-1; human s tumor-associated antigens such as Her2/Neu, HoxB7.

According to an embodiment of the present invention, the nucleotide sequence expressing the exosome-anchoring protein of sequence SEQ ID N0:1 can be the following sequence SEQ ID N0:2: atg ggt tgc aag tgg tea aaa agt agt gtg gtt gga tgg cct get gta agg gaa aga 1 o atg aga cga get gag cca gca gca gat ggg gtg gga gca gca tct cga gac eta gaa aaa cat gga gca ate aca agt age aat aca gca get ace aat get gat tgt gee tgg eta gaa gca caa gag gag gag gag gtg ggt ttt cea gtc aca ect eag gta cct tta aga cca atg act tac aag gea get gta gat ett age eae ttt tta aaa gaa aag ggg gga ctg gaa ggg eta att eac tee caa cga aga caa gat ate ctt 15 gat ctg tgg ate tac cac aca eaa ggc tac ttc cct gat tgg cag aac tac aca cca gga cca ggg gtt aga tat cca ctg ace ttt gga tgg tgc tac aag eta gta cca gtt gag cca gag aag tta gaa gaa gee aac aaa gga gag aac ace age ttg tta cac cct gtg age ctg cat gga atg gat gac ccg gcg aga gaa gtg tta gag tgg agg ttt gac age cgc eta gca ttt cat cac gtg gee cga gag ctg cat ccg gag tac ttc aag 2 o aac tgc tga The pharmaceutical composition can be administered preferably by intramuscular administration; other routes of administration can be aerosol administration (i.e. administration to the upper airway), intradermal, mucosal, sub-cute administration. 25 In addition, the present invention concerns a pharmaceutical composition as mentioned above for use in vaccine prevention and therapy for instance in the prevention and treatment of diseases chosen from the group consisting of chronic infective diseases such as HCV and HIV, tuberculosis and malaria, acute infective diseases such as influenza, 30 West Nile, Crimean-Congo hemorrhagic fever and Ebola diseases, tumors such as breast, pulmonary, prostate or bladder tumor.

The nucleotide sequence, the DNA expression vector or the pharmaceutical composition comprising the same according to the present 13 invention can be used in medical field as well as in veterinary field.

The present invention now will be described by an illustrative, but not !imitative way, according to preferred embodiments thereof, with particular reference to enclosed drawings, wherein: s Figure 1 shows the scheme of the mechanism underlying the CTL activation induced by the inoculation of Nef"'ut_based DNA vectors. After injection with DNA vector expressing an antigen fused to Nef'1°t, transfected muscle cells release both unmodified and engineered exosomes. The contents of these latter, once internalized by APC and 10 cross-presented, induce the priming/activation of COB+ T lymphocytes specific for the antigens uploaded in endogenous engineered exosomes.

Figure 2 shows the detection of engineered exosomes in supernatants of transfected murine muscle cells. A. FACS analysis of both human 293T and murine C2C12 muscle cells two days after 15 transfection with either Nef1ut/GFP or NefG2AIGFP expressing vectors. M1 marks the range of positivity as established by the analysis of mocktransfected cells. Percentages of positive cells are reported. B.

Quantification in terms of AchE activity of exosomes recovered by differential centrifugations of supernatants from the same number (i.e., 20 5x106 ) of both 293T and C2C12 transfected cells. C. Western blot analysis of exosomes from both 293T and C2C12 transfected cells. Nef-based products were detected in both cell lysates and exosomes, while J3-actin and Alix served as markers for cell lysates and exosomes, respectively.

Arrows sign 'the relevant protein products. Molecular markers are given in 25 kDa. D. FACS analysis of exosomes from C2C12 transfected cells. 10 mu of exosomes from C2C12 cells transfected with either Nef1ut_GFP- or NefG2A-GFP-expressing vectors were analyzed by FACS in terms of both forward/side scatter (upper panels) and GFP fluorescence (lower panels).

Quadrants indicate either the dimension of the detected particulate (upper 3 o panels), or the range of positivity as calculated by the analysis of exosomes from mock-transfected cells. Results are representative of two independent experiments. 14 Figure 3 shows the detection of fluorescent nanovesicles in plasma from mice inoculated with a NeFu1-GFP expressing DNA vector. A. Analysis of the expression of GFP-related products in muscle tissues from mice inoculated with the indicated DNA vectors. s Magnification: 40x. 8. C57 BI/6 mice were inoculated i.m. with DNA vectors expressing the indicated products, and after 3 and 9 days exosomes were isolated from plasma by differential centrifugations. Then, equivalent amounts (i.e., 1 mU) of exosomes were bound to surfactantfree white aldehyde/sulfate latex beads, and finally assayed for their 10 fluorescence. As control, 10 μU of exosomes isolated from the supernatants of 293T cells transiently transfected with Nef'1ut_GFP vector were used (Ctrl+). Quadrants were set on the basis of the fluorescence of untreated beads. Percentages of positive events are indicated. Results are representative of two assays. 1s Figure 4 shows the inoculation of Nerut/E7 DNA vector inducing an E7-specific cos+ T cell immune response in the absence of antibody production. CDS+ T cell immune response in mice inoculated with DNA vectors expressing either E7 or Nef1u1/E7, or with empty vector. C57 B1/6 mice (six per group) were inoculated two times with the different 2 o DNA vectors. Splenocytes recovered from mice were incubated with or without 5 ~tg/ml of either unrelated (not shown), E7, or Nef specific nonamers. Cell activation extents were evaluated by IFN-y Elispot assay carried out in triplicate with 105 cells/well. As control, untreated cells were also incubated with 5 ng/ml of PMA and 500 ng/ml of ionomycin. Shown 2s are the number of IFN-y spot-forming cells (SFU)/105 cells from triplicate wells seeded with splenocytes from each inoculated mice. Intergroup means + SD of SFU were also reported. The results are representative of three independent experiments. * p<0.05. B. CTL assay carried out with cos+ T cells from mice inoculated with the indicated vectors. cos+ T cells 3 o isolated from splenocytes from different inoculated mice were pooled and cultured for 6 hours at different cell ratios (i.e., from 20: 1 to 5: 1) with EL-4 cells previously labeled with CFSE and pre-treated with either unrelated or E7 peptides for 16 h. Six h later, the EL-4 cell mortality levels were scored by FAGS analysis upon 7-AAD labeling. Shown are the results 3 s representative of four independent experiments. C. Anti-E7 antibody detection in plasma from mice inoculated with the indicated DNA vectors.

As internal positive control standard (Ctrl+), 1 :10,000 dilutions of plasma from mice injected with 10 μg of either recombinant E7 or Nef proteins plus adjuvant were used. Shown are the mean absorbance values +SD of triplicates of plasma pooled from six mice per group.

Figure 5 shows that the injection of wtNef-expressing DNA 5 vector fails to elicit Nef-specific cos+ T cell immune response in mice. Net-specific coa+ T cell immune response in mice inoculated with DNA vectors expressing wtNef, Neflut, or with empty vector. C57 B1/6 mice (four per group) were inoculated i.m. two times with the DNA vectors, and ten days after the last immunization, mice were sacrificed and splenocytes 10 cultured in IFN-y Elispot microwells for 16 hours in the absence or presence of either unrelated or Net-specific nonamers. As control, untreated cells were also incubated with 5 ng/ml of PMA and 500 ng/ml of ionomycin. Shown are the mean + SD number of SFU/105 cells. The results are representative of two independent experiments. * p<0.05. 15 Figure 6 shows E7-specific cos+ T cell immunity induced in mice injected with exosomes from mice inoculated with Nernut/E7 DNA vector. cos+ T cell immune response in mice inoculated with exosomes isolated from plasma of syngeneic mice previously injected with vectors expressing E7, Nef1u1/E7, or empty vector. C57 BI/6 mice (8 for 20 group, donor mice) were inoculated two times with the indicated DNA vectors, and ten days after the last inoculation, PBMCs were recovered from retro orbital bleeding and tested in IFN-y Elispot assay for the presence of E7-specific CD8+ T cell response (upper panels}. Two days later, the mice were sacrificed, and exosomes isolated from plasma by 2 5 differential centrifugations. Equivalent amounts of these exosomes were then used to inoculate syngeneic mice (3 per group) three times. Ten days after the last inoculation, the splenocytes were recovered and the coa+ T cell activation extents evaluated by IFN-y Elispot assay carried out in triplicate (lower panel). 30 In all lFN-y Elispot assays, cells were also incubated with 5 ng/ml of PMA and 500 ng/ml of ionomycin. Shown are the mean + SD number of SFU/105 cells. Results are representative of two independent experiments. * p<0.05.

Figure 7 shows the therapeutic anti-tumor effect induced by 35 i.m. inoculation of Nef"1ut/E7 DNA vector. C57 BI/6 mice were challenged with 2><105 TC-1 cells and 4 days later, when tumor masses 16 were detectable by palpation, were inoculated with DNA vector expressing Nef11ut/E7 (seven mice) or, as control, Nef11ut, empty vector, or vehicle (four mice per group). The DNA inoculations were repeated at day 11 after tumor cell implantation, and the growth of tumor mass was followed over s time. A. E7-specific cos+ T cell response by IFN-y Elispot assay in PBMCs recovered from retro orbital bleeding 7 days after the last immunization, and cultivated for 16 hours in the presence of either unrelated or E7 peptides. As control, PBMCs were also incubated with 5 ng/ml of PMA and 500 ng/ml of ionomycin. Shown are the number of 10 SFU/105 cells from triplicate wells seeded with splenocytes from each inoculated mice B. Determination of the tumor size during the 30-day observation time. C. Weight measure of tumors from mice injected with either Nef11ut or Nef11u1/E7 DNA vectors at the time of sacrifice.

Shown are the values detected for each inoculated mouse. Results 1s are representative of two independent experiments.

Figure 8 shows the detection of exosomes engineered with HER2/neu ECD • in supernatants of transfected cells. Western blot analysis of lysates of both cells and exosomes from cultures of 293T cells transfected with vector expressing either Nef"ut, Nef"u1/HER2 ECD, or the 2 o void vector. Net-based products were detected in both cells and exosomes, while 13-actin and Alix served as markers for cell lysates and exosomes, respectively. Arrows sign the relevant protein products.

Molecular markers are given in kDa. Results are representative of five independent experiments. 2 s Figure 9 shows the detection of anti-HER2/neu antibodies in plasma from inoculated mice. Plasma for mice injected with vectors expressing either Nef"ut or Nef11u1/HER2-ECD were incubated with 293T cells transfected two days before with an HER2/neu expressing vector.

After incubation with secondary Abs, the cells were fixed and FACS 30 analyzed. As positive controls, both plasma from mice injected with lysates of 676-1-25 tumor cells constitutively over-expressing HER2/neu (HER2/neu cells), and an anti-HER2/neu mAb (Ctrl+) were used. Results 17 are presented as mean values +SD of the mean fluorescent intensities (MFI) detected by FACS using plasma from each injected mouse, and are representative of two assays.

Figure 10 shows the detection of HER2/neu-specific cos+ T cell s immunity induced in mice upon injection of DNA vector expressing Nef'1ut/HER2-ECD. CD8+ T cell immune response in mice inoculated with DNA vectors expressing either Nef1u1 or Nef1u1/HER2-ECD, or with empty vector (Void). 129Sv-Neu T mice (five per group) were i.m. inoculated two times with the different DNA vectors. At the time of sacrifice, 105 10 splenocytes were incubated o.n. with or without 5 μg/ml of either unrelated, Nef-, or HER2-ECD-specific nonamers in either duplicate or triplicate IFN-y Elispot microwells. As control, cells were also incubated in the absence of peptides (Nil). Shown are the mean number of IFN-y spotforming units (SFU)/105+SD. The results are representative of three 1s independent experiments. * p<0.05. On the bottom, a developed IFN-y Elispot plate from a representative assay is shown.

Figure 11 shows the detection of the HER2/neu-specific cos+ T cell immunity induced in DNA injected mice couples with an antigenspecific CTL activity. CTL assay carried out with CD8+ T cells from mice 20 inoculated with the indicated vectors. cos+ T cells were isolated from pooled splenocytes, cultured in duplicate for 6 hours at 1 O: 1 cell ratio with TC-1 cells previously labeled with CFSE, and treated for 16 h with either unrelated, Nef-, or HER2-ECD-specific peptides. Six h later, TC-1 cell mortality was scored by FAGS analysis upon 7-AAD labeling. Shown are 2 s the mean values +SD calculated from three independent experiments. * p<0.05. Mean value of background conditions (i.e., co-culture of cos+ T lymphocytes from narve mice with untreated TC-1 cells): 8.1±3.5. On the bottom, representative dot plots from FAGS analysis of the co-cultures are shown. The percentages of double-fluorescent over the total of CFSE- 30 positive cells are indicated.

Figure 12 shows the Anti-tumor effect induced by inoculation of Nef'1u1/HER2-ECD DNA vector. 129Sv- NeuT mice (5 for group) were 18 inoculated two times with either the indicated DNA vectors or the vehicle (Nil) at both 15 and 17 weeks of age. A. Tumor incidence, expressed as the number of mice with at least one tumor >1 mm in diameter. B. Tumor multiplicity, calculated as the cumulative number of tumors/total number of s mice +SD. Data are representative of three independent experiments.

Figure 13 shows the Internalization in iDCs of exosomes released by human primary skeletal muscle cells. A. FAGS analysis of SKMC 2 days after transfection with vectors expressing either GFP, NefluVGFP, or empty vector. Shown are GFP fluorescence levels as 10 detected in a representative of five independent experiments. The percentages of GFP positive cells are indicated. M1: range of positivity. B.

Confocal microscope analysis of co-cultures comprising iDCs and SKMC transfected with DNA vectors expressing either GFP or Net"1u1/GFP, the latter carried out in the presence or not of both GW4869 and 15 spiroepoxide. Slides were stained with both DAPI (blue fluorescence) and anti-CD45 mAb (red fluorescence) before analysis. For co-cultures comprising Nef"1u1/GFP-transfected SKMC, two sections of the same field are reported, the first one highlighting CD45 positive cells (top panel, black arrows), whereas in the image at the bottom, both Net"1u1/GFP- 20 expressing SKMC (greenblack arrow) and regions of fluorescence accumulation into iDCs (white arrows) are indicated.

Figure 14 shows the Net-specific CTL activity elicited by human DCs co-cultivated with muscle cells expressing Nernut_based DNA vectors. A. Scheme of the cross-priming assays. SKMC were transfected 25 and, 48 hours later, put in co-culture with iDCs which, after additional 24 hours, were isolated and matured. Autologous PBLs were then added to mDCs, and the co-cultivation was carried out for 7 days. Afterwards, the PBL stimulation was repeated, and after additional 7 days, CD8+ T lymphocytes were isolated and tested in CTL assays through co-cultivation 3 o with syngeneic target cells. B. Western blot analysis of cell lysates from either parental or Net"1ut stably transfected MCF-7 cells. Filters were incubated with either anti-Nef or anti-p-actin Abs. Arrow signs the relevant protein product. Molecular markers are given in kDa. C. CTL assay carried 19 out by co-cultivating primed coa+ T lymphocytes with MCF-7 cells expressing or not Nernut in a 10:1 cell ratio. Results were presented as mean values +SD calculated from triplicate conditions of three independent experiments. * p<0.05. Mean value of background conditions s (i.e., co-culture of na'ive coa+ T lymphocytes with MCF-7): 11.9±5.

Figure 15 shows that the treatment with inhibitors of exosome synthesis blocks the cross-priming induced by DCs isolated from cocultures with transfected SKMC. SKMC were transfected with a DNA vector expressing the NefTiu1/MART-1 fusion product and, after 2 days, put 1 o in co-culture with iDCs in the presence or not of both GW4869 and spiroepoxide. After 16 hours, iDCs were isolated, matured, and put in coculture with autologous PBLs. After two cycles of stimulation, CD8+ T lymphocytes were isolated and challenged in a CTL assay by 1 O: 1 cocultivations with CFSE-labeled, syngeneic B-LCLs previously treated with 15 either unrelated or MART-1 specific peptides. Shown are the mean percentages of target cell mortality +SD calculated from triplicate conditions of three independent experiments. Mean value of background conditions (i.e., co-culture of na"ive coa+ T lymphocytes with untreated syngeneic B-LCLs): 7.3±2.1 20 EXAMPLE 1: Study of anti-tumor HPV El-specific CTL activity elicited by in vivo engineered exosomes produced through DNA inoculation MATERIALS AND METHODS Molecular constructs and cell cultures 2s All molecular constructs were based on IE-CMV-promoted vectors.

The constructions of vectors expressing Nef1ut (13), NefTiu1-GFP (13), NefG2A-GFP (23), wtNef (24), and HPV-E7 (25), have been already described. 293T, murine muscle C2C12, and HPV-E7 expressing TC-1 tumor cells were grown in Dulbecco's modified Eagle's medium plus 3 o 10% heat-inactivated fetal calf serum (FCS). Transfection assays were carried out using the Lipofectamine 2000-based method, which in the 85213194 case of C2C12 cells was modified by adding liposomes on freshly trypsinized cells. Both mouse splenocytes and EL-4 cells, i.e., murine thymic lymphoma CD4+ T cells originally obtained from C57 Bl/6 mice upon treatment with 9, 10-dimethyl-1,2-benzanthracene, were cultivated in s RPMI medium supplemented with 10% FCS.

Exosome isolation. detection. and characterization Exosomes were isolated from cell supernatants through differential centrifugations. In detail, supernatants were centrifuged at 50Qxg for 10 min. Then, supernatants underwent differential centrifugations 10 consisting in a first ultracentrifugation at 1 0,000xg for 30 min.

Supernatants were then harvested, filtered with 0.22 μM pore size, and ultracentrifuged at 70,000xg for I h. Pelleted vesicles were resuspended in 1 xPBS, and ultracentrifuged again at 70,000xg for 1 h.

Afterwards, pellets were resuspended in 1: 100 of the initial volume of 1s 1 xPBS. The recovery of exosomes from plasma of inoculated mice was carried out in a similar way except that samples were 5-fold diluted before starting centrifugations whose running times were doubled. The amounts of recovered exosomes were evaluated by measuring the activity of acetylcholinesterase (AchE), i.e., a classical exosome marker, through the 20 Amplex Red™ kit (Molecular Probes) following the manufacturer's recommendations. The AchE activity was measured as mU/mL, where 1 mu is defined as the amount of enzyme which hydrolyzes 1 pmole of acetylcholine to choline and acetate per minute at pH 8.0 at 37 °C.

Fluorescent exosomes from transfected cell cultures were either 2s directly detected by FAGS (Gallios, Beckman Coulter), or, in the case of exosomes isolated from plasma, analyzed upon binding with aldehyde/sulfate latex beads (lnvitrogen Molecular Probes). To this end, samples were incubated with 5 μI of beads overnight at r.t. on a rotating plate, and then washed, resuspended in 1 xPBS-2% v/v formaldehyde, 30 and FAGS analyzed.

For western blot analysis of exosomes, equivalent amounts of nanovesicles were lysed in PBS, 1% Triton™ X-100 in the presence of antiproteolytic agents, and then separated by 10% SDS-PAGE. Meanwhile, Date Rei;ue/Date Received 2024-05-22 21 western blot analysis was carried out also on lysates of transfected cells by washing cells twice with 1 xPBS (pH 7.4) and lysing them for 20 min on ice with lysis buffer (20 mM HEPES pH 7.9, 50 mM NaCl, 10 mM EDTA, 2 mM EGTA, 0.5% nonionic detergent IGEPAL CA-630, supplemented with s anti-proteolytic agents. Whole cell lysates were centrifuged at 6,000xg for 10 min at 4°C. Protein concentration of cell extracts was determined by the Lowry protein quantitation assay. Aliquots of 30 to 50 μg of total proteins were resolved by 10% SDS-PAGE. Proteins were transferred by electroblotting on a 0.45 μm pore size nitrocellulose membrane 10 (Amersham) overnight using a Bio-Rad Trans-Blot. Filters were revealed using 1: 1000 diluted sheep anti-Net antiserum ARP 444 (a generous gift of M. Harris, University of Leeds, Leeds, UK), and both 1 :250 diluted anti-~ actin AC-74 mAb from Sigma, and anti-Alix H-270 polyclonal Abs from Santa Cruz. 15 Mice immunization and detection of IFN-r producing COB+ T lymphocytes All studies with animals here described have been approved by the Ethical Committee of the lstituto Superiore di Sanita, Rome, Italy (protocol n. 555/SA/2012) according to Legislative Decree 116/92 which has 20 implemented in Italy the European Directive 86/609/EEC on laboratory animal protection. Animals used in the research have been housed and treated according to the guidelines inserted in here above mentioned Legislative Decree. C57 81/6 mice were purchased from Charles River Laboratories, and inoculated i.m. two times at ten day intervals with 50 μg 2s each back leg of plasmid DNA purified with endotoxin-free Qiagen kit.

Mice were also inoculated subcutaneously (s.c.) with 6 mU equivalents of AchE activity of exosomes purified from plasma of mice injected with DNA vectors for three times at ten day intervals, and sacrificed ten days after the last imm_unization. To detect both E7- and Net-specific CD8+ T cell 3 o immune responses, splenocytes were put in culture in IFN-y Elispot microwells (Millipore) in the presence of 5 μg/ml of either HPV-E7 or HIV-1 Nef 8- or 9-mer peptides already identified to efficiently bind the H-2 Kb 22 complex of C57 BI/6 mice, i.e., DL YCYEQL (aa 21-28) (SEQ ID NO: 3) and RAHYNIVTF (aa 49-57) (SEQ ID NO: 4) for E7 (HPV-16 Gene Bank accession n. AAD33252.1), and TAATNADCA (aa 48-56) (SEQ ID NO: 5) for Nef (HIV-1, F12 strain, accession number EMBL 211530). H-2 Kb s binding HPV E6-specific KLPQLCTEL (aa. 18-26) (SEQ ID NO: 6) and YDFAFRDL (aa 50-57) (SEQ ID NO: 7) peptides (HPV-16 Gene Bank accession n. AAD33253.1) were used as unrelated peptides. After o.n. incubation, IFN-y Elispot plates were developed (Mabtech AB), and spotforming cells were analyzed and counted using an Elispot reader 10 (A.EL.VIS. Elispot reader and Analysis software GmbH).

Fluorescence microscope analysis For analysis by fluorescence microscope, 7 μM slices from quadriceps of inoculated mice were prepared by cryostat (Leika CM 3050) sectioning and placed to slides. The slices were then incubated with 4',6'- 15 diamidino-2-phenylindole (DAPI, Vector Laboratories) together with an antifade mounting medium. Finally, coverslips were mounted to slides which were then observed with a Zeiss Axioskop 2 Plus fluorescence microscope.

CTL assay CDS+ T cells were isolated from splenocytes of inoculated mice by positive immunomagnetic selection (Miltenyi Biotec). They were put in coculture for 6 hours in RPMI 10% FCS with EL-4 cells previously labeled with carboxyfluorescein succinimidyl ester (CFSE, lnvitrogen), and treated overnight with either E? or unrelated peptides. The co-cultures were run at 25 different cell ratios (i.e., from 20:1 to 5:1 effector/target cells) in 200 μI of RPMI 20% in U-bottom 96 well plates. Afterwards, EL-4 cell mortality was scored by FACS analysis soon after addition of 7-AAD at final concentration of 1 μg/ml.

Detection of anti-El and anti-Nef antibodies in plasma Plasma from inoculated mice were pooled, and two-fold serial dilutions starting from 1 : 1 O were assayed for the presence of anti-E7 Abs.

The end-point dilution corresponded to a <0.1 OD absorbance at 450 nm. 23 Each plasma was assayed in triplicate, and the mean of the absorbance value was taken as final readout. Both recombinant E7 and Nef were used for the assay. The proteins were adsorbed overnight at 4 °C in carbonate buffer (pH 9.4) into Maxisorp microtiter plates (NUNC) at the s concentrations of 0.25 μg/well. After a blocking step of 2 h of at 37 °C in PBS containing 3% non-fat dry milk (NFDM), plates were incubated at 37 °C for 1 h with 100 μL of serially diluted plasma in 1% NFDM-PBS.

Specific antigen-antibody complexes were detected by a peroxidaseconjugated goat anti-mouse lgG (GE Healthcare Ltd) using tetramethyl 1 o benzidine as substrate. After 30 min at room temperature, the enzymatic reaction was stopped by adding 50 μI of 1 M sulphuric acid/well. Washing steps were done with 200 μI/well of PBS containing 0.05 % Tween-20 in an automatic washer.

Anti-tumor effects of Nerut/E7 exosomes The anti-tumor activity induced by the inoculation of Nef1ut/E7 - expressing vector was evaluated in mice previously challenged with 2x105 TC-1 cells. DNA inoculations were performed 4 and 11 days after tumor cell challenge following the above reported protocol, and only in mice which developed palpable tumors. Tumor growth was monitored by visual 20 inspection, palpation, and measurement of tumor nodule diameter calculated as (lengthxwidth2)/2. At the end of the observation time, tumors were explanted and weighted.

Statistical analysis When appropriate, data are presented as mean + standard 25 deviation (SD). In some instances, the paired Student's t-Test was used and confirmed using the non-parametric Wilcoxon rank sum test. p<0.05 was considered significant.

RESULTS Detection of engineered exosomes released by DNA transfected 30 murine muscle cells Muscle cells represent the ideal target for a both efficient and stable expression of ectopic DNA upon in vivo administration. The aim was to 24 express Nef11u1-based DNA vectors in vivo to engineer the exosomes constitutively released by cells expressing the inoculated DNA. These endogenous exosomes were expected to show characteristics at least similar to those produced in tissue cultures in terms of induction of s antigen-specific CTL immune responses.

As already assessed in human cell types of different origin, whether the internalization of a Nef11u1-expressing DNA vector in murine muscle cells was sufficient for the production of engineered exosomes has been preliminarily investigated. Notably, murine muscle cells release 1 o nanovesicles with exosome-like characteristics whose biogenesis, however, differ from that of MVB-generated exosomes. For the sake of clarity, exosome-like nanovesicles released by murine muscle cells are here defined exosomes.

Murine C2C12 muscle cells and, as control, human 293T cells were 1 s transfected with vector expressing GFP fused at the C-terminus of either Nernut or a Nef isotype (i.e., NefG2A) already characterized for its inefficiency to associate with exosomes (26). Transfected cell cultures were monitored for the respective efficiency of transfection (Fig. 2A) which in muscle cells appeared to be over 50% of that detected in 293T cells. 2 o The supernatants were collected, and exosomes isolated through differential centrifugations. Exosome preparations were then titrated in terms of AchE activity (Fig. 2B). The two cell types produced apparently similar levels of AchE positive nanovesicles whatever the transfection conditions. The western blot analysis of equal amounts of exosomes 2 s shown the presence of Net-derived molecules in exosomes from both 293T and C2C12 cells transfected with Nef11u1-GFP but not NefG2A-GFP vectors (Fig. 2C). The FACS analysis of exosome preparations confirmed the association of fluorescence with the nanovesicles recovered from C2C12 cells transfected with Nef11u1-GFP but not NefG2A-GFP (Fig. 2D). 30 In sum, it has been proved that exosome-like nanovesicles released by murine muscle cells can be engineered by Nef11u1-derivatives as previously proven in epithelial-like, transformed human 293T cells.

Neflut_derived products can be detected in exosomes from plasma of DNA inoculated mice On the basis of the in vitro results which were obtained with murine muscle cells, the expression of the Neflu1-based vector in vivo has been 5 attempted. To this aim, 50 μg of either Neflu1-GFP, NefG2A-GFP, or empty vector were inoculated in each quadriceps of C57 B1/6 mice. Three days later, a number of inoculated mice was sacrificed and their legs cryopreserved. Then, slices obtained from the zones of inoculation were analyzed for the expression of GFP-related products. Consistently with the 1 o already described features of Nef and its mutants/derivatives, Neflut apparently accumulated at the plasma membrane meanwhile disposing also in an intracellular punctate pattern. Differently, the NefG2A mutant, as consequence of the lack of N-terminal myristoylation, disposed in a more diffuse intracytoplasmic distribution (Fig. 3A). Three and nine days after 15 inoculation, plasma were recovered from the remainder inoculated mice, and the exosomes isolated by differential centrifugations. Exosome preparations were then titrated in terms of AchE activity, and the same amounts of exosomes were bound to white aldehyde/sulphate latex beads. Through this method, even rare fluorescent nanovesicles were 20 expected to be detectable by FACS analysis. Positive signals were scored in samples comprising exosomes isolated from plasma of mice both 3 and 9 days after injection with Neflu1-GFP but not Nefo2A-GFP vector (Fig. 3B).

These results suggested that the inoculation in mice of vectors expressing Neflu1-derivatives can lead to generation of engineered exosomes. 25 HPV-E7 specific CTL response upon i.m. inoculation of a Nef1u1/E7 expressing DNA vector Next, the immunogenicity of the antigens uploaded in engineered exosomes generated by the inoculation of DNA vectors expressing Nernut_ derivatives was evaluated. To this aim, C57 B1/6 mice (six per group) were 3 o inoculated i.m. in each back lag with 50 μg of vectors expressing either Neflu1/E7 or E7 alone, or with empty vector. Of note, the analysis of the immune response after injection of a vector expressing E7 alone was 26 instrumental to evaluate the benefit of the NefT'u1-fusion in terms of CDS+ T cell immunogenicity. The inoculations were repeated 1 O days later, and after additional 10 days the mice were sacrificed, and the splenocytes cultured o.n. in IFN-y Elispot microwells in the presence of unrelated, Nefs or E7-specific H-2 Kb nonamers. The levels of CDB+ T cell activation observed in cultures with unrelated peptides remained at background levels and similar to those detected in splenocytes cultured in the absence of peptides (not shown). On the other hand, cell activation was clearly detectable in splenocytes from mice inoculated with the NefT'u1/E7 1 o expressing vector after incubation with either E7 or Nef nonamers (Fig. 4A). Conversely, no CDS+ T cell response was detected in cultures of splenocytes from mice receiving either E7-expressing or empty vector, whatever the peptide used.

To evaluate whether the CD8+ T cell response associated with a 1s measurable CTL activity, CDS+ T cells were isolated from pools of splenocytes, and then put in co-culture for 6 h at different cell ratios (i.e., from 20:1 to 5:1) with CFSE-labelled EL-4 cells pre-treated o.n. with either unrelated or E7 nonamers. Afterwards, the co-cultures were labelled with 7-AAD, and the mortality levels of target cells scored by FACS analysis. 20 The results reported in fig. 4B show a clear increase of target cell mortality in both 20: 1 and 1 O: 1 co-cultures comprising CDS+ T lymphocytes only from mice inoculated with the NefT'u1/E7-expressing vector with EL-4 pretreated with E7-specific nonamers. This result demonstrated that activated cos+ T lymphocytes detected in mice inoculated with the NefT'u1/E7- 2 s expressing vector by IFN-y Elispot assay possessed E7-specific cytotoxic activity. Notably, anti-E7 antibodies were detected only in plasma from mice inoculated with the vector expressing E7 alone (Fig. 4C).

Taken together, these data indicated that the i.m. inoculation of a vector expressing an heterologous antigen fused with NefT'ut leads to the 3 o induction of a strong antigen-specific CTL response in the absence of antibody production.

The inoculation of DNA vector expressing the wild-type Nef isoform 27 does not elicit Nef-specific COB"' T cell acUvation The results provide evidence that the i.m. injection of DNA vectors expressing Nef1°t-derivatives leads to the production of exosomes uploading Nef1°t products correlating with the induction of a CTL response s against the foreign antigen incorporated into the exosomes. To support the idea that the high levels of Nef1°1 incorporation in exosomes were mandatory to elicit the antigen specific CD8"' T cell response, the immunogenicity experiments were reproduced however by inoculating mice with vectors expressing the wild-type isoform of Nef which 10 incorporates in exosomes at much lower extents compared to Nef1°1 (13).

To this end, C57 BI/6 mice (four per group) were injected i.m. in each back lag with 50 μg of a vector expressing either wtNef or Nef1°t, or with the empty vector. The inoculations were repeated 10 days later, and after additional 10 days the mice were sacrificed. Splenocytes were then 15 isolated and cultured o.n. in IFN-y Elispot microwells in the presence of either unrelated or Nef-specific nonamers. As shown in Fig.5, mice inoculated with the vector expressing wtNef, differently to those receiving the Nef11u1-vector, failed to mount a detectable CD8"' T Nef-specific response. 2 o These results indicate that the efficiency of antigen uploading in exosomes is critical for the induction of the immune response, also suggesting that the functions of wtNef were not per se involved in the cos+ T cell activation we observed.

Exosomes isolated from plasma of mice immunized with a DNA vector expressing Nef'u1/E7 induce an El-specific COB"' T cell response in svngeneic mice.

To enforce the hypothesis that the cos+ T cell immune response detected upon inoculation of Nef1°t-expressing vectors relies on the in vivo production of engineered exosomes, whether exosomes purified from the 3 o plasma of inoculated mice were immunogenic in recipient na'ive mice was assessed. To this aim, eight mice were inoculated with vectors expressing E7, Nef11°1/E7 or the empty vector following the here above detailed 28 schedule. Eight day after the last immunization, PBMCs were recovered through retro orbital bleeding, and put in IFN-y Elispot microwells to check the E7-specific cos+ T cell response. As already observed, the injection of the Nernut/E7 expressing vector, but not that expressing E7 alone, gave s rise to a well detectable E7-specific cos+ T cell response (Fig. 6A).

Plasma from homogeneous groups were pooled, and exosomes isolated by differential centrifugations. Afterwards, exosomes were titrated in terms of AchE activity, and the equivalent of 6 mU of AchE activity of exosomes were injected s.c. in syngeneic mice three times with ten day intervals. 10 Finally, mice were sacrificed, and splenocytes tested for the E7-specific coa+ T cell responses. Interestingly, by o.n. culture in IFN-y Elispot microwells we noticed a E7-specific cell activation only in splenocyte cultures from mice inoculated with exosomes purified from mice injected with the Nernut/E7 expressing vector (Fig. 6B).

These results indicate that the i.m. injection of DNA expressing Nernut/E? leads to the production of immunogenic exosomes, hence further supporting the idea that the DNA-directed production of endogenous, engineered exosomes was on the basis of the observed strong E7-specific coa+ T cell immune response.

Therapeutic anti-tumor effect of the HPV-E7-specific CTL response induced by i.m. inoculation of Nerut/E7-expressing DNA vector Finally, the potency of the cos+ T cell immune response evoked by injection of Nefrlu1/E7 expressing vector in terms of anti-tumor effect has been evaluated. To this end, therapeutic immunization assays on C57 BI/6 25 mice inoculated s.c. with 2x105 TC-1 cells have been set up. Mice developing a tumor mass detectable by palpation, i.e., of about 2 mm of diameter, were then inoculated with 50 μg/back leg of vectors expressing either empty vector, Nernut {4 mice per each group) or Nerr1u1/E7 (six mice) at both days 4 and 11 after cell implantation. As control, 4 tumor-implanted 30 mice were injected with the vehicle alone. At day 21, retro orbital bleeding carried out on mice injected with Nernut_ or Nernut/E7-expressing vectors served to assess the induction of E7-specific CD8+ T cell immune 29 response (Fig. 7A). The growth of tumors was monitored over 30 days, and thereafter mice were sacrificed, tumors explanted, and weighted. Fig. 7B clearly shows that, whereas the injection of control DNA vectors did not influence the growth of implanted tumor cells, their expansion was 5 severely impaired in mice inoculated with Nef"1ut/E7 vector, being tumor cells still apparently cleared in 3 mice, as confirmed by the tumor weight evaluation {Fig. 7C).

From these data it can be concluded that the inoculation of Nef"1ut/E7-expressing DNA vector elicits a cos+ T cell immune response 1 o also in the presence of tumor cells. Most important, this immune response was both strong and rapid enough to strongly inhibit the growth of previously implanted syngeneic tumor cells.

Taken together, these results represent a relevant milestone towards possible therapeutic applications of immunization strategies 15 based on Nerut_based endogenous exosomes.

EXAMPLE 2: Study on CDB+ T cell immunity elicited by in vivo inoculation of vectors expressing antigens fused with Nef'ut The strategy of immunization based on inoculation of DNA vectors expressing an antigen fused to the C-terminus of Neflut has been 20 successfully applied also to a variety of additional viral antigens (see Tab. 1). In detail, vectors expressing such antigens fused with Neflut have been injected in either C57 B1/6 or Balb/c mice following the here above described schedule. From 10 to 15 days after the last inoculation, IFNy ELISPOT assays were carried out with splenocytes from the injected mice 25 using the peptides listed in Table 1.

Table 1. Antigen-specific coa+ T cell immunity induced in mice inoculated with vectors expressing different antigens fused with Nef"ut. a Antigen SpoMorming Peptides for detecting coa+ Sequence units/106 cells T cell immunity accession number EboVVP24 310±35 KFINKLDALH (SEQ ID AY142960 NO:8) DAVL YYHMM(SEQ ID NO:9) EboVVP40 285±18 LRIGNQAFLQEFVLPP(SEQ L11365 ID NO:10} EboV NP 409±21 VYQVNNLEEIC(SEQ ID AY142960 NO:11) DAVLYYHMM(SEQ ID NO:12) HCVNS3 190±57 ITQMYTNV(SEQ ID NO:13) AFN53788.1 WYEL TPAETSV(SEQ ID NO:14) WNVNS3 210±17 GYISTKVEL(SEQ ID ABG67747.1 NO:15) DRRWCFDGPRTNTIL(SEQ ID NO:16) Flu NP 232±44 ASNENMETM(SEQ ID ACX46208.1 NO:17) ashown are the mean values ±SD subtracted background values as calculated from data obtained with splenocytes from four inoculated mice each tested in triplicate wells. s The results support the idea that the injection of DNA expressing antigens fused to Nef1u1 is instrumental to induce CTL immunity against a wide range of full-length antigens.

EXAMPLE 3: Study of the CTL activity elicited by in vivo engineered exosomes according to the present invention in breast cancer 1 o Materials and methods Molecular constructs DNA coding for the extra-cellular domain (ECD) of activated rHER2/neu was recovered by RT-PCR carried out on total RNA extracted from N202.1A cells, i.e., a cell line derived from FVB mice transgenic for 1s rHER-2/neu (27). The following primers comprising the Nhe I and Eco RI restriction sites at the respective 5' end were used: forward Oust downstream to the signal peptide) 5' CTAGCT AGCACCCAAGTGTGTACCGGC 3'(SEQ ID N0:18); reverse: 5'CCGGAATTCTCAGTGGGT CA GTTGATGGG 3'(SEQ ID N0:19). To 2 o obtain the vector expressing the Nef1u1/HER2-ECD fusion product, the PCR product was Nhe I/Eco RI cut, and inserted in frame at the 3' terminus of an Nhe I/Eco RI digested pcDNA3-based vector expressing Nef1u1 . Through this strategy, both rat and mouse HER2-ECD sequences 85213194 31 were expected to be fused with Neflut in the resulting molecular constructs. The selection was made on the basis of the presence of rHER2/neu sequence. Vectors expressing Neflut, Neflu1/GFP, and Neflu1/MART-1 have been already described (13). The IE-CMV-promoted s vector expressing the rHER2/neu was kindly provided by A. Amici, University of Urbino, Italy.

Cell cultures and transfections 293T, MCF-7, murine muscle C2C12 (all obtained from American Type Culture Collection), and TC-1 cells (28) were grown in Dulbecco's 10 modified Eagle's medium plus 10% heat-inactivated fetal calf serum (FCS). Transfection assays were carried out by Lipofectamine 2000- based method (lnvitrogen, Thermo Fisher Scientific), which in the case of C2C12 cells was modified by adding liposomes on freshly trypsinized cells. HLA-A.02 B-LCLs (29), murine splenocytes, and cos+ T 15 lymphocytes were cultivated in RPMI medium plus 10% FCS. Human primary skeletal muscle cells (SKMC) were obtained from Lonza, and cultivated with the recommended medium.

Human PBMCs were isolated from healthy donors by FycollHypaque density gradients. Monocytes were isolated from PBMCs using 20 an immunomagnetic monocyte selection kit (Miltenyi). Purity of recovered cell populations was assayed by FACS analysis using PE-conjugated antiCD14 mAb (Becton Dickinson). Monocytes were differentiated to iDCs upon 4-5 days of culture in RPMI medium supplemented with 20% FCS, 30 ng/mL granulocyte-macrophage colony-stimulating factor (GM-CSF) 25 (Serotec Ltd), and 500 units/ml IL-4 (R&D Systems). DC maturation was obtained through o.n. treatment with 10 ng/mL of lipopolysaccharide (LPS).

Exosome preparation and purification Exosomes were isolated through differential centrifugations as 3 o previously described (30) starting from supematants of 293T cells 48 to 72 hours after transfection. The amounts of recovered exosomes were evaluated by measuring the activity of acetylcholinesterase (AchE, i.e., a classical exosome marker) (31) through Amplex Red™ kit (Molecular Date Rei;ue/Date Received 2024-05-22 32 Probes, Thermo Fisher) following the manufacturer's recommendations.

Western blot Western blot analyses of both cell lysates and exosomes were s carried out as described (13). Filters were revealed using 1:1000 diluted sheep anti-Nef antiserum ARP 444 (MRC), 1 :250 diluted anti-~ actin AC- 74 mAb from Sigma, and 1:100 diluted anti-Alix H-270 polyclonal Abs from Santa Cruz.

Mouse model 10 All studies with animals here described have been approved by the Ethical Committee of the ISS (protocol n. 107/2016-PR) according to Legislative Decree 116/92 which has implemented in Italy the European Directive 86/609/EEC on laboratory animal protection. Animals used in our research have been housed and treated according to the guidelines 1s inserted in here above mentioned Legislative Decree. A colony of 129SvNeuT transgenic mice generated and bred in the ISS animal facility (32) was used. In these mice, the activated rHER-2/neu gene is promoted by MML V L TR and virgin females spontaneously develop mammary carcinomas becoming palpable at 15-20 weeks of age. The presence of 2 o the rHER2/neu transgene was routinely checked by PCR as described (32). Mice were inoculated i.m. two times at 15 and 17 weeks of age with 50 μg for each quadriceps of plasmid DNA purified with endotoxin-free Qiagen kit. The mammary glands were inspected once a week for tumor monitoring. Mice bearing tumors exceeding 30 mm of diameter were 2 s euthanized.

Antibody detection Plasma from inoculated mice were 1 :20 diluted and tested for the presence of anti-HER2/neu antibodies on 293T cells transfected two days before with a HER2/neu expressing vector. After 2 hours of incubation at 4 3 o °C, cells were washed and incubated with FITC-conjugated anti-mouse lgGs, and FACS analyzed 1 hour later. As a positive control, 1 :20 diluted anti HER2/neu mAb clone 7.16.4 (Sigma) was used. 33 EL/SPOT assay To detect both HER2/neu- and Net-specific CDB+ T cell immune responses, splenocytes were put in IFN-y Elispot microwells (Millipore) in the presence of 5 μg/ml of either HER2/neu or HIV-1 Nef 9-mer peptides s binding the H-2 Kb complex of 129Sv transgenic mice, i.e., ILHDGAYSL (aa 436-444) (33) and TAATNADCA (aa 48-56) (34), respectively. H-2 Kb binding heterologous peptides (35) were used as control. After o.n. incubation, IFN-y Elispot plates were developed (Mabtech), and spotforming units (SFUs) counted. 10 Cross-priming assay A total of 106 SKMC was transfected with 10 μg of either Neflut_ based or control vectors. After 48 hours, the cells were put in co-culture with iDCs in a 1 :5 cell ratio, and, in some instances, in the presence of 2 μM of the inhibitors of exosome biosynthesis GW4869 and spiroepoxide 15 (36-41 ). After an overnight incubation, iDCs were isolated and matured by LPS treatment for 24 hours. Thereafter, iDCs were washed, and put in coculture with autologous peripheral blood lymphocytes (PB Ls) in a 1: 10 cell ratio. A week later, the stimulation procedure was repeated, and, after an additional week, CD8+ T cells were recovered for CTL assays. 20 CTL assays CTL assays with murine cells were performed by isolating CD8+ T cells from splenocytes by positive immunomagnetic selection (Miltenyi).

They were put in co-culture for 6 hours in RPMI 10% FCS with TC-1 cells previously labeled with carboxyfluorescein succinimidyl ester (CFSE, 25 lnvitrogen, Thermo Fisher) following the manufacturer's recommendations, and treated overnight with either HER2/neu, Nef, or unrelated peptides.

The co-cultures were run at 10:1 effector/target cell ratio in 200 μL of RPMI 20% in U-bottom 96 well plates. Afterwards, TC-1 cell mortality was scored by FAGS analysis soon after addition of 7-AAD at final 3 o concentration of 1 ~lg/ml. CTL assays in human cells were carried out in a similar way except that either MCF-7 or B-LCLs were used as target cells.

Confocal microscope analysis 34 Overnight co-cultures comprising iDCs and SKMC transfected two days before with vectors expressing either GFP or Nef1u1/GFP, were carried out in a 1 :5 cell ratio in the presence or not of GW4869 and spiroepoxide. Thereafter, cells were stained first with anti-CD45 ( i.e., a s marker of iDCs) for 1 hour at 4 °C, and then with Alexa-Fluor 610- conjugated secondary Abs. Finally, co-cultures were labelled with 4',6' diamino-2-phenylindole (DAPI, Vector Laboratories), and fixed in buffered formaldehyde (2% v/v). Phase contrast and fluorescence images were recorded with an Olympus IX-81 device. 10 Statistical analysis When appropriate, data are presented as mean + standard deviation (SD). In some instances, the paired Student's t-Test was used and confirmed using the non-parametric Wilcoxon rank sum test. p<0.05 was considered significant. 1s Results The extra-cellular domain of rHER2/neu is efficiently uploaded in exosomes upon fusion with Nerut_ ECD of rHER2/neu deprived of the signal peptide was fused at the C-terminus of Nef1u1 in the context of a IE-CMV-promoted eukaryotic 2 o vector. To check both stability and exosome incorporation of the fusion product, 293T cells were transiently transfected with vectors expressing either Nef1u1 or Nef1u1/HER2-ECD, or with void vector. After 48 hours, cells were lysed and supernatants underwent differential centrifugations to isolate exosomes. Both cell and exosome lysates were analyzed by 2s western blot {Fig. 8). The fusion product appeared stable and uploaded at valuable extents in exosomes. Similar results were obtained by transfecting C2C12 murine muscle cells (not shown).

The iniection in rHER2/neu transgenic mice of a DNA vector expressing Ner'u1/HER2-ECD induces a specific COB+ T lymphocyte 3 o activation in the absence of antibody response It has been assumed that, as already proven for other Nef1u1-based fusion products (21 ), i.m. injection in mice of the Nef"1ut/HER2-ECD expressing vector leads to production of immunogenic endogenously engineered exosomes incorporating the Nef"1ut/HER2-ECD fusion product.

The question was whether the expected cos+ T lymphocyte 5 immunogenicity of these exosomes was strong enough to break the tolerance towards HER2/neu.

The induction of anti-HER2/neu antibodies, i.e., an effect already described in mice injected with rHER2/neu DNA vectors (42, 43) has been tested first(). To this end, HER2/neu transgenic mice were injected with 10 DNA vectors expressing either Nef"1ut or Nef"1u1/HER2-ECD (3 per group).

Fifteen days after the second injection, plasma were recovered and tested for the presence of anti-HER2/neu Abs using as indicator cells 293T transiently transfected with a DNA vector expressing HER2/neu. As reported in fig.9, no HER2/neu-specific antibodies were detectable in 15 plasma from mice injected with DNA vector expressing Nef"1u1/HER2-ECD.

Differently, the Abs were detectable in plasma from mice injected with lysates of rHER2/neu expressing cells, as previously described (32).

These results appeared fully consistent with what we previously reported about the lack of antibody response against the products incorporated into 20 engineered exosomes (14, 21).

Next, the antigen-specific cos+ T lymphocyte response testing splenocytes from injected mice through IFN-y Elispot assays carried out upon stimulation with H2b-restricted Nef and HER2-ECD nonamers was analyzed. As shown in fig.10, lymphocyte activation was detected when 2 s splenocytes from mice injected with Nef"1u1-expressing DNA were stimulated with the Nef peptide, but not with the HER2-ECD one. On the other hand, both Nef and HER2-ECD peptides induced lymphocyte activation in splenocyte cultures from mice injected with Nef"1u1/HER2- ECD. Similar results were obtained testing PBMCs recovered by retro- 3 o orbital bleeding (not shown).

These data demonstrate the induction of both Nef and HER/neu specific coa+ T lymphocyte responses in mice injected with Nef"1u1/HER2- ECD DNA vector. 36 Induction of antigen-specific CTL activity in rHER2/neu transgenic mice injected with Nef'ut/HER2-ECD- expressing DNA vector.

Next, the aim of the study was to assess whether the injection of Nef1ut/HER2-ECD-expressing DNA vector can induce an HER2/neus specific CTL activity. To this end, coa+ T lymphocytes were isolated from splenocytes of HER2/neu transgenic mice inoculated with void vector or with vectors expressing either Nef1u1 or Nef1u1/HER2-ECD. The CD8+ T lymphocytes were then put in co-culture with syngeneic, CFSE-labeled TC-1 cells pre-treated with the appropriate peptides. After 5 hours, the co- 10 cultures were stopped, labeled with 7-AAD, and analyzed by FAGS to evaluate percentages of dead TC-1 target cells. As shown in fig.11, an increase of target cell mortality was detectable when CD8+ T lymphocytes from mice injected with Nef'ut DNA vector were co-cultured with TC-1 pretreated with the Nef peptide. More important, a CTL activity was evident 1s also when CD8+ T lymphocytes from mice injected with Nef1ut/HER2-ECD DNA vector were co-cultured with TC-1 pre-treated with either Nef- or HER2-specific, H2b-restricted peptides.

These results established a link between the i.m. delivery of Nef1u1/HER2-ECD DNA vector and the induction of HER2/neu-specific 20 CTL activity.

The break of HER2/neu tolerance associates with an anti-tumor activity Next, the aim of the study was to assess whether the HER2-ECDspecific CTL activity coupled with a detectable anti-tumor activity. Fifteen 2 s weeks old 129Sv-Neu T transgenic mice still free from palpable lesions were injected with either vehicle or DNA vectors expressing Nernut and Nef1u1/HER2-ECD. The injections were repeated two weeks later, and the appearance of palpable tumors was monitored weekly. As reported in fig.12, the injection of Nef1u1/HER2-ECD expressing DNA associated with 3 o a significant delay in the development of tumors. The monitoring was stopped at the time of first sacrifices needed for ethical reasons.

These data highlight a direct relationship between the HER2-ECDspecific CTL activity induced by DNA i.m. injection and anti-tumor activity. 37 Translating the CTL vaccine platform to humans: induction of antigen-specific CTL activity by engineered exosomes To open the possibility to exploit our CTL vaccine platform in clinic, demonstrating its effectiveness in human system is mandatory. To this s end, experiments using conditions at least in part reproducing the mechanism underlying the induction of antigen-specific CD8+ T lymphocyte immune response previously described in mice injected with Nef1ut_expressing DNA vectors were set up (1). The transfer of exosomes from transfected muscle cells to iDCs was first documented. SKMC were 10 transfected with either GFP or Nef1u1/GFP DNA vectors, and the transfection efficiency was checked by FAGS analysis (Fig.13A). On this subject, it has been previously documented that the expression of Nef1ut/GFP leads to production of fluorescent exosomes (13). After cocultivation of transfected SKMC with iDCs, the presence of fluorescent 15 aggregates into iDCs was documented by confocal microscope analysis upon labeling recipient iDCs with anti-CD45 mAb (Fig. 13B, middle panels). Meanwhile, no GFP fluorescence was detected within the CD45+ cell population when GFP-transfected SKMC were used, as well as when the co-cultures were treated with the inhibitors of exosome biosynthesis 2 o GW4869 and spiroepoxide (Fig.13B, left and right panels, respectively).

This result supports the idea that the entry of Nef1u1/GFP molecules in iDCs was mediated by intercellular transmission of exosomes.

Next, cross-priming assays aimed at evaluating the induction of antigen-specific CTL activity were performed as summarized on fig.14A. In 2s detail, SKMC were transfected with DNA vectors expressing Nef1ut_ derivatives, and then co-cultivated with HLA-A.02 iDCs. Twenty-four hours later, iDC were isolated, LPS-matured, and then put in co-culture with autologous PBLs. The mature (m)DC-PBLs co-cultures were carried out for seven days, and, thereafter, the lymphocytes were isolated and 3 o subjected to a second stimulation cycle by adding fresh mDC previously co-cultivated with transfected SKMC. After additional seven days, lymphocytes were recovered from the co-cultures, the COB+ T fraction isolated, and put in co-culture in the context of a CTL assay with HLA-A.02 38 MCF-7 cells either parental or engineered for stable expression of Neflut (Fig.148). The results from CTL assays (Fig.14C) showed a mortality of MCF-7/Neflut target cells appearing higher when they were challenged with cos+ T cells stimulated by DCs co-cultivated with Neflut expressing s SKMC compared to that detected in co-cultures with cos+ T cells stimulated by DCs from co-cultures with SKMC transfected with control vector. On the other hand, no antigen-specific CTL activity was detectable throughout using parental MCF-7 as target cells.

Next, these investigations were extended towards antigens fused 10 with Nef1u1 . In addition, whether the production of engineered exosomes was indeed on the basis of the induction of the antigen-specific CTL activity was verified. To this aim, cross-priming assays were reproduced using a DNA vector expressing Neflut fused with MART-1, i.e., a human melanoma-associated antigen (44), and following the procedures depicted 15 in fig.14A, except that SKMC-iDC co-cultures were carried out in the presence or not of the inhibitors of exosome biosynthesis GW4869 and spiroepoxide. CTL assays were finally performed by co-cultivating the coa+ T lymphocytes with HLA-A.02 B-LCLs previously treated with either HLA-A.02-restricted MART-1 (i.e., AAGIGIL TV (SEQ ID NO:20), aa 27- 20 35) (45) or unrelated peptides. As reported in fig.15, stimulated cos+ T lymphocytes showed MART-1 specific CTL activity. It, however, was no more detectable when coa+ T lymphocytes stimulated by DCs from cocultures with SKMC carried out in the presence of the exosome inhibitors were used. 25 These data indicate that the production by transfected muscle cells of exosomes engineered for the incorporation of Nef1u1 or derivatives thereof are part of the mechanism underlying the induction of the antigenspecific CTL activity we observed with human cells. Hence, these findings support the idea that the CTL vaccine platform has the potential to be 3 o applied in humans against tumor antigens.

REFERENCES 39 1. Halstead S.B., S.J. Thomas. 2011. New Japanese encephalitis vaccines: alternatives to production in mouse brain. Expert Rev.

Vaccines. 10: 355-64. doi:10.1586/erv.11.7. 2. Ng T., D. Hathaway, N. Jennings, D. Champ, Y.W. Chiang, H.J.

Chu. 2013. Equine vaccine for West Nile virus. Dev. Biol.;114: 221- 7. 3. El Garch H., J.M. Minke, J. Rehder, S. Richard, C. Edlund Toulemonde, S. Dinic, C. Andreoni, J. C. Audonnet, R. Nordgren, V.

Juillard. 2008. A West Nile virus (WNV) recombinant canarypox 10 virus vaccine elicits WNV-specific neutralizing antibodies and cellmediated immune responses in the horse. Vet. lmmunol. lmmunopathol. 123: 230-9. 4. Stuve 0., T.N. Eagar, E.M. Frohman, P.D. Cravens. 2007. DNA plasmid vaccination for multiple sclerosis. Arch. Neural. 64: 1385-6. 15 5. Guescini M., D. Guidolin, L. Vallorani, L. Casadei, A. M.

Gioacchini, P. Tibolla, M. Battistelli, E. Falcieri, L. Battistin, L.F.

Agnati, V. Stocchi. 2010. C2C12 myoblasts release micro-vesicles containing mtDNA and proteins involved in signal transduction. Exp Cell Res. 16: 1977-84. doi:10.1016/j.yexcr.2010.04.006. 20 6. Romancino D.P., G. Paterniti, Y. Campos, A. De Luca, V. Di Felice, A. d'Azzo, A. Bongiovanni. 2013. Identification and characterization of the nano-sized vesicles released by muscle cells. FEBS Lett. 587: 1379-84. doi:10.1016/j.febslet.2013.03.012. 7. Morse M.A., J. Garst, T. Osada, S. Khan, A. Hobeika, T.M. Clay, 25 N. Valente, R. Shreeniwas, M.A. Sutton, A. Delcayre, D.H. Hsu, J.B. Le Pecq, H.K. Lyerly. 2005. A phase I study of dexosome immunotherapy in patients with advanced non-small cell lung cancer. J. Transl Med. 3:9. 8. Escudier B., T. Dorval, N. Chaput, T. Andre, M.P. Caby, S. 30 Novault, C. Flament, C. Leboulaire, C. Borg, S. Amigorena, C.

Boccaccio, C. Bonnerot, 0. Dhellin, M. Movassagh, S. Piperno, C.

Robert, V. Serra, N. Valente, J.B. Le Pecq, A. Spatz,C 0. Lantz, T.

Tursz, E. Angevin, L. Zitvogel. 2005. Vaccination of metastatic melanoma patients with autologous dendritic cell (DC) derivedexosomes: results of thefirst phase I clinical trial. J. Transl Med. s 3:10. 9. Dai S., D. Wei, Z. Wu, X. Zhou, X. Wei, H. Huang, G. Li. 2008.

Phase I clinical trial of autologous ascites-derived exosomes combined with GM-CSF for colorectal cancer. Mo/ Ther. 16: 782-90. doi: 10 .1038/mt.2008.1. 10 10. Tan A., H. De La Pena, A.M. Seifalian. 2010. The application of exosomes as a nanoscale cancer vaccine. Int J Nanomedicine. 5: 889-900. doi:10.2147/IJN.S13402. 11. Chaput N., C. Thery. 2011 Exosomes: immune properties and potential clinical implementations. Semin lmmunopathol. 33:419-40. doi:10.1007/s00281. 12. Peretti S., I. Schiavoni, K. Pugliese, M. Federico. 2005. Cell death induced by the herpes simplex virus-1 thymidine kinase delivered by human immunodeficiency virus-1-based virus-like particles. Mo/ Ther. 12: 1185-96. 20 13. Lattanzi L., M. Federico. 2012. A strategy of antigen incorporation into exosomes: comparing cross-presentation levels of antigens delivered by engineered exosomes and by lentiviral virus-like particles. Vaccine. 30: 7229-37. doi: 10.1016/j.vaccine.2012.10.010. 25 14. Di Bonito P., B. Ridolfi, S. Columba-Cabezas, A. Giovannelli, C.

Chiozzini, F. Manfredi, S. Anticoli, C. Arenaccio, M. Federico. 2015.

HPV-E7 delivered by engineered exosomes elicits a protective cos+ T cell-mediated immune response. Viruses. 7: 1079-99. doi: 10.3390/v7031079. 41 15. Fry EA, Taneja P, Inoue K. 2016. Clinical applications of mouse models for breast cancer engaging HER2/neu. lntegr Cancer Sci Ther 3(5):593-603. 16. Rolla S, Nicolo C, Malinarich S, Orsini M, Forni G, Cavallo F, Ria F. 2006. Distinct and non-overlapping T cell receptor repertoires expanded by DNA vaccination in wild-type and HER-2 transgenic BALB/c mice. J /mmuno/ 177(11):7626-7633. 17. Rovero S, Amici A, Di Carlo E, Bei R, Nanni P, Quaglino E, Porcedda P, Boggio K, Smorlesi A, Lollini PL, Landuzzi L, Colombo MP, Giovarelli M, Musiani P, Forni G. 2000. DNA vaccination against rat her-2/Neu p185 more effectively inhibits carcinogenesis than transplantable carcinomas in transgenic BALB/c mice. J. /mmuno/ 165(9):5133-5142. 18. Quaglino E, Iezzi M, Mastini C, Amici A, Pericle F, Di Carlo E, Pupa SM, De Giovanni C, Spadaro M, Curcio C, Lollini PL, Musiani P, Forni G, Cavallo F.2004. Electroporated DNA vaccine clears away multifocal • mammary carcinomas in her-2/neu transgenic mice.

Cancer Res 64(8):2858-2864. 19. Quaglino E, Mastini C, Iezzi M, Forni G, Musiani P, Klapper LN, 20 Hardy B, Cavallo F. 2005. The adjuvant activity of BAT antibody enables DNA vaccination to inhibit the progression of established autochthonous Her-2/neu carcinomas in BALB/c mice. Vaccine 23(25):3280-3287. 20. Schreiber RD, Old LJ, Smyth MJ. 2011. Cancer immunoediting: integrating immunity's roles in cancer suppression and promotion.

Science 331(6024):1565-1570. 21. Di Bonito P, Chiozzini C, Arenaccio C, Anticoli S, Manfredi F, Olivetta E, Ferrantelli F, Falcone E, Ruggieri A, Federico M. 2017.

Antitumor HPV E7-specific CTL activity elicited by in vivo engineered exosomes produced through DNA inoculation. Int J Nanomedicine 12:4579-4591. 42 22. van der Burg SH, Arens R, Ossendorp F, van Hall T, Melief CJ. 2016. Vaccines for established cancer: overcoming the challenges posed by immune evasion. Nat Rev Cancer16(4):219-233. 23. Keppler O.T., I. Allespach, L. Schuller, D. Fenard, W.C. Greene, O.T. Fackler. 2005. Rodent cells support key functions of the human immunodeficiency virus type 1 pathogenicity factor Nef. J.

Virol. 79: 1655-65. 24. D'Aloja P., E. Olivetta, R. Bona, F. Nappi, D. Pedacchia, K.

Pugliese, G. Ferrari, P. Verani, M. Federico. 1998. gag, vif, and nef genes contribute to the homologous viral interference induced by a nonproducer human immunodeficiency virus type 1 (HIV-1) variant: identification of novel HIV 1-inhibiting viral protein mutants. J. Virol. 72: 4308-19. 25. Massa S., P. Simeone, A. Muller, E. Benvenuto, A. Venuti, R. 15 Franconi. 2008. Antitumor activity of DNA vaccines based on the human papillomavirus-16 E7 protein genetically fused to a plant virus coat protein. Hum. Gene Ther. 19: 354-64. doi: 10.1089/hum.2007. 122. 26. Arenaccio C., C. Chiozzini, S. Columba-Cabezas, F. Manfredi, M. 20 Federico. 2014. Cell activation and HIV-1 replication in unstimulated CD4+ T lymphocytes ingesting exosomes from cells expressing defective HIV-1. Retrovirofogy. 11: 46. doi: 10.1186/1742-4690-11-46. 27. Nanni P, Nicoletti G, De Giovanni C, Landuzzi L, Di Carlo E, 25 Cavallo F, Pupa SM, Rossi I, Colombo MP, Ricci C, Astolfi A, Musiani P, Forni G, Lollini PL 2001. Combined allogeneic tumor cell vaccination and systemic interleukin 12 prevents mammary carcinogenesis in HER-2/neu transgenic mice. J Exp Med 194:1195-1205. 43 28. Halbert CL, Demers GW, Galloway DA. 1991. The E7 gene of human papillomavirus type 16 is sufficient for immortalization of human epithelial cells. J. Virol 65: 473-478. 29. Di Bonito P, Grasso F, Mochi S, Petrone L, Fanales-Belasio E, Mei 5 A, Cesolini A, Laconi G, Conrad H, Bernhard H, Dembek CJ, Cosma A, Santini SM, Lapenta C, Donati S, Muratori C, Giorgi C, Federico M. 2009. Anti-tumor CDB+ T cell immunity elicited by HIV- 1-based virus-like particles incorporating HPV-16 E7 protein.

Virology 395:45-55. 10 30. Thery C, Amigorena S, Raposo G, Clayton A . 2006. Isolation and characterization of exosomes from cell culture supernatants and biological fluids. Curr Prot Cell Biol 3. doi: 10.1002/0471143030.cb0322s30. 31. Rieu S, Geminard C, Rabesandratana H, Sainte-Marie J, Vidal M. 2000. Exosomes released during reticulocyte maturation bind to fibronectin via integrin alpha4beta1. Eur J Biochem; 267:583-590. 32. Arico E, Sestili P, Carpinelli G, Canese R, Cecchetti S, Schiavoni G, D'Urso MT, Belardelli F, Proietti E. 2016. Chemo-immunotherapy induces tumor regression in a mouse model of spontaneous mammary carcinogenesis. Oncotarget 7(37):59754-59765. 33. Gritzapis AD, Mahaira LG, Perez SA, Cacoullos NT, Papamichail M, Baxevanis CN. 2006. Vaccination with human HER-2/neu (435- 443) CTL peptide induces effective antitumor immunity against HER-2/neu-expressing tumor cells in vivo. Cancer Res 66(10):5452-5460. 34. Liang X, Fu TM, Xie X, Emini EA, Shiver JW. 2002. Development of HIV-1 Nef vaccine components: immunogenicity study of Nef mutants lacking myristoylation and dileucine motif in mice. Vaccine 20:413-421. 30 35. Bauer S, Heeg K, Wagner H, Lipford GB. 1995. Identification of H- 2Kb binding and immunogenic peptides from human papilloma virus tumour antigens E6 and E7. Scand J lmmunol 42:317-323. 44 36. Chairoungdua A, Smith DL, Pochard P, Hull M,Caplan MJ. 2010.

Exosome release of beta-catenin: a novel mechanism that antagonizes Wnt signaling. J Cell Biol 190:1079-1091. 37.Kogure T, Lin WL, Yan IK, Braconi C, Patel T. 2011. lntercellular nanovesicle-mediated microRNA transfer: a mechanism of environmental modulation of hepatocellular cancer cell growth.

Hepatology 54:1237-1248. 38. Kosaka N, lguchi H, Yoshioka Y, Takeshita F, Matsuki Y, Ochiya T. 2010. Secretory mechanisms and intercellular transfer of microRNAs in living cells. J Biol Chem 285: 17442-17452. 39. Kosaka N, lguchi H, Yoshioka Y, Hagiwara K, Takeshita F, Ochiya T. 2012. Competitive interactions of cancer cells and normal cells via secretory microRNAs. J Biol Chem 287:1397-1405. 1s 40. Trajkovic K, Hsu C, Chiantia S, Rajendran L, Wenzel D, Wieland F, Schwille P, Brugger B, Simons M. 2008. Ceramide triggers budding of exosome vesicles into multivesicular endosomes. Science 319:1244-1247. 41. Yuyama K, Sun H, Mitsutake S, lgarashi Y. 2012. Sphingolipidmodulated exosome secretion promotes clearance of amyloid-beta by microglia. J Biol Chem 287:10977-10989. 42. Nanni P, Landuzzi L, Nicoletti G, De Giovanni C, Rossi I, Croci S, Astolfi A, Iezzi M, Di Carlo E, Musiani P, Forni G, Lollini PL. 2004. lmmunoprevention of mammary carcinoma in HER-2/neu transgenic mice is IFN-gamma and B cell dependent. J lmmunol 173(4):2288-2296. 43. Rolla S, Marchini C, Malinarich S, Quaglino E, Lanzardo S, Montani M, Iezzi M, Angeletti M, Ramadori G, Forni G, Cavallo F, Amici A. 2008. Protective immunity against neu-positive carcinomas elicited by electroporation of plasmids encoding decreasing fragments of rat neu extracellular domain. Hum Gene Ther 19(3):229-240. 44. Busam KJ, Jungbluth AA. 1996. Melan-A, a new melanocytic differentiation marker. Adv Anat Pathol 6: 12-18. 45. Rivoltini L, Kawakami Y, Sakaguchi K, Southwood S, Sette A, Robbins PF, Marincola FM, Salgaller ML, Yanne.lli YR, Appella E, Rosenberg SA. 1995. Induction of tumor-reactive CTL from peripheral blood and tumor-infiltrating lymphocytes of melanoma patients by in vitro stimulation with an immunodominant peptide of the human melanoma antigen MART-1. J lmmunol 154: 2257-2265.

SEQUENCE LISTING IN ELECTRONIC FORM In accordance with Section 111 (1) of the Patent Rules, this description contains a sequence listing in electronic form in ASCII text format (file: 85213194 Seq 17-APR-2019 v1 .txt).

A copy of the sequence listing in electronic form is available from the Canadian Intellectual Property Office.

Claims (8)

1. CLAIMS: 1) Nucleotide sequence expressing a fusion protein, said fusion protein comprising or consisting of the exosome-anchoring protein of sequence SEQ ID NO:1 5 fused at its C-terminus with an immunogenic antigen, or a DNA expression vector comprising said nucleotide sequence, for use in vaccine prevention and therapy by inducing a CTL immune response, wherein SEQ ID NO:1 is the following sequence: MGCKWSKSSV VGWPAVRERM RRAEPAADGV GAASRDLEKH GAITSSNTAA TNADCAWLEA QEEEEVGFPV TPQVPLRPMT YKAAVDLSHF 10 LKEKGGLEGL IHSQRRQDIL DLWIYHTQGY FPDWQNYPTG PGIRYPLTFG WCYKLVPVEP EKLEEANKGE NTSLLHPVSL HGMDDPGREV LEWRFDSRLA FHHVARELHP EYFKNC.
2. 2) Nucleotide sequence or DNA expression vector according to claim 1, for use according to claim 1, wherein said nucleotide sequence or DNA expression vector is 15 in a form for intramuscular administration.
3. 3) Nucleotide sequence or DNA expression vector according to any one of claims 1-2, for use according to any one of claims 1-2, wherein the antigen is chosen from the group consisting of Human Papilloma virus antigen, HIV antigen, Ebola virus antigen, West Nile virus antigen, HBV antigen, HCV antigen, Crimean-Congo virus antigen, 20 Influenza A virus antigen, human melanoma antigen, and human tumor-associated antigens.
4. 4) Nucleotide sequence or DNA expression vector according to claim 3, for use according to claim 3, wherein the Human Papilloma virus antigen is chosen from the group consisting of E6 and E7, the HIV antigen is chosen from the group consisting of 25 Gag and Tat, the Ebola virus antigen is chosen from the group consisting of VP24, VP40, NP, and GP, the West Nile virus antigen is NS3, the HBV antigen is Core, the HCV antigen is chosen from the group consisting of Core, NS3, E1 and E2, the Crimean-Congo virus antigen is chosen from the group consisting of GP and NP, the Influenza A virus antigen is chosen from the group consisting of NP and M1, the human melanoma antigen 30 is chosen from the group consisting of MAGE-A3 and MART-1, and the human tumorassociated antigens are chosen from the group consisting of Her2/Neu and Hex B7.
5. 5) Nucleotide sequence or DNA expression vector according to any one of claims 1-4, for use according to any one of claims 1-4, wherein the nucleotide sequence Date Rec;ue/Date Received 2024-05-22 85213194 47 expressing the exosome-anchoring protein of sequence SEQ ID N0:1 is the following nucleotide sequence SEQ ID N0:2: atg ggt tgc aag tgg tea aaa agt agt gtg gtt gga tgg cct get gta agg gaa aga atg aga cga get gag cca gca gca gat ggg gtg gga gca gca tct cga gac eta gaa aaa cat gga gca ate aca 5 agt age aat aca gca get ace aat get gat tgt gee tgg eta gaa gca caa gag gag gag gag gtg ggt ttt cca gtc aca cct cag gta cct tta aga cca atg act tac aag gca get gta gat ctt age cac ttt tta aaa gaa aag ggg gga ctg gaa ggg eta att cac tee caa cga aga caa gat ate ctt gat ctg tgg ate tac cac aca caa ggc tac ttc cct gat tgg cag aac tac aca cca gga cca ggg gtt aga tat cca ctg ace ttt gga tgg tgc tac aag eta gta cca gtt gag cca gag aag tta gaa gaa gee 1 o aac aaa gga gag aac ace age ttg tta cac cct gtg age ctg cat gga atg gat gac ccg gcg aga gaa gtg tta gag tgg agg ttt gac age cgc eta gca ttt cat cac gtg gee cga gag ctg cat ccg gag tac ttc aag aac tgc tga.
6. 6) Nucleotide sequence or DNA expression vector according to any one of claims 1-5, for use according to any one of claims 1-5, for the prevention and treatment 15 of diseases chosen from the group consisting of chronic infective diseases, acute infective diseases, and tumors.
7. 7) Nucleotide sequence or DNA expression vector according to claim 6, for use according to claim 6, wherein the chronic infective diseases are chosen from the group consisting of HBV, HCV, HIV, tuberculosis, and malaria, the acute infective 20 diseases are selected from the group consisting of influenza, West Nile, Crimean-Congo hemorrhagic fever, and Ebola diseases, and tumors are chosen from the group consisting of breast, pulmonary, prostate, and bladder tumor.
8. 8) Pharmaceutical composition, that is immunogenic, comprising or consisting of a nucleotide sequence expressing a fusion protein, said fusion protein comprising or 25 consisting of the exosome-anchoring protein of sequence SEQ ID N0:1 fused at its Cterminus with an antigen, or a DNA expression vector comprising said nucleotide sequence, in association with one or more pharmaceutically acceptable excipients and/or adjuvants, wherein SEQ ID N0:1 is the following sequence: MGCKWSKSSV VGWPAVRERM RRAEPMDGV GAASRDLEKH 30 GAITSSNTM TNADCAWLEA QEEEEVGFPV TPQVPLRPMT YKMVDLSHF LKEKGGLEGL IHSQRRQDIL DLWIYHTQGY FPDWQNYPTG PGIRYPLTFG WCYKLVPVEP EKLEEANKGE NTSLLHPVSL HGMDDPGREV LEWRFDSRLA FHHVARELHP EYFKNC. Date Rec;ue/Date Received 2024-05-22 85213194 48 9) Pharmaceutical composition according to claim 8, wherein the antigen is chosen from the group consisting of Human Papilloma virus antigen, HIV antigen, Ebola virus antigen, West Nile virus antigen, HBV antigen, HCV antigen; Crimean-Congo virus antigen; Influenza A virus antigen; human melanoma antigen; and human tumors associated antigens. 10) Pharmaceutical composition according to claim 9, wherein the Human Papilloma virus antigen is chosen from the group consisting of E6 and E?, the HIV antigen is chosen from the group consisting of Gag and Tat, the Ebola virus antigen is chosen from the group consisting of VP24, VP40, NP, and GP, the West Nile virus antigen is 10 NS3, the HBV antigen is Core, the HCV antigen is chosen from the group consisting of Core, NS3, E1 and E2, the Crimean-Congo virus antigen is chosen from the group consisting of GP and NP, the Influenza A virus antigen is chosen from the group consisting of NP and M1, the human melanoma antigen is chosen from the group consisting of MAGE-A3 and MART-1, and the human tumor-associated antigens are 15 chosen from the group consisting of Her2/Neu and Hox B7. 11) Pharmaceutical composition according to any one of claims 8-10, wherein the nucleotide sequence expressing the exosome-anchoring protein of sequence SEQ ID NO: 1 is the following sequence SEQ ID NO:2: atg ggt tgc aag tgg tea aaa agt agt gtg gtt gga tgg cct get gta agg gaa aga atg aga cga 2 o get gag cca gca gca gat ggg gtg gga gca gca tct cga gac eta gaa aaa cat gga gca ate aca agt age aat aca gca get ace aat get gat tgt gee tgg eta gaa gca caa gag gag gag gag gtg ggt ttt cca gtc aca cct cag gta cct tta aga cca atg act tac aag gca get gta gat ctt age cac ttt tta aaa gaa aag ggg gga ctg gaa ggg eta att cac tee caa cga aga caa gat ate ctt gat ctg tgg ate tac cac aca caa ggc tac ttc cct gat tgg cag aac tac aca cca gga cca ggg gtt aga 25 tat cca ctg ace ttt gga tgg tgc tac aag eta gta cca gtt gag cca gag aag tta gaa gaa gee aac aaa gga gag aac ace age ttg tta cac cct gtg age ctg cat gga atg gat gac ccg gcg aga gaa gtg tta gag tgg agg ttt gac age cgc eta gca ttt cat cac gtg gee cga gag ctg cat ccg gag tac ttc aag aac tgc tga. 12) Pharmaceutical composition according to any one of claims 8-11, wherein 30 the pharmaceutical composition is in a form suitable for a route of intramuscular administration. 13) Pharmaceutical composition according to any one of claims 8-12, wherein the adjuvant is an adjuvant of COB+ T cells response. Date Rec;ue/Date Received 2024-05-22 85213194 49 14) Pharmaceutical composition according to any one of claims 8-13, for use in vaccine prevention and therapy. 15) Pharmaceutical composition according to claim 14, for use according to claim 14, for the prevention and treatment of diseases chosen from the group consisting 5 of chronic infective diseases, acute infective diseases and tumors. 16) Pharmaceutical composition according to claim 14, for use according to claim 14, wherein the chronic infective diseases are chosen from the group consisting of HBV, HCV HIV, tuberculosis, and malaria, the acute infective diseases are chosen from the group consisting of influenza, West Nile, Crimean-Congo hemorrhagic fever, and Ebola 10 diseases, and the tumors are chosen from the group consisting of breast, pulmonary, prostate, and bladder tumor. Date Rec;ue/Date Received 2024-05-22