Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
  • C07K14/705—Receptors; Cell surface antigens; Cell surface determinants
  • C07K14/70503—Immunoglobulin superfamily
  • C07K14/7051—T-cell receptor (TcR)-CD3 complex
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
  • A61P11/02—Nasal agents, e.g. decongestants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
  • A61P31/12—Antivirals
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • C07K14/005—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from viruses
  • C07K14/01—DNA viruses
  • C07K14/03—Herpetoviridae, e.g. pseudorabies virus
  • C07K14/05—Epstein-Barr virus
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
  • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
  • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants

Definitions

• the present invention relates to a T-cell receptor (TCR) capable of recognising an antigen from Epstein Ban * Virus (EBV).
• TCR T-cell receptor
• EBV Epstein Ban * Virus
• the present invention also relates to the use of TCR gene transfer to produce EBV-specific T cells and their use to treat and/or prevent an EBV-associated disease.
• Epstein-Barr virus a member of the herpesvirus family, is found throughout the world. Studies show that up to 95% of all adults have antibodies against this common virus, meaning that they have been infected at some point in their lives. EBV generally persists throughout life in most people who are infected and rarely causes any problems. In some cases, however, EBV has been linked to the development of cancers and serious conditions, including Burkitt's lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, and post transplant lymphoproliferative disorder, a type of B-cell lymphoma which can occur in patients following solid organ or hematopoietic stem cell transplantation (HSCT).
• HSCT solid organ or hematopoietic stem cell transplantation
• Figure 1 Schematic of retroviral vector construct pMP71-pp65(alpha-2A-beta)- Cysl.
• the present inventors have developed a cellular therapy to treat and/or prevent EBV-associated diseases which involves using TCR gene therapy to produce EBV- specific T cells.
• the present inventors have assembled a T-cell receptor that is specific for the LMP- 2 protein of EBV. They have also constructed a retroviral vector comprising the TCR a and ⁇ genes and used this to transduce human T cells. The cells were shown to express LMP2-specific TCR and show functional antigen specific activity.
• the present invention provides a T-cell receptor (TCR) specific for the LMP2 protein of Epstein Barr Virus.
• TCR may recognise the epitope CLGGLLTMV (SEQ ID No. 1) from LMP-2.
• the TCR may be capable of binding to a peptide having the amino acid sequence CLGGLLTMV (SEQ ID No. 1) when presented by a major histocompatability complex (MHC) molecule.
• MHC major histocompatability complex
• the a chain and the ⁇ chain of the TCR each have three complementarity determining regions (CDRs).
• the a chain and the ⁇ chain of the TCR may have the following CDR3 sequences:
• the CDRs of the a chain may having the following amino acid sequences:
• the CDRs of the ⁇ chain may having the following amino acid sequences:
• the TCR of the first aspect of the invention may comprise the amino acid sequence shown as SEQ ID No. 8 or a variant thereof having at least 80% amino acid sequence identity.
• the TCR of the first aspect of the invention may comprise one or more mutations at the TCR a chain/ ⁇ chain interface, such that when the TCR a chain and ⁇ chain as defined in any preceding claim are expressed in a T-cell, the frequency of mis- pairing between these chains and the endogenous TCR a chain and ⁇ chain is reduced.
• the constant region domains of the a chain and ⁇ chain may each comprise an additional cysteine residue, enabling the formation of an extra disulphide bond between the a chain and the ⁇ chain.
• the second aspect provides nucleotide sequences encoding all or a part of the TCR according to the first aspect of the invention.
• a first embodiment of the second aspect of the invention relates to a nucleotide sequence encoding the a chain of a TCR according to the first aspect of the invention.
• the nucleotide sequence of this first embodiment may comprise bases 1-810 of the nucleotide sequence shown as SEQ ID No. 9 or a variant thereof having at least 80% sequence identity.
• a second embodiment of the second aspect of the invention relates to a nucleotide sequence encoding the ⁇ chain of a TCR according to the first aspect of the invention.
• the nucleotide sequence of this second embodiment may comprise bases 886-1812 of SEQ ID No. 9 or a variant thereof having at least 80% sequence identity.
• a third embodiment of the second aspect of the invention relates to a nucleotide sequence encoding a TCR a chain linked to a TCR ⁇ chain.
• the nucleotide sequence may comprise the TCR a and ⁇ genes linked by an internal self-cleaving sequence.
• the nucleotide sequence of this third embodiment may comprise the sequence shown as SEQ ID No. 9 or a variant thereof having at least 80% sequence identity.
• the present invention provides a vector comprising a nucleotide sequence according to the second aspect of the invention.
• the vector may, for example, be a retroviral vector.
• the invention provides a cell which comprises a nucleotide sequence according to the second aspect of the invention.
• the cell may, for example be a T-cell or a stem cell.
• the cell may be derived from a T-cell isolated from a subject.
• the present invention provides a method for producing a cell according to the fourth aspect of the invention which comprises the step of transducing or transfecting a cell in vitro or ex vivo with a vector according to the third aspect of the invention.
• the present invention provides a method for treating and/or preventing a disease associated with EBV in a subject which comprises the step of adoptive transfer of a EBV-specific T-cell to the subject, wherein the EBV-specific T-cell is made by TCR gene transfer.
• the T-cell comprises one or more heterologous nucleotide sequence(s) capable of encoding a EBV-specific TCR.
• the TCR may be in accordance with the first aspect of the invention.
• the method may be used to treat or prevent an EBV-associated disease such as EBV positive Hodgkin Lymphoma, EBV positive Nasopharyngeal Carcinoma or EBV positive post transplant lymphoproliferative disorder (PTLD).
• EBV-associated disease such as EBV positive Hodgkin Lymphoma, EBV positive Nasopharyngeal Carcinoma or EBV positive post transplant lymphoproliferative disorder (PTLD).
• PTLD EBV positive post transplant lymphoproliferative disorder
• the present invention also provides a vector according to the third aspect of the invention or a cell according to the fourth aspect of the invention for use in treating and/or preventing a disease associated with EBV in a subject.
• the present invention also provides a pharmaceutical composition comprising a vector according to the third aspect of the invention or a cell according to the fourth aspect of the invention.
• the present invention also provides the use of a TCR according to the first aspect of the invention, a nucleotide sequence according to the second aspect of the invention, a vector according to the third aspect of the invention, or a cell according to the fourth aspect of the invention in the manufacture of a medicament for use in treating and/or preventing a disease associated with EBV in a subject.
• MHC major histocompatability complex
• the T cell receptor or TCR is the molecule found on the surface of T cells that is responsible for recognizing antigens bound to MHC molecules.
• the TCR heterodimer consists of an alpha and beta chain in 95% of T cells, whereas 5% of T cells have TCRs consisting of gamma and delta chains.
• TCR TCR-associated antigen and MHC results in activation of its T lymphocyte through a series of biochemical events mediated by associated enzymes, co-receptors, and specialized accessory molecules.
• Each chain of the TCR is a member of the immunoglobulin superfamily and possesses one N-terminal immunoglobulin (Ig)-variable (V) domain, one Ig- constant (C) domain, a transmembrane/cell membrane-spanning region, and a short cytoplasmic tail at the C-terminal end.
• variable domain of both the TCR a-chain and ⁇ -chain have three hypervariable or complementarity determining regions (CDRs).
• CDR3 is the main CDR responsible for recognizing processed antigen, although CDRl of the alpha chain has also been shown to interact with the N-terminal part of the antigenic peptide, whereas CDRl of the beta chain interacts with the C-terminal part of the peptide.
• CDR2 is thought to recognize the MHC molecule.
• the constant domain of the TCR domain consists of short connecting sequences in which a cysteine residue forms a disulfide bond, making a link between the two chains.
• the TCR of the present invention may have an additional cysteine residue in each of the a and ⁇ chains such that the TCR comprises two disulphide bonds in the constant domains (see below).
• the structure allows the TCR to associate with other molecules like CD3 which possess three distinct chains ( ⁇ , ⁇ , and ⁇ ) in mammals and the ⁇ -chain. These accessory molecules have negatively charged transmembrane regions and are vital to propagating the signal from the TCR into the cell.
• the signal from the T cell complex is enhanced by simultaneous binding of the MHC molecules by a specific co-receptor.
• this co-receptor is CD4 (specific for class II MHC); whereas on cytotoxic T cells, this co-receptor is CD8 (specific for class I MHC).
• CD4 specific for class II MHC
• CD8 specific for class I MHC
• the co-receptor not only ensures the specificity of the TCR for an antigen, but also allows prolonged engagement between the antigen presenting cell and the T cell and recruits essential molecules (e.g., LC ) inside the cell involved in the signaling of the activated T lymphocyte.
• essential molecules e.g., LC
• T-cell receptor is thus used in the conventional sense to mean a molecule capable of recognising a peptide when presented by an MHC molecule.
• the molecule may be a heterodimer of two chains a and ⁇ (or optionally ⁇ and ⁇ ) or it may be a single chain TCR constuct.
• the present invention also provides the a chain or ⁇ chain from such a T cell receptor.
• the TCR of the present invention may be a hybrid TCR comprising suences derived from more than one species.
• murine TCRs have been found to be more efficiently expressed in human T cells than human TCRs.
• the TCR may therefore comprise human variable regions and murine constant regions.
• a disadvantage of this approach is that the murine constant sequences may trigger an immune response, leading to rejection of the transferred T cells.
• the conditioning regimens used to prepare patients for adoptive T-cell therapy may result in sufficient immunosuppression to allow the engraftment of T cells expressing murine sequences.
• the TCR of the first aspect of the invention comprises two chains (a and ⁇ ) each of which comprise three complementarity determining regions.
• T-cell receptor diversity is focused on CDR3 and this region is primarily responsible for antigen recognition.
• TCR of the present invention may be:
• the a chain may comprise CDRs having the following amino acid sequences:
• the ⁇ chain may comprise CDRs having the following amino acid sequences:
• the CDRs may comprise one or more "changes", such as substitutions, additions or deletions from the given sequence, provided that the TCR retains the capacity to bind the pp65 epitope:MHC complex.
• the change may involve substitution of an amino acid for a similar amino acid (a conservative substitution).
• a similar amino acid is one which has a side chain moiety with related properties as grouped together , for example as shown below:
• acidic side chains aspartic acid and glutamic acid
• uncharged polar side chains aspargine, glutamine, serine, threonine and tyrosine
• non-polar side chains glycine, alanine, valine, leucine, isoleucine, proline, phenylalanine, methionine, tryptophan and cysteine.
• any amino acid changes should maintain or improve the capacity to bind MHC molecules.
• the amino acids at position 2 of the peptide i.e. the second amino acid from the N-terminus
• the amino acids at position 2 of the peptide are leucine or methionine, although isoleucine, valine, alanine and threonine are also tolerated.
• the amino acid at position 9 or 10 is valine, leucine or isoleucine, although alanine, methionine and threonine are also tolerated.
• the preferred MHC binding motifs or other HLA alleles are disclosed in Celis et al, Molecular Immunology, Vol. 31, 8, December 1994, pages 1423 to 1430.
• the TCR of the first aspect of the invention may comprise the following amino acid sequence (SEQ ID No. 8) or a variant thereof having at least 70%, 80%, 90%, or 95% amino acid sequence identity: EBVal4-p2A-Vb7.7-aa:
• Variant sequences may comprise amino acid additions, deletions and/or insertions.
• the variation may be concentrated in one or more regions, such as the constant regions, the linker, or the framework regions of the a or ⁇ claim, or they may be spread throughout the molecule.
• Identity comparisons can be conducted by eye, or more usually, with the aid of readily available sequence comparison programs. These commercially available computer programs can calculate % identity between two or more sequences. % identity may be calculated over contiguous sequences, i.e. one sequence is aligned with the other sequence and each amino acid in one sequence is directly compared with the corresponding amino acid in the other sequence, one residue at a time. This is called an "ungapped" alignment. Typically, such ungapped alignments are performed only over a relatively short number of residues.
• BLAST and FASTA are available for offline and online searching (see Ausubel et al., 1999 ibid, pages 7-58 to 7-60). However, for some applications, it is preferred to use the GCG Bestfit program.
• BLAST 2 Sequences is also available for comparing protein and nucleotide sequences (see FEMS Microbiol Lett 1999 174(2): 247-50; FEMS Microbiol Lett 1999 177(1): 187-8 and tatiana@ncbi.nlm.nih.gov).
• sequences may also have deletions, insertions or substitutions of amino acid residues which produce a silent change and result in a functionally equivalent substance.
• Deliberate amino acid substitutions may be made on the basis of similarity in polarity, charge, solubility, hydrophobicity, hydrophilicity, and/or the amphipathic nature of the residues as long as the secondary binding activity of the substance is retained.
• negatively charged amino acids include aspartic acid and glutamic acid; positively charged amino acids include lysine and arginine; and amino acids with uncharged polar head groups having similar hydrophilicity values include leucine, isoleucine, valine, glycine, alanine, asparagine, glutamine, serine, threonine, phenylalanine, and tyrosine. Conservative substitutions may be made, for example according to the Table below. Amino acids in the same block in the second column and preferably in the same line in the third column may be substituted for each other:
• the present invention also encompasses homologous substitution (substitution and replacement are both used herein to mean the interchange of an existing amino acid residue, with an alternative residue) may occur i.e. like-for-like substitution such as basic for basic, acidic for acidic, polar for polar etc. Non-homologous substitution may also occur i.e.
• Z ornithine
• B diaminobutyric acid ornithine
• O norleucine ornithine
• pyriylalanine thienylalanine
• naphthylalanine phenylglycine
• the first aspect of the invention relates to a TCR which binds specifically to EBV latent membrane protein 2 (LMP-2).
• LMP-2 refers to two viral proteins associated with Epstein-Barr virus, LMP-2 A and LMP-2B.
• LMP-2A/LMP-2B are transmembrane proteins that act to block tyrosine kinase signaling. It is believed that they act to inhibit activation of the viral lytic cycle.
• LMP-2A has the sequence given below:
• LMP-2B has the sequence given below:
• the peptide CLGGLLTMV recognised by the T-cell receptor of the first aspect of the invention is shown in red in each sequence.
• the TCR may recognise all or part of this sequence.
• the TCR may recognise a part of this sequence together with one or more (for example up to 5) upstream or downstream amino acids.
• the TCR may recognise all or part of the following sequence GPVFMCLGGLTMVAGAVW.
• the TCR binds to the peptide as a peptide :MHC complex.
• the MHC molecule may be an MHC class I or II molecule.
• the complex may be on the surface of an antigen presenting cell, such as a dendritic cell or a B cell, or it may be immobilised by, for example, coating on to a bead or plate.
• HLA human leukocyte antigen system
• MHC major histocompatibility complex
• the TCR of the first aspect of the invention may be expressed in a T cell to alter its antigen specificity.
• TCR-transduced T cells express at least two TCR alpha and two TCR beta chains. While the endogenous TCR alpha/beta chains form a receptor that is self-tolerant, the introduced TCR alpha/beta chains form a receptor with defined specificity for the given target antigen. However, mis-pairing between endogenous and introduced chains may occur to form novel receptors, which might display unexpected specificities for self-antigens and cause autoimmune damage when transferred into patients.
• an additional cysteine in the constant domains of the alpha and beta chain allows the formation of an additional disulfide bond and enhances the pairing of the introduced chains while reducing mis-pairing with wild type chains.
• the TCR of the present invention may therefore comprise an additional cysteine in the a chain and the ⁇ chain, which form an additional disulphide bond between the two chains, making two disulphide bonds in total.
• NUCLEOTIDE SEQUENCE
• the second aspect of the invention relates to a nucleotide sequence encoding a TCR receptor of the first aspect of the invention or a part thereof, such as one or more CDR; the variable sequence of the a chain or the ⁇ chain; the a chain and/or the ⁇ chain.
• the nucleotide sequence may be double or single stranded, and may be RNA or DNA.
• the nucleotide sequence may be codon optimised. Different cells differ in their usage of particular codons. This codon bias corresponds to a bias in the relative abundance of particular tRNAs in the cell type. By altering the codons in the sequence so that they are tailored to match with the relative abundance of corresponding tRNAs, it is possible to increase expression. Many viruses, including HIV and other lentiviruses, use a large number of rare codons and by changing these to correspond to commonly used mammalian codons, increased expression of the packaging components in mammalian producer cells can be achieved. Codon- usage tables are known in the art for mammalian cells, as well as for a variety of other organisms.
• Codon optimisation may also involve the removal of mRNA instability motifs and cryptic splice sites.
• nucleotide sequence of the second aspect of the invention may comprise all or part of the following sequence (SEQ ID No. 9) or a variant thereof having at least 70%, 80%, 90%, or 95% amino acid sequence identity:
• the nucleotide sequence may comprise the part(s) of the above sequence which encode one or more CDRs or a variant thereof having at least 70%, 80%, 90%, or
• the nucleotide sequence may comprise the part(s) of the above sequence which encode one or more variable regions or a variant thereof having at least 70%, 80%, 90%, or 95% amino acid sequence identity, these parts are:
• the nucleotide sequence may comprise the part(s) of the above sequence which encode the a chain and/or the ⁇ chain or a variant thereof having at least 70%, 80%, 90%, or 95% amino acid sequence identity, these parts are:
• the variant sequences may have additions, deletions or substitutions or one or more bases. If the variation involves addition(s) or deletion(s) they may either occur in threes or be balanced (i.e. an addition for each deletion) so that the variation does not cause a frame-shift for translation of the remainder of the sequence.
• Some or all of the variations may be "silent" in the send that they do not affect the sequence of the encoded protein due to the degeneracy of the protein code. Some or all of the variations may produce conservative amino acid substitutions as explained above.
• the variation may be concentrated in one or more regions, such as the regions encoding the constant regions, the linker, or the framework regions of the a or ⁇ clains, or they may be spread throughout the molecule.
• the variant sequence should retain the capacity to encode all or part of a sequence which binds an CLGGLLTMV:MHC complex.
• VECTOR The present invention also provides a vector comprising a nucleotide sequence according to the second aspect of the invention.
• vector includes an expression vector i.e. a construct capable of in vivo or in vitro/ex vivo expression.
• Viral delivery systems include but are not limited to adenovirus vector, an adeno- associated viral (AAV) vector, a herpes viral vector, retroviral vector, lentiviral vector, baculoviral vector.
• Retroviruses are RNA viruses with a life cycle different to that of lytic viruses.
• a retrovirus is an infectious entity that replicates through a DNA intermediate. When a retrovirus infects a cell, its genome is converted to a DNA form by a reverse transcriptase enzyme. The DNA copy serves as a template for the production of new RNA genomes and virally encoded proteins necessary for the assembly of infectious viral particles.
• retroviruses for example murine leukemia virus (MLV), human immunodeficiency virus (HIV), equine infectious anaemia virus (EIAV), mouse mammary tumour virus (MMTV), Rous sarcoma virus (RSV), Fujinami sarcoma virus (FuSV), Moloney murine leukemia virus (Mo-MLV), FBR murine osteosarcoma virus (FBR MSV), Moloney murine sarcoma virus (Mo-MSV), Abelson murine leukemia virus (A-MLV), Avian myelocytomatosis virus-29 (MC29), and Avian erythroblastosis virus (AEV) and all other retroviridiae including lentiviruses.
• retroviruses A detailed list of retroviruses may be found in Coffin et al ("Retroviruses” 1997 Cold Spring Harbour Laboratory Press Eds: JM Coffin, SM Hughes, HE Varmus pp 758-763). Lentiviruses also belong to the retrovirus family, but they can infect both dividing and non-dividing cells (Lewis et al (1992) EMBO J. 3053-3058).
• the vector may be capable of transferring a nucleotide according to the second aspect of the invention to a cell, such as a T-cell, such that the cell expresses a EBV-specific TCR.
• the vector should ideally be capable of sustained high-level expression in T cells, so that the introduced TCR may compete successfully with the endogenous TCR for a limited pool of CD3 molecules.
• the vector may be a retroviral vector.
• the vector may be based on or derivable from the MP71 vector backbone.
• the vector may lack a full-length or truncated version of the Woodchuck Hepatitis Response Element (WPRE).
• WPRE Woodchuck Hepatitis Response Element
• viral particles may be packaged with amphotropic envelopes or gibbon ape leukemia virus envelopes.
• the vector may therefore also comprise the genes for CD3-gamma, CD3-delta, CD3-epsilon and/or CD3-zeta.
• the vector may just comprise the gene for CD3-zeta.
• the genes may be linked by self-cleaving sequences, such as the 2A self-cleaving sequence.
• one or more separate vectors may be provided encoding CD3 gene for co-transfer with the TCR-encoding vector(s).
• the fourth aspect of the present invention relates to a cell which comprises a nucleotide sequence according to the second aspect of the invention.
• the cell may express a T-cell receptor of the first aspect of the invention.
• the cell may be a T-cell.
• the cell may be derived from a T-cell isolated from a subject.
• the T-cell may be part of a mixed cell population isolated from the subject, such as a population of peripheral blood lymphocytes (PBL).
• PBL peripheral blood lymphocytes
• T cells within the PBL population may be activated by methods known in the art, such as using anti-CD3 and CD28 antibodies.
• the T-cell may be a CD4+ helper T cell or a CD8+ cytotoxic T cell.
• the cell may be in a mixed population of CD4+ helper T cell/CD8+ cytotoxic T cells.
• Polyclonal activation, for example using anti-CD3 antibodies optionally in combination with anti-CD28 antibodies will trigger the proliferation of CD4+ and CD8+ T cells, but may also trigger the proliferation of CD4+25+ regulatory T-cells.
• TCR gene transfer into regulatory T cells is undesirable as they may suppress the anti-viral activity of the gene-modified cytotoxic and helper T cells.
• the CD4+CD25+ population may therefore be depleted before TCR gene transfer.
• the present invention also provides a method of producing a cell according to the fourth aspect of invention which comprises the step of transfecting or transducing a cell in vitro or ex vivo with a vector according to the third aspect of the invention.
• the cell may be isolated from the subject to which the genetically modified cell is to be adoptively transferred.
• the cell may be made by isolating a T- cell from a subject, optionally activating the T-cell, TCR gene transfer ex vivo and subsequent immunotherapy of the subject by adoptive transfer of the TCR- transduced cells.
• the cell may be isolated from a different subject, such that it is allogeneic.
• the cell may be isolated from a donor subject. For example, if the subject is undergoing allogeneic haematopoietic stem cell transplantation (Allo- HSCT), the cell may be derived from the donor, from which the HSCs are derived. If the subject is undergoing or has undergone solid organ transplant, the cell may be derived from the subject from whom the solid organ was derived.
• Allo- HSCT allogeneic haematopoietic stem cell transplantation
• the cell may be, or be derived from, a stem cell, such as a haemopoietic stem cell (HSC).
• HSC haemopoietic stem cell
• the gene-modified stem cells are a continuous source of mature T-cells with the desired antigen specificity.
• the cell may therefore be a gene-modified stem cell, which, upon differentiation, produces a T-cell expressing a TCR of the first aspect of the invention.
• the present invention also provides a method of producing a T-cell expressing a TCR of the first aspect of the invention by inducing the differentiation of a stem cell which comprises a nucleotide sequence according to the second aspect of the invention.
• a disadvantage of the stem cell approach is that TCRs with the desired specificity may get deleted during T-cell development in the thymus or may induce tolerance when expressed in peripheral T-cells. Another possible issue is the risk of insertional mutagenesis in stem cells. EBV-ASSOCIATED DISEASES
• the present invention also relates to a method for treating and/or preventing a disease associated with EBV in a subject which comprises the step of adoptive transfer of a EBV-specific T-cell to the subject.
• the EBV-specific T-cell may recognise the LMP-2 protein.
• the EBV-specific T cell may recognise the epitope CLGGLLTMV.
• the term 'preventing' is intended to refer to averting, delaying, impeding or hindering the contraction of the disease.
• the treatment may, for example, prevent or reduce the likelihood of EBV infection.
• EBV-specific T cells could be used to treat any EBV- associated condition, in which the LMP-2 antigen in expressed.
• EBV-specific T cells could be used in the management of EBV positive Hodgkin Lymphoma, EBV positive Nasopharyngeal Carcinoma or EBV positive post transplant lymphoproliferative disorder (PTLD).
• Burkitt's lymphoma is the most common childhood malignancy in equatorial Africa. Tumors are characteristically located in the jaw. Genetic studies have shown that in equatorial Africa (where over 95% of children have been infected with EBV by age 3), the vast majority of Burkitt lymphomas originate from an EBV-infected lymphocyte. Hodgkin's lymphoma is characterized by the orderly spread of disease from one lymph node group to another, and by the development of systemic symptoms with advanced disease. EBV genetic material is found in up to 50% of cases of Hodgkin lymphoma in certain geographic areas and patient populations.
• Nasopharyngeal carcinoma is one of the most common cancers in southern China. It originates in the nasopharynx, the uppermost region of the pharynx or "throat", where the nasal passages and auditory tubes join the remainder of the upper respiratory tract.
• Post-transplant lymphoproliferative disease refers to a category of conditions that may develop in people following an organ transplant.
• the EBV virus has been implicated in the majority of cases of PTLD.
• Manifestations can vary, ranging from an increased number of lymphocytes in the bloodstream to blood-cell malignancies such as B-cell lymphoma.
• PTLD is an uncontrolled proliferation of B cell lymphocytes following infection with Epstein-Barr virus. Depletion of T cells by use of anti-T cell antibodies in the prevention or treatment of transplant rejection further increases the risk of developing post-transplant lymphoproliferative disorder.
• Polyclonal PTLD may form tumor masses and present with symptoms due to a mass effect, e.g. symptoms of bowel obstruction.
• Monoclonal forms of PTLD tend to form a disseminated malignant lymphoma.
• PTLD may spontaneously regress on reduction or cessation of immunosuppressant medication, and can also be treated with addition of anti-viral therapy.
• Hematopoietic stem cell transplantation is the transplantation of blood stem cells derived from the bone marrow or blood. Stem cell transplantation is most often performed for people with diseases of the blood, bone marrow, or certain types of cancer. With the availability of the stem cell growth factors GM-CSF and G-CSF, most hematopoietic stem cell transplantation procedures are now performed using stem cells collected from the peripheral blood, rather than from the bone marrow.
• Collecting peripheral blood stem cells provides a bigger graft, does not require that the donor be subjected to general anesthesia to collect the graft, results in a shorter time to engraftment, and may provide for a lower long-term relapse rate.
• Hematopoietic stem cell transplantation remains a risky procedure with many possible complications; it has traditionally been reserved for patients with life- threatening diseases. While occasionally used experimentally in nonmalignant and nonhematologic indications such as severe disabling auto-immune disease and cardiovascular disease, the risk of fatal complications appears too high to gain wider acceptance.
• HSCTs Many recipients of HSCTs are multiple myeloma or leukemia patients who would not benefit from prolonged treatment with, or are already resistant to, chemotherapy.
• Candidates for HSCTs include pediatric cases where the patient has an inborn defect such as severe combined immunodeficiency or congenital neutropenia with defective stem cells, and also children or adults with aplastic anemia who have lost their stem cells after birth.
• Other conditions treated with stem cell transplants include sickle-cell disease, myelodysplasia syndrome, neuroblastoma, lymphoma, Ewing's Sarcoma, Desmoplastic small round cell tumor and Hodgkin's disease.
• Allo-HSCTs have been developed. These approaches reduce the toxicity of transplantation in older patients with more co-morbidities.
• Allogeneic HSCT involves two people: the (healthy) donor and the (patient) recipient. Allogeneic HSC donors must have a tissue (HLA) type that matches the recipient. Matching is performed on the basis of variability at three or more loci of the (HLA) gene, and a perfect match at these loci is preferred. Even if there is a good match at these critical alleles, the recipient will require immunosuppressive medications to mitigate graft-versus-host disease.
• HLA tissue
• Allogeneic transplant donors may be related (usually a closely HLA matched sibling), syngeneic (a monozygotic or 'identical' twin of the patient - necessarily extremely rare since few patients have an identical twin, but offering a source of perfectly HLA matched stem cells) or unrelated (donor who is not related and found to have very close degree of HLA matching). About 25 to 30% of allogeneic HSCT recipients have an HLA-identical sibling. Allogeneic transplants are also performed using umbilical cord blood as the source of stem cells. In general, by transplanting healthy stem cells to the recipient's immune system, allogeneic HCSTs appear to improve chances for cure or long-term remission once the immediate transplant-related complications are resolved.
• the subject may be a human subject. In particular the subject may be a transplant recipient.
• TCR gene therapy An important issue for TCR gene therapy is the selection of vectors capable of sustained high-level expression in T lymphocytes. High expression levels are required to allow the introduced TCR to compete with the endogenous TCR for a limited pool of CD3 molecules. Further requirements for TCR gene therapy are (i) a transduction efficiency of up to 30% with minimal ex vivo manipulation, (ii) the absence of replication competent vectors, and (iii) stable TCR expression over time to allow for memory development. In this study the MP71 vector backbone was used with a codon-optimised TCR sequence and an additional cysteine in each alpha and beta chain constant region to enhance gene expression and minimize mis-pairing with endogenous TCR chains.
• the MP71 vector backbone has been described previously (Hildigner et al (1999) J. Virol. 73:4083-4089).
• the LTR of the MP71 vector is derived from the Myeloproliferative Sacrcoma Virus (MPSV) and the leader sequence (LS) is derived from the Mouse Embryonic Stem Cell Virus (MESV).
• MPSV Myeloproliferative Sacrcoma Virus
• LS Mouse Embryonic Stem Cell Virus
• the leader sequence was designed to increase vector safety in clinical applications. All ATG codons have been removed to decrease the risk of possible protein/peptide production and reduce the likelihood of homologous recombination with endogenous retroviral sequences.
• the expression of genes inserted into MP71 is enhanced by a minimal splice acceptor site at the 3' end of the leader sequence.
• the original MP71 vector contained a full length Woodchuck Hepatitis Response Element (WPRE) to enhance gene expression at the post-transcriptional level.
• WPRE Woodchuck Hepatitis Response Element
• the MP71 vector containing a truncated WPRE with mutated ATG codons is currently used in Germany in a clinical trial using gene-modified T cells in HIV patients.
• the present inventors have further modified the MP71 vector and tested variants without any WPRE sequences.
• the vector comprises the EBV TCR alpha and beta genes, linked via an internal self-cleaving porcine teschovirus 2A sequence, as shown in Figure 1.
• the alpha and beta TCR genes were synthesised based on dominant TCR usage by EBV LMP-2-specific CTL clones.
• the amino acid sequence for the TCR alpha-2A-TCR beta product is given as SEQ ID No. 8 and its coding sequence given as SEQ ID No. 9.
• TCR Human T cell receptor
• retroviral vectors carrying the desired TCR genes were transduced into human T cells by using retroviral vectors carrying the desired TCR genes. Briefly, amphotropic packaging cells expressing the retroviral gag-pol genes were transfected with the specified TCR-retroviral vectors by using calcium phosphate precipitation method. After the retroviral transfection, the transfection medium was changed into human T cell medium for the harvesting of retroviral supernatant. The collected retroviral supernatant containing the viral particles expressing the desired TCR genes were then used to infect/transduce activated human T cells. 24 hours later, the introduced TCR genes are expressed on the surface of transduced T cells, and can be detected by FACS staining.
• Retroviral transfer of the LMP-2-specific TCR results in TCR expression on the surface of recipient T cells as determined by peptide/MHC tetramer staining and anti-V i 3 antibody staining ( Figure 2).
• Figure 2 Retroviral transfer of the LMP-2-specific TCR results in TCR expression on the surface of recipient T cells as determined by peptide/MHC tetramer staining and anti-V i 3 antibody staining ( Figure 2).
• Figure 2 Example 3 - Intracellular cytokine staining of TCR transduced T cells
• TCR-transduced T cells (2xl0 5 ) were incubated with 2xl0 5 T2 stimulator cells coated with 100 mM relevant (pCLG: CLGGLLTMV) or irrelevant (pNLV: NLVPMVATV) peptide in 200 ml of culture medium containing brefeldin A (Sigma- Aldrich) at 1 mg/ml. After an incubation period of 18 h at 37°C with 5% C0 2 , the cells were first stained for surface CD8 or CD4 and then fixed, permeabilized, and stained for intracellular IFNg, IL2 and TNFa using the Fix & Perm kit (Caltag) according to the manufacturer's instructions. Samples were acquired on a LSR II flow cytometer and the data was analyzed using FACSDiva software (BD Biosciences).

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