Directed evolution-based discovery of ligands for in vivo restimulation of CAR-T cells

Chimeric antigen receptor (CAR) T cell therapy targeting CD19 elicits remarkable clinical efficacy in B-cell malignancies, but many patients relapse due to failed expansion and/or progressive loss of CAR-T cells. We recently reported a strategy to potently restimulate CAR-T cells in vivo, enhancing their functionality by administration of a vaccine-like stimulus comprised of surrogate peptide ligands for a CAR linked to a lymph node-targeting amphiphilic PEG-lipid (termed CAR-T-vax). Here, we demonstrate a general strategy to generate and optimize peptide mimotopes enabling CAR-T-vax generation for any CAR. Using the clinical CD19 CAR FMC63 as a test case, we employed yeast surface display to identify peptide binders to soluble IgG versions of FMC63, which were subsequently affinity matured by directed evolution. CAR-T vaccines using these optimized mimotopes triggered marked expansion of both murine CD19 CAR-T cells in a syngeneic model and human CAR-T cells in a humanized mouse model of B cell acute lymphoblastic leukemia (B-ALL), and enhanced control of leukemia progression. This approach thus enables vaccine boosting to be applied to any clinically-relevant CAR-T cell product.

A particulate saponin/TLR agonist vaccine adjuvant alters lymph flow and modulates adaptive immunity

[Figure: see text].

Tabletized Supramolecular Assemblies for Sublingual Peptide Immunization

Widespread vaccination is essential to global health. Significant barriers exist to improving vaccine coverage in lower- and middle-income countries, including the costly requirements for cold-chain distribution and trained medical personnel to administer the vaccines. A heat-stable and highly porous tablet vaccine that can be administered sublingually via simple dissolution under the tongue is described. SIMPL tablet vaccines (Supramolecular IMmunization with Peptides subLingually) are produced by freeze-drying a mixture of self-assembling peptide-polymer nanofibers, sugars, and adjuvant. Sublingual immunization with SIMPL tablets raises antibody responses against both a model epitope from ovalbumin and a clinically relevant epitope from Mycobacterium tuberculosis. Further, sublingual antibody responses are not diminished after heating the tablets for 1 week at 45 °C, in contrast to a more conventional carrier vaccine (KLH). This approach directly addresses the need for a heat-stable and easily deliverable vaccine to improve equity in global vaccine coverage.

Effect of area-level factors on heat-associated morbidity and mortality in the Eastern Townships

Background

Multiple individual risk factors for morbidity and mortality during heat waves have previously been identified. Based on these, five categories of area-level indicators are used in Quebec, Canada, to identify geographical regions with presumed increased vulnerability: economic, social and biological vulnerability, housing characteristics and urban environment. However, we do not know which indicators correlate with an increase in morbidity and mortality during heat waves. This study evaluated, among 13 different area-level vulnerability factors from these five categories, which ones predict an effect modification of hot temperatures on morbidity and mortality.

Methods

For 2008 to 2018, we first explored the association between average daily temperature and four daily health indicators for the Eastern Townships region in Quebec: all-cause ambulance transports, all-cause emergency department (ED) visits, all-cause mortality and heat-related hospitalizations. We then used Poisson regression linear mixed models to investigate effect modification from the 13 area-level risk factors.

Results

Three vulnerability factors significantly caused positive effect modification between temperature and daily all-cause ambulance counts: the chronic diseases index, the percentage of people aged 65 years or older and the percentage of people aged 65 or older and living alone. For heat-related hospitalizations, four factors caused positive effect modification: the same three as for ambulance counts, plus the proportion of people that spend 30% or more household income on rent. For the ED-temperature association, only the percentage of people with low income caused positive effect modification. There was no significant association between temperature and daily mortality.

Conclusions

This study will help public health officials target preventive interventions to areas with the vulnerability factors that most strongly predict heat-related morbidity.

Key messages

Some, but not all, individual risk factors are useful at the area-level to predict areas with the strongest increases in morbidity associated with hot temperatures. The chronic diseases index and the percentage of people 65 and older living alone both accentuated the association between hot temperatures and ambulance transports or hospitalizations.

Enhanced CAR-T cell activity against solid tumors by vaccine boosting through the chimeric receptor

Chimeric antigen receptor-T cell (CAR-T) therapy has been effective in the treatment of hematologic malignancies, but it has shown limited efficacy against solid tumors. Here we demonstrate an approach to enhancing CAR-T function in solid tumors by directly vaccine-boosting donor cells through their chimeric receptor in vivo. We designed amphiphile CAR-T ligands (amph-ligands) that, upon injection, trafficked to lymph nodes and decorated the surfaces of antigen-presenting cells, thereby priming CAR-Ts in the native lymph node microenvironment. Amph-ligand boosting triggered massive CAR-T expansion, increased donor cell polyfunctionality, and enhanced antitumor efficacy in multiple immunocompetent mouse tumor models. We demonstrate two approaches to generalizing this strategy to any chimeric antigen receptor, enabling this simple non-human leukocyte antigen-restricted approach to enhanced CAR-T functionality to be applied to existing CAR-T designs.

Slow Delivery Immunization Enhances HIV Neutralizing Antibody and Germinal Center Responses via Modulation of Immunodominance

Conventional immunization strategies will likely be insufficient for the development of a broadly neutralizing antibody (bnAb) vaccine for HIV or other difficult pathogens because of the immunological hurdles posed, including B cell immunodominance and germinal center (GC) quantity and quality. We found that two independent methods of slow delivery immunization of rhesus monkeys (RMs) resulted in more robust T follicular helper (TFH) cell responses and GC B cells with improved Env-binding, tracked by longitudinal fine needle aspirates. Improved GCs correlated with the development of >20-fold higher titers of autologous nAbs. Using a new RM genomic immunoglobulin locus reference, we identified differential IgV gene use between immunization modalities. Ab mapping demonstrated targeting of immunodominant non-neutralizing epitopes by conventional bolus-immunized animals, whereas slow delivery-immunized animals targeted a more diverse set of epitopes. Thus, alternative immunization strategies can enhance nAb development by altering GCs and modulating the immunodominance of non-neutralizing epitopes.

Trichothecene mycotoxins in the dust of ventilation systems in office buildings

Analysis of trichothecene mycotoxins in dust samples from ventilation systems of office buildings was applied as a rapid and inexpensive method for the detection of mycotoxins. Dust samples from three different office spaces of the Montreal urban area, reportedly affected by the "sick buildings syndrome", were analysed by thin-layer chromatography (TLC). Positive colour reaction on TLC plates with 4-(p-nitrobenzyl) pyridine, specific for the 12,13-epoxy group in the trichothecene nucleus, was obtained for the extracts of 0.5- to 50-g dust samples. The dust samples contained at least four trichothecenes: T-2 toxin, diacetoxyscirpenol, roridine A and T-2 tetraol. The results were confirmed by high-performance liquid chromatography analysis. Screening of dust samples from air ventilation systems of reportedly affected buildings provided direct evidence of trichothecene mycotoxins, with the detection limit estimated as 0.4-4 ng/mg dust. Thus, the dust sample analysis is suggested as a rapid technique for detecting the presence of myotoxins in the dust of ventilation systems.