Transient antibody targeting of CD45RC inhibits the development of graft-versus-host disease

L Boucault, MD Lopez Robles, A Thiolat… - Blood …, 2020 - ashpublications.org
L Boucault, MD Lopez Robles, A Thiolat, S Bézie, M Schmueck-Henneresse, C Braudeau…
Blood Advances, 2020ashpublications.org
Allogeneic bone marrow transplantation (BMT) is a widely spread treatment of many
hematological diseases, but its most important side effect is graft-versus-host disease
(GVHD). Despite the development of new therapies, acute GVHD (aGVHD) occurs in 30% to
50% of allogeneic BMT and is characterized by the generation of effector T (Teff) cells with
production of inflammatory cytokines. We previously demonstrated that a short anti-CD45RC
monoclonal antibody (mAb) treatment in a heart allograft rat model transiently decreased …
Abstract
Allogeneic bone marrow transplantation (BMT) is a widely spread treatment of many hematological diseases, but its most important side effect is graft-versus-host disease (GVHD). Despite the development of new therapies, acute GVHD (aGVHD) occurs in 30% to 50% of allogeneic BMT and is characterized by the generation of effector T (Teff) cells with production of inflammatory cytokines. We previously demonstrated that a short anti-CD45RC monoclonal antibody (mAb) treatment in a heart allograft rat model transiently decreased CD45RChigh Teff cells and increased regulatory T cell (Treg) number and function allowing long-term donor-specific tolerance. Here, we demonstrated in rat and mouse allogeneic GVHD, as well as in xenogeneic GVHD mediated by human T cells in NSG mice, that both ex vivo depletion of CD45RChigh T cells and in vivo treatment with short-course anti-CD45RC mAbs inhibited aGVHD. In the rat model, we demonstrated that long surviving animals treated with anti-CD45RC mAbs were fully engrafted with donor cells and developed a donor-specific tolerance. Finally, we validated the rejection of a human tumor in NSG mice infused with human cells and treated with anti-CD45RC mAbs. The anti-human CD45RC mAbs showed a favorable safety profile because it did not abolish human memory antiviral immune responses, nor trigger cytokine release in in vitro assays. Altogether, our results show the potential of a prophylactic treatment with anti-human CD45RC mAbs in combination with rapamycin as a new therapy to treat aGVHD without abolishing the antitumor effect.
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