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A humanized IL-2 mutein expands Tregs and prolongs transplant survival in preclinical models
Orhan Efe, … , Thiago J. Borges, Leonardo V. Riella
Orhan Efe, … , Thiago J. Borges, Leonardo V. Riella
Published March 1, 2024
Citation Information: J Clin Invest. 2024;134(5):e173107. https://doi.org/10.1172/JCI173107.
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Research Article Immunology

A humanized IL-2 mutein expands Tregs and prolongs transplant survival in preclinical models

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Abstract

Long-term organ transplant survival remains suboptimal, and life-long immunosuppression predisposes transplant recipients to an increased risk of infection, malignancy, and kidney toxicity. Promoting the regulatory arm of the immune system by expanding Tregs may allow immunosuppression minimization and improve long-term graft outcomes. While low-dose IL-2 treatment can expand Tregs, it has a short half-life and off-target expansion of NK and effector T cells, limiting its clinical applicability. Here, we designed a humanized mutein IL-2 with high Treg selectivity and a prolonged half-life due to the fusion of an Fc domain, which we termed mIL-2. We showed selective and sustainable Treg expansion by mIL-2 in 2 murine models of skin transplantation. This expansion led to donor-specific tolerance through robust increases in polyclonal and antigen-specific Tregs, along with enhanced Treg-suppressive function. We also showed that Treg expansion by mIL-2 could overcome the failure of calcineurin inhibitors or costimulation blockade to prolong the survival of major-mismatched skin grafts. Validating its translational potential, mIL-2 induced a selective and sustainable in vivo Treg expansion in cynomolgus monkeys and showed selectivity for human Tregs in vitro and in a humanized mouse model. This work demonstrated that mIL-2 can enhance immune regulation and promote long-term allograft survival, potentially minimizing immunosuppression.

Authors

Orhan Efe, Rodrigo B. Gassen, Leela Morena, Yoshikazu Ganchiku, Ayman Al Jurdi, Isadora T. Lape, Pedro Ventura-Aguiar, Christian LeGuern, Joren C. Madsen, Zachary Shriver, Gregory J. Babcock, Thiago J. Borges, Leonardo V. Riella

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Figure 7

Effect of mIL-2 on Treg-suppressive function and its CTLA-4–dependent efficacy in skin transplantation.

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Effect of mIL-2 on Treg-suppressive function and its CTLA-4–dependent ef...
(A) Illustration of the Treg suppression assay performed by coculturing naive CTV-labeled CD4+ Tconv cells with Tregs from B6 FOXP3-GFP mice treated with control IgG or mIL-2 (0.5 mg/kg). (B) Percentages of proliferating CD4+ Tconv cells after coculturing with different ratios of Tregs (n = 3/group; representative data are from 3 independent experiments). (C) Illustration of the experimental design to assess the functional surface markers and inhibitory cytokines of splenic Tregs in which B6 FOXP3-GFP mice were treated with control IgG or mIL-2 at 0.5 mg/kg subcutaneously on days 0 and 3, and splenocytes were harvested on day 4. Flow cytometric analyses of (D) total Tregs, (E) CTLA-4+, (F) ICOS+, and (G) LAG3+ Tregs. Flow cytometric analyses of (H) IL-10+ and (I) LAP+ (TGF-β+) Tregs after in vitro stimulation with a PMA/ionomycin/brefeldin cocktail for 6 hours (n = 4/group, data are representative of 2 independent experiments). (J) Illustration of B6.mOVA to WT B6 skin transplantation, in which the recipient mice were treated with subcutaneous control IgG or mIL-2 (0.5 mg/kg) with or without anti–CTLA-4 antibodies (combination of 2 antibodies from the clones of UC10-4F10-11 and 9H10; 200 μg/mouse for each clone, intraperitoneally) twice a week starting on day 0 (n = 3–12/group, data were pooled from 4 different experiments). (K) Kaplan-Meier curves of the graft survivals. (L) Flow cytometric analysis of peripheral blood Tregs from the recipient mice. (M) Plasma anti-OVA antibody levels as determined by ELISA on days 0 and 21 (n = 3–4/group). Graphs show the mean ± SD. A 2-tailed t test was used for 2-group comparisons (B and D–I) and 1-way (M) and 2-way (L) ANOVA with Tukey’s multiple-comparison test for 3 or more group comparisons as appropriate. The long-rank test was used for graft survival comparisons (K). CTV, CellTrace Violet.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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