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US20180214487A1 - Pd-l1 expressing hematopoietic stem cells and uses - Google Patents

Pd-l1 expressing hematopoietic stem cells and uses Download PDF

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US20180214487A1
US20180214487A1 US15/745,553 US201615745553A US2018214487A1 US 20180214487 A1 US20180214487 A1 US 20180214487A1 US 201615745553 A US201615745553 A US 201615745553A US 2018214487 A1 US2018214487 A1 US 2018214487A1
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Paolo FIORINA
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Boston Childrens Hospital
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    • A61K35/28—Bone marrow; Haematopoietic stem cells; Mesenchymal stem cells of any origin, e.g. adipose-derived stem cells
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Definitions

  • T1D autoimmune type 1 diabetes
  • DCCT Diabetes Control and Complications Trial
  • MSCs Mesenchymal stem cells
  • a study showed short-term reversal of diabetes in 88% of BALB/c-MSC-treated hyperglycemic NOD mice. However, NOD mice treated with NOD-MSCs remained hyperglycemic.
  • HSCs Hematopoietic stem cells transplantation
  • TID Hematopoietic stem cells
  • AHSCT protocols used in these studies were designed for adults and not for pediatric subjects with T1D, and thus AHSCT can be only considered for a well-defined group of individuals that may benefit from this treatment.
  • HSCs are endowed with immunoregulatory properties.
  • Preclinical studies demonstrated that T cell-depleted bone marrow-resident CD34+ stem cells overcome MHC barriers in sublethally irradiated mice and that murine HSCs may delete effector cells. This effect can be reverted by the addition of a caspase inhibitor, suggesting a deletion-based mechanism.
  • the human CD34 + population have been shown to be endowed with potent veto activity and neutralized precursors of cytotoxic T lymphocytes (CTLs) directed against their antigens.
  • CTLs cytotoxic T lymphocytes
  • Embodiments of the present disclosure provide programmed cell death-1 ligand 1 (PD-L1) expressing hematopoietic stem cells (HSCs), methods of making these cells, and therapeutic methods of using these cells for the treatment of autoimmune diseases such as type 1 diabetes (T1D), and for the suppression of the immune system in a subject.
  • the therapeutic methods are useful after an organ or bone marrow transplantation, and when a subject has a defect in producing PD-L1 + expressing HSCs, e.g. in Type 1 diabetes (T1D).
  • the disclosure provides PD-L1 + expressing HSCs that are stimulated by prostaglandin E2 (PGE 2 ) treatment or by transduction with an exogenous copy of a nucleic acid that encodes for the PD-L1 protein for promoting PD-L1 expression in the cell after transduction of the nucleic acid.
  • PGE 2 prostaglandin E2
  • Type 1 diabetes (T1D) mouse models and human T1D patients have fewer HSCs that express PD-L1 and these HSCs express lower amounts of PD-L1. Supplementing the missing PD-L1 promote immune tolerance prolong survival of transplanted islet grafts in mouse model of T1D and in T1D subjects.
  • the present disclosure provides that PGE 2 -stimulated HSCs promote immune tolerance and prolong survival of transplanted islet grafts in mouse model of T1D.
  • the PGE 2 -stimulated HSCs are now re-programmed to express PD-L1 prior to the PGE 2 -stimulation.
  • the PGE 2 -stimulated HSCs also are now re-programmed to express more PD-L1 prior to the PGE 2 -stimulation.
  • This HSC-mediated immune tolerance occurs via the programmed cell death-1 (PD-1) pathway.
  • Programmed cell death-1 receptor (PD-1) is found on activated T-cells; the programmed cell death-1 receptor ligand (PD-L1, also known as B7-H1) is expressed in other cells, e.g. HSC.
  • the reception/ligand PD-L1/PD-linteraction deactivates T cell's cytotoxic activity and leads to the immune system inhibition and tolerance.
  • the present disclosure provides that in vivo administration of anti-PD-1 mAb, PIM2, in NOD mice delayed the onset of diabetes and also delayed the islet allografts rejection.
  • a NOD mouse is the mouse model of human TID. If a human is at high risk for developing T1D, administering the PD-L1 + cells can delay the onset of T1D too.
  • the PD-L1 expression in HSC can be increased by: (a) an overexpression of a PD-L1 cDNA, e.g., via a lentiviral system or an avian virus system or an adeno-associated virus system; and (b) ex vivo culture of HSC in PGE 2 , ie., contact with PGE 2 .
  • the exogenous copy of cDNA has been introduced or transfected into the HSCs.
  • PGE 2 stimulates endogenous expression of PD-L1 in HSCs, even the defective HSCs from T1D that have lower expression of PD-L1.
  • a population of modified HSCs where the cells carry an exogenous copy of a nucleic acid encoding a PD-L1 or the HSCs are ex vivo stimulated by PGE 2 described herein to stimulate PD-L1 expression the cells.
  • a population of modified HSCs for use in the prevention and treatment of an autoimmune disease or disorder in a subject, for use in suppressing an immune response in a subject, for use in the delay of the onset of TID in a subject at risk of developing T1D, for use in preventing or delaying an allogenic tissue/organ rejection in a subject, and for use in the treatment of T1D in subjects (adult and pediatric T1D patients).
  • the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • the modified HSCs express more PD-L1 compared to non-modified cells not carrying an exogenous copy of a nucleic acid encoding a PD-L1.
  • the modified HSCs have been ex vivo stimulated by PGE 2 via methods described herein to stimulate PD-L1 expression the cells.
  • the PGE 2 stimulated cells express more PD-L1 after stimulation compared to prior to the stimulation.
  • a population of modified HSCs for use in the manufacture of medicament for the prevention and treatment of an autoimmune disease or disorder in a subject, for the suppressing an immune response in a subject, for delaying of the onset of T1D in a subject at risk of developing T1D, for use in preventing or delaying an allogenic tissue/organ rejection in a subject, and for the treatment of T1D in subjects (adult and pediatric T1D patients).
  • the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • the modified HSCs have been ex vivo stimulated by PGE 2 via methods described herein to stimulate PD-L1 expression in the cells.
  • composition comprising a population of modified HSCs described herein, where the cells carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • compositions for transplantation into a subject for the prevention and treatment of an autoimmune disease or disorder, for suppressing/reducing an immune response in a subject, for use in the delay of the onset of T1D in a subject at risk of developing T1D, for use in preventing or delaying an allogenic tissue/organ rejection in a subject, and for the treatment of T1D in adult and pediatric subjects, the composition comprising the modified HSCs described herein, where the HSCs are modified and carry an exogenous copy of a nucleic acid encoding a PD-L1 or the HSCs are ex vivo stimulated by PGE 2 via methods described herein to stimulate PD-L1 expression in the cells.
  • the HSCs are ex vivo stimulated with both PGE 2 and a steroid such as dexamethasone.
  • a composition the modified HSCs described herein for the manufacture of medicament for use in transplantation into a subject, for the prevention and treatment of an autoimmune disease or disorder, for suppressing/reducing an immune response in a subject, for use in the delay of the onset of T1D in a subject at risk of developing T1D, for use in preventing or delaying an allogenic tissue/organ rejection in a subject, and for the treatment of T1D in adult and pediatric subjects, where the HSCs are modified and carry an exogenous copy of a nucleic acid encoding a PD-L1 or the HSCs are ex vivo stimulated by PGE 2 via methods described herein to stimulate PD-L1 expression in the cells.
  • the HSCs are ex vivo stimulated with both PGE 2 and a steroid such as dexamethasone.
  • the HSCs are expressing PD-L1.
  • the HSCs exhibit increased PD-L 1 expression.
  • the population of HSCs exhibits an increase proportion of PD-L1 + expressing cells, e.g., an increase of at least one fold.
  • the nucleic acid is a copy DNA (cDNA).
  • the nucleic acid is a genomic DNA.
  • the nucleic acid is integrated into the genome of the cells.
  • the nucleic acid is introduced into the HSCs via a vector.
  • the vector is a viral vector.
  • the viral vector is a lentiviral vector, an avian virus vector or an adeno-associated virus.
  • the HSCs are mammalian cells.
  • the mammalian cells are human cells.
  • the HSCs are obtained from the bone marrow, umbilical cord, amniotic fluid, chorionic cord blood, placental blood or peripheral blood.
  • the HSCs are obtained from mobilized peripheral blood.
  • the HSCs are derived from a healthy individual.
  • the HSCs are derived from an individual with a diagnosed disease or disorder, or an individual who is an organ or bone marrow transplant recipient.
  • the HSCs are derived from an individual who has newly been diagnosed with T1D.
  • the HSCs are derived from an individual who has newly been detected to have self-autoantibodies associated with T1D, e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the diagnosed disease or disorder is an autoimmune disease or disorder.
  • the autoimmune disease or disorder is T1D.
  • the cells are ex vivo cultured before the introduction of the exogenous copy of a nucleic acid encoding a PD-L 1, or after the introduction of the exogenous copy of a nucleic acid encoding a PD-L 1, or both before and after the introduction of the exogenous copy of a nucleic acid encoding a PD-L1.
  • the cells are cryopreserved prior to the introduction of the exogenous copy of a nucleic acid encoding a PD-L1, or after the introduction of the exogenous copy of a nucleic acid encoding a PD-L1, or both before and after the introduction of the exogenous copy of a nucleic acid encoding a PD-L1.
  • the cells are cryopreserved prior to use, for example, use in the treatment of an autoimmune disease or for deliberate/intentional suppression of an immune response or the immune system in a subject.
  • the population of modified HSCs are produced by a method comprising contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs to produce a population of modified HSCs cells that express PD-L1.
  • the method further comprises ex vivo culturing to expand the resultant modified cells from the contacting with the vector.
  • the method further comprises establishing the expression of PD-L1 on the modified HSCs.
  • the method further comprises establishing that there is at least one fold increase in the number of PD-L1 + expressing cells compared to non-modified cells.
  • the composition further comprises at least an additional immunosuppression therapy agent or drug.
  • the composition further comprises a pharmaceutically acceptable carrier.
  • the carrier is preferable not cell or tissue culture media.
  • the composition further comprises serum or plasma.
  • an ex vivo method of producing a population of modified, PD-L1 + expressing HSCs comprising contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs whereby the exogenous copy of a nucleic acid is introduced into the HSCs thereby producing a population of modified HSCs cells expressing PD-L1.
  • the method further comprises ex vivo culturing of the resultant modified cells from the contacting with the vector carrying an exogenous copy of a nucleic acid encoding a PD-L1.
  • the method further comprises establishing the expression of PD-L1 on the modified HSCs.
  • the method further comprises comprises establishing that there is at least one fold increase in the number of PD-L1 + expressing cells compared to non-modified cells.
  • the sample of HSC is obtained from the bone marrow, umbilical cord, amniotic fluid, chorionic villi, cord blood, placental blood or peripheral blood.
  • the sample of HSC is obtained from mobilized peripheral blood, e.g., mobilized by granulocyte colony stimulating factor (G-CSF).
  • G-CSF granulocyte colony stimulating factor
  • the sample of HSCs is obtained from a healthy individual.
  • the sample of HSCs is obtained from an individual with a diagnosed disease or disorder.
  • the diagnosed disease or disorder is an autoimmune disease or disorder.
  • the autoimmune disease or disorder is T1D.
  • the sample of HSCs is obtained from an individual who has newly been diagnosed with T1D.
  • the sample of HSCs is obtained from an individual who has newly been detected to have self-autoantibodies associated with T1D, e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • self-autoantibodies associated with T1D e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the vector is viral vector.
  • the viral vector is a lentiviral vector, an avian virus vector or an adeno-associated virus.
  • the nucleic acid is a cDNA.
  • the nucleic acid is a genomic DNA.
  • the nucleic acid is integrated into the genome of the cells.
  • provided herein is a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof, the method comprising administering to a subject a composition comprising the hematopoietic stem cells described herein.
  • a method of preventing or treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising providing a population of HSCs; ex vivo contacting the sample of HSCs with prostaglandin E2 (PGE 2 ) at 10 ⁇ M concentration for about 60 minutes at 37° C.; removing the PGE 2 after 60 minutes, thereby producing a population of PD-L1 + expressing HSCs; transplanting the population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • PGE 2 prostaglandin E2
  • a method of delaying the onset of T1D in a subject in need thereof comprising providing a population of HSCs; ex vivo contacting the sample of HSCs with prostaglandin E2 (PGE 2 ) at 10 ⁇ M concentration for about 60 minutes at 37° C.; removing the PGE 2 after 60 minutes, thereby producing a population of PD-L1 + expressing HSCs; transplanting the population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • the subject is at risk of developing T1D.
  • the subject is asymphomatic for T1D and is not hyperglycemia.
  • the subject's a blood sugar level is not higher than 11.1 mmol/l (200 mg/dl).
  • the subject is has recently been detected to have self-autoantibodies associated with T1D, e.g., ICA, IAA and 1A-2A.
  • a method of preventing or delaying an allogenic tissue/organ rejection in a subject in need thereof comprising providing a population of HSCs; ex vivo contacting the sample of HSCs with prostaglandin E2 (PGE 2 ) at 10 ⁇ M concentration for about 60 minutes at 37° C.; removing the PGE 2 after 60 minutes, thereby producing a population of PD-L1 + expressing HSCs; transplanting the population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • the subject is an organ or tissue transplant recipient.
  • a method of preventing or treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising providing a population of HSCs; ex vivo contacting the sample of HSCs with prostaglandin E2 (PGE 2 ) at 0.1 ⁇ M concentration for at least 24 hours at 37° C.; removing the PGE 2 , thereby producing a population of PD-L1 + expressing HSCs; transplanting the population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • PGE 2 prostaglandin E2
  • a method of delaying the onset of T1D in a subject in need thereof comprising providing a population of HSCs; ex vivo contacting the sample of HSCs with prostaglandin E2 (PGE 2 ) at 0.1 ⁇ M concentration for at least 24 hours at 37° C.; removing the PGE 2 , thereby producing a population of PD-L1 + expressing HSCs; transplanting the population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • the subject is at risk of developing T1D.
  • the subject is asymphomatic for T1D and is not hyperglycemia.
  • the subject's a blood sugar level is not higher than 11.1 mmol/l (200 mg/dl).
  • the subject is has recently been detected to have self-autoantibodies associated with T1D, e.g., ICA, IAA and 1A-2A.
  • a method of preventing or delaying an allogenic tissue/organ rejection in a subject in need thereof comprising providing a population of HSCs; ex vivo contacting the sample of HSCs with prostaglandin E2 (PGE 2 ) at 0.1 ⁇ M concentration for at least 24 hours at 37° C.; removing the PGE 2 , thereby producing a population of PD-L1 + expressing HSCs; transplanting the population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • the subject is an organ or tissue transplant recipient.
  • a method of preventing or treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising: providing a population of HSCs; ex vivo contacting the sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1; ex vivo culturing the resultant modified cells from the contacting; establishing the expression of PD-L1 on the modified HSCs, thereby producing a population of modified HSCs cells expressing PD-L1, transplanting said population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • a method of delaying the onset of T1D in a subject in need thereof comprising: providing a population of HSCs; ex vivo contacting the sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1; ex vivo culturing the resultant modified cells from the contacting; establishing the expression of PD-L1 on the modified HSCs, thereby producing a population of modified HSCs cells expressing PD-L1, transplanting said population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • a method of preventing or delaying an allogenic tissue/organ rejection in a subject in need thereof comprising: providing a population of HSCs; ex vivo contacting the sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1; ex vivo culturing the resultant modified cells from the contacting; establishing the expression of PD-L1 on the modified HSCs, thereby producing a population of modified HSCs cells expressing PD-L1, transplanting said population of PD-L1 + expressing HSCs into a recipient subject, thereby modulating the immune response in the recipient subject.
  • the autoimmune disorder is T1D.
  • the population of HSCs provided is autologous to the recipient subject.
  • the subject is newly diagnosed with T1D.
  • the subject is newly been detected to have self-autoantibodies associated with T1D, e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the population of HSCs provided is non-autologous and allogenic to the recipient subject.
  • the population of HSCs provided is non-autologous and xenogeneic to the recipient subject.
  • the population of HSCs provided is obtained from the bone marrow, umbilical cord, amniotic fluid, chorionic villi, cord blood, placental blood or peripheral blood.
  • the population of HSCs provided is obtained from mobilized peripheral blood.
  • the population of HSCs provided is obtained from a healthy individual.
  • the population of HSCs provided is obtained from an individual with a diagnosed disease or disorder.
  • the diagnosed disease or disorder is an autoimmune disease or disorder.
  • the autoimmune disease or disorder is T1D.
  • the population of HSCs provided is obtained from an individual who has newly been diagnosed with T1D.
  • the population of HSCs provided is obtained from an individual who has newly been detected to have self-autoantibodies associated with T1D, e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the population of HSCs provided is at the minimum CD 34 + .
  • the population of HSCs provided is at the minimum CD 34 + and Lin ⁇ .
  • the population of HSCs provided is CD34 + , CD59 + , Thy1/CD90 + , CD38 lo/ ⁇ , and C-kit/CD117 + .
  • the population of HSCs provided is CD34 + -selected HSCs.
  • the HSCs are negatively selected against CD38. That is, only CD38 lo/ ⁇ cells are selected.
  • the HSCs are selected for CD34 + and CD38 lo/ ⁇ .
  • the PGE 2 stimulated HSCs are also treated with steroids such as dexamethasome ex vivo, prior to use in implantation into the recipient.
  • the population of HSCs are cryopreserved after the removal of excess PGE 2 or cryopreserved after ex vivo culturing to expand the population of HSCs post-transfection with the vector carrying an exogenous copy of a nucleic acid encoding a PD-L1.
  • the population of HSCs are culture expanded ex vivo after the removal of excess PGE 2 or after transfection with a vector the vector carrying an exogenous copy of a nucleic acid encoding a PD-L1.
  • the method further comprising identifying a recipient subject having an autoimmune disease or disorder or an individual who is an organ or bone marrow transplant recipient.
  • the method further comprising selecting a recipient subject having an autoimmune disease or disorder or an individual who is an organ or bone marrow transplant recipient.
  • the method further comprising identifying a recipient subject in need of the suppression of an immune response or immune system or an individual who is an organ or bone marrow transplant recipient.
  • the method further comprising selecting a recipient subject in need of the suppression of an immune response or immune system.
  • a recipient subject for example, an individual who is an organ or bone marrow transplant recipient.
  • the method further comprising identifying a subject at risk of developing T1D.
  • a subject who is newly been detected to have self-autoantibodies associated with T1D e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the PGE 2 that stimulates PD-L1 expression in the HSCs is 16,16-Dimethyl prostaglandin E 2 (dmPGE 2 ).
  • nucleic acid when used in reference to encoding a PD-L1 refers to refers to deoxyribonucleotides (DNA) or ribonucleotides (RNA) and polymers thereof (“polynucleotides”) in either single- or double-stranded form. Unless specifically limited, the term encompasses nucleic acids containing known analogues of natural nucleotides that have similar binding properties as the reference nucleic acid and are metabolized in a manner similar to naturally occurring nucleotides. Unless otherwise indicated, a particular nucleic acid molecule/polynucleotide also implicitly encompasses conservatively modified variants thereof (e.g.
  • degenerate codon substitutions and complementary sequences as well as the sequence explicitly indicated.
  • degenerate codon substitutions may be achieved by generating sequences in which the third position of one or more selected (or all) codons is substituted with mixed-base and/or deoxyinosine residues (Batzer et al., Nucleic Acid Res. 19: 5081 (1991); Ohtsuka et al., J. Biol. Chem. 260: 2605-2608 (1985); Rossolini et al., Mol. Cell. Probes 8: 91-98 (1994)).
  • Nucleotides are indicated by their bases by the following standard abbreviations: adenine (A), cytosine (C), thymine (T), and guanine (G).
  • the term “genetically engineered,” “genetically modified” or “modified” refers to the addition, deletion, or modification of the genetic material in a cell.
  • the terms, “genetically modified cells” and “modified cells,” are used interchangeably.
  • modified cells refer to pharmacologically PGE 2 -stimulated HSCs or pharmacologically PGE 2 -modified HSCs that express PD-L1 compared to prior to the stimulation.
  • non-modified HSCs refers to HSCs that do not carry exogenous copies of a nucleic acid encoding a PD-L1.
  • non-modified HSCs refers to HSCs that have not been ex vivo pharmacologically stimulated by PGE 2 .
  • the term “exogenous copy” in the context of a coding nucleic acid refers to an extra copy of the coding nucleic acid that is not the original copy of the gene found in the genome of the HSCs.
  • the extra copy of the coding nucleic acid is typically introduced into the cells.
  • the extra copy is carried in a vector.
  • the extra copy may be integrated into the genome of the cells.
  • coding or “encoding” in the context of a nucleic acid encoding a PD-L1 means the nucleic acid contains instruction or information therein to specify the genetic code for a protein, e.g., the cell surface protein PD-L1.
  • the instruction or information in a coding nucleic acid can be transcribe and translated to the encoded protein.
  • cDNA refers to complementary DNA that is double-stranded DNA synthesized from a messenger RNA (mRNA) template in a reaction catalysed by the enzyme reverse transcriptase.
  • mRNA messenger RNA
  • the cDNA lacks introns.
  • genomic DNA encoding a PD-L1 means the copy of the gene as found in the genome of a cell.
  • the genomic DNA encoding a PD-L1 would include introns and other regulatory sequences in addition to the coding exons.
  • a vector when used in the context of carrying an exogenous copy of a nucleic acid encoding a PD-L1 vector, refers broadly to a nucleic acid construct designed for delivery an exogenous nucleic acid to a host cell or transfer between different host cells.
  • a vector can be viral or non-viral.
  • a vector refers to any plasmid, phagemid or virus encoding an exogenous nucleic acid.
  • the term is also be construed to include non-plasmid, non-phagemid and non-viral compounds which facilitate the transfer of nucleic acid into virions or cells, such as, for example, poly-lysine compounds and the like.
  • the vector may be a viral vector that is suitable as a delivery vehicle for delivery of the nucleic acid, or mutant thereof, to a cell, or the vector may be a non-viral vector which is suitable for the same purpose.
  • examples of viral and non-viral vectors for delivery of DNA to cells and tissues are well known in the art and are described, for example, in Ma et al. (1997, Proc. Natl. Acad. Sci. U.S.A 94: 12744-12746).
  • viral vectors include, but are not limited to, a recombinant Vaccinia virus, a recombinant adenovirus, a recombinant retrovirus, a recombinant adeno-associated virus, a recombinant avian pox virus, and the like (Cranage et al., 1986, EMBO J. 5: 3057-3063; International Patent Application No. WO94/17810, published Aug. 18, 1994; International Patent Application No. WO94/23744, published Oct. 27, 1994).
  • non-viral vectors include, but are not limited to, liposomes, polyamine derivatives of DNA, and the like.
  • viral vector is used according to its art-recognized meaning. It refers to a nucleic acid vector construct that includes at least one element of viral origin and may be packaged into a viral vector particle. The vector may be utilized for the purpose of transferring DNA, RNA or other nucleic acids into cells either in vitro or in vivo. Numerous forms of viral vectors are known in the art.
  • lentivirus refers to a group (or genus) of retroviruses that give rise to slowly developing disease.
  • Viruses included within this group include HIV (human immunodeficiency virus; including HIV type 1, and HIV type 2), the etiologic agent of the human acquired immunodeficiency syndrome (AIDS); visna-maedi, which causes encephalitis (visna) or pneumonia (maedi) in sheep, the caprine arthritis-encephalitis virus, which causes immune deficiency, arthritis, and encephalopathy in goats; equine infectious anemia virus, which causes autoimmune hemolytic anemia, and encephalopathy in horses; feline immunodeficiency virus (FIV), which causes immune deficiency in cats; bovine immune deficiency virus (BIV), which causes lymphadenopathy, lymphocytosis, and possibly central nervous system infection in cattle; and simian immunodeficiency virus (SIV), which cause immune deficiency and encephal
  • HIV human immuno
  • viruses Diseases caused by these viruses are characterized by a long incubation period and protracted course. Usually, the viruses latently infect monocytes and macrophages, from which they spread to other cells. HIV, FIV, and SIV also readily infect T lymphocytes, i.e., T-cells.
  • lentiviral vector refers to a vector having a nucleic acid vector construct that includes at least one element of lentivirus origin.
  • Lentiviral vectors of the disclosure include, but are not limited to, human immunodeficiency virus (e.g., HIV-1, HIV-2), feline immunodeficiency virus (FIV), simian immunodeficiency virus (SIV), bovine immunodeficiency virus (BIV), and equine infectious anemia virus (EIAV). These vectors can be constructed and engineered using art-recognized techniques to increase their safety for use in therapy and to include suitable expression elements and therapeutic genes.
  • autoimmune disease or “autoimmune disease or disorder” herein is a disease or disorder arising from and directed against an individual's own tissues or a co-segregate or manifestation thereof or resulting condition therefrom.
  • Auto-immune related diseases and disorders arise from an overactive and/or abnormal immune response of the body against substances (autoantigens) and tissues normally present in the body, otherwise known as self or autologous substance.
  • This dysregulated inflammatory reaction causes an exaggerated response by macrophages, granulocytes, and/or T-lymphocytes leading to abnormal tissue damage and cell death. Subsequent loss of function is associated with inflammatory tissue damage.
  • Autoantigens are endogenous proteins or fragments thereof that elicit this pathogenic immune response.
  • Autoantigen can be any substance or a portion thereof normally found within a mammal that, in an autoimmune disease, becomes the primary (or a primary) target of attack by the immune system.
  • the term also includes antigenic substances that induce conditions having the characteristics of an autoimmune disease when administered to mammals.
  • the term includes peptic subclasses consisting essentially of immunodominant epitopes or immunodominant epitope regions of autoantigens. Immunodominant epitopes or regions in induced autoimmune conditions are fragments of an autoantigen that can be used instead of the entire autoantigen to induce the disease.
  • immunodominant epitopes or regions are fragments of antigens specific to the tissue or organ under autoimmune attack and recognized by a substantial percentage (e.g. a majority though not necessarily an absolute majority) of autoimmune attack T-cells.
  • Autoantigens that are known to be associated with autoimmune disease include myelin proteins with demyelinating diseases, e.g. multiple sclerosis and experimental autoimmune myelitis; collagens and rheumatoid arthritis; insulin, proinsulin, glutamic acid decarboxylase 65 (GAD65); islet cell antigen (ICA512; ICA12) with insulin dependent diabetes.
  • Th1 type cytokines include interleukin 2 (IL-2), ⁇ -interferon, TNF ⁇ and IL-12.
  • IL-2 interleukin 2
  • TNF ⁇ IL-12
  • IL-12 interleukin 2
  • Such pro-inflammatory cytokines act to stimulate the immune response, in many cases resulting in the destruction of autologous tissue.
  • Cytokines associated with suppression of T cell response are the Th2 type, and include IL-10, IL-4 and TGF- ⁇ . It has been found that Th1 and Th2 type T cells may use the identical antigen receptor in response to an immunogen; in the former producing a stimulatory response and in the latter a suppressive response.
  • hematopoietic stem cell refers to a stem cell that give rise to all the blood cell types of the three hematopoietic lineages, erythroid, lymphoid, and myeloid. These cell types include the myeloid (monocytes and macrophages, neutrophils, basophils, eosinophils, erythrocytes, megakaryocytes/platelets, dendritic cells), and the lymphoid lineages (T-cells, B-cells, NK-cells).
  • the term “hematopoietic stem cell” or “HSC” refers to a stem cell that have the following cell surface markers: CD34 + , CD59 + , Thy1/CD90 + , CD38 lo/ ⁇ , and C-kit/CD117 + .
  • the term “hematopoietic stem cell” or “HSC” refers to a stem cell that is at least CD34 + .
  • the term “hematopoietic stem cell” or “HSC” refers to a stem cell that is at least CD38lo/ ⁇ .
  • the term “hematopoietic stem cell” or “HSC” refers to a stem cell that is at least CD34 + and CD38 lo/ ⁇ .
  • the term “hematopoietic stem cell” or “HSC” refers to a stem cell that is at least lin ⁇ . In one embodiment, the term “hematopoietic stem cell” or “HSC” refers to a stem cell that is at least CD34 + and lin ⁇ . In one embodiment, the term “hematopoietic stem cell” or “HSC” refers to a stem cell that is at least CD34 + , CD38 lo/ ⁇ and lin ⁇ . In one embodiment, the term “hematopoietic stem cell” or “HSC” refers to a stem cell that is at least CD34 + and C-kit/CD117 + .
  • hematopoietic stem cell refers to a stem cell that is at least CD34 + , CD38 lo/ ⁇ and C-kit/CD117 + .
  • the term “hematopoietic stem cell” or “HSC” includes hematopoietic stem and progenitor cells (HSPC).
  • a progenitor cell refers to refer to an immature or undifferentiated cell that has the potential later on to mature (differentiate) into a specific cell type, for example, a blood cell, a skin cell, a bone cell, or a hair cells.
  • a progenitor cell also can proliferate to make more progenitor cells that are similarly immature or undifferentiated.
  • Cells of the disclosure can be autologous/autogeneic (“self”) or non-autologous (“non-self,” e.g., allogeneic, syngeneic or xenogeneic). “Autologous,” as used herein, refers to cells from the same subject.
  • Allogeneic refers to cells of the same species that differ genetically to the cell in comparison.
  • “Syngeneic,” as used herein, refers to cells of a different subject that are genetically identical to the cell in comparison.
  • Xenogeneic refers to cells of a different species to the cell in comparison. In preferred embodiments, the cells of the disclosure are allogeneic.
  • isolated cell refers to a cell that has been obtained from an in vivo tissue or organ and is substantially free of extracellular matrix.
  • a “subject,” as used herein, includes any animal that possess a hematopoietic system, an immune system and HSCs.
  • a subject includes any animal that exhibits symptoms of a disease, disorder, or condition of the immune system, e.g., autoimmune disease, that can be treated with the HSCs described herein, and methods contemplated herein.
  • Suitable subjects include laboratory animals (such as mouse, rat, rabbit, or guinea pig), farm animals, and domestic animals or pets (such as a cat or dog).
  • Non-human primates and, preferably, human patients, are included.
  • Typical subjects include animals that exhibit aberrant amounts (lower or higher amounts than a “normal” or “healthy” subject) of one or more physiological activities that can be modulated by the HSCs described herein, and methods disclosed elsewhere herein.
  • the subject is a human.
  • treatment includes any beneficial or desirable effect on the symptoms or pathology of a disease or pathological condition, and may include even minimal reductions in one or more measurable markers of the disease or condition being treated.
  • treatment can involve optionally either the reduction or amelioration of symptoms of the disease or condition, or the delaying of the progression of the disease or condition. “Treatment” does not necessarily indicate complete eradication or cure of the disease or condition, or associated symptoms thereof.
  • self-autoantibodies associated with T1D refer to the autoantibodies that are markers of beta cell autoimmunity in type 1 diabetes: Islet Cell Antibodies (ICA, against cytoplasmic proteins in the beta cell), antibodies to Glutamic Acid Decarboxylase (GAD-65), Insulin Autoantibodies (IAA), and IA-2A, to protein tyrosine phosphatase.
  • ICA Islet Cell Antibodies
  • GAD-65 Glutamic Acid Decarboxylase
  • IAA Insulin Autoantibodies
  • IA-2A protein tyrosine phosphatase
  • the term “pharmaceutically acceptable” means approved by a regulatory agency of the Federal or a state government or listed in the U.S. Pharmacopeia or other generally recognized pharmacopeia for use in animals, and more particularly in humans. Specifically, it refers to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
  • carrier refers to a diluent, adjuvant, excipient, or vehicle with which the therapeutic is administered.
  • Such pharmaceutical carriers can be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable or synthetic origin, such as peanut oil, soybean oil, mineral oil, sesame oil and the like. Water is a preferred carrier when the pharmaceutical composition is administered intravenously. Saline solutions and aqueous dextrose and glycerol solutions can also be employed as liquid carriers, particularly for injectable solutions.
  • Suitable pharmaceutical excipients include starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol and the like.
  • the composition if desired, can also contain minor amounts of wetting or emulsifying agents, or pH buffering agents. These compositions can take the form of solutions, suspensions, emulsion, tablets, pills, capsules, powders, sustained-release formulations, and the like.
  • the composition can be formulated as a suppository, with traditional binders and carriers such as triglycerides.
  • Oral formulation can include standard carriers such as pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharine, cellulose, magnesium carbonate, etc. Examples of suitable pharmaceutical carriers are described in Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed. (Mack Publishing Co., 1990). The formulation should suit the mode of administration.
  • “pharmaceutically acceptable carriers” exclude tissue culture medium.
  • “pharmaceutically acceptable carriers” include serum or plasma. The serum or plasma can be derived from human or the subject recipient.
  • an effective amount means an amount of biologically active vector particles or PGE 2 concentration sufficient to provide successful transduction of cells with the exogenous nucleic acid or to provide successful stimulation of PD-L1 expression in the cell respectively.
  • administering refers to the placement of the HSCs described herein or the composition comprising the HSCs described herein into a recipient subject by a method or route which results in at least partial localization of the HSCs at a desired site, or results in the proliferation, engraftment and/or differentiation of the HSCs to PD-L1 expressing progeny cells.
  • the HSCs or the composition comprising the HSCs can be administered by any appropriate route which results in an effective treatment in the subject.
  • FIG. 1 shows that PD-L1 genetic deletion abrogates HSC immunomedulatory properties in vitro.
  • FIGS. 2A and 2B show that the percentage of peripheral PD-L1 + HSCs is reduced in NOD mice compared to B6.
  • FIG. 2C shows the confirmation of PD-L1 expression defect in NOD mice by PCR.
  • FIGS. 2D and 2E show that the murine PD-L1 defect on HSCs can be overturned in vitro by pharmacologic approach. After 8 days of in vitro culture, an increase in the percentage of PD-L1 + KLS cells was evident.
  • FIGS. 3A and 3B show that the PD-L1+ HSCs are fewer in number in TID individuals as compared to healthy individuals.
  • FIG. 3C shows the confirmation of PD-L1 defect, by PCR, in HSCs of individuals affected with TID.
  • FIGS. 3D and 3E show that the human PD-L1 defect on HSCs can be overturned in vitro by pharmacologic approach. After 7 days of in vitro culture, an increase in the percentage of PD-L1 + HSCs was evident.
  • FIGS. 4A and 4B show that PD-L1/PD-1 cross-linking with PIM2 delays diabetes onset in NOD mice ( FIG. 4A ) and prolongs islet survival post islet transplantation (inBALB/c into B6) ( FIG. 4B ).
  • FIGS. 5A and 5B show that the HSCs transduced with PDL1 cDNA bearing lentivirus become highly PDL1+ and once adoptively transferred into newly diabetic NOD mice normalized glycemia. NOD untreated mice remained hyperglycemic at >250 mg/dl.
  • FIG. 6 show the effect of PGE2 on PDL1 expression on HSC.
  • FIG. 7 show that the murine PD-L1 transduced KLS cells reverted hyperglycemia in NOD mice.
  • FIG. 8A is a table summarizing the microarray analyses of Sca-1 + Lineage ⁇ c-kit + HSCs from bone marrow of NOD and B6 mice showing that genes were differentially expressed.
  • FIG. 8B is a Western Blot showing the reduced expression of PD-L1 in Sca-1 + Lineage ⁇ c-kit + HSCs from bone marrow of NOD compared to normal B6 control mice.
  • FIG. 8C is a histogram summarizing the relative expression of PD-L1 in Sca-1 + Lineage ⁇ c-kit + HSCs from bone marrow of NOD compared to normal B6 control mice, data obtained by Western blot analysis and quantitative measurements. Open histogram is NOD mice, closed histogram is C57BL/6 mice.
  • FIG. 8D is a histogram summarizing the relative mRNA expression of PD-L1 in Sca-1 + Lineage ⁇ c-kit + HSCs from bone marrow of NOD compared to normal B6 control mice. Open histogram is NOD mice, closed histogram is C57BL/6 mice.
  • FIGS. 8E and 8F show the FACS dot plots and the histograms of PD-L1 + KLS: Sca-1 + Lineage ⁇ c-kit + cells from bone marrow of NOD compared to normal B6 control mice. Open histogram is NOD mice, closed histogram is C57BL/6 mice.
  • FIGS. 8G and 8H show the FACS dot plots and the histograms of PD-L1 + CD41 ⁇ CD48 ⁇ CD150 + cells from bone marrow of NOD compared to normal B6 control mice. Open histogram is NOD mice, closed histogram is C57BL/6 mice.
  • FIGS. 8I and 8K show the FACS dot plots and the histograms of PD-L1 + KL: Lineage ⁇ c-kit + cells from bone marrow of NOD compared to normal B6 control mice. Open histogram is NOD mice, closed histogram is C57BL/6 mice.
  • FIGS. 8J and 8L show the FACS dot plots and the histograms of PD-L1 + CD244 ⁇ CD48 ⁇ CD150 + cells from bone marrow of NOD compared to normal B6 control mice. Open histogram is NOD mice, closed histogram is C57BL/6 mice.
  • FIG. 9A shows the flow cytometric analysis of PD-L1 expression on KL cells extracted from NOD mice prior to transduction with PD-L1 lentivirus, also known as wild type (WT) KL cells.
  • FIG. 9B shows the flow cytometric analysis of PD-L1 expression on KL cells from NOD mice after transduction with PD-L1 lentivirus, labeled as Tg cells.
  • FIG. 9C shows the histogram summarizing the increased in PD-L1 expression on KL cells from NOD mice after transduction with PD-L1 lentivirus.
  • FIG. 9D shows the histogram summarizing the flow cytometric analysis of INF ⁇ production by CD4+ T cells extracted from NOD-BDC2.5 TCRtg mice stimulated by BDC2.5 peptides in the presence of DCs and upon coculture with KL cells and with PD-L1. Tg KL cells.
  • FIG. 9E shows the flow cytometric analysis of INF ⁇ production by CD4+ T cells extracted from NOD-BDC2.5 TCRtg mice stimulated by BDC2.5 peptides in the presence of DCs and upon coculture with KL cells and with PD-L1. Tg KL cells in the presence of PD-L1 blocking/neutralizing Ab.
  • FIG. 9F shows the histogram summarizing the flow cytometric analysis of INF ⁇ production by CD4+ T cells extracted from NOD mice stimulated by soluble anti-CD3/anti-CD28 upon coculture with KL cells and with PD-L1. Tg KL cells.
  • FIG. 9G shows the flow cytometric analysis of INF ⁇ production by CD4+ T cells extracted from NOD mice stimulated by soluble anti-CD3/anti-CD28 upon coculture with KL cells and with PD-L1. Tg KL cells in the presence of PD-L1 blocking/neutralizing Ab.
  • FIGS. 9H-9K are graphical representations of reversal of diabetes in NOD-Hyperglycemic treated with untransduced KL cells ( FIG. 9K ) and PD-L1.Tg KL cells ( FIG. 9I ) as demonstrated by blood glucose levels following administration of 3 ⁇ 10 6 untransduced KL cells or PD-L1.Tg KL cells. No reversal was achieved with doxycycline ( FIG. 9J ); ( FIG. 9H ) Untreated group used as control.
  • FIGS. 10A-10F demonstrated that the PD-L1 defect in human HSCs from T1D patients as compared to healthy controls human subjects (HC).
  • FIGS. 10A-10B are representative flow cytometric analysis showing PD-L1 expression in selected CD34 + HSCs from healthy controls (HC) ( FIG. 10A ) and from type 1 diabetic individuals (T1D) ( FIG. 10B ).
  • FIG. 10C shows the bar graph related to the flow cytometric analysis in FIGS. 10A-10B , illustrating the defect in PD-L1 expression in T1D.
  • FIG. 10D is a representative Western-blot analysis showing reduced PD-L1 expression in CD34+ HSCs of T1D individual compared to HC.
  • FIG. 10E is a histogram summarizing the Western-blot analysis showing reduced PD-L1 expression in CD34 + HSCs of T1D individual compared to HC.
  • FIG. 10F is a histogram summarizing the RT-PCR data for PD-L1 expression in CD34 + HSCs of T1D individual compared to HC.
  • FIG. 11 shows the effect of dual PGE 2 and dexamethasone-stimulated KL cells in normalizing hyperglycemia in NOD mice after the onset of hyperglycemia.
  • Each line represents the blood sugar of a test NOD mouse.
  • the KL cells were stimulated ex vivo prior to implantation into the recipient mouse shortly after the onset of hyperglycemia.
  • FIG. 12 shows that mice treated with PGE 2 -stimulated HSC have delayed islet allograft rejection. Similar strategy can be used in general to prevent and also treat allograft rejections.
  • the present disclosure relates to modified hematopoietic stem cells (HSCs), compositions comprising modified HSCs, methods of using these modified HSCs for treating autoimmune diseases and disorders and for modulating the immune system.
  • the modified HSCs express the programmed cell death-1 receptor ligand (PD-L1) if the cells did not express PD-L1 prior to the modification or the modified HSCs now express more PD-L1 compared to prior to the modification.
  • the modification is by transducing an exogenous copy of a nucleic acid encoding PD-L1 to facilitate PD-L1 protein expression in the transduced cell or by pharmacological re-programming of the HSCs with stimulation by PGE 2 .
  • the disclosure described herein does not concern a process for cloning human beings, processes for modifying the germ line genetic identity of human beings, uses of human embryos for industrial or commercial purposes or processes for modifying the genetic identity of animals which are likely to cause them suffering without any substantial medical benefit to man or animal, and also animals resulting from such processes.
  • embodiments of the present disclosure are based on the discovery that increasing PD-L1 expression in the HSCs of patients with Type 1 diabetes (T1D) can alleviate the deficiencies in the patients' immunoregulation.
  • T1D Type 1 diabetes
  • NOD mice and human T1D patients have reduced number of PD-L1 expressing HSCs and the HSCs express lower amounts of PD-L1.
  • the decrease PD-L1 contribute to defects in the mice and patients' ability to immunoregulation. Externally supplementing this PD-L1 deficiency help recorrect this immunoregulation defect by promoting immune tolerance.
  • stem cell-based therapy using mesenchymal stem cells and autologous hematopoietic stem cell transplantation (AHSCT) yield only short-term insulin-independence in NOD mice and T1D humans, and for only a select population of afflicted with the disease. None of the stem cell-based therapies have not been applicable to pediatric patients. Moreover, certain stem cell based therapies present potential oncogenic concerns, especially for pediatric patients.
  • the problem to solve here is to provide a therapy that is applicable to a larger population of T1D patients, both adults and pediatric patients, and a therapy that allows the patients to be long term insulin-independent.
  • HSCs previously, preclinical studies on the use of HSCs in NOD mice are lacking and primarily employ allogeneic HSCs.
  • allogeneic HSCs from 0-gal transgenic donors were transplanted into NOD mice, diabetes onset was successfully preventing in all treated mice, but reversal was obtained in only 1 out of 50 mice despite full hematopoietic engraftment. If a human is at high risk for developing T1D, perhaps administering the PD-L1 + cells can delay the onset of the disease too.
  • PD-L1 also known as CD274 or B7-H1
  • PD-L1 is the ligand of the inhibitory receptor programmed death 1 receptor (PD-1), which is expressed primarily on activated T cells. Crosslinking between PD-L1 and PD-1 inhibits T cells activation and favor their exhaustion/apoptosis. PD-1 knockout mice develop accelerated diabetes, and PD-1/PD-L1 signaling activates an inhibitory signal inducing T cell anergy.
  • PD-1 programmed death 1 receptor
  • the inventors found that the HSCs from T1D patients were defective in their immunoregulatory properties. When tested in an anti-CD3/CD28 ELISPOT immunoassay, the HSCs from these patients affected by T1D were less capable of suppressing an immune response.
  • HSCs derived from patients affected by T1D or other autoimmune disorders represent useful therapeutic strategies in treating autoimmune diseases and disorders, and for modulating the immune system.
  • the inventors have discovered that ex vivo incubating the HSCs derived from T1D patients with prostaglandin E2 (PGE 2 ) stimulates expression of PD-L1 in the HSCs.
  • PGE 2 prostaglandin E2
  • transfecting an exogenous nucleic acid that codes for PD-L1 into HSCs promotes the expression of PD-L1 in the transfected/transduced HSCs.
  • HSCs Hematopoietic Stem Cells
  • an ex vivo method of producing a population of modified, PD-L1+ expressing HSCs where the modified HSC cells carry an exogenous copy of a nucleic acid encoding a programmed cell death-1 receptor ligand (PD-L1) comprising contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs, whereby the exogenous copy of a nucleic acid is introduced into the HSCs, thereby producing a population of modified HSCs cells expressing PD-L1.
  • the method further comprises establishing the expression of PD-L1 on the resultant modified HSCs.
  • the method further comprises ex vivo culturing the resultant modified cells after contact with the vector and/or ex vivo culturing the resultant modified cells after establishing the expression of PD-L1 on the resultant modified HSCs.
  • the culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with the vector described.
  • an ex vivo method of producing a population of modified, PD-L1+ expressing HSCs where the modified HSC cells carry an exogenous copy of a nucleic acid encoding a PD-L1 comprising (a) contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs whereby the exogenous copy of a nucleic acid is introduced into the HSCs; and (b) establishing the expression of PD-L1 on the resultant modified HSCs, thereby producing a population of modified HSCs cells expressing PD-L1.
  • the method further comprises ex vivo culturing the resultant modified cells after contact with the vector and/or ex vivo culturing the resultant modified cells after establishing the expression of PD-L1 on the resultant modified HSCs.
  • the culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with the vector described.
  • an ex vivo method of producing a population of modified, PD-L1+ expressing HSCs where the modified HSC cells carry an exogenous copy of a nucleic acid encoding a PD-L1 comprising (a) contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs whereby the exogenous copy of a nucleic acid is introduced into the HSCs; (b) ex vivo culturing the resultant modified cells from the contacting with the vector; and (c) establishing the expression of PD-L1 on the resultant modified HSCs, thereby producing a population of modified HSCs cells expressing PD-L1.
  • the culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with the vector described.
  • a population of modified HSCs where the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • the modified HSCs express more PD-L1 compared to non-modified cells not carrying an exogenous copy of a nucleic acid encoding a PD-L1.
  • a population of modified HSCs wherein the cells are produced by a method comprising contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs whereby the exogenous copy of a nucleic acid is introduced into the HSCs, thereby producing a population of modified HSCs cells expressing PD-L1.
  • the sample of HSCs comprises non-modified HSCs.
  • non-modified HSCs do not carry exogenous copies of a nucleic acid encoding a PD-L1.
  • the method further comprises establishing the expression of PD-L1 on the resultant modified HSCs.
  • the method further comprises ex vivo culturing the resultant modified cells after contact with the vector and/or ex vivo culturing the resultant modified cells after establishing the expression of PD-L1 on the resultant modified HSCs. The culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with the vector described.
  • a population of modified HSCs wherein the cells are produced by a method comprising (a) contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs whereby the exogenous copy of a nucleic acid is introduced into the HSCs; and (b) establishing the expression of PD-L1 on the modified HSCs, thereby producing a population of modified HSCs cells expressing PD-L1.
  • the method further comprises ex vivo culturing the resultant modified cells after contact with the vector and/or ex vivo culturing the resultant modified cells after establishing the expression of PD-L1 on the resultant modified HSCs.
  • the culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with the vector described.
  • a population of modified HSCs wherein the cells are produced by a method comprising (a) contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs whereby the exogenous copy of a nucleic acid is introduced into the HSCs; (b) ex vivo culturing the resultant modified cells from the contacting; and (c) establishing the expression of PD-L1 on the modified HSCs, thereby producing a population of modified HSCs cells expressing PD-L1.
  • the culturing expands or increases the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with the vector described.
  • the modified HSCs are engineered modified cells, engineered to carrying an exogenous copy of a nucleic acid encoding a PD-L1 in the cell. These engineered HSCs express PD-L1 compared HSCs not carrying an exogenous copy of a nucleic acid encoding a PD-L1. In one embodiment, these engineered HSCs express more PD-L1 compared HSCs not carrying an exogenous copy of a nucleic acid encoding a PD-L1.
  • an ex vivo method of stimulating the expression of PD-L1 in a population of HSCs comprising (a) contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 10 ⁇ M concentration for about 60 min at 37° C.; (b) washing the contacted cells to remove excess PGE 2 , and (c) establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs, thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • PGE 2 prostaglandin E2
  • the PGE 2 -stimulated HSC has increased PD-L1 expression compared to non-PGE 2 -stimulated HSC. In one embodiment, the PGE 2 -stimulated HSC has at least 1% increased PD-L1 expression compared to non-PGE 2 -stimulated HSC.
  • the PGE 2 -stimulated HSC has at least 2%, at least 3%, at least 5%, at least 8%, at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 1-fold, at least 2-fold, at least 5-fold, at least 10 fold, at least 100 fold higher, at least 1000-fold higher, or more increased PD-L1 expression compared to non-PGE 2 -stimulated HSC.
  • an ex vivo method of stimulating the expression of PD-L1 in a population of HSCs comprising (a) contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 0.1 ⁇ M concentration for at least 24 hrs at 37° C.; (b) washing the contacted cells to remove excess PGE 2 , and (c) establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs, thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • PGE 2 prostaglandin E2
  • an ex vivo method of stimulating the expression of PD-L1 in a population of HSCs comprising contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 0.1 ⁇ M concentration for at least 24 hrs at 37° C., thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • PGE 2 prostaglandin E2
  • an ex vivo method of stimulating the expression of PD-L1 in a population of HSCs comprising contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 10 ⁇ M concentration for about 60 min at 37° C., thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • PGE 2 prostaglandin E2
  • the method further comprises washing the contacted cells to remove excess PGE 2 .
  • the method further comprises establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • the method further comprises ex vivo culturing of the PGE 2 -stimulated HSCs after contact with PGE 2 and/or ex vivo culturing of the PGE 2 -stimulated HSCs after establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • the culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with PGE 2 .
  • an ex vivo method of stimulating the expression of PD-L1 in a population of HSCs comprising (a) contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 10 ⁇ M concentration for about 60 min at 37° C., and (b) establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs, thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1 thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • the culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with PGE 2 .
  • an ex vivo method of stimulating the expression of PD-L1 in a population of HSCs comprising (a) contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 0.1 ⁇ M concentration for at least 24 hrs at 37° C., and (b) establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs, thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1 thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • PGE 2 prostaglandin E2
  • the method further comprises ex vivo culturing of the PGE 2 -stimulated HSCs after contact with PGE 2 and/or ex vivo culturing of the PGE 2 -stimulated HSCs after establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • the culturing expands the number of modified cells available for therapy.
  • the sample of HSCs can be culture expanded prior to contacting with PGE 2 .
  • a population of PD-L1 + expressing HSCs wherein the cells are produced by a method comprising (a) contacting a sample of HSCs with PGE 2 at 10 concentration for about 60 min at 37° C.; (b) washing the contacted cells to remove excess PGE 2 , and (c) establishing the expression of PD-L1 on the contacted HSCs, thereby producing a population of HSCs cells expressing PD-L1.
  • a population of PD-L1 + expressing HSCs wherein the cells are produced by a method comprising (a) contacting a sample of HSCs with PGE 2 at 0.1 concentration for at least 24 hrs at 37° C.; (b) washing the contacted cells to remove excess PGE 2 , and (c) establishing the expression of PD-L1 on the contacted HSCs, thereby producing a population of HSCs cells expressing PD-L1.
  • the method further comprises ex vivo culturing of the PGE 2 -stimulated HSCs after contact with PGE 2 and/or ex vivo culturing of the PGE 2 -stimulated HSCs after establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • a population of PD-L1 + expressing HSCs where the cells have been stimulated to increase the expression of endogenous PD-L1 by an ex vivo or in vivo or in vitro contact with PGE 2 .
  • a population of modified HSCs where the modified HSCs express more PD-L1 compared to non-modified cells that have not been stimulated or contacted with PGE 2 .
  • a population of PD-L1 + expressing HSCs wherein the cells are produced by a method comprising contacting a sample of HSCs with PGE 2 at 10 concentration for about 60 min at 37° C., thereby producing a population of HSCs cells expressing PD-L1.
  • a population of PD-L1 + expressing HSCs wherein the cells are produced by a method comprising contacting a sample of HSCs with PGE 2 at 0.1 ⁇ M concentration for at least 24 hrs at 37° C., thereby producing a population of HSCs cells expressing PD-L1.
  • the method further comprises washing the contacted cells to remove excess PGE 2 .
  • the method further comprises establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • the method further comprises ex vivo culturing of the PGE 2 -stimulated HSCs after contact with PGE 2 and/or ex vivo culturing of the PGE 2 -stimulated HSCs after establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • a population of PD-L1+ expressing HSCs wherein the cells are produced by a method comprising (a) contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 10 ⁇ M concentration for about 60 min at 37° C., and (b) establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs, thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1 thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • PGE 2 prostaglandin E2
  • a population of PD-L1+ expressing HSCs wherein the cells are produced by a method comprising (a) contacting a sample of HSCs with prostaglandin E2 (PGE 2 ) at 0.1 ⁇ M concentration for at least 24 hrs 37° C., and (b) establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs, thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1 thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • PGE 2 prostaglandin E2
  • the HSCs are also contacted with a steroid such as dexamethasone.
  • a steroid such as dexamethasone
  • the HSCs are ex vivo contacted with both PGE 2 and a steroid such as dexamethasone, ie., co-stimulated simultaneously with both PGE 2 and dexamethasone.
  • the method further comprises ex vivo culturing of the PGE 2 -stimulated HSCs after contact with PGE 2 and/or ex vivo culturing of the PGE 2 -stimulated HSCs after establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • the sample of HSCs is cultured ex vivo in the absence of PGE 2 before the addition/contact of PGE 2 .
  • the ex vivo culturing expands or increases the number of starting HSCs available for contact and stimulation with PGE 2 .
  • the ex vivo culturing in the absence of PGE 2 occurs for at least 48 hrs prior to the first/initial addition or contact with PGE 2 .
  • the ex vivo culturing expands or increases the number of starting HSCs available for contact and stimulation with PGE 2 .
  • the HSCs are in contact with PGE 2 in culture for at least 24 hrs. In other embodiments, the HSCs are in contact with PGE 2 in culture for at least 36 hrs, at least 48 hrs, at least 60 hrs, at least 72 hrs, at least 84 hrs, at least 96 hrs, at least 108 hrs, at least 120 hrs, at least 132 hrs, at least 144 hrs, at least 156 hrs, at least 168 hrs, at least 196 hrs and all intervening time in hours between 24-196 hrs.
  • the HSCs are in contact with PGE 2 in culture for up to eight days. In other embodiments, the HSCs are in contact with PGE 2 in culture for up to three days, for up to four days, for up to five days, for up to six days and for up to seven days.
  • the HSCs are in contact with PGE 2 in culture for about 24 hrs, about 36 hrs, about 48 hrs, about 60 hrs, about 72 hrs, about 84 hrs, about 96 hrs, about 108 hrs, about 120 hrs, about 132 hrs, about 144 hrs, about 156 hrs, about 168 hrs, about 196 hrs and all intervening time in hours between 24-196 hrs.
  • composition comprising a population of modified HSCs described herein, wherein the modified HSCs express PD-L1 + .
  • the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • the composition further comprises a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier does not include tissue culture media.
  • a pharmaceutical composition comprising a population of modified HSCs described herein and a pharmaceutically acceptable carrier.
  • composition comprising a population of PD-L1 + expressing HSCs described herein wherein the HSCs are modified HSCs carrying an exogenous copy of a nucleic acid encoding a PD-L1 or the HSCs are ex vivo stimulated to increase the expression of endogenous PD-L1 by an ex vivo contact with PGE 2 .
  • the composition further comprises a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier does not include tissue culture media.
  • composition comprising a population of modified HSCs described herein for use in conjunction with a transplantation procedure, or for use with the treatment of an autoimmune disease or disorder, or for use in reducing or modulating an immune response, wherein the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1 and express PD-L1.
  • the composition further comprises a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier does not include tissue culture media.
  • composition comprising a population of PD-L1 + expressing HSCs described herein for use in conjunction with a transplantation procedure, or for use with the treatment of an autoimmune disease or disorder, or for use in reducing or modulating an immune response, wherein the HSCs are modified HSCs carrying an exogenous copy of a nucleic acid encoding a PD-L1 or the HSCs are ex vivo stimulated to increase the expression of endogenous PD-L1 by an ex vivo contact with PGE 2 .
  • the composition further comprises a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier does not include tissue culture media.
  • composition comprising a population of modified HSCs described herein for manufacture of a medicament for use in conjunction with a transplantation procedure, or for use with the treatment of an autoimmune disease or disorder, or for use in reducing or modulating an immune response, wherein the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1 and express PD-L1.
  • the composition further comprises a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier does not include tissue culture media.
  • composition comprising a population of PD-L1 + expressing HSCs described herein for manufacture of a medicament for use in conjunction with a transplantation procedure, or for use with the treatment of an autoimmune disease or disorder, or for use in reducing or modulating an immune response, wherein the HSCs are modified HSCs carrying an exogenous copy of a nucleic acid encoding a PD-L1 or the HSCs are ex vivo stimulated to increase the expression of endogenous PD-L1 by an ex vivo contact with PGE 2 .
  • the composition further comprises a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier does not include tissue culture media.
  • modified HSCs or PGE 2 -contacted HSCs are further analyzed to establish the expression of PD-L1 on the respective HSCs.
  • Methods of determining PD-L1 expression are known in the art, for example, by using immunoflowcytometry, fluorescence-activated cell sorting (FACS) or any immunoassays known in the art, and by RT-PCR.
  • the modified HSCs are expressing PD-L1.
  • the modified HSCs express increased amount of PD-L1. In one embodiment, there is at least one fold increase in the amount of PD-L1 + expressed compared to control HSCs which are HSCs that were not contacted with the vector and are non-modified HSCs that is not carrying an exogenous copy of a nucleic acid encoding a PD-L1. In one embodiment, there is up to ten fold increase in the amount of PD-L1 + expressed compared to control HSCs that were not contacted with the vector and are non-modified HSCs that is not carrying an exogenous copy of a nucleic acid encoding a PD-L1.
  • the PD-L1 + expressing HSCs express increased amount of PD-L1. In one embodiment, there is at least one fold increase in the number of PD-L1 + expressing cells compared to control HSCs which are non-PGE 2 incubated and stimulated HSCs. In one embodiment, there is up to ten fold increase in the number of PD-L1 + expressing cells compared to control HSCs that are non-PGE 2 contacted/incubated and stimulated HSCs.
  • the modified HSCs exhibit an increase expression of PD-L1 over control, non-modified HSCs.
  • the increase in the number of PD-L1 + expressing cells or the increase in the amount of PD-L1 expressed is at least 1% higher, at least 3% higher, at least 5% higher, at least 8% higher, at least 10% higher, at least 20% higher, at least 30% higher, at least 40% higher, at least 50% higher, at least 60% higher, at least 70% higher, at least 80% higher, at least 90% higher, at least 1-fold higher, at least 2-fold higher, at least 5-fold higher, at least 10 fold higher, at least 100 fold higher, at least 1000-fold higher, or more than a comparable control non-modified HSCs or non-PGE 2 stimulated cells.
  • Programmed cell death protein 1 also known as PD-1 and cluster of differentiation 279 (CD279), is a receptor protein that in humans is encoded by the PDCD1 gene.
  • PD-1 is a cell surface receptor that belongs to the immunoglobulin superfamily and is expressed on activated T cells and pro-B cells.
  • PD-1 binds two ligands, PD-L1 (also known as B7 homolog 1 (B7-H1) or cluster of differentiation 274 (CD 274)) and PD-L2.
  • B7-H1 B7 homolog 1
  • CD 274 cluster of differentiation 274
  • PD-1 and its ligands play an important role in down regulating the immune system by preventing the activation of T-cells.
  • PD-L1/PD-linteraction deactivates T cell's cytotoxic activity and leads to the inhibition of immune system. This in turn reduces autoimmunity and promotes self-tolerance.
  • the inhibitory effect of PD-1 is accomplished through a dual mechanism of promoting apoptosis (programmed cell death) in antigen specific T-cells in lymph nodes while simultaneously reducing apoptosis in regulatory T cells (suppressor T cells).
  • PD-L1 one of the ligand of the receptor PD-1, is a 40 kDa type 1 transmembrane protein encoded by the CD274 gene (Gene ID: 29126).
  • Other abbreviated symbols for PD-L1 are B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1, and PDL1PD-L1.
  • the human CD274 gene can be found on chromosome 9 at the location NC_000009.12 (5450381 . . . 5470567) according to the Assembly from the Genome Reference Consortium Human Build 38 patch release 2 (GRCh38.p2), under RefSeq or GENBANK assembly accession No: GCF_000001405.28, dated Dec. 5, 2014.
  • the mRNA of the human PD-L1 can be found at GENBANK accession Nos: NM_001267706.1, NM_014143.3, BC113734.1, BC113736.1, BC074984.2 and BC069
  • the mRNA of the human PD-L1 is the isoform b precursor of the mRNA (variant 2) having the DNA sequence of atgaggatattt gctgtcttta tattcatgac ctactggcat ttgctgaacg ccccatacaa caaaatcaac caaagaattt tggttgtgga tccagtcacc tctgaacatg aactgacatg tcaggctgag ggctacccca aggccgaagt catctggaca agtgacc atcaagtcct gagtggtaag accaccacca ccaattccaa gagagaggag aagcttttca atgtgaccag cacactgaga atcaacacaa caactaatga gatitictac tta
  • the mRNA of the human PD-L1 is the isoform a precursor of the mRNA (variant 1) having the DNA sequence of atgaggatattt gctgtcttta tattcatgac ctactggcat ttgctgaacg catttactgt cacggttccc aaggacctat atgtggtaga gtatggtagc aatatgacaa ttgaatgcaa attcccagta gaaaaacaat tagacctggc tgcactaatt gtctattggg aaatggagga taagaacatt attcaatttg tgcatggaga ggaagacctg aaggttcagc atagtagcta cagacagagg gcccggctgt tgaaggacca gctcccttttga
  • PD-L1 plays a major role in suppressing the immune system during particular events such as pregnancy, tissue allografts, autoimmune disease and other disease states such as hepatitis. Normally the immune system reacts to foreign antigens where there is some accumulation in the lymph nodes or spleen which triggers a proliferation of antigen-specific CD8+ T cell.
  • the formation of PD-1 receptor/PD-L1 or B7.1 receptor/PD-L1 ligand complex transmits an inhibitory signal which reduces the proliferation of these CD8+ T cells at the lymph nodes and supplementary to that PD-1 is also able to control the accumulation of foreign antigen specific T cells in the lymph nodes through apoptosis which is further mediated by a lower regulation of the gene BCL-2.
  • PD-L1 protein is upregulated on macrophages and dendritic cells (DC) in response to LPS and GM-CSF treatment, and on T cells and B cells upon TCR and B cell receptor signaling.
  • DC dendritic cells
  • PD-L 1 is expressed in a variety of tissues and cells, e.g., heart, lung, thymus, spleen, kidney and HSCs.
  • PD-L1 is expressed on almost all murine tumor cell lines, including PA1 myeloma, P815 mastocytoma, and B16 melanoma upon treatment with IFN- ⁇ .
  • the nucleic acid encoding a PD-L 1 encodes a human PD-L1.
  • the nucleic acid encoding PD-L1 is a copy DNA (cDNA).
  • the cDNA encoding PD-L1 is an mRNA.
  • the mRNA is SEQ. ID. NO: 1 or 2.
  • the mRNA is derived from the GenBank accession Nos: NM_001267706.1, NM_014143.3, BC113734.1, BC113736.1, BC074984.2 or BC069381.1.
  • the nucleic acid encoding PD-L1 is a genomic DNA.
  • the genomic DNA encoding PD-L1 is derived from the GenBank assembly accession No: GCF_000001405.28.
  • the nucleic acid is integrated into the genome of the HSC cells.
  • the nucleic acid is introduced into the cells via a vector.
  • the vector is a viral vector.
  • the viral vector is a lentiviral vector, an avian virus vector or an adeno-associated virus.
  • the lentivirus is selected from the group consisting of: human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type 2 (HIV-2), caprine arthritis-encephalitis virus (CAEV), equine infectious anemia virus (EIAV), feline immunodeficiency virus (FIV), bovine immune deficiency virus (BIV), and simian immunodeficiency virus (SIV).
  • HAV-1 human immunodeficiency virus type 1
  • HV-2 human immunodeficiency virus type 2
  • CAEV caprine arthritis-encephalitis virus
  • EIAV equine infectious anemia virus
  • FIV feline immunodeficiency virus
  • BIV bovine immune deficiency virus
  • SIV simian immunodeficiency virus
  • cells transduced with the vectors contemplated herein are genetically modified.
  • the genetically modified cells contemplated herein are transduced in vitro or ex vivo with vectors carrying an exogenous copy of a nucleic acid encoding a PD-L1, and optionally culture expanded ex vivo.
  • the transduced cells are then administered to a subject in need of gene therapy.
  • the transduced cells can be cryopreserved prior to administered to a subject in need of gene therapy.
  • the cells are mammalian cells.
  • the mammalian cells are human cells.
  • HSCs are known to give rise to committed hematopoietic progenitor cells (HPCs) that are capable of generating the entire repertoire of mature blood cells over the lifetime of an organism.
  • HPC hematopoietic stem cell
  • myeloid e.g., monocytes and macrophages, neutrophils, basophils, eosinophils, erythrocytes, megakaryocytes/platelets, dendritic cells
  • lymphoid lineages e.g., T-cells, B-cells, NK-cells
  • hematopoietic stem and progenitor cells When transplanted into lethally irradiated animals or humans, hematopoietic stem and progenitor cells can repopulate the erythroid, neutrophil-macrophage, megakaryocyte and lymphoid hematopoietic cell pool.
  • HSCs Mature blood cells have a finite lifespan and must be continuously replaced throughout life. Blood cells are produced by the proliferation and differentiation of a very small population of pluripotent HSCs that also have the ability to replenish themselves by self-renewal. HSCs are multipotent, self-renewing progenitor cells that develop from mesodermal hemangioblast cells. HSCs are the blood cells that give rise to all the other blood cells, that includes all the differentiated blood cells from the erythroid, lymphoid and myeloid lineages. HSCs are located in the adult bone marrow, peripheral blood, and umbilical cord blood.
  • Bone marrow is the major site of hematopoiesis in humans and, under normal conditions, only small numbers of HSCs and hematopoietic progenitor cells can be found in the peripheral blood (PB).
  • cytokines in particular granulocyte colony-stimulating factor; G-CSF
  • myelosuppressive drugs used in cancer treatment, and compounds that disrupt the interaction between hematopoietic cells and BM stromal cells can rapidly mobilize large numbers of stem and progenitor cells into the circulation.
  • Hematopoietic progenitor cell refers to cells of a hematopoietic stem cell lineage that give rise to all the blood cell types including the myeloid (monocytes and macrophages, neutrophils, basophils, eosinophils, erythrocytes, megakaryocytes/platelets, dendritic cells), and the lymphoid lineages (T-cells, B-cells, NK-cells).
  • a “cell of the erythroid lineage” indicates that the cell being contacted is a cell that undergoes erythropoeisis such that upon final differentiation it forms an erythrocyte or red blood cell (RBC).
  • Such cells belong to one of three lineages, erythroid, lymphoid, and myeloid, originating from bone marrow hematopoietic progenitor cells.
  • hematopoietic progenitor cells Upon exposure to specific growth factors and other components of the hematopoietic microenvironment, hematopoietic progenitor cells can mature through a series of intermediate differentiation cellular types, all intermediates of the erythroid lineage, into RBCs.
  • cells of the “erythroid lineage,” as the term is used herein, comprise hematopoietic progenitor cells, rubriblasts, prorubricytes, erythroblasts, metarubricytes, reticulocytes, and erythrocytes.
  • the HSCs similar to the hematopoietic progenitor cells, are capable of proliferation and giving rise to more progenitor cells having the ability to generate a large number of mother cells that can in turn give rise to differentiated or differentiable daughter cells.
  • the daughter cells themselves can be stimulated to proliferate and produce progeny that subsequently differentiate into one or more mature cell types, while also retaining one or more cells with parental developmental potential.
  • stem cell refers then, to a cell with the capacity or potential, under particular circumstances, to differentiate to a more specialized or differentiated phenotype, and which retains the capacity, under certain circumstances, to proliferate without substantially differentiating.
  • the term progenitor or stem cell refers to a generalized mother cell whose descendants (progeny) specialize, often in different directions, by differentiation, e.g., by acquiring completely individual characters, as occurs in progressive diversification of embryonic cells and tissues.
  • Cellular differentiation is a complex process typically occurring through many cell divisions.
  • a differentiated cell may derive from a multipotent cell which itself is derived from a multipotent cell, and so on. While each of these multipotent cells may be considered stem cells, the range of cell types each can give rise to may vary considerably.
  • Some differentiated cells also have the capacity to give rise to cells of greater developmental potential. Such capacity may be natural or may be induced artificially upon treatment with various factors.
  • stem cells are also “multipotent” because they can produce progeny of more than one distinct cell type, but this is not required for “stem-ness.”
  • Self-renewal is the other classical part of the stem cell definition, and it is essential as used in this document. In theory, self-renewal can occur by either of two major mechanisms. Stem cells may divide asymmetrically, with one daughter retaining the stem state and the other daughter expressing some distinct other specific function and phenotype. Alternatively, some of the stem cells in a population can divide symmetrically into two stems, thus maintaining some stem cells in the population as a whole, while other cells in the population give rise to differentiated progeny only.
  • progenitor cells have a cellular phenotype that is more primitive (i.e., is at an earlier step along a developmental pathway or progression than is a fully differentiated cell). Often, progenitor cells also have significant or very high proliferative potential. Progenitor cells can give rise to multiple distinct differentiated cell types or to a single differentiated cell type, depending on the developmental pathway and on the environment in which the cells develop and differentiate.
  • PBPC Peripheral blood progenitor cells
  • G-CSF granulocyte-colony stimulating factor
  • the sample of HSCs is obtained from the bone marrow, umbilical cord, chorionic villi, amniotic fluid, placental blood, cord blood or peripheral blood.
  • the HSCs are isolated from the bone marrow, umbilical cord, chorionic villi, amniotic fluid, placental blood, cord blood or peripheral blood.
  • the sample of HSCs is obtained from mobilized peripheral blood.
  • Methods of mobilizing HSCs from the places of origin or storage are known in the art.
  • cytokines in particular granulocyte colony-stimulating factor (G-CSF) and compounds (e.g., plerixafor, a chemokine CXCR4 antagonist) that disrupt the interaction between HSCs and bone marrow (BM) stromal cells
  • G-CSF granulocyte colony-stimulating factor
  • compounds e.g., plerixafor, a chemokine CXCR4 antagonist
  • the sample of HSCs is CD34 + selected cells obtained from the bone marrow, umbilical cord, chorionic villi, amniotic fluid, placental blood, cord blood or peripheral blood, or mobilized peripheral blood.
  • the HSCs are CD34 + cells. In other embodiments, the HSCs are CD38 lo/ ⁇ cells. In other embodiments, the HSCs are c-kit + cells.
  • the HSCs are hematopoietic progenitor cells.
  • these hematopoietic progenitor cells are CD34 + cells.
  • these hematopoietic progenitor cells are CD38 lo/ ⁇ cells.
  • these hematopoietic progenitor cells are c-kit + cells.
  • the HSCs are erythroid progenitor cells. In one embodiment, these erythroid progenitor cells are CD34 + cells.
  • the HSCs are erythroid cells. In one embodiment, these erythroid cells are CD34 + cells.
  • the HSC is selected for the CD34 + surface marker prior to the contacting with the vector carrying the exogenous copy of the nucleic acid described herein.
  • the HSC is selected for the CD38 lo/ ⁇ surface marker prior to the contacting with the vector carrying the exogenous copy of the nucleic acid described herein.
  • the HSC is selected for the c-kit + surface marker prior to the contacting with the vector carrying the exogenous copy of the nucleic acid described herein.
  • Positive or negative selection for the described surface markers can be performed by any method known in the art, e.g., using the anti-CD34 immunomagnetic bead described in the Example section.
  • the isolated CD34 + HSC is contacted with the PGE 2 composition described herein or contacted with the vector carrying the exogenous copy of the nucleic acid described herein.
  • the HSC has at least one of the cell surface marker characteristic of HSCs: CD34 + , CD59 + , Thy1/CD90 + , CD38 lo/ ⁇ , and C-kit/CD117 + .
  • the HSCs have several of these markers.
  • the HSCs are CD34 + , CD59 + , Thy1/CD90 + , CD38 lo/ ⁇ , and C-kit/CD117 + .
  • the HSCs are CD 133 + .
  • the hematopoietic progenitor cells are CD 133 + .
  • the hematopoietic progenitor cells of the erythroid lineage have the cell surface marker characteristic of the erythroid lineage: CD71 and Ter119.
  • the HSCs have the cell surface marker characteristic of the erythroid lineage: CD71 and Ter119.
  • the HSCs have at least one of the cell surface marker selected from the group consisting of CD34 + , CD59 + , Thy 1/CD90 + , CD38 lo/ ⁇ , and C-kit/CD117 + .
  • the HSCs are positively selected for at least one of the cell surface marker selected from the group consisting of CD34 + , CD59 + , Thy1/CD90 + , and C-kit/CD117 + .
  • the ex vivo method, or the composition described herein the HSCs are negatively selected for CD38 lo/ ⁇ .
  • the sample of HSCs is obtained from a healthy individual or subject.
  • the HSCs are obtained or isolated from an individual with a diagnosed disease or disorder or an individual who is an organ or bone marrow transplant recipient.
  • the HSCs are obtained or isolated from an individual who is newly diagnosed with T1D.
  • the diagnosed disease or disorder is an autoimmune disease or disorder.
  • the autoimmune disease or disorder is T1D.
  • the contacting of the HSCs with the vector carrying the exogenous copy of the nucleic acid described herein is repeated at least once. That is, after the initial first contacting of the HSC with the virus or vector described herein, the cell is washed and collected, and the washed cell is then contacted for a second time with the virus or vector carrying a nucleic acid molecule described herein. These cells are then washed a second time and collected.
  • the contacting is repeated at least twice after the initial first contacting.
  • the ex vivo method, or the composition described herein the isolated or collected HSCs are ex vivo cultured before and/or after the introduction of the exogenous copy of a nucleic acid encoding a PD-L1.
  • the ex vivo culturing serve to expand or grow the population of present cells, that is, to increase the number of similar cells.
  • the ex vivo method, or the composition described herein the isolated or collected HSCs are ex vivo cultured before contacting, incubation or stimulation with PGE 2 .
  • the ex vivo method, or the composition described herein the isolated or collected HSCs are ex vivo cultured after contacting, incubation or stimulation with PGE 2 .
  • the ex vivo method, or the composition described herein the isolated or collected HSCs are ex vivo cultured before and after contacting, incubation or stimulation with PGE 2 .
  • the ex vivo culture expansion take place prior to use, for example, use in cryopreservation, or use in implantation/engraftment into a recipient subject.
  • the HSCs are cryopreserved prior to the introduction of the exogenous copy of a nucleic acid encoding a PD-L1.
  • the HSCs are cryopreserved after the introduction of the exogenous copy of a nucleic acid encoding a PD-L1.
  • the HSCs are cryopreserved prior to and after the introduction of the exogenous copy of a nucleic acid encoding a PD-L1.
  • the HSCs are cryopreserved prior to contacting, incubation or stimulatiot with PGE 2 , or after contacting, incubation or stimulatiot with PGE 2 , or both prior to and after contacting, incubation or stimulatiot with PGE 2 .
  • the ex vivo method, or the composition described herein the modified PD-L1 + expressing HSCs are ex vivo culture expanded and then cryopreserved prior to use.
  • ex vivo cell expansion and/or implantation/engraftment into a subject are ex vivo culture expanded and then cryopreserved prior to use.
  • cryopreserving refers to the preservation of cells by cooling to low sub-zero temperatures, such as (typically) 77 K or ⁇ 196° C. (the boiling point of liquid nitrogen). Cryopreservation also refers to preserving cells at a temperature between 4-10° C. At these low temperatures, any biological activity, including the biochemical reactions that would lead to cell death, is effectively stopped. Cryoprotective agents are often used at sub-zero temperatures to prevent the cells being preserved from damage due to freezing at low temperatures or warming to room temperature.
  • Freezing is destructive to most living cells. Upon cooling, as the external medium freezes, cells equilibrate by losing water, thus increasing intracellular solute concentration. Below about 10°-15° C., intracellular freezing will occur. Both intracellular freezing and solution effects are responsible for cell injury (Mazur, P., 1970, Science 168:939-949). It has been proposed that freezing destruction from extracellular ice is essentially a plasma membrane injury resulting from osmotic dehydration of the cell (Meryman, H. T., et al., 1977, Cryobiology 14:287-302).
  • Cryoprotective agents and optimal cooling rates can protect against cell injury.
  • Cryoprotective agents which can be used include but are not limited to dimethyl sulfoxide (DMSO) (Lovelock, J. E. and Bishop, M. W. H., 1959, Nature 183:1394-1395; Ashwood-Smith, M. J., 1961, Nature 190:1204-1205), glycerol, polyvinylpyrrolidine (Rinfret, A. P., 1960, Ann. N.Y. Acad. Sci. 85:576), Dextran, trehalose, CryoSoFree (Signa Aldrich Co.) and polyethylene glycol (Sloviter, H. A. and Ravdin, R.
  • the preferred cooling rate is 1° to 3° C./minute. After at least two hours, the T-cells have reached a temperature of ⁇ 80° C. and can be placed directly into liquid nitrogen ( ⁇ 196° C.) for permanent storage such as in a long-term cryogenic storage vessel.
  • the PGE 2 is 16,16-Dimethyl prostaglandin E2 (dmPGE 2 ).
  • the modified PD-L1 expressing HSCs described herein can be used to treat an autoimmune disorder, getting to the root cause of an autoimmune disorder, a defect in immunoregulation.
  • the modified PD-L1 expressing HSCs are used to modulate or suppress an immune response in a subject having the autoimmune disorder.
  • the autoimmune disorder is TID.
  • Subjects with TID have defects in producing PD-L1 expression HSCs.
  • the modified PD-L1 expressing HSCs are used to supplement this defect and modulate or suppress the immune response against the 13 islet cells of the panceaus of the subject having TID.
  • the modified PD-L1 expressing HSCs described herein are used to treat TID in a subject diagnosed with TID.
  • the subject is newly diagnosed with TID.
  • the term “newly diagnosed” refers to diagnosis for the disorder for less than one calendar year.
  • the subject is newly been detected to have self-autoantibodies associated with TID, e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the term “newly detected” refers to the detection of self-autoantibodies associated with TID in the last 6 calender months.
  • a human subject has been newly diagnosed with TID.
  • a sample of HSCs can be harvested from this subject.
  • the HSCs obtained can be ex vivo expanded to increase the number of available HSCs for the procedures described herein to increase PD-L1 expression.
  • a sample of HSCs can be transfected with an exogenous of a PD-L1 cDNA to bring about overexpression of PD-L1 in the transfected HSCs.
  • a sample of HSCs can be contacted ex vivo with PGE 2 as described herein to stimulate increased PD-L1 expression in the PGE 2 -contacted HSCs. Both PGE 2 and steroids such as dexamethasome also can be use together to stimulate PD-L1 expression.
  • Either method of increasing PD-L1 expression and increasing the pool of PD-L1 expressing HSCs can be used.
  • the resultant HSCs are then analysed to confirmed increased PD-L1 expression compared to non-transfected HSCs or non-PGE 2 -contacted HSCs respectively.
  • the resultant HSCs can be further ex vivo expanded to increase the number of available HSCs for transplantation back into the subject.
  • the resultant HSCs can also be ex vivo expanded to increase the number of available PD-L1 expressing HSCs for cryopreservation and for transplantation back into the subject, i.e., have a portion of PD-L1 expressing HSCs kept in cryostorage and another portion for transplantation back into the subject.
  • the PD-L1 expressing HSCs are autologous to the recipient subject because the original HSCs were obtained from the same subject, therefore the HSCs are HLA matched to the subject.
  • a human subject has been newly been detected to have self-autoantibodies associated with T1D, e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the four autoantibodies that are markers of beta cell autoimmunity in type 1 diabetes are: islet cell antibodies (ICA, against cytoplasmic proteins in the beta cell), antibodies to glutamic acid decarboxylase (GAD-65), insulin autoantibodies (IAA), and IA-2A, to protein tyrosine phosphatase.
  • ICA islet cell antibodies
  • GAD 65 antibodies to glutamic acid decarboxylase
  • IAA insulin autoantibodies
  • IA-2A protein tyrosine phosphatase.
  • Autoantibodies against GAD 65 are found in 80% of type 1 diabetics at clinical presentation. Presence of ICA and IA-2A at diagnosis for type 1 diabetes range from 69-90% and 54-75%, respectively.
  • the subject is not yet symptomatic for T1D (ie., hyperglycemia).
  • the therapeutic methods using the PD-L1 expressing HSCs are used to delay onset of hyperglycemia for such an individual.
  • Hyperglycemia, or high blood sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l (200 mg/dl), but symptoms may not start to become noticeable until even higher values such as 15-20 mmol/l (250-300 mg/dl).
  • a subject with a consistent range between 5.6 and 7 mmol/1 (100-126 mg/dl) (American Diabetes Association guidelines) is considered hyperglycemic, while above 7 mmol/l (126 mg/dl) is generally held to have diabetes.
  • the subject has blood sugar below 11.1 mmol/l (200 mg/dl).
  • the blood sugar below 15 mmol/l ( ⁇ 250 mg/dl) or below 20 mmol/l 300 mg/dl).
  • Administering the PD-L1 + cells can delay the onset of diabetes.
  • the modified PD-L1 expressing HSCs described herein can also be used to suppress an immune response in a subject who is an organ or bone marrow transplant recipient, or a subject who is going to be recipient in the near futher.
  • the modified PD-L1 expressing HSCs are used to prevent or treat or both prevent and treat host-versus-graft disease (GVHD).
  • GVHD host-versus-graft disease
  • GvHD is a medical complication following the receipt of transplanted tissue from a genetically different person. GvHD is commonly associated with stem cell or bone marrow transplant but the term also applies to other forms of tissue graft. A sample of HSCs can be harvested from this subject.
  • the HSCs obtained can be ex vivo expanded to increase the number of available HSCs for the procedures described herein to increase PD-L1 expression.
  • a sample of HSCs can be transfected with an exogenous of a PD-L1 cDNA to bring about overexpression of PD-L1 in the transfected HSCs.
  • a sample of HSCs can be contacted ex vivo with PGE 2 as described herein to stimulate increase PD-L1 in the PGE 2 -contacted HSCs.
  • PGE 2 and a steroid such as dexamethasome can be use together to stimulate PD-L1 expression. Either method of increasing PD-L1 expression and increasing the pool of PD-L1 expressing HSCs can be used.
  • the resultant HSCs are then analysed to confirmed increased PD-L1 expression compared to non-transfected HSCs or non-PGE 2 -contacted HSCs respectively.
  • the resultant HSCs can be further ex vivo expanded to increase the number of available HSCs for transplantation back into the subject.
  • the resultant HSCs can also be ex vivo expanded to increase the number of available PD-L1 expressing HSCs for cryopreservation and for transplantation back into the subject.
  • composition comprising the PD-L1 expressing hematopoietic stem cells described herein or PD-L1 + HSCs produced by any one of the method described herein for use in the prevention or treatment of an autoimmune disease or disorder, for use in suppressing an immune response in a subject, for use in the delay of the onset of T1D in a subject at risk of developing T1D, for use in the prevention and delay of an allogenic tissue or organ transplant rejection, and for the treatment of T1D in adult and pediatric subjects.
  • composition comprising the PD-L1 expressing HSCs described herein or PD-L1 + HSCs produced by any one of the method described herein for the manufacture of medicament for use in the prevention or treatment of an autoimmune disease or disorder, in the suppression of an immune response in a subject, in the delay of the onset of T1D in a subject at risk of developing T1D, in the prevention and delay of an allogenic tissue or organ transplant rejection, and for the treatment of T1D in adult and pediatric subjects.
  • a population of PD-L1 expressing HSCs described herein or PD-L1 + HSCs produced by any one of the method described herein for use in the prevention or treatment of an autoimmune disease or disorder, for use in suppressing an immune response in a subject, for use in the delay of the onset of T1D in a subject at risk of developing T1D, for use in the prevention and delay of an allogenic tissue or organ transplant rejection, and for the treatment of T1D in adult and pediatric subjects.
  • a population of PD-L1 expressing HSCs described herein or PD-L1 + HSCs produced by any one of the method described herein for the manufacture of medicament for use in the prevention or treatment of an autoimmune disease or disorder, in the suppression of an immune response in a subject, in the delay of the onset of T1D in a subject at risk of developing T1D, in the prevention and delay of an allogenic tissue or organ transplant rejection, and for the treatment of T1D in adult and pediatric subjects.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising administering to a subject a composition comprising a population of modified HSCs described herein.
  • the modified HSCs express PD-L1.
  • the modified HSCs exhibit increase expression of PD-L1 over the control, non-modified HSCs.
  • the method further comprises identifying a subject afflicted with an autoimmune disease or disorder.
  • the method further comprises selecting a subject having an autoimmune disease or disorder, or an individual who is an organ or bone marrow transplant recipient.
  • a method of preventing host-versus-graft disease, or organ or tissue graft rejection in a subject in need thereof comprising administering to a subject a composition comprising a population of modified HSCs described herein.
  • the subject has received an allogenic tissue or organ graft.
  • the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • the modified HSCs express PD-L1.
  • the modified HSCs exhibit increase expression of PD-L1 over the control, non-modified HSCs.
  • the modified HSCs are PGE 2 -stimulated, PD-L1 + expressing HSCs described herein. In one embodiment, the modified HSCs are PGE 2 asd dexamethasone-stimulated, PD-L1+ expressing HSCs described herein.
  • a method of delaying the onset of Type 1 diabetes in a subject in need thereof comprising administering to a subject a composition comprising a population of modified HSCs described herein.
  • the subject is newly been noted to have detectable amounts of a self-autoantibody associated with T1D.
  • the subject does not have clinical hyperglycemia.
  • the subject is a pediatric patient under the age of 20 years old.
  • the subject is a pediatric patient under the age of 15 years old, 10 years old, 5 years old, and 1 years old.
  • the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • the modified HSCs express PD-L1.
  • the modified HSCs exhibit increase expression of PD-L1 over the control, non-modified HSCs.
  • the modified HSCs are PGE 2 -stimulated, PD-L1 + expressing HSCs described herein. In one embodiment, the modified HSCs are PGE 2 asd dexamethasone-stimulated, PD-L1+ expressing HSCs described herein.
  • autoimmune diseases or disorders are known in the art, for example, those described in the definition section.
  • the skilled physician would be able to diagnose an autoimmune disease or disorder that is known in the art.
  • the method further comprises selecting a subject in need of immune response suppression.
  • deliberately induced immunosuppression is performed to prevent the body from rejecting an organ transplant or an allograft transplant, treating GVHD after an organ or bone marrow transplant, or for the treatment of autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis or Crohn's disease.
  • an organ transplantation include liver, skin, lung transplantation, pancreas, kidney, ovary, colon, intestine, and heart transplantation.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising administering to a subject a composition comprising a population of modified HSCs where the modified HSCs carry an exogenous copy of a nucleic acid encoding a PD-L1.
  • the modified HSCs express PD-L1.
  • the modified HSCs exhibit increase expression of PD-L1 over the control, non-modified HSCs.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising administering to a subject a composition comprising a population of modified PD-L1 + expressing HSCs where the modified HSCs are produced by an ex vivo method comprising contacting a sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to modify the HSCs whereby the exogenous copy of a nucleic acid is introduced into the HSCs, thereby producing a population of modified HSCs cells expressing PD-L1.
  • the method further comprises establishing the expression of PD-L1 on the resultant modified HSCs.
  • the method further comprises ex vivo culturing the resultant modified cells after contact with the vector. In another embodiment, the method further comprises ex vivo culturing the resultant modified cells after establishing the expression of PD-L1 on the resultant modified HSCs. In another embodiment, the method further comprises ex vivo culturing the resultant modified cells after contact with the vector and ex vivo culturing the resultant modified cells after establishing the expression of PD-L1 on the resultant modified HSCs.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising administering to a subject a composition comprising a population of PGE 2 -stimulated, PD-L1+ expressing HSCs described herein.
  • the method further comprises identifying a subject afflicted with an autoimmune disease or disorder.
  • the method further comprises selecting a subject having an autoimmune disease or disorder, or a subject who is an organ or bone marrow transplant recipient, or a subject who is an organ or bone marrow transplant recipient and is at risk of developing GVHD.
  • a subject who has received an allogenic graft transplant a subject who has received an allogenic graft transplant.
  • the method further comprises selecting a subject in need of immune response suppression. For example, a subject who an organ or bone marrow transplant recipient and is at risk of developing GVHD.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising administering to a subject a composition comprising a population of PD-L1 + expressing HSCs wherein the HSCs are stimulated to express PD-L1 + by contacting with PGE 2 .
  • the stimulated HSCs exhibit an increase expression of PD-L1 over the control, non-PGE 2 -stimulated HSCs.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising administering to a subject a composition comprising a population of PD-L1 + expressing HSCs where the PD-L1 + expressing HSCs are produced by an ex vivo method comprising contacting a sample of HSCs with PGE 2 at 10 ⁇ M concentration for about 60 min at 37° C., thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising administering to a subject a composition comprising a population of PD-L1 + expressing HSCs where the PD-L1 + expressing HSCs are produced by an ex vivo method comprising contacting a sample of HSCs with PGE 2 at 0.1 ⁇ M concentration for at least 24 hrs at 37° C., thereby producing a population of PGE 2 -stimulated HSCs cells expressing PD-L1.
  • the method further comprises washing the contacted cells to remove excess PGE 2 .
  • the method further comprises establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • the method further comprises ex vivo culturing of the sample of HSCs prior to PGE 2 -stimulation. This ex vivo culturing expands the number of cells available for PGE 2 -stimulation.
  • the method further comprises ex vivo culturing of the PGE 2 -stimulated HSCs after contact with PGE 2 , or ex vivo culturing of the PGE 2 -stimulated HSCs after establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs, or both ex vivo culturing of the PGE 2 -stimulated HSCs after contact with PGE 2 and ex vivo culturing of the PGE 2 -stimulated HSCs after establishing the expression of PD-L1 on the PGE 2 -stimulated HSCs.
  • This ex vivo culturing expands the number of PD-L1 expressing cells available for therapy.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising providing a population of HSCs; contacting the sample of HSCs with a vector carrying an exogenous copy of a nucleic acid encoding a PD-L1 to produce a population of modified HSCs cells expressing PD-L1; and administering the population of modified, PD-L1 + expressing HSCs into a recipient subject to promote immunoregulation and immuneself-tolerance in the recipient subject.
  • the method further comprises establishing the expression of PD-L1 on the resultant modified HSCs.
  • the method further comprises ex vivo culturing the resultant modified cells after contact with the vector and/or ex vivo culturing the resultant modified cells after establishing the expression of PD-L1 on the resultant modified HSCs.
  • the treatment method further comprises identifying a recipient subject afflicted with an autoimmune disease or disorder and is in need of increased immunoregulation and immune self-tolerance.
  • the treatment method further comprises selecting a recipient subject having an autoimmune disease or disorder or is in need of suppressing an immune response.
  • the treatment method further comprises identifying and selecting a donor subject to provide the sample of HSCs for contacting with the described vector or stimulation with PGE 2 .
  • the donor subject and recipient subject are the same subject, that is the recipient subject would be administered autologous HSCs.
  • the donor subject and recipient subject are different subjects.
  • the donor subject and recipient subject at the minimum HLA type matched.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising providing a population of HSCs; contacting sample of HSCs with PGE 2 at 10 ⁇ M concentration for about 60 min at 37° C. to produce a population of PGE 2 -stimulated HSCs cells expressing PD-L1; and administering the population of PGE 2 -stimulated PD-L1 + expressing HSCs into a recipient subject to promote immunoregulation and immuneself-tolerance in the recipient subject.
  • the method further comprises establishing the expression of PD-L1 on the resultant PGE 2 -stimulated HSCs.
  • a method of treating an autoimmune disorder or suppressing an immune response in a subject in need thereof comprising providing a population of HSCs; contacting sample of HSCs with PGE 2 at 0.1 ⁇ M concentration for at least 24 hrs at 37° C. to produce a population of PGE 2 -stimulated HSCs cells expressing PD-L1; and administering the population of PGE 2 -stimulated PD-L1 + expressing HSCs into a recipient subject to promote immunoregulation and immuneself-tolerance in the recipient subject.
  • the method further comprises establishing the expression of PD-L1 on the resultant PGE 2 -stimulated HSCs.
  • the PGE 2 -stimulated HSCs are also contacted with steroids such as dexamethasone.
  • the method further comprises ex vivo culturing the resultant PGE 2 -stimulated cells after contact with PGE 2 , or ex vivo culturing the resultant PGE 2 -stimulated cells after establishing the expression of PD-L1 on the resultant PGE 2 -stimulated HSCs, or both ex vivo culturing the resultant PGE 2 -stimulated cells after contact with PGE 2 and ex vivo culturing the resultant PGE 2 -stimulated cells after establishing the expression of PD-L1 on the resultant PGE 2 -stimulated HSCs.
  • the method further comprises identifying a recipient subject afflicted with an autoimmune disease or disorder and is in need of increased immunoregulation and immune self-tolerance. In one embodiment, the method further comprises identifying a recipient subject who is an organ or bone marrow transplant recipient, and is in need of increased immunoregulation and immune self-tolerance. In another embodiment, the method further comprises selecting a recipient subject having an autoimmune disease or disorder or who is an organ or bone marrow transplant recipient. In another embodiment, the treatment method further comprises identifying and selecting a donor subject to provide the sample of HSCs for contacting with PGE 2 . In one embodiment, the donor subject and recipient subject are the same subject, that is the recipient subject would be administered autologous HSCs. In another embodiment, the donor subject and recipient subject are different subjects. In another embodiment, the donor subject and recipient subject at the minimum HLA type matched.
  • the HSCs are isolated from a host subject, transfected with a vector, cultured (optional), and transplanted back into the same host, i.e. an autologous cell transplant.
  • the HSCs are isolated from a donor who is an HLA-type match with a host (recipient) who is diagnosed with an autoimmune disease or disorder, or TID. Donor-recipient antigen type-matching is well known in the art.
  • the HLA-types include HLA-A, HLA-B, HLA-C, and HLA-D. These represent the minimum number of cell surface antigen matching required for transplantation.
  • transfected cells are transplanted into a different host, i.e., allogeneic to the recipient host subject.
  • the donor's or subject's HSCs can be transfected with a vector or nucleic acid comprising the nucleic acid molecule described herein, the transfected cells are culture expanded ex vivo, and then transplanted into the host subject.
  • the transplanted cells engrafts in the host subject.
  • the transfected HSCs can also be cryopreserved after transfected and stored, or cryopreserved after cell expansion and stored.
  • the autoimmune disorder is selected from the group consisting of thyroiditis, type 1 diabetes mellitus, Hashimoto's thyroidits, Graves' disease, celiac disease, multiple sclerolsis, Guillain-Barre syndrome, Addison's disease, and Raynaud's phenomenon, Goodpasture's disease, arthritis (rheumatoid arthritis such as acute arthritis, chronic rheumatoid arthritis, gout or gouty arthritis, acute gouty arthritis, acute immunological arthritis, chronic inflammatory arthritis, degenerative arthritis, type II collagen-induced arthritis, infectious arthritis, Lyme arthritis, proliferative arthritis, psoriatic arthritis, Still's disease, vertebral arthritis, and juvenile-onset rheumatoid arthritis, arthritis chronica progrediente, arthritis deformans, polyarthritis chronica primaria, reactive arthritis, and ankylosing spondylitis), inflammatory hyperproliferative skin diseases, psori
  • the method further comprises identifying a subject who is at risk of developing T1D, so as to prevent or delay onset of diabetes symptoms.
  • identifying a subject who is at risk of developing T1D so as to prevent or delay onset of diabetes symptoms.
  • an individual who has detectable amount of self-autoantibodies associated with T1D that is known in the art. See the risk factors and markers described by Ping Xu and Jeffrey P. Krischer in “Prognostic classification factors associated with development of multiple autoantibodies, dysglycemia, and Type 1 Diabetes—A recursive partitioning analysis” in Diabetes Care, 2016, 39(6): 1036-1044.
  • the autoimmune disorder is Type 1 diabetes (T1D).
  • the subject has been newly diagnosed with T1D.
  • the subject has been newly been detected to have self-autoantibodies associated with T1D, e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • self-autoantibodies associated with T1D e.g., GAD65 autoantibody, and islet antigen 2 autoantibody.
  • the HSCs are autologous to the recipient subject.
  • the HSCs are non-autologous and allogenic to the recipient subject.
  • the HSCs are non-autologous and xenogeneic to the recipient subject.
  • the population of HSCs is obtained from the bone marrow, umbilical cord, amniotic fluid, chorionic villi, cord blood, placental blood or peripheral blood.
  • the population of HSCs is obtained from mobilized peripheral blood.
  • the population of HSCs comprises CD34 + cells.
  • the population of HSCs comprises CD34 + selected cells obtained from the bone marrow, umbilical cord, amniotic fluid, chorionic villi, cord blood, placental blood or peripheral blood or mobilized peripheral blood.
  • the population of HSCs is autologous to the recipient subject.
  • the population of HSCs is at the minimum HLA type matched to the recipient subject.
  • the population of HSCs are cryopreserved after the removal of excess PGE 2 or after post-transfection with the vector, ex vivo cultured to expand the population of modified HSCs, prior to transplantation into the recipient subject.
  • the HSCs can be ex vivo culture expanded any time to increase the number of starting HSCs for transduction with a vector described herein or stimulation with PGE 2 or for use in therapy.
  • ex vivo culture cell expansion can take place after harvesting from a donor subject, after transduction with the vector described herein, after contact with PGE 2 , after any cryopreservation step described herein.
  • cryopreservation of the HSCs can take place any time after harvesting from a donor subject, after culture expansion following harvesting from a donor subject, after transduction with the vector described herein, after contact with PGE 2 , after the removal of excess PGE 2 , after culture expansion following transduction with the vector described herein or after contact with PGE 2 .
  • the population of HSCs are ex vivo culture expanded after the removal of excess PGE 2 or after post-transfection with the vector, prior to transplantation into the recipient subject.
  • the HSC after the contacting, is cryopreserved prior to use, for example, ex vivo expansion and/or implantation into a subject.
  • the HSC after the contacting, is culture expanded ex vivo prior to use, for example, cryopreservation, and/or implantation/engraftment into a subject.
  • the method further comprises identifying a subject afflicted with an autoimmune disease or disorder or an individual who is an organ or bone marrow transplant recipient.
  • the method further comprises selecting a subject having an autoimmune disease or disorder or an individual who is an organ or bone marrow transplant recipient.
  • the method further comprises selecting a recipient subject in need of immune response modulation.
  • a recipient subject in need of immune response modulation Such as an individual who is an organ or bone marrow transplant recipient who has received an allogenic graft.
  • the method further comprises identifying a subject in need of immune response suppression.
  • a subject in need of immune response suppression Such as an individual who is an organ or bone marrow transplant recipient who has received an allogenic graft.
  • the method further comprises selecting a subject in need of immune response suppression.
  • a subject in need of immune response suppression Such as an individual who is an organ or bone marrow transplant recipient who has received an allogenic graft.
  • the method further comprises allowing the population of PD-L1 + expressing HSCs to differentiate in vivo into PD-L1 + expressing progeny cells.
  • the HSC after the contacting, is differentiated in culture ex vivo prior to use, for example, cryopreservation, and/or implantation/engraftment into a subject.
  • the chemotherapy and/or radiation is to reduce endogenous stem cells to facilitate engraftment and/or reconstitution of the implanted cells.
  • the PD-L1 expressing HSCs or progeny cells thereof are further treated ex vivo with prostaglandin E2 and/or antioxidant N-acetyl-L-cysteine (NAC) to promote subsequent engraftment and/or reconstitution of the cells when implanted in a recipient subject.
  • prostaglandin E2 and/or antioxidant N-acetyl-L-cysteine (NAC) to promote subsequent engraftment and/or reconstitution of the cells when implanted in a recipient subject.
  • the method further comprises administering an additional immunosuppression therapy to the subject.
  • the additional immunosuppression therapy comprises thymoglobulin, cyclophosphamide, or both thymoglobulin plus cyclophosphamide.
  • the additional immunosuppression therapy comprises antithymocyte antigens (ATG), or CTLA4-fusion immunoglobulins, or both.
  • ATG antithymocyte antigens
  • CTLA4-fusion immunoglobulins or both.
  • non-limiting examples of additional immunosuppression therapy are calcineurin inhibitors (such as cyclosporine, voclosporin and tacrolimus); CD80/86:CD28 costimulation inhibitors (CTLA4-fusion immunoglobulins such as abatacept and belatacept); CD154:CD40 costimulation inhibitors (anti-CD40 monoclonal antibodies such as ASKP1240; Astellas); CD20 inhibitors (anti-CD20 antibodies such as rituximab, ocrelizumab, ofatumumab, and veltuzumab); CD22 inhibitors (anti-CD22 antibodies such as epratuzumab); B cell differentiation inhibitors (such as belimumab and atacicept); antibody-producing plasma cell inhibitors (such as bortezomib); inhibitor of the complement process (such as eculizumab); inhibitors of cytokines that are involved in the immune response with the T or B cells (such as steroids
  • dexamethasome, glucocorticoid and corticosteroid Janus kinase inhibitor e.g. tofacitinib; IL-6 receptor inhibitor, e.g. basiliximab; TNF inhibitors e.g. infliximab, adalimumab, golimumab, and certolizumab; IL-1 inhibitors e.g. anikinra, rilonacept, and canakinumab; and IL-17 inhibitor e.g.
  • inhibitors of chemokines and cell adhesion such as CCR5 receptor antagonist maraviroc, CXCR4 antagonist plerixafor, CCR4 humanized mAb mogamulizumab, and CCL2 (also known as monocyte chemotactic protein 1) inhibitor emapticap; pooled intravenous immunoglobulins (IVIG) from several thousand plasma donors; polyclonal antithymocyte globulin (ALG) and antithymocyte antigens (ATG); CD52 inhibitors (anti-CD25 e.g.
  • alemtuzumab alemtuzumab
  • mTOR inhibitors e.g., rapamycin, sirolimus and everolimus
  • DNA synthesis inhibitor e.g., azathioprine (AZA), mycophenolate, leflunomide, and cytotoxic agents such as cyclophosphamide.
  • AZA azathioprine
  • mycophenolate e.g., mycophenolate
  • leflunomide e.g., mycophenolate, leflunomide
  • cytotoxic agents such as cyclophosphamide.
  • Lentiviral vectors of the disclosure include, but are not limited to, human immunodeficiency virus (e.g., HIV-1, HIV-2), feline immunodeficiency virus (FIV), simian immunodeficiency virus (SIV), bovine immunodeficiency virus (BIV), and equine infectious anemia virus (EIAV).
  • human immunodeficiency virus e.g., HIV-1, HIV-2
  • feline immunodeficiency virus e.g., HIV-1, HIV-2
  • FV feline immunodeficiency virus
  • SIV simian immunodeficiency virus
  • BIV bovine immunodeficiency virus
  • EIAV equine infectious anemia virus
  • the vectors can be designed in different ways to increase their safety in gene therapy applications.
  • the vector can be made safer by separating the necessary lentiviral genes (e.g., gag and pol) onto separate vectors as described, for example, in U.S. Pat. No. 6,365,150, the contents of which are incorporated by reference herein.
  • recombinant retrovirus can be constructed such that the retroviral coding sequence (gag, pol, env) is replaced by a gene of interest rendering the retrovirus replication defective.
  • the replication defective retrovirus is then packaged into virions through the use of a helper virus or a packaging cell line, by standard techniques.
  • packaging cell lines are used to propagate vectors (e.g., lentiviral vectors) of the disclosure to increase the titer of the vector virus.
  • packaging cell lines are also considered a safe way to propagate the virus, as use of the system reduces the likelihood that recombination will occur to generate wild-type virus.
  • packaging systems can be use in which the plasmids encoding the packaging functions of the virus are only transiently transfected by, for example, chemical means.
  • the vector can be made safer by replacing certain lentiviral sequences with non-lentiviral sequences.
  • lentiviral vectors of the present disclosure may contain partial (e.g., split) gene lentiviral sequences and/or non-lentiviral sequences (e.g., sequences from other retroviruses) as long as its function (e.g., viral titer, infectivity, integration and ability to confer high levels and duration of therapeutic gene expression) are not substantially reduced.
  • Elements which may be cloned into the viral vector include, but are not limited to, promoter, packaging signal, LTR(s), polypurine tracts, and a reverse response element (RRE).
  • the LTR region is modified by replacing the viral LTR promoter with a heterologous promoter.
  • the promoter of the 5′ LTR is replaced with a heterologous promoter.
  • heterologous promoters which can be used include, but are not limited to, a spleen focus-forming virus (SFFV) promoter, a tetracycline-inducible (TET) promoter, a ⁇ -globin locus control region and a ⁇ -globin promoter (LCR), and a cytomegalovirus (CMV) promoter.
  • the promoter is a regulatable promoter, an inducible promoter, for the regulating the production of PD-L1.
  • a Tetracyclin-inducible or Doxycyclin-inducible promoter for the regulating the production of PD-L1.
  • the viral vectors such as lentiviral vector or AAV or avian viral vectors of the disclosure also include vectors which have been modified to improve upon safety in the use of the vectors as gene delivery agents in gene therapy.
  • an LTR region, such as the 3′ LTR, of the vector is modified in the U3 and/or U5 regions, wherein a SIN vector is created. Such modifications contribute to an increase in the safety of the vector for gene delivery purposes.
  • the vector comprises a deletion in the 3′ LTR wherein a portion of the U3 region is replaced with an insulator element.
  • the insulator prevents the enhancer/promoter sequences within the vector from influencing the expression of genes in the nearby genome, and vice/versa, to prevent the nearby genomic sequences from influencing the expression of the genes within the vector.
  • the 3′ LTR is modified such that the U5 region is replaced, for example, with an ideal poly(A) sequence. It should be noted that modifications to the LTRs such as modifications to the 3′ LTR, the 5′ LTR, or both 3′ and 5′ LTRs, are also included in the disclosure.
  • the promoter of the lentiviral vector can be one which is naturally (i.e., as it occurs with a cell in vivo) or non-naturally associated with the 5′ flanking region of a particular gene.
  • Promoters can be derived from eukaryotic genomes, viral genomes, or synthetic sequences. Promoters can be selected to be non-specific (active in all tissues) (e.g., SFFV), tissue specific (e.g., (LCR), regulated by natural regulatory processes, regulated by exogenously applied drugs (e.g., TET), or regulated by specific physiological states such as those promoters which are activated during an acute phase response or those which are activated only in replicating cells.
  • Non-limiting examples of promoters in the present disclosure include the spleen focus-forming virus promoter, a tetracycline-inducible promoter, a ⁇ -globin locus control region and a ⁇ -globin promoter (LCR), a cytomegalovirus (CMV) promoter, retroviral LTR promoter, cytomegalovirus immediate early promoter, SV40 promoter, and dihydrofolate reductase promoter.
  • the promoter can also be selected from those shown to specifically express in the select cell types such as HSCs and their progenies.
  • the promoter of the vecter is cell specific such that gene expression is restricted to red blood cells. Erythrocyte-specific expression is achieved by using the human ⁇ -globin promoter region and locus control region (LCR).
  • the parameters can include: achieving sufficiently high levels of gene expression to achieve a physiological effect; maintaining a critical level of gene expression; achieving temporal regulation of gene expression; achieving cell type specific expression; achieving pharmacological, endocrine, paracrine, or autocrine regulation of gene expression; and preventing inappropriate or undesirable levels of expression. Any given set of selection requirements will depend on the conditions but can be readily determined once the specific requirements are determined.
  • the promoter is cell-specific such that gene expression is restricted to red blood cells. Erythrocyte-specific expression is achieved by using the human ⁇ -globin promoter region and locus control region (LCR).
  • lentiviral stock solutions may be prepared using the vectors and methods of the present disclosure. Methods of preparing viral stock solutions are known in the art and are illustrated by, e.g., Y. Soneoka et al. (1995) Nucl. Acids Res. 23:628-633, and N. R. Landau et al. (1992) J. Virol. 66:5110-5113.
  • lentiviral-permissive cells referred to herein as producer cells
  • producer cells are transfected with the vector system of the present disclosure.
  • Suitable producer cell lines include, but are not limited to, the human embryonic kidney cell line 293, the equine dermis cell line NBL-6, and the canine fetal thymus cell line Cf2TH.
  • the step of collecting the infectious virus particles also can be carried out using conventional techniques.
  • the infectious particles can be collected by cell lysis, or collection of the supernatant of the cell culture, as is known in the art.
  • the collected virus particles may be purified if desired. Suitable purification techniques are well known to those skilled in the art.
  • the sample of HSCs is contacted with at least 10 3 vectors or viral vectors or particles per 10 6 HSC cells in the ex vivo transfection or transduction procedure.
  • the vector carries an exogenous copy of a nucleic acid encoding a PD-L1.
  • Other vector dosage ranges set forth herein for contacting with the sample of HSCs is exemplary only and are not intended to limit the scope or practice of the claimed composition or methods described herein.
  • the vector dosage is ranges from 10 3 -10 8 viral particles/10 6 HSC cells.
  • the vector dosage is ranges from 10 3 -10 5 viral particles/10 6 HSC cells, 10 4 -10 6 viral particles/10 6 HSC cells, 10 5 -10 7 viral particles/10 6 HSC cells, 10 3 -10 8 viral particles/10 6 HSC cells. In one embodiment, the dosage is about 10 4 viral particles/10 6 HSC cells.
  • retroviral or lentiviral vectors, or avian viral vector or adeno-associated viral vectors are ex vivo contacted with the HSCs using standard transfection techniques well known in the art.
  • the retroviral or lentiviral vectors or avian viral vector or adeno-associated viral vectors are transduced into HSCs, hematopoietic progenitor cells or precursors of erythrocytes.
  • compositions comprising the vectors described.
  • the composition includes a lentiviral vector or avian viral vector or adeno-associated viral vectors in an effective amount sufficient to transduce a sample of HSCs and a pharmaceutically acceptable carrier.
  • An “effective amount” with respect to vector transduction refers to an amount effective, at dosages and for periods of time necessary, to achieve the desired result of introducing the exogenous PD-L1 encoding nucleic acid into HSCs.
  • An effective amount of viral vector may vary according to factors such as the disease state, age, sex, and weight of the donor individual, and the ability of the viral vector to elicit a desired response in the transduced HSCs.
  • Dosage regimens may be adjusted to provide the optimum response.
  • An effective amount is also one in which any toxic or detrimental effects of the viral vector are outweighed by the beneficial effects.
  • the potential toxicity of the viral vectors of the disclosure can be assayed using cell-based assays or art recognized animal models and an effective modulator can be selected which does not exhibit significant toxicity.
  • Sterile solutions can be prepared by incorporating lentiviral vector in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization.
  • dispersions are prepared by incorporating the active compound into a sterile vehicle which contains a basic dispersion medium and the required other ingredients from those enumerated above.
  • the preferred methods of preparation are vacuum drying and freeze-drying which yields a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered solution thereof.
  • the PD-L1 + HSC cells or compositions comprising the PD-L1 + HSC cells are sterile and are formulated for therapy in a subject.
  • the subject is a mammal, e.g., a human.
  • the PD-L1 + HSC cells or compositions comprising the PD-L1 + HSC cells comprise serum or plasma.
  • the compositions comprise a cryopreservative, e.g., DMSO.
  • compositions or pharmaceutical compositions are formulated for systemic delivery.
  • the compositions can be formulated for delivery to specific organs, for example but not limited to the liver, spleen, the bone marrow, and the skin.
  • Pharmaceutical compositions comprise pharmaceutically acceptable carrier.
  • compositions or pharmaceutical compositions described herein can be administered together with other components of biologically active agents, such as pharmaceutically acceptable surfactants (e.g., glycerides), excipients (e.g., lactose), carriers, serum, plasma, diluents and vehicles.
  • pharmaceutically acceptable surfactants e.g., glycerides
  • excipients e.g., lactose
  • carriers serum, plasma, diluents and vehicles.
  • compositions or pharmaceutical compositions described herein contain about 1 ⁇ 10 6 cells to about 3 ⁇ 10 6 cells; about 1.0 ⁇ 10 6 cells to about 5 ⁇ 10 6 cells; about 1.0 ⁇ 10 6 cells to about 10 ⁇ 10 6 cells, about 10 ⁇ 10 6 cells to about 20 ⁇ 10 6 cells, about 10 ⁇ 10 6 cells to about 30 ⁇ 10 6 cells, or about 20 ⁇ 10 6 cells to about 30 ⁇ 10 6 PD-L1 expressing cells or HSCs or their progeny.
  • compositions or pharmaceutical compositions described herein contain about 1 ⁇ 10 6 cells to about 30 ⁇ 10 6 cells; about 1.0 ⁇ 10 6 cells to about 20 ⁇ 10 6 cells; about 1.0 ⁇ 10 6 cells to about 10 ⁇ 10 6 cells, about 2.0 ⁇ 10 6 cells to about 30 ⁇ 10 6 cells, about 2.0 ⁇ 106 cells to about 20 ⁇ 10 6 cells, or about 2.0 ⁇ 10 6 cells to about 10 ⁇ 10 6 PD-L1 expressing cells or HSCs or their progeny.
  • compositions or pharmaceutical compositions described herein contain about 1 ⁇ 10 6 hematopoietic stem or progenitor cells, about 2 ⁇ 10 6 cells, about 5 ⁇ 10 6 cells, about 7 ⁇ 10 6 cells, about 10 ⁇ 10 6 cells, about 15 ⁇ 10 6 cells, about 17 ⁇ 10 6 cells, about 20 ⁇ 10 6 cells about 25 ⁇ 10 6 cells, or about 30 ⁇ 10 6 PD-L1 expressing cells or HSCs or their progeny.
  • the dosage of PD-L1+ HSC cells administered to a recipient subject will vary depending upon a variety of factors, including the number of PD-L1+ HSCs available, the level of expression of PD-L1 in the HSCs, route of administration, size, age, sex, health, body weight and diet of the recipient; nature and extent of symptoms of the disease being treated, kind of concurrent treatment, frequency of treatment, and the effect desired.
  • the dosage of PD-L1 expressing HSCs should be large enough a cell population transplanted to ensure sufficient engraftment and reconstitution in vivo after implantation into the subject.
  • the dosage is at least 1 ⁇ 10 4 cells per implantation. In other embodiments, the dosage is at least 5 ⁇ 10 4 cells, at least 1 ⁇ 10 5 cells, at least 5 ⁇ 10 5 cells, at least 1 ⁇ 10 6 cells, at least 5 ⁇ 10 6 cells, at least 1 ⁇ 10 7 cells, at least 5 ⁇ 10 7 cells, at least 1 ⁇ 10 8 cells, at least 5 ⁇ 10 8 cells, at least 1 ⁇ 10 9 cells, at least 5 ⁇ 10 9 cells, or at least 1 ⁇ 10 10 cells or more per implantation into a subject. Second or subsequent administrations can be administered at a dosage which is the same, less than or greater than the initial or previous dose administered to the individual.
  • the dosage of PD-L1+ HSC cells administered to a recipient subject is about at least 0.1 ⁇ 10 5 cells/kg of bodyweight, at least 0.5 ⁇ 10 5 cells/kg of bodyweight, at least 1 ⁇ 10 5 cells/kg of bodyweight, at least 5 ⁇ 10 5 cells/kg of bodyweight, at least 10 ⁇ 10 5 cells/kg of bodyweight, at least 0.5 ⁇ 10 6 cells/kg of bodyweight, at least 0.75 ⁇ 10 6 cells/kg of bodyweight, at least 1 ⁇ 10 6 cells/kg of bodyweight, at least 1.25 ⁇ 10 6 cells/kg of bodyweight, at least 1.5 ⁇ 10 6 cells/kg of bodyweight, at least 1.75 ⁇ 10 6 cells/kg of bodyweight, at least 2 ⁇ 10 6 cells/kg of bodyweight, at least 2.5 ⁇ 10 6 cells/kg of bodyweight, at least 3 ⁇ 10 6 cells/kg of bodyweight, at least 4 ⁇ 10 6 cells/kg of bodyweight, at least 5 ⁇ 10 6 cells/kg of bodyweight, at least 10 ⁇ 10 6 cells/kg of bodyweight, at least 15
  • the dosage is at least 2 ⁇ 10 6 cells/kg bodyweight of the recipient subject. In other embodiments, the dosage is at least 3 ⁇ 10 6 cells/kg of bodyweight, at least 4 ⁇ 10 6 cells/kg of bodyweight, at least 5 ⁇ 10 6 cells/kg of bodyweight, at least 6 ⁇ 10 6 cells/kg of bodyweight, at least 7 ⁇ 10 6 cells/kg of bodyweight, at least 8 ⁇ 10 6 cells/kg of bodyweight, at least 9 ⁇ 10 6 cells/kg of bodyweight, at least 10 ⁇ 10 6 cells/kg of bodyweight, at least 15 ⁇ 10 6 cells/kg of bodyweight, at least 20 ⁇ 10 6 cells/kg of bodyweight, at least 25 ⁇ 10 6 cells/kg of bodyweight, or at least 30 ⁇ 10 6 cells/kg of bodyweight of the subject recipient.
  • the dosage is at least greater than 5 ⁇ 10 6 cells/kg bodyweight of the recipient subject.
  • the dosage is at least greater than 10 ⁇ 10 6 cells/kg bodyweight of the recipient subject.
  • a second or subsequent administration is preferred.
  • second and subsequent administrations can be given between about one day to 30 weeks from the previous administration.
  • Two, three, four or more total administrations can be delivered to the individual, as needed.
  • Effective doses may be extrapolated from dose-response curves derived from in vitro or animal model test systems.
  • Efficacy testing can be performed during the course of treatment using the methods described herein. Measurements of the degree of severity of a number of symptoms associated with a particular ailment are noted prior to the start of a treatment and then at later specific time period after the start of the treatment. For example, the amount of insulin in the blood or blood glucose after a meal.
  • CD34 + cells were isolated from patients (20 ml of blood) using magnetic beads and ⁇ 1 ⁇ 10 6 cells were plated in a U-bottom 96-well plate with 200 ⁇ l of the indicated medium.
  • STFIA medium was defined as serum-free medium supplemented with 10 ⁇ g/ml heparin, 10 ng/ml human SCF, 20 ng/ml human TPO, 10 ng/ml human FGF-1, 100 ng/ml IGFBP2, and 500 ng/ml Angptl3.
  • PGE 2 was added the culture at 0 h, 24 h, 72 h and 6 days.
  • cells are cultured in the same conditions for 48 h in the absence of PGE 2 , after which and PGE 2 is added and then later at 24 h after the initial additional.
  • PGE 2 is added to the same approximate final concentration of PGE 2 of 0.1 ⁇ M.
  • the percentage of CD34 + PD-L1 + cells obtained at day 0 without culturing in healthy subjects is nearly 24%, in individuals with T1D is 8-10%.
  • This protocol produces increased expression of PD-L1 as compared to baseline (at least 5-fold increase).
  • Murine HSCs (Lin ⁇ c-Kit + Sca-1 + , KLS) express PD-L1.
  • Lin ⁇ c-Kit + Sca-1 + cells were sorted from islet-transplanted or na ⁇ ve CXCR4 antagonist-treated mice after 7 and 14 days of treatment.
  • most positive costimulatory molecules were found to be negative or scarcely expressed (CD40, CD80, CD86, PD-L2, ICOS, OX40, OX40L)
  • PD-L1 was highly expressed by mobilized HSCs (58.0 ⁇ 7.1%).
  • Extracted HSCs also expressed CXCR4 (38.4 ⁇ 4.2%).
  • HSC mobilization increases the generation of PD-L1 + HSCs, and PD-L1 + HSCs did not increase in bone marrow from B6 islet-transplanted mice 6 h after the initiation of CXCR4 antagonist treatment.
  • PD-L1 genetic deletion abrogates HSC immunoregulatory properties.
  • To evaluate the immunoregulatory role of PD-L1 in murine HSCs we investigated the effect of mobilized HSCs from WT and PD-L1 KO mice on the alloimmune response in vitro.
  • HSCs from WT B6 or PD-L1 KO mice were syngeneic to responder cells (CD4 + cells from B6) but allogeneic to bone marrow-derived DCs (from BALB/c). While HSCs from WT B6 mice abrogated the MLR response when added to culture, HSCs from PD-L1 KO mice failed to do so ( FIG. 1 ). The percentage of peripheral PD-L1 + HSCs is reduced in NOD mice compared to B6. The percentage of peripheral PD-L1 + KLS in 10-week-old NOD and B6 mice was evaluated by FACS.
  • the percentage of peripheral PD-L1 + HSCs is reduced in T1D individuals as compared to healthy subjects.
  • PD-L1/PD-1 crosslinking delays diabetes onset in NOD mice and islet graft rejection in streptozotocinated B6 mice.
  • We used an anti-PD-1 mAb (hybridoma PIM-2, rat IgG2a) recently developed to stimulate PD-1, thus mimicking PD-L1 crosslinking to PD-1.
  • PIM2 Ab delayed the onset of diabetes in NOD mice and islet allograft rejection (BALB/c into B6), ( FIGS. 4A-4B ). Infusion of PD-L1 transduced KLS reverted hyperglycemia in NOD mice.
  • KLS were isolated from bone marrow of NOD mice and were transduced with PD-L1 pseudoviral particles previously obtained by infecting with a lentivirus vector, expressing a fluorescent marker ZsGreen and PD-L1 gene, 293TN producer cells. After obtaining a high concentration of the virus, KLS can be infected and subsequently expanded as PD-L1 transduced KLS in a 7-day culture. Expression of PD-L1 was under the control of a doxa promoter, thus doxacyclin needs to be injected in order to stimulate PD-L1 expression on transduced cells.
  • Autologous haematopoietic stem cell transplant is an immunosuppressive chemotherapy treatment combined with reinfusion of blood stem cells to help re-build the immune system.
  • AHSCT in new-onset T1D rendered normoglycemic nearly 60% of treated individuals at 6 months.
  • AHSCT in a non-myeloablative setting achieved insulin independence in nearly 60% of T1D individuals within the first 6 months after receiving conditioning immunosuppression (ATG+Cyclophosphamide) and a single infusion of autologous HSCs. 32% of treated subjects remained insulin-independent at the last time point of their follow-up.
  • Treated subjects showed a decrease in HbA1c and an increase in C-peptide levels as compared to pre-treatment.
  • HSCs of T1D individuals are defective in their immunoregulatory properties.
  • Addition of HSCs obtained from healthy subjects led to a dose-dependent decrease of IFN- ⁇ -producing CD4+ T cells.
  • a defect in immunoregulatory properties was evident when HSCs from individuals with T1D were added.
  • HSCs exhibited impaired mobilization in individuals with T1D.
  • CD34+ HSCs cells
  • Padua University Dr. Gianpaolo Fadini
  • CD34+ cells significantly increased in healthy controls
  • an impaired mobilization of CD34+ was observed in T1D individuals. This data confirm the existence of a HSC “mobilopathy” in T1D individuals.
  • HSC mobilization with a CXCR4 antagonist does not increase PD-L1+ HSCs of T1D individuals.
  • Murine we cultured isolated HSCs (KL cells) in a serum-free culture medium supplemented with standard stem cell growth factors and pulsed with the novel small molecule derived from prostaglandins E2 (PGE 2 ) at different timepoints during a 8-day culture. Briefly, peripheral Lin neg Sca-1 + Kit + cells were isolated from 10-week-old NOD mice, and 150-200 plated into each well on a 96-well plate with 200 ml of Stemspan serum-free medium (Stem-Cell Technologies) supplemented as already described.
  • PGE 2 prostaglandins E2
  • PGE 2 which has been shown to implement expansion of murine/human isolated HSCs in vitro and it is now being tested in humans in phase II clinical trials, has been added (2 ⁇ l, 10 ⁇ M, Chemicon) at 24 h, 96 h and at 6 days to enrich the pool of PD-L1 + HSCs newly generated. Cells were cultured for 8 days at 37° C. in 5% CO 2 .
  • human HSCs were cultured using StemSpan supplemented with human stem cell growth factors as previously reported (22). Briefly, CD34 + cells were plated at 5 ⁇ 10 5 cells/ml in supplemented StemSpan on a 96-well plate, at 200 ⁇ l/well for 7 days. HSCs were pulsed with PGE 2 as described in murine experiments. PD-L1 + HSCs were quantified by FACS analysis at different timepoints and at the end of the procedure.
  • Hematopoietic cells will be collected from the patient in advance of the treatment, to serve as a salvage procedure (“back-up graft”), should there be no hematopoietic recovery observed 6 weeks following the injection of genetically-manipulated cells, or should manipulated cells fail to meet release criteria.
  • Bone marrow (up to 20 ml/kg) will be harvested from the patient under general anesthesia from the posterior iliac crests on both sides by multiple punctures at a minimum of 4 weeks prior to gene therapy. A portion of the bone marrow containing 2 ⁇ 10 6 CD34+ cells/kg will be frozen and stored unmanipulated in liquid nitrogen vapors ( ⁇ 162° C. and ⁇ 180° C.) according to standard clinical procedures for autologous bone marrow collection to constitute the back-up graft. The remainder of the harvest will be selected for CD34+ cells (described below) and utilized for gene modification (described below).
  • the remainder of the first bone marrow harvest in excess of the needed back up marrow will be utilized with a second bone marrow harvest for gene transfer.
  • the second harvest will occur no sooner than 4 weeks after the initial harvest (described above).
  • bone marrow will again be harvested from the patient under general anesthesia from the posterior iliac crests on both sites by multiple punctures.
  • the amount of marrow collected will be up to 20 ml/kg of body weight. This will give a total nucleated cell count of greater than ⁇ 4 ⁇ 10 8 cells/kg. This in turn should yield a CD34 + cell dose of greater than 4 ⁇ 10 6 cells/kg after CD34+ cell selection.
  • Subjects from whom the estimated CD34+ count of both harvests is ⁇ 4 ⁇ 10 6 cells/kg will not receive conditioning. After a period of at least 6 weeks, if the subject wishes to remain on study, he may be harvested again. Subjects withdrawn from the study prior to administration of transduced CD34+ cells will resume normal clinical care (supportive care and/or allogeneic HSCT). Efficacy and safety assessments will not be carried out from the point of withdrawal and data will not be collected for the database.
  • whole bone marrow will be held overnight.
  • the bone marrow will be red cell-depleted by density gradient centrifugation.
  • CD34+ cells will be positively selected from the bone marrow mononuclear cells using the CliniMACS reagent and instrument.
  • Quality control (QC) samples are taken to assess purity and sterility. Purified cells will be immediately processed for pre-stimulation and transduction.
  • Transduction will be carried out on one or both harvests. Transduction of cells in excess of the back-up marrow target from the first harvest will be transduced and frozen for future use.
  • the second harvest will be used for gene transfer in its entirety and the transduced product of the second harvest will be infused with the thawed transduced cells from the first harvest after conditioning.
  • Purified CD34+ cells are seeded in closed culture bags at a density of 0.5-1 ⁇ 10 6 /ml in serum-free medium supplemented with growth factors (IL-3, SCF, FLT3L, TPO) and placed in an incubator at 37 C, 5% CO 2 . After 24-30 hours, cells are harvested and counted. Additional QC testing includes cell viability, and Colony Forming Unit (CFU) assay. Cells are transferred to a new culture bag and treated with lentiviral supernatant. For this first round of transduction, cells are incubated for 18-24 hours. Cells are then harvested, counted, and transferred to a new bag, with lentiviral supernatant for a second round of transduction.
  • QC includes cell count, viability, sterility on wash supernatant, Mycoplasma , Endotoxin on supernatant, phenotype, CFU, RCL (samples taken and archived), insertional analysis, and average vector copy number by qPCR (cultured cells).
  • a sample for Gram stain is taken from the product immediately before delivery to the patient.
  • Purified CD34+ cells are seeded in closed culture bags at a density of 0.5-1 ⁇ 10 6 /ml in STFIA medium was defined as serum-free medium supplemented with 10 ⁇ g/ml heparin, 10 ng/ml human SCF, 20 ng/ml human TPO, 10 ng/ml human FGF-1, 100 ng/ml IGFBP2, and 500 ng/ml Angptl3, placed in an incubator at 37 C, 5% CO 2 and cultured for 48 h. The media is changed and PGE 2 is added to the cells to achieve a final concentration of 0.1 ⁇ M. After another 24 h hrs, PGE 2 is added to the cell again. The cells are harvested at 1-8 days after the second PGE 2 addition. For harvest later than day 2, addition PGE 2 in added to the culture media at day 2, day 4 and day 6, together changes of culture media.
  • Samples are collected during and at the end of the procedure for cell count and viability (trypan blue exclusion or equivalent), sterility, mycoplasma, transduction efficiency (vector copy number), Gram stain, endotoxin and RCL testing. Of these only cell viability, sterility (in process, 72 hours), Gram stain and endotoxin measurements will be available prior to infusion.
  • microbiological cultures reveal transient bacterial contamination, by Gram stain or positive culture at 72 hours, Cell Manipulation Core Facility staff will contact the PI, the assistant medical director and attending physician to decide whether to infuse the back-up harvest or infuse the product with antibiotic coverage. If back-up harvest is infused, the subject will be withdrawn from the protocol. If the cell viability is ⁇ 70%, sterility testing is positive, or endotoxin is >5 EU/kg/hr, the cells will not be returned, back-up harvest will be infused and the subject will be withdrawn from the protocol.
  • viable cell count from both harvests/transductions is greater than or equal to 4 ⁇ 10 6 CD34+ cells/kg at the end of transduction, cells will be infused. If viable cell count from both harvests/transductions is less than 4 ⁇ 10 6 CD34+ cells/kg at the end of transduction, cells will not be infused and back-up harvest will be infused 48 hours later.
  • Samples of the CD34+ cells may be tested for PD-L1 expression.
  • Busulfan ⁇ 4 mg/kg intravenously daily, adjusted for weight, (given over 3 hours once daily) administered on days ⁇ 4 to ⁇ 2, prior to infusion of transduced cells. Conditioning will occur concurrent with purification and transduction of bone marrow cells. Busulfan levels will be drawn on all 3 days of administration, and levels on days 1 and 2 will be used to adjust for weight.
  • Cells will be infused intravenously over 30-45 minutes after standard prehydration and premedication according to conventional hospital Hematopoietic Stem Cell Transplantation Unit standard guidelines. This standard requires that the patient be on continuous cardiac, respiratory and oxygen saturation monitor throughout the infusion and for 30 minutes afterwards. Vital signs will be measured and recorded pre-transfusion, 15 minutes into transfusion, every hour for duration of infusion, and end of transfusion. The RN will stay with the patient for the first 5 minutes of the transfusion. If two transduction products are administered, the second transduced product will be administered without delay after the first.
  • ToleraCyteTM a programmed CD34 + /PD-L1 + immuno-regulatory cell product of Fate Therapeutics, Inc., have been show to treat T1D mice.
  • ToleraCyteTM is a programmed CD34+ cell immunotherapy that is undergoing preclinical investigation for the treatment of autoimmune and inflammatory disorders.
  • the immuno-regulatory cell therapy is comprised of CD34+ cells that have been programmed ex vivo with a proprietary combination of pharmacologic modulators.
  • ToleraCyte is designed to optimize the capacity of CD34+ cells to effectively traffic to sites of inflammation and express potent T-cell regulatory factors, including PD-L1 and IDO1.
  • T1D non-obese diabetic mice
  • T1D human Type 1 diabetes
  • ToleraCyteTM results in durable correction of T1D diabetes in a NOD mouse model.
  • the hyperglycemic NOD mice are designed to mimic new-onset type 1 diabetes.
  • PBMC peripheral blood mononuclear cells
  • Exclusion criteria were pregnancy or lactation; recent (within 2 months from study entry) surgery, trauma, or acute diseases; immune diseases (except from type 1 diabetes and autoimmune thyroiditis); chronic infectious diseases; hematologic malignancies either past or present; solid tumor known or strongly suspected; leukocytosis, leukopenia, or thrombocytopenia; solid organ transplant or immunosuppression; alteration of hepatic function (transaminases>2 upper limit of normality); severe chronic diabetic micro- or macroangiopathy; HbA 1c >11%; deficit in renal function (estimated glomerular filtration rate ⁇ 50 mL/min/1.73 m 2 ); significant abnormalities of the peripheral lymphocyte immunophenotype; known hypersensitivity to plerixafor or its excipients; and refusal or inability to provide informed consent.
  • PD-L1 To assess PD-L1, PD-L2 and PD-1 expression on human HSCs, fresh blood collected from healthy individuals, T1D and new-onset T1D individuals was stained with PE-Cy5.5 anti-human CD34, PE anti-human PD-L1 or PD-L2 or PD-1 (BD Biosciences). Fresh blood was also stained with PE anti-human PD-L1 together with PECy7 anti-human-CD19, APC anti-human CD11c or Pacific blue anti-human CD16 (all BD Biosciences) to assess PD-L1 expression on B cells, dendritic cells or monocytes, respectively. BD LSRFortessa flow cytometer (BD Biosciences) was used to analyze cells with the light scatter properties of stem cells or lymphocytes.
  • CD34+ cells were first isolated using magnetic beads (Milteny kit) from PBMCs obtained from blood samples of enrolled subjects. Next, CD34+ cells were stained with CFSE (FITC, Invitrogen C1157) and cultured for 72 hours at 37° C. in 5% CO2 in StemSpam SFEM II media (StemCell Technologies). Proliferation was visualized by flow cytometry according to the dye dilution at 24 h, 48 h and 72 h. To assess whether glucose exposure affects PDL-1 expression on CD34+ cells, we cultured CD34+ cells, previously isolated from PBMCs obtained from CTRL and T1D, in DMEM without serum at different glucose concentrations (5 mM, 20 mM and 35 mM) for 72 h. PDL-1 expression was assessed by FACS as previously described.
  • ELISPOT assay was used to measure the number of IFN- ⁇ -producing cells according to the manufacturer's protocol (BD Biosciences, San Jose, Calif.) as previously showed by our group (16).
  • Cells were collected at day 2 and plated in a human IFN- ⁇ ELISpot assay with or without CD34+ HSCs, Trifecta-modulated CD34+ HSCs in a ratio of 1:1, 1:2, 1:4, or 1:8 in RPMI media un-supplemented. Spots were counted using an A.El.VIS Elispot Reader (A.EL.VIS GmbH, Hannover, Germany) or on an Immunospot Reader.
  • Total proteins of intestinal bioptic samples were extracted in Laemmli buffer (Tris-HCl 62.5 mmol/l, pH 6.8, 20% glycerol, 2% SDS, 5% ⁇ -mercaptoethanol) and their concentration was measured (Lowry et al., 1951). 35 ⁇ g of total protein was electrophoresed on 7% SDS-PAGE gels and blotted onto nitrocellulose (Schleicher & Schuell, Dassel, Germany). Blots were then stained with Ponceau S.
  • Laemmli buffer Tris-HCl 62.5 mmol/l, pH 6.8, 20% glycerol, 2% SDS, 5% ⁇ -mercaptoethanol
  • Membranes were blocked for 1 h in TBS (Tris [10 mmol/l], NaCl [150 mmol/l]), 0.1% Tween-20, 5% non-fat dry milk, pH 7.4 at 25° C., incubated for 12 h with a polyclonal goat anti-human Pdcd-1L1 antibody (Santa Cruz Biotechnology, Santa Cruz, Calif., USA) diluted 1:200 or with a monoclonal mouse anti- ⁇ -actin antibody (Santa Cruz Biotechnology) diluted 1:1000 in TBS-5% milk at 4° C., washed four times with TBS-0.1% TWEEN®-20, then incubated with a peroxidase-labeled mouse anti-goat IgG secondary antibody (or rabbit anti mouse for ⁇ -actin) diluted 1:1000 (Santa Cruz Biotechnology) in TBS-5% milk, and finally washed with TBS-0.1% Tween-20. The resulting bands were visualized using enhanced chemiluminescence (SuperS
  • RNA from isolated CD34+ cells was extracted using Trizol® Reagent (Invitrogen), and qRT-PCR analysis was performed using TaqMan assays (Life Technologies, Grand Island, N.Y.) according to the manufacturer's instructions. The normalized expression values were determined using the ⁇ Ct method. Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) data were normalized for the expression of ACTB, and ⁇ Ct values were calculated. Statistical analysis compared gene expression across all cell populations for each patient via one-way ANOVA followed by Bonferroni post-test for multiple comparisons between the population of interest and all other populations. Statistical analysis was performed also by using the software available RT 2 profiler PCR Array Data Analysis (Qiagen). For two groups comparison Student t test was employed. Analysis was performed in triplicates after isolation of fresh CD34 + cells. Below are reported the main characteristics of primers used:
  • mice Female NOD/ShiLtJ (NOD) and male C57BL/6J mice were purchased from The Jackson Laboratory (Bar Harbor, Me.). All mice were used according to institutional guidelines, and animal protocols were approved by the Boston Children's Hospital Institutional Animal Care and Use Committee.
  • Overt diabetes was defined as blood glucose levels above 250 mg/dL for 2 consecutive days. Blood glucose was measured using the Breeze2 (Bayer S.p.A., Viale Certosa, Milano, Italy) blood glucose meter.
  • mice Female NOD mice were monitored beginning at 10 weeks of age, and on day 2 of hyperglycemia (>250 mg/dl), were injected with KL-PD-L1.Tg cells, or HSCs-unmodulated cells, HSCs-mock-transduced cells or HSCs-modulated with trifecta (see description above), were administered as 3 ⁇ 10 6 cells via vein tail. Mice were monitored daily by measuring blood glucose until the time of sacrifice (normoglycemia was observed the following day post-treatment as below 250 mg/dl), and measurements were performed by tail bleeding according to National Institutes of Health guidelines.
  • Bone marrow cells were obtained from femurs and tibiae of NOD and C57BL/6J mice by flushing with phosphate buffered saline (PBS). Bone marrow cells were lineage depleted by using the Lineage Negative Depletion Kit (Miltenyi Biotec). Upon depletion, lineage negative c-kit + cells were isolated using CD117 Microbeads (Miltenyi Biotec), following the manufacturer's instruction.
  • PBS phosphate buffered saline
  • the following antibodies were used for flow cytometric analysis for assessing phenotypic characterization of KL extracted from bone marrow and spleen: phycoerythrin (PE)-conjugated anti-human PD-L1 (CD274) or allophycocyanin (APC)-conjugated rat anti-mouse PD-L1 (CD274), phycoerythrin (PE)-conjugated rat anti-mouse PD-1 (CD279), phycoerythrin (PE)-conjugated rat anti-mouse PD-L2 (CD273), were purchased from BD Biosciences or Biolegend respectively.
  • the following antibodies corresponded to different isotype controls for the abovementioned murine antibodies: PE Mouse IgG1, ⁇ Isotype Ctrl; and APC Mouse IgG2b, ⁇ Isotype Ctrl.
  • Murine KL cells previously extracted from bone marrow were suspended in 200 ⁇ L, of buffer, then stained with the following antibodies and incubated according to manufacturer's instructions for 30 minutes at 4° C. Cells were washed with buffer, centrifuged at 300 g for 10 minutes and suspended in 300 ⁇ l of buffer. The following antibodies were used for the staining: Rat anti-mouse CD274 or CD273 or anti-mouse CD279. PD-L1, PD-L2 and PD-1 expression on KL cells was represented as histograms.
  • Anti-Lineage negative cocktail-APC Anti-C-kit-PerCP, anti-Sca1-FITC, anti-CD150-PE, anti CD41FITC, anti-CD48-PerCP, anti-CD244 PerCP, anti-PD-L1-PE and anti-PD-L1-APC. All antibodies were purchased from eBioscience and from BD Pharmingen. Samples will be incubated for 30 min in the dark at 4° C. and then washed again with Flow Medium and eventually fixed with Formalin 1%. Samples will be examined at FACS Calibur and results will be analysed using Flowjo software.
  • Isolated KL cells were washed twice with cold PBS and then resuspended in 1 ⁇ Binding Buffer (component no. 51-66121E; BD Pharmingen) at a concentration of 1 ⁇ 10 6 cells/ml. Then 100 ⁇ l of the solution (containing 1 ⁇ 10 5 HSCs) were transferred into a 5 ml culture tube and proceeded by a staining with 5 ⁇ l of PE Annexin V and 5 ⁇ l 7-AAD and followed by a vortex of cells and incubation for 15 min at RT (25° C.) in the dark. After incubation, 400 ⁇ l of 1 ⁇ Binding Buffer to each tube were added to each tube prior to their acquisition by flow cytometry.
  • 1 ⁇ Binding Buffer component no. 51-66121E; BD Pharmingen
  • the following controls were used to set up compensation and quadrants: unstained cells, cells stained with PE Annexin V (no 7-AAD) and cells stained with 7-AAD (no PE Annexin V). Cells that stained positive for PE Annexin V and negative for 7-AAD were undergoing apoptosis. Cells that stained positive for both PE Annexin V and 7-AAD were either in the end stage of apoptosis, were undergoing necrosis, or were already dead. Cells that stained negative for both PE Annexin V and 7-AAD were alive and not undergoing measurable apoptosis.
  • Isolated KL cells were washed twice with cold PBS buffer without FCS, then resuspended in half final volume of buffer at 3 ⁇ 10 7 cells/ml and into the other half of volume was added CFSE to reach a final concentration of 10 ⁇ M. Diluted CFSE will be added to cell suspension followed by a vortex and incubation at 37° C. for 15 minutes. After incubation, FCS was added to cell suspension in order to quench any remaining free CFSE, and the tube will be filled completely with PBS buffer. After a second wash, cells were resuspended in media and were cultured for 3 days at 37° C. in 5% CO 2 . After 72 h proliferation of KL cells can be visualized at flow cytometry according to the dye dilution.
  • ELISPOT assay was used to measure the number of IFN- ⁇ -producing cells according to the manufacturer's protocol (BD Biosciences, San Jose, Calif.) as previously showed by our group (16).
  • Spots were counted using an A.El.VIS Elispot Reader (A.EL.VIS GmbH, Hannover, Germany)
  • Lenti-XTM 293T Cell Line used in this study was purchased from Clontech as recommended. All procedures involving human cell line HEK293T and lentiviral methodologies were approved by the Institutional Biosafety Committee (IBC) of Boston Children's Hospital Committee, Harvard Medical School.
  • IBC Institutional Biosafety Committee
  • VSV-G pseudotyped lentiviruses were generated by co-transfection of the murine PD-L1 transfer plasmid together with the packaging expression plasmids (Gag/Pol, Tat, Rev) and the envelope expressing plasmid encoding for VSV-G into 293T cells using the Trans-IT 293 transfection reagent (Minis).
  • KL cells isolated from NOD.FVB-Tg(CAG-luc,-GFP)L2G85Chco/FathJ were purchased from Jackson Laboratory then were transduced with PD-L1 lentivirus and injected to NOD-hyperglycemic. After 24 hours, treated mice were injected with luciferin. Following luciferin injection, luciferase expression is assessed by IVIS Spectrum. Details of the whole procedure can be found in supplemental methods.
  • Murine bone marrow KL cells were isolated using magnetic beads and MACS® separation columns (Miltenyi) and ⁇ 2 ⁇ 10 5 cells were plated in a U-bottom 96-well plate (3799; Corning) with 200 ⁇ l of the following medium.
  • Stemspan-SFEMII StemCell Technologies
  • Cells were cultured for 24 hours at 37° C. in 5% CO 2 .
  • PD-L1 expression was evaluated before culture by FACS using rat anti-mouse PD-L1 (BD Pharmingen) with the corresponding isotype control Rat IgG2a, ⁇ (BD Pharmingen).
  • Isolated KL cells were resuspended in SFEMII (StemCell Technologies) supplemented with 50 ng/ml of recombinant human SCF (StemCell Technology), 50 ng/ml of Mouse TPO (StemCell Technology), 50 ng/ml of Recombinant Mouse IL-3 (R&D SYSTEMS), Recombinant Mouse IFN- ⁇ (1000 U/ml) (R&D SYSTEMS), Mouse IFN- ⁇ (5 ng/ml) (R&D SYSTEMS) and 1 ⁇ g/ml of human Ploy (I:C) (Polyinosinic-polycytidylic acid) (InvivoGen).
  • SFEMII StemCell Technologies
  • Murine KL cells were homogenized in RIPA buffer (20 mM Tris pH 8.0, 150 mM NaCl, 0.1% SDS, 0.5% DOC, 0.5% triton X-100) with protease inhibitors cocktail (Roche). Cell lysates equivalent to 50 ⁇ g of total protein were fractionated on 4%-20% SDS-polyacrylamide gradient gels (Bio-Rad) and transferred to nitrocellulose membranes (0.2 ⁇ m, Bio-Rad). Membranes were blocked with 5% BSA at room temperature for 1 hour and then incubated overnight with anti-PD-L1 (Santa Cruz Biotechnology), anti-Rabbit GAPDH (Cell Signaling TECHNOLOGY). Detection was performed by using anti-rabbit IgG, HRP-linked antibodies.
  • Bone marrow extracted from femur and tibiae of 8 weeks old NOD and B6 mice were embedded in OCT and snap frozen in ⁇ 80° C. N-methylbutane chilled in a slurry of ethanol and dry ice. Sections (7 ⁇ m) were prepared using a Microtome and air dried then stained with the corresponding antibodies. Images were captured on Zeiss LSM 510 Meta confocal microscope (Carl Zeiss SpA). Details of the staining procedure can be found in supplemental procedures.
  • RNA isolation was conducted using Arcturus PicoPure RNA Isolation Kit (Applied Biosystems) and then diluted to roughly 1.0 ng.
  • RNA integrity was assessed for all RNA samples and the final concentration was measured on a Bioanalyzer using RNA Pico Chips (Agilent Technologies). Only RNA with a RIN score of 7 or higher were used. Between 1-2 ng was used as template to construct cRNA through a series of reactions involving cDNA synthesis, adaptor synthesis and a 16 hr amplification step (Affymetrix).
  • ss-cDNA was synthesized, fragmented and labeled (Affymetrix).
  • Each MTA 1.0 or HTA 2.0 Genechip was hybridized for 17 hrs at 45 C. Arrays were then stained on a FS450 Fluidic station (Affymetrix) and scanned on a Gene Chip 7G Scanner (Affymetrix). Probe intensities were normalized according to a log scale robust multi-array analysis (Expression Console—RMA, Affymetrix) method and normalized intensities were plotted with Spotfire 6.0 (PerkinElmer).
  • PD-L1 is Defective in HSCs from NOD Mice—
  • HSCs hematopoietic stem cells
  • PD-L1 defect was mainly restrained to the HSC populations in NOD mice, as other bone marrow-derived immune relevant cells (e.g.; B220 + B lymphocytes cells, CD11c + dendritic cells and F4/80+ macrophages) were not defective in PD-L1 (data not shown).
  • Other costimulatory molecules e.g.; PD-L2, PD-1, CD40, CD80 and CD80
  • HSCs from NOD displayed a higher percentage of AnnexinV+/7-AAD-apoptotic cells as compared with HSCs from C57BL/6, after 24 hours and 72 hours of culture, an opposite scenario was evident with more apoptotic HSCs in C57BL/6 as compared to HSCs from NOD (data not shown).
  • Our data confirmed the existence of a HSC-specific defect in PD-L1 expression in NOD mice, mainly restrained to hematopoietic stem cells populations.
  • Isolated murine HSCs were transduced with PD-L1 pseudoviral particles previously obtained by infecting HEK 293TN producer cells with a lentivirus vector containing PD-L1 gene whose expression was under the control of a doxycycline promoter, and a fluorescent marker designed as ZsGreen.
  • PD-L1 + .Tg HSCs with an efficiency of 60% positive PD-L1 + cells as compared to nearly 7% pre-transduction ( FIGS. 9A-9C ).
  • PD-L1 + Tg.HSCs generated from normoglycemic NOD mice were cocultured at 3 different ratios to CD4+CD25 ⁇ T cells (1:1; 1:5 and 1:10) with CD11c + DCs and BDC2.5 transgenic CD4 + CD25 ⁇ T cells in the presence of the islet mimotope peptide BDC2.5.
  • IFN- ⁇ + CD4 + CD25 ⁇ T cells as quantified by flow cytometry, showed a significant decrease when coculture with PD-L1 + .Tg HSCs at high ratio (p ⁇ 0.005) compared with non transduced HSCs (KL cells) ( FIGS. 9D and 9E ).
  • CD4 + CD25 ⁇ T cells extracted from NOD normoglycemic were stimulated by soluble anti-CD3/anti-CD28 and cocultured with PD-L1 + .Tg HSCs at 3 different ratios to CD4 + CD25 ⁇ T cells (1:1; 1:5 and 1:10).
  • the immunoregulatory effect was confirmed with a significant decrease in the percentage of IFN- ⁇ + CD4 + CD25 ⁇ T cells when PD-L1 + .Tg HSCs were added, although less evident as compared to the autommune assay, but still PD-L1 dependent ( FIGS. 9F and 9G ).
  • Immunophenotype of PD-L1 + .Tg HSCs-treated hyperglycemic NOD-mice showed at day 14 after treatment a two fold increase in the percentage of FoxP3 + regulatory CD4 + T cells as compared to untreated mice, while no changes were observed in the percentage of IFN- ⁇ + and IL-17 + CD4 + /CD8 + T cells (data not shown).
  • PD-L1 + .Tg HSCs once infused into hyperglycemic NOD preferentially traffic to the pancreas (data not shown) and home to a lower extent to the spleen and PLN (data not shown). While, PD-L1 + .Tg HSCs preferentially home to bone marrow into normoglycemic NOD (data not shown). GFP + cells were visualized by confocal imaging into the pancreas of PD-L1 + .Tg HSCs treated hyperglycemic, but not normoglycemic, NOD mice NOD (data not shown).
  • Luminescence images of NOD-hyperglycemic adoptively transferred with Luciferase + PD-L1.Tg KL cells within 24 hours of treatment further confirmed our data.
  • T1D a genetic approach to cure T1D might not be an easy task, we explore the feasibility of a PD-L1 pharmacological modulation by small molecules.
  • We came out with a cocktail of 3 agents that we named Trifecta: IFN- ⁇ , IFN- ⁇ , PolyI:C) capable of strongly upregulating PD-L1, (from nearly 6% of PD-L1 + cells in a population of HSCs up to 65% of PD-L1 + cells in the population after treatment with Trifecta) and creating programmed HSCs (pHSCs).
  • pHSCs generated from normoglycemic NOD mice were cocultured at 3 different ratios to CD4 + CD25 ⁇ T cells (1:1; 1:5 and 1:10) with CD11c + DCs and BDC2.5 transgenic CD4+CD25 ⁇ T cells in the presence of BDC2.5 peptides.
  • the quantification by flow cytometry of IFN- ⁇ + CD4 + CD25 ⁇ T cells revealed a pronounced and significant decrease when pHSCs were added (p ⁇ 0.005) compared to controls (data not shown).
  • pHSCs were pre cultured with an anti-PD-L1 blocking mAb the immunoregluatory effect was hampered (data not shown).
  • the PD-L1 dependent immunoregulatory properties were confirmed by using the CD8-dependent assay where pHSCs were cocultured at 3 different ratios (1:1; 1:5 and 1:10) with CD11c + DCs and 8.3 NOD transgenic CD8 + T cells in the presence of the islet mimotope peptide IGRP.
  • CD4 + CD25 ⁇ T cells extracted from NOD normoglycemic were stimulated by soluble anti-CD3/anti-CD28 and cocultured with pHSCs at 3 different ratios to CD4 + CD25 ⁇ T cells (1:1; 1:5 and 1:10).
  • pHSCs In order to evaluate the immunoregulatory properties in vivo of pHSCs, newly hyperglycemic NOD mice were adoptively transferred with 3 ⁇ 10 6 pHSCs. Infused pHSCs successfully reverted diabetes in 40% of NOD mice with 30% of treated hyperglycemic NOD mice remaining normoglycemic till the completion of the study at day 40. Kaplan-Meier curve showed a stronger effect of PD-L1 + .Tg HSCs in reverting hyperglycemia in NOD mice, with pHSCs performing a little bit less better.
  • Immunophenotype of treated NOD-mice showed at day 40 after treatment a reduction in the percentage of IFN- ⁇ + CD4 + and IL ⁇ 17 and IFN- ⁇ + CD8 + T cells (data not shown). while no effect on Tregs (FoxP3 + regulatory CD4 + T cells) was detected.
  • FIGS. 10A-10C A western blot analysis and PCR analysis performed on RNA extracted from CD34 + cells previously isolated from PBMCs, confirmed PD-L1 reduced expression in HSCs obtained from healthy subjects as compared to those obtained from T1D individuals ( FIGS.
  • PBMCs depleted of HSCs were cocultured with HSCs or hpHSCs at 3 different ratios to PBMCs (1:1; 1:5 and 1:10) in the presence of insulin-associated autoantigen-2 (I-A2), and IFN- ⁇ production by I-A2 stimulated PBMCs was assessed in an ELISPOT assay.
  • I-A2 insulin-associated autoantigen-2
  • NRG-Akita hyperglycemic mice have firstly received human PBMCs (10 ⁇ 10 6 cells) followed by islet transplantation with human islets ( ⁇ 2000 IEQ) and were then adoptively transferred with 1 ⁇ 10 6 pHSCs (data not shown). Infused pHSCs successfully maintained NRG-Akita mice normoglycemic in NRG-Akita mice till the completion of the study.

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