In this Project we will focus on the biology of GVHD and immune regulation by utilizing novel imaging strategies, immune assessments, animal modeling and clinical translational studies to develop a deeper understanding of GVHD and GVT reactions. For the first time, we will explore a novel imaging strategy to image activated T cells, the known effector cells in GVHD, to explore the fate of adoptively transferred cells in the setting of GVHD induction. This approach, if proven to be successful, can also be utilized by a number of other Projects in this Program to explore the biological fate of adoptively transferred T cells. We will also explore the biological activity and translational capability of invariant natural killer T (iNKT) cells. Our prior work has demonstrated that iNKT cells have remarkable biological function and are approximately 20-50x more potent than Treg in suppressing GVHD in murine models of HCT. There is also compelling clinical correlative studies to justify intense interest in this cell population. Interestingly, iNKT cells function at very early time points within hours to days following HCT and result in the expansion of Treg highlighting the immune regulatory networks that are critical for proper immune regulation. We will build upon our findings that iNKT cells can be expanded ex vivo and can be used from third party donors with equal efficacy as compared to donor derived cells which is likely to aid in clinical translation. Our goals are to study the biology of iNKT cells in the setting of HCT with the goal of developing an effective strategy to reduce the risk of GVHD while maintaining or enhancing GVT reactions and to develop strategies for their clinical translation in the setting of HCT. We will determine whether in vivo imaging of activated T cells can be successfully imaged to non-invasively identify patients with GVHD and those who are at high risk for developing GVHD with the ultimate goal of earlier intervention that may be more effective. We will test whether invariant NKT cells result in the expansion of a population of Treg with enhanced function resulting in prevention of GVHD and can be engineered to maintain or enhance GVL activities. We will test the hypothesis that iNKT cells hold great promise in reducing the risk of GVHD while maintaining GVT reactions and through the proposed studies our goal is to develop strategies to isolate and expand donor or third party iNKT cells for GVHD prevention and improvement in GVHD free, relapse free survival.

Public Health Relevance

Immune function is critical in health and disease as is clearly demonstrated in the setting of allogeneic hematopoietic cell transplantation where immune recognition of the malignancy, termed the graft vs tumor (GVT) effect, is critical to favorable outcomes whereas graft vs host disease (GVHD) can result in significant morbidity and mortality. In this proposal we develop novel approaches to image activated T cells in patients and explore the role of potent immune regulatory mechanisms with a focus on invariant natural killer T cells to prevent GVHD while reducing the risk or treating disease relapse. Our goals are to develop a deeper understanding of the biology of GVHD while promoting GVT responses and develop clinical strategies to improve patient outcomes.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Program Projects (P01)
Project #
5P01CA049605-30
Application #
10018813
Study Section
Special Emphasis Panel (ZCA1)
Project Start
1997-05-01
Project End
2024-08-31
Budget Start
2020-09-01
Budget End
2021-08-31
Support Year
30
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Stanford University
Department
Type
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
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