We give thanks to the Cellular Immunotherapies-Investigator Initiated Trials Award Intramural Funding Opportunity from Moffitt Cancer Center for providing the funding for this protocol development. We also thank Dr. Claudio Anasetti for his invaluable help and guidance through this project. Finally, we thank Dr. Justin Boucher for his insights and review of the manuscript.

NOTE: IRB approval was obtained, and informed consent was obtained from the donors.
1. Lymphocyte isolation
<ol>
	<li>Transfer the apheresis product to a clean room. 
	NOTE: Process validation was performed using normal donor apheresis from an external commercial vendor compliant with raw cellular material collection regulations.</li>
	<li>Collect samples for sterility testing, cell count, and cell phenotyping.</li>
	<li>Elutriate on the counterflow centrifugation device using a primary medium of Hanks Balanced Salt Solution with 1% human serum albumin (HSA) and a secondary medium of saline solution (0.9% sodium chloride Injection USP) or Dulbecco&#39;s Phosphate-Buffered Saline (DPBS). Set the elutriation centrifugation speed at 900 &#215; g and collect fractions based on flow rate and time.</li>
	<li>Collect samples from fraction 2 and perform the following tests: 2 mL for sterility testing; 0.5 mL for cell count and viability using acridine orange/propidium iodide (AO/PI); 5 &#215; 106 cells for cell phenotyping by flow cytometry.</li>
	<li>Expand a pure lymphocyte fraction (fraction 2) of cells in culture at 10 &#215; 106 cells/cm2 in a 1 L closed-system bioreactor with 5 &#181;mol/L of zoledronic acid and 300 IU/mL of IL-2.</li>
	<li>Incubate for seven days in an incubator set at 37 &#176;C with 5% CO2.</li>
</ol>
2. Alpha-beta (&#945;&#946;) T cell depletion
<ol>
	<li>Harvest cells from the 1 L closed-system bioreactor flask. Sterile-weld a 1 L transfer pack to the red line of the closed-system bioreactor, and use the appropriate pharmaceutical pump to transfer the cells into the transfer pack.</li>
	<li>Take the following samples: 10 mL for spent medium sterility; 0.5 mL of cells for cell count and viability using AO/PI; 5 &#215; 106 cells for flow cytometry</li>
	<li>Resuspend the cells at ~5 &#215; 108 cells/mL in phosphate-buffered saline (PBS) or (PBS/ethylenediaminetetraacetic acid (EDTA)) buffer + 0.5% HSA and biotinylated TCR &#945;&#946;-specific antibody.</li>
	<li>Place the shaker in the refrigerator and incubate the cells at 2-8 &#176;C for approximately 15 min with shaking.</li>
	<li>Wash the cells with a total of 600 mL of PBS/EDTA buffer + 0.5% HSA. Centrifuge to remove the unbound antibody at 200-500 &#215; g for 15 min at 2-8 &#176;C. Resuspend ~5 &#215; 108 cells/mL in PBS/EDTA buffer + 0.5% HSA with anti-biotin-specific microbeads (7.5 mL/1 vial).</li>
	<li>Place the shaker in the refrigerator and incubate the cells at 2-8 &#176;C for approximately 15 min with shaking. After incubation, centrifuge the cells at 200-500 &#215; g for 15 min at 2-8 &#176;C to remove the unbound microbeads. Resuspend ~6 &#215; 107 cells/mL in PBS/EDTA buffer + 0.5% HSA and transfer them to a transfer pack bag.</li>
	<li>Install the tubing set in the clinical grade magnetic cell separation device by following the manufacturer&#39;s instructions, place the packs with the PBS/EDTA buffer and the transfer pack with the cell product in the instrument and spike it when instructed by the instrument.</li>
	<li>Select the Depletion 1.2 protocol for the depletion of the labeled &#945;&#946; T cells.</li>
	<li>Centrifuge the target fraction (enriched &#947;&#948; T cells) and resuspend the cells in medium supplemented with 10% human AB serum.</li>
	<li>Take a 0.5 mL sample and perform a cell count and viability with AO/PI stain. Bring cells to a final concentration of approximately 1 &#215; 106 cells/mL. Take a sample of 5 &#215; 106 cells of the product for flow cytometry phenotyping post-depletion.</li>
</ol>
3. Co-culture with aAPCs
<ol>
	<li>Irradiate 5 &#215; 107 aAPCs/flask at 100 Gy on the X-ray generating instrument.</li>
	<li>Use the aAPCs in co-culture at a 10:1 ratio with the &#947;&#948; T cells. Place the irradiated aAPCs (5 &#215; 107 cells/flask) and &#947;&#948; T cells (5 &#215; 106 cells/flask) in 1 L closed-system bioreactor flasks with 1 L of culture medium supplemented with 10% human AB serum. Seed up to 10 flasks.</li>
	<li>Expand the cells in culture for 10 days in an incubator at 37 &#176;C and 5% CO2.</li>
	<li>Monitor glucose and lactate levels every 3-4 days using strips, glucose, and a lactate meter.</li>
	<li>If glucose drops to 250 mg/dL, reduce the volume in the flask to 200 mL using a pharmaceutical pump by sterile-welding a 1 L transfer pack to the red line of the closed system bioreactor.</li>
	<li>Mix the cells in the remaining 200 mL, and take a 0.5 mL sample for cell counting and viability measurement by AO-PI staining. If the cell count is &#8805;109, split one flask into two flasks and fill each flask up to 1 L with AIM-V supplemented with 10% human AB serum. If the cell count is &#60;109, feed the cells with a fresh liter of culture medium supplemented with 10% human AB serum.</li>
	<li>Repeat step 3.6 for all the flasks and return them to the incubator at 37 &#176;C and 5% CO2. Repeat steps 3.4-3.7 every 3 to 4 days.</li>
</ol>
4. Cell harvest
<ol>
	<li>At the end of 10 days in co-culture, harvest all the bioreactor flasks. Harvest 1 bioreactor flask at a time, and pool all the cells into a transfer pack of appropriate size. Sterile-weld the transfer pack to the red line of the closed-system bioreactor, and use the pharmaceutical pump to transfer the cells into the transfer pack.</li>
	<li>Remove the following quality control samples: 1% of the drug product (DP) for sterility by blood culture and gram staining; 0.5 mL for cell counting and viability using AO/PI; 5-10 &#215; 106 cells for flow cytometry (see Figure 1 for gating strategy); 0.5 mL for endotoxin; 0.5 mL for gram staining; 106 cells spiked into 10 mL of spent medium for Mycoplasma testing.</li>
	<li>Centrifuge the cells at 200-500 &#215; g for 15 min at room temperature and discard the supernatant.</li>
	<li>Wash the cells in a solution of balanced crystalloid solution+ 0.5% HSA at 200-500 &#215; g for 15 min at room temperature. Resuspend them in a target volume of 100-300 mL of balanced crystalloid solution + 0.5% HSA.</li>
</ol>
5. Release testing
<ol>
	<li>Perform quality control testing of the &#947;&#948; T cell DP for the following: purity and Identity by flow cytometry (Live/Dead, CD45, CD3, TCR &#945;&#946;, TCR &#947;&#948;, CD20, CD56, CD16); viability by AO/PI staining; endotoxin; Mycoplasma testing by polymerase chain reaction (PCR); sterility by gram staining and aerobic and anaerobic blood cultures; residual K562 assay by flow cytometry (CD3-CD16-CD56-CD71+).</li>
</ol>

<ol>
	<li>Bejanyan, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Survival+of+patients+with+acute+myeloid+leukemia+relapsing+after+allogeneic+hematopoietic+cell+transplantation:+a+center+for+international+blood+and+marrow+transplant+research+study.">Survival of patients with acute myeloid leukemia relapsing after allogeneic hematopoietic cell transplantation: a center for international blood and marrow transplant research study.</a> Biology of Blood and Marrow Transplantation. 21 (3), 454-459 (2015).</li><li>Bejanyan, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+outcomes+of+AML+patients+relapsing+after+matched-related+donor+and+umbilical+cord+blood+transplantation.">Clinical outcomes of AML patients relapsing after matched-related donor and umbilical cord blood transplantation.</a> Bone Marrow Transplantation. 49 (8), 1029-1035 (2014).</li><li>Schmid, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment,+risk+factors,+and+outcome+of+adults+with+relapsed+AML+after+reduced+intensity+conditioning+for+allogeneic+stem+cell+transplantation.">Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation.</a> Blood. 119 (6), 1599-1606 (2012).</li><li>Siegers, G. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anti-leukemia+activity+of+in+vitro-expanded+human+gamma+delta+T+cells+in+a+xenogeneic+Ph++leukemia+model.">Anti-leukemia activity of in vitro-expanded human gamma delta T cells in a xenogeneic Ph+ leukemia model.</a> PLoS One. 6 (2), 16700 (2011).</li><li>Airoldi, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=&#947;&#948;+T-cell+reconstitution+after+HLA-haploidentical+hematopoietic+transplantation+depleted+of+TCR-&#945;&#946;+/CD19++lymphocytes.">&#947;&#948; T-cell reconstitution after HLA-haploidentical hematopoietic transplantation depleted of TCR-&#945;&#946;+/CD19+ lymphocytes.</a> Blood. 125 (15), 2349-2358 (2015).</li><li>Acuto, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+human+T+cell+receptor:+appearance+in+ontogeny+and+biochemical+relationship+of+alpha+and+beta+subunits+on+IL-2+dependent+clones+and+T+cell+tumors.">The human T cell receptor: appearance in ontogeny and biochemical relationship of alpha and beta subunits on IL-2 dependent clones and T cell tumors.</a> Cell. 34 (3), 717-726 (1983).</li><li>Xiao, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Large-scale+expansion+of+V&#947;9V&#948;2+T+cells+with+engineered+K562+feeder+cells+in+G-Rex+vessels+and+their+use+as+chimeric+antigen+receptor-modified+effector+cells.">Large-scale expansion of V&#947;9V&#948;2 T cells with engineered K562 feeder cells in G-Rex vessels and their use as chimeric antigen receptor-modified effector cells.</a> Cytotherapy. 20 (3), 420-435 (2018).</li><li>Peters, C., Kouakanou, L., Oberg, H. H., Wesch, D., Kabelitz, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vitro+expansion+of+V&#947;9V&#948;2+T+cells+for+immunotherapy.">In vitro expansion of V&#947;9V&#948;2 T cells for immunotherapy.</a> Methods in Enzymology. 631, 223-237 (2020).</li><li>Xu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Allogeneic+V&#947;9V&#948;2+T-cell+immunotherapy+exhibits+promising+clinical+safety+and+prolongs+the+survival+of+patients+with+late-stage+lung+or+liver+cancer.">Allogeneic V&#947;9V&#948;2 T-cell immunotherapy exhibits promising clinical safety and prolongs the survival of patients with late-stage lung or liver cancer.</a> Cellular &amp; Molecular Immunology. 18 (2), 427-439 (2021).</li></ol>

The authors have no conflicts of interest to disclose.

The Moffit Cell Therapy Lab has developed a protocol with a biphasic expansion of highly pure &#947;&#948; T cells for use as a DP in clinical trials. This protocol provides a manufacturing method under cGMP guidelines in a closed system that yields a highly pure &#947;&#948; T cell DP that is successfully activated and expanded by zoledronic acid and the WCB aAPCs. This protocol has been approved by the FDA for the manufacture of an allogeneic &#947;&#948; T cell DP for AML patients. Using healthy donors, we successfully expanded the small population of donor &#947;&#948; T cells in just 7 days from 2.06 &#177; 0.45% to 54.45 &#177; 28.34%. After the 7-day expansion with zoledronic acid, it was observed that donor 2 had an increase in the NK population.
Zoledronic acid inhibits farnesyl diphosphate synthase (FDPS) in monocytes, which, in turn, leads to the accumulation of isopentenyl pyrophosphate (IPP), which has been correlated with a significant increase in the proliferation of T cells and natural NK cells7,8,9. This increased NK population hinders the 2nd phase of expansion with the aAPCs, as the aAPCs will only contribute to the further expansion of NK cells. For this reason, the donor criteria were modified to exclude donors with high NK populations. After depletion of the &#945;&#946; T cells, the &#947;&#948; T cells were further enriched to 76.61 &#177; 27.51%. This unique protocol includes a second expansion utilizing the Moffit-manufactured aAPCs to target the CD8, CD28, and CD127L receptors in the &#947;&#948; T cells. This second expansion phase with the aAPCs yielded a DP with &#8805;65% for CD3+TCR &#947;&#948;+ T cells, &#8804;1% TCR&#945;&#946; T, and &#60;35% CD3-CD16+CD56+ NK cells. Owing to the use of K562-derived aAPCs, it was necessary to demonstrate that these aAPCs comprised &#60;1% of the final product.
The Moffit CTF developed a flow cytometric assay used for the release criteria to measure the percentage of the residual K562 cells in the final DP. This flow cytometric assay mitigates all the issues of utilizing cell surface antigens to identify the K562 cells. As activated T cells can express CD71, we devised a strategy to exclude all T cells and NK cells by gating on CD3- CD56- and CD16- populations and then examining the CD71+ cells, which would be exclusively K562 cells. This protocol demonstrates that the &#947;&#948; T cell DP yields 0.48 &#177; 0.42% of residual K562 cells and meets all the release criteria of &#8805;70% viability, Mycoplasma negativity by PCR, no organisms seen by gram staining, &#8804;2 EU/mL of endotoxin, and no growth final (14 days) blood culture sterility.

Leukemia relapse is the leading cause of mortality after hematopoietic cell transplantation (HCT) in patients with AML1,2,3. Better leukemia-free survival was reported with the increased recovery of blood &#947;&#948; T cells after HCT without increased risk of Graft-versus-Host Disease (GVHD)4. The ability of &#947;&#948; T cells to recognize antigens in an MHC-independent manner and develop strong cytolytic and Th1-like effector functions make this minor subpopulation of T cells ideal for the treatment of AML patients undergoing allogeneic transplantation at risk for relapse5. Given that the V&#947;9V&#948;2 T cells are a minor subset of T lymphocytes ranging from 0.5% to 5% of T cells in the periphery6, we set out to establish a robust system to expand this rare population of blood cells to achieve potentially therapeutic doses for clinical trials.
Although others have successfully expanded &#947;&#948; T cells using zoledronic acid and even aAPCs, we have developed a process that can potentially expand &#947;&#948; T cells by 229,749-fold. The expansion is biphasic: first, lymphocytes are obtained by elutriation using the separation instrument. The equipment provides a closed system that allows the separation of cells based on their size, shape, and density by counterflow centrifugation. After enriching for lymphocytes, selective expansion of V&#947;9V&#948;2 T cells is achieved by treatment with zoledronic acid and IL-2 for 7 days. Immediately following this treatment, TCR-&#945;&#946; T cells are depleted using microbead technology, allowing for subsequent expansion of the &#947;&#948; T cells with K562-derived aAPCs.
For process validation, only 5 &#215; 106 zoledronic acid-expanded &#947;&#948; T cells were used for the phase-2 co-culture expansion with aAPCs. In this second phase of expansion, &#947;&#948; T cells are activated using a current Good Manufacturing Practices (cGMP)-compliant Working Cell Bank (WCB) of genetically engineered K562-derived aAPCs (K562VL6(scFv-CD3-41BBL;scFv-CD28-IL15-RA)) manufactured at Moffitt. The rationale of this biphasic expansion is based on the ability of zoledronic acid to inhibit farnesyl diphosphate synthase (FDPS) in monocytes, leading to the accumulation of isopentenyl pyrophosphate, which directly stimulates the V&#947;2V&#948;2 cells. In the second phase of expansion, the K562-derived aAPCs (K562VL6(scFv-CD3-41BBL;scFv-CD28-IL15-RA)) provide a robust stimulation to all T cells. However, the cell product has already been enriched for the &#947;&#948; T cells, resulting in a robust expansion of the &#947;&#948; T cells.
With the use of specific equipment and flasks, the process is a functionally closed system, thus decreasing the risk of contamination. In addition, the 1 L closed-system bioreactor facilitates maximal growth and expansion of cells in a total volume of 1 L of medium with minimal need for feeding. The advantage of the Moffitt method is that it provides a rapid, reproducible, and highly feasible GMP system to produce a highly pure, donor-derived &#947;&#948; T cell product for allogeneic administration. This method can be applied to any clinical trial that aims at using human &#947;&#948; T cells expressing V&#947;2V&#948;2 T cell receptors as adoptive immunotherapy to mediate immunity against microbes and tumors in cancer patients with partial and complete remission. In addition, it provides a robust platform for the development and production of &#947;&#948; chimeric antigen receptor-positive (CAR+) T cells.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Hanks Balanced Salt Solution</td>
			<td>R&#38;D</td>
			<td>285-GMP</td>
			<td></td>
		</tr>
		<tr>
			<td>Human Albumin 25%</td>
			<td>Grifolis</td>
			<td>65483-16-071</td>
			<td></td>
		</tr>
		<tr>
			<td>Plasmalyte A</td>
			<td>Fisher</td>
			<td>2B2543Q</td>
			<td></td>
		</tr>
		<tr>
			<td>Zoledronic Acid (Zometa)</td>
			<td>Hos pira</td>
			<td>4215-04--8</td>
			<td>FDA approved drug</td>
		</tr>
		<tr>
			<td>DMSO</td>
			<td>WAK-CHEMIE MEDICAL GMBH</td>
			<td>WAK-DMSO-10</td>
			<td></td>
		</tr>
		<tr>
			<td>CS10</td>
			<td>BIOLIFE SOLUTIONS</td>
			<td>210374</td>
			<td></td>
		</tr>
		<tr>
			<td>3 mL syringe</td>
			<td>BD</td>
			<td>309657</td>
			<td></td>
		</tr>
		<tr>
			<td>10 mL syringe</td>
			<td>BD</td>
			<td>309604</td>
			<td></td>
		</tr>
		<tr>
			<td>20 mL syringe</td>
			<td>BD</td>
			<td>302830</td>
			<td></td>
		</tr>
		<tr>
			<td>50 mL syringe</td>
			<td>BD</td>
			<td>309653</td>
			<td></td>
		</tr>
		<tr>
			<td>100 mL syringe</td>
			<td>JMS</td>
			<td>992861</td>
			<td></td>
		</tr>
		<tr>
			<td>18g Needle</td>
			<td>Fisher</td>
			<td>305198</td>
			<td></td>
		</tr>
		<tr>
			<td>Cryovials 1.8 mL</td>
			<td>Fisher</td>
			<td>375418</td>
			<td></td>
		</tr>
		<tr>
			<td>5 mL pipette</td>
			<td>Fisher</td>
			<td>1367811D</td>
			<td></td>
		</tr>
		<tr>
			<td>50 mL pipette</td>
			<td>Fisher</td>
			<td>1367610Q</td>
			<td></td>
		</tr>
		<tr>
			<td>10 mL pipette</td>
			<td>Fisher</td>
			<td>1367811E</td>
			<td></td>
		</tr>
		<tr>
			<td>100 mL pipette</td>
			<td>Fisher</td>
			<td>07-200-620</td>
			<td></td>
		</tr>
		<tr>
			<td>15 mL conical</td>
			<td>Fisher</td>
			<td>05-539-12</td>
			<td></td>
		</tr>
		<tr>
			<td>50 mL conical</td>
			<td>Fisher</td>
			<td>05-539-7</td>
			<td></td>
		</tr>
		<tr>
			<td>250 mL conical</td>
			<td>Fisher</td>
			<td>430776</td>
			<td></td>
		</tr>
		<tr>
			<td>600 mL Transfer Pack</td>
			<td>TERUMO BCT INC</td>
			<td>1BBT060CB71</td>
			<td></td>
		</tr>
		<tr>
			<td>4&#34; Plasma Transfer Set</td>
			<td>INDEPENDENT MEDICSL ASSOCIATES</td>
			<td>03-220-90</td>
			<td></td>
		</tr>
		<tr>
			<td>Elutra Tubing Set</td>
			<td>TerumoBCT</td>
			<td>70800</td>
			<td></td>
		</tr>
		<tr>
			<td>100 MCS GREX</td>
			<td>WILSON WOLF MFG CORP</td>
			<td>81100-CS</td>
			<td></td>
		</tr>
		<tr>
			<td>Ashton Sterile Pumpmatic Liquid dispensing system</td>
			<td>Fisher Scientific</td>
			<td>22-246660</td>
			<td></td>
		</tr>
		<tr>
			<td>Acacia Pump boot</td>
			<td>MPS Medical In</td>
			<td>17789HP3MLL</td>
			<td></td>
		</tr>
		<tr>
			<td>CliniMACS PBS/EDTA Buffer</td>
			<td>Miltenyi Biotec Inc</td>
			<td>130-070-525</td>
			<td></td>
		</tr>
		<tr>
			<td>Dornase Alpha</td>
			<td>Genentech, Inc</td>
			<td>50242-100-40/186-0055</td>
			<td>FDA approved drug</td>
		</tr>
		<tr>
			<td>1000 mL 0.22 um Filter</td>
			<td>Fisher</td>
			<td>157-0020</td>
			<td></td>
		</tr>
		<tr>
			<td>Blood Filter 170um</td>
			<td>B.Braun</td>
			<td>V2500</td>
			<td></td>
		</tr>
		<tr>
			<td>CliniMACs Tubing set</td>
			<td>Miltenyi Biotec Inc</td>
			<td>130-090-719</td>
			<td></td>
		</tr>
		<tr>
			<td>CliniMACS TCR&#945;/&#946; Kit</td>
			<td>Miltenyi Biotec Inc</td>
			<td>130-021-301</td>
			<td></td>
		</tr>
		<tr>
			<td>Y-Type blood set</td>
			<td>Fenwal</td>
			<td>FWL4C2498H</td>
			<td></td>
		</tr>
		<tr>
			<td>75 mL Flask</td>
			<td>Fisher</td>
			<td>430641U</td>
			<td></td>
		</tr>
		<tr>
			<td>IL-2</td>
			<td>Prometheus</td>
			<td>65483-116-071</td>
			<td>FDA approved drug</td>
		</tr>
		<tr>
			<td>AIM-V</td>
			<td>Fisher</td>
			<td>0870112BK</td>
			<td></td>
		</tr>
		<tr>
			<td>Human AB serum</td>
			<td>Gemini Bio-Product</td>
			<td>100H41T</td>
			<td></td>
		</tr>
		<tr>
			<td>3 Liter Transfer pack</td>
			<td>Independent Medical Associates</td>
			<td>T3109</td>
			<td></td>
		</tr>
		<tr>
			<td>1000&#160; pipette tips</td>
			<td>Fisher Scientific</td>
			<td>5991040</td>
			<td></td>
		</tr>
		<tr>
			<td>CF-250</td>
			<td>KOLBio</td>
			<td>CF-250</td>
			<td></td>
		</tr>
		<tr>
			<td>Elutra</td>
			<td>TERUMOBCT</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>CliniMACS</td>
			<td>Miltenyi Biotec Inc</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>GatheRex Liquid Handling, Cell Harvest Pump</td>
			<td>WILSON WOLF MFG CORP</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>HERAcell Vios CO2 Incubator</td>
			<td>Thermo Scientific</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

expansion and enrichment of gamma-delta (&#947;&#948;) t cells from apheresed human product

Although V&#947;9V&#948;2 T cells are a minor subset of T lymphocytes, this population is sought after for its ability to recognize antigens in a major histocompatibility complex (MHC)-independent manner and develop strong cytolytic effector function that makes it an ideal candidate for cancer immunotherapy. Due to the low frequency of Gamma-Delta (&#947;&#948;) T cells in the peripheral blood, we developed an effective protocol to greatly expand a highly pure &#947;&#948; T cells drug product for first-in-human use of allogeneic &#947;&#948; T cells in patients with acute myeloid leukemia (AML). Using healthy donor apheresis as an allogenic cell source, the lymphocytes are isolated using a validated device for a counterflow centrifugation method of separating cells by size and density. 
The lymphocyte-rich fraction is utilized, and the &#947;&#948; T cells are preferentially activated with zoledronic acid (FDA-approved) and interleukin (IL)-2 for 7 days. Following the preferential expansion of &#947;&#948; T cells, a clinical-grade magnetic cell-separation device and TCR&#945;&#946; beads are used to deplete contaminating T-cell receptor (TCR)&#945;&#946; T cells. The highly enriched &#947;&#948; T cells then undergo a second expansion using engineered artificial antigen-presenting cells (aAPCs) derived from K562 cells-genetically engineered to express single-chain variable fragment (scFv) for CD3 and CD28, 41BBL (CD137L) and IL15-RA-together with zoledronic acid and IL-2. Seeding all day-7 enriched &#947;&#948; T cells in co-culture with the aAPCs facilitates the manufacture of highly pure &#947;&#948; T cells with an average fold expansion of &gt;229,000-fold from healthy donor blood.

Watch this Scientific Journal Video about Expansion and Enrichment of Gamma-Delta ÃŽÂ³ÃŽÂ´ T Cells from Apheresed Human Product at JoVE.com

Expansion and Enrichment of Gamma-Delta &#947;&#948; T Cells from Apheresed Human Product

Presented is a protocol for the expansion of Gamma-Delta (&#947;&#948;) T cell drug product. Lymphocytes are isolated by elutriation and &#947;&#948;-enriched with zoledronic acid and interleukin-2. Alpha-beta T cells are depleted using a clinical-grade magnetic separation device. The &#947;&#948; cells are co-cultured with K562-derived, artificial antigen-presenting cells and expanded.

Expansion and Enrichment of Gamma-Delta (&#947;&#948;) T Cells from Apheresed Human Product

Although V&#947;9V&#948;2 T cells are a minor subset of T lymphocytes, this population is sought after for its ability to recognize antigens in a major ...

expansion-enrichment-gamma-delta-t-cells-from-apheresed-human

Research

JoVE Journal

Cancer Research

8.8K Views.  Moffitt Cancer Center and Research Institute. Presented is a protocol for the expansion of Gamma-Delta (γδ) T cell drug product. Lymphocytes are isolated by elutriation and γδ-enriched with zoledronic acid and interleukin-2. Alpha-beta T cells are depleted using a clinical-grade magnetic separation device. The γδ cells are co-cultured with K562-derived, artificial antigen-presenting cells and expanded. 

Video: Expansion and Enrichment of Gamma-Delta γδ T Cells from Apheresed Human Product

Target Cell Pre-enrichment and Whole Genome Amplification for Single Cell Downstream Characterization

Rare target cells can be isolated from a high background of non-target cells using antibodies specific for surface proteins of target cells. A recently developed method uses a medical wire functionalized with anti-epithelial cell adhesion molecule (EpCAM) antibodies for in vivo isolation of circulating tumor cells (CTCs)1. A patient-matched cohort in non-metastatic prostate cancer showed that the in vivo isolation technique resulted in a higher percentage of patients positive for CTCs as well as higher CTC counts as compared to the current gold standard in CTC enumeration. As cells cannot be recovered from current medical devices, a new functionalized wire (referred to as Device) was manufactured allowing capture and subsequent detachment of cells by enzymatic treatment. Cells are allowed to attach to the Device, visualized on a microscope and detached using enzymatic treatment. Recovered cells are cytocentrifuged onto membrane-coated slides and harvested individually by means of laser microdissection or micromanipulation. Single-cell samples are then subjected to single-cell whole genome amplification allowing multiple downstream analysis including screening and target-specific approaches. The procedure of isolation and recovery yields high quality DNA from single cells and does not impair subsequent whole genome amplification (WGA). A single cell&#39;s amplified DNA can be forwarded to screening and/or targeted analysis such as array comparative genome hybridization (array-CGH) or sequencing. The device allows ex vivo isolation from artificial rare cell samples (i.e. 500 target cells spiked into 5 mL of peripheral blood). Whereas detachment rates of cells are acceptable (50 - 90%), the recovery rate of detached cells onto slides spans a wide range dependent on the cell line used (&#60;10 - &#62;50%) and needs some further attention. This device is not cleared for the use in patients.

This protocol is to recover and prepare rare target cells from a mixture with non-target background cells for molecular genetic characterization at the single-cell level. DNA quality is equal to non-treated single cells and allows for single-cell application (both screening based and targeted analysis).

Rare target cells can be isolated from a high background of non-target cells using antibodies specific for surface proteins of target cells. A recently ...

Multiplexed Immunofluorescence Analysis and Quantification of Intratumoral PD-1+ Tim-3+ CD8+ T Cells

Immune cells are important components of the tumor microenvironment and influence tumor growth and evolution at all stages of carcinogenesis. Notably, it is now well established that the immune infiltrate in human tumors can correlate with prognosis and response to therapy. The analysis of the immune infiltrate in the tumor microenvironment has become a major challenge for the classification of patients and the response to treatment.
The co-expression of inhibitory receptors such as Program Cell Death Protein 1 (PD1; also known as CD279), Cytotoxic T Lymphocyte Associated Protein 4 (CTLA-4), T-Cell Immunoglobulin and Mucin Containing Protein-3 (Tim-3; also known as CD366), and Lymphocyte Activation Gene 3 (Lag-3; also known as CD223), is a hallmark of T cell exhaustion. We developed a multiparametric in situ immunofluorescence staining to identify and quantify at the cellular level the co-expression of these inhibitory receptors. On a retrospective series of frozen tissue of renal cell carcinomas (RCC), using a fluorescence multispectral imaging technology coupled with an image analysis software, it was found that co-expression of PD-1 and Tim-3 on tumor infiltrating CD8+ T cells is correlated with a poor prognosis in RCC. To our knowledge, this represents the first study demonstrating that this automated multiplex in situ technology may have some clinical relevance.

Multiplexed Immunofluorescence Analysis and Quantification of Intratumoral PD-1+ Tim-3+ CD8+ T Cells

Studying tumor microenvironment may identify prognostic or predictive biomarkers of clinical response to immunotherapy. Presented here, is an innovative method based on in situ fluorescence multispectral imaging to analyze and count automatically various subpopulations of CD8+ T cells. This reproducible and reliable technique is suitable for large cohort analyses.

Immune cells are important components of the tumor microenvironment and influence tumor growth and evolution at all stages of carcinogenesis. Notably, it ...

Isolation of Human Endothelial Cells from Normal Colon and Colorectal Carcinoma - An Improved Protocol

Primary cells isolated from human carcinomas are valuable tools to identify pathogenic mechanisms contributing to disease development and progression. In particular, endothelial cells (EC) constituting the inner surface of vessels, directly participate in oxygen delivery, nutrient supply, and removal of waste products to and from tumors, and are thereby prominently involved in the constitution of the tumor microenvironment (TME). Tumor endothelial cells (TECs) can be used as cellular biosensors of the intratumoral microenvironment established by communication between tumor and stromal cells. TECs also serve as targets of therapy. Accordingly, in culture these cells allow studies on mechanisms of response or resistance to anti-angiogenic treatment. Recently, it was found that TECs isolated from human colorectal carcinoma (CRC) exhibit memory-like effects based on the specific TME they were derived from. Moreover, these TECs actively contribute to the establishment of a specific TME by the secretion of different factors. For example, TECs in a prognostically favorable Th1-TME secrete the anti-angiogenic tumor-suppressive factor secreted protein, acidic and rich in cysteine-like 1 (SPARCL1). SPARCL1 regulates vessel homeostasis and inhibits tumor cell proliferation and migration. Hence, cultures of pure, viable TECs isolated from human solid tumors are a valuable tool for functional studies on the role of the vascular system in tumorigenesis. Here, a new up-to-date protocol for the isolation of primary EC from the normal colon as well as CRC is described. The technique is based on mechanical and enzymatic tissue digestion, immunolabeling, and fluorescence activated cell sorting (FACS)-sorting of triple-positive cells (CD31, VE-cadherin, CD105). With this protocol, viable TEC or normal endothelial cell (NEC) cultures could be isolated from colon tissues with a success rate of 62.12% when subjected to FACS-sorting (41 pure EC cultures from 66 tissue samples). Accordingly, this protocol provides a robust approach to isolate human EC cultures from normal colon and CRC.

Tumor endothelial cells are important determinants of the tumor microenvironment and the course of the disease. Here, a protocol for the isolation of pure and viable endothelial cells from human colorectal carcinoma and normal colon to be used in drug testing and pathogenesis research is described.

Primary cells isolated from human carcinomas are valuable tools to identify pathogenic mechanisms contributing to disease development and progression. In ...

Morphology-Based Distinction Between Healthy and Pathological Cells Utilizing Fourier Transforms and Self-Organizing Maps

The appearance and the movements of immune cells are driven by their environment. As a reaction to a pathogen invasion, the immune cells are recruited to the site of inflammation and are activated to prevent a further spreading of the invasion. This is also reflected by changes in the behavior and the morphological appearance of the immune cells. In cancerous tissue, similar morphokinetic changes have been observed in the behavior of microglial cells: intra-tumoral microglia have less complex 3-dimensional shapes, having less-branched cellular processes, and move more rapidly than those in healthy tissue. The examination of such morphokinetic properties requires complex 3D microscopy techniques, which can be extremely challenging when executed longitudinally. Therefore, the recording of a static 3D shape of a cell is much simpler, because this does not require intravital measurements and can be performed on excised tissue as well. However, it is essential to possess analysis tools that allow the fast and precise description of the 3D shapes and allows the diagnostic classification of healthy and pathogenic tissue samples based solely on static, shape-related information. Here, we present a toolkit that analyzes the discrete Fourier components of the outline of a set of 2D projections of the 3D cell surfaces via Self-Organizing Maps. The application of artificial intelligence methods allows our framework to learn about various cell shapes as it is applied to more and more tissue samples, whilst the workflow remains simple.

Here, we provide a workflow that allows the identification of healthy and pathological cells based on their 3-dimensional shape. We describe the process of using 2D projection outlines based on the 3D surfaces to train a Self-Organizing Map that will provide objective clustering of the investigated cell populations.

The appearance and the movements of immune cells are driven by their environment. As a reaction to a pathogen invasion, the immune cells are recruited to ...

Extraction of Aqueous Metabolites from Cultured Adherent Cells for Metabolomic Analysis by Capillary Electrophoresis-Mass Spectrometry

Metabolomic analysis is a promising omics approach to not only understand the specific metabolic regulation in cancer cells compared to normal cells but also to identify biomarkers for early-stage cancer detection and prediction of chemotherapy response in cancer patients. Preparation of uniform samples for metabolomic analysis is a critical issue that remains to be addressed. Here, we present an easy and reliable protocol for extracting aqueous metabolites from cultured adherent cells for metabolomic analysis using capillary electrophoresis-mass spectrometry (CE-MS). Aqueous metabolites from cultured cells are analyzed by culturing and washing cells, treating cells with methanol, extracting metabolites, and removing proteins and macromolecules with spin columns for CE-MS analysis. Representative results using lung cancer cell lines treated with diamide, an oxidative reagent, illustrate the clearly observable metabolic shift of cells under oxidative stress. This article would be especially valuable to students and investigators involved in metabolomics research, who are new to harvesting metabolites from cell lines for analysis by CE-MS.

The purpose of this article is to describe a protocol for extraction of aqueous metabolites from cultured adherent cells for metabolomic analysis, particularly, capillary electrophoresis-mass spectrometry.

Metabolomic analysis is a promising omics approach to not only understand the specific metabolic regulation in cancer cells compared to normal cells but ...

Using Human Induced Pluripotent Stem Cells for the Generation of Tumor Antigen-specific T Cells

The generation and expansion of functional T cells in vitro can lead to a broad range of clinical applications. One such use is for the treatment of patients with advanced cancer. Adoptive T cell transfer (ACT) of highly enriched tumor antigen-specific T cells has been shown to cause durable regression of metastatic cancer in some patients. However, during expansion, these cells may become exhausted or senescent, limiting their effector function and persistence in vivo. Induced pluripotent stem cell (iPSC) technology may overcome these obstacles by leading to in vitro generation of large numbers of less differentiated tumor antigen-specific T cells. Human iPSC (hiPSC) have the capacity to differentiate into any type of somatic cell, including lymphocytes, which retain the original T cell receptor (TCR) genomic rearrangement when a T cell is used as a starting cell. Therefore, reprogramming of human tumor antigen-specific T cells to hiPSC followed by redifferentiation to T cell lineage has the potential to produce rejuvenated tumor antigen-specific T cells. Described here is a method for generating tumor antigen-specific CD8&#945;&#946;+ single positive (SP) T cells from hiPSC using OP9/DLL1 co-culture system. This method is a powerful tool for in vitro T cell lineage generation and will facilitate the development of in vitro derived T cells for use in regenerative medicine and cell-based therapies.

This article describes a method to generate functional tumor antigen-specific induced pluripotent stem cell-derived CD8&#945;&#946;+ single positive T cells using OP9/DLL1 co-culture system.

The generation and expansion of functional T cells in vitro can lead to a broad range of clinical applications. One such use is for the treatment of ...

Isolation and Expansion of Cytotoxic Cytokine-induced Killer T Cells for Cancer Treatment

Adoptive cellular immunotherapy focuses on restoring cancer recognition via the immune system and improves effective tumor cell killing. Cytokine-induced killer (CIK) T cell therapy has been reported to exert significant cytotoxic effects against cancer cells and to reduce the adverse effects of surgery, radiation, and chemotherapy in cancer treatments. CIK can be derived from peripheral blood mononuclear cells (PBMCs), bone marrow, and umbilical cord blood. CIK cells are a heterogeneous subpopulation of T cells with CD3+CD56+ and natural killer (NK) phenotypic characteristics that include major histocompatibility complex (MHC)-unrestricted antitumor activity. This study describes a qualified, clinically applicable, flow cytometry-based method for the quantification of the cytolytic capability of PBMC-derived CIK cells against hematological and solid cancer cells. In the cytolytic assay, CIK cells are co-incubated at different ratios with prestained target tumor cells. After the incubation period, the number of target cells are determined by a nucleic acid-binding stain to detect dead cells. This method is applicable to both research and diagnostic applications. CIK cells possess potent cytotoxicity that could be explored as an alternative strategy for cancer treatment upon its preclinical evaluation by a cytometer setup and tracking (CS &#38; T)-based flow cytometry system.

Here, we present a protocol to perform the isolation and expansion of peripheral blood mononuclear cells-derived cytokine-induced CD3+CD56+ killer cells and illustrate their cytotoxicity effect against hematological and solid cancer cells by using an in vitro diagnosis flow cytometry system.

Adoptive cellular immunotherapy focuses on restoring cancer recognition via the immune system and improves effective tumor cell killing. Cytokine-induced ...

Isolating Human Peripheral Blood Mononuclear Cells and CD4+ T cells from S&#233;zary Syndrome Patients for Transcriptomic Profiling

Cutaneous T-cell lymphomas (CTCL) are derived from the transformation and uncontrolled proliferation of mature skin-homing T cells, and mycosis fungoides (MF) and S&#233;zary syndrome (SS) represent the most common subtypes. Despite a number of studies on characterizing gene expression, genetic alterations, and epigenetic abnormalities of CTCL, the molecular pathogenesis of MF/SS remains unclear. MF refers to the more common CTCL with a skin-predominance, and is usually limited to skin, whereas&#160;SS is an aggressive leukemic variant of CTCL with widespread skin involvement and is characterized by neoplastic distribution mainly involving blood, skin, and lymph node. Focusing on clinical practice, the identification of gene expression biomarkers has&#160;enormous potential to improve diagnosis and treatment of MF/SS. Indeed, recent transcriptomic studies have identified potential diagnostic biomarkers from differences in gene expression between normal and malignant T cells, which may improve our understanding of SS biology, and reveal potential therapeutic targets. This manuscript describes a detailed reproducible protocol for the isolation of peripheral blood mononuclear cells from fresh whole blood from patients diagnosed with SS, selection of CD4+ memory T cells (CD4+CD45RO+ T cells), chemical stimulation, and preparation of RNA suitable for transcriptomic profiling to discover novel prognostic molecular markers to gain additional insight in disease etiology. The stimulation using chemical agonist to activate nuclear regulation provides more specific assessment for pathways important in the dynamic transcription regulation and gene expression and eliminates confounding defects that may arise from upstream signaling defects arising from TCR antigen loss at the cell membrane. The data obtained from comparison of transcriptome of unstimulated to stimulated SS T cells unmasks functional regulatory gene expression defects not evident from analysis of quiescent unstimulated cells. Furthermore, the method outlined from this approach can be adapted for studying T cell gene expression defects in other T cell immune diseases.

We present a simple protocol for the isolation of peripheral blood mononuclear cells from whole blood obtained from patients diagnosed with S&#233;zary Syndrome, followed by selection of CD4+ T cells, their stimulation with phorbol12-myristate13-acetate and A23187 ionophore, and preparation of RNA for transcriptomic profiling.

Cutaneous T-cell lymphomas (CTCL) are derived from the transformation and uncontrolled proliferation of mature skin-homing T cells, and mycosis fungoides ...

Isolation and Functional Assessment of Human Breast Cancer Stem Cells from Cell and Tissue Samples

Breast cancer stem cells (BCSCs) are cancer cells with inherited or acquired stem cell-like characteristics. Despite their low frequency, they are major contributors to breast cancer initiation, relapse, metastasis and therapy resistance. It is imperative to understand the biology of breast cancer stem cells in order to identify novel therapeutic targets to treat breast cancer. Breast cancer stem cells are isolated and characterized based on expression of unique cell surface markers such as CD44, CD24 and enzymatic activity of aldehyde dehydrogenase (ALDH). These ALDHhighCD44+CD24- cells constitute the BCSC population and can be isolated by fluorescence-activated cell sorting (FACS) for downstream functional studies. Depending on the scientific question, different in vitro and in vivo methods can be used to assess the functional characteristics of BCSCs. Here, we provide a detailed experimental protocol for isolation of human BCSCs from both heterogenous populations of breast cancer cells as well as primary tumor tissue obtained from breast cancer patients. In addition, we highlight downstream in vitro and in vivo functional assays including colony forming assays, mammosphere assays, 3D culture models and tumor xenograft assays that can be used to assess BCSC function.

This experimental protocol describes the isolation of BCSCs from breast cancer cell and tissue samples as well as the in vitro and in vivo assays that can be used to assess BCSC phenotype and function.

Breast cancer stem cells (BCSCs) are cancer cells with inherited or acquired stem cell-like characteristics. Despite their low frequency, they are major ...

Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines

Current methodologies for the expansion of primary tumor cell lines from rare tumor types are lacking. This protocol describes methods to expand primary tumor cells from surgically resected, malignant pleural mesothelioma (MPM) by providing a complete overview of the process from digestion to enrichment, expansion, cryopreservation, and phenotypic characterization. In addition, this protocol introduces concepts for tumor generation that may be useful for multiple tumor types such as differential trypsinization and the impact of dissociation methods on the detection of cell surface markers for phenotypic characterization. The major limitation of this study is the selection of tumor cells that will expand in a two-dimensional (2D) culture system. Variations to this protocol, including three-dimensional (3D) culture systems, media supplements, plate coating to improve adhesion, and alternate disaggregation methods, could improve this technique and the overall success rate of establishing a tumor line. Overall, this protocol provides a base method for establishing and characterizing tumor cells from this rare tumor.

The goal of this method paper is to demonstrate a robust and reproducible methodology for the enrichment, generation, and expansion of primary tumor cell lines from surgically resected pleural mesothelioma.

Current methodologies for the expansion of primary tumor cell lines from rare tumor types are lacking. This protocol describes methods to expand primary ...