Ferrantelli et al. described a vaccine platform consisting of DNA vectors expressing a tumor antigen (either HPV16 E7 or E6 in this report) linked to a protein (Nefmut) that anchors to the inner membrane of naturally occurring extracellular vesicles (EVs). EVs from cells transfected with a Nefmut/tumor antigen vector contained both tumor antigen and Nefmut. Compared to non-Nefmut-containing vectors, i.m. DNA immunization with Nefmut-containing vectors induced enhanced tumor-specific polyfunctional CD8+ T cell responses and slowed the growth of established tumors – curing them in 7 of 12 cases. Cured mice were resistant to tumor rechallenge.

Contributed by Margot O’Toole

ABSTRACT: We developed an innovative method to induce antigen-specific CD8(+) T cytotoxic lymphocyte (CTL) immunity based on in vivo engineering of extracellular vesicles (EVs). This approach employs a DNA vector expressing a mutated HIV-1 Nef protein (Nef(mut)) deprived of the anti-cellular effects typical of the wild-type isoform, meanwhile showing an unusual efficiency of incorporation into EVs. This function persists even when foreign antigens are fused to its C-terminus. In this way, Nef(mut) traffics large amounts of antigens fused to it into EVs spontaneously released by the recipient cells. We previously provided evidence that mice injected with a DNA vector expressing the Nef(mut)/HPV16-E7 fusion protein developed an E7-specific CTL immune response as detected 2 weeks after the second immunization. Here, we extended and optimized the anti-HPV16 CD8(+) T cell immune response induced by the endogenously engineered EVs, and evaluated the therapeutic antitumor efficacy over time. We found that the co-injection of DNA vectors expressing Nef(mut) fused with E6 and E7 generated a stronger anti-HPV16 immune response compared to that observed in mice injected with the single vectors. When HPV16-E6 and -E7 co-expressing tumor cells were implanted before immunization, all mice survived at day 44, whereas no mice injected with either void or Nef(mut)-expressing vectors survived until day 32 after tumor implantation. A substantial part of immunized mice (7 out of 12) cleared the tumor. When the cured mice were re-challenged with a second tumor cell implantation, none of them developed tumors. Both E6- and E7-specific CD8(+) T immunities were still detectable at the end of the observation time. We concluded that the immunity elicited by engineered EVs, besides counteracting and curing already developed tumors, was strong enough to guarantee the resistance to additional tumor attacks. These results can be of relevance for the therapy of both metastatic and relapsing tumors.

Author Info: (1) National Center for Global Health, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy. (2) National Center for Global Health, Istituto Superiore di Sanit, V

Author Info: (1) National Center for Global Health, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy. (2) National Center for Global Health, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy. (3) National Center for Global Health, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy. (4) National Center for Global Health, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy. (5) National Center for Animal Experimentation and Welfare, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy. (6) National Center for Global Health, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy. (7) National Center for Global Health, Istituto Superiore di Sanit, Viale Regina Elena 299, 00161 Rome, Italy.