Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Conjugation of haematopoietic stem cells and platelets decorated with anti-PD-1 antibodies augments anti-leukaemia efficacy

Abstract

Patients with acute myeloid leukaemia who relapse following therapy have few treatment options and face poor outcomes. Immune checkpoint inhibition, for example, by antibody-mediated programmed death-1 (PD-1) blockade, is a potent therapeutic modality that improves treatment outcomes in acute myeloid leukaemia. Here, we show that systemically delivered blood platelets decorated with anti-PD-1 antibodies (aPD-1) and conjugated to haematopoietic stem cells (HSCs) suppress the growth and recurrence of leukaemia in mice. Following intravenous injection into mice bearing leukaemia cells, the HSC–platelet–aPD-1 conjugate migrated to the bone marrow and locally released aPD-1, significantly enhancing anti-leukaemia immune responses, and increasing the number of active T cells, production of cytokines and chemokines, and survival time of the mice. This cellular conjugate also promoted resistance to re-challenge with leukaemia cells. Taking advantage of the homing capability of HSCs and in situ activation of platelets for the enhanced delivery of a checkpoint inhibitor, this cellular combination-mediated drug delivery strategy can significantly augment the therapeutic efficacy of checkpoint blockade.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Characterization of the S–P–aPD-1 cellular combination delivery system.
Fig. 2: In vivo treatment efficacy of S–P–aPD-1.
Fig. 3: Analysis of T cells, cytokines and chemokines.
Fig. 4: S–P–aPD-1 induced a durable immune response.

Similar content being viewed by others

Data availability

The data supporting the findings of this study are available within the paper and its Supplementary Information. Source data for the figures are available in Figshare at https://doi.org/10.6084/m9.figshare.7033481.

References

  1. Huntly, B. J. & Gilliland, D. G. Leukaemia stem cells and the evolution of cancer-stem-cell research. Nat. Rev. Cancer 5, 311–321 (2005).

    Article  CAS  Google Scholar 

  2. Dick, J. E. Acute myeloid leukemia stem cells. Ann. NY Acad. Sci. 1044, 1–5 (2005).

    Article  Google Scholar 

  3. Estey, E. & Döhner, H. Acute myeloid leukaemia. Lancet 368, 1894–1907 (2006).

    Article  Google Scholar 

  4. Döhner, H. et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European Leukemia Net. Blood 115, 453–474 (2010).

    Article  Google Scholar 

  5. Lowenberg, B., Downing, J. R. & Burnett, A. Acute myeloid leukemia. N. Engl. J. Med. 1999, 1051–1062 (1999).

    Article  Google Scholar 

  6. Advani, R. et al. Treatment of refractory and relapsed acute myelogenous leukemia with combination chemotherapy plus the multidrug resistance modulator PSC 833 (Valspodar). Blood 93, 787–795 (1999).

    CAS  PubMed  Google Scholar 

  7. Fernandez, H. F. et al. Anthracycline dose intensification in acute myeloid leukemia. N. Engl. J. Med. 361, 1249–1259 (2009).

    Article  CAS  Google Scholar 

  8. Leith, C. P. et al. Frequency and clinical significance of the expression of the multidrug resistance proteins MDR1/P-glycoprotein, MRP1, and LRP in acute myeloid leukemia. A Southwest Oncology Group Study. Blood 94, 1086–1099 (1999).

    CAS  PubMed  Google Scholar 

  9. Gottesman, M. M., Fojo, T. & Bates, S. E. Multidrug resistance in cancer: role of ATP-dependent transporters. Nat. Rev. Cancer 2, 48–58 (2002).

    Article  CAS  Google Scholar 

  10. Leith, C. P. et al. Acute myeloid leukemia in the elderly: assessment of multidrug resistance (MDR1) and cytogenetics distinguishes biologic subgroups with remarkably distinct responses to standard chemotherapy. A Southwest Oncology Group study. Blood 89, 3323–3329 (1997).

    CAS  PubMed  Google Scholar 

  11. Ofran, Y. & Rowe, J. M. Treatment for relapsed acute myeloid leukemia: what is new? Curr. Opin. Hematol. 19, 89–94 (2012).

    Article  Google Scholar 

  12. Ding, L. et al. Clonal evolution in relapsed acute myeloid leukemia revealed by whole genome sequencing. Nature 481, 506–510 (2012).

    Article  CAS  Google Scholar 

  13. Lagasse, E. et al. Purified hematopoietic stem cells can differentiate into hepatocytes in vivo. Nat. Med. 6, 1229–1234 (2000).

    Article  CAS  Google Scholar 

  14. Wilson, A. & Trumpp, A. Bone-marrow haematopoietic-stem-cell niches. Nat. Rev. Immunol. 6, 93–106 (2006).

    Article  CAS  Google Scholar 

  15. Maude, S. L. et al. Chimeric antigen receptor T cells for sustained remissions in leukemia. N. Engl. J. Med. 371, 1507–1517 (2014).

    Article  Google Scholar 

  16. Ellebrecht, C. T. et al. Reengineering chimeric antigen receptor T cells for targeted therapy of autoimmune disease. Science 353, 179–184 (2016).

    Article  CAS  Google Scholar 

  17. Wu, C.-Y., Roybal, K. T., Puchner, E. M., Onuffer, J. & Lim, W. A. Remote control of therapeutic T cells through a small molecule-gated chimeric receptor. Science 350, aab4077 (2015).

    Article  Google Scholar 

  18. Brentjens, R. J. et al. CD19-targeted T cells rapidly induce molecular remissions in adults with chemotherapy-refractory acute lymphoblastic leukemia. Sci. Transl. Med. 5, 177ra138 (2013).

    Article  Google Scholar 

  19. Kingwell, K. CAR T therapies drive into new terrain. Nat. Rev. Drug Discov. 16, 301–304 (2017).

    Article  CAS  Google Scholar 

  20. Jackson, H. J., Rafiq, S. & Brentjens, R. J. Driving CAR T-cells forward. Nat. Rev. Clin. Oncol. 13, 370–383 (2016).

    Article  CAS  Google Scholar 

  21. Kershaw, M. H., Westwood, J. A. & Darcy, P. K. Gene-engineered T cells for cancer therapy. Nat. Rev. Cancer 13, 525–541 (2013).

    Article  CAS  Google Scholar 

  22. Topalian, S. L., Drake, C. G. & Pardoll, D. M. Immune checkpoint blockade: a common denominator approach to cancer therapy. Cancer Cell 27, 450–461 (2015).

    Article  CAS  Google Scholar 

  23. Ishida, Y., Agata, Y., Shibahara, K. & Honjo, T. Induced expression of PD-1, a novel member of the immunoglobulin gene superfamily, upon programmed cell death. EMBO J. 11, 3887–3895 (1992).

    Article  CAS  Google Scholar 

  24. Keir, M. E. et al. Tissue expression of PD-L1 mediates peripheral T cell tolerance. J. Exp. Med. 203, 883–895 (2006).

    Article  CAS  Google Scholar 

  25. Tumeh, P. C. et al. PD-1 blockade induces responses by inhibiting adaptive immune resistance. Nature 515, 568–571 (2014).

    Article  CAS  Google Scholar 

  26. Topalian, S. L. et al. Safety, activity, and immune correlates of anti-PD-1 antibody in cancer. N. Engl. J. Med. 366, 2443–2454 (2012).

    Article  CAS  Google Scholar 

  27. Zhou, Q. et al. Program death-1 signaling and regulatory T cells collaborate to resist the function of adoptively transferred cytotoxic T lymphocytes in advanced acute myeloid leukemia. Blood 116, 2484–2493 (2010).

    Article  CAS  Google Scholar 

  28. McClanahan, F. et al. PD-L1 checkpoint blockade prevents immune dysfunction and leukemia development in a mouse model of chronic lymphocytic leukemia. Blood 126, 203–211 (2015).

    Article  CAS  Google Scholar 

  29. Zhang, L., Gajewski, T. F. & Kline, J. PD-1/PD-L1 interactions inhibit antitumor immune responses in a murine acute myeloid leukemia model. Blood 114, 1545–1552 (2009).

    Article  CAS  Google Scholar 

  30. Kamath, S., Blann, A. & Lip, G. Platelet activation: assessment and quantification. Eur. Heart J. 22, 1561–1571 (2001).

    Article  CAS  Google Scholar 

  31. Giralt, S. A. & Champlin, R. E. Leukemia relapse after allogeneic bone marrow transplantation: a review. Blood 84, 3603–3612 (1994).

    CAS  PubMed  Google Scholar 

  32. Hu, C.-M. J. et al. Nanoparticle biointerfacing by platelet membrane cloaking. Nature 526, 118–121 (2015).

    Article  CAS  Google Scholar 

  33. Wang, C. et al. In situ activation of platelets with checkpoint inhibitors for post-surgical cancer immunotherapy. Nat. Biomed. Eng. 1, 0011 (2017).

    Article  Google Scholar 

  34. Hang, H. C., Yu, C., Kato, D. L. & Bertozzi, C. R. A metabolic labeling approach toward proteomic analysis of mucin-type O-linked glycosylation. Proc. Natl Acad. Sci. USA 100, 14846–14851 (2003).

    Article  CAS  Google Scholar 

  35. Shi, P. et al. Spatiotemporal control of cell–cell reversible interactions using molecular engineering. Nat. Commun. 7, 13088 (2016).

    Article  CAS  Google Scholar 

  36. Zhao, M. et al. Clickable protein nanocapsules for targeted delivery of recombinant p53 protein. J. Am. Chem. Soc. 136, 15319–15325 (2014).

    Article  CAS  Google Scholar 

  37. Eeftens, J. M., van der Torre, J., Burnham, D. R. & Dekker, C. Copper-free click chemistry for attachment of biomolecules in magnetic tweezers. BMC Biophys. 8, 9 (2015).

    Article  Google Scholar 

  38. Leopold, L. H. & Willemze, R. The treatment of acute myeloid leukemia in first relapse: a comprehensive review of the literature. Leuk. Lymphoma 43, 1715–1727 (2002).

    Article  CAS  Google Scholar 

  39. Swami, A. et al. Engineered nanomedicine for myeloma and bone microenvironment targeting. Proc. Natl Acad. Sci. USA 111, 10287–10292 (2014).

    Article  CAS  Google Scholar 

  40. Hu, Q. et al. Engineered nanoplatelets for enhanced treatment of multiple myeloma and thrombus. Adv. Mater. 28, 9573–9580 (2016).

    Article  CAS  Google Scholar 

  41. Ruggeri, Z. M., Orje, J. N., Habermann, R., Federici, A. B. & Reininger, A. J. Activation-independent platelet adhesion and aggregation under elevated shear stress. Blood 108, 1903–1910 (2006).

    Article  CAS  Google Scholar 

  42. Miyazaki, Y. et al. High shear stress can initiate both platelet aggregation and shedding of procoagulant containing microparticles. Blood 88, 3456–3464 (1996).

    CAS  PubMed  Google Scholar 

  43. Yan, M. & Jurasz, P. The role of platelets in the tumor microenvironment: from solid tumors to leukemia. Biochim. Biophys. Acta 1863, 392–400 (2016).

    Article  CAS  Google Scholar 

  44. Velez, J. et al. Platelets promote mitochondrial uncoupling and resistance to apoptosis in leukemia cells: a novel paradigm for the bone marrow microenvironment. Cancer Microenviron. 7, 79–90 (2014).

    Article  CAS  Google Scholar 

  45. Zhou, Q. et al. Depletion of endogenous tumor-associated regulatory T cells improves the efficacy of adoptive cytotoxic T-cell immunotherapy in murine acute myeloid leukemia. Blood 114, 3793–3802 (2009).

    Article  CAS  Google Scholar 

  46. Hlavacek, W. S., Posner, R. G. & Perelson, A. S. Steric effects on multivalent ligand–receptor binding: exclusion of ligand sites by bound cell surface receptors. Biophys. J. 76, 3031–3043 (1999).

    Article  CAS  Google Scholar 

  47. Costinean, S. et al. Pre-B cell proliferation and lymphoblastic leukemia/high-grade lymphoma in Eμ-miR155 transgenic mice. Proc. Natl Acad. Sci. USA 103, 7024–7029 (2006).

    Article  CAS  Google Scholar 

  48. Pandolfi, A. et al. PAK1 is a therapeutic target in acute myeloid leukemia and myelodysplastic syndrome. Blood 126, 1118–1127 (2015).

    Article  CAS  Google Scholar 

  49. Moynihan, K. D. et al. Eradication of large established tumors in mice by combination immunotherapy that engages innate and adaptive immune responses. Nat. Med. 22, 1402–1410 (2016).

    Article  CAS  Google Scholar 

  50. Döhner, H., Weisdorf, D. J. & Bloomfield, C. D. Acute myeloid leukemia. N. Engl. J. Med. 373, 1136–1152 (2015).

    Article  Google Scholar 

  51. Ayar, S. P., Ravula, S. & Polski, J. M. Granulocyte, monocyte and blast immunophenotype abnormalities in acute myeloid leukemia with myelodysplasia-related changes. Ann. Clin. Lab. Sci. 44, 3–9 (2014).

    PubMed  Google Scholar 

  52. Stetler-Stevenson, M. et al. Diagnostic utility of flow cytometric immunophenotyping in myelodysplastic syndrome. Blood 98, 979–987 (2001).

    Article  CAS  Google Scholar 

  53. Lu, Y., Aimetti, A. A., Langer, R. & Gu, Z. Bioresponsive materials. Nat. Rev. Mater. 1, 16075 (2016).

    Article  Google Scholar 

  54. Wang, Q. et al. Non-genetic engineering of cells for drug delivery and cell-based therapy. Adv. Drug Deliv. Rev. 91, 125–140 (2015).

    Article  CAS  Google Scholar 

  55. Chen, Z., Hu, Q. & Gu, Z. Leveraging engineering of cells for drug delivery. Acc. Chem. Res. 51, 668–677 (2018).

    Article  CAS  Google Scholar 

  56. Cheng, H. et al. Stem cell membrane engineering for cell rolling using peptide conjugation and tuningof cell-selectin interaction kinetics. Biomaterials 33, 5004–5012 (2012).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from the start-up packages of UNC/NC State and UCLA, the Sloan Research Fellowship of the Alfred P. Sloan Foundation, the National Key R&D Program of China (2017YFA0205600), the National Natural Science Foundation of China (51728301, 81690263) and the China Scholarship Council (CSC). We acknowledge B. Blazar at the University of Minnesota for providing the C1498-Luc cell line and M. Liu at New York University for assistance in cytokine analysis. Z.G. acknowledges support from W. Gu and P. Zhang.

Author information

Authors and Affiliations

Authors

Contributions

Q.H. and Z.G. designed the experiments. Q.H., W.S., J.W., H.R., Y.Y., X.Z. and C.W. performed the experiments and collected the data. All authors contributed to writing the manuscript, discussing the results and implications, and editing the manuscript at all stages.

Corresponding author

Correspondence to Zhen Gu.

Ethics declarations

Competing interests

Patents describing the cell-combination drug-delivery system documented in this article have been filed with the US Patent Office. Q.H. and Z.G. are inventors of the following provisional patent application: US 62/653,843. J.F.Z. has received honoraria from Agios, Celgene and Tolero, consultancy from Celgene and Asystbio Laboratories, and research funding from Merck, Takeda and Tolero. The other authors declare no competing interests.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Supplementary Information

Supplementary Figures 1–35

Reporting Summary

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hu, Q., Sun, W., Wang, J. et al. Conjugation of haematopoietic stem cells and platelets decorated with anti-PD-1 antibodies augments anti-leukaemia efficacy. Nat Biomed Eng 2, 831–840 (2018). https://doi.org/10.1038/s41551-018-0310-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41551-018-0310-2

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing