Oncogene-induced TIM-3 ligand expression dictates susceptibility to anti-TIM-3 therapy in mice

J Clin Invest. 2024 Jun 25;134(16):e177460. doi: 10.1172/JCI177460.

Abstract

Leukemia relapse is a major cause of death after allogeneic hematopoietic cell transplantation (allo-HCT). We tested the potential of targeting T cell (Tc) immunoglobulin and mucin-containing molecule 3 (TIM-3) for improving graft-versus-leukemia (GVL) effects. We observed differential expression of TIM-3 ligands when hematopoietic stem cells overexpressed certain oncogenic-driver mutations. Anti-TIM-3 Ab treatment improved survival of mice bearing leukemia with oncogene-induced TIM-3 ligand expression. Conversely, leukemia cells with low ligand expression were anti-TIM-3 treatment resistant. In vitro, TIM-3 blockade or genetic deletion in CD8+ Tc enhanced Tc activation, proliferation, and IFN-γ production while enhancing GVL effects, preventing Tc exhaustion, and improving Tc cytotoxicity and glycolysis in vivo. Conversely, TIM-3 deletion in myeloid cells did not affect allogeneic Tc proliferation and activation in vitro, suggesting that anti-TIM-3 treatment-mediated GVL effects are Tc induced. In contrast to anti-programmed cell death protein 1 (anti-PD-1) and anti-cytotoxic T lymphocyte-associated protein 4 (anti-CTLA-4) treatment, anti-TIM-3-treatment did not enhance acute graft-versus-host disease (aGVHD). TIM-3 and its ligands were frequently expressed in acute myeloid leukemia (AML) cells of patients with post-allo-HCT relapse. We decipher the connections between oncogenic mutations found in AML and TIM-3 ligand expression and identify anti-TIM-3 treatment as a strategy for enhancing GVL effects via metabolic and transcriptional Tc reprogramming without exacerbation of aGVHD. Our findings support clinical testing of anti-TIM-3 Ab in patients with AML relapse after allo-HCT.

Keywords: Bone marrow transplantation; Transplantation.

MeSH terms

  • Allografts
  • Animals
  • CD8-Positive T-Lymphocytes / immunology
  • CTLA-4 Antigen / antagonists & inhibitors
  • CTLA-4 Antigen / genetics
  • CTLA-4 Antigen / immunology
  • CTLA-4 Antigen / metabolism
  • Gene Expression Regulation, Leukemic
  • Graft vs Leukemia Effect / genetics
  • Graft vs Leukemia Effect / immunology
  • Hematopoietic Stem Cell Transplantation
  • Hepatitis A Virus Cellular Receptor 2* / genetics
  • Hepatitis A Virus Cellular Receptor 2* / metabolism
  • Humans
  • Leukemia, Myeloid, Acute / genetics
  • Leukemia, Myeloid, Acute / immunology
  • Leukemia, Myeloid, Acute / metabolism
  • Leukemia, Myeloid, Acute / pathology
  • Leukemia, Myeloid, Acute / therapy
  • Ligands
  • Mice
  • Mice, Knockout
  • Oncogenes

Substances

  • Hepatitis A Virus Cellular Receptor 2
  • Havcr2 protein, mouse
  • Ligands
  • Ctla4 protein, mouse
  • CTLA-4 Antigen
  • HAVCR2 protein, human