Systemic β-Adrenergic Receptor Activation Augments the ex vivo Expansion and Anti-Tumor Activity of Vγ9Vδ2 T-Cells

Abstract

TCR-gamma delta (gamma delta) T-cells are considered important players in the graft-vs.-tumor effect following allogeneic hematopoietic cell transplantation (alloHCT) and have emerged as candidates for adoptive transfer immunotherapy in the treatment of both solid and hematological tumors. Systemic beta-adrenergic receptor (beta-AR) activation has been shown to mobilize TCR-gamma delta T-cells to the blood, potentially serving as an adjuvant for alloHCT and TCR-gamma delta T-cell therapy. We investigated if systemic beta-AR activation, using acute dynamic exercise as an experimental model, can increase the mobilization, ex vivo expansion, and anti-tumor activity of TCR-gamma delta T-cells isolated from the blood of healthy humans. We also sought to investigate the beta-AR subtypes involved, by administering a preferential beta(1)-AR antagonist (bisoprolol) and a non-preferential beta(1) + beta(2)-AR antagonist (nadolol) prior to exercise as part of a randomized placebo controlled cross-over experiment. We found that exercise mobilized TCR-gamma delta cells to blood and augmented their ex vivo expansion by similar to 182% compared to resting blood when stimulated with IL-2 and ZOL for 14-days. Exercise also increased the proportion of CD56+, NKG2D+/CD62L-, CD158a/b/e+ and NKG2A-cells among the expanded TCR-gamma delta cells, and increased their cytotoxic activity against several tumor target cells (K562, U266, 221.AEH) in vitro by 40-60%. Blocking NKG2D on TCR-gamma delta cells in vitro eliminated the augmented cytotoxic effects of exercise against U266 target cells. Furthermore, administering a beta(1) + beta(2)-AR (nadolol), but not a beta(1)-AR (bisoprolol) antagonist prior to exercise abrogated the exercise-induced enhancement in TCR-gamma delta T-cell mobilization and ex vivo expansion. Furthermore, nadolol completely abrogated while bisoprolol partially inhibited the exercise-induced increase in the cytotoxic activity of the expanded TCR-gamma delta T-cells. We conclude that acute systemic beta-AR activation in healthy donors markedly augments the mobilization, ex vivo expansion, and anti-tumor activity of TCR-gamma delta T-cells and that some of these effects are due to beta(2)-AR signaling and phenotypic shifts that promote a dominant activating signal via NKG2D. These findings highlight beta-ARs as potential targets to favorably alter the composition of allogeneic peripheral blood stem cell grafts and improve the potency of TCR-gamma delta T-cell immune cell therapeutics.