# Enhancing Treg Therapeutic Efficacy in GVHD

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2021 · $549,004

## Abstract

Abstract: This renewal continues our optimization of regulatory T cell (Treg) infusion for creating transplant
tolerance to prevent graft-vs-host disease (GVHD) in the clinic. Our first-in-human phase I Treg trials showed
reduction but not elimination of GVHD. High Treg numbers were needed and suppression was variable. We
propose to tackle both limitations by infusing high potency Tregs. Whereas protein kinase C theta (PKC-θ)
localization to the proximal immunological synapse (IS) is required for optimal Teffector function it is excluded
from the IS in Tregs where it is located in a distal pole complex (DPC). Mouse or human Tregs treated with a
clinically tested PKC-θ inhibitor increased suppression by 300%. Phospho-proteomics show down-regulation of
vimentin, a cytoskeletal filament preferentially expressed in Tregs, as well as targets involved in actin
cytoskeletal dynamics and cell motility. Vimentin physically sequesters PKC-θ in the DPC, believed to have
negative regulatory function, and tethers mitochondria. PKC-θ inhibitors and vimentin siRNA each caused DPC
disruption and increased suppression and, upon adoptive transfer, had heightened potency in GVHD
prevention and reduced host dendritic cell priming of alloantigen-specific Teffectors. These data point to the
surprising conclusion that DPC disruption per se and not inhibitor targeting of PKC-θ kinase activity was
responsible for Treg super-suppressor function. Proliferating Tregs increase mitochondrial fatty acid β-
oxidation (FAO) to meet energy needs. Super-suppressor Tregs up-regulated fatty acid (FA) uptake and
increased oxidative phosphorylation and FAO without altering glycolysis. Increased suppression was
associated with down-regulation of the mTOR component, mTORC2, that affects cytoskeletal dynamics and
mitochondrial anchoring, with no mTORC1 effects. Intracellular metabolomics of DPC disrupted Tregs indicate
significant effects on FA metabolism and de novo FA biosynthesis, leading to the central hypothesis that the
cytoskeleton structure restrains Treg function by regulating mitochondrial function and FAO. Thus the DPC
disrupted Tregs have a super-suppressive phenotype with coordinately regulated attributes of signaling,
metabolism and function. In aim 1A, we hypothesize mitochondrial fusion is induced by Treg DPC disruption
and gain-or-loss-of function fusion will alter super-suppression. In aim 1B, we hypothesize that DPC disruption
increases mitochondrial motility to the IS to modulate calcium signaling by altering mitochondria-cytoskeletal
tethering. In aim 2A, we will determine whether Treg loss-of-function for FA uptake, de novo synthesis or
mitochondrial metabolism precludes super-suppressor function. In aim 2B, we hypothesize that key aim 2A
metabolic proteins sequestered by vimentin or actin fibers must be dispersed to drive Treg super-suppression.
In aim 3, we hypothesize super-suppressor mechanisms identified above will translate into in vivo suppressor
capacity in ...

## Key facts

- **NIH application ID:** 10133710
- **Project number:** 5R01HL118979-08
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Bruce R Blazar
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $549,004
- **Award type:** 5
- **Project period:** 2014-04-15 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10133710

## Citation

> US National Institutes of Health, RePORTER application 10133710, Enhancing Treg Therapeutic Efficacy in GVHD (5R01HL118979-08). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10133710. Licensed CC0.

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