Potential of HLA-E-targeting diabodies to induce lysis of HIV-1-infected cells by CD8 ⁺ T cells

A long-lived reservoir of cells harboring intact HIV-1 provirus persists throughout decades of antiretroviral therapy and can give rise to rapid viral rebound after treatment interruption. Some cure strategies employ cytotoxic T lymphocytes (CTL) to target this reservoir; however, the applicability and efficacy of immunotherapeutic strategies involving MHC class I-restricted CTL is limited by the polymorphic nature of MHC class I molecules and their downregulation by HIV-1 Nef. The non-polymorphic non-classical class I molecule HLA-E is stably expressed on HIV-1-infected CD4 ⁺ T cells and presents a potential universal target. We generated a single-chain diabody RLP-13 that redirects CTLs to target cells presenting a well-characterized peptide derived from Mycobacterium tuberculosis in the context of HLA-E. We verified the affinity and specificity of RLP-13. Through co-culture experiments, we confirmed that RLP-13 mediates polyfunctional, HLA-agnostic CTL responses. Using an HIV-1 reporter construct encoding the target peptide, we demonstrated robust and specific elimination of the HIV-1-expressing cell population. This proof-of-concept study shows that HLA-E antigens are promising immunotherapeutic targets that can bypass the limitations of classical MHC class I antigens – allelic variation and downregulation – and that such bispecific antibodies recognizing HIV-1-derived HLA-E binding epitopes could induce elimination of productively infected cells.