决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Siglec-6 is a novel target for CAR T-cell therapy in acute myeloid leukemia.
这些数据提示,Siglec-6 CAR-T 细胞治疗或可有效治疗 AML,且无需后续进行同种异体造血干细胞移植。
急性髓系白血病(AML)适合开发嵌合抗原受体(CAR)T细胞免疫疗法,因为AML原始细胞可被T细胞介导清除。本研究提出唾液酸结合免疫球蛋白样凝集素6(Siglec-6)可作为AML中CAR T细胞的新靶点。研究者设计了Siglec-6特异性CAR,其靶向结构域来源于人单克隆抗体JML-1。Siglec-6常见于AML细胞系和原代AML原始细胞,包括AML干细胞亚群。临床前模型显示,Siglec-6 CAR T细胞具有特异性抗白血病活性,且活性与Siglec-6表达相关;在免疫缺陷小鼠(NSG/U937)异种移植AML模型中还诱导了完全缓解。此外,研究确认慢性淋巴细胞白血病(CLL)的转化B细胞也表达Siglec-6,Siglec-6 CAR T细胞在体外对CLL具有特异性反应。值得关注的是,正常造血干细胞和祖细胞(HSPC)检测不到Siglec-6;在集落形成实验中,Siglec-6 CAR T细胞治疗也未影响这些细胞的存活和谱系分化。这些结果提示,Siglec-6 CAR T细胞疗法有望有效治疗AML,且可能无需后续异基因造血干细胞移植。在成熟的正常造血细胞中,一部分记忆B细胞(以及初始B细胞)和嗜碱性粒细胞表达Siglec-6,提示可能存在有限的靶向肿瘤同时损伤正常组织的风险。正常HSPC不表达Siglec-6,是其区别于其他正在AML中研究的Siglec家族成员(如Siglec-3/CD33)和CAR靶抗原(如CD123)的关键特点,支持进一步开展Siglec-6 CAR T细胞疗法的临床研究。
Acute myeloid leukemia (AML) is an attractive entity for the development of chimeric antigen receptor (CAR) T-cell immunotherapy because AML blasts are susceptible to T-cell-mediated elimination. Here, we introduce sialic acid-binding immunoglobulin-like lectin 6 (Siglec-6) as a novel target for CAR T cells in AML. We designed a Siglec-6-specific CAR with a targeting domain derived from the human monoclonal antibody JML-1. We found that Siglec-6 is commonly expressed on AML cell lines and primary AML blasts, including the subpopulation of AML stem cells. Treatment with Siglec-6 CAR T cells confers specific antileukemia reactivity that correlates with Siglec-6 expression in preclinical models, including induction of complete remission in a xenograft AML model in immunodeficient mice (NSG/U937). In addition, we confirmed Siglec-6 expression on transformed B cells in chronic lymphocytic leukemia (CLL), and specific anti-CLL reactivity of Siglec-6 CAR T cells in vitro. Of particular interest, we found that Siglec-6 is not detectable on normal hematopoietic stem and progenitor cells (HSPCs) and that treatment with Siglec-6 CAR T cells does not affect their viability and lineage differentiation in colony-formation assays. These data suggest that Siglec-6 CAR T-cell therapy may be used to effectively treat AML without the need for subsequent allogeneic hematopoietic stem cell transplantation. In mature normal hematopoietic cells, we detected Siglec-6 in a proportion of memory (and na ve) B cells and basophilic granulocytes, suggesting the potential for limited on-target/off-tumor reactivity. The lack of expression of Siglec-6 on normal HSPCs is a key to differentiating it from other Siglec family members (eg, Siglec-3 [CD33]) and other CAR target antigens (eg, CD123) that are under investigation in AML, and it warrants the clinical investigation of Siglec-6 CAR T-cell therapy.
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